HomeMy WebLinkAboutBEST CONTRACTING SERVICES, INC. Recording Requested By,
And When Recorded Mail To:
City of Santa Ana,Public Works Agency M22 Recorded in Official Records, Orange County
20 Civic Center Plaza,P.O.Box 1988 Hugh Nguyen, Clerk-Recorder
Santa Ana,CA 92702 11E�11
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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
ca construction of MAIN ROOF LIBRARY IMPROVEMENTS under contract entered into on
M APRIL 20, 2021, with BEST CONTRACTING SERVICES, on which contract THE
aHANOVER INSURANCE COMPANY is surety. The property on which such work
W o improvement was placed is in the City of Santa Ana, County of Orange, State of California, and
o z described as Project No. 21-7536 located at: THE CITY OF SANTA ANA MAIN LIBRARY.
The work improvement on said property was accepted as completed on JULY 27, 2021.
CITY OF SANTA ANA,A UNICIPAL CORPORATION
w
w By
yr F
Dated: 3 ✓� Princi al Civil En eer—Jason Gabriel
O TITLE
U p -------------------------------------------------
--
VERIFICATION
I, the undersigned, say: I am the Acting City Engineer — Zdenek Kekula 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 M 0,9,C,1� 8 I ZOZZ , at Santa Ana, California
Acting City Engineer---Zdenek Kekula
THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN(l 0)DAYS AFTER COMPLETION
I ...IiA -OUIRED
4'J OCEE)
JUtvUL CITY OF SANTA ANA
iiA� p 3 %o�� CONSTRUCTION CONTRACT
PROJECT 21-7536
(1,A) MAIN LIBRARY ROOF IMPROVEMENTS
J lThis CONSTRUCTION CONTRACT is made and entered into this 20th day of April, 2021 by and
between the City of Santa Ana, California, a charter city and municipal corporation organized and existing
under the Constitution and laws of the State of California (hereinafter "CITY"), and Best Contracting
Services, 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 Main Library Roof Improvements Project (hereinafter referred
to as the "WORK OF IMPROVEMENT") identified in and in accordance with the Contract
Documents prepared by the City's Public Works Agency and approved by the City Council.
2. The complete Construction Contract consists of the "Contract Documents" as defined by the Standard
Specifications for Public Works Construction and which include the following:
• Notice Inviting Bids
• Information to Bidders
• Bid Proposal
• Bid Bond
• Contract Form
• Contract Bonds
• General Provisions
• Special Provisions
• Technical Provisions and Project Plans
• Community Workforce Agreement
• Appendices
In case of conflict between the Contract Documents, the precedence of documents shall be as
established in the Standard Specifications for Public Works Construction.
3. CITY agrees to pay and CONTRACTOR agrees to accept in full payment to complete the WORK OF
IMPROVEMENT the sum total amount not to exceed Four Hundred Ninety -One Thousand One
Hundred Eighty -Eight and No Cents ($491,188.00), as set forth and identified in the BID PROPOSAL,
which is attached hereto and incorporated herein as Exhibit "A."
The BID PROPOSAL contains a schedule of unit price(s) or lump sum(s) based on approximate
quantities only, and the City does not expressly or by implication agree that the actual amount of work
will correspond therewith, but reserves the right to increase or decrease the amount of any class or
portion of the work or to omit portions of the work as may be deemed necessary or advisable.
TM 09/01/2017 Page 1 of 3
4. CONTRACTOR agrees to complete the WORK OF IMPROVEMENT within the time specified in
the Time for Completion of Improvements section of the BID PROPOSAL (Exhibit "A") including
commencing construction within the timeframe therein specified after issuance of a Notice to Proceed.
5. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the WORK
OF IMPROVEMENT a salary or wage at least equal to the prevailing salary or wage established for
such work as set forth in the wage determinations for this work in accordance with applicable State
and Federal law.
6. If applicable, the CONTRACTOR shall adhere to the CITY'S Community Workforce Agreement
(CWA), a pre -hire collective bargaining agreement, which establishes the labor relations policies and
procedures for CONTRACTOR to follow in the crafts persons employed to complete the WORK OF
IMPROVEMENT as more fully described in the CWA. The CWA may be found on the City's website
at: htlp//www_santa-ana:org(pwa/docume�its/CWA:pdf
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.
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.
10. INDEMNIFICATION.
To the fullest extent allowed by law, CONTRACTOR and its Subcontractors hereby agree to defend,
indemnify, and hold harmless CITY, its City Council, boards and commissions, officers, agents,
employees, representatives and volunteers (hereinafter collectively referred to as "Indemnitees"),
through legal counsel acceptable to CITY, from and against any liability, claims, actions, costs,
damages or losses, including reasonable costs and attorney's fees, for injury, including death to any
person or damage to any property, arising directly or indirectly from, or in any manner relating to, any
of the following:
(i) Performance or nonperformance of the Work of Improvement by CONTRACTOR or its
Subcontractors of any lower tier;
(ii) Performance or nonperformance by CONTRACTOR or its Subcontractors of any lower tier,
of any of the obligations under the Contract Documents;
Page 2 of 3
(iii) The construction activities of CONTRACTOR or its Subcontractors of any lower tier, either
on the project site or on other properties;
(iv) The payment or nonpayment by CONTRACTOR of any of its Subcontractors of any lower
tier, for Work of Improvement performed on or off the project site; and
(v) Any personal injury, property damage or economic loss to third persons related to and arising
from the performance or nonperformance by CONTRACTOR or its Subcontractors of any
lower tier, of the Work of Improvement.
(vi) The indemnity obligations of Subcontractors provided by this Section shall be included in all
subcontract documents issued by CONTRACTOR.
Nothing in the Contract Documents shall be construed to give rise to any implied right of indemnity in
favor of CONTRACTOR against CITY or any other Indemnitee.
IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and
year first above written.
ATTEST:
DAISY Go
Clerk of the Council
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By: 7�'. -f.L
JWHN FUNK
Senior Assistant City Attorney
RECOMMENDED FOR APPROVAL:
�A —,I'sti-f�
NABIL SABA, PE
Executive Director
Public Works Agency
CITY OF SANTA ANA
g4"
SII R�TINE RIDG
City Manager
CONTRACTOR:
Best Contracting Services, Inc.
EVP
M
Fatemi
Page 3 of 3
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIM LIBRARY ROOF IMPROVEMENTS
BID PROPOSAL
TO: CITY COUNCIL OF THE CITY OF SANTA ANA
FROM: _ Best Contracting Services, Inc.
REQUIREMENT:
EXHIBIT 3
ADDENDUM NO. f
The undersigned bidder declares that they have carefully examined the location of the proposed
work, that they have examined the Contract Documents in'iLs entirety and hereby proposes to
furnish all material and do all the work required to complete the said work in accordance with
said plans and the specifications for the unit price(s) or lump sum(s) set forth in the following
schedule:
Item
Description
Quantity
Unit
Unit Price
Amount
I
Roofing
I
LS
$ 412,884.00
$ 412,884.00
2
Plywood Sheet (4'xs')
100
EA
$ 180.00
$ 18,000.00
3
Fumigation
I
LS
$ 50,30000
$ 50,304.00
4
Construction Permit
I
LS
$10,000
$IQ000
TOTAL BASE BID
$ 491,188.00
The lowest responsible bidder shall be selected based on the total base bid. The City reserves the
right to award the Base Bid, and any, all, or none of the add -alternate bid items (if any).
TIME FOR COMPLETION OF IMPROVEMENTS AND U[OUIDATED DAMAGES
The undersigned bidder hereby proposes to complete the Work for the total base bid amount
shown above, within thirty (30) working days after the commencement date stated in the Notice
to Proceed.
The liquidated damages amount, in lijeof the amount specified in Subsection 6-9 of the
Standard Specifications, shall be $5 er lendar day.
Name of Firm Best G seyrAces, Inc.
Signature of BIDDE
Title can Tabazadeh, CEO/Secretary
(If an individual, so state. If a firm or co -partnership, state the firm name and give the names of
all individual co-parhrers composing the firm. If a corporation, state legal name of corporation,
and names of President, Secretary, Treasurer and Manager, thereof.)
Best Contracting Services, Inc.
Moji Tabazadeh, President - Sean Tabazadeh, CEO/Secretary/RMO - Fatemeh Tabazadeh, Treasurer
P-1 ofP-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
BIDDER'S STATEMENT
BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent
Construction Contract Agreement shall constitute the entire agreement between BIDDER and the
AGENCY only after it has been accepted by the City Council. endorsed by the Clerk of the
Council with her signature and official seal noting hereon the action ofiapproval 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 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 outer 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 finds, check, drabs, 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
undersigned certificS under penalty
Name of Firm
Signature of BIDDER
California Business and Professions Code, the
that the foregoing is true and correct.
Title Aan"abazadeh, CEO/Secretary
(If an individual„ so state. If a firm or co -partnership, state the firm name and give the names of
all individual co-partners composing the firm. If a corporation. state legal name of corporation.
and names of President. Secretary, Treasurer and Manager, thereof.)
Best Contracting Services, Inc.
Moji Tabazadeh, President
Sean Tabazadeh, CEO/Secretary/RMO
Patetneh Tabazadeh, Treasurer
P-2 of P-16
CITY 01F SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
CONTRACTOR'S LICENSING AND REGISTRA'fJON STATEMENT
The undersigned contractor, or corporate officer, declares under penalty of perjury that helshc
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: Best Contracting Services, Inc.
Business Address: 19027 S. Hamilton Ave. Gardena, CA 90248
Business E-Mail Address: estimating@bestcontracting.coom
Telephone: (310)328-6969
State Contractor's License No. and Class: # 456263 / CLASS: A,B,C17,C39,C43
License Expiration Date: May 31, 2022
State Dept. of' Industrial Relations (DIR)
Registration No.:
State Dept. of l trhrRclations (DIR)
# 1000000563
N/A
' '' Sean Tabazadeh, CEO/Secretary
* POCKET LICENSE 8r DIR PROOF ATTACHED *
P-3 of P-16
CONTRAS
STATE LICENCTORSE BOARD
ACTIVE LICENSE
K466263f9, CORP
BEST CONTRACTING SERVICES
INC
C39 8 A C43 C17
05/31/2022 www cslbca,gov WN.4
Registrations
Page 1 of 2
State of CaliftApt* to DIR>> (htips://www.dir.ca.gov/)
(http, Irlr.oa.gDv/Department of Industrial Relations
,Contractor Information
Legal Entity Name HESTGONTRACTING SERVICES, INC,:
Corporation
Active
1000000563
07/01/19
06/30/22
19027 S. HAIAI;JON AVENUE GARDENA 90248 CA United States of America
190275,. HAMILTON AVENUE GARDENA 90248 CA United States or America
iomanalo@I bestcontracting,tom
License Number (s)
CSLBAS6263
° Legal Entity Information
Corporation Entity Number:
Federal Employment Identification Number:
President Name:
Vice President Name:
Treasurer Name:
Secretary Name:
CEO Name:
Agent of Service Name:
Agent of Service Mailing Address:
C1158028
953781209
MODJTABA TABAZADEH
SEAN TABAZADEH
MODJTABA TABAZADEH
190275. HAMILTON AVENUE GARDENA 902
Worker's Compensation
Do you lease employees through professional Employer Organization (PEO)?: No
Please provide your current worker's compensation insurance information below:
PEO PEO PEO
PEOlnformationName Phone Email
Insured by Carrier
Policy Holder Name:
BEST CONTRACT
Insurance Carrier:
AMERICAN ZURI
Policy Number:
WC9805198.05
Inception date:
12/01/18
Expiration Date:
12/01/19
https://cadir.secure.force.com/ContractorSearchlregistrationSearchDetails?id=a I Rt0000001... 2/l /2021
Registrations
Pagel of 2
State of Celifamia
(httpt ""rm.govpepart► ant of Industrial Relations
Contractor Information
Legal Entity Nam.
cmparan..
kline
locoomms
01101/19
06130/21
592 E. Staie Slreet Onimlo 91761 CA Unlled Stain of America
592 E. StaV SImet Ontad091761 CA UNIeG Stain of Amerka
kiora ikercmtludlen®gmelldom
1 K40NpIKECONStp000ON SERVICES INC
ueeme Nuatlerh)
mhnation
Legal Entity Information
40N011<1:CONVINCnQN SERVICE5INC
Corporation Entity Number
3600667
Federal Employment Identification Number.
463632937
President Names
DAVID B. BOORSTEIN
Vice President Namm
DAVID B. BOORSTEIN
Treasurer Name:
DAVID B. BOORSTEIN
Secretary Name:
CEO Name:
en ,�,Cr_viSS
Back to QIR» (hnps.fm wv diroa GOO
Agent of Service Name: DAVID R.. ROORSTEIN
Agent of Service Mailing Address! 592 E, Stale Street Ontario 91761 CA United States of America
Worker's Compensation
i Do you lasso employees through Pro/essbnal Employer Organization (PE017r No
Please pmvide your cement worker's compensation Insurance Information below;
PEO PIED RED
'.. PEO lnrormalionName Phone Emag
Insured by Carrier
Policy Holder Name;
KLONDIKE CONSTRUCTION SERVICES INC
Insurance Carrier.
STATE COMPENSATION INSURANCE FUND
Policy Number;
90E7190-2019
Inception date;
01/25119
Expiration Dater
01/25120
About DIR
Who we are (hops:/A~ dir,cagovlabouldir;html)
DIR Divisions, Boards a Commissions(htlps:INAVw,dim.m.govldivisions_and-irogmme,html)
Contact DIR(https./hv dlr.m,gov/Contactus.html)
Worh with Us
Jobs at DIR(hRps.lAmanv.dir.cagovMlrlobsfdlrjobs him)
Licensing, registrations, cedificecons g permits (hlips:fNrww.dices.govlpermlU-IlwnsesceNficatlons.htm
Required Notalcations (hhps-.8wxw.dir,ca.govldo.9MRequired.Nntifi=Vons hlmq
Public Records Requests (hllps.fMrvrw dirco.Bovlpra_requesthtml)
Learn More
ACCeso at idioms (bull /Nixes,dir,co.0ovllBllingtw"eNices-Acgdefaull.html)
Frequency Asked Questions thcpe:rlsvw.v dir,ca gmilfagsllSLhhnl)
https://cadir.secure.force.com/ContractorSearch/registrationSearchDetails?id=alRt00NO— 12/16/2020
c
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OF
was^..
STATE
Legal Disclaimer & Consent.
Notice and Consent to Use Personal Information (Civil Code Section 1798 et seq.)
By submitting personal information about yourself and your company In order to obtain a License or Registration, you consent to
DLSE's use of that personal Information for purposes authorized by Department Of Industrial Relations, which provides for the Issuance
of such IIl enses and registration. Note that OLSE's use of such personal information includes the disclosure of information about you
and your company to third parties who want to verify your Registration Application. This Notice Is effective January 2012, and subject
to revision.
SOCIAL SECURITY NUMBER COLLECTION
The social security number will be collected pursuant to California Family Code section 17520(d). it Is used In the administration bf
registering employers in the Garment Manufacturing & Contractor Industry, and to aid in the collection of monies owed pursuant to a
judgment or order for child or family support in a case being enforced under Title iV.A of the Social Security Act: Collection of the'social
security number is mandatary. Failure to furnish the social security number may result In DENIAL of an application for issuance or
renewal of a registration to engage In the business of Garment Manufacturing & Contractor.
INFORMATION PRACTICES ACT NOTICE (California Civil Code Section 1798.17)
1. The information an this application is being requested by the Department of Industrial Relations, Division of Labor Standards
Enforcement.
2. The state official responsible for maintaining this application, and who shall, upon written request, inform you of the location of
where this application is maintained and the categories of any persons who use the Information contained herein is:
Division of tabor Standards Enforcement
Manager, Licensing and Registration Unit
1515 Clay Street, Ste. 1902
Oakland, CA 94612
Telephone: (510)•285•3398
3.7he information an this application is collected and maintained pursuant to California Labor Code section 2675,
4. With respect to the information requested on this application, all of it Is either mandated by California tabor Code section 2675 or
must be ascertained by the Labor Commissioner in order to issue a license, except for the following information, which is provided
voluntarily. A) Tide of corporate officers/ LLC members
5,if you fall to provide all or any part of the information requested In this application, the Labor Commissioner may deny issuance /
renewal of a registration to engage in the business of Garment Manufacturing & Contractor,
6. The principal purposes within the Division of Labor Standards Enforcement for which the information no this application will be used
are: (1) administration of the registration program for the Garment Manufacturing & Contractor Industry, and (2) enforcement of
California labor laws.
7. The following are known or foreseeable disclosures of the information contained herein which may be made pursuant to subdivision
(e) or (f) of Section 1798.24 of the California Civil Code by the Division of Labor Standards Enforcement, Response to a request under
the Caiirornra Mtimn, necurw Act.
S. you have the right to access records containing your personal information that are maintained by the Division of Labor Standards
Enforcement. To make an appointment to access such records, please contact the Manage(, Licensing and Registration Unit at the
address shown In Item 2 above.
Legal Disclaimer & Consent
Notice and Consent to Use Personal Information (Civil Code Section 1798 et seq.)
Registration Services.- page 1 of 7 12/16/2p201ri:pltSra AM
By submitting personal information about yourself and Your company in order to obtain a License or Registration, you cons amid
DLSE's use of that personal information for purposes authorized by Department Of Industrial Relation 5. Which provides for the Issuance
of such licenses and registration. Note that DLSE,5 use of such personal Information Includes the disclosure of information about you
and your company to third parties who want to verity your Registration Application. This Notice Is effective Pintuoy 2012, and subject
to revision.
SOCIAL SECURITY NUMBER COLLECTION
The social security number will he collected pursuant to California Family Code section 17520(U), it is used in the administration of
registering employers in the Garment Manufacturing & Contractor industry, and to aid in the collection of mordini owed pursuant to a
judgment or order for child or family support in a case being enforced under Title IV-D of the Social Security AcL Collection of the soclat
security number is mandatory. Failure to furnish the social security number may result in DENIAL of an apply:a6cin for issuance or
renewal of a registration to engage in the business of Garment Manufacturing & Contractor.
INFORMATION PRACTICES ACT NOTICE (California Civil Code Section 1799.17)
1, The Information On this application is being requested by the Department of industrial Relations, DIVIscon of Labor Standards
Enforcement.
2, The state official responsible for maintaining this application, and who shall, upon written request, Inform you of the location of
where this application is maintained and the categories of any persons who Use the Information contained herein is:
Division of Labor Standards Enforcement
Manager, Licensing and Registration Unit
1515 Clay Street, Ste. 1902
Oakland, CA 94612
Telephone: (510)-285-3398
3.Theinformailon on mls application is collected and maintained pursuant to California Labor Code section 2675.
4. With respect to the Information requested an this application, all of it is either mandated by California Labor Code section 2675 or
mum be ascertained by the Labor Commissioner in order to issue a license, except for the following information, which Is provided
voluntarily: A) Title of corporate officers/ LLC members
5, if you fall to provide all or any part of the Information requested in this application, the Labor Cpmrms%'oner may deny issuance
renewal of a registration to engage In the business of Garment Manufacturing & Contractor.
6. The principal purposes within the Division of Labor Standards Enforcement for which the information an this application will be used
are: (1) administration of the registration program for the Garment Manufacturing rit contractor industry, and (2) enforcement at
California labor laws.
7. The following are known or foreseeable disclosures of the Information contained herein which may be made pursuant to subdivision
(a) or (f) of Section 1798.24 of the California Civil Code by the Division of Labor Standards Enforcement: Response to a request under
the California Public Records Act.
a. You have the right to access records containing your personal information that are maintained by the Division of Labor Standards
Enforcement. To make an appointment to access such records, please contact the Manager, Licensing and Registration Unit at the
address shown In item 2 above.
Disclaimer Confirmation
I Agree: Yes
Enter Your Name: Donald E Seaman
Registration Services Page 2 Of 7
Company Type
Company Type: Corporation
Company Information
License/Registration Number: GA-LR-IOW701441
Entity Information
Legal Entity Name: Southwood Pest Control, Inc State of Incorporation. CA
State Employer Identification
Number: 00697734
Federal Employer
Identification Number: 900723884
Physical Address
Physical Business Country: United States of America
Physical Business Address: 1505 HARMONY CIRCLE
Mailing Address
Mailing Country: United States of America
Mailing Address: 1505 HARMONY CIRCLE
Contact Info
Daytime Phone, (714)579-7855
Mobile Phone; (714) 713-9805
Date Pormed: 13.4.08
Corp or LLC ID, C3173393
Good Standing with CA yes
Secretary of state
Physical Business City/ Anaheiim
Province;
Physical Business State,. CA
Physical Business Postal 92807
Code
Mailing City /Province:- Anahelim
Mailing State CA
Mailing Postal Code 92907
Daytime Phone Ext.;
Business Email: southwoodpcst@aoi.com
Applicant's Email:: southwoodpest@aol,com
All processing emails will be sent to the Applicant's Email address for action. The approved registration will be sent to the Business Email
for posting
Beg+straoan Serwces�- Page 3 of 7
Workers' Compensation Insurance
Workers' Compensation Overview
Are you contracting with the employee leasing company as the employer? Yes
Are you functioning as an Employee Leasing Company:
Workers' Compensation Selectron
Workers' Compunsation Carrier United Wisconsin Insurance Co
July 23, 2020
Workers' Componsa Lou Effective Date: iuly 23, 2620
Workers' Compensation Expiration Date.: July 23, 2021
Workers' Compensation Address: 210 Wingo Way ste 400
Mount Pleasant, SC 29464
United States of Amerfca
7� f :r. - r
Attachment Name
%DD quarterly reports (DE9/DOC) reflecting number of employees
FEIN
surety Bondisp
Bond Wider
owners Driver License or Photo iD • Donald Seaman
WCI Certificate from PEO
Employee Leasing Contract
Articles of Incorporation
Statement of Information
Attachment Type
Miscellaneous Documents
Federal Emptcyorldentification Number
(FEIN)
Bond Certification
Bond Certification
Driver License or Photo ID - Donald
Seaman
Workers Compensation Insurance (WCI)
Signed Employee Leasing Cunvact
Articles of Incorporation/organization
Statement of Information
Registration Sefvke5 Page 4, Of
Company Locations
DBAs
RM
fteg�s[ratlon 4ervices. page 5 nt 7
Company Finances
BOND TYPE Name of Surety Company Bond Status Bond Amount Effective Date
Registration/Surety Bond Western Surety Company Active $12,000.00
Company People
Company Owners
Flrst Name NameM_�_---Ownership-+ OTitl-e µ�_-- �_� Residential�Cty%�-��Residontial -Residential P-_
Percentage Province State Country
Donald Seaman 100 CEO/President Anaheim CA United States of
Amerfta
Management
Questionnaire
Within the past three years has any person named as an owner, manager or supervisor been issued agitation or
assessment by either the United States Department of tabor or the Department of Industrial Relations for violating
the Fair tabor Standards Act a, No
Within the past Five years, has any person named as an owner, manager or supervisor been issued a judgment or entered
into a settlement agreement for unpaid wages?f No
Has any person named as an owner, manager or supervisor had a garment registration revoked or an application for .
registration denied at any time?: No
Has any person named as an owner, manager or supervisor filed bankruptcy last year?: No
Has the applicant (owners of the company) previously or had a registration suspended or revoked under the same or
another business name?! No
Fallow -up Questions
Registration services- Page 6 of 7
9
Labor Code Compliance Acknowledgement
Applicant hereby acknowledges that he/she is aware of and agree$ to comply with the provisions of Labor Code Section 3700 that �.
requires every employer to secure the payment of compensation fin liability under the State's worker compensation low, Applicant
hereby submits proof that the payment Of compensation for Ilablldy under the State s worker compensation law has been secured In a
lawful manner.
Applicant understands and acknowledges that any msreprosentatfdh, falsification, OF material emission on this application or any
document submitted In connection herewith Is grounds for denialOf this application or subsequent revocation of registration.
Applicant hereby agrees to complete an IRS form 8822, Tax Information Authorization and submit it to the IRS.
The undersigned hereby certifies under penalty of perjury that the Statements made and information provided on this application are
true and correct and that the applicant is in complete Compliance with local government's business licensing and regional regulatory
requirements.
ANY MATERIAL MISREPRESENTATION IS GROUNDS FOR DENIAL OR SUBSEQUENT REVOCATION OF A LICENSE/REGISTRATION,
Labor Code Compliance Acknowledgement
I Acknowledge Labor CodeCompliance: Yes -.„._.....____....._.._...____._.-...___..__.___....__....„.n.__.
Enter Your Name, Donald ESeaman
Registration Serincei:- Page 7 of 7
CALIFORNIA DEPARTMXNT OF PESTICIDE REGULATION
cip r 100 1 1 STREET
SACRANIEWO, CALFORINIA 95814
ISSUED: January 0I.2020 Pest Control Business - Main
EXPIRES: Deccmber3l,2021 LICENSE
LICENSE NO. 30377
Invalid if in5umce md'arqualificd pcmn(s) lapse before expimcinn date
Mailing Aeldros
SOUTI-MOOD PEST CONTROL, INC.
1505 HARMONY CIR
ANAHEIM, CA 92807
Business L"Itsol
SOUTHWOOD PEST CONTROL, INC,
1505 HARMONY CIR
ANAHEM, CA 02807
POSTTHIS LICENSE PROMINI!NTLY IN PUBLIC VIEW
CITY OF SANTA ANA
PROPOSAL
PROJECT NO;. 214316
MAIN LIBRARY ROOF IMPROVEMENTS
PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT
Contractor is aware of the requirements of California Labor Code Section 1720. at seq., as well
as California Code of Regulations, Title 8, Section 16,000. at seq.. ("Prevailing Wage Laws").
which require the payment of prevailing wage ratct_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, indemoily and hold ilia 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 1' is true and correct.
Name of Firm . Best,6154ctlea Services. Inc,
Signature of BIRD
Title Sewn Tab
(if an individual. so state)
P-4ofP-16
CITY OF SANT.A,ANA
PROPOSAL
PROKCT NO.: 21-7536
MAIN I.IBIIARN' ROOF IMPROVENJl.; TN;
o\}tNr:rtsr"rrrr A[ rrnAvrr
STAI li OF CALIFORNIA 1
COGNI Y OF ORANGE ISS:
C11YOF SANTA ANA I
Sean Tabazadeh, CEO/Secretary
. Ix•ing Jul} SuopG Ivpn�ca mld na+s:
[INDIVIDUAL 'Ilia helshe is the part making me Ihrcgoing proposal:
0 pAWINFRSIIn' 'That be/shy is a member of tine copartnership line dcAgnmed as:
find %slim has hewn and is duly yelled milli the nunmrhg a+make and eeecute inxnaamialf
for the arvpannumbip by:
mlm cnnslitute the other mcmbcrs ml'lhc co-pnnnershlp.
fm C•I wrolm,ri 1 , 'I bill he is nl'•
�}est rontracti „fie Services Ine.._,__��,___
it curpinntion mhich is making the ILregninp InuposaL
�,IOIN I' \'liN'I't9tE Ihal he is oil
one ill the pataiex making the litregding pmpusal iA u •luint eonture. and the heCs11C him
hcen and is duly rested milli the outhnrill In etec,ne inarnments Ibr an an hclmll"nt'illh."
parries making said bid mhn am:
that sue s genuine slid not collusive or ,hand. and has not in any manner sought b%
collu ` t c any advantage against the City of Santa Ana or any' person interested in the
pr tffor himself or any other person.
'Signature W Bidrer Sean Tabazadeh, CEO/Secretary
* SEE ATTACHED NOTARY *
Subscribed and sworn to before me this dal, of 20
Signature of'oflicer Administering Oath (Notary Public)
1'-i of P-10
CALIFORNIA J11RAT WITH AFFIANT STATEMENT GOVERNMENT CODE g 8202
rc�'14t'.fGrdc:C,M.csr.PSS6:i)s:Y•a:f.GCPS,M,cs`area'a:C,cC.exXticsaSxscsd;1%:SSCCcCa;LlcCa.Y•kY1rSdMc�icPa;Gr.2`e3`a:Oc�cC.cCa:'G•e
F-I See Attached Document (Notary to cross out lines 1-6 below)
❑ See Statement Below (Lines 1-6 to be completed only by document signer[s), not Notary)
Signature of Document Signer No. f
Signature of Document Signer No. 2 (if any)
A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document
State of California
County of Los Angeles
0.
CAMELLQlic • Cabfomiales Countyls Count t 2res Mar 2t,. 202tw
Subscribed and sworn to (or affirmed) before me
on this 22nd day of February 20 -�1 •,
by Date Month Year
(and
Sean Tabazadeh
Name(s) of Signers)
Proved to me an the basis of satisfactory evidence
to be the person(s) who appeared before me.
Signature-4,lkY1 ,
na re of Notary public
Seat
Place Notary Seal Above
OdaTfONAL
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: Ownership Affidavit Document Date: 02122r2021
Number of pages:? Signer(s) OtherThan Named Above:
CS:L"5:tC4,Z•�GY2i.Y36r,L'CLY.'YJS',Cn.Z Y:U�:CL'CLY�S.'�'Ci'A'3.F'.G`5i.".i.Z'+.,7t>'CL`Sa`44 `i:�."S,LY.ZGCY
2014 National Notary Association - www.Nationa)Notary.org • 1-80D-US NOTARY (1-800-876.6827) Item #5910
02-15-2";12:32FM;
;310-128-9176 # 2/ 2
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
KNOW ALL PRESENT that,
_ _ uesr t:omracnnp aervicas. mu , as BIDDER, and
The f lannvar insurance Company , as SURETY,
are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of _
I OV* of Amount Bid Dollars ($ ?, which is ten percent of the
total amount bid by BIDDER to AGENCY for the above -stated project, for the payment of
which su n,'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 WHEREO :R parties hereto have set their names. titles. hands, and seal this
lsth day of F:.... 2ozl
BIDDER*
Sean Tabazadeh, CEO/Secretary
Patricia T. Moughan, Attorney -in -Pact
Subscribed and sworn to before me this day of
20--
Signature:
Notary Public in and for the County of. State of
* 'Provide BIDDER/ SURETY name, address, and telephone number and the name, title,
address, and telephone number of authorized representative.
P.6 of P•16
CIVIL CODE a 11 B®
:�..r�srsrs:s.��,y^sx�rs�rssre^ca^rs�.crcxs^rn.cus:zxs�,cs;s.raara�c.�rkr6�cr�rti5a
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 1.As An eles )
On 02l22f2021
Data
Personally appeared
before me, Kaim A. Comellu NotlryPublic
Here Insert Name and Title of the Officer
Sean Tabazadcb
Name) of Signer(4
who to me on
isl
subsribedproved to the withintInsttrasis rumenttandlatactory evidence to cknowledged to mebthathhe/serpon(A) whose /tg6y executed he�sameae
his/hr/t air authorized capacity(io), and that by his/hgf/tlWktr signaturso on thgo instrument the person(4,
or the eltity upon behalf of which the personA acted, executed the instrument.
�!! tfAYLYNA,CAMELLO-
*r "r Notary Public -California
x � 405 Angeles County
Compission k 2235312
MY COMM, Expfres Mar 22, 2022
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
Signature
i furs Cf Notary Puhiic
- OPTIONAL
Though this section is ophonai, Completing this'infbmlehon 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: Bid Bond
Document Date: 02/15/2021 Number of Pages: t
Signer(s) Other Than Named Above: Patrick Moughan
Capacity[ies) Claimed by Si ner(s)
Signer's Name: Scan Tabazadeh
IX Corporate Officer — Title(s): Ce0
1 Partner — i' i Limited 0 General
Individual U Attorney in Fact
U Trustee UGuardian or Conservator
I Other:
Signer Is Representing: nest cwat*actinG Service [nc.
Signer's Name:
1 Corporate Officer — Title(s):
C7 Partner -- 0 Limited 0 General
f.l Individual UAttorney in Fact
1-1 Trustee L., Guardian or Conservator
0 Other:
Signer Is Representing:
4K�S.'+''LWd4Y f.': i �r-{Miiu%'{v[•ii4°L`w'S.�i,'��('iT.'�tr"Siliati' '. ' .it(rVwtiixr `% r MFAR,'ifYiW� "Wi ::tX .vW.,LiTvZ'JV'+iL+U'�i�
02016 National Notary Association - www.NotionalNotary.org-1-800-US NOTARY (1-800.876-6827) Item tt5907
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA.
POWER OPATTORIVEY
THIS Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to
the extent heroin stated.
KNOW ALL PERSONS BY THESE PRESENTS:
That THE HANOVER INSGRAN`MMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corpdra6ons organized and existing
under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OFAMERICA,a corporation organized and existing under the laws
of the State of Michigan, (hereinafter Individually and collectively the 'Company*) does hereby constitute and appoint.
Patrick T. Moug ban, Mark O. Miller, Alec D. Martinez, andfor Map Gun, Mason
Of Global Risk, LLC of Los Angeles, CA each Individually, if there be more then one named., as its true and lawful adomey(s)•m-fact to sign; execute,
seal, acknowledge and deliver for, and on Its behalf, and as Its act and deal anyplace within the United Stales, any and all surely bonds, recognizances,
undertakings, or other surety obligations,, The execution of such surety bonds, mcognizances, undertakings or surety obligations, In pursuance of these
presents, shall be as binding upon the Company as if they had been duty signed by the president and attested by the secretary ofthe Company, In their own
proper persons. Provided however, that this power orattorney limits the acts of those named herein, and they have no authority to bind the Company except
In the manner stated and to the extent of any limitallon staled below:
Any such obligations in the United States, not to exceed Fifty Million and Nof100 ($60,000,000) In any single Instance
That this power is made and executed pursuant to the authority of the following Resolutions passed by the Board of Directors of said Company, and said
Resolutions remain in full force and effect
RESOLVED, That the President or any Vice President, in conjunction with any Vice President, be and they hereby are authorized and
empowered to appoint AOomeysdndact of the Company,. in Its name and as flack, to execute and acknowledge for and on its behalf as surety,
any and all bonds, reeognizonces, contracts of Indemnity,walvers of citation and all otherwritings obligatoryIn the nature thereof, with power to
attach thereto the seal of the Company. Any such writings so executed by such AOameys•in•fact shall be binding upon the Company as if they
had been duly executed and acknowledged by the regularly elected ofOcem of the Company in their own proper persons.
RESOLVED'That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification In respect thereto, granted
and executed by the President or Vice President In conjunction with any Vice Pieskient of the Company, shall be binding an the Company to the
same extent as If all signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile..
(Adopted October 7; 1981 — The Hanover Insurance Company; Adopted April 14,1982 - Massachusetts Bay Insurance Company; Adopted
September 7, 2001— Citizens Insurance Company of America)
IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE
COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by two Vice Presidents,: this 290
day of March, 2017.
The no... 9eswrnne. Company
Moosuc Insko'osay Simv}xnao Company
l�lxuns ninsura„ca Coo, peag aP Amavkm
Jobit C. Roche, EVP and lkeridem
THE COMMONWEALTH OF MASSACHUSETTS )
COUNTY OF WORCESTER )as'.
r
Wyk
'r'ha lanauavar auaueanea Campaap
MALeW chumaaen ..4DA ""oCnmpaery
Carenwa nuurnnca Compaaey M Amorlen
-Tames H. RawiccK Vice lkeaident
On this 20* day of March, 2017 before me came the above named Vice Presidents of The Hanover insurance Company, Massachusetts Bay Insurance
Company and Citizens Insurance Companyof America, tome personallyknown to be the individuals and officers described herein, and acknowledged that
the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company, Massachusetts Bay Insurance Company and
Citizens Insurance Company of America, respectively, and that the said corporate seals and f neirslgnatures as officers were an yatfixed end subscribed to
Mid Nwry WI,NC
My Cmfmurim a,piro Much a, ]e:P
I, the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company
of America, hereby certify that the above and foregoing is a full, true and correct copy of the Original Power of Attorney Issued by sold Companies,.
and do hereby further certify that the sold Powers of Attorney are still In force and egecl.
GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this 161h day of February, 2021.
CERTIFIED COPY�� ~~
__ 'Itwdam Q Marlins, Vise tknidnflt�. .
CALIFORNIA ALL-PURPOSE
��} r ri . x
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 La11�707
}
On IS' before me, Ashle Greenber , NotaryPublic
re n name an a a cer
personally appeared Patrick T. Moughan _ who proved to me on the basis of satisfactory evidence to be the _ person() whose
name(.&)Is re subscribed to the within instrument and acknowledged to me that
( aihe/they executed the same in(q ler/their authorized capacity(ies), and that by
Is er/their signature(&-) on the instrument the person(&), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
ASHLEYGREENBER
WITNESS my hand and official seal. �. � commission No. 2a11A29
_NOTARY FUM1.16-CALIFONNIA
LOS ANGELES COUNTY
Notary Public SignatA _- --- L7 _ (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM
This farm
no rm'
DESCRIPTION OF THE ATTACHED DOCUMENT
complies wlih current Callfornia smlutes regarding notary wording and.
(('needed should he conipletedand auached to the document, lcknowledbm enes
from other states may he completedfor documents heingsant to thar stare so long
as the wording does cat require: the Catifarnio notary to violate Califarala notary
(Ttlta or deecllption Of attached documad)
law.
a State and County infomiatiun main be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
(title ordescription of attached document continued)
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is compleled.
Number of pages Document Date
• The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title (notary public):
• Print the entrails) of document signers) who percsonally appear at den time of
f
m ton.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
hetshchthey- is /are) ur ciicling the correct forms. Failure to correctly indicate this
information may lead to rejection ofdocument recording.
• The notary awl impression most be clear and photographically reproducible.
Impression most not cover test or lines. If seal impression smudges, re-swl If a
sufficient am permits, otherwise complete a difrtxettt acknowledgment Cum.
• Signature of the notary public most match the signamrc on file with the office of
die county clerk.
C Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
r• Indicate tine or type of attached document, number of pages and date,
0 Indicate the capacity claimed by the signer. If die claimed capacity is a
corporate officer, indicate the (isle (i.e. CEO, CFO, Secretary),
2015 Version Lvir.v.No(aryCtnsses.com 800-873-9865 + Securely attach this document to the signed document with a staple.
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
LIST OF SUB -CONTRACTORS
Section 4100 et. seq, of the Public Contract Code requires listing of all subcontractors with the bid for all
subcontract work exceeding the folloa,ing amount.
a Streets, highways including bridge projects: %% of the bid or $10.000. whichever is greatcr
a Buildings.parks, or other projects: ''/%of the bid
Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State
Department of Industrial Relations (DIR).
BIDDER proposes to subcontract certain portions afthe work to the firms listed below:
Name Klondike Construction Services, Inc.
License #/L-•xp.
# 990645 ! ExP:07./2$/2022
DIR Reg. #/Exp.
# 100000$336 / E7CP: 6(0l2021
Location
592 E. State Street Ontario. CA 91761
Phone j909
395-0160
Type Of Work
- j&QQg )E0
Amount $
$41,250.00
Name
License #/Exp.
DIR Reg. #/Exp.
Location
phone
Type Of Work
Amount $
Name Southwood Pest Control, Inc.
Name
License #/Exp. tyjjoAk
License #/Exp.
DIR Reg. #/lixp.GA-IR-7000T
DIR Reg. #/Exp. T
License #7
License
Location 1505 Hxmtony Circle Anaheim, CA 92807
Location
Phone (714)579-7855
Phone
Type Of Work DRYWOOD TERMITES TREATMENT Type Of Work
Amount $ $50,304.00 Amount $
Name
License #/Exp.
DIR Reg.#/Exp.
License #
Location
Phone -41
'type Of Wor
Amount $,
Sean Tabazadeh, CEO/Secretary
Name
License #/Exp.
DIR Reg,#/Exp,
License #
Location
Phone
Type Of Work
Amount $
11-7 oI' P-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENT'S
REFERENCES
The following are the names, addresses. and telephone numbers for THREE public agencies for
which the BIDDER has pertbrmed similar work within the past three years.
1, Manhattan Beach USD 325 S. Peck Ave. Manhattan Beach, CA 90266
Name and Address of Owner.
Name and Telephone Number of person familiar with
$1,664,193.00 Reroof with BUR Hot at Manhattan
Contract Amount Type of Work
2• Torrance USD 2335 Plaza Del Amo Torrance, CA 90501
USD 2019 2/11/2020
Date Completed
Name and Address of owner.
Dan Brown E: Danid0rown@Balfaurbeatlyus cam P: 805-758.3828
Name and Telephone Number of person familiar with -- project.
$3,119,976.00 Rowed with BUR Hot at West HSModernization &Auditorium 3/26/2019
Contract Amount Type of Work Date Completed
3. Murrieta USD 41870 McAlby Court Murieta, CA 92562
Name and Address of owner.
ri.Noor'igtan P-. (951) 696-10 ect 1080 E-. Inoor3gianomureieta.ki2 a us
Name and Telephone Number of person familiar with project,
SI.634.234.00 Reroof with BUR Hot at Mwrieta Valley PSD Various Sites 3/19/2019
Contract Amount Type of Work Date Completed
The following are the names. addresses. and telephone numbers of all brokers and suretics from
whom BIDDER intends to procure insurance and bonds.
SURETY: The Hanover Insurance Comyany
AGENT: Global Risk, LLC
800 Wilshire Blvd 2nd Mr. Los Angeles, CA 90017
BOND INFO CONTACT: Patrick T. Moughan (415) 702-1073
INSURANCE INFO CONTACT: Mark I iger (310) 415.3500
P-8 of P-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
ADDITIONAL REFERENCES
The following are the names, addresses. and telephone numhers for THREE public agencies for
which the BIDDER or Subcontractor has performed similar work in the past Eve years.
l • Lang Reach Unified School DisMct 2201 E Markot 5t Lang Reach CA 90830
Name and Address of Owner.
jgl n Epic E• E s 16sahools net P� Bz� 997-7550
Name and Telephone Number of person familiar with project.
$i,103,I19.00 Reroofwith Hot BUR at MlBikan HS&Stamford MS 1010912018
Contract Amount Type of Work Date Completed
2. Claremont Unified School District 170 West San lose Ave. Claremont, CA 91711
Name and Address of owner.
Rick Cota E.- rcotagkg sd ciarement edu (9099) 398.0 09Ext 71001
Name and Telephone Number or person I'atttiliar with project.
_$3,7,Ua&.o0 Reroofwtth BUR Hot for Claremont USD-various locations 04/10/2018
Contract Amount Type orWork Date Completed
3. palm Springs Unified School District 990 E. Tohquitz Canyon Way palm springs, CA 92262
Name and Address of owner.
John Vega E: iva$a@psusd us (.760) 416.6112
Name and Telephone Number or person fnnilior with project.
$1,282,978.00 ntaaf atB t at and frre MS 3/19/2018
Contract Amount Type of Work Date Completed
The following are the names, addresses. and telephone numbers of all brokers and Sureties from
whom BIDDER intends to procure insurance and bonds.
SURETY: The Hanover Insurance Company
AGENT- Global Risk LLC
800 Wilshire Blvd 2nd Mr. Los Angeles CA 90017
BOND INFO CONTACT: Patrick T. Moughan (915) 702-1073
INSURANCE INFO CONTACT: Mark IOger (310) 415-3500
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CITY OF SANTA ANA
PROPOSAL
PROJECTNO.: ? 1-7536
IMAIN LIBRARY ROOF IMPROVEMENTS
NON-C OLLUSION Arl'[DAVrf
(Title 33 United States Code Section 112 and Public Contract Code Section 7106)
In conformance will, "ride 23 United States Code Section 112 and Public Contract Code 7106 the
BIDDER declares that the bid is not made in the interest of. or on behalf of. any undisclosed
person, partnership, company, association, organization. or corporation: that the bid is genuine
and not collusive or sham: that the BIDDER has not directly or indirectly induced or solicited
any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded.
conspired. connived, or agreed with any BIDDER or anyone else to put in a sham bid. or that
anyone shall refrain from bidding: that the BIDDER has not in any manner, directly or indirectly.
sought by agreement, communication, or conference with anyone to fix the bid price of the
BIDDER or any other BIDDER. or to IN any overhead, profit, or cost element or the bid price,
or a1'that of cry they Bl DUGR, 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 hid are
true: and. further. that the BIDDER has not, directly or indircctl} ;subntiucd his or her hid price
or any breakdown thereof, or the contents thereof. or divulged information or data relative
thereto. or paid, and +ill not nay. any fee to any corporation, parunership. company m suciutitnn.
organization. bid deposito tr to any member or agent thcreol'to effectuate a collusive or sham
bid.
Note: The aboveI ton Affidavit is part of the proposal. BIDDI RS arc cautioned that
making a false c' t subject the certifier to criminal prosecution.
Signed Sean Tabazadch, CEO/Secret
State of-'alil'ontia *SEEATTACHEIDNOTARY*
County of
Subscribed and stnorn to (or affirmed) before me on [his day of 20 . by
. proved to me on the basis ors itiafactory evidence to he the
person(s) who appeared before me ,
Notary public Signature Notary Public Seal
P-10 of P-I 6
CALIFORNIA JUNAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202
xcrrssrsresacrosscs<sasccrrrsrr�sc:crr.Y;crecuxrrsaccccrcras<:occcrcrdxrs�;cc:cr.��rrfscxrraec
IN See Attached Document (Notary to cross out lines 1-6 below)
C] See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary)
Signature of Document Signer No. 1
Signature of Documant Signer No. 2 (if any)
A no public or other officer completing this certificate verifies only the Identity of the Individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
KAYLYN A. CAMa.L0
Notary Public - California
1`x "t Los Angeles County
Cormisston k 22353 i t
' all MY Comm. ExpicesAWr 22, 2022
Subscribed and swam to (or affirmed) before me
on this 22nd day of February 20. 21
by Date Month Year
(1) Sean Tabazadeh
(and (2) 3
Name(s) of Signer(s)
proved to me on the basis of satisfactory evidence
to be the persons) who'appeared before me.
Signature V+tlffl Ihn j/� jt( j[ ti j
ign, furs of Notary Public
Sea/
Place Notary Seal Above
OP770N,9L
'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: Non Collusion Affidavlt Document Date: 02t22i2021
Number of Pages: I Signers) Other Than Named Above:...
02014 National Notary Association • www.NationsilNotary.org - i 800-US NOTARY (1-800.876-6827) Item it591 o
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
NON-DISCRIMI�iATfO�+1
The undersigned 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 aFrace, 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 f'or
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 or the Secretary of Labor.
5. The Contractor shall famish 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 ror 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 fit 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 tray be imposed and remedies invoked as provided in Executive Order 112,16 of
September 24, 1965. or by rule, regulations. or order of the Secretary of Labor, or as
otherwise provided by law.
11-I I of P-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21.7536
MAIN LIBRARY ROOF IMPROVEMENTS
The Contractor shall include the portion of the sentence immediately preceding paragraph (I )
and the provisions of paragraphs (1) through (7) in every subcontract or purchase order
unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to
Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be
binding upon each subcontract or purchase order as the administering agency may direct as
means of enforcing such provisions, including sanctions for noncompliance: provided,
however, that in the event the Contractor becomes involved in, or is threatened with.
litigation with a subcontractor or vendor as a result of such direction by the administering
agency, the Contractor may request that the United States enter into such litigation to protect
the interests of the United States.
8. Pursuant to California Labor Code Section 1735. as added by Chapter 643 Stats. 1939, and as
amended, no discetv-�
shall be made in the employment of persons upon public works
because of race, rced, color. national origin, ancestry, physical handicaps, mental
condition, maritalsex of such persons, except as provided in Section 1420, and any
contractor orplating this Section is subject to all the penalties imposed for a
violation o' ,
Signc� fir''
Title: Sean Tabazadeh, CEO/Secretary
Firm: Best Contracting Services, Inc.
Date: February 23, 2021
P-12 of P-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
STATEMENT REGARDING APPRENTICESHIP REQUIREMENTS
The undersigned BIDDER is familiar with the requirements or Section 1777.5 orthe State labor
Code regarding employment of apprentices. and understands that contractors on contracts
exceeding $30,000 or 20 working days shall:
Apply to the ,joint apprenticeship committee administering the apprenticeship standards or
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 ol'apprentices
in the area or industry affected.
2. Employ the number or apprentices or the ratio or apprentices to journeymen stipulated in the
apprenticeship standards.
3. Contribute to the run s in each craft or trade in which he/she employs journeymen or
apprentices on th rk. in the same amount or upon the same basis and in the same
manner as the act rs. except contractors not signatorN, to the trust agreement shall
pay a like a ie f'nia Apprenticeship Council.
Signed:
Scan Tabazadch, CEO/Secretary
Firm: Best Contracting Services, Inc.
Date: February 23, 2021
11-13 of P-I6
CITY qr SANTA ANA
PROPOSAL
PROJECTNO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
STAT MENTEEGARp_IN_G__"ANTI-KICKBACK" R OUIRFMENTS
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 De in nt of Labor regulations (29 CPR. Port 3), This act provides that
each contractor or for shall be prohibited from inducing, by any means, tiny person
employed in the r or repair of public work. to give up any part of the compensation to
which It, /she r' d v n ' ed.
Signed::
Title: Sean Tabandeh, CEO/Secretary
Firm: Best Contracting Services, Inc.
Date: February 23, 2021
P-14 of P-16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
PUBLIC C0N't'RACTCQDESI:CTION 10162—QUt:S`r10N AAIRE
to conformance with Public Contract Code Section 10162, the BIDDER shall complete,
tinder penalty of perjury, the fallowing 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.
11-15 of P•16
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
STATEMENT REGARDING COMMUNITY WORKFORCE AGREEMENT iMA)
REQUIREMENTS
This is to certify that the undersigned BIDDER, and subcontractors, have rear) and understood
the CWA entered into by and between the City, of Santa Ana, the Los Angeles/Orange Counties
Building and Construction Trades Council, and the signatory Craft Councils and Local.Unions,
effective as of September I, 2017. The CWA is available at:
h;tp:ltwwtiv:santa-sui•t ore�'p�aaldocumentslGWA.ndl'
The undersigned BIDDER hereby agrees to comply with all terms and conditions of the CWA,
and is capable of completing c struction of the project continuously, and without interruption;;
or delays. If awarded any rr covered by the CWA. BIDDER will also be required to sign the
Letter of Assent that ap a tachment A to the CWA.
The undersigned D t, eviewed the Public Works Construction Permit and required
deposit descriii c a d the Notice of Inviting Bids.
Signed:
Title: Sean Tabazadeh, CEO/Secret
Firm: Best Contracting Services, Inc.
Date: February 23, 2021
P-16 off'- 16
\VORKk;RS' COMPE(VSATIOIV IimS[iRAhdCE CERTIFIC:ATIOIV
As required by California Labor Code Section 18M and 1861. the Contractor certifies as follows:
I mn aware of the provisions 'f Section 3700 of the Labor Code, which requires every employer to be
insured against liability fo orker's compensation or to undertake self-insurance in accordance with the
provisions of the Cud d 11 comply will, such provisions before commencing the performance of
the work of this co c! .;
Signed;f
Title: &can Tabtzadeh, CEO/Secretary
Finn: Best Contracting Services, Inc.
Date: February 23, 2021
ucffl';' _
City of Santa Ana
Section 3 Contract Clause
These Clauses are to be inserted in all contracts
A. The work to be performed under this contract number 21-7536 by and between the City of
Santa Ana. hereinafter referred to as "City and Hest ContractinS Services, Inc. , hereinafer referred to as
"Contractor", is subject to the requirements of Section 3 of the Housing and Urban pevelopment Act of 1968, as
amended 12 U.S.C. 1701u (section 3). The purpose of Section 3 is to ensure that employment and other
economic opportunities generated HUD assistance or HUD -assisted projects covered by Section 3. shall, to the
greatest extent feasible. be directed to low -and very low-income persons.
B. The parties to this contract agree to comply with HUD's regulations in 24 CFR Part 135, which implement
Section 3. As evidenced by their execution of this contract, the parties to this contract certify that they are under
no contractual or other constraint that would prevent them from complying with the Pan 135 regulations.
C. The contractor agrees to send to each labor organization or representative of workers, Willi which the Contractor
has an agreement or other understanding, if any, a notice advising the labor organization or workers'
representative of fhc Contractor's commitments tinder this Section 3 clause, and will poet copies of the notice in
conspicuous places at the work site where both employees and applicants for training and employment positions
can see the notice. The notice shall describe file Section 3 preference, shall set forth minimum number and job
titles subject to hire, availability of apprenticeship and training positions, the qualifications: for each: and the
name and location of the person(s) taking applications for each ofthe positions: and the anticipated date the work
shall begin.
D. The Contractor agrees to include a Section 3 clause in every subcontract subject to compliance with regulations
in 24 CFR Part 135, and agrees to take appropriate action, upon a finding that the subcontractor is in violation of
the regulations in 24 CFR part 135. The Contractor will not subcontract with any subcontractor where the
Contractor has notice or knowledge that the subcontractor has been found in violation of the regulations in 24
CFR fart 135.
E The Contractor will Certify that any vacant employment positions, including training positions, that are filled (1)
after the Con tractor is selected but before the contract is executed, and (2) with persons other than those to
whom the regulations of 24 CFR part 135 require employment opportunities to be dir eeted, were not to
circumvent the Contractor's obligations under 24 CFR part 135.
F. Noncompliance with regulations in 24 CFR Part 135 may result its sanctions, termination of ihit; conimct For
default. and debarment or suspension from future HUD assisted projects.
The Contr this signature affixed hereto declares under penalty of p erjury: Contractor has read City`
regdire n a accepts all its requirements cmnained therein for all of his/her operations within fhe City of Santa
An.
' L - Sean Tabazadeh CEO/Secretary February 23 2021
gna re of Contructor Print Name and Title Date
# 4S62G3 /CLASS: A B C17 C39 C43 / CALIPORMA 95-3781209
Contractor License Number R Designation Federal DUNS Number
City of Santa Ana
Section 3 New hire Calculation Form
Project Name: MAIN LIBRARY ROOF IMPROVEMENTS, PROJECT NO.: 21-7536
Project Location: 26 Civic Center Plaza Santa Ana, CA 92701
Street City State Zip
Contractor Name: Best Contracting Services, Inc
Contractor Contact: Jim Adib Project Estimator
Contractor Telephone Number;. (310) 328-6969
Contractor Email Address: estimating@bestcontraeting.com
Section 3 Resident Hiring Goals
Trade/Craft
ROOFING LABOR - JOURNEYMAN
Number of New Hires
4
ROOFINGAPPRENTICE
1
ROOFING - FOREMAN
1
Total Number f New Hires: 6
Total #kjkbfirof Section 3 resident new hires necessary to comply with contract:
February 23, 2021
Date
Sean Tabazadeh, CEO/Secretary
E?C>1i BIT 8
Contractor's Section 3
Aff rinative Action Plan
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
Project f4umher and Title
The undersigned contractor agrees to implement the following afiirmativc action steps directed at'increaling the
Utilization of lower income residents and business concerns located within the County of Orange.
i. Take affirmative action to ensure that employees or applicants for employment or twining are not
discriminated agninst because of race, color, religion, sex or national origin.
2. Send a notice or the contractor's Section 3 earn mitment to each labor organization or representative of
workers and post a copy of the notice at a conspicuous place available to employees and appl ieanis for
employment or training.
3. To the greatest extent feasible. make a good faith Won to recruit for employment or thinini over income
residents from the County. and to award contact$ to business concerns which are located in or owned in
substantial part by person% residing in the County through use of local advertising media, signs placed at the
project site and notification to community organizations and public or private institutions operating within or
serving the project area such as Service Employment and Redevelopment (SER), Opportunities
Industrialization Center (OIC). Urban League, Contracted Employment Program, U.S. Employment Service.
Chamber of Commerce, labor unions, trade associations and businesaconcerns,
4. Maintain a file of all low-income area residents who applied f'or employment or training either on their own or
on referral front any source, and tine action taken with respect to each area resident.
5. Maintain a rile of all business concerns located in the County who submitted a bid for work on the project,
and the action taken with respect to each bid.
6. Maintain records, including copie
action steps have been taken.
7. Incorporate the Section 3 clause I
Section 3 Affirmative Action Plan.
Best Contracting Services, Inc.
Company Name
19027 S, Hamllton Ave, Gardena, CA 90248
Address: Street. City. State, Zip
11-312-3483
DUNS Number
Sean Tabazadeh
Printed Name
CEO01 ecretary
Title
tcument that a ffinnative
ntractor(s) to submit a
City of Santa Ana
Section 3 Contract Award Consideration
Bidder's Name: Best Contracting Services, Inc.
Please cheek the numbered statement that is applicable to your businass:
1. __ My business qualifies as a Section 3 business concern:
If you have checked statement NIIMBER i please read the attached Section 3 Business Concern
Preference - Blrlding Requirements.
(Pleave check the applicable gualiy1calinn for statement number 1)
5 1 % owned by Section 3 residents, or
Permanent. full-time employees include at least 3004 Section 3 residents: or
Will subcontract more than 250A of the dollar award of id subcontracts to be awarded to
business concern(§) that meet either ofthe two preceding qualifications.
Note: You are required to list all subcontractors and owner -operators in your bid statement.
X My busgaos does not qualify as a Section 3 business concern.
concern attflnifiM are located in this project's C'oniract Documents cC SpecrJicutiaas
t titled Secdan 31:conomlcOpportunities Plan.
February 23, 2021
Date
Sean Tabazadeh, CEO/Secretary
print Name
EXHIBIT Ix
CITY OF SANTA ANA
WOMEN OWNED/MINORITY BUSINESS OWNED ENTERPRIS S
(W/MBE) GOOD FAITH EFFORTS
Pursuant to 24 CFR Part 83 § 85.36 (e) of Code of Federal Regulations, contractor must take all necessary
affirmative steps to assu re that minority bu5ianes5 firms, iwomen's business enterprises and labor surphm finms are
used whenevor possible.
ConlractorthalI submit the following information to demonstrate that aloof faith effort has been made=to comply
with the above section of the Code of Federal Regulations. Submittal of this form, in and of itself, may not
provide sufficient documentation to demonstrate than goor faith effort Was made. documentation such as
copies of advertisement, letters of solicitation, telephone logs, rejected quotes, etc. shoo Id accompanya this
form.
1. The names and dates of advertisement of each newspaper, trade paper, and minority -focus paper intvhich a
request for WIMBE participation for this project was placed by the bidder:
2. The names and dales of written notices sent to WIMBE soliciting bids for this project and methods used for
following up initial solicitation to determine with certainty whether the WIMBE were interested.
Names of
WIMBE Solicited
No solicitation
Dales of
Solicitation
Follow-up Melhods
and Dates
3. `file items of work which the bidder made available to W/MBE firms,including. where appropriate, any
breaking down or the contracts into economically feasible units to facilitate W/MBE participation, and t he
information furnished to W/MBE such as plans, Spec 'ffiiea ons. and re i entents foible wgrhk.
If further solicitation, is neede , we w� orov e e following
items
Breakdown of Items: DEMO EXISTING,
Information Furnished: No solicitation made
r%DW$1PRQPSVe6WVDFo"MSMaU M0 iMR. 5anW36p Wo
4. Efforts made to assist W/MBG in obtaining bonding, lines of credit or insurance, and any technical assistance
related to the,plans, specifications and requirements for the work which was provided to W/MBE
S. Any additional data to support a demonstration of good faith effbri, such as contracts with W1M13C assistance
agencies:
I declare underlxirr
raulertstand that the
Nre hV61-rnation pro
io fidly and trwill(OR
i+ that the foregahig igforrnalion is true and correct to the hest of qik fiaan leelge. /
tAna andlor the U, Da1wrvment of and Urban Developtnent may'v&jAi=
in connection with IWATBE compliance erahrationloudit activiiies and that,failure
is form nrav result in ecotionde no- other sanctions,
Name of Contractor/Subcontractor:
Best Contracting Services, Inc.
Contractor/Subcontractor Identifiention
Number:
95-3781209
Address (Street, City, State, Zip): 19027 S. Hamilton Ave.
Gardena, CA 90245
Business ltaciai/Ethoic/Gender Code:
Circle the numeric code which indicates the racial/ethnic/gender character of the owner(s) and controller(s) of 51 %
of the business. When 5 1 % or more is not owned and controlled by any single racial/ethnicityigender category,
circle the code which seems most appropriate.
1 = White Americans
2 = Black Americans
3 = Native Americans
Woman Owned Business:
Circle One:
Yes or
4 = Hispanic Americans
5 = Asian/Pacific Americans
6 = Hasidic Jews
NONE
r Q0CWRDPSVCSWUDFORMSIM8USUWAMa • 8x &&pea bQc
EXHIBIT 15
NONCOLLUSION AFFIDAVIT
(Title 23 United States Code Section I I � and
Public Contract Code Section 7106)
To the City or Santa Ana
DEP-1 R1',I &W OF Pldf1LK' II'ORTS
In accordance with Title 23 United States Code Section 112 and Publ is Contract Code 7106the bidder declares
that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company.
association. organi7arion. or corporation; that the hid is genuine and not collusive or sham; that the bidder has not
directly or indirectly induced orsoliched any other bidder to put in a iatse orsham hid, and has not directly or
indirectly colluded, conspired. connived, or agreed with any bidder or anyone else to put in a shun bid, or that
anyone shall refrain from bidding: that the bidder has net in tiny manner, directly or indirectly, sought by
agreement. communication. or conference with anyone to fix the hid price of the bidder or ant other bidder, or to
lix any overhead. profit. or cost clement orthe hid price, or of that orally other bidder, or to secure tun advantage
against the public had)' awarding the contract of anyone interested in the proposed contract: that all statements
contained in the bid ire une; and, further. that the bidder has not. directly or indirectly, submitted his or tier hid
price or any breakdown thercor or the contents thereof, or divulged iof rriation or data relative Iheroai. or paid,
and will not pay. any fee to any corporation, partnership, company ussociation, organisation, hid depository. or to
any member or agent thereof to effectuate a collusive orsham bid,
Hest Contracting Services Inc
Name of Contractor
* SEE ATTACKED NOTARY *
and
February 22, 2021
Date
r WOCS'PR'SPavC$'JIVeFaRt.,S9.vE:L�aCdeJ,;R St.4unaryiwca UtC
CA 90248
Sean Tabazadeh/
CALIP0RN1A ALL-PURPOSE ACKHOWL.EDGh1ENY CIVIL CODE § 1189
nary rscxs cr cec ssrr,�rW cs saw c
[Anotary public or other o#ieer completing this certificate verifies only the Idenffty of the indi=documenl?
ment to which this certificate is attached, and not the truthfulness, accuracy, or validity of t
State of California )
County of Los Angeles )
On 02(22/2021
Date
Personally appeared
before me, _ Kaylyn A. Camello, Notary Public
Here Insert Name and Title of the Ofllcer
Senn Tabazadeh
Name) of Signer(jo
who proved to me on the basis of satisfactory evidence to be the persono whose name(4 is/r/de
subsc Ibed to the within Instrument and acknowledged to me that he/s17� t y executed the same in
his/h /th fr authorized capacity(fe�), and that b his r/ It si nature(M do tlh3�� Instrument the person(¢(,
or the an ity upon behalf of whin the person(j) act e�acuted the Instrument.
NOUN A. CAMELLe ,
Notary Public - California r
$= Los Artistes County t
=
Commission N 2235312
My Comm. Expires Mar 22, 202E
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
St nature 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: Non Collusion Affidavit
Document Date: 02/22/2021
Signers) Other Than Named Above:
Capacity(fes) Claimed by Signer(s)
Signer's Name: Scan Tabazadeh
h Corporate Officer — Title(s): Ce0
I__t Partner — , Limited [J General
rf Individual h.? Attorney in Fact
.1 Trustee I j Guardian or Conservator
Q Other:
Signer Is Representing: c,
Number of Pages:
Signer's Name: _
r-1 Corporate Officer -- Title(s):
I'D Partner — 0 Limited 0 General
17 Individual CI Attorney In Fact
i_1 Trustee 1_I Guardian or Conservator
Other:
Signer Is Representing:
cw �xxxtiYxsxx:vrc.�scw�,�,rc�,wzou.�cn�:x�x�sx.xrtcsxs;cwaxa:wc�rcR.*fuwvv;.ccxsc^saesx.�ct,w�.u-sa.�,�,u�c+
02016 National Notary Association • www.NationalNotary.org - 1.800-US NOTARY (1-600-876-6827) Item #5907
FEDERAL LOBBYIST REQUIREMENTS CERTIFICATION
Name of Firm; Best Contracting Services, Inc.
Address: 19027 S, Hamilton Ave. Gardena
Date: February23,2021
State: CA Zip Code: 90248 , Telephone: (L 328 6469
Acting on behalf of the above -named firm as its Authorized Official, I make the following Certification to ilia
Department or Housing and Urban Development (14UD) and the Community Development Commission. County of
Los Angeles:
1) No Federal appropriated funds have been paid, by or on behalf of ilia above -named firm to any person for
influencing or attempting to influence an officer or employee of any agenev, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in co nnection with the
awarding of any Federal contract, the making of any Federal grant. loan, or cooperative agreement. and any
extension, continuation, renewal. amendment, or modification thereof; and
21 if any funds outer than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee or any 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, Iota), or cooperative agreement, the above -named firm shall complete and submit Standard
Form—LLL, "Disclosure Form to Report Lobbying" in accordance with its instructions: and
3) The above-nmmed firm shall require that the language of this certification he Included in the award
documents for all sub=awards at all tiers (including subcontracts, sub -grants, and contracts under grants.
loans. and cooperative agreements) and that all suh-recipients shall certify and disclose accordingly.
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 ilia transaction
imposed by Section 1352 Title 31'C.S. Code. Any person who fails to file the required certification sliall he subject
to a civil penalty of not less than $10.000 and not more than $100,000 for each such failure.
Title: CEO/Secretary
Date: �___ February 23, 2021
F UIeC51PRpP5VCSWUaPORkB\MBUSBOSAMB•Se 00S,D%OX
rAMIUM1111F 7
CERTIFICATION OF UNDERSTANDING
AND AUTHORIZATION
Project Name: MAIN LIBRARY ROOF IMPROVEMENTS
Project Number: 21-7536
This is to certify that the principals and the authorized payroll officer, below, have read and understand the labor
standards clauses pertaining to the subject project.
The following person(s) is designated as the payroll officer for the undersigned and is authorized to sign the
Statement of Compliance, which will accompany our weekly certified payroll reports for this project:
Payroll Officer's Name
A,ceyd&l
Payroll Officer's Signature
Contractor/Subc ntractor
by
Signature
Printed Name
Title
Date
61 10Y-
Contractor/Subcontractor License No.
02-7`70c)21a 3
DUNS Number
F WOCIPPROPS MMUFORMMMBU34MA 10• SOMMSFb+.00C
MAYOR
Vicente Sarmiento
,.,
MAYOR PRO TEM
.�
David Pension
<,,—
COUNCILMEMBERS
Phil Bacerra
Ca
Johnathan Ryan Hernandez
t
Jessie Lopez
Notice. Mendoza
Thai Vet Phan
PUBLIC WORKS AGENCY
20 Civic Center Plaza (M,36)
P.O.. BOX 1988 .:52nla Ana, California 92702 .
(714) 647.5690 � Fax (714) 647-5823
www.santa•ana.org
CITY MANAGER.
Kristine Ridge
CITY ATTORNEY
Sonia R. Cavaiho
CLERK OF THE COUNCIL
Daisy Gomez
HUGH NGUYEN, CLERK RECORDER
NOTICE OF EXEMPTION By: _ La �nEPUTY
From the Requirements of the California Environmental Quality Act (CEQA)
Fee Exemption per California Government Code Section 6103
To: COUNTY CLERK
County of Orange
P.O. Box'238
Santa Ana, CA 92702
Project Title: Main Library Roof Improvements
Project Number(s):
Project Location: 26 Civic Center Piz
City: Santa Ana County: Orange ER Number: ER-2021-34
Project Description:
Facility re -roof.
Applicant Name: City of Santa Ana, Public Works Agency
Applicant Address: 20 Civic Center Plaza M-36
Santa Ana, CA 92702
Name of Public Agency Approving Project: City Council
Name of Agency Carrying Out Project: Public Works Agency
Exempt Status:
❑ Ministerial (Sec. 15268)
❑ Declared Emergency (Sec. 15259 (a))
❑ Emergency Project (Sec. 15269 (b through e))
❑ General Rule (Sec. 15061(b)(3)/(5))
❑ Statutory Exemption:
EMI Categorical Exemption: 15301(a)
Reason(s) Why Project is Exempt From CEQA:
Interior/exterior alterations,
City Contact: Robert Aguirre Title:
Signature:
From: City of Santa Ana
Public Works Agency
20 Civic Center Plaza (M-36)
Santa Ana, CA 92702
pate of Approvak 04/20/2021
Recorded in Official Records, Orange County
Hugh N uyen,Clerk-Recorder
III L III IIIIIIII IIIIIIIIIIIII I I I IIII I II II NO FEE
*$ R 0 0 1 2 6 5 5 9 3 7 $
202185000201 9:58 am 03/24/21
323 304A Z01
0.00 50,00 0.00 0.00 0.00 0,00 0.00 0.00
Associate Engineer Telephone: (714) 647-5051
SANTA ANA CITY COUNCIL
Date:
Vincenle Sarmienio David Nanaloaa Thal Viet Phan Jessie Lopez Phil Bacerra Johnathan Ryan Hernandez Nelida Mendoza
Mayor Mayor Pro Tom, Ward Ward Ward Ward Ward Ward
a , ' n n - na. d,RgngazarOiQnfa-ana nrg jyhwASanfaa ra oroiAessiQlgp_a anta-ar�a.grg b Cerra $an �prg.jrvanhemandezCa)san Cana o p'.nmQn�pza(o7santa ana or
CALIFORNIA NEWSPAPER SERVICE BUREAU
DAILY JOURNAL CORPORATION
Mailing Address: 915 E FIRST ST, LOS ANGELES, CA 90012
Telephone (213) 229-53001 Fax (213) 229-5481
Visit us @ WWW.LEGALADSTORE.COM
EDUARDOFLORES
SANTA ANA/PUBLIC WORKS AGENCY
20 CIVIC CENTER PLAZA 4TH FL ROSS ANNEX
SANTA ANA, CA 92702
COPY OF NOTICE
Notice Type: BID NOTICE INVITING BIDS
Ad Description 21-7536 MAIN LIBRARY ROOF IMPROVEMENTS
To the right Is a copy of the notice you sent to us for publication in the
ORANGE COUNTY REGISTER. Please read this notice carefully and call us
with any corrections. The Proof of Publication will be filed with the County
Clerk, if required, and mailed to you after the last date below. Publication
date(s) for this notice is (are):
01121 /2021 . 01 /28/2021
The charge(s) for this order is as follows. An invoice will be sent after the last
date of publication. If you prepaid this order in full, you will not receive an
invoice.
Daily Journal Corporation
Serving your legal advertising needs throughout California. Call your local
BUSINESS JOURNAL, RIVERSIDE
(951) 784-0111
DAILY COMMERCE, LOS ANGELES
(213) 229-5300
LOS ANGELES DAILY JOURNAL, LOS ANGELES
(213) 229-5300
ORANGE COUNTY REPORTER, SANTA ANA
(714) 543-2027
SAN FRANCISCO DAILY JOURNAL, SAN FRANCISCO
(800) 640-4829
SAN JOSE POST -RECORD, SAN JOSE
(408) 287-4866
THE DAILY RECORDER, SACRAMENTO
(916) 444-2355
THE DAILY TRANSCRIPT, SAN DIEGO
(619) 232-3486
THE INTER -CITY EXPRESS, OAKLAND
(510) 2724747
III III it II II IIIIIIIIIIIIIIIIII
* A 0 0 0 0 0 5 6 2 2 4 8 2
ArOF;<rLsxLrYy
vlllno
bond must be
a
notarized.
- IS
- In addition to
GIVEN
electronic Bid
City of
submittals Bidders
is will
shall deliver an
Bids
orig/na/hard copy of
BY via
the Bid Proposal
on or
Guaranty. For
80 pm,
further Instructions
11, 2021,
regarding Original
s will be
Bid Proposal
Jo other
Guaranty submittal,
A bid
refer to PlanetBids.
will be
Failure to provide
required
NO.: 21-
dead ments with B�d
mayy cause the b d
{RARV
to be deemed non-
F
responsive.
MENTS
121 1/28/21
CORANGE
ions are
COUNTY
able on
REGISTER
Mole.
ther
1 on how
call
Division
Public
CITY OF SANTA ANA Bond No. 1085410
BONDS
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS that Rest Contracting Services, Inc-
as CONTRACTOR, and The Hanover Insurance Company
a corporation, organized and existing under the laws of the State, and duly authorized to transact
business under the laws of the State of California, as SURETY, are held and firmly bound unto
the City of Santa Ana, as AGENCY, in the penal sum of
Four Hundred Ninety One Thousand One Hundred Eiehty-Eiehty Dollars
($ 491,188.00 1, 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
April 20, 2021 for Main Library Roof Improvements. Project No. 21-7536
if CONTRACTOR or any subcontractor fails to pay for any labor or material of any kind used in
the performance of the Work of Improvement to be done under said Contract Agreement, or fails
to submit amounts due under the State Unemployment Insurance Act with respect to said labor,
SURETY will pay for the same in an amount not exceeding the sum set forth above, which
amount shall insure to the benefit of all persons entitled to file claims under the State Code of
Civil Procedures; provided that any alterations in the work to be done, materials to be furnished,
or time for completion made pursuant to the terms of the contract documents shall not in any
way release either CONTRACTOR or SURETY, and notice of said alterations is hereby waived
by SURETY.
IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this
Ath day of March , 202�L.
CONTRACTOR'
SURETY*
Subscribed and sworn to
,20_
Signature:
CA 92707
Notary Public in and for the County of State of
this day of
Rate of premium on this bond is $ 5.58 per thousand.
Total amount of premium charge is $ 2,741 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.
2of3
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS SAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA
POWER OF ATTORNEY
THIS Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except In the manner and
to the extent herein stated.
KNOW ALL PERSONS BY THESE PRESENTS:
ThatTHE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing
under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the
laws of the State of Michigan, (hereinafter Individually and collectively the "Company") does hereby constitute and appoint,
Patrick T. Moughan, Mark D. Kiger, Alec D. Martinez, andlor Jing Goo Mason
Of Global Risk, LLC of Los Angeles, CA each individually, If there be more than one named, as Its true and lawful attorney(s)-in-fact to sign, execute,
seal, acknowledge and deliver for, and on Its behalf, and as Its act and deed any place within the United Stales, any and all surety bonds, recognizances,
undertakings, or other surety obligations. The execution of such surety bonds, recognizances, undertakings or surety obligations, in pursuance of these
presents, shall be as binding upon the Company as if they had been duly signed by the president and attested by the secretary of the Company, in their
own proper persons. Provided however, that this power of attorney limits the acts of those named herein; and they have no authorilyto bind the Company
except In the manner stated and to the extent of any limitation slated below:
Any such obligations in the United States, not to exceed Fifty Million and NoN 00 ($60,000,000) In any single Instance
Thatthis power is made and executed pursuant to the authority ofthe following Resolutions passed by the Board of Directors of said Company, and said
Resolutions remain In full force and effect:
RESOLVED: That the President or any Vice President, in conjunction with any Vice President, be and they hereby are authorized and
empowered to appoint Attorneys -in -fact of the Company, in Its name and as It acts, to execute and acknowledge for and on Its behalfas surety,
any and all bonds, recognizances, contracts of Indemnity, waivers of citation and all otherwri8ngs obligatory in the nature thereof, with powerto
attach thereto the seal of the Company. Any such writings so executed by such Attom ys-in-fact shall be binding upon the Company as if they
had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons.
RESOLVED: That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification In respect thereto, granted
and executed by the President or Vice President In conjunction with any Vice President of the Company, shall be binding on the Company to the
same extent as If all signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile.
(Adopted October 7, 1981 —The Hanover Insurance Company; Adopted April 14, 1982 — Massachusetts Bay Insurance Company; Adopted
September 7, 2001 —Citizens Insurance Company of America)
IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE
COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by two Vice Presidents, this 29h
day of March, 2017.
The nanover Inwrance Company
Massaelmusnite6ay hmsuleamxe tbmpany
Cahenn Insnranre Co.any W America
Tolhn+C.. RRoche, EVP andtMesideet
y„T
1\ r
THE COMMONWEALTH OF MASSACHUSETTS )
COUNTY OF WORCESTER ) as.
The Hanovee Inamanw Company
Nnasschuseits aaV Insuea nca Cmmparty
CR¢ Insurervce Cmnpa,rymf Ameeira
Jam wiecld, [5ceY�recidene
On this 29s day of March, 2017 before me come the above named Vice Presidents of The Hanover Insurance Company, Massachusetts Bay Insurance
Company and Citizens Insurance Company of America, to me personally known to be the individuals and officers described herein, end acknowledged
that To seals affixed to the preceding Instrument are the corporate seals of The Hanover Insurance Company, Massachusetts Bay Insurance Company
and Citizens Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and
subscribed to said instrument by the authority and direction of said Corporations.
. rraiurio I'
x arwe.M�QI/�il.Uitl/It
W Ouevees Iglre mw,e J. e n a Nanry Pumlc
My Conm nsron Eapa March .20:2
I, the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of
America, hereby certify that the above and foregoing Is a full, true and correct copy of the Original Power of Attomey Issued by said Companies, and do
hereby further certify that the said Powers of Attorney are still In force and effect.
GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this 8" day of March, 2021
CERTIFIED COPY
mieodom O. Martinez, Vice Pmesidcnl/ -
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 Los Angeles )
On _ March 8. 2021 before me, Michaels Anne Vo, geler Notary Public
Here Insert Name and Title of the Officer
personally appeared Kayhan Fatemi
Nam of SignerK—
who proved to me on the basis of satisfactory evidence to be the persor�hose name(s)-is/are'
&
..i_ �Cw .._.I n "7' ~':�HF'p^/eyertrfed the same in
his/ the�uthorized capacity(io<-and that by his/I;iia�r/thefr signature(eron the instrument the persop(gy,—
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.
WICMAI'LAMNE VCNiELEA ■ WITNESS my hand and official seal.
NCalNLa^YeinC-r-YJl/7fC/_/1/-)1^—'ammisslm/2145117 -omm. Extra 315. 17Va
Signature
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: Pmt Bond
Document Date: 3/8/2021
Signer(s) Other Than Named Above,
Patrick T. Moughan
Capacity(ies) Claimed by Signer(s)
Signer's Name: Kaayhan Fatemi
ER Corporate Officer — Title(s): EVP
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing: Rest cnntrarHng Servica Tnc.
Number of Pages:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
02016 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles }
On Zo ( before me, Ashley Greenberg, Notary Public
eremsert name enea eott eo ce1)j
personally appeared Patrick T. Moughan
who proved to me on the basis of satisfactory evidence to be the person(s) whose
name($) 1s re subscribed to the within instrument and acknowledged to me that
< she/they executed the same in is er/their authorized capacity(ies), and that by
(Esher/their signature(s) on the instrument the person($), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
', ASHLEY GRE g RRG
WITNESS my hand and official seal. Commission No. 2311429
NOTARY PUBLIC-CALIFORNIA n
LOS ANGELES COUNTY
My Comm. Expires No,. 3, 2023
Notary Public Signat re (Notary Public Seal)
Lai JIt l�lC1�\�ICIa�I C�1'IG�■
DESCRIPTION OF THE ATTACHED DOCUMENT
(Title or description of attached document)
(Tice or description of attached document
of Pages _ Document Date
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
❑ Corporate Officer
Td e)
❑ Partner(s)
O Attorney -in -Fact
❑ Trustee(s)
❑ Other
2015 Version vasnv.NolaryClasses.com 800-873-9865
PH
INSTRUCTIONS FOR COMPLETING THIS FORM
Thisformcomplieswith crmreni Californiastatutesregardingnoiar),wordingand,
fneeded, should be completed and attached to the document Acknowledgments
from other states may be completed for documents being sent to that state so long
as the um, ding does not require the California notary to violate California notary
Imv.
• State and County information must be the State and County where the document
signers) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title (notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect fortes (ice
he/shelthe),, is fare ) or circling the correct forms. Failure to correctly indicate this
information may lead to rejection of document recording.
• The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re -seal if a
sufficient area permits, otherwise complete a different acknowledgment form.
• Signature of the notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title fie CEO, CFO, Secretary).
• Securely attach this document to the signed document with a staple.
CITY OF SANTA ANA
BONDS
PROJECT NO.: 21-7536
MAIN LIBRARY ROOF IMPROVEMENTS
FAITHFUL PERFORMANCE BOND
Bond No. 1085410
KNOW ALL MEN BY THESE PRESENTS that Best Contracting Services, Inc.
as CONTRACTOR, and The Hanover insurance Company
a corporation, organized and existing under the laws of the State, and duly authorized to transact
business under the laws of the State of California, as SURETY, are held and firmly bound unto
the City of Santa Ana, as AGENCY, in the penal sum of
Four Hundred Ninety One Thousand One Hundred Eighty -Eight Dollars
($ 491,188.00 1, 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
April 20, 2021 for Main Library Roof Improvements, Project No. 21-7536
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
8th day of March 202J_,
CONTRACTOR*
SURETY* The Hanover
Subscribed and sworn to
,20
90248
011016
Signature:
Notary Public in and for the County of State of
EIMS1:i113
this day of
Rate of premium on this bond is $ 5.58 per thousand.
Total amount of premium charge is $ 2,741 To be filled in by Surely
*Provide CONTRACTOR /ADMITTED SURETY name, address, and telephone number and the
name, title, address, and telephone number of authorized representative.
1 of 3
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA
POWER OFATTORNEY
THIS Power of Attorney Ilmlts the acts of those named herein, and they have no authority to bind the Company except In the manner and
to the extent herein stated.
KNOW ALL PERSONS BY THESE PRESENTS:
ThatTHE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing
under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the
laws of the State of Michigan, (hereinafter individually and collectively the "Companyl does hereby constitute and appoint,
Patrick T. Moughan, Mark D. Kiger, Alec D. Martinez, andfor Jing Guo Mason
Of Global Risk, LLC of Los Angeles, CA each Individually, If there be more than one named, as Its true and lawful attorney(s)-in-fact to sign, execute,
seat, acknowledge and deliver for, and on Its behalf, and as Its act and deed any place within the United Stales, any and all surely bonds, recognizances,
undertakings, or other surely obligations. The execution of such surety bonds, recegnizances, undertakings or surety obligations, In pursuance of these
presents, shall be as binding upon the Company as If they had been duly signed by the president and attested by the secretary of the Company, In their
own proper persons. Provided however, that this power of attorney limits the acts of those named herein; and they have no authority to bind the Company
except In the manner stated and to the extent of any limitation stated below:
Any such obligations In the United States, not to exceed Fifty Million and NoM 00 ($80,000,000) in any single Instance
That this power is made and executed pursuant to the authority ofthe following Resolutions passed by the Board of Directors of said Company, and said
Resolutions remain In full force and effect:
RESOLVED: That the President or any Vice President, in conjunction with any Vice President, be and they hereby are authorized and
empowered to appoint Attorneys -in -fact of the Company, in Its name and as It acts, to execute and acknowledge for and on its behalf as surety,
any and all bonds, recognizances, contracts of Indemnity, waivers of citation and all other writings obligatory in the nature thereof, with powerto
attach thereto the seal of the Company. Any such wriffngs so executed by such Attorneys -In -fact shall be binding upon the Company as If they
had been duly executed and acknowledged by the regularly elected of wm of the Company In their own proper persons.
RESOLVED: That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto, granted
and executed by the President or Vice President in conjunction with any Vice President of the Company, shall be binding on the Company to the
same extent as if all signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile.
(Adopted October 7, 1981 —The Hanover Insurance Company; Adopted April 14, 1982— Massachusetts Bay Insurance Company; Adopted
September 7, 2001 — Citizens Insurance Company of America)
IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE
COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by two Vice Presidents, this 29h
day of March, 2017.
The Ha noyarynsorance Company
Haasachusatts Bay zesuhanca company
Cd§ans Insurance Canny f Ameri s
Jahn C. Roche,ENT and&eddent
THE COMMONWEALTH OF MASSACHUSETTS )
COUNTY OF WORCESTER )as.
4r>
On this 291h day of March, 2017 before me came the above named Vice Presidents of The
Company and Citizens Insurance Company of America, to me personally known to be the
that the seals affixed to the preceding Instrument are the corporate seals of The Hanover I
and Citizens Insurance Company of America, respectively, and that the said corporate
subscribed to said Instrument by the authority and direction of said Corporations.
MansJ. HQ
Iknn nAMo
W
W eauw.,
The Hanover xnuaran . Ca,npany
Massachusetts Bay ynsueanc<Cumpany
Case ru lnsuuana Cumpany of (uneeiea
lames 11. Kawiecki;Vice Resident
Bay Insurance
acknowledged
signatures as officers were
DimeJ.1p}p�• w, Naa
My C.Msioh a pirw M..h 4, 2U?2
I, the undersigned Vice President of The Hanover Insurance Company, Massachusetts Say Insurance Cont any and Citizens Insurance Company of
America, hereby certify that the above and foregoing Is a full, true and correct copy of the Original Power ofAttemey issued by said Companies, and do
hereby further certify that the said Powers of Attorney are still in force and effect.
GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this 8' day of March, 2021
CERTIFIED COPY e�
Theodore G. Martinez, VicPesidentl
CALIFORNIA• • • • ■
A notary public or other officer completing this certificate verges only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California )
County of Los Angeles )
On March 8.2021 before me, Michaela Anne Vogeler. Notary Public ,
Here Insert Name and Title of the Officer
personally appeared Kayhan Fatemi
Name(i) of SigneAVf
who proved to me on the basis of satisfactory evidence to be the pere nK'whose nameK_is/are�
subscr' ed to the within Instrument and 8_!;rc,^,-1k'!,^ayg Me'
cw6U!'.6"'la
hi r/thodauthorized capacity(ig and that by i rRhelr signaturgWon the Instrument the perso o,
or the entity upon behalf of which the persoracted, 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.
eWITNESS m hand and official seal.
MICU Public.
VOGELEA y
Notary npi C•INomN
LW Mgeln County
Cammlubn 1' z34a117
y Comm. E>@b•siM �, Sar7 Signature
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: Perf Bond
Document Date: 3/8/2021 Number of Pages:
Signer(s) Other Than Named Above: Patrick T. Moughan
Capacity(ies) Claimed by Signer(s)
Signer's Name: Kayhan Fatemi
IR Corporate Officer — Title(s): EVP
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing: neat cnntrarting servires Inc.
Signer's Name:
❑ Corporate Officer — Thle(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other.
Signer Is Representing:
02016 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of Lo Angeles c}
On 3 a o-14 before me, Ashley Greenberg, Notary Public
ue insert name en3ut e o the o car
personally appeared Patrick T. Moughan
who proved to me on the basis of satisfactory evidence to be the person(s) whose
name(-&) Is re subscribed to the within instrument and acknowledged to me that
le he/they executed the same in Is er/their authorized capacity(ies), and that by
Is er/their signature(s) on the instrument the person(-&), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
ASHLEY GREENBERG
commission No. 2311429
WITNESS my hand and official seal. V
NOTARY PUBLIC-CALIFORNIA
LOS ANGELES COUNTY
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OF THE ATTACHED DOCUMENT
(Title or description of attached document)
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2015 Version wanv.NotaryClasses.cor 800-873-9865
INSTRUCTIONS FOR COMPLETING THIS FORM
Thisform complies with current California statutes regardingnotary wording and,
if needed, should be completed and attached to the docmnent. Ackno rledgmenis
frmn other states inay be completed for documents being sent to that state so long
as the wording does not require the California notary to violate California notary
/an.
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Additional information is not required but could help to ensure this
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CITY OF SANTA ANA
PUBLIC WORKS AGENCY
CONTRACT CHANGE ORDER
project Number Pro eat No. 21.7636: Main Library Roof Improvements _ Wige Order Number 1 _
To A188 COntraat ervioes, InC.
., _ . Commuter
You are hersbydimated to make the herbfn charges from theplans and spedlications ordo Ihafollowngdescdbed work not fbcludedin the plans and speollt rows
on 06 contract,
NOTR; THIS CHANGE ORDER 18 NOT EITECTIVC ONTIL_APPROVE6 BY THE CITY COUNCIL OR.CITY MANAGER.
Unless othen+fspstaled, rates for rental of equipment cover only such Case as equipment N actually used and naallbwanca Gllfba madatatldle tfr e,
Change requested by - � � PUBLIC WORK!/ GENCY
� it • - � _- i
1. Furnish and install two (2) oast iron drain pipes with no -hub couplings per PCO #1 dated June $, 2021,
AGREED COST = $30,525.67
Pagel 02
CITY OF SANTA ANA
PUBLIC WORKS AGENCY
CONTRACT CHANGE ORDER
Project Number Project No. 21-7536: Main Library Roof Improvements Change Order Number
_ 1
TO Best ConVacting Services, Inc. "-'
Contractor
You are hereby directed to make the herein changes from the plans and specificaltans ordo the fold wing described work not included in the plans and specifications
on the contract.
NOTE. THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANAGER
Unless otherwise staled, rates for rental of equipment cover only such lime as equipment Is actually used and no allowance will be made for idle —µhoe �—
Changemquesledby 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
impacton 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 $ 30,525.67 INCREASE $ _I)_
By reason of this order the CONTRACT TIME completion will be adjusted as follows: Ten (10) Working Days
We the undersigned contractor have given careful consideralion to the charge proposed and hereby agree, if this
equipment furnish all materials, except as may otherwise be noted above, and perform all service necessary for the workabovespec'rfi, th and w w illaccepdes all
Payment therefor the prices shown above.full
Accepted. Date( t4. 2D22 Contractor
Best ContraMing Services, Inc.
B liter ----
Approval recommended b;4 A _ Date
7 PUBLIC WORKSAGENCYEKECUTIVE DIRECTOR � -
Approved by ✓'y-�_ _..�_... _ Date
CI MANAGER �_ __
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