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Home My WebLink AboutLINCOLN PACIFIC BUILDERS, INC.Recording Requcsled By, And When Ruord¢d Mail To, Clerk of IheCouncil, LYIy of Santa Ane 20 avic Center Plana, P.O. Boa 1988 Santa Ana, CA 92702 Recorded in Official Records, Orange County i11111111111111111?IIIIIIIIBIIIIIIIII?IIIIIIIIIIIIIIIIIIAIIIIIIIIIIIII No FEE Tom Daly, Clerk-Recorder 2011000423655 2.34 pm 08126111 41SN1P 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIS SPACE FOR COUNTY RECORDERS USE ONLY 227 NOTICE OF COMPLETION Atl?ll NOTICE IS HEREBY GIVEN that the wdersigued Cily of Santa Ana, California, a ceoshueUoE of TRAFPIC SIGNAL MSTAILATIONS under oonlracl entered into on A 2010, with LINCOLN PACIFIC BUILDERS IN C. on which contract TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA is surety. The property on which such work improvement was planed is in the Gty of Santa Ana, Cowty of Orange, Slate of California, and desrnbed asProject No. 08-5017 Totaled al, WILLITS ST & SULLIVAN ST RAITT ST. & GLENWOOD AVE. HARBOR BLVD & KENT AVE AND SANTA ANA BLVD. & FLOWER ST The work improvement on said property was accepted as completed on AUGUST 19.2011. CITY OP SANTA ANA, A MUNICIPALCORPORATION Dated: Auguet 26,2011 CitvEngioeu ?? TITLE VERIFICATION municipal corporation, with the address of City Hall, 20 Civic Center Plaza, Santa Ana, California, 92701, is the owner of the properly hereinafter described, [hat said owner has caused I, the undersized, say: I am the Cily Enpoeer of the City of Santa Ana, Califomia; I eRceuled the foregoing Notice of Completion acting on behalf of the owner of the propery theraln described; I make this venficatiou on behalf of said corporation by aulhonzation of [he City Coancil of the City of Santa Ana; l have read said notice and know the centenls thereof; and I declare wrier penalty of perjury that the fats fheraln slated are tNe. Eaecaledon August26 2011 ,atSanlsAna,Cslifomia (SigoaN ofindividuel aNwinalhal Ee ?ooknfsofNoli?eafCooipl¢fion aalm¢,) THIS NOTICEOF WMPLE1YON MAST BEREWRDED WITHIN TEN QO) DAYS AFfBR COMPLETION CLERK OF COUNCIL USE ONLY: DECEMBER 6, 2010 TITLE: INCREASED CONTINGENCY FOR TRAFFIC SIGNAL INSTALLATION AND MODIFICATION AT FOUR LOCATIONS (PROJECT NOS. 085017, 085021, 085022 AND 085023) CITY MANAGER RECOMMENDED ACTION APPROVED ;??-:?,? ,l .J III"??? 23 ? I?As Recommended ? As Amended 0 Ordinance on 1 ?` Reading (] Ordinance on 2"d Reading 0 Implementing Resolution ? Set Public Hearing For CONTINUED TO FILE NUMBER Increase the contingency for the contract with Lincoln Pacific Builders, Inc. for Traffic Signal Installation and Modification at four locations by $52,300 to a total estimated contract amount of $793,166 and authorize the City Manager to execute a change order in an amount not to exceed the authorized contingency. DISCUSSION Last year the City awarded a contract for Traffic Signal Installation and Modification at four locations to Lincoln Pacific Builders, Inc. in the estimated amount of $673,515 plus a contingency of $67,351 totaling $740,866. One of the four locations is the traffic signal modification at Flower Street and Santa Ana Boulevard. When this intersection was originally designed, the project scope was reduced by eliminating the upgrade to the signal communication system to stay within the available Hazard Safety Improvement grant funds. With an actual bid that is lower than the available funding, the City is able to include the signal communication system upgrade. This upgrade requires the approval of a change order. A change order in an amount not exceed $52,300 is required to upgrade the signal communications system. This modification will be paid based on a per unit basis, subject to the not to exceed amount. ENVIRONMENTAL IMPACT This is no environmental impact associated with this action. Increased Contingency for Traffic Signal Installation and Modification At Four Locations December 6, 2010 Page 2 FISCAL IMPACT The contingency increase is $52,300. Funds are available in the Select Street Construction Fund (accounting unit 05917660-66220), the Measure M Street Construction Fund (accounting unit 03217660-66220), the Federal Aid Safety Fund (accounting unit 1 471 761 1-66220), and the Traffic System Management Grant Fund (accounting unit 1 481 761 1-66220). Rau t-Cr o nez II Franciscoutierrez Executive Director Finance & Management Services Agency RG/TC ?- 1 '9? .. CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number PROJECT NO. 08-5017, 08-5021 , 08-5022 AND 08- Change Order Number 1 5023; TRAFFIC SIGNAL INSTALLATIONS AT WILLITS & SULLIVAN, RAITT & GLENWOOD, HARBOR & KENT AND SANTA ANA BL & FLOWER. -FEDERAL PROJECT NO. SR2SF-5063 (120), SR2SF-5063 (124), SR2SF-5063 (118) AND SR2SF-5063 (119) To Lincoln Pacific Builders, Inc. Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCILOR CITY MANAGER. Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS 1 . EXTRA WORK AT AGREED PRICE Provide two new Type 26-4-100 traffic signal poles with 45' SMA, 12' LMA and two reflective street name signs. AGREED PRICE _ $19,766.00 2. NEW CONTRACT BID ITEM Item # New Bid Item Unit Quantity Unit Price Total Provide and install 3" 21 sch 80 conduit Lf 850 $45.00 $38,250.00 Provide and install 12 22 pair / 22 sic wire Lf 1000 $3.30 $3,300.00 Provide and install N36 23 Christy pull box Ea 5 $350.00 $1,750.00 Estimated Total $43;300 The compensation both time and cost set forth in this final change order comprises the total compensation due the Contractor, all Subcontractors, and all Suppliers for all work performed per this change order, including impact on unchanged work. By signing this final 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 final 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. Page 1 of 2 .r r CITY OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number PROJECT NO. 08-5017, 08-5021 , 08-5022 AND 08- Change Order Number ? 5023; TRAFFIC SIGNAL INSTALLATIONS AT WILLITS & SULLIVAN, RAITT & GLENWOOD, HARBOR & KENT AND SANTA ANA BL & FLOWER. -FEDERAL PROJECT NO. SR2SF-5063 (120), SR2SF-5063 (124), SR2SF-5063 (118) AND SR2SF-5063 (119) To Lincoln Pacific Builders, Inc. Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCILOR CITY MANAGER. Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUF1l. IC Wf7RKR A(;FNCV The signing of this final 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 final change order constitutes the total equitable adjustments owed the Contractor, all Subcontractors, and all Suppliers for all work pertormed on this project. The Contractor on behalf of himself, all Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation of any whatsoever to file any further claim related to this project. TOTAL COST THIS CHANGE ORDER: DECREASE ? _ _ _ _ _ INCREASE ? 62,550.00 By reason of this order the CONTRACT TIME completion will be adjusted as follows: Add 70 Working Days We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will provide all equipment, furnish all materials, except as may otherwise be noted above, and perform all service necessary for the work above specified, and will accept as full payment thereTor the p ?ces shown above. Acceptec?D?t? _1 ?ZS?2o 11 Contractor Lincoln Pacific Builders, Inc. ?v .i ??P-?\ ?l ?? TitLen • ? ??X ? G llfl ?1G ?. Approved by CITY Date ?' ? ? ' "vV Date 2/ZJ??i Page 2 of 2 i REQUEST COUNCIL FOR ACTION CITY COUNCIL MEETING DATE: APRIL 5, 2010 TITLE: CONTRACT AWARD FOR TRAFFIC SIGNAL INSTALLATIONS AND MODIFICATION AT FOUR LOCATIONS (PROJECT NOS. 085017, 085021, 085022, AND 085023) ,7 CITY MANAGER RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED 04/05/2010 ~As Recommended , ; ^ As Amended ^ Ordinance on 1St Reading ^ Ordinance on 2"d Reading ^ Implementing Resolution ^ Set Public Hearing For_ CONTINUED TO FILE NUMBER 1. Award a contract to Lincoln Pacific Builders, Inc., the lowest responsible bidder, in accordance with unit bid prices in the estimated amount of $673,515 for construction of traffic signal installations and modification at four locations. 2. Approve a Funding Analysis with a total estimated construction cost of $841,900. DISCUSSION This project provides for traffic signal installations at the intersections of Willits and Sullivan Streets, Raitt Street and Glenwood Place, and Harbor Boulevard and Kent Street, and traffic signal modification at the intersection of Santa Ana Boulevard and Flower Street (Exhibit 1). Once completed these signal improvements will increase safety of motorists and pedestrians at these locations. The Notice Inviting Bids was advertised on February 1 and 3, 2010, and bids were opened on February 25, 2010. A summary of the bid invitations mailed, the bids received, and the bid results follows. Santa Ana Contractors receiving notices: 22 Contractors requesting bidding documents: 21 Bids received: 9 Bids received from Santa Ana Contractors: 0 • • Contract Award For Traffic Signal Installations and Modification at Four Locations April 5, 2010 Page 2 CITY BID AMOUNT NA ME OF RESPONSIVE BIDDER 1. Lincoln Pacific Builders, Inc. Baldwin Park $673,515 2. Christopher R. Morales, Inc San Dimas $729,900 3. California Professional Engineering S. EI Monte $758,196 4. PTM General Engineering Services, Inc. Riverside $774,074 5. Steiny & Company, Inc. Baldwin Park $780,400 6. International Line Builders Riverside $791,848 7. Terno, Inc. La Mirada $825,056 8. DBX, Inc. Temecula $849,086 9. C. T. & F., Inc. Bell Gardens $1,479,624 A total of nine bids were received and all were responsive. The lowest bid was submitted by Lincoln Pacific Builders, Inc., for $673,515 which is below the Engineer's estimate of $1,099,658. ENVIRONMENTAL IMPACT Environmental Review Nos. 2008-09, 2008-07, 2008-05 and 2008-04 have been completed. Categorical Exemptions were filed for these projects pursuant to the California Environmental Quality Act. FISCAL IMPACT The funding analysis shows a total estimated construction cost of $841,900, for the project (Exhibit 2). Funds are available in the Select Street Construction Fund (accounting unit 05917660-66220), the Measure M Street Construction Fund (accounting unit 03217660-66220), the Federal Aid Safety Fund (accounting unit 14717611-66220), and the Traffic System Management Grant Fund (accounting unit 14817611-66220). APPROVED AS TO FUNDS AND ACCOUNTS: ~~ Raul Godi ez II Executive Director Public Works Agency ~~~~ ~ ~.~ - r~ Francisco Gutierrez Executive Director Finance & Mgmt. Services Agency RG/ET Exhibit 1: Project Location Map 2: Funding Analysis Raitt & Glenwood Project 085021 CONTRACT AWARD FOR TRAFFIC SIGNAL INSTALLATIONS AND SANTA ANA MODIFICATION AT FOUR LOCATIONS ~ City Council P~ WA ~ Agenda Date April 5, 2010 (PROJECT NOS. 085017, 085021, 085022 AND 085023) PUBLIC WORKS AGENCY ,,:~:. . EXHIBIT 1 • FUNDING ANALYSIS u PROJECT NOS. 085017, 085021, 085022 and 085023 TRAFFIC SIGNAL INSTALLATIONS AND MODIFICATION AT FOUR LOCATIONS Construction Contract $673,515 Contract Administration $36,034 Inspection and Testing $65,000 Contingencies $67,351 TOTAL ESTIMATED CONSTRUCTION COSTS 841 900 Exhibit 2 ~~ ORANGE COUNTY REPORTER -SINCE 1921 600 W SANTA ANA BLVD, SANTA ANA, CA 92701 Telephone (714) 543-2027 /Fax (714) 542-6841 Dina Melgar SANTA ANA/PUBLIC WORKS AGENCY 20 CIVIC CENTER PLAZA SANTA ANA, CA - 92702 PROOF OF PUBLICATION (2015.5 C.C.P.) State of California ) County of ORANGE ) ss Notice Type: BID -NOTICE INVITING BIDS Ad Description: Traffic Signal Install I am a citizen of the United States and a resident of the State of California; I am over the age of eighteen years, and not a party to or interested in the above entitled matter. I am the principal clerk of the printer and publisher of the ORANGE COUNTY REPORTER, a newspaper published in the English language in the city of SANTA ANA, county of ORANGE, and adjudged a newspaper of general circulation as defined by the laws of the State of California by the Superior Court of the County of ORANGE, State of California, under date 06/20/1922, Case No. 13421. That the notice, of which the annexed is a printed copy, has been published in each regular and entire issue of said newspaper and not in any supplement thereof on the following dates, t0-Wlt: 02/01/2010, 02/03/2010 Executed on: 02/03/2010 At Los Angeles, California I certify (or declare) under penalty of D~jury that the foregoing is true and correct. ~ ~ this space for filing stamp only OR #:1787560 NOTICE INVRING BIDS NOTICE IS HEREBY GIVEN that the Ciry of Santa Ana, California will receive at the Ciry Hall-Ross Annex, (M-43), 20 Civic Center Plaza, Santa Ana, California 92701, the Public Works A enc Fourth Floor Rece tionist, on or a ore t e our o :00 p. m. on ursday, Fehruary 25. 2009 sealed bids andlor proposals for: PROJECT NO. OB-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST 8 SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST 8 GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD 8 KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST (Work includes excavation, sidewalks, curb romps, signing & striping, installation of new traffic signal and traffic signal modification, detector loops, signal interconnect) Notice is hereby given bidders that this project is funded with SR2S and HSIP monies, and that the rate of wages for each craft or type of work or mechanic employed under this contract shall be as specified under the current determinations of the De artment of Labor as wired under the aura-Bacon ct. Where a discrepancy exists between ederal and State prevailing wage rate, the higher of the two prevailing wage rates shall apply. Each bid shall be accompanied by cash, a cashier's or certified check payable to the Ciry of Santa Ana, or bid bond issued by a corporate surety, for an amount not less than ten percent (10%) of the aggregate of the bid, as a guarantee that the bidder will enter into the proposed contract if the same is awarded to him. The signature of the Bidder on the bid bond must be notarized. The Ciry Council reserves the right to rsject any or all bids. The successful Bidder must possess or obtain a valid California Class C-10 Contractor's prior to the scheduled award date of this contract. The Disadvantage Business Enterprise (DBE) and Underutilized Disadvantage Business Enterprise (UDBE) goal for this project is $57,857 that is 3.89% of the federal funds in the project. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or second or third low bidder, it must be submitted and received by the administering agency no later than the time specified in the federal requirements attached (Appendix F). The time for completion of this contract is 50 working days for construction from the date of the Notice to Proceed issued by the Engineer. Liquidated damages of $1000 per calendar day for construction not completed within the 50 working days from the effective date of Notice to Proceed. Substitution of securities for any monies withheld by the City of Santa Ana to ensure performance is allowed in accordance with the Public Contract Code. Com lete sets of the Plans and eci ications will be umished u on a ication tote ublic Wo s enc first lour oss Annex om ex 20 ivic enter laza -93 anta na ali ornia 92701. ohone 714 647-5680. there is a 24.53 charge non- refundable) for these Plans and Specifications, plus a minimum $14.42 additional fee if mailed. Make checks payable to the Ciry of Santa Ana. DO NOT CALL PURCHASING DIVISION REGARDING AVAILABILITY OF PLANS AND SPECIFICATIONS 2/1, 213/10 OR-1787560# VWIIAVI~IIIVVIIIIIIIIIIIIIVIVIRIIVVIIN~~I~IV CITY OF SANTA ANA PROJECT N0.08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST • PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: LINCOLN PAGFlC • INC REQUIlZEMENT: The undersigned declares that he/she has carefully examined the location of the proposed work, that he/she has examined the Plans and Specifications and read the accompanying instruction to BIDDERS, and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said plans (if any), specifications and special provisions, for the unit price(s) or lump sum(s) set forth in the following schedule: Item # Bid Item Unit Quantity Unit Price Amount Project # 08-5017 1. Traffic Signal Installation on Willits St & Sullivan St LS LS 2. Signing and Stnpmg LS LS 3. Furnish and Install Traffic Signal Loops EA 30 4. Pothole * EA 10 5. Construct PCC Curb Ramp SF 1200 Project No: 08-5017, subtotal .................... Proiect # 08-5021 6. Traffic Signal Installation on Raitt St & LS LS Glenwood Pl 7. Signing and Striping LS LS 8. Furnish and Install Traffic Signal Loops EA 32 9. Pothole * EA 10 10. Construct PCC Curb Ramp SF 1800 Project No.: 08-5021, subtotal .............. ~J J r'ti ~ ~ ~Si~ _~ r $ X9(7.00 $~_~UU . ll~ $ oc~. DDo $ 3, aoo. ~v $ ~o•~o $ ~Z~~zo.oo $ t ~G, l~-lG.vrj $ X30, oov. a~ $ ~3a, or~a. ~ $ Ictw~~~.OvP$ ~~-~3~~.G~~ $ t~iU.UO $ (r~0$O.0'b $ on.cN $ 3 DW. ~D $ 10 • b0 $ 1 , D o. Qb TO BE INCLUDED IN BID PACKAGE BP 1 of 34 CITY OF SANTA ANA ' PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST . PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT N0.08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL continued... Item # Bid Item Unit Quantity Unit Price Amount Project # 08-5022 11. Traffic Signal Installation on Harbor Blvd & Kent Ave 12. Signing and Striping 13. Furnish and Install Traffic Signal Loops 14. Pothole 15. Construct PCC Curb Ramp LS LS~ ~ i !-~ ~g~ OCR), (;~7~ , ~ I y 3, ~ u~~ . i~b EA 10 $ 3aa<W $ 3,oao. cn SF 1500 $ { b . b 0 $ I S,~l Ov. ~ Project No: 08-5022, subtotal .................... $ l °1 ~;_ ~~- ~ - U~ Proiect # 08-5023 16. Traffic Signal Modification on Santa Ana LS LS $12`~~ ~~• ~ $ 625 cT~V. W Blvd & Flower St 17. Signing and Striping LS LS $ (~ 0 ~-~~ ~~ $ E ~ ~t L ~ • 18. Furnish and Install Traffic Signal Loops EA 43 $ j Q. dD $ ~'i I ~ 0. llD 19. Pothole * EA 10 $ ~uU . U~D $ 3,oa0. ~ 20. Construct PCC Curb Ramp SF 1200 $ l b . 6 0 $ t 2,'7 2a. U-p Project No: 08-5023, subtotal .................. $ I y~ , ~ SU. l_?~ Projects 08-5017, 08-2021, 08-5022 & 08-5023 Grand Total Bid---_---- $ ~~ ~ , `> / ~ ~ ~ -~ *Note: The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the " 25%" limit as stated in Section 3-2 of the Standard Specifications. The actual amount for this item will be dictated by the actual time and material used, and the Agency reserves the right to increase or decrease the quantity of this item accordingly. • TO BE INCLUDED IN BID PACKAGE BP 2 of 34 . • CITY OF SANTA ANA PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST • PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL & CONTRACT AGREEMENT BIDDER PROJECT NO. 08-5017 Traffic Signal Installation Firm LINCOLN PACIFlC BUfLDERS, INC On Willits St & Sullivan St PROJECT NO. 08-5021 Traffic Signal Installation Address ~`~ { i i `+ `` ~` `-`~ ' . On Raitt St & Glenwood Pl .. ` ' ~ PROJECT NO. 08-5022 ~,;-~t,:i~,.J s;~ ~~, ~~ ~ ; -p,~,tN Traffic Signal Installation On Harbor Blvd & Kent Ave Phone(s) (~~1.,~:= } ~( ~- ~:; -~~~7 f ~ ~~ Bidder PROJECT NO. 08-5023 ~ . . Traffic Signal Modification Signature-. .. -~ .,-I ,,,~. On Santa Ana Blvd & Flower St '~ °~ ° '" ``-'' • 4 _ ._-- C TO BE INCLUDED IN BID PACKAGE BP 3 of 34 • CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WIL,LITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT LIST OF SUB-CONTRACTORS Section 4100 et. seq. of the Public Contract Code requires listing of all subcontractors with the bid for all subcontract work exceeding the following amount: - Streets, highways including bridge projects;'/2% of the bid or $10,000, whichever is greater - Buildings, parks, or other projects: '/z% of the bid C, BIDDER proposes to subcontract certain portions of the work to the firms listed below: r NAME r~ ~r T 1Nd I~-1~ ~1~L LOCATION (/V 1 L VDU M ~ 1~- C.¢} PHONE `~~ 1 '~ 1S- (o ~o ~ -1 TYPE OF WORK GOnIUQ-t'TL $r~Q~ -DO LOCATION ;' ~•.--~'k-?`~~- E , C,?~ _ PHONE { ~ ! ~~ 1 (~ ~~r; '-F~~ C) TYPE OF WORK SrTYLt !p 1 ~.JG,$~ Sj TYPE OF WORKTI2~IL $ ZOO-UD TYPE OF WORK S 1 ~ Nll'1_ l,~ cnPS NAME C~'iL:~~~a'~~t~ LC~~"~.~; -~ S~~f~'L{Pl~~ NAME on- I t~l(~ NAMEC.r~°I-1 PII~-N 1 ~ ~P~D~ SS ~0/J Rt- CN6/n1~~d~"" ~~, / - LOCATION S0 . E (,. M Q~J`Tt: , ~ LOCATION PHONE ((o2b~ ~f5 2 - $ !o s ~ PHONE TYPE OF WORK'Dt tSC'f10~'rR.$ ZOT!!ti TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK NAME ~ ~'~ g ~ 1 ~' L~ { 0 /~ >~1_. ~ 012) IJ(rINAME - LOCATION GO 0 LOCATION PHONE (~S 1 Z~ $-q~i (oZ PHONE NAME LOCATION PHONE LOCATION PHONE (~ ~-t'-r ,"~~YPE OF WORK NAME LOCATION PHONE TYPE OF WORK $ TYPE OF WORK $ UNOOLN PAClFlC BUIU~i3. MIC :7 Name of Firm Submitting Bid BP 4 of 34 TO BE INCLUDED IN BID PACKAGE • CITY OF SANTA ANA ' PROJECT NO. 08-501.7: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLNAN ST • PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL & CONTRACT AGREEMENT BIDDER'S STATEMENT BIDDER understands and agrees that this written proposal (or any part thereof specifically designated and accepted by the City of Santa Ana, hereinafter AGENCY) shall constitute the entire agreement between BIDDER and the AGENCY only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Public Works Agency Executive Director or his duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to BIDDER or deposited with the United States Postal Service properly addressed to the BIDDER with the correct postage affixed thereto. BIDDER further agrees that upon delivery (as defined above) of the accepted agreement he/she will furnish AGENCY all required bonds and certificate of liability insurance within ten (10) days (excluding Saturdays, Sundays and AGENCY'S legal holidays), or the funds, check, draft, or BIDDERS bond substituted in lieu thereof accompanying this proposal shall become the property of the AGENCY and shall be considered as payment of damages due to the delay and other causes suffered by AGENCY because of the failure to • furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered is difficult to ascertain; otherwise said funds, check, drafts, or BIDDER'S bond substituted in lieu thereof shall be returned to the undersigned. BIDDER understands that a bid is required for the entire work, that 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. All terms contained in the Specifications, the Certification of Non-Discrimination by Contractors, and the Workers' Compensation Insurance Certificate are to be incorporated by reference into this Agreement and are made specifically as part of this bid. /" Name of Firm LINCOW PACIFIC =r-r Signature of Bi Title ~- (if an individual, so state) • U N cA~I c~t~rJ C~ TO BE INCLUDED IN BID PACKAGE BP 5 of 34 ~J • CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT continued (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.) LINOOIN PACIFlC BUILDERS, iNC LiNtot.~1 c,H~N~,~ yoH tJ W otJ C-t , ~X~ e. V. P ML~fZ L_1N~i~ iJG~l.I,~E~ ,SEC. Awarded to(~ ~ ~ ~ ,~ ~ i ,r /~{ e4' : , ~ ,,.,.~ ~ ~~ ,Ci ~., , on the basis of lowest responsible an responsive bidder in the amount of ~ ~ -' ~-/ .~ ACTION OF COUNCIL: Date ~ o ' /. ~..`~ 20 ~'(~' ATTEST: ~- ~~ ~~ ~Y t~-~ r-~; ~ ~ . CLERK OF THE COUNCIL APPROVED AS TO FORM: ACCEPTED FOR THE CITY OF SANTA ANA: -. r--- C ' ATTORNEY EXECUTIVE DIIZ C OR PUBLIC WORKS AGENCY • BP6of34 TO BE INCLUDED IN BID PACKAGE • CITY OF SANTA ANA PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder v~-N PACIRC BUILDERS. INC proposed subcontractor ,hereby certifies that he has ~, has not ,participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. • Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt. ) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. r~ TO BE INCLUDED IN BID PACKAGE BP 7 of 34 CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT CERTIFICATION OF NONDISCRIMINATION BY CONTRACTOR The undersigned contractor or corporate officer, during the performance of this contract, certifies as follows: 1. The Contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The Contractor shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. • 3. The Contractor shall send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Contractor shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Contractor shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures ,authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. • TO BE INCLUDED IN BID PACKAGE BP8of34 • • CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021.: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT CERTIFICATION OF NONDISCRIMINATION BY CONTRACTOR (continued) 7. The Contractor shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request that the United States enter into such litigation to protect the interests of the United States. 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, No discrimination shall be made in the employment of persons upon public works because of race, religious . creed, color, national origin, ancestry, 'cal handicaps, mental condition, marital status, or sex of such persons, except as provided in Sectio 142 ,and any contractor of public works violating this Section is subject to all the penal`tie~pos~ a vi ation of the Chapter. Signed Title ~`~ ~ LI N ~.oLaJ G(-t.[~rJ , G~ Firm LINCOLN PACIFIC BUILDERS, INC Date a2.2~{-• I o • TO BE INCLUDED IN BID PACKAGE BP 9 of 34 CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT WORKERS' COMPENSATION INSURANCE CERTIFICATION As required by California Labor Code Section 1860 and 1861, the Contractor certifies as follows: I am aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of the Code, and I will comply with such provisions before commencing the performance of the work of this contract. If I, as the Contractor, now or at any time during the course of this agreement, qualify as an employer under California Labor Code Section 3300, unless the hired employee(s) is (are) persons excluded by said Labor Code, I shall furnish the City of Santa A ith an insurance certificate from my workers' compensation insurance carrier certifying that I carry uch nsurance and that the policy shall not be canceled nor the coverage reduced excepty~ c thirt~.~30 ay prior written notice to the City of Santa Ana. • Signed ~/ ""~'" Title L~N~-~-tJ c=N1~1 ,~ Firm LINCOLN PACIFlC BUILDERS, WC Date 02.24-~ ~~ TO BE INCLUDED IN BID PACKAGE BP 10 of 34 CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WII.LITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT REFERENCES The following are the names, addresses, and telephone numbers for three public agencies for which BIDDER has performed similar work within the past two years. GTK o~ PA.S~.n~NA ~ loo tJ~ UAR[=tom AVE ;~~~DEri~ _c3°s `~' 11 O°l Name and Address of Owner. t3o~ C-~A~nNE-~2 ,(loz(~~ '~ ?44- 46'3 Name and Telephone Number of person familiar with project. `~ / o / 3, ooh STieEEr GI4~ ~ T/L~F~res~cN~-G. Contract Amount Type of Work 2• C%!ZY oj- ~,~EtJDAI.E ,~ 633 E• c3RoaDwpy , G,t.~Jva~E , Gt 9/2p6 Name and Address of owner. Aw~wr~ s,moN~aa , ta~a) s~-s- 3a~-s Name and Telephone Number of person familiar with project. • ~ ~?.C) ~ O c7~ .STi~7 c,/G HT ~ ?RgF~F~c S~4•val.- °~ / o Contract Amount Type of Work Date Completed CiT`1 oF" S~-tTt~i C,~-rar 8~5o cA-l-tFoR.~liPr ~JF.. So~.tTr-~ ca+T~ , c~ Ro28o Name and Address of owner. MAI-lMo~dD AtJ Jo M 5N o,AA (323 ~ 5 b 3 -Q s ~ ~ Name and Telephone Number of person familiar with project. ~ Z~S ooJ Contract Amount • STET u~,Hr Type of Work ~~loq Date Completed y3 f to 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. _ _ PI~~tS ~ SCE AST AGH~ TO BE INCLUDED IN BID PACKAGE BP 11 of 34 Bid Bond, Payment Bond, and Performance Bond Surety: Liberty Agency Underwriters Attn: Dirk DeGraw 525 B Street, 12t" Floor San Diego, CA 92101 (619)744-6156 Broker: The Bond Exchange Attn: Yung Mullick 24800 Chrisanta Drive, Suite 160 Mission Viejo, CA 92691 (949) 461-7002 Insurance Surety for General Liability Insurance: Surety for Commercial Auto Insurance: Surety for Excess Umbrella Liability Surety for Inland Marine: Liberty Surplus Insurance Golden Eagle Insurance National Union Fire One Beacon Insurance Broker: Hamilton Brewart Insurance Agency Attn: Anthony Moreno 1282 W. Arrow Highway Upland, CA 91785 (909) 981-5210 Worker's Compensation Insurance Surety: Employer's Direct 30301 Agoura Road, Suite 100 Agoura Hills, CA 91301 (818) 575-8500 CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT REGARDING APPRENTICESHIP REQUIREMENTS The undersigned Bidder is familiar with the requirements of Section 1777.5 of the State Labor Code regarding employment of apprentices, and understands that contractors on contracts exceeding $30,000 or 20 working days shall: 1. Apply to the joint apprenticeship committee administering the apprenticeship standards of the craft or trade in the area of the site of the public work for a certificate approving the contractor under the apprenticeship standards for the employment and training of apprentices in the area or industry affected. 2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards. 3. Contribute to the fund or funds in each craft or trade in which he employs journeymen or apprentices on the public work, in the same amount on the same basis and in the same manner as the other contractors, except contractors not signat y to e trust agreement shall pay a like amount to the California • Apprenticeship Council. /1 ~/A/ /2- Signed ~- ~ ~" ~" v ~ ` - Title '~_~ LlNcou~l Gf-(~,G~v Firm LINCOW PACIFlC BUILDERS, INC Date ~2 • ?~-• l~ .7 TO BE INCLUDED IN BID PACKAGE BP 12 of 34 CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT NON-COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid • price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion ffidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also consti to sjignature of this Non-collusion Affidavit. Bidders are cautioned that making a false cercationi~a J~ject the certifier to criminal prosecution. Signed ~~~~t~-'~ v ~ G"''---- Subscribed alxLs~f o~~.~~'~~'1 day of _ Signed to before me this ~~ r G?t li (,~i~ ~ - Notary Public Notary Seal: ~~wr~w ROSIE CUELLAR Commission #~ 1764777 Motary Public -California Los Angeles County ~ M Comm. Ez fires Aug 30.2011 • TO BE INCLUDED IN BID PACKAGE BP 13 of 34 CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT REGARDING "ANTI-KICKBACK" REQUIREMENTS The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti-Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, 3). This act provides that each contractor or subcontractor shall be prohibited from inducing, by any a s, any person employed in the construction or repair of public work, to give up any part of t~e,.gomp~ji o which he/she is otherwise entitled. Signed _ ~-'~- J'" ` v 1 Title ~ ~ll~~~ ~'~~ , C~ Firrn. LINCOLN PACIFIC BUILDERS, INC Date t~2 •?~I-• I o r1 U TO BE INCLUDED IN BID PACKAGE BP 14 of 34 • • CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT CONTRACTOR'S LICENSING STATEMENT The undersigned contractor, or corporate officer, declares under penalty of perjury that the following is true and correct. Contractor's Name: UNCOUV PACIFlC BUIU)ERS, INC Business Address: !.x-50 ( (~~TrC-~Jp~I~ ST. ~ B~LD4-11N ~'pt2K, C.,~, q ~-Io6 Telephone: ~ (0 2 (o) q fo 0 - 7~ 3 ~ State Contractor's License No. and Class: SLS~"~o • Expiration Date Signed: Title: (~1c.ILOu.I c-H~n1, c~ • 0(~.3o.la BP 15 of 34 TO BE INCLUDED IN BID PACKAGE • a CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLTI'S ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT FEDERAL REQUIREMENTS FOR FEDERAL-AID CONSTRUCTION PROJECTS • • GENVERAI, -The woik Fein proposed will be lirrarrcecl in whole or in pmt with Feda-al fiords, and dreretore all of the statutes, Hiles, arcl -L~grilations promulgated by the F~eder-al Goverrunent and a)~plic~ble to wait finarrt~cl in whole or in pmt wtlh Federal funds wiIl apply w such wvdc. The "I2egrmacl Carhacx ProviSiais, Feder~il- Aid Cor~strr~,tiorr Cash-acts, `Y'nnn FHWA 1273. are included in this Section 14. Whenever in said rearmed cont<acx provisions refererces me rrrade to "SHA contracting offiCCa", SHA dent engirreet", or `authori~d ~rtabve of the SHA', such references shall be ax~hued to mean "Drgirre~" as defined in Section 1-1.18 of the Starrlard Specificatiatis. PERFORMAN(.~ OF PREVIOUS C'ONTRACT' - In addition to the provisions in Section II. ` 1Vordisaulvrtialion," and Section VII, "Subletting or Assigning the Carhact," of the n~qurtecl mnhact pmvisiorrs, the Carhagor sha0 carPly with the following The bidder shall execrrte the CERTIFICATION WITH REGARD TO THE PERFORMANCE OF PREVIOUS CONTRACTS OR SUBCONTRACTS SUBJECT 'PO THE EQUAL OPPORT[JNIIY CLAUSE AND THE FIL.INNG OF REQUIRFA REPORTS located in the proposal No request for subletting or assigning any portion of the ccxVract in excess of $10(IQO wr1[ be caged under the provisions of Section VII of the requQad a»>tixt provisions Curless such n;quest is acaxr~uried by the CERTIFICATION refeneci to above, exeecrted by the piB~oeecl srrboartractor. NON~OI.LUSION PROVISIONS -The provisions in this section are applicable to all a Hrnacts excx~r[ axrh-acts forF~ederal Aid Secondmy projects. Title 23, United Shales Code, Sectiar 112, regrmes as a cardition preoedart to approval by the Federal Higlrway Administrator of the mrrtrxxt fa tins wuk that each bidder file a swrxn statement executed by, or an behalf of, the persar. fimr, association, or capcn-ation to whom such conh-acrt is to be awarded, a~tifying that such person, furry, association, or eorporatiar has rrot, either dQecdy or in-drtecily, entered into any agreement, pmticipated in any collusion or ottrc~vvise taken any acticxr in restraint of free con~etitive bidding in caurection with die submitted bid. A fomr to rrra}ce the norr-collu9on affidavit staterrent nryuited by Section 112 as a cenificatiar under penalty of perjwy rather- dean as a sworn statarent as pemtitted by 28, U,SC, Sec.1746, is included in die proposal. PARTICIPATION BY MINORTIY BUSINESS IIVT'ERPRISES IN SUBC7~NTRACTING - Pat 23, Title 49, Code ofFeder-al Regulations supplies to dus F'ederul-aid project Pertinent sections of said Cade are irrcapor-ated in pmt a in its entir~y within ode sections of these special provisiorn. Schedule B - Intinnration for Detarrrining Joint Venture Eligibility. (This form need not be filled in if all joint venture firms are minority owned.) // 1. Name of joint venture ~ 1~, 2. Address of join venture 3. Phone number of joint venture 4. Identify the firms which comprise the ' int venture. (The DBE partner must complete Schedule A) a. Describe the role of the DBE in this joint venture. b. Describe very briefly the experie e and business qualifications of each non-MBE joint venture: 5. Nature of the joint venture's burin ss 6. Provide a copy of the joint venture agreement. 7. What is the claimed percentage DBE ownership? 8. Ownership of joint venture: ('This eed not be filled in if described in the joint venture agreement, provi by question (6). a. Profit and loss sharing b. Capital contributions, including equipment. c. Other applicable ownership interests Athadmrent Eadv'bitA-FRI 8-(17-97 BP 16 of 34 TO BE INCLUDED IN BID PACKAGE • CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT 9. Control of and participation in this contract. Identify byname, race, sex, and "6m~"those individuals (and their titles) who are n~ponsble for day-today management and policy decision malting, including, NameofFum NameofFum but not limited to, those with prime n~po->srbr7ity for. a Financial decisions ~'~,~- Signature Signahue Name Name b. Managerrent decisions, such as: Title Title 1. Estimating Date Date 2. Marketing and sales Date State of 3. Ruing and firing of management County of .7 4. Prurhasing of major items or supplies c. Supervision of field operations Note: If after filing this Schedule B and before the axrrpletion of the joint ventrno's work on the contract covered by this regulation, [hero is any significant change in the infonnation sulmvtted, the joint venture must inform the grantee, either directly or through the prime contractor if the joint venttue is a subcontractor. Affidavit "Itie rnidersigned swear that the foregoing staterrents are cart~ct and include all nrateiial information necessary to identify and explain the terms and operation of our joint ventr>re and the intended participation by each joint venttutx in the wrdertaltirtg Ftutlier•, the uixlersigned covenant and agree to provide to grantee cwrent, complete and actuate inforrriation reganJing acaial joint venture work and die payment therefore and any proposed changes in any of the joint venture atrarmgements and to pewit the audit and examination of the books, imx:ads, and files of the joint ven[rire, by authorized r~xrsentatives of the grantee a' the dal fwiding agency. Any n><~mterial misrt'presentation will he gtnurmds for terminating any contract which may be awarded and for initiating action order F~er-al or State laws cxmncerning false slaterrents." Atha~~art F.arlubiRA-FR2 8-07A7 Cm this day of 19 before Ir>e appeared (name) me personally known, who, being duly sw~om,, did execute the foregoing affidavit and did state that he or she was properly atrttraizecl by (Name of firm) so as his or herfiEe act and deed. Notary ]?ubfic Commission expires [sal Date State of Courmty of On this _ day of 19_, before ine appeared Name) to me personally known, vvho being swan, did execute die foregoing affidavit and did state that he or she was properly authorized by (Name of firm) so as his orha-fiee act and deed. Notary 1'ubfic Conmmission expires [~11 to execute the affidavit and did to execute the affidavit and did TO BE INCLUDED IN BID PACKAGE BP I7 of 34 • LJ CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 DEBARMENT AND SUSPENSION CERTIFICATION The bidder under penalty of perjury, certifies that except as noted below, he/she or any person associated therewith in the capacity of owner, partner, director, officer, manager: is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal agency within past three years; has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. • If there are any exceptions to this certification, insert the exceptions in the following space. N o~ • Exceptions will not necessarily result in denial of award, but will be considered in determining bidders responsibility. For any exception noted above, indicate below to whom it applies, initialing agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. UNCOW PACIFIC ERS, INC Name of Bidder Signature of B' ®c~--- Date 2• . o FED.8-22-88 TO BE INCLUDED IN BID PACKAGE BP 18 of 34 • • Local Agency Bidder UDBE Commitment (Construction Contracts) • C~ AGENCY: Crib D~ SMITPt ,141~IA LOCATION: PROJECT NO 08-5017: TRAFFIC SIGNAL INSTALLATION ON PROJECT DESCRIPTION: T WILLITS ST & SULLIVAN ST -~.F.F I~- SIEil~lf~ ~!~!t"CAtlf~Tio,V Il OTAL CONTRACT AMOUNT: $ !_!G ,!~-. ~J ~ (~ ' l)~ BID DATE: 02.25 •~~ IDDER'S NAME: LINCOLgN PACIFIC BUILflER3• INC ONTRACT UDBE GOAL: 3.8 l ~~~ CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED ert. No. of UDBE ND EXPIRATION ATE AME OF UDBEs (Must be certified on the date bids e opened -include UDBE address nd hone number) DOLLAR AMOUNT UDBE t 5 ~ L of Go L ~.I ~ L o ou . 2d ~ !~ 5 vJ~N c. 6 0-7? g or Local Agency to Complete: l A C Total Claimed $ (3 ~r V W ca gency ontract Number: ederal Aid Project Number: ederal Share: $9.648 Participation --7 f ~ ~/o ontract Award Date: ` ocal Agency certifies that all information is complete and accurate. w `•~ riot Name Signature Date ocal Agency Representative Signatur of Bidder ~~026 ~ ~ C ~~~ ~Z' Z~" ( O (Area Code) Tele hone Number: Date (Area Code) Tel. No. or Caltrans Review: L ~ tJc,o VtJ ~~ Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder -UDBE Commitment (Rec 3/09) uistnbuhon: (I) Copy - hax ~mmed~ately to the Caltrans District Local Assistance Engineer (DLAE) upon award. (2) Copy -Include in award package to Caltrans District Local Assistance (3) Original -Local agency files TO BE INCLUDED IN BID PACKAGE BP 19 of 34 • Local Agency Bidder DBE Information (Construction Contracts) r~ • AGENCY: ~TY ~ SANT~ ANA PROJECT DESCRIPTION: ~TRl~f=tG SICaI~IA OTAL CONTRACT AMOUNT: $ 1 ~~ ~ L9 ~ ~' BID DATE: ~2'2S • ~~ BIDDER'S NAME: LINCOLN PACIFIQ~j(J~(,p LOCATION: L ~' ~ E}~r~ PROJECT NO 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST aNSTAI.t_ATto~ ONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED BE Cert. No. ND EXPIRATION ATE AME OF DBEs (Must be certified on the date bids e opened -include DBE address nd hone number) DOLLAR AMOUNT BE L 1 35S i gut, ooo. n ST b b ~ bb ? or Local Agency to Complete: Total Claimed ~ ~ 35, o 00 . ocal Agency Contract Number: ederal Aid Project Number: ederal Share: _ $7,258 Participation C~ ontract Awazd Date: ` ocal Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. ~L--- riot Name Signature Date Signnature f Bidder ~ ~ ~~ ~2'~• ~ 0 q b a- 773 g ocal Agency Representative (Area Code) Tele hone Number: Date (Area Code) Tel. No. ~~ ~ ~ LO ~A or Caltrans Review: Print Name Signature Caltrans District Local Assistance Engineer Date Person to Contact (Please Type or Print) Local Agency Bidder DBE Information (Re~~ 3/09; U~stnbution: (1) Copy -Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within I S days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in the de-obligation of funds for this project. (2) Copy -Include in awazd package to Caltrans District Local Assistance (3) Original -Local agency files TO BE INCLUDED IN BID PACKAGE BP 20 of 34 Local Agency Bidder UDBE Commitment (Construction Contracts) • .7 AGENCY: ~~ 1 ~~ ~-L~ ANA LOCATION: PROJECT NO 08-502 L TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD PL ROJECT DESCRIPTION: TRA~F' 1 ~- s IUnt$L 1 N.sTAI,LRjio OTAL CONTRACT AMOUNT: $_ ~ ~ ~ I ~~~ ! ' ~~ (~ BID DATE: ~2'2S " ~ ~ BtDDER's NAME: LINCaLN PAf:IF1C Blp1.DER.S, INE' 2 p 0 ONTRACT UDBE GOAL: /' S 1 0 ONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED ert. No. of UDBE AND EXPIRATION ATE AME OF UDBEs (Must be certified on the date bids re opened -include UDBE address nd hone number) OLLAR AMOUNT DBE C ~ 5$ IIJGOL G UoU. 50 L L 706 626 5 ~ ? or Local Agency to Complete: l A Total Claimed ~ ~ 3 G~ (~Q(f, ca gency Contract Number: ederal Aid Project Number: ederal Share: $10.124 Participation _ °~o ontract Award Date: ~ Local Agency certifies that all information is complete and accurate. ~+ (i1/~-- Print Name Signature ocal Agency Representative Date Signatur of Bidder ~ 6~(~~ 02 , ~, ~0 ~ 60 ~~~~ (Area Code) Tele hone Number: Date (Area Code) Tel. No. or Caltrans Review: (.(N~-o1..1J cE-P~4n~ Print Name Signature Caltrans District Local Assistance Engineer Date Person to Contact (Please Type or FrinU Local Agency Bidder -UDBE Cornrttitmen[ (Rev 3/09 u~smounon: t t 1 ropy - rax ~mmeotatery to the Cattrans D~stnct Local Assistance Engineer (DLAE) upon award. (2) Copy - Include in award package to Caltrans District Local Assistance • (3) Original -Local agency 61es TO BE INCLUDED IN BID PACKAGE BP 21 of 34 Local Agency Bidder DBE Information (Construction Contracts) • .7 GENCY: CiITY D~ 6ANTPr AIJA LOCATION: PROJECT N008-5021: TRAFFIC SIGNAL INSTALLTION ON RAITT ST & GLENWOOD PL PROJECTDESCR[PTION: TR~~1L S1bNOrl.. ItJsTALL.A'fT~t~l OTAL CONTRACT AMOUNT: $ 1 ~ 7 i ~Cj ~ ~ l~ BID DATE: O2~~5' ~ ~ BIDDER'S NAME: tJNCOLN PACIRC BUILDERS ~C ONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED BE Cert. No. D EXPIRATION ATE AME OF DBEs (Must be certified on the date bids reopened -include DBE address nd hone number) OLLAR AMOUNT BE (~ GAL o OOU. a l t 'f two s L 2b ~tb0-7 3 or Local Agency to Complete: l A C N b Total Claimed ~ 13 U~ Q ~ . oca gency ontract um er: ederal Aid Project Number: Federal Share: $7.616 Participation 3 % ontract Award Date: cal Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. ~_ riot Name Signature Date Signature fBidder ~6aZ~O, p QZ -2'~ ~~ -l b C'~73 6 ocal Agency Representative (Area Code) Tele hone Number: Date (Area Code) Tel. No. ~ _ 1 ~ n ~ I ~ ~~ `- or Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Acency Bidder DBE Information (Rev i/09) u~smounon: t i ~ copy - rax or scan a copy to the Caltrans llistnct Local Assistance Engineer (DEAF} within I S days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in the de-obligation of funds for this project. (2) Copy -Include in award package to Caltrans District Local Assistance (3) Original -Local agency files BP 22 of 34 TO BE INCLUDED IN BID PACKAGE • Local Agency Bidder UDBE Commitment (Construction Contracts) • • AGENCY: GI T~ D ~ SA(~ITA AJJQ LOCATION: PROJECT NO 08-5022: TRAFFIC SIGNAL INSTALLATIN ON HARBOR B VD & KENT AVE PROJECT DESCRIPTION: ~~l C S( C71S1~ 1_ t N C Tfk(.L~TiO ~ j rf OTAL CONTRACT AMOUNT: $ ~ ~ ~ ~ ~ ~ ~ ~~•~ ID DATE: ~2 • ZS (l7 BIDDER'S NAME: LINCOLN PACIFlC BUILDERS, INC pp 0 ONTRACT UDBE GOAL: 3• S p o ONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED ert. No. of UDBE ND EXPIRATION ATE AME OF UDBEs (Must be certified on the date bids re opened -include UDBE address d hone number) OLLAR AMOUNT UDBE 1 C'T (~ l.V L OOu . D 1 L. 4 S . ~7 or Local Agency to Complete: l A C N b Total Claimed ~ ~ ~~ d 0 V, oca gency ontract um er: Federal Aid Project Number: Federal Share: _ _$7.252 Participation ~ ~ ~/p ontract Award Date: ` Local Agency certifies that all information is complete and accurate. ~- rat Name Signature Date ocal Agency Representative Signat e of Bidder / b~ 1 ` p J V Z ~~ ~~ 1 b~ "113 (Area Code) Tele hone Number: Date (Area Code) Tel. No. or Caltrans Review: (,r((Jc.o(~1 Gt-IArJ Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Aoeocy Bidder - UDBE Conunitment (A,ev 3/09 utsmbunon: t t) copy - rax ~mmed~ately to the Caltrans Distract Local Assistance Engineer (DLAE} upon award. • (2) Copy -Include in award package to Caltrans District Local Assistance (3) Original -Local agency files TO BE INCLUDED IN BID PACKAGE BP 23 of 34 • Local Agency Bidder DBE Information (Construction Contracts) • AGENCY: G~ T~ d~ SMITPt -1~f~(A LOCATION: PROJECT DESCRIPTION: -TR~'~l L ~~j~,AL_ l S" OTAL CONTRACT AMOUNT: $_ ~ ~~~ ~ ~ G) ~° C"~ BID DATE: ~Z'~i.~" ( ~ IDDER's NAME: LINCOW PACIFlC BUILDERS, INC PROJECT NO 08-5022: TRAFFIC SIGNAL INSTALLATIN ON HARBOR BLVD & KENT AVE ['AL.LA'[' 10 ONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED BE Cert. No. AND EXPIRATION ATE NAME OF DBEs (Must be certified on [he date bids re opened -include DBE address nd hone number) OLLAR AMOUNT DBE L ~ L 6 r7C1.4a S 2(0 or Local Agency to Complete: cal Agency Contract Number: ederal Aid Project Number: Federal Shaze: $5,456 Total Claimed Participation ~ ' TSB OQIJ • 'ice (~ J• ontract Award Date: ocal Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. w Print Name Signature Date Signature f Bidder b2 ~~• lD ((02(0 Qto ~-?"13 8 ca] Agency Representative (Area Code) Tele hone Number: Date 1 (Area Code) Tel. No. ~ J LaNco~1~ -HA- or Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder DBE Information (Rev 3/OS? Distribution: (I) Copy -Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within I S days of contract execution. Failure to send a copy to the DLAE within I S days of contract execution may result in the de-obligation of funds for this project. (2) Copy -Include in award package to Caltrans District Local Assistance (3) Original -Local agency files TO BE INCLUDED IN BID PACKAGE BP 24 of 34 • • • • Local Agency Bidder ~~ UDBE Commitment (Construction Contracts) AGENCY: CI T~ d ~ `~ T~1 L~IJA LOCATION: PROJECT NO 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BLVD & FLOWER ST PROJECTDESCRIPT[ON: ~R1~~FIL SI~~IAI. IIJSTALLA'rt f_ c% ~;1, IJ~ OTAL CONTRACT AMOUNT: $ ~ 'T BID DATE: DZ' ~ ' f ~ IDDER's NAME: L-~NCOLN PA/CIFlC BUILDERS, INC ONTRACT UDBE GOAL: 3• ~CI OJ ONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED ert. No. of UDBE D EXPII2ATION ATE AME OF UDBEs (Must be certified on the date bids e opened -include UDBE address nd hone number) OLLAR AMOUNT UDBE l S (,0 OW . 14 L tT 1.0 or Local Agency to Complete: Total Claimed ~ ~ 25~0(/U. ocal Agency Contract Number: ederal Aid Project Number: ederal Share: $5.994 Participation ~ '~~ ontract Awazd Date: ocal Agency certifies that all information is complete and accurate. ~.~---_- Print Name Signature Local Agency Representative Date Signatu a of Bidder ~Z •2~. I'p (626, ~' ~ ~, ~'~~ O O (Area Code) Tele hone Number: Date (Area Code) Tel. No. or Caltrans Review: L(N ~ t-!~ G 4-{,q~ Print Name Signature Caltrans District Local Assistance Engineer Date Person to Contact (Please Type or Print) Local Agency Bidder -UDBE Commitment (Rev 3/Ov) Distribution: (I) Copy -Fax immediately to the Caltrans District Local Assistance Engineer (DLAE) upon award. (2) Copy -Include in award package to Caltrans District Local Assistance (3) Original -Local agency files BP 25 of 34 TO BE INCLUDED IN BID PACKAGE • Local Agency Bidder DBE Information (Construction Contracts) • • AGENCY: r/-T~ O~ SAfJT~ ~tfSl A LOCATION: PROJF,CT NO 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA AN BLVD & FLOWER ST PROJECT DESCRIPTION: T2AFF 1 L SL UN ~L, 1 LJ STALL,AT~'J OTAL CONTRACT AMOUNT: $ ~ ~ ~ ~C ' ID DATE: ~Z'~>' (~ BIDDER'S NAME: LINCOLN PACIFlC BUILDERS, INC ONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED BE Cert. No. ND EXPIRATION ATE NAME OF DBEs (Must be certified on the date bids are opened -include DBE address nd hone num er) DOLLAR AMOUNT DBE Ll DvJ nl Ob 0 ~~ or Local Agency to Complete: Total Claimed ~ ~ ZS~ QV Q , cal Agency Contract Number: Federal Aid Project Number: Federal Shaze: $4,509 Participation f) Contract Award Date: Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. ~__ Print Name Signature Date Signatu of Bidder Ce ~ 1 t72 Z~ LO G~bO'"J,138 ocal Agency Representative (Area Code) Tele hone Number: Date (Area Code) Tel. No. ~ I.IN~°u~ ~~` or Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print} Local Agency Bidder DBE Information (I~eo 3/09) u~sMbuuon: (1) Copy - h'ax or scan a copy to the Caltrans District Local Assistance Engineer (DEAF) within 15 days of contract execution. Failure to send a copy to the DLAE within I S days of contract execution may result in the de-obligation of funds for this project. (2) Copy -Include in award package to Caltrans District Local Assistance (3) Original -Local agency files TO BE INCLUDED IN BID PACKAGE BP 26 of 34 CITY OF SANTA ANA PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST • PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT NON-LOBBYING CERTIFICATION FOR FEDERAL AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influence or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriate funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the • undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective parti ~ nt also agrees by submitting his or her bid or proposal that he or she shall require that the language f thi certification be included in all lower tier subcontracts, which exceed $100,000 anc~~ia~ all sl~ -re ipients shall certify and disclose accordingly. Bidder's gnature LINCOLN PACIFIC SUILDER3, INC Firm ~2 • yy-. t,~ Date • Standard Form LLL may be obtained from Caltrans and FHWA offices. • TO BE INCLUDED IN BID PACKAGE BP 27 of 34 • .] CITY OF SANTA ANA PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose IobbyinQ activities pursuant to 31 U.S.C. 1352 NINE. 1. Type of Federal Action 2. Status of Federal Action 3. Report Type: ^ a. Contract ^ a. Bid/offer/application ^ a. initial b. Grant b. initial award h. material change c. Corporate Agreement c, post-award d. Ban For Material Change only: e. Loan Guarantee Year quarter f. Loan Insurance date of last re rt _ 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: ^ Prime ^ Subwardee Tier , If krwwn Con essional District, if known Con essional District, i known 6. Federal Department/Agency: 7. Federal Program Name/Description CFDA Number, If a licable 8. Federal Action Number, if known 9. Award Amount, if known 10. a. Name and Address of Lobbying Entity b. Individual Performing Services (including crldress~d~fer~tifrorrcNo. (.:frelit~a~ ~StrrAr~ f~M/) ICIZ) (lastncm~ firstrunn~ MI) (attach Continuation Sheet(s) if necess ) 11. Amount of Payment (check all that apply): 13. Type of Payment (check all that apply) $ ^ Actual ^ Planned ^ a. retainer ^ b. one-time fee 12. Form of Payment (check all that apply): ^ c. commission ^ a. cash ^ d. contingent fee ^ b. in-kind; specify: nature ^ e. deferred value ^ f. other, s i 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment indicated in item 11: (attach. Continuation Sheet(s) i necessary) 15. Continuation Sheet(s) attached: ^ Yes ^ No 16. Irilixrr>allon n~quesled duough this form is atlrttoti~d by Title 31 USC Section 1352.'~hisdisclostneoflobbyingactivitiesisamaterialrelxesartaaonoffactupon Signature which reliance vtas plaoad hythe tier-above when die harisaclion was made orc~ttered into. 'I}usdisclostQeist~urtudputsuarttto3l U.S.C.1352. 'll»sinfonnationwtll be Pr-nt Name reponad to the Congress semi-annuaIly and will be available forpublic inslxcfioa Any person who fails rv file the tequued disclosure shall be subject to ac7vil penalty of Title rtot less than $10,000 and rrctt mere than $100,000 foreach such failure. Tele hone No. Date Federal Use Only: Authorized for Local Reproduction Standa~ Form - LLL BP 28 of 34 TO BE INCLUDED IN BID PACKAGE CITY OF SANTA ANA • PROJECT NO. OS-5017: TRAFFIC SIGNAL INSTALLATION ON WIL,LITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT REGARDING REQUIRED FEDERAL CONTRACT PROVISIONS (Form FHW A-1273) The undersigned, is submitting this proposal or performing by contract the work required by these bid documents, agrees to comply with the requir d ederal Contract Provision (Form FHWA-1273) as shown in the appendix of the special prQyi~ions ~t pr,6ject. Signed ~~~ ~- Title LINlALi~ G~,t~,~, CC-o Firm uNCO~-N PACIFlC BUILDERS, tNC Date jS 2. • 2-10 C~ • TO BE INCLUDED IN BID PACKAGE BP 29 of 34 C~ CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WII,LITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT CERTIFICATION FOR FEDERAL AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief; that: (l) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal Agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, grant, loan, or cooperative agreement. (2) If any funds other Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL*, "Disclosure of Lobbying Activities" in accordance with its instructions. • This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 3l, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective parti tpa t also agrees by submitting his or her proposal that he or she shall require that the language of this certification be ' cluded in all lower tier subcontracts, which exceed $100,000 and that all such sub- recipients 11 certi n ~ c se accordingly. a- Bidder S~ nature LINCOLN PACIFlC BUIU?ERS, INC Firm Date %Standard Form LLL may be obtained from Caltrans or FHWA offices. • TO BE INCLUDED IN BID PACKAGE BP 30 of 34 • CITY OF SANTA ANA PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST • PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT BIDDER'S CERTIFICATE OF COMPLIANCE REGARDING "BUY AMERICA" REQUIREMENTS FOR STEEL OR MANUFACTURED PRODUCTS The undersigned, is submitting this proposal for documents, certify to comply with the "Buy Transportation Assistance Act of I9i~and a~h~ orming by contract the work required by these bid rica" requirements of Section 165 of the Surface the special provisions of this project. Signed ~~ ~~ Title 1~11J LO(~ ~~A~~I , GC-~ Firm LINCOLN PACIFlC BUILDERS, INC Date p 2- 2~ f• c u .7 • TO BE INCLUDED IN BID PACKAGE BP 31 of 34 • CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ ,has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bids are cautioned that making a false certification may subject the certifier to criminal prosecution. Signed Title ~1 U N ~otjJ C-hA-N , GE° Firm LINCOLN PACIFIC BUILDERS, INC Date 02•Zti-~ l v TO BE INCLUDED IN BID PACKAGE BP 32 of 34 • CITY OF SANTA ANA • PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLNAN ST • PROJECT NO. 08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT PUBLIC CONTRACT CODE SECTION 10162 OUESTIONAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or/a safety regulation? Yes No V If the answer is yes, explain the circumstances in the following space. • TO BE IIVCLUDED IN BID PACKAGE BP 33 of 34 • • • CITY OF SANTA ANA PROJECT NO. 08-5017: TRAFFIC SIGNAL INSTALLATION ON WILLITS ST & SULLIVAN ST • PROJECT N0.08-5021: TRAFFIC SIGNAL INSTALLATION ON RAITT ST & GLENWOOD AVE PROJECT NO. 08-5022: TRAFFIC SIGNAL INSTALLATION ON HARBOR BLVD & KENT AVE PROJECT NO. 08-5023: TRAFFIC SIGNAL MODIFICATION ON SANTA ANA BL & FLOWER ST PROPOSAL AND CONTRACT AGREEMENT PUBLIC CONTRACT CODE SECTION 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal • prosecution. Signed Title Firm Date r~ u~,~uJ u-I'~-~J, ~~ LINCOW PACIFlC BUILDERS, INC a2.24~~ J TO BE INCLUDED IN BID PACKAGE BP 34 of 34 THE AM~ICAN INSTITUTE OF AR`IITECTS \~~ 111 ~`~ ~/1' .~~~~--- AIA Document A310 Bid Bond BOND # NIA KNOW ALL MEN BY THESE PRESENTS, that we LINCOLN PACIFIC BUILDERS, INC. 4501 LITTLEJOHN STREET BALDWIN PARK, CA 91706 (Here insert full name ,and address or legal title of Contractor) as Principal, hereinafter called the Principal, and THE OHIO CASUALTY INSURANCE COMPANY 9920 PACIFIC HEIGHTS BLVD. SUITE 425 SAN DIEGO, CA 92121 (Here insert full name ,and address or legal title of Surety) a corporation duly organized under the laws of the State of OHIO as Surety, hereinafter called the Surety, are held and firmly bound unto CITY OF SANTA ANA 20 CIVIC CENTER PLAZA, M-43 SANTA ANA, CA 92702 (Here insert full name ,and address or legal title of Owner) as Obligee, hereinafter called the Obligee, in the sum of TEN AND 00/100 PERCENT of attached bid ------------------------------------------ Dollars ($ 10 ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for TRAFFIC SIGNAL AT WILLITS AT SULLIVAN, RAITT AT GLENWOOD, HARBOR AT KENT, SANTA ANA AT FLOWER; INVITATION NO. 08-5017, 21, 22, 23 (Here insert full name, address and description of project) NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 19th day of February 2010 (Seal) (Witness) (Seal) (Witness) (Title) JENNIFER C. GIB EY, Attorney-in-Fact AIA DOCUMENT A310 BID BOND AIA ® FEBRUARY 1970 ED THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W. WASHINGTON, D.C. 20006 • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ~.~.~c~'~cr~ _ - - „c,R~r,~~vo~ ; ~o4.r.- ~~~~~r~~~r- - ~S`~cS~~S`.~^- =' ~","~C~.c=~h - :c~f~K~~- -'^"^,C~ State of California Count-y of ~U S ~~L ~ ~~ ~ ~ On -t{.~j..~L-`~ Date ~~ e before me, ~ ~~ t--.-1 ~ 1~-~` personally appeared ~~ r,.~l+~ N (t=f who proved to me on the basis of satisfactory evidence to be the person( whose nam s/' subscribed to the within instrument and acknowledged to me that he s+~efthep executed the s me in ~h~rttF11?tr authorized capacity(ie~and that b his ignature~) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. ROSIE CUELLAR Commission #r 1764777 _ -~ Notary Public -California i Z Los Angeles County My Camm. Expires At:g 30, 201 t J 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 and off~ial seal. Signature Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Title or Type of Document: ~ Il,l I° DY l ~ T L' U ~~~~~' ~-~~~ Document Date: ~~V% ~ ~.~~,~' ~ ,~~, +~)~ (~ Number of Pages: ~ !° Signer(s) Other Than Named Above: /~ ~ ~ ~'~' ~~ Capacity(ies) Clair~d by Signer' ~ndi 'dual ^ Corpo Partner - ^ Lir ~^ Attorney in Fact ^ Trustee ^ Guardian or of ^ Other: Title(s): General Signer Is Re~esenting Top of thumb here - ~~ ~: ~'~s ^ Guardian or Conservator Other: Signer Is Representing: Si is Name: Indivi ^ Corporate er -Title(s): ^ Partner - ^ Liml ^ General ^ Attorney in Fact ^ Trustee ©2007 National Notary Association • 9350 De Soto Ave., PO. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotary.org Item #5907 Reorder: Call Toll-Free 1-800-876-6827 J u ACKNOWLEDGMENT State of California County of Orange ) On February 19, 2010 before me, Christine T. Hoang, Notary Public (insert name and title of the officer) personally appeared Jennifer C. Gibonev who proved to me on the basis of satisfactory evidence to be the person() whose name() is/~~; subscribed to the within instrument and acknowledged to me that bte/she/tdxsztjc executed the same in i~her/#~~ authorized capacity(i~j, and that by Ptl~her/tom signature(s) on the instrument the person(), or the entity upon behalf of which the person() acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. .~ . WITNESS my hand and official seal. N ~'~sw10z>N~~. CFiftISTiNE T. ~iOAfdG co~lw. # lszrsas ~ =m R NOTARY PU~IIGCAUFORNIA ~ ~ ~ ~ r 4~.ANGE~ COUNTY °-~ ~~ ~~, ~~7~5 vow 7~;5~ c~~ Signature ~ (Seal) ~ THIS POWER OF ATTORNEY IS NOT V~D UNLESS IT IS PRINTED ON RED BACK~ND. CERTIFIED COPY OF POWER OF ATTORNEY THE OHIO CASUALTY INSURANCE COMPANY No. 42-378 Know All Men by These Presents: That THE OH10 CASUALTY INSURANCE COMPANY, an Ohio Corporation, pursuant to the authority granted by Article III, Section 9 of the Code of Regulations and By-Laws of said Company, does hereby nominate, constitute and appoint: James W. Moilanen ,Yung T. Mullick, Jennifer C. Giboney, Austin P. Neff or Christine T. Hoang of Mission Viejo, California its true and lawful agent (s) and attorney (s)-in-tact, to make, execute, seal and deliver for and ou its behalf as sw'ety, and as its act and deed any and all BONDS, UNDERTAKINGS, and RECOGNIZANCES, not exceeding in any single instance TWENTY MILLION ($20,000,000.00) Dollars, excluding, however, any bond(s) or undertaking(s) guaranteeing the payment of notes and interest thereon And the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Company, as fully and amply, [o all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its office in Fairfield, Ohio, in their own proper persons. The authority granted hereunder supersedes any previous authority heretofore granted the above named attorney(s)-in-fact. In WITNESS WHEREOF, the undersigned officer of the said The Ohio Casualty Insurance Company has hereunto subscribed his name and affixed the Corporate Seal of the said The Ohio Casualty Insurance Company this 13th day~/o`/f~May, 2009. STATE OF OHlO, COUNTY OF BUTLER Mark E. Schmidt, Assistant Secretary On this 13th day of May, 2009 before the subscriber, a Notary Public of the State of Ohio, in and for the County of Butler, duly cormnissioned and qualified, came Mark E. Schmidt, Assistant Secretary of THE OHIO CASUALTY INSURANCE COMPANY, to me personally known to be the individual and officer described in, and who executed the preceding instrument, and he acknowledged the execution of the same, and being by me duly sworn deposes and says, that he is the officer of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, 1 have hereunto set my hand and affixed my Official Seal at the City of Hamilton, State of Ohio, the day and year first above written. ~'? ,~-~~ t<.*;'vs .a.c~ P"1 . tom' t~ Notary Public in and for County of Butler, State of Ohio My Commission expires August 17, 2013. This power of attorney is granted under and by authority of Article III, Section 9 of the Code of Regulations and By-Laws of The Ohio Casualty Insurance Company, extracts from which read: Article lll, Section 9. Appointment of Attorneys-in-Fact. The Chairman of the Board, the President, any Vice-President, the Secretary or any Assistant Secretary of the corporation shall be and is hereby vested with full power and authority to appoint attorneys-in-tact for the purpose of signing the Warne of the corporation as surety to, and to execute, attach the seal of the corporation to, acknowledge and deliver any and aII bonds, recognizances, stipulations, undertakings or other instruments of suretyship and policies of inswance to be given in favor of any individual, tinn, corporation, partnership, limited liability company or other entity, or the official representative thereof, or to any county or state, or any official board or boards of any county or state, or the United States of America or any agency thereof, or to any other political subdivision thereof This instrument is signed and sealed as authorized by the following resolution adopted by the Boards of Directors of the Companies on October 21, 2004: RESOLVED, That the signature of any otlicer of the Company authorized under Article III, Section 9 of its Code of Regulations and By-laws and the Company seal may be affixed by facsimile to any power of attorney or copy thereof issued on behalf of the Company to make, execute, seal and deliver for and on its behalf as sw'ety any and all bonds, undertakings or other written obligations in the nature thereof; to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment. Such signatures and seal are hereby adopted by the Company as original signatures and seal and shall, with respect to any bond, undertaking or other written obligations in the nature thereof to which it is attached, be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATE I, the undersigned Assistant Secretary of The Ohio Casualty Insurance Company, do hereby certify that the foregoing power of attorney, the referenced By-Laws of the Company and the above resolution of its Board of Directors ar-e true and correct copies and are in full force and effect on this date. IN WITNESS WHEREOF, 1 have hereunto set my hand and the seal of the Company this 19TH day of FEBRUARY, 2010 A.D., ,t , t... ~ ~ Assistant Secretary R 73 N C 'N ~~I N _ ~ ~ O VH ~N d W C O Q. Q M O~ L ~ ~ O ~ a~ N O L O ., .. 4.. Q1 O C ~_~ 73 ~ •- .. l0 d >~ T L ~~ L LV r r T JAN 0 ~ ZQ08 70M D LER -RECORDER I -o~' I dE~k4' MAYOR Miguel A. Pulido MAYOR PRO TEM Carlos Bustamante COUNCILMEMBERS Claudia C. Alvarez P. David Benavides Michele Martinez Vincent F. Sarmiento Sal Tinajero Recorded in Offici• ords, Orange County j°"~ T i ~n Daly, Clerk-R der (J I III~I! Illll llfll VIII VIII VIII I li IILII . Illl 11111 11111 lllllill ~0 F~ ~ JAN 0 ~ 2008 TOM Q SEC B~ C ~F~Y 20088500000411:3gam 01104108 yU 81 Z01 G.00 0.00 0.00 0.00 0-00 O.OU 0.00 0.00 ~s p':~" , .~ ..:_ ~ __I ~~ i ' , ; ~~~ CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M-20) P.O. Box 1988 . Santa Ana, California 92702 (714) 667-2700 • Fax (714) 973-1461 www.santa-ana.org CITY MANAGER David N. Ream CITY ATTORNEY Joseph W. Fletcher CLERK OF THE COUNCIL Patricia E. Healy NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) --Fee-Exemption per-California Government Code Section 6103 TO: COUNTY CLERK/County of Orange FROM: City of Santa Ana P.O. Box 238 Planning & Building Agency Santa Ana, CA 92702 20 Civic Center Plaza Santa Ana, CA 92702 --PROJECT-TITLE: Traffic Signal at Harbor Boulevard and Kent Avenue DATE OF DECISION: 1/04/08 PROJECT NUMBER(S): N/A ER NUMBER: ER 2008-04 PROJECT LOCATION: Citywide CITY: Santa Ana COUNTY: Orange DESCRIPTION OF THE PROJECT: The project will provide a new traffic signal at Harbor Boulevard. and Kent Avenue. The construction will include installing new traffic signal poles, foundations, conduits, signal equipment and minor concrete work on sidewalk.. NAME 8 ADDRESS OF APPLICANT: City of Santa Ana Public Works Agency, 20 Civic Center Plaza, Santa Ana, CA 92701 NAME OF PUBLIC AGENCY APPROVING PROJECT: City of Santa Ana Public Works Agency NAME OF PERSON OR AGENCY CARRYING OUT PROJECT: City of Santa Ana Public Works Agency EXEMPT STATUS: ^ Ministerial (Sec. 15268) ^ Declared Emergency (Sec. 15269 (a) ) ^ Emergency Project (Sec. 15269(a)&(b) ) ^ General Rule (Sec. 15061(b)(3) ) ^ Statutory Exemption: State Code number ® Categorical Exemption: State class and section number:15303, Class 3 REASON(S) WHY PROJECT IS EXEMPT FROM CEQA: Project involves installation of a new accessory structure and related work. CITY CONTACT PERSON: Pedro Guillen TELEPHONE NO: (714) 667-2729 SIGNATURE: , - DATE: _! ' G ~'t ' Q Q _ TITLE: Associate Planner 1~~~ Jp,N 0 y 2008 ~PasrE® JAN 0 4 2008 Kecorr' Official Records, Orange County Tom9~ ~;lerk-Recorder Illillllli!II~IRIlllililllllillllllllllllllllllll!IIIIIIIIII - IIIIIIII NO FEE so B~ z~g8~~00a0511:40am 01f04108 0.00 0.00 0.00 0.00 0.00 O.OD o.oo D.oD TQM pAI,Y~LERI~-RECORDEN ~/ , ' ~%_ OEt~U~~, T~ , CLER RECORDER .-- f BY I DEPUTY MAYOR Miguel A. Pulido MAYOR PRO TEM Carlos Bustamante COUNCILMEMBERS Claudia C. Alvarez P. David Benavides Michele Martinez Vincent F. Sarmiento Sal Tinajero ~ .~.~ ~/ ~ -dL °~ " , .. _,m'; _: CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M-20) P.O. Box 1988 • Santa Ana, California 92702 (714) 667-2700 . Fax (714) 973-1461 www.santa-ana.org CITY MANAGER David N. Ream CITY ATTORNEY Joseph W. Fletcher CLERK OF THE COUNCIL Patricia E. Healy NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) - ----Fee Exemption per-California Government Code Section 6103 TO: COUNTY CLERK/County of Orange FROM: City of Santa Ana P.O. Box 238 Planning & Building Agency Santa Ana, CA 92702 20 Civic Center Plaza Santa Ana, CA 92702 - - -PROJECT TITLE: Traffic Signal Modification at Flower Street and Santa Ana Blvd DATE OF DECISION: 1/04/08 PROJECT NUMBER(S): N/A ER NUMBER: ER 2008-05 PROJECT LOCATION: Citywide CITY: Santa Ana COUNTY: Orange DESCRIPTION OF THE PROJECT: The project will modify the existing traffic signal on Flower Street and Santa Ana Blvd to provide left turn arrows for all four directions. The construction will include replacing traffic signal poles, foundations, conduits, signal equipment and minor concrete work on sidewalk. NAME & ADDRESS OF APPLICANT: City of Santa Ana Public Works Agency, 20 Civic Center Plaza, Santa Ana, CA 92701 NAME OF PUBLIC AGENCY APPROVING PROJECT: City of Santa Ana Public Works Agency NAME OF PERSON OR AGENCY CARRYING OUT PROJECT: City of Santa Ana Public Works Agency EXEMPT STATUS: ^ Ministerial (Sec. 15268) ^ Declared Emergency (Sec. 15269 (a) ) ^ Emergency Project (Sec. 15269(a)&(b) ) ^ General Rule (Sec. 15061(b)(3) ) ^ Statutory Exemption: State Code number ® Categorical Exemption: State class and section number:15301, Class 1 REASON(S) WHY PROJECT IS EXEMPT FROM CEQA: Project involves modification and alteration of an existing structure and related work. CITY CONTACT PERSON: Pedro Guillen TELEPHONE NO: (714) 667-2729 SIGNATURE: .~ DATE: ~ " ~ ~ " y TITLE: Associate Planner /LEO JAN o ~ 2oa~ TOM DAL~ERK•R CORD€f~ -- -- / ~EP,IiTY MAYOR Miguel A. Pulido MAYOR PRO TEM Carlos Bustamante COUNCILMEMBERS Claudia C. Alvarez P. David Benavides Michele Martinez Vincent F. Sarmiento Sal Tinajero ~ ~~~~~ CITY MANAGER David N. Ream CITY ATTORNEY Joseph W. Fletcher CLERK OF THE COUNCIL Patricia E. Healy CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M-20) P.O. Box 1988 • Santa Ana, California 92702 (714) 667-2700 • Fax (714) 973-1461 www.santa-ana.org NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) Fee Exemption-per California Government Code Section 6103 TO: COUNTY CLERK/County of Orange FROM: City of Santa Ana P.O. Box 238 Planning & Building Agency Santa Ana, CA 92702 20 Civic Center Plaza Santa Ana, CA 92702 -"PROJECT TITLE: Traffic Signal at Willits Street And Sullivan Street DATE OF DECISION: 1/04/08 PROJECT NUMBER(S): N/A ER NUMBER: ER 2008-07 PROJECT LOCATION: Citywide CITY: Santa Ana COUNTY: Orange DESCRIPTION OF THE PROJECT: The project will provide a new traffic signal at Willits Street And Sullivan Street. The construction will include installing new traffic signal poles, foundations, conduits, signal equipment and minor concrete work on sidewalk. . NAME 8~ ADDRESS OF APPLICANT: City of Santa Ana Public Works Agency, 20 Civic Center Plaza, Santa Ana, CA 92701 NAME OF. PUBLIC AGENCY APPROVING PROJECT: City of Santa Ana Public Works Agency NAME OF PERSON OR AGENCY CARRYING OUT PROJECT: City of Santa Ana Public Works Agency EXEMPT STATUS: ^ Ministerial (Sec. 15268) ^ Declared Emergency (Sec. 15269 (a) ) ^ Emergency Project (Sec. 15269(a)&(b) ) ^ General Rule (Sec. 15061(b)(3) ) ^ Statutory Exemption: State Code number ® Categorical Exemption: State class and section number:15303, Class 3 REASON(S) WHY PROJECT IS EXEMPT FROM CEQA: Project involves installation of a new accessory structure and related work. CITY CONTACT PERS.. ~ Pedro Guillen TELEPHONE NO: (714) 667-2729 SIGNATURE: l ••~'Vr ~ DATE: ' i ~ ~ ~ ~ y • P0•STED JAN 0 4 2008 Illlillllll~~ Illlllllllllliilllllllllllllllllllll!illlilllll NOFEE 200 8500000711:41 am 01104108 eo B~ zap n o0 o.oa o.oo o.oo o.oo o-oo o.oo o.oo TOM DALY, CLERK-R ORDER ~~~ DEPUTY BY ~ ~ /; TITLE: Associate Planner BILE JAN 0 4 2008 TOM DAB. LERK•R~FCORDEit Fjy DEPUi". ~ / MAYOR Migue- A. Pulido MAYOR PRO TEM Carlos Bustamante COUNCILMEMBERS Claudia C. Alvarez P. David Benavides Michele Martinez Vincent F. Sarmiento Sal Tinajero ~'OSTED JAN a ~ Laos TOM DALY, CLERK-RECORDER By `-~ ~_ DEPl1TY Recorde i Official Records, Orange County Terri C Jerk-Recorder IIIIlil11111i11i Illlllllllllllllllllllllllillllllllillllllllll NO FEE 20088500000911:41am 01/04/08 so a~ zoo o_oo o.oo o.oo o.oo o.oo o.oo o.oo o.oo CITY MANAGER David N. Ream CITY ATTORNEY Joseph W. Fletcher CLERK OF THE COUNCIL Patricia E. Healy CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M-20) P.O. Box 1988 • Santa Ana, California 92702 (714) 667-2700 • Fax (714) 973-1461 www.santa-ana.org NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) Fee Exemption per California Government Code Section 6103 TO: COUNTY CLERK/County of Orange FROM: City of Santa Ana P.O. Box 238 Planning & Building Agency Santa Ana, CA 92702 20 Civic Center Plaza Santa Ana, CA 92702 PROJECT TITLE: Traffic Signal at Raitt Street And Glenwood Place DATE OF DECISION: 1/04/08 PROJECT NUMBER(S): N/A ER NUMBER: ER 2008-09 PROJECT LOCATION: Citywide CITY: Santa Ana COUNTY: Orange DESCRIPTION OF THE PROJECT: The project will provide a new traffic signal at Raitt Street And Glenwood Place. The construction will include installing new traffic signal poles, foundations, conduits, signal equipment and minor concrete work on sidewalk. NAME & ADDRESS OF APPLICANT: City of Santa Ana Public Works Agency, 20 Civic Center Plaza, Santa Ana, CA 92701 NAME OF PUBLIC AGENCY APPROVING PROJECT: City of Santa Ana Public Works Agency NAME OF PERSON OR AGENCY CARRYING OUT PROJECT: City of Santa Ana Public Works Agency EXEMPT STATUS: ^ Ministerial (Sec. 15268) ^ Declared Emergency (Sec. 15269 (a) ) ^ Emergency Project (Sec. 15269(a)&(b) ) ^ General Rule (Sec. 15061(b)(3) ) ^ Statutory Exemption: State Code number ® Categorical Exemption: State class and section number:15303, Class 3 REASON(S) WHY PROJECT IS EXEMPT FROM CEQA: Project involves installation of a new accessory structure and related work. CITY CONTACT PERSON: Pedro Guillen TELEPHONE NO: (714) 667-2729 ,. SIGNATURE: - DATE: ` (j~ `~. TITLE: Associate Planner REQUEST FOR COUNCIL ACTION ' CITY COUNCIL MEETING DATE: DECEMBER 8, 2010 TITLE; INCREASED CONTINGENCY FOR TRAFFIC SIGNAL INSTALLATION AND MODIFICATION AT FOUR LOCATIONS (PROJECT NOS, 085017, 085021, 085022 AND 085023) CITY MANAGER CLERK OF COUNCIL USE ONLY; MMMM APPROVED ?a;?„ ?,1 ? 7?J'I?? 231 Recommended f?As Q As Amended O Ordinanceoni"'Reading (] Ordinanne on 2"° Reading ? ImplemanlingAesolufwn CONTINUED TO Increase the contingency far the contract with Lincoln Pacific BuiMers, Inc for Tra((Ic Signal Installation and Modifcafien at four locations by $52,300 to a total estimated contrac! amount of $193,166 and aufhoriie the Clty Manager fo execute a change order in an amount not to exceed the authorized contingency DISCUSSION 0 Set Public Hearing For_ Last year the Clty awarded a contract for Traiflc Signal Installation and Modlfiratlon at (our locations to Lincoln Pacific BuiMers, Ina. in the estimated amount of $613,516 plus a contingency of $67,351 totaling $740,866 One of the four locations is the iraific signal modlficatlon of Flower Street and Santa Ana Boulevard. PAL fltE NUMBER When this intersection was originally designed, the project scope was reduced by eliminating the upgrade to the signal communicatien system to stay within the available Haiard Safety Improvement grant funds. With an actual bid that Is lower than the available funding, the City is able to include the signal communication system upgrade. This upgrade requires the approval of a change order. A change order in an amount not exceed $62,300 is required to upgrade the signal communicallons system. This modification will be paid based on a per unit basis, subject to the not to exceed amount. ENVIRONMENTAL IMPACT This is no environmental impact associated with this action. Increased Contingency for Traffic Signal Installation and Modificetlw At Four Locations December 6, 2010 Page 2 FISCAL IMPACT The cenfingwcy increase Is $52,300. Funds are available in the Select Street Construction Fwd (accounting unit 05917660.66220, the Measure M Street Construction Funtl (accounting wit 03217660-66220, the Federal Ald Safely Fund (accounting wit 14117611.66220, antl the Traffic System Management Grant Fwd (accowfing unI114617611.66220?. Rau o nei II Ezecutlve Direct Public We4cs Agency APPROVED AS TO FUNDS AND ACCOUNTS Francisce utlerrei ?? Ezeculive Director Finance & Management SeNices Agency acrC I0r CI" `OF SANTA ANA y I PUBLICWGRKSAGENCY CONTRACT CHANGE ORDER Project NumNa? PROJECT N0.08-5017, 08.5021, 08-5022 AND OB• Changa0rda?Numba? 1 5023; TRAFFIC SIGNAL INSTALLATIONS AT WILLITS & SULLIVAN, RAITT & GLENWOOD, HARBOR & KENT AND SANTA ANA BL & FLOWER. -FEDERAL PROJECT NO. SR2SF5063 (120, SR2SF5063 (124, SR20F•50631118?ANDSR2SF•50631119) To Lincoln Pacific Builders, Inc. coohacm? You are hereby tlinadad to maNe Iha Wa daogea hom Ne plans and speoilhllons a do He Nlbwiry tli urak ool Ircletl¢tl to IBa pUos and sp?ilirofioosonHIS ooNiad NOTE. THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE C17Y COUNCIL OR CITY MANAGER Uolessalh¢rdseslalel,raleslairaotalofeauipmeotowaraolysuoh6maas¢quipmaollsaNuallyuselaotl?oall?wdnoawi??madab?'mtefims, ChaoLa requttdd 6y PUBLIC WORKS AGENCY Provide M,ro new Type 264100 fraftlc signal poles with 43 SMA,12' LMA and hvo re0edive sUeet Dame signs. AGREED PRICE _ $19,76fi,00 2. NEW CONTRACT BID ITEM Ifemp New Bidltem Unit Ouaofity Uoi(Price Total Provide and ios(all3" 21 sch80coodui( Lf 850 $45.00 $38,250,00 Provide aod'ms(all 12 22 pairl22sicwire Lt 1000 $3.30 $3,300,00 Provide and las(all N36 23 Christy pull boa Ea S $350,00 $1,750,00 EsfmatedTolal $43,300 1 EXTRA WORK AT AGREED PRICE The compensation both time and cost set forth in this final change order composes the total compensation due the Contractor, all SubcooUactors, and all Suppliers for all work performed per Phis change order, incluoing impact on unchanged work. By signing this final 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 Mal change order, plus all paymeatfor Intermpfion of schedules, exjended field overhead, home office overhead, profit, delay, and all impact, ripple effect or cumulative impact on all other work under this Contract. Page 1 of 2 ^, CI' ' OF SANTA ANA ???P I PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Pmjaat Nomha? PROJECT N0.08-5011, 06.5021, 06.5022 AND OBChanga0rda?Nomba? 1 5023; TRAFFIC SIGNAL INSTALLATIONS AT WILLITS & SULLIVAN, RAITT & GLENWOOD, HARBOR & KENT AND SANTA ANA BL & FLOWER. -FEDERAL PROJECT NO. SR2SF-5063 (120), SR2SF•5063 (124), SR2SF•5063(118)AND SR2SF•5063(119) To Lincoln Pack Builders, Inc. Cootracto? You ara har¢6y bhaUad U maNa iha hai?o glaogas Irom the plans ?d spaoitloallaos of do the Idlowiog dasorlUetl woiN flat Inbatlad to iha fans arld speciliraliaos oa Ihis coaVad NOiE.1HISCHaNGEORCERISNOiEffECiIVEUNiIIPPPROVE?BViHECIiY000NCILORCiiYMNNPGER, Uoleualhwuisestal¢?, isles lorraolbal epuipmaolamaimlysuch Ilma as ?uipmaot Is actually usadarboo aDowao? wUl bemada laritlle6'ma, Change i¢quesl¢d by PUBLICWGRKSAGENCY The signing of this final change order constitutes full mutual accord and satisfaction for all changes and work performed on Ihis project, and that the Time and cost paid per Ihis final 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 behah of himseM, all Subcontractors, and all Suppliers agrees to waive all rights, without ezceptioo or reseNatioo of any whatsoeuerto file any further claim related to ihls project. roru¢osrraism??aAOrA, gacm?sr g ..... w?E? $ 62,550.00 By?¢asonolth?o?tle?theCOMRACTTIEIEcompRlioowillbeabjustetlaslollows, Add 70WorkiogDays Weiheuodars?etl?lraclorhavegiv?camlufnxaidarallonlothachaogaprapos2daodh¢i¢6yag2¢,Iflhlspmp?sallsappiw?,lhafwamllpmvitlaall aquipmeN,IumisM1allmalanals,excaplasmayolfienaissberdaba6we,aodpedwmallseminaoacassarylo?lheumik¢6wsapacNtd,alltlwillaoosplasWl I I Cammeloi Lincoln Pacrfic Builders, Inc. V, Appmuad by Dale Hale 1I jf /'I Page 2 of 2 MEMORANDUM Paul Walters To; In(erim City Manager Dale: Sepfember1,2011 Raul Godinez, Executive Director From; Public Works Agency Subj?t; PROJECT NO, 08.5011, 08.50211 06.6022 AND 085023, TRAFFIC SIGNAL INSTALLATIONS AT WILLITS 8 SULLIVAN, RAITT & GLENWOOD, HARBOR 8 KENT AND SANTA ANA BL & FLOWER. -FEDERAL PROJECT NO. SR2SF5063 I120?, 5R2SF-5063 (124j, HSIPL-5063 j118)AND HSIPL-5063 (119) CHANGE ORDER N0.2 Contractor LincoloPacifcBuilders,lnc. 4501 Lifllejohn SUeet BaldvNn Park, CA 91706 Project Description: TRAFFIC SIGNAL INSTALLATIONS AND MODIFICATION AT FOUR LOCATIONS Change Order Number 2 Amount: $1,800.00 GlenwoodlRait1?08-5021) Flowed5antaAna?085023) Account Number: 14811611 03211660 ACCOUNT 66220 66220 Work Order: 08502101028 0850230128 Amount $3,900 $3,900 OriginalConlractCosC $673,515 %atOriginal Amountof The Change Order', $1,800 1.16% Previously Approved $62,556 9.26% Change Orders: Ta?IChangeOrders$10,350 1042% REASON FOR CHANGES The contract documents require'mslallagon of new treffo signal poles al ihe'mtemeotlons of Glendwrood Place and Railt 5ireel and Flower Sireel and Santa Ana Boulevard. During the installagon, it was disccuered that overhead power Imes would interfere with the installation of these new Imffc signal poles. Therefore it was recommended to shorten Iha irafflc signal poles around these lines. This work was done on a time•and-materials basis. Prior approval was obtained on July21, 20011, (PC0 No.4jFINAL COST=$1,800 Project Nos. 08.5017, 085021, OB-5022 and 0&5023 RFA Change Order No. 2 September 1, 2011 Page 2 Raul Godinez Eaecugve Director Public Works Agency APPROVED AS TO FUNDS AND ACCOUNTS Francisco Gutierrez ?Q E><ecuVve Director F'mance and Management SeruicesAgency AGNIIEi10&3017 AFA COq Z CITY OF SANTA ANA . ill h. PUBLIC WORKS AGENCY F CONTRACT CHANGE ORDER Pmjecl Number PROJECT NO. 08-5017, 08.5021, 08.5022 AND 08- Chasge OrderNumd¢r 2 5023; TRAFFIC SIGNAL INSTALLATIONS AT WILLITS & SULLIVAN, RAITT& GLENWOOD, HARBOR & KENT AND SANTA ANA BL & FLOWER. - FEDERAL PROJECT N0. SR2SF-5063 (120), SR2SF-5063 (124)1 HSIPL-5063 (118) AN DHSIPL-5063 (119) To Lmoelo Pacific Builders, Inc. ooolrador s?rAlralhsmNlsmoliV, NOiF. THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCIL OR CITY MANIOGER Ooless oNaraiseslalEd, ial?(orrEnml ol¢gNpmeoloo?smlysu?llmeas ?Npmaot'maNUallyusadaod ooallowmcewiil?madeforldla dme. Charl?r¢qu¢sfelby PUBLIC WORKS AGENCY Modify pole and mast amt at'mtersectlons of Glendwood and Rail Street and Flower Street and Santa Ana Boulevard relocate sheet signs', as directed in the field, (PCO No, 4) AGREED PRICE =$7,800 You as her¢6y dhal¢d to maNe he heiaio ahmgs ham He plans and sp°cilloatloos or co the IolRrvlog dasuiCed woM col lodud¢tl is Ne plans aotl The compensation both time and east set fodh in this change order comprises the io(al compensator due the Contractor, all Subcontractors, and all Suppliers forallwork performed perihis change order, including Impact o0 unchanged work, By signing this ohacge order, the Contractor acknowledges and agrees on behalf of himself, all Subconhactom, and all Suppliers, that the stipulated compensation includes payment (or all work contained'm this change order, plus all payment for interruption of schedules, extended field overhead, home ofllce ovefnead, proflL delay, and all Impact, ripple effect or cumulafloe impact on all other work under (his Conhact. The signing of iNs change order constitutes full mutual accoM and satisfaction (or all changes and work performed on this project, and that the time and oast paid per this change order consttutes the Total equitable adjustments owed (he Contactor, all Subcontracors, and all Suppliers for all work performed on Ihls project. The Contractor on behalf of himself, all Subcontractors, and all Suppliers agrees to waive all dghis, without exception or reservation eiany whatsoeverto file any fudher claim related tothis project TOTAL COST THISCHANGEOROER,DECREASE?INCREASE 7800,00 ByreasoooldtordsrmaCONTRACTTIMEaompfadoo udkbs adjuslsd asfo0aws, Add 165 WOrkIDg tl2y5. EXTRA WORK ATAGREED TIME AND MATERIAL W¢Ihauotla?sigoed?fiaoloih2vagimnmmfulooosidera4aitolhe?aogepr?p?¢daodh¢r?yagme,NlhlsReposallsappmuad,l?lwawillpioeideall e?uipmeol,Nimshallmaletlafs,¢ceplmmayolda?wisebeanieda6ova,arldpwlmmaltsami?¢oecessarylorlhawoMa6w¢spe?ih'¢4aodwillao?ptaslull paymaofNarelotlhapioesshcwoa6ove tiaepCd, Dale 1 ll ir?er L'moolo Pacific Builders, Inc. sY r? ? n7 er.? 'i NpPiovCi?xmmeod¢? ? ? i?f ( Dale ?'?' ??( RJi;CE[ F 9 I(SaG YEN V e18ECiCk Appre?ddY SEP 6) Dare 4?iz-b GiYMPNF FR Page 1 of 1