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Home My WebLink AboutNIKOLA CORPORATION.,,., ,U. Recorded in Official Records, Orange County Clerk of the Council. Citv of Santa Ana Recording Requested By, And When Recorded Mail To: Clerk of the Council, City of Santa Ana 20 Civic Center Plaza, P.O. Box 1988 Santa Ana, CA 92702 Recorded in Official Records, Orange County Tom Daly, Clerk-Recorder Illllllllllllllllllllllllllllnllllllllllllllllllllllllllllllllllllllllllllll NO FEE 20120000359281:31 pm 01/23/12 10414N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIS SPACE FOR COUNTY RECORDERS USE ONLY 0 NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN that the undersigned City of Santa Ana, California, a municipal corporation, with the address of City Hall, 20 Civic Center Plaza, Santa Ana, California, 92701, is the owner of the property hereinafter described, that said owner has caused construction of LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS Q under contract entered into on MARCH 7. 2011, with NIKOLA CORPORATION INC, on Us which contract MERCHANTS BONDING COMPANY is surety. The property on which such = w work improvement was placed is in the City of Santa Ana, County of Orange, State of u c California, and described as Project No. 11-7508 located at: VARIOUS LOCATIONS. The W F work improvement on said property was accepted as completed on JANUARY 13. 2012. F Z z q z CITY O SANTA ANA, A MUNICIPAL CORPORATION o by AKA,? Oc y" A6AXJ- x C Dated: 1 City Engineer ?, F t TITLE Z ------------------------------------------------------------------------------------------- D h a VERIFICATION I, the undersigned, say: I am the City Engineer of the City of Santa Ana, California; I executed the foregoing Notice of Completion acting on behalf of the owner of the property therein described; I make this verification on behalf of said corporation by authorization of the City Council of the City of Santa Ana; I have read said notice and know the contents thereof; and I declare under penalty of perjury that the facts therein stated are true. Executed on at Santa Ana, California ? n ?%?NYt j /1 nn l` (Signature of individual swearing that the contents of Notice of Completion are true.) THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN (10) DAYS AFTER COMPLETION REQUEST FOR ?,_,_ , COUNCIL ACTION ?,: CITY COUNCIL MEETING DATE: MARCH 7, 2011 TITLE: CONTRACT AWARD FOR LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS (PROJECT N0.117508) CLERK OF COUNCIL USE ONLY: APPROVED ,3` 7- ?? L`? As Recommended ?3 0 As Amended 0 Ordinance on ?s? Reading 0 Ordinance on 2ntl Reading ? Implementing Resolution ? Set Public Hearing For CONTINUED TO /?/• FILE NUMBER CITY MANAGER RECOMMENDED ACTION Award a contract to Nikola Corporation, the lowest responsible bidder, in accordance with unit bid prices in the estimated amount of $1 ,161 ,351 for construction of Lacy Neighborhood sewer and water main improvements- 2. Approve a Funding Analysis with a total estimated construction cost of $1 ,451 ,500. DISCUSSION This project provides for the replacement of deteriorated and undersized sewer and water pipes (Exhibit 1 ). The improvements include installation of new sewer and water mains, fire hydrants, main gate valves, and water laterals. Once completed, water main breaks and leaks associated with the older and deteriorated water mains will be eliminated, and meter service capacity and fire protection will be enhanced- In addition, sewer capacity will be increased. The Notice Inviting Bids was advertised on January 17 and 19, 2011, and bids were opened on February 10, 2011. A summary of the bid invitations mailed, the bids received, and the bid results follows. Santa Ana Contractors receiving notices: 8 Contractors requesting bidding documents: 35 Bids received: 13 Bids received from Santa Ana Contractors: 1 Contract Award For Lacy Neighborhood Sewer and Water Main Improvements March 7, 2011 Page 2 NAME OF RESPONSIVE BIDDER 1 . Nikola Corporation 2. Garcia Juarez Construction, Inc. 3. Cedro Construction, Inc. 4. Paulus Engineering, Inc. 5. T.B.U., Inc. 6. Mike Prlich & Sons, Inc. 7. Sully-Miller Contracting Company 8. Dominguez General Engineering, Inc. 9. MNR Construction, Inc. 10. Mike Bubalo Construction Company, Inc 11. SRD Engineering Inc. 12. Kana Pipeline, Inc. 13. Sandavol Pipeline Engineering 14. J. De Sigio Construction, Inc. 15. Kennedy Pipeline Company CITY BID AMOUNT Irvine $1 ,161 ,351 .00 Baldwin Park $1,167,180.00 Santa Paula $1 ,267,313.00 Anaheim $1 ,269,661 .00 Beaumont $1 ,271 ,550.00 Santa Ana $1 ,287,581 .50 Brea $1 ,289,450.00 Rosemead $1 ,289,802.00 San Dimas $1 ,299,295.00 Baldwin Park $1 ,319,590.00 Anaheim $1 ,357,182.00 Placentia $1 ,479,970.00 Rancho Cucamonga $1 ,499,240.00 Baldwin Park $1 ,580,440.00 Aliso Viejo $2,462,723.86 A total of 15 bids were received and all were responsive. The lowest bid was submitted by Nikola Corporation for $1 ,161 ,351 which is below the Engineer's estimate of $1 ,510,330. ENVIRONMENTAL IMPACT In accordance with the California Environmental Quality Act, the recommended action is exempt from further review. Categorical Exemption Environmental Review No. 2010-150 has been filed. In addition, a Certification of Categorical Exclusion and a Statutory Worksheet have been prepared in accordance to the National Environmental Policy Act. The City has received the authority to use grant funds in response to the request for release of funds submitted to the U.S. Dept. of HUD. FISCAL IMPACT The funding analysis shows a total estimated construction cost of $1 ,451 ,500 for the project (Exhibit 2). Funds are available in the CDBG Public Facilities fund (accounting unit 13518783- 66220). Contract Award For Lacy Neighborhood Sewer and Water Main Improvements March 7, 2011 Page 3 Ra odinez II Executive Direct r Public Works Age cy Nancy E ards Interim E cutive Director Community Development Agency RG/ET APPROVED AS TO FUNDS AND ACCOUNTS: Francisco Gutierrez r? Executive Director O Finance & Management Services Agency Exhibit 1 : Project Location Map 2: Funding Analysis EXn?b?t i VICINITY MAP NOT TO SCALE T\ N I 1 I 'V' ? !? p I? R? City Council Title` LACY NEIGHBORHOOD ?OJ . AAA ? -? Agenda Date SEWER ANO WATER MAIN IMPROVEMENTS ? } ?.?.? ? w?,k„?. ?? ??, MARCH 7, 2011 PROJECT NO. 11-7508 FUNDING ANALYSIS PROJECT NO. 11-7508 LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS Construction Contract $1,161,351 Contract Administration $58,034 Inspection and Testing $81,200 Survey Staking $34,800 Contingencies $116,135 TOTAL ESTIMATED CONSTRUCTION COSTS 1.451.500 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 r>f California ) County of ORANGE ) ss Notice Type: BID -NOTICE INVITING BIDS Ad Description: Lacy Neighborhood Swr & Wtr Main Imprv 1 am a citizen of the United States and a resident of the State of Califomia; 1 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 Califomia by the Superior Court of the County of ORANGE, State of Califomia, under date 05/20/1922, Case No. 13421. That the notice, of which the annexed is a printed copy, has been publishetl in each regular and entire issue of said newspaper and not in any supplement thereof on the following dates, to-wit: O 1 /14!201 1 - 01 /19/201 1 Executed on: 01/199//22p?11 At Los Angeles. CajipGrrti< I certify (or declare) under penahy of p?jt?v t1(?t t1'? f regoing?is true and GOfreC[. i / _/ ?? space f« ating stamp OR #: 2025366 NOTICE IN VIr IN6 BIDS NOTICE IS HEREBY GIVEN ihel the dry of Santa Ana. Calilornie will receive at the Ciry Hall-Ross Annex, (M-43). 20 Gvle Center Plaza. Santa Ana, Celllomia 92]01, [he Public Works Agenev Fouts Floor R Ironral, on or belore?t to 1Tour o p. m. on ureday, February 10. 2011 sealetl bitls enNOr proposel® for PROJECT NO. rt-]508; Lery Neiglrbortrootl Sewer end Water Main Improvertrenls A) The construetlon of epprortlmately 3,345 Nnear leer of B' PVC newer rtrln and aPPUrtenerrees. irrdudng manhdea entl sewer laterals. B) The eortetnretlon of ap«oximsle 850 flnear leer of 12' entl 475 linear lee?of B" PVC water mein entl appurtenaneee, inducing fire hydrants entl water aeMees. Notkxl le hereby glean BIDDERS that this project Is luntletl with CDBO money. entl that the rare of wages br eeeh crek or type of work or msehanle emplged under this connect shall be es epeeMed untler Ma wrrant tleterrninetions of Ms snm t o1 Leb rear 1 t v re a ?screpanry_ erasta tween FetlarN entl State prevetflrp wage rata. Me Ngher of the two Prevarllnp wage tales shell apply. Eeeh bid shall txt 8aornPanNtl by cash, a easMers or eeNfisd check peyads Io Ms Gry of Santa Ma, or dtl bontl Isauatl by a corporate surely, for en arttount not lass then ten perpsnt (10°6) of Ma rsgew of the bid, ss a guarerees Mat Ma BIDDER will enter mro Me proposed eomraet If Me same Is awarded ro him. The slgrrature of the BIDDER en tlM bW borttl mwt be rrotarlsd. Ths City Council reserves the fight ro reject snY « NI dds. The succeeatul BIDDER moat possess « obtain a valid Califomia loss (A or C34) Contractors prior to its achadubd ewe tlata of Mla txntraet. The DlasWentage Buelness Enterprise NE) 091 br tlws prolaol Is ].14%. The a?izatl d.awanrege Businses Enterprise (UDBE) goal f« thN prgsct is e.]]%. these pereenfaoea .Hall ?pp1? ro Me Doer of the ant?rs ProMPL TNs Mlamatlon may be stlbmittetl wIM your bid Proposal. 11 It Is trot, and you are Ma appsrsnt low ddder or the seeontl « the Mird low odder, it trust be submllNd end repaivstl the adrtYNeterirp agency n0 later then t tlme spaelfiatl in the Federal Ifleaflons. Appentlix F of Ms The tlrtte 1« eonpetlen W IhM eontraet Is 150 workng toys. Uquldetetl dam?pes o/ S? per worWrq dsy shell bepln lolbwtng Me sion o1 Ms flret 130 working days sitar Noise ro Pr'poeed is iasuwtl. $Ubetltall «t d ee[.uhtlee I« any rrlWtlea wiMheld by Me Ciry of Santa Ane to errsuro pedomance is albwad In aoc«tlenoe with Me Pubic Contract Cotle. l m l r nn x rw n r l ]14 are s e c arge rron- refuntlebN) br these Runs entl Spselflaatlona, ?ue a ninlrrum Sl].]2 edditlonel lee 1 mailed. Mak. ofreow psyede to the Gry of Santa Ane. 00 NOT CALL PURCHASING DIVISgN REGARDING AVAILABILTI' OF PLANS AND SPECIFICATIONS. vu, v1a11 OR-2026398/ 1111111 IHI 11N1 IIIII IIIII IIIII IlNlallll IIN1111? III IIBI VIII ? IIN +r A o 0 o a o z o 2 i ? z s >t `C O R P O R A T / O N SEALED BID DO NOT OPEN WITH REGULAR MAIL CITY OF SANTA ANA For LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS Project No. 1 1-7508 Attn: City Hall-Ross Annex, (M-43) 20 Civic Center Plaza Santa Ana, CA To be opened on: February 1 O, 2011 - 2:00 pm Submitted by: NIKOLA CORPORATION Johnny Klichan 18012 Cowan, Suite 290 Irvine, California 92614 (949) 752-1 900 -fax (949) 752-1 91 O ? ? "?-- - F?8 1 ? 2?" ? r ; ? .? ?,ci ?? ?1: "T y?? -.. l_? tS -^^^^^.?,w?A i r CITY OF SANTA ANA PROJECT NO.. 11-7508; LACY NEIGI-IBORHOOD SEWER AND WATER MAII?T IIVIPROVEMENTS PROPOSAL 1Rt CONTRACT AGREEMENT BID PROPOSAL TO: CITY.COUNCIL OF THE Cl'TY OF SANTA ANA A FROM: / V ???o Gam- ? ep o2e?l' _ / i e N ? REQi 1iR RMRT7'I'. 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 aad do all the work required to complete the said work in accordance with said plans, 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 1. Construct 8" PVC SDR-35 Sewer Main LF 3,345 $? . $ 2 ?'Y ?( a 2. Imported Backfill for . .Sewer Main CY 2,230 $ . $_?A_ . 7?3 r' ? Construction (if Required) ` ? 3. Construct New P.C.C. Sewer Manhole EA 14 $ ?3 Z ? . $ Go?_ro 4. Remove Existing Sewer Manhole EA 11 $ / 7 TG $ / ? S/ ? 5. Construct 4" or 6" PVC Sewer Lateral 64 and Cleanout from Sewer Main to EA $ v / ? $ r ZpjSZ Property Line per C.S.A. Std. 1204 (Open Trench) 6. Construct 4" or 6" PVC Sewer Lateral 11 and Cleaaout from sewer Main to EA $ 36 ? ?j ////ff1f $?9 Property Line per C.S.A. Std. 1204A (Pipe-Blast) 7. Sewer Flow Level Monitoring and EA 2 . $ ?0 7 / 2 $ ? 3 X12 y Alarming Device 8_ CCTV Inspection of Newly Constructed 1 PVC Sewer Main and Laterals LS $ L/2G > $ ?/2 G/ - 9. Sheetiag Shoring and Trench Protection LS 1 $ i S3 p $ / ?,7a7 TO BE INCLUDED IN BID PACKAGE BP 1 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IIVIPROVEMENTS PROPO SAL 8c CONTRACT AGREEMENT BID PROPOSAL_ continued Item # Bid Item Unit Quantity Unit Price Amount 10. 12" Class 200, AWWA C900 P.V.C. LF 850 $ 1 27 $ (c37 9So Water Main 11. 8" Class 200, AWWA C900 P.V.C. EA 475 $ / y 7 $ 6 ?? 2? Water Main 12. 2" Water Service per City Std. Plan 1402. EA 36 $ 3 1 0 0 $ / ( f ? oc? 13. 4" Domestic Service Connection EA 5 $ f? 4 ? ? $ By ??? Including 4" RWGV and Vault Per City Std. Plan 1403A or 1403B and 1403D. 14. 4" Domestic Service Connection EA 1 $ .?-??1 ° $ S? y O Including 4" RWGV. - 15. 4" Fire Line Connection Including 4" EA 4 $ 3 y6 ? $ / 3f?l1 ,RWGV Per City Std. Plan 1417. ?; .. 16_ 6^ Fire Line Connection Including 4" EA 2 $ '?7 ? 6 F'." - $ c?3 7? p RWGV Per City Std. Plan 14.17. 17. 12" Resilient Wedge Gate Valve EA 2 $2 S?? w $ SV ? V 18. 8" Resilient wedge Gate Valve EA 1 $ 1 ?1 O b $ J 5/y O 19. 12" X 12" Hot Tap Including Tapping EA 1 $?oo'r $ 9 ?b? Sleeve and Valve 20. 12" X 8" Hot Tap Including Tapping EA 1 $ ?z y0 $ 72 /? Sleeve and Valve 21. 8" X 8" Hot Tap Including Tapping EA 1 $ ?/ 3 ? $ ?? 3 Sleeve and Valve 22. New Fire Hydrant Assembly, Including EA 4 $ 7?? 3 26 33Z $ r Gate Valve and Lateral Pipe 23. Traffic Control, Striping and Pavement LS 1 $ ? ?D-7 ? $ ?07? Markings TO BE INCLUDED IN BID PACKAGE BP2of31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS PROPOSAL 8c CONTRACT AGREEMENT BID PROPOSAL. continued Item # Bid Item Unit Quantity Unit Price Amount 24. AC Pavement TN 870 $ 1 O o $ 8?°'vU 25. Cold Milling O-1" SF 33,400 $ `18 $ /6 o?Z 26. Adjust R:;?;t,g water Valve Pot to Grade EA 13 $ 71 7 $ ?? Zl 27. Research, Tie-Out and Reestablish Survey EA 8 $ s? 7 $ ? ? 3 G Monuments TOTAL BID ---------------?-?-------------------------------- $_I, ? ? / 3'S? 3 The lowest responsible bidder shall be selected based on the lowest Total Bid. * 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 Sectioa 3-2 of the Standard Specifications. The actual amount for this - item will be dictated by the actual quantity used, and the Agency reserves the right to increase'or . decrease the quantity of this item accordingly: . PROJECT NO. 11-7508: LACY NEIGHBORHOOD BIDDER SEWER AND WATER MAII?T IIVIPROVEMENTS Firm /ll /lam Efi ?!L%e??-?„? Address ? / 8 y l Z ?G..s eq..r . 6?.:, sZr..2q? S?v•'?-GSa 'PZ6/y Phone ?? ? ,? 7 5? -I 5.ota Fax Email i ?'1 % b /l •l?ol ? ?o _ ce ?r _ ? BIDDER Si TO BE INCLUDED IN BID PACKAGE BP 3 of 31 CITY OF SANTA ANA PROJECT' NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN I1??ROVEMENTS 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; '/:% of the bid or $10,000, whichever is greater - Buildings, Parks, or other projects: %s% of the bid BIDDER propose?s?lto subcontract cp**?++n portions of the work to the firms listed below: NAME f '/o f'o •n? NAME LOCATION' ?yv?t a cn_ LOCATION ' PHONE to .SY Y . ? s 3G PHONE TYPE OF WORK ?? _. $ v v TYPE OF WORK $ NAME ?zL iy,. ? ?.,.., .e?sf.,?? NAME . . LOCATION- ?a-vim..- a- c?--° ? - LOCATION. PHONE ?if? 7 3 G - 7Gae? PHONE TYPE OF WORK /?.a+??tYle. $ 9n -9?+ ? TYPE-OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ ???? LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ Name of Firm Submitting Bid Si?oature of BIDDER NAME LOCATION PHONE , TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK $ TO BE INCI..LTDED IN BID PACKAGE BP 4 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAII?T IMPROVEMENTS 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 (1 O) 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 o£' _ - . 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.- .. .. :. t•. BIDDER understands that a bid is:required-for the entice 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' CompP*+QAtion Insurance Certificate are to be incorporated by reference into this Agreement and are made specifically as part of this bid. l> Name of Firm l C/ / ? ?`i a ?? Signature of BIDDER /? Title T? ?r?r ?? (if an individual, so state) TO BE INCLUDED IN BID PACKAGE BPSof31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAiN IIVIPROVEMENTS 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.) /? iU / I?9c,a1- ? J' ?R..G f /..n? C ? l'-?eJL4 T7.aN DQ.A ! /?//K.?c.?f C o/%O.?L ?-?- ?- ?l + 1u .yn. y N 1?'L, 2 K,,rti/ P.?rrx ?tG..s?- -'? ?'?-./.,/i?-+-L_. APPROVED AS TO FORM: l CITY ATTORNEY ACCEPTED FOR THE. CTI'Y OF SANTA ANA: ______ -?C/h EXE IVE DIItECTOR PUBLIC WORKS AGENCY BP6of31 TO BE INCLUDED IN BID PACKAGE CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN 11??ROVEMENTS (T'HE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE APART OF THIS PROPOSAL EQUAL E1??LOYMENT OPPORTUNITY CERTIFICATION The BIDDER /? //` OLD CQy?/IO2A-?T7?i 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 contrasting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling req?¦?reR+ents. Nete: The above certification is required by the Equal Employment Opportunity Regulations of the -. . Secretary of Labor (41 CFR 60-?.7(b) (1)), and must be submitted by BIDDERS and proposed subcontractors only in•connectlon 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 contrasts 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. TO BE INCLUDED IN BID PACKAGE BP7of31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER. MAIN IMPROVEMENTS 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 recnritment advertising; layoff or tP*'r++?natiOII; rates of pay or other forms of compensation; and selection for tra+*,;rrg, 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 nondiscri**? nation clause. 2: The Contractor shall, ih all solicitations or advertisements for employees placed b?y?or o?n behalf of the :Contractor, state that- all .qualified applicants will receive consideration for?en?loyment without _ regard to race, color, religion, sex, or national origin_ ? .. ,.: ,. ` . 3. ..The: Contractor shall send to each labor union or representative of workers with which he/she has :.. ? . . .a collectivefbar-gaining agreement. or other contract or understanding, a notice«.tq,be vided_?advasiag.-: ,:• -?; the said labor union or workers' representatives of the Contractor's commitments under this section, and shall- post copies o£ 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 nondiscri**+i.,ation 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 BP8of31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IIvIPROVEMENTS 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 A?TMinistering 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,.nationa.# origin, ancestry; physical handicaps, mental condition, marital-status; or. ::= sex of such persons, ex as provided in Section 1420, and any contractor .of public works violating this Section is subjec al the ties imposed for a violation of the Chapter. ., _ ,._ Signed ,>.:, er, .; r ,: .r ._ i_., Title ? ?iG?dS?`"' ?`'___. Firm ?? ???° E/a- ??/?+?L.A?f7.?/ Date _ 'Z ? ? o ?`? i TO BE INCLUDED INBID PACKAGE BP9of31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAII?T IMPROVEMENTS PROPOSAL AND CONTRACT AGREEMEN'T' 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 Ana with as insurance certificate from my workers' compensation +*+??*?+*+ce can-ier certifying that I carry such insurance and that the policy shall not be canceled nor the covera aced except upon thirty (30) days prior written notice to the City of Santa _. .: .Ana ?..:; _. Title i7???'rl...? ?-? _ _, _/ , Firm /?/?ikoL.? ?i?/c?e lLa?rT'oN Date ?_ ?. O/ c, TO BE INCLUDED IN BID PACKAGE BP 1O of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IIviPROVEMENTS ` PROPOSAL AND CONTRACT AGREEMENT REFERENCES ?; The following are the names, addresses, aad telephone numbers for three public agencies for which BIDDER has performed similar work within the past two years. 1. Name sad Address of Owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 2. Name and Address of owner. Name aad Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 3. Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed The following are the names, addresses, aad telephone numbers of all brokers aad sureties from whom BIDDER intends to procure insurance aad bonds. /y g ? ? /.G?o2 !? ?vra ?fv o ?G cc?r+ni? ??-?r'?-G3 ?' TO BE INCLUDED II?i BID PACKAGE BP 11 of 31 N/KOLA Genera/ Engineering Contractor C.a Lic_ # 813357 REFERENCES -PROJECTS 2008 21.OWNER: City of San Bernardino CONTACT: Mr. Michael D. Wolff, Construction Engineer (909) 384 - 5166 DATE: December 2007 -March 2008 PROJECT: Sewer & Street Improvements (Cedar, Canyon, Wallace, 24) 8,000 L.F. of 8" PVC Pipe and Manholes and Laterals AMOUNT: $ 950,000 22.OWNER: Rutter Development Corporation MESA CONSOLIDATED WATER DISTRICT CONTACT: Mr. Jay Rutter, President Mr. Mark Pelka, (949) 631-1291 (949) 863-1298 DATE: March 2008 -May 2008 PROJECT: Pacifica Residences, Costa Mesa On-site Storm Drain System: 1 ,000 LF On-site Sewer System: 600 LF including Manholes On-site/Off-site Water System: Domestic & Fire Water (hyd) AMOUNT: $ 310,000 23.OWNER: City of Anaheim CONTACT: Mr. Sean Razmy, Construction Engineer (714) 765-5059 DATE: June 2008 -August 2008 PROJECT: Sewer Improvements (St. College Blvd_ & La Palma Ave.) 1 ,500 L_F_ of 18" VCP and Manholes and Laterals AMOUNT: $ 565,000 24.OWNER: City of San Bernardino CONTACT: Mr. Michael D. Wolff, Construction Engineer (909) 384 - 5166 DATE: September 2008 -November 2008 PROJECT: Sewer & Street Improvements (Tippecanoe, "I", Sterling Ave) 21" - 15" PVC Pipe and Manholes and Laterals & Bursting AMOUNT: $ 720,000 1 80? 2 COWAN, SUITE 290, IRVINE, CA 926'14 TEL: (949) 752-? 900 FAX: (949) 752-1 91 O VJ?M/V. NIKO LACORP.COM N/KOLA Genera/ Engineering Contractor C.a Lic_ # 813357 25.OWNER: CONTACT DATE: PROJECT: AMOUNT: REFERENCES -PROJECTS 2009 City of Pasadena Mr. Bob Gardner (626) 744312 November 2008 -January 2009 2009 Sewer Pipe Repairs Sewer Main "point repairs" and Manholes $ 1 09, 000 26.OWNER: Jurupa Community Services District CONTACT: Mr. Kiran "Sam" Sampat (951) 685-7434 DATE: February 2009 -April 2009 PROJECT: JCS Headquarters On-site Sewer Improvements Sewer Main, Manholes, Vaults and Electrical AMOUNT: $ 275,000 27.OWNER: CONTACT DATE: PROJECT: AMOUNT: City of Redondo Beach Mr. Mazin Azzawi, Project Engineer (31 O) 318-0661 June 2009 -November 2009 Sanitary Sewer Rehabilitation -Phase 8A 5,300 LF of 12" VCP and 24 Manholes $ 1 , 066, 000 1 80'12 COWAN, SUITE 290, IRVINE, CA 926'14 TEL_ (949) 752-? 900 FAX. (949) 752-1 91 O :M/WV.NIKOLACORP.COM N/KO L.A Genera/ Engineering Contractor C.a Lic. # 8 ? 3357 REFERENCES -PROJECTS 2010 28.OWNER: City of Redondo Beach CONTACT: Mr. Mike Shay, Project Engineer (31 O) 318-0661 DATE: November 2009 -June 201 O PROJECT: Sapphire Storm Low Flow Diversion Pump Station, Forced Main, Electrical & Filtration System AMOUNT: $ 690,000 29.OWNER: City of Fullerton CONTACT: Mr_ Eliseo Bravo, Construction Inspector (714) 738-5348 DATE: May 201 O -November 201 O PROJECT: Riverside Or_ and Raymond Ave. Sewer & Street /mp. 4,300 L.F_ of 8" and 10" Verified Clay Pipe and Manholes AMOUNT: $1,100,000 30.OWNER: Costa Mesa Sanitary District CONTACT: Mr. Robin Hamers, District Engineer (949) 631 -1731 DATE: October 201 O -November 201 O PROJECT: Sewer Replacement Project No. 183-2 Remove existing 8" VCP and install new 8" PVC sewer AMOUNT: $ 63,000 31.OWNER: North Orange Community College District CONTACT: Ms. Dorothy Whitehurst, District Director Purchasing (714) 808-4776 DATE: November 201 O -February 201 1 PROJECT: Fu//erton Co//ege Storm gain /mprovements CDS Units and StormGate Manhole - 24" Pipe and appurtenances AMOUNT: $220,000 18012 COWAN, SUITE 290, IRVINE, CA 92614 TEL: (949) 752-1 900 FAX: (949) 752-191 O NANV.NIKO LACORP.COM CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT REGARDING APPRENTICESHIP REOL??MENTS The undersigned BIDDER is familiar with the req¦¦+T?..ents 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 **a+*+:*?g of apprentices in the area or industry affected. 2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards. 3. Contribute to the fund or funds in each craft or trade in which he?she employs .journeymen or apprentices on the public work, in the same amount or upon the same basis aad in the same manner as the other contractors t contractors not signatory. to the trust agreement .shall pay a like amount to the California ti 'p cil. Signed Title ?in l?s??'-- Firm !? v lLIO??? ? ?iOo-R-?`^? Date ????? TO BE INCLUDED. IN BID PACKAGE BP 12 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IIvIPROVEMENTS PROPOSAL AND CONTRACT AGREEMENT NON-COLLUSION AFFIDAVIT' (Title 23 United States Code Section 112 and Public Contrast 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, orgA*+i?gtion, or corporation; that the bid is genuine and ?t 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, say fee to any corporation, partnership, company association, orga.,+?1+*+on, bid depository, or to any member. or agent. thereof to effectuate a illusive or sham bid. Note: The above Non-collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non-collusion Affidavit. BIDDERS are cautioned t a false certification may subject the certifier to criminal prosecution. Signed `/ State of California County of iA'Z?Wes c? Subscribed and sworn to (or affirmed) before me on this q_7? day of ?? 201 by ?OIINniJ N KLIG1"llAn? proved to me on the basis of satisfactory evidence to be the person(s) who appesrea before me. ? Sr9Z 9r 'Ntl? S3MIdX3 'W WOE ?ic? AJ:Nf10? 3•JNVMO v tlIN710il1tl? - ?I780d A71tl10N ? Q 486Li6i #'WWO? () ., n _ ? n .? ? ?Itsni -n ?oav? Notary Public Sign'?tdre U Notary Public Seal TO BE INCLUDED IN BID PACKAGE BP 13 of31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT REGARDING "ANTI-KICKBACK" RE The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti-Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that each contractor or subcontractor shall be prohibited from inducing, by any means, any person employed in the construction or repair of pub ' r 've up any part of the compensation to which he/she is otherwise entitled. Signed Title ?J ?rGC?t't/G. r-- Finn ??/l'?al? ?ir„? a ,2?f-rte s Date _ ?, e ? t p ;? TO BE INCLUDED IN BID PACKAGE BP 14 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN II??ROVEMENTS 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 cont. Contractor's Name: / v ??o t/,? ?irpe /?.?i.an/ Business Address?? ?? ? c Z ?' ??..,J _ p? . ? ?? c? ??y .?- GH Telephone: _???" 4 °r 7? ?? -?) F .e v S ZC i y State Contractor's License No, and class: ?' i 3 3 ? ? _ .?- c -? t- ExpiratiE+*+ Date: Signed: Title: TO BE INCLUDED IN BID PACKAGE BP 15 of 31 ' CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN II??ROVEMLNTS PROPOSAL AND CONTRACT CLAUSES SECTION 3 -CONTRACT CLAUSES A. The work to be performed under this contract is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (Section 3). The purpose of Section 3 is to ensure that employment and other economic opportunities generated by HUD assistance or HUD-assisted projects covered by Section 3, shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly persons who are recipients of HUD assistance for housing. B. The parties to this contract agree to comply with HUD's regulations in 24 CFR Part 135, which implement Section 3. As evidenced by their execution of this contract, the parties to this contract certify that they are under no contractual or other impediment that would prevent them from complying with the part 135 regulations. C. The contractor agrees to send to each labor orga•+;?Ation or representative of workers with which the contractor has a collective ba*??;*+g agreement or other understanding, if any, a notice advising the labor orgA*+;?9r;on or workers' representative of the contractor's commitments under __- this Section- 3 clause, and will post copies of the notice in conspicuous places -at-the work site where both employees anti applicants for +?;n;ng and employment positions can see the notice. The notice shall describe the Section 3 preference, shall set forth m;.?;..,um number and job titles _ subject to hire, availability of apprenticeship anti training positions, the qustifications for -each; and the name and location of the person(s) taking applications for each of tlie-positions; -and the anticipated date the work shall begin. D. The contractor agrees to include the Section 3 clause in every subcontract subject to compliance with regulations in 24 CFR Part 135, and agrees to take appropriate action, as provided in an applicable provision of the subcontract or in this Section 3 clause, upon a fmding that the subcontractor is in violation of the regulations in 24 CFR Part 135. The contractor will not subcontract with any subcontractor where the contractor has notice or knowledge of that the subcontractor has been found in violation of the regulations in 24 CFR Part 135. TO BE INCLUDED IN BID PACKAGE BP 16 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS PROPOSAL AND CONTRACT AGREEMENT SECTION 3 -CONTRACT CLAUSE continued E. The Contractor will certify that any vacant employment positions, including training positions, that are filled (1) after the contractor is selected, but before the contract is executed, and (2) with persons other than those to whom the regulations of 24 CFR Part 135 require employment opportunities to be directed, were not filled to circumvent the contractor's obligations under 24 CFR Part 135. F. Noncompliance with HUD's regulations in 24 CFR part 35 may result in sanctions, termination of this contract for default, and debarment or suspension from future HUD assisted contracts. G. With respect to work performed in connection with Section 3 covered Indian housing assistance, Section (7) b of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450e) also applies to the work to be performed under this contract. Section 7(b) requires that to the greatest extent feasible (n preference and opportunities for training .and employment subcontracts shall be given to Indians, and (ii) preference in the award . of contracts and - subcontracts -shall be given to Indian organizations and Indian-owned Economic Enterprises.. ..Parties to-this .contract that- are subject to the provisions of Section 3 and: Section.? (b) agree to -? comply with. Section 3 to the maximum extent feasible, but not in derogation of compliance with ? _ _ ,,.. For thepurpose of *?+¦'*?:*+g and employment the primary Section 3 covered project=area is the area in closest proximity to the actual construction work site within the U.S. Census Tract in which the project is located. It is understood that priority for employment opportunity is to be given to residents residing within the primary Section 3 area as defined_ A Section 3 area resident is any lower. income individual residing within the Section 3 area, whose- total family income does not exceed 80% of the median income of the metropolitan statistical area in which the project is located (Orange County). A public housing resident is defined by regulations as Section 3 resident, regardless of income. The contractor and each subcontractor certifies that they will provide, to the greatest extent feasible, opportunities for employment to lower income residents (local residents) and job opportunities in connection with projects in their neighborhoods. For fiscal yeaz 1996-97, minimum goal for each project is 30%. BP 17 of 31 TO BE INCLUDED 1N BID PACKAGE CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND. WATER MAIN IIVIpROVEMENTS PROPOSAL AND CONTRACT AGREEMENT SECTION 3 -CONTRACT CLAUSE continued The Contractor/Sub-contractor/Service Provider by the signaxure axed hereto declares under penalty of perjury: Contractor/Sub-contractor/Service Provider has read Section 3 requirements and accepts all its requirements contained therein for all of his/her operations within the City of Santa Ana. ?? ?? ' t Nam and Title BP 18 of 31 TO BE INCLUDED IN BID PACKAGE CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS PROPOSAL AND CONTRACT AGREEMENT v /J? FEDERAL REQUIREMENTS FOR FEDERAL.-AID CONSTRUCTION PROJECTS (?tAL-The wodcl?apaposad wiH be So®mdawhole or inpe?wifli Fndeml fads, a?? ? afE?e s?R?s, Hies a?xgi?o? ?lg?bd by be Feder C??ae? earl appic?le b v?dc f®ed in whole a in pat w? Fademifa?wilapplybarbaade 'Ilse`RagesadCYs?dPbovhona,Fade?i- Aid O?rbim Q?Imc?, `FsmmFHWA 1273, ad io<i?dod a ? Ser.Vm 14. Whme? a ssd aa}>md aood? paovimo? ? aar >mde b `SETA ?B ??," `gIA 1e?elmt ?; Q `>;it®d aqe ?'be SHA; ' Sadt? shall be moabnal b ?'Fo?ad' as drfned in Soerim 1-1.18afbeShodad OI' PREV)tOi75 QOI?TIItAGT - ]ba ad3um b ?e ptvvi? a Sac6m 7>; ,• and Sbcbon VI>; `Sliielbg Q Aug ?e ?„ dbe ns}ad omaart povi®e, be ?r ?fl om?plywihbefoloa?ig The shall omn? be ?7FK'AT7CH?T WIIH REGARD TD 1IIE ? PREVIOC]S OCInTII2ACI5 tai SCI' TD THE BQCIAI. QP'QiTLIN[IY e7 wr tQr ??THI? FQIlVC' OF REQUIRID RE?E*?IS bid in?e p? No m4? fr s+blelmf Q ?6 ffiY Pa?'afbe aoo?ct in , oaoe??lOp00wi7beom®demd?ader8=pmveo?af5actim VII af#?e ?clessad eoo>otex gwame ide•? sueh mcler?s aoam?d by ire s-?db above, e?¢a?dby4?epmpoa?d silximleacbc PIi>OR?S -The p®vi9oe8 in !? secbm aee ?pii®Uteballoo?c?omeptoo?acffifrFademlAidSmm?cypeajec? T3®e 23, iSiasd 9Y?a Czxlr, Seam 112, as a ce?m poecedezY b appeoval by tie Fedez9l I?ltasy Ado?or af1?e amYad fr>b wndc ? ®rliBl>? fie a so??lmmt e?a?dby, amb?atfa? 1?ep®m, fm; a®oe»iq Q ottpe>aron b whom sts? amlesrt is b be aaiaeded. ?t ate p®oq $no, a®oeielioo, a ootpo?on has mS e>ber daecfly or Y. ea?d im any a?eezaa? pa6opadd in any oo3am a aiawis ml? any+ actioninr?ie*affeeoa?npel?uebiddignaome?mwi9?f?eae??i?+dbid A f? b males 1?e ?mism aSsdavit s?®®t iag?d by 51ectim 112 as a o?emvaderp®Yy afpajery?er banes a see??®taep?ledbY 2$L7? gee 1'74C?isioeideda?epmp®L PAI>?A1IdN SY D6AD?VANTe?i[?D BIB II?Tffi?lN -Pait2byT5®e49,GbdeafPedessl RegieAo? b ib Fede?aid pwjeet Piediastt aecti? 'said C7ode ? noapo?edapacta aim ?etywibu o? s?ctiooa afire ape®lgwis? Sd?e3ieB-h1'cm?'anfrDe?JoiYVmrae?Y- Aflarhmmt ?/ /? - I?hibltA-PRl / 8?07?J7 (Ibis fi:m>bcd mt be SOed m ifaII jobs ve?ae firma aie nmoahy owned.) 1. Nave a?fjobt venhae 2. Addeess afjoia ve?ae 3. Phone n.? ofjobt venhae 4.7dmtid'y the fig which oomFinae the joint vestieae. (The DBE patwrr na?st oo?leoe Sr?6,tr A) a. Desmbe the sole of@ie D$E firm in this jabtvenhae. b. Deac?e veiybricHy ffie ?imoe a? busmeBS 4 of : - each ?E joint vm?ae: 5. Nauae of?e jabs venhae's bps 6. Provide a cagy ol'?e joint ve?ae ag?eemeat 7. Whet is ffie claimed pQOmta?e oI"DBE o?w?shipT 8. Ow?abig ofjobt venbae: (I]ria mad mt be wed in if'desai5ed in ?e jabt vemae ag?ee>neof, p:wided by cgrslion ??- a. ProSt and loss sbmmg b. ? can?'beu:aos, ?? c. O?trr applicable oovne?lrip inmeaes? TO BE INCi.UDED IN BID PACKAGE BP 19 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND. WATER MAIN IIVIPROVEMENTS PROPOSAL AND CONTRACT' AGREEMENT 9 Cl»olat'aodpatiopadonasisoou?c;t ?y??? ?, aoa'Y?[' a? ?? (aoafl??liees> who ?. ? y aoa ?u?y aao? males Wig. butnoc3miea•? a?oae wlfbp®e?.-ray fQ: a. Fi?m®lae®oos >xra??? ?. 2Mada?gaodsales 3. Ham sod fmg oI'n»oag?t 4. Aaot:?g afnagor i? Q aipQlies - c S?pavimmat.SddaQ®6o? I`k?c 7?a?r?g?BSd1e371eB?dbei'??Ieoomplefimaf?e jo?v'?e's RVfcm?e CO?CtCOt?edbylb6ag?l?iu, tae s ?Y ?®? ia>be ikon ai>?ed, 8ie jam ?aa n>:rt nfoon floc ?amr? e? diecfly a 4za? >be pQne ao?ca? if'?e jet vmY?es a s?omlmctic "Ibe uod?,?ed awes that flee f®eg?ig ace aonar2 and ior]?ade a1 dal idoo?mma?yb idmety and ?xpiaabe>? and aQ®tim cfalr jas v?ae and 91e io?ded patid?on by each joiY venltaa a 1be ?lioo? Fuses >be indeed oo?'msY .and a?ee b ?ovide b ?a?e ? cQapleb and amnae nEms+tim aahs+l jod vie walcaod S?epaym? ?e aodaaygapo®d ? aany of $?e jaiY ve?ae and b pit >be audi and o®tion af'>be boolm, amoade, sod flea o!'8ie )opt v?ze, by aid af' be wee or flee Fod®i findi? ?7'• ?Y n?t?l tim w>B be gauods for ??B ?Y om`act vvlirb nsy be avuaa9od and for ?ali?g a?indc Fed®l a S1erc laws oooo®g false •> A1la?rt EsbtltA?-I+It2 8-097 Smaeaf ?Y? %?I? Al .1? _ day a4' 20? bdae me ePP?? ???) b ? p?aDy lmows? wLq bdgg duly swop did ooeu? 8?e fang a?arit sod. did e? 8iat lie or abe was paapaiy aid by (N?x of Son) b ooea? 8le a?idavt?d did so as bs ala five scx ?d doe[L No?[YA?1c Chone f?1] Dime Slaleaf QomlYaF Qo Sis _ day of 2D? berme nz appe?ed ??ia?) b me p?afly lmowo, who beag ?. d'd a®a? !be fagoog a>5davi< and did a? ?t lie a she was gapedy aid by (l?ia? of fam) b oasts?e affdavitaodd'dao aabsalafiaeactaoddeed Nol?yPuhl;c C7?o?? [?1] ?v/i?'_' TO BE INCLUDED IN BID PACKAGE BP 20 of 31 CITY OF SANTA ANA PROPOSAL AND CONTRACT AGREEMENT PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS TTTLE 49, CODE OF FEDERAL. REGULATIONS, PART 29 DEBARMENT AND SUSPENSION CERTIFICATION The BIDDER under penalty of perjury, certifies that except as noted below, heJshe or any person associated therewith in the capacity of owner, partner, director, officer, manager. is not cxurently 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 beers indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in A?tPr+..+*±?*+g . 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 signatuue of this Certification. Name of BIRD /11?.Fv??-?a„rrP?l?,y-•;,,J Signature of BIDDE Date 2/sli 0 - FED.8-22-88 TO BE INCI..UDED IN BID PACKAGE BP 21 of 31 Local Agency BIDDER-DBE (Construction Contracts}Information successful BIDDER must execute and return the LOCAL AGENCY BIDDER -DBE IIVFORMAT70N forth, even if no DBE icipation will be reported. AGENCY: ' v vi Ffi?_¢ LOCATION: ori.?, s4 .Arv' « ( 4 c PROJECT UESCRIPTIO ,_rG«?yt rJIwM ?/`.IF-rY?+-? /L. /J? w rLr?I?twti? s? fl ? t/ CONTRACT NUMBER: ri 74e 1! /V67?.y Qst/.t.,at FEDERAL-AID PROJECT NUMBER TOTAL CONTRACT AMOUNT: S FEDERAL SHARE (For local agotcy m complete) : S BID DATE: 21?o%i BIDDERS NAME: ? 1tr /Kac..t. ? ie???t+-fT.?A ADVERTISED DBE CONTRACT AVwn ssaiLlTy ADVISORY Poem NTRACT ITEM NO. OF WORK AND DESCRIPTION R SERVICES TO BE UBCON'17tACTED OR MATERIALS BE PROVIDED' BE Cot. No. EXPIRATION ATE E OF DHES ' ust be eatified on the date bide opoted -include DBE address bane number • .t w R AMOUNT BE' PORTANT: Identify all DBE fittr® being parttetpat6tg is the project, re?rdkss of 'er. Names of the Fitat Tie DHE Subemtraeton and their respectlve item(s) of work Total Claimed $ ?? fisted above should be cansistet; whets epplicsbk, with the names and itetrr of work in 'Last of Subeantrae0ws^ submitted with yaa bid. Reside copies of the DBEs' uotcs, and if applicable, a copy of joint ve?ahtto agreernesta. pursuant m the traetoo Lasting Law and the Special Pmvieiats. Parbcipaban . ? o ?o 1. Faster DBE pttra end subeontnetcrs ceetificsticn nuveber. Rime owttraeson shall indicate all work m be performed by DBEs ineludnrg wank pofanted by its own forces. . If 100% of horn is not m ba performed or fianished by DBE, deetenlte eaeaet portion of item m be perfarrrted a firrnished by DHE. S S a ^Di ^ ar a°"' of BIDDER ? / ?? ' ( y ?n? • ! 4 ?6' . ee ex oo eadwo Busntess En taged terprise (DBE), of the Special Provisions (construction contracts): m detvmme how m cant the putieipation of DBE firtrs. Date , (Area Code) Tel. No. l..oael Ageaey BIDDER -DBE Iofar>oseion (Rev S/01/06) Dietnbutrao: (1) copy -Fax immediately m the Caltrans District Lain Assistance Engineo (DEAF) upon aware. (2) Copy - Inehrde in award package m Caltr?ts Dirtrict Lceal Assistsn? (3) Orlgtaal - Il.seal agesey glee / J TO BE 1NCI..UDED IN BID PACKAGE BP 22 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGI-IBORHOOD SEWER AND WATER MAIN IIVIPROVEMENTS PROPOSAL AND CONTRACT AGRFF-7?iF?NT NONLOBBYING CERTIFICATION FOR FEDFItA7 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 ofl5icer 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 nay 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 is connection with this Federal contract, grant, .loan,:or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, ."Disclosure of ,_ Lobbying Activities," in accordance with its instructions. , This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into_ Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub-recipients shall certify and disclose accordingly. D gnature Firm fL ?,?/„ --- Date standard Form Lr1. may be obf?ed 8om Caltrana and FHWA o8icea. TO BE INCI.,UDED IN BID PACKAGE BP 23 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAII?I IIVIPROVEMENTS PROPOSAL AND CONTRACT AGREEMENT DISCLOSURE OF LOBBYING ACTIVITIES fia..r.lw?n rhis fivwr m ii;ae?l..m lid.1..,:..e n.-N..:ti.w .....v.e..r r.. 17 7 7 C !` N ??-- 7 ac?i /1fD Gsr B.lit??.?? ? o aF 2. Slates of Federal Action 3. Report : /jzn y. ne3 Q a. Bid/off'edapplil Q a initial b. Clzaot b. initial award b. matrrial change c. Cocpatate Agte®eoR c, Post-awaud d Ban For Material ?Ee only: e. I.aan ?anmee Year quailQ £ Loan Instaance dale of lest 4. Name and Address ofRepostiog Entity 5. lfRepoa>mg Entity. inNo. 4 is Sllbawardee, En6er Name and Addtea4 ofPrime: p Prime p s?tbwazdee Tier .Ijlbrow.. . lasown blo?l+n 6: FadQal Dep?/Ageoty. 7. Federal Paogiam NamdDeseipdon CFDA I?hnnbQ If livable 8. Fedasl Action NtaaUea, ifJbaox+R 9. Award Amoaart, if, bso?a?s ,- .: - _.. - $ .... a. Name aad Ad?eas afLobbying Entity b. ml Pafo?tg Savices'(?i?ail?iig;; adi+??'?rfwnllbe attach Cooti?mtion s if 11. Amoaart ofPaymrat: ( OaII ? ap?ly) 13. Type ?(choc]c aII that apply) A l p?d O ? ? b. ooe-time fee 12. Farm ofPaymet>R (chec-]c all that apply): ? c. oa?on ? a. cash ? ? d eaeotitlg? fee Q b. in-1®d; apecifY. nahac ? e. deLeaed vahte £ other 14. B77efDesQlptlon of Services Ptrfotmed or do be perfo®ed al]d Date(s) of Service, iacLtding OgLOer(s? eQinlOyee(s), Ot member(s) cotataa6ed, far Payment inlfiCated in itiem 11: 77#OCl! C071lDw/QdOVr s ' >'sPOees 15. Ce?aatian s at?ched: Yes No 16 f?t?th'sf?isa>dl®dby'IfAe31LJSCSactim 13SL'Il>ed'®dosaeef7diryi?ac?vitiesisam?aelaffacxtpan whic37.tr]'t®aev?plemdbytbe tieraborewhmthe ?rSmwsmadeQ?aed i>b?'IIsd'Bdoa=esacgs?dgaaatto3lUS.G13SLT1sidooz?mwiflbe ??N?e npaledbthe?s?etalaltyandwiHbeavatleble?P;? i®pectim A?.p®anovho?biiethes?iedder]oaae?flbesubjectbadvilpmaYyef Tiit? ?l?»ffialopooa?anotmod»?sloo?ooo??s,?hfa? T No. Date _ _?lilee0oly. wlltlv>md thrlawt xep.o3atim Send?dt+me-I3L a TO BE INCLUDED IN BID PACKAGE BP 24 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAII?T IMPROVEMENTS PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT REGARDING REOLTIRED FEDERAL CONTRACT PROVISIONS CForm FHWA-1273) The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the required Federal Contract Provision (Form FHWA-1273) as shown in the app of ial provisions of this project. Signed Title ?? Firm Date TO BE INCLUDED 1N BID PACKAGE BP 25 of 31 _. CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER. MAIN IMPROVEMENTS PROPOSAL AND CONTRACT AGREEMEIV I' CERTIFICATION FOR FEDFR wi -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her loaowledge and belief; that: (1) No Federal appropriated fiords 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 aay person for influencing or attempting to influence an officer m 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 malting or entering into this - t?ansaction unposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her proposal that he or she shall require that the lan this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such reci en certify and disclose accordingly. D /f??ureG Firm ai/.? ?i Date TO BE INCLUDED IN BID PACKAGE BP 26 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IMPROVEMENTS PROPOSAL AND CONTRACT AGREEMENT B_IDDER'S CERTIFICATE OF COMPLIANCE REGARDING "BLn' AMERICA" REQUIREMENTS FOR STEEL OR MANUFACTURED PRODUCTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the "Buy America" req¦++re*?+ents of Section 165 of the Surface Transportation a of 1982 aad as shown in the special provisions of this project. Signed /f Title firs mod, ?li.?- / Firm ??oth ?i?t??c.w.-y?r/?i Date ???s ? .. - .. .... TO BE INCLUDED IN BID PACKAGE BP 27 of 31 CITY OF SANTA ANA PROJECT NO.' 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IIVIPROVEMENTS PROPOSAL AND CONTRACT AGREEMENT PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT 7n 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 otI'enses 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 ofthe Cglifonria State University. The term "BIDDER" is understood to include any partner, member, otI'icer, director, responsible managing ofl3cer, or responsible managing employee thereof, as referxiCd to in:Section ? .:.: . 10285.1. Note: The BIDDER must place a check mark after "has^ or "has not^ in one of the blank spaces provided_ The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. BIDDERS are cautioned that making a falsefication may subject the certifier to r*+*+++*+s+1 prosecution. Signed Title y ,?«?? Firm /??/ /(mod-?.?- ??Z?? AP- ?h?-? Date U//e TO BE INCLUDED IN BID PACKAGE BP 28 of 31 a. CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD SEWER AND WATER MAIN IlVIPROVEMENTS 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 ? - If:the answer is yes, explain the. circumstances in the following space: ... - . .. .. . i .. ... ,. -. .. TO BE INCLUDED IN BID PACKAGE BP 29 of 31 CITY OF SANTA ANA PROJECT NO. 11-7508; LACY NEIGHBORHOOD. SEWER AND WATER MAIN IIVIPROVEMI:NTS 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 thaw one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the ?**+**+ediately preceding two year period because of the Contractor's failure to comply with ffi 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 Questio*+*+g+*e are part of the Proposal. Signing this. Proposal on the signature portion thereof shall also constitute signature of flue-Statement aad Questionnaire. i. BIDDERS are cautioned that malring a false certification may subject the Certifier to criminal prosecution. Signed Title _ ?? ? `?i??tr??r??`?. Firm JV ??eG? ??SL?aa.?Trjy`J Date ?ro /j , TO BE INCLUDED IN BID PACKAGE BP 30 of 31 FEDERAL MINIMUM WAGE RATES Insert the Federal m;n;muln wage rates in Appendix H. Go to Caltrans website to obtain a copy: http://www.access. gpo. gov/davisbacon/ca.html Scholl down to Orange County Select latest highway entry . Li TO BE INCLUDED IN BID PACKAGE BP 31 of 31 MAYOR Migue] A. Pulido MAYOR PRO'I'FM Claudia C. Alvaro COUNCIL-MF.MRERS Car]os F3ustamante David I3enavides Michele Martinez Sal "1'inajero Vincent F- Sarmien to January 14, 2011 ADDENDUM No. 1 CITY OF SANTA ANA PUBLIC WORKS AGEI?ICY 220 S_ Uaisy Rve-, M-85 - P.O_ Bo: 1988 Santa Ana, California 92702 CITY MANAGE-K I]avid N- Ream CITY ATTORNEY Joseph W. Fletcher CLERK OF THE COi1NC1L Maria D. F[uizar Subiect: Proiect 11-750$ - Lacv Neiehborhood Sewer and Water Main Improvements ote: The bidder shall execute the certii9cate at the end of Addendum No. 1 and shall include same is the Bid Package_ The following revisions have been made to the specifications of this project. SPECIFICATIONS • Section 2.11 CONSTRUCT SEVER LATERAL AND CLEANOUT (PIPE BRUST): the last three paragraphs of page 26 shall read as follows= The Contractor shall submit certification by the manufacturer of the pipe bursting system to have successfully completed training in operating the bursting head, installing proposed replacement pipe and operation- and maintenance of all equipment to be used. The Contractor shall submit certification by the manufacturer of the fusing equipment having successfully completed training in handling replacement of pipe materials, butt- fusion of pipe joints and saddle fusion of fittings for service laterals, and operation and maintenance of all equipment to be used. The Certificate of Training shall include at a minimum: Installer's name, date of issuance and process or product the person is certified to install. All certifications shall be submitted prior to commencing work. All other terms and conditions remain the same. The bid date remains February 1 O, 2011. FOR THE CITY OF SANTA ANA odolf sas, P.E. Acting Senior Civil Engineer Project 1 ] -7508 Lacy Neighborhood Sewer and Water Main Improvements January 14, 2011 Page 2 BIDDER CERTIFICATE I hereby acknowledge receipt of the Addendum No. 1 and accept all conditions contained therein. Date Bid Title MERCHANTS BONDING COMPANY (MUTUAL) 2100 FLEUR DR., DES MOINES, IOWA 50321 BID BOND BOND NO. 5463 KNOW ALL MEN BY THESE PRESENTS, That we, Nikola Corporation as Princi al, and Merchants Bonding Company (Mutual) P a corporation authorized to transact 9 general surety business in the Slate of CA as Surety, era held and firmly bound unto City o£ Santa Ana - Public Works Agency (hereinafter called the Obligee) in the full and just sum of TEN PERCENT OF THE AMODN'P OF THE BID Dollars, ($ lO.g'k'k? for the payment whereof in lawful money of the United States, we bind ourselves, our heirs, administrators, executors, successors and assigns, jointly and severally, finely by these presents. WHEREAS, the said PRINCIPAL has submitted the accompanying bid for - Project No_ 11-7508 Lacy Neighborhood Sewer R Water Maim Improvements NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accrordance with the terms of such bid, or in the event of the failure of the Principal to enter such Contract. If the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specked in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covared by said bid, than this obligation shall be null and void, otherwise I. remain in full force and effect. Signed and Sealed this 7t1i day of February 2011 vEAR ola o ion Mar ants Bo din C an Mutual) By _ gy: ohany ichan - Presidemr Pr4io°ai Ry Mantle Attorney-in-Fact CALIFORNIA ALL-PUIYPOSE ACKNOWLEDGEMENT STATE OF CALIFORNIA j,?r ) COUNTY OF ? ?? ? ? L ) On-a- 1-? ? before me, ?-??nL ? - 1-yS???"7 F??1?2? fl y?L]L DATE INSERT NAME, TITLE OF OFFICER - E.G.., "JANE DOE, NOT Y PUBLIC personally appeared, ???'? ?V ? • ? ] C'3-4-?7 who proved to me on the basis of satisfactory evidence to be the person( whose nameEs) is/are subscribed to the within instrument and acknowledged to me that he/sk?e{#l?rey executed the same in his?i< authorized capacity(ieg), and that by his icrrincir signature(- on the instrument the person{sj, or the entity upon behalf of which the person($) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal_ ? CAROL A LUSTIG U _ COMM_ # 1917984 ? • NO NIA C ? ORANGE COUNTV COMM. EXPIRES JAN. 16 2015 (SEAL) NOTARY PUBLIC SI ATURE OPTIONAL INFORMATION THIS OPTIONAL INFORMATION SECTION TS//??NOT REQUIRED HY LAW BUT MAY BE BENEFlCIAL TO PERSONS RELYING ON THISpNOTARIZED DOCUMENT. TITLE OR TYPE OF DOCUMENT L?2.? ? ?`? ? ???-1_?? ??? "'r\ ?l-A DATE OF DOCUMEN? -?i ?! NUMBER OF PAGES I SIGNERS(S) OTI-IER THAN NAMED ABOVE SIGNER'S NAME SIGNER' S NAME RIGI-rr THUMBPRINT 1 1 RIGHT THUMBPRINT 1 To order supplies, please contact McGlone inm•.a..? Services, Inc. at (916) 484 0804. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of --Orange On ?-? - ? `l before me, Mary Martignoni - Notary Public Date Here Insert Neme antl Tltle o/ the Oflicar ' personally appeared Ryan Mantle ?+?srti+arur ' _ _:,:,?,_ MARY MARTIGNONI o- _°_? •.'. COMM_ # ? 76'125'1 r Q '- NOTARY PUB L/C -CALIFORNIA ? OrtANG? COUNTY My Comm. Expires Sept. g, 201'1 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the persort?Q whose name'(' isl"?t1[4 subscribed to the within instrument and acknowledged to me that he?hyil?e>Texecuted the same in his1At14F($mif authorized capacity?cj, and that by his)T'yl%f7tRpef signature(y',[ on the instrument the person(}Cj, or the entity upon behalf of which the person acted, executed the instrument- certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct- WITNESS my hand and official seal. Signature Signature o Not Public OPTIONAL Though the information be/ow is not required by law, it may prove valuab/e to persons relying on the document and cou/d prevent fraudulent remove/ and reattachment of this farm to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Ryan Mantle Signer's Name Number of Pages: D Individual ? Individual ri, Corporate Officer -Title(s): n Corporate Officer -Title(s): C7 Partner - O Limited O General _ __ _ _ O Partner - D Limited U General _ , _ _ Ll Attorney in Fac[ • O Attorney in Fact GI TfUStee Top of thumb here ? TfUStee Top al thumb here O Guardian or Conservator LJ Guardian or Conservator ? Other: O Other: Signer Is Representing: ? ? Signer Is Representing Merchants Bondi Company CMutual ®200] National Notary Association ? 9350 Da Solo Ave., PO. Bon 2402 - Cher worts, CA 91313-2402 ? www.NafionalNOtary org Item N590] RaoNec OHII Toll-Free l-BOO-B]6-682] Merchants Bonding Company (Mutual) POWER OF ATTORNEY Know All Persons By These Pr¢sents, that the MERCHANTS BONDING COMPANY (MUTUAL). a corporation tluly org armed urttler the laws of the Sla le of Iowa, end having its principal office in the City of Des Moines. County of Polk. Stale of Iowa, barn mane. constituted and appointed, and does by these presents make, constitute ono appoint Les M. Mantle, Ryan Mantle of Fullerton and State of California its true and lawful Attorney-in-Fact, with full power and authority hereby conferred in its name. place and stead. to sign, execute, acknowledge and d¢liver in its behalf as sur¢ty any and all bonds, undertakings. recognizances or other written obligations in the nature thereof. subject to the limitation that any such instrument Shall not exceed the amount of: SIX A7ILLIOV ($6,000.000.00) DOLLARS and to bind the MERCHANTS BONDING COMPANY (MUTUAL) thereby as fully and to the same extent as if such bond or undertaking was Signed by the duly authorized officers of the MERCHANTS BONDING COMPANY (MUTUAL). and ail the acts of said Attomey-in-Fact, pursuant to the authority herein given, are ,hereby ratified and confirmed. This Power-of-Attorney is made and executed pursuant to and by authority of the following Amended Substituted and Restated By- Laws adopted by the Board of Directors of the MERCHANTS BONDING COMPANY (MUTUAL) on November l6. 2002. ARTICLE II. SECTION 8 -The Chairman of the Board or President or any Vice President or Secretary shall have power and authority to appoint Attorneys-in-Fact, and to authorize them to ax¢cuta on behalf of the Company, and attach the Seal of the Company thereto. bonds and undertakings, r¢cognizances, contracts of indemnity and other writings obligatory in the nature thereof ARTICLE 11, SECTION 9 -The signature of any authorized officer and the Seal of the Company may be affixetl by }a rsimile to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or olh¢r suretyship obligations oT the Company, and Such Signature and seal when so used Shall have the same force and effect as though manually fixed. In Witness Whereol, MERCHANTS BONDING COMPANY (MUTUAL) has caused these presents to be signed by its President and its corporate seal to be hereto off xed, this 20th day of January 2009 . ?o?p\N P O O,?p ?? MERCHANTS 90NOING COMPANY (MUTUAL) .? 9?:y<: . y,. 1933 ?? ey z . ???T? STATE OF IOWA ?' .. President COUNTY OF POLK ss. On this 20th day of January 2009 ,before me appeared Larry Taylor, [o me personally known, who being by me duly sworn did say that he is President of [he MERG HANTS BONDING COMPANY (MUTUAL), [he corporation described in the foregoing instrument, and that the Seal affixed,to [he said instrument is the Corporate Seal o! the said Corporation and that the saitl instrument was signetl and sealed in behal/ of saitl Corporation by authority of its Board of Directors. In Testimony Whereof, 1 have hereunto set my hand antl off xed my Official Seal at the Ci[y of Des Moines, Iowa. the day and year firs[ above written. y CINDY SMYTH / i.L ??,r/t?/1??u? i Commission Numbsr 1?750a L??ti (;// YY" e? My Commlaaion Ezpi?es March 16, 2009 Notary Pub/!c, Polk Covnry. Iowa STATE OF IOWA COUNTY OF POLK ss. I, William Warner, Jr., Secretary of the MERCHANTS BONDING COMPANY (MUTUAL), do hereby certify that the above and foregoing is a true and correct copy of [he POWER-OF-ATTORNEY executed by said MERCHANTS BONDING COMPANY (MUTUAL)- which is still in full force and effect antl has not been amended or revoked. In Witness Whereof, 1 have hereunto set my hand and affixed the seal of the Company on [his 7th day or Februarys 2011 LNG cp R q9 . ?_.. ?: 3? Secrete " s?' 1933 c. ry .• Y POA 0001 (1/06) J6-?sy'-...-"\'\-ate: - _