HomeMy WebLinkAboutBEN'S ASPHALT, INC. (2)Clerk of the Council, City 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
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NOTICE OF COMPLETION
NOTICE IS HEREBY GIVEN that the undersigned City of Santa Ana, California, a
municipal corporation, with the address of City Hall, 20 Civic Center Plaza, Santa Ana,
California, 92701, is the owner of the property hereinafter described, that said owner has caused
construction of SANTA ANA ZOO WALKWAY IMPROVEMENTS under contract entered
°w into on MARCH 5, 2012, with BEN'S ASPHALT INC., on which contract FIDELITY AND
o DEPOSIT COMPANY OF MARYLAND is surety. The property on which such work
w improvement was placed is in the City of Santa Ana, County of Orange, State of California, and
U C described as Project No. 12-2621 located at: SANTA ANA ZOO. The work improvement on
M F said property was accepted as completed on MAY 15, 2012.
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a VERIFICATION
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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 ? (2 7i at Santa Ana, California
(Signature of individual swearing that the
contents of Notice of Completion are true.)
i
THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN (10) DAYS AFTER COMPLETION
REQUEST FOR w'
COUNCIL ACTION
CITY COUNCIL MEETING DATE: CLERK OF COUNCIL USE ONLY:
MARCH 5, 2012
TITLE: APPROVED 3
CONTRACT AWARD FOR SANTA ANA 0? "As Recommended CA36
ZOO WALKWAY IMPROVEMENTS ? As Amended
PROJECT NO. 122621 ? Ordinance on 15t Reading
) ? Ordinance on 2nd Reading
? Implementing Resolution
? Set Public Hearing For
CONTINUED TO
FILE NUMBER
CITY MANAGER
RECOMMENDED ACTION
1. Award a contract to Ben's Asphalt, Inc., the lowest responsible bidder, in accordance with unit
bid prices for the base bid plus alternate one in the estimated amount of $62,675 for
construction of the Santa Ana Zoo walkway improvements.
2. Approve a funding analysis with a total estimated construction cost of $75,000.
DISCUSSION
In September 2011, the Friends of Santa Ana Zoo received a donation of $75,000 from the McBeth
Foundation to refurbish the asphalt and decomposed granite walkways and service roads
throughout the Santa Ana Zoo at Prentice Park (Exhibit 1). The walkways and service roads have
been maintained over the past 20 years with temporary patches and fixes. Replacement or
permanent repairs are needed to provide safe access to the zoo for the public and staff. This
project provides for the reconstruction of the walkways and service road.
The Notice Inviting Bids was advertised on January 18 and 19, 2012, with outreach efforts to 17
Santa Ana contractors. Bids were opened on February 7, 2012. A summary of the bid notices
and the bid results follows:
Contractors requesting bid documents: 32
Santa Ana contractors sent bid notices: 17
Total bids received: 10
Bids received from Santa Ana contractors: 2
Contract Award for
Santa Ana Zoo Walkway Improvements
March 5, 2012
Page 2
NAME OF RESPONSIVE BIDDER CITY BASE BID AMOUNT
1. Ben's Asphalt, Inc. Santa Ana $62,675
2 Excel Paving Company Long Beach $66,693
3. Newcon Development Santa Ana $73,800
4. Green Giant Landscape, Inc. La Habra $74,800
5. Super Technical, Inc. Anaheim $75,388
6. Oliver Mahon Asphalt, Inc. Costa Mesa $79,780
7. Century Paving, Inc. La Mirada $82,210
8. Ted Enterprises San Clemente $85,610
The engineer's estimate was $57,000. A total of 10 bids were received with eight being
responsive. Ruiz Engineering, Inc. and EBS General Engineering submitted incomplete bids that
were deemed nonresponsive. The bid documents require the contractor be selected by the lowest
base bid. The lowest bid was submitted by Ben's Asphalt, Inc. in the amount of $62,175.
Therefore, staff recommends awarding base bid plus alternate one in the total amount of $62,675.
ENVIRONMENTAL IMPACT
Environmental Review #ER-2012-02 is completed and a Negative Declaration is filed pursuant to
the California Environmental Quality Act.
FISCAL IMPACT
The funding analysis shows a total estimated construction cost of $75,000 for the project
(Exhibit 2). Funds are available in the State Contract Services Fund (accounting unit 02213200-
62300).
APPROVED AS TO FUNDS AND ACCOUNTS:
Raul Godinez II Francisco Gutierrez
Executive Director Executive Director
Public Works Agency Finance & Management Services Agency
V
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Gerardo Mouet
Executive Director
Parks, Recreation, and Community Services Agency
RG/ET
Exhibits: 1. Project Location Map
2. Funding Analysis
FIRST STREET
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EXHIBIT 1
SANTA ANA
TITLE:
CIE! DCOUNCIL
A DATE: CONTRACT AWARD FOR f 1
LWA AGENDA DATE:
March s, 2012 SANTA ANA ZOO AC WALKWAY IMPROVEMENTS
~.[..~..tr (PROJECT 12-2621)
Exhibit 2
FUNDING ANALYSIS
PROJECT NO. 122621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
Construction Contract $62,675
Contract Administration $1,000
Inspection and Testing $2,800
Survey Staking $1,000
Contingencies $7,525
TOTAL ESTIMATED CONSTRUCTION COSTS 75 000
THE REGISTER This space for filing stamp only
625 N GRAND AVE, SANTA ANA, CA 92701
Telephone (714) 796-7000 / Fax (714) 796-6059
CNS#: 2243661
NOTICE INVITING BIDS phone (7141 647-5680._ The
Plans end pacification are
NOTICE IS HEREBY GIVEN now available in portable
that the City of Santa Ana, document format (PDF) on a
California will receive at the compact disk (CD) only.
City Hall-Ross Annex, (M- There is no charge for the
43), 20 Civic Center Plaza, Plans and Specifications on
Santa Ana, California 92701, Co. To request a CD by mail,
the Public Works A enc the Contractor must submit
Fourt oor ec t on st, an email request to
on or be ore the hour o 2:00 sarmour®santa-ana.org and
PROOF OF PUBLICATION saalon February 2012 provide the following
scaled tads and/or proposals information: Company name,
for mailing address, phone
number, FedEx account, and
PROJECT 12-2621 email Subject heading: CD
(2015.5 C.C.P.) SANTA ANA ZOO Request for PROJECT 12-
WALKWAY 2621 SANTA ANA ZOO
IMPROVEMENTS WALKWAY
State of California ) IMPROVEMENTS. Checks
Notice is hereby given are no longer accepted. Any
County of ORANGE ) SS BIDDERS that in accordance addenda will be issued by
with the provisions of the email to those who received
California Labor Code, not CDs directly from the Public
Notice Type: BID - NOTICE INVITING BIDS less h n t wares evailrate ingeach Works Agency.
for
of per
craft or type of worker and DO NOT CALL
mechanic needed to execute PURCHASING DIVISION
the contract in the locality in REGARDING
Ad Description: which the work is to be AVAILABILITY OF PLANS
perf ormed, and not less than AND SPECIFICATIONS.
Santa Ana Zoo Walkway Imprv the general prevailing rate of 1/18,1/19/12
per diem wages for holiday CNS-2243661#
and overtime work as THE REGISTER
determined by the Director of
Industrial Relations of the
State of California shall be
I am a citizen of the United States and a resident of the State of California; I am paid to all workers employed.
over the age of eighteen years, and not a party to or interested in the above Each bid shall be
entitled matter. I am the principal clerk of the printer and publisher of the THE accompanied by cash, a
REGISTER, a newspaper published in the English language in the city p of payaya ablle e or certified check
to the City of Santa
SANTA ANA, county of ORANGE, and adjudged a newspaper of general Ana, or bid bond issued by a
corporate surety, for an
circulation as defined by the laws of the State of California by the Superior amount not less than ten
Court of the County of ORANGE, State of California, under date 11/19/1905, percent (10i) of the
of as
Case No. A21046. That the notice, of which the annexed is a printed copy, has guarantee that aggregate guarantee the the bid, D a
BIDDER
been published in each regular and entire issue of said newspaper and not in will treanter if tot the sproposed
con any supplement thereof on the following dates, to-wit: awarded to him. The
signature of the BIDDER
on the bid bond MUST be
notarized.
The City Council reserves
the right to reject any or all
bids.
The successful BIDDER
must possess or obtain a
valid California Class A or
C12 Contractor's license
01/18/2012, 01/19/2012 prior to the scheduled award
date of this contract.
Substitution of securities for
Executed on: 01/19/2012 any monies withheld by the
City of Santa Ana to ensure
At SANTA ANA, California performance is allowed in
accordance with the Public
Contract Code.
I certify (or declare) under penalty of perjury that the foregoing is true and
correct. ~~ppm__ppgI t?g__ tr m t of
the Decifications
will be furnished upon
application to the Public
Works A gy counter . First
Floor 20 ivi Center Plaza,
Santa Ana California 92701.
Sig lure
I IIIIIII IIII VIII VIII I IIII VIII VIII III VIII II VIII IIII IIII
* A 0 0 09 0 1 4 9 4 5
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BID
ASPHALT, INC.
MAINTENANCE DIVISION
2200 S. Yale Street Tel: 714-540-1700
Santa Ana CA 92704 Fax: 714-540-1 709
SEALED BID FOR:
Project 12-2621
*Santa Ana Zoo Walkway Improvements
In the city of Santa Ana
*Do not open with regular mail*
CITY OF SANTA ANA ADDENDUM NO. TWO
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
PROPOSAL & CONTRACT AGREEMENT
BID PROPOSAL
TO: CITY COUNCIL OF THE CITY OF SANTA ANA
FROM: IN`s C~~IPNAL-C~ ~/VC.
REQUIREMENT:
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
1. Unclassified Excavation * CY 5 $ $ ~J
2. AC Pavement * TN 240 $ ~J $ ~ol~,
3. Cold Mill Base Material* SF 25,000 $ $ ~CS, OOO~
4. Dispose Excess Base Material * CY 40 $ LAO $ t 'Qs -b0
5. Root Shave LS 1 $ c~•,5co $ `a rj00
6. Decomposed Granite * TN 5 $ d '~)o $ CID 0
7. Adjust Sewer Manhole to Grade EA 3 $ $ q p0
8. Adjust Sewer Cleanout to Grade EA 3 $ I co 5a(J),
9. Adjust Water Meter to Grade EA 2 $ -i $ 3rzIc
oa o•
10. Adjust Drain Grate to Grade EA 2 $ r.7 $
11. Furnish & Install New Sewer Cleanout* EA 1 $ l 000 $ Q0~
12. 1'x1' PCC footing for benches EA 12 $ -i cJ•~ $
TO BE INCLUDED IN BID PACKAGE
BP I of 13
CITY OF SANTA ANA ADDENDUM NO. TWO
PROJECT 12-2621: SANTA ANA ZOO WALKWAY IMPROVEMENTS
PROPOSAL & CONTRACT AGREEMENT
BID PROPOSAL
TO: CITY COUNCIL OF THE CITY OF SANTA ANA
00
TOTAL BASE BID---------------------------------------------------------------------------- $
ADD ALTERNATE ONE:
L 00 oe
12. Recycle Solid Plastic Lumber Edging LF 100 $ J $
(include steel stakes placed at 4' o.c.) *
TOTAL ADD ALTERNATE ONE----------------------------------------------------- CJ
ADD ALTERNATE TWO: a-5
13. Form Edge of AC Walkway LF 1,000 $ $ 450
TOTAL ADD ALTERNATE TWO----------------------------------------------------- $ S o
The lowest responsible bidder shall be selected based on the TOTAL BASE BID for PROJECT 12-
2621, SANTA ANA ZOO WALKWAY IMPROVEMENTS. The City reserves the right to award the
Base Bid and any, all, or none of the Add Alternate Bid items.
* The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to
the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual amount for this
item will be dictated by the actual quantity used, and the Agency reserves the right to increase or
decrease the quantity of this item accordingly.
BIDDER
PROJECT 12-2621
SANTA ANA ZOO WALKWAY Firm N ` ~~p 4{qL-( -co C.
IMPROVEMENTS
Address
c~.~40 SovTf1 ~jAL.~
Phone `-1 p ` oo
Fax 'c4 k L; Syc '4 cot
Email
BIDDER
Signature
TO BE INCLUDED IN BID PACKAGE
BP2of13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
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; ''/z% of the bid or $10,000,
whichever is greater
- Buildings, parks, or other projects: ''/z% of the bid
BIDDER proposes to subcontract certain portions of the work to the firms listed below:
NAME rr' rIKS WF-9- pluml btvv V NAME
LOCATION (a NA HAM LOCATION
PHONE y _ ~y 3 00~ 3 PHONE
TYPE OF WORK EwzL $ 1 U~- TYPE OF WORK $
NAME Qm.?-X(,o I ~ P a, So N$ NAME
LOCATION (4ZQ c,,p LOCATION
PHONE C ~'i - PHONE
TYPE OF WORK TooT tE $ '3, ooh TYPE OF WORK $
1= ooT'trti c,s
NAME NAME
LOCATION LOCATION
PHONE PHONE
TYPE OF WORK $ TYPE OF WORK $
NAME NAME
LOCATION LOCATION
PHONE PHONE
TYPE OF WORK $ TYPE OF WORK $
NAME NAME
LOCATION LOCATION
PHONE PHONE
TYPE OF WORK TYPE OF WORK $
vzvp-pNq~cl
c..
Name of Firm,S mitting Bid
Si ature
TO BE INCLUDED IN BID PACKAGE
BP3of13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY 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
g 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. )6v= r
Name of Firm
Signature of
BIDDER
Title %.U
(if an individual, so state)
TO BE INCLUDED IN BID PACKAGE
BP 4 of 13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
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.)
WzL T.Rrn Sk~~~' NGTc~iJ C
N CJ J -t. ) To IJ t~
a; t uQLT, mac_.
ACTION OF COUNCIL:
Awarded to
on the basis of lowest responsib and responsive
bidder in the amount of
Date 20 ~o
ATTEST:
CLERK OF THE COUNQJL
APPROVED AS TO FORM: ACCEPTED FOR THE CITY OF SANTA ANA:
CITY ATTORNEY EX TIVE DIREC R
PUBLIC WORKS AGE CY
TO BE INCLUDED IN BID PACKAGE
BP5of13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY 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 recruitment advertising; layoff
or termination; rates of pay or other forms of compensation; and selection for training, including
apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and
applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination
clause.
2. The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf
of the Contractor, state that all qualified applicants will receive consideration for employment without
regard to race, color, religion, sex, or national origin.
3. The Contractor shall send to each labor union or representative of workers with which he/she has
a collective bargaining agreement or other contract or understanding, a notice to be provided advising
the said labor union or workers' representatives of the Contractor's commitments under this section, and
shall post copies of the notice in conspicuous places available to employees and applicants for
employment.
4. The Contractor shall comply with all provisions of Executive Order 11246 of September 24,
1965, and of the rules, regulations, and relevant orders of the Secretary of Labor.
5. The Contractor shall furnish all infonnation 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
BP6of13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
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, physical handicaps, mental condition, marital status, or
sex of such persons, except as provided in Section 1420, and any contractor of public works violating
this Section is subject to all the penalties imposed for a violation of the Chapter.
Signed
Title i - U
Firm -r&N (a ~QLT
Date `a-
TO BE INCLUDED IN BID PACKAGE
BP7of13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
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 1, 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 an insurance certificate from my workers'
compensation insurance carrier certifying that I carry such insurance and that the policy shall not be
canceled nor the coverage reduced except upon thirty (30) days prior written notice to the City of Santa
Ana.
Signed
Title \VK 6 ' . F.
Firm 1 N~ll~ 71"C,
c
Date
TO BE INCLUDED IN BID PACKAGE
BP8of13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
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.
1. Z-- A Vac-NE D
Name and 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 and 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, and telephone numbers of all brokers and sureties from whom
BIDDER intends to procure insurance and bonds.
SV-- 7-- Q -tr(lc r n
I
CU 1 Q>E t 5o r-3 S ,y SU P'V~ NC£ Q c Eg , .Z~c
~Sc~o E ~p CANya?~ Q-D SvsrE I
Ca-NC~NEZr~~ CA ~'~t41°lal~as"So
~acv~ gac- ao~~
TO BE INCLUDED IN BID PACKAGE
BP9of13
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ASPHALT, INC.
LICENSE # 668417
REFERENCE LIST
City of Mission Viejo
949-470-3092
27204 La Paz Rd.
Mission Viejo, CA 92692
Chris Robinson
Annual Routine Maintenance in 2009-2010 for $262,000.00
City of Brea
714-990-7691
Number One Civic Center Circle
Brea, CA 92621-5758
Jerry Mestas
Annual Maintenance in 2009-2010 for $200,000.00
Innovative Technical Solutions
925-946-3100
2730 Shadelands Dr., Ste 100
Walnut Creek, CA 94598
Pave Perimeter Road US Air Force in 2009-2010 for $1,045,000.00
HBI, Inc.
949-851-2211
4921 Birch St., Ste. One
Newport Beach, CA 92660
Bob Braido
Trench patching at Various Wal-mart Locations in 2010 for $30,000.00
Santa Ana U.S.D.
714-558-5743
1601 E. Chestnut St.
Santa Ana, CA 92701
Dave Woosley
Patching at several school locations in 2008 for $325,000.00 in 2009 for $682,000.00
2200 S. Yale Street, Santa Ana, CA 92704
Phone 714-540-1700 fax 714-540-1709
~n
ASPHALT, INC.
LICENSE # 668417
PUBLIC WORKS / CITY JOBS
CITY JOB NAME
City of Santa Ana V&5 1h St. Rehab
20 Civic Center Plaza Shelton St.
Santa Ana, CA 92702 Fairview Str. Rehabilitation
Edward Torres (714) 647-5018 Fairview/Edinger Ave. Intersection Widening
Warner Ave. Improvements
Warner Ave. Rehabilitation
Westminster Ave. Widening
City of Huntington Beach Warner/Newland Improvements
2000 Main St.
Huntington Beach, ca 92648
Eric Charlonne (714) 536-5430
City of Anaheim Broadway Str. Improvements
200 S. Anaheim Blvd. Anaheim Blvd.
Anaheim, CA 92805 La Palma Ave. Str. Improvements
Mike Woods (714) 765-5176 La Palma Ave. Str. Rehab
Magnolia Ave.
City of Westminster Bushard Str. Improvements
8200 Westminster Blvd.
Westminster, CA 92683
Kevin Sin (714) 898-3311
City of Tustin Tustin Ranch Rd.
300 Centennial Way
Tustin, CA 92780
Benny Tenkean (714) 573-3161
City of Lynwood San Jose, Platt & Carlin
11330 Bullis Rd.
Lynwood, CA 90262
Elias Saikaky (310) 603-0220
City of Placentia Placentia Ave. Rehabilitation
401 E. Chapman Ave.
Placentia, CA 92870
Art Burgner (714) 993-8245
City of Garden Grove Garden Grove Str Rehab
11222 Acacia Parkway
Garden Grove, CA 92842
(714) 741-5000
City of Corona 2002/2003 Pavement Rehab
730 Corporation Yard Way
Corona, CA 92880
Scott Briggs (909) 736-2454
City of Mission Viejo Cabot Road Pavement Rehab
200 Civic Cneter
Mission Viejo, CA 92692
(949) 470-3000
2200 S. Yale St., Santa Ana, CA 92704-4427 Phone (714) 540-1700 Fax (714) 540-1709 1
ASPHALT, INC.
LICENSE # 668417
CITY JOB NAME
City of La Puente Temple Ave. Reconstruction
15900 East Main St. Francisquito & Nelson Aves
La Puente, CA 91744
(626) 855-1500
City of Newport Beach Monrovia Ave.
3300 Newport Blvd. Newport Heights Pavement Overlay
P.O. Box 1768
Newport Beach, CA 92658-8915
(949)644-3311
City of Westminster Bushard & Magnolia Aves
Civic Center
8200 Westminster Blvd.
Westminster. CA 92683
(714) 898-3311
City of Villa Park Collins Ave./Wanda Rd.
17855 Santiago Blvd.
Villa Park, CA 92861-4187
(714) 998-1500
City of Chino 2003-04 Str. Rehab
13220 Central Ave.
Chino, CA 91710
(909) 464-8367
County of San Bernardino Various Roads - Chino Area
Engineering Department
825 East Third St.
San Bernardino, CA 92415-0835
(909) 387-8104
2200 S. Yale St., Santa Ana, CA 92704-4427 Phone (714) 540-1700 Fax (714) 540-1709 2
in rn
ASPHALT, INC.
LICENSE # 668417
CITY REFERENCE LIST
City of Santa Ana City of Anaheim
1St & 5th Street/ Shelton Street Broadway Street Improvements
20 Civic Center Plaza 200 S. Anaheim Blvd.
Santa Ana, CA 92702 Anaheim, CA 92805
Edward Torres (714) 647-5018 Mike Woods (714) 765-5176
City of La Puente City of Santa Ana
Temple Ave. Reconstruction Shelton Street
15900 E. Main Street 200 Civic Center Plaza,
La Puente, CA 91744 Santa Ana, CA 92702
Joe Boada (626) 855-1500 Edward Torres (714) 647-5018
City of Huntington Beach City of Santa Ana
Warner/ Newland Improvements Fairview / Edinger Ave. Intersection Widing
2000 Main Street 20 Civic Center Plaza
Huntington Beach, CA 92648 Santa Ana, CA 92702
Eric Charlonne (714) 536-5430 Ed Torres (714) 647-5018
City of Anaheim City of Placentia
Anaheim Blvd. Placentia Ave Rehabilitation
200 S. Anaheim Blvd. 401 E. Chapman Avenue
Anaheim, CA 92805 Placentia, CA 92870
Mike Woods (714) 765-5176 Art Burgner (714) 993-8245
City of Santa Ana City of Tustin
Warner Avenue Improvements Tustin Ranch Road
200 Civic Center Drive 300 Centennial Way
Santa Ana, CA 92702 Tustin, CA 92780
Ed Torres (714) 647-5018 Benny Tenkean (714) 573-3161
City of Westminster City of Anaheim
Bushard Street Improvements La Palma Avenue Street Improvements
8200 Westminster Blvd. 200 S. Anaheim Blvd.
Westminster, CA 92683 Anaheim, CA 92805
Kevin Sin (714) 898-3311 Daryl Lopez (714) 765-5126
City of Santa Ana City of Lynwood
Fairview Street Rehabilitation San Jose, Platt & Carlin
20 Civic Center Plaza 11330 Bullis Road
Santa Ana, CA 92702 Lynwood, CA 90262
Ed Torres (714) 647-5018 Elias Saikaly (310) 603-0220
2200 S. Yale Street, Santa Ana, CA 92704
Phone 714-540-1700 fax 714-540-1709
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
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:
I. Apply to the joint apprenticeship committee administering the apprenticeship standards of the
craft or trade in the area of the site of the public work for a certificate approving the contractor under the
apprenticeship standards for the employment and training of apprentices in the area or industry affected.
2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the
apprenticeship standards.
3. Contribute to the fund or funds in each craft or trade in which he/she employs journeymen or
apprentices on the public work, in the same amount or upon the same basis and in the same manner as
the other contractors, except contractors not signatory to the trust agreement shall pay a like amount to
the California Appre ticeship Council.
Signed
Title i .
Firm N~ \Q1, V,
Date a 13
TO BE INCLUDED IN BID PACKAGE
BP 10 of 13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
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 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 tha aking a false certification may subject the certifier to criminal prosecution.
Signed
State of Cali mia
County of
Subscribed and sworn to (or affirmed) before me on this fl\ day of Fe. lj 2011 by
h in proved to me on the basis of satisfactory evidence to be the person(s) who
appeared before me.
TERI BRADEN
Commission #t 1924994
Notary Public California
orange County
M Comm. Ex ires Feb 10, 2015
ry Public Signature Notary Public Seal
TO BE INCLUDED IN BID PACKAGE
BP 11 of 13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
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, Part 3). This act provides that each contractor or
subcontractor shall be prohibited from inducing, by any means, any person employed in the construction
or repair of public work to give up any part of the compensation to which he/she is otherwise entitled.
Signed
Title
Firm
Date
TO BE INCLUDED IN BID PACKAGE
BP 12 of 13
CITY OF SANTA ANA
PROJECT 12-2621
SANTA ANA ZOO WALKWAY IMPROVEMENTS
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: \bF I-) 1H ( L-T `t NC-.
Business Address: 319-00 SdU -C M R B
Telephone: ( q `-i 4bli 0 - ~ 140 0
State Contractor's License No. and
Class:
Expiration
Date:
Signed:
Title: -O•
TO BE INCLUDED IN BID PACKAGE
BP 13 of 13
Jeremy Taylor
From: Jeremy Taylor
Sent: Tuesday, February 07, 2012 12:28 PM
To: 'Ly, Mindy'
Subject: RE: Zoo Walkway Improvements Addendum
Mindy,
I have received the addendums and this email serves as confirmation that I did receive them
Jeremy Taylor
Project Manager
2200 S. Yale Street
Santa Ana, CA 92704
Tel: 714-540-1700
Mobile: 714-231-9487
Fax: 714-540-1709
Email: jeremy.taylorCa~bensasohalt.com
(Check us out in the Orange County Register!)
"Celebrating 50 Years of Service"
From: Ly, Mindy rmailto:MLy(absanta-ana.orcal
Sent: Monday, February 06, 2012 4:25 PM
To: Jeremy Taylor
Subject: Zoo Walkway Improvements Addendum
Jeremy,
Per request, attached are addenda one and two. Please reply to this email to confirm the receipt of the addenda.
Mindy
1
MAYOR
CITY MANAGER
Miguel A. Pulido David N. Ream
MAYOR PRO TEM CITY ATTORNEY
Claudia C. Alvarez Joseph W. Fletcher
COUNCILMEMBERS CLERK OF THE COUNCIL
David Benavides Maria D. Huizar
Carlos Bustamante
Michele Martinez CITY OF SANTA ANA
Vincent F. Sarmiento
Sal Tinaiero PUBLIC WORKS AGENCY M-36
P.O. Box 1988
Santa Ana, California 92702
January 23, 2012
ADDENDUM No. ONE
SUBJECT: PROJECT No. 12-2621: Santa Ana Zoo Walkway Improvements
The following change has been made to specifications of the subject project:
Specifications
1. Page iii, Notice Inviting Bids; Add the following paragraph to the Notice Inviting
Bids:
"There will be a PRE-BID JOB WALK at Santa Ana Zoo, 1801 E. Chestnut
Avenue on Tuesday, January 31, 2012 at 10:00am."
Note: the bid date shall remain the same.
All other terms and conditions remain the same.
FOR THE CITY OF SANTA ANA
JAI
Souri Amirani
City Engineer
a.
AI
MAYOR CITY MANAGER
Miguel A. Pulido David N. Ream
MAYOR PRO TEM CITY ATTORNEY
Claudia C. Alvarez Joseph W. Fletcher
COUNCILMEMBERS CLERK OF THE COUNCIL
David Benavides Maria D. Huizar
Carlos Bustamante
Michele Martinez CITY OF SANTA ANA
Vincent F. Sarmiento
Sal Tinajero PUBLIC WORKS AGENCY M-36
P.O. Box 1988
Santa Ana, California 92702
February 2, 2012
ADDENDUM No. TWO
SUBJECT: PROJECT No. 12-2621: Santa Ana Zoo Walkway Improvements
The following changes have been made to specifications of the subject project:
Specifications
1. Page BP 1 and 2 of 13; Replace pages BP 1 and 2 of 13 with the attached BP 1
and 2 of 13.
2. Page 1, Section 1.03 Time of Completion; Revise Section 1.03 with the
following:
The Contractor shall complete all work under the contract within 24 working days
from the date of the Notice to Proceed issued by the Engineer. Additionally,
contractor shall complete the main zoo walkway (PRIORITY 1 per plan) within the
first 14 calendar days. Work is authorized on weekends as needed to
accommodate the additional 4 calendar days for PRIORITY 1 work.
Contract time shall begin on a designated Monday at the preconstruction meeting.
The area of the zoo in the construction area will be closed starting on this
designated Monday for two weeks and re-open on the 3rd Monday. All work must
be completed and cleared by 5 pm on the Sunday prior to the zoo reopening to the
public. Liquidated damages shall be assessed if contractor exceeds the 14
calendar days of work on the PRIORITY 1 areas. Contractor shall move on to the
zoo keeper's area (PRIORITY 2 per plan) immediately after work has been
completed in the main zoo. No weekend work is authorized for PRIORITY 2 work.
Contractor shall provide liability insurance, business license, submittals, and all
required documents immediately after execution of the contract. Preconstruction
meeting shall take place within two weeks of awarding and notice to proceed shall
be issued on April 16."
3. Appendix E, Construction Plan; Replace construction plan in appendix E with the
attached construction plan.
February 2, 2012
ADDENDUM No. TWO
PROJECT No. 12-2621
Page 2
4. Page 18, Section 2.10 Root Shaving; Add the following sentence to the end of
the first paragraph:
"Where tree roots exist, contractor shall remove the existing AC to expose the
roots for Tree Maintenance Supervisor's inspection. Tree roots shall be shaved
and removed prior to cold milling the AC."
All other terms and conditions remain the same.
FOR THE CITY OF SANTA ANA
~11r11`,
Souri Amirani
City Engineer
r
i
i 1
I 08739254
Bond No._-- -
Fidelity and Deposit Company
POST OFFICE BOX 1227 OF MARYLAND BALTIMORE, MD 21203 i
I ~
BID BOND
KNOW ALL MEN BY THESE PRESENTS:
Asphalt, Inc . -
That we, Ben-------'--s - -
'
as Principal, (hereinafter called the "Principal"),
and !the FIDELITY AND DE osrr COMPANY OF MARYLAND, P.O. Box 1227, Baltimore, Maryland 21203, a corporation f
. duly organized under the laws of the State of Maryland, as Surety, (hereinafter called the "Surety"), are held and
{ fcrmty bound unto__ CitY_ofwSanta Ana
- - - - -
Obligee, (hereinafter called the "Obligee"),
in the sum of____.ten percent of _amou_nt_ bid Dollars
10 ° 4
for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, f
executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the Principal has submitted a bid for.-122621- -Santa-Ana-Zoo AC Walkway _
Improvements
r
- - - - - - - - - - - - - -
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
into 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.
3rd
-----day of_ - February br_u...a_ r- y- 20 12
Signed and sealed --------------------A.D.,
E
4
Ben's As halt, Inc. (SEAL)
Principal
- - -
Vitness
BY: C _
Title
FIDELITY AND DE C PANY OF YLAND
Sur
- By--- - - - -------------------(SEAL)
Witness AT EY -FACT Title
c370-50M, 7.91 - Charles L. Flake
C-roans W Am"imn Wtitute or Ardtitow u«ument A-310- -
Fobmry 1970 Edition.
k
F
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
STATE OF CALIFORNIA
County of Orange
On 2-3-12 before me, Lexie Sherwood Notary Public
Date Here Insert Name and Title of the Officer
personally appeared Charles L. Flake
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies),
and that by his/her/their signature(s) on the instrument the
LEXIE SHERWOOD person(s), or the entity upon behalf of which the person(s)
COMM. #1856389 3 acted, executed the instrument.
0 NOTARY PUBLIC • CALIFORNIA A
ORANGE COUNTY I certify under PENALTY OF PERJURY under the laws of
Comm. Exp. JULY 27, 2013 the State of California that the foregoing paragraph is true
and correct.
Witness my hand and fficial seal.
Signature
Place Notary Seal Above Signature of Not ry 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 Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
? Individual ? Individual
? Corporate Officer - Title(s): ? Corporate Officer - Title(s):
? Partner - ? Limited ? General ? Partner - ? Limited ? General
? Attorney in Fact .1 M. ? Attorney in Fact
? Trustee ? Trustee
? Guardian or Conservator Top of thumb here ? Guardian or Conservator 7Topofumb here
? Other: ? Other:
Signer Is Representing: Signer Is Representing:
02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotary.org Item #5907 Reorder: Call Toll-Free 1-800-876-6827
Power of Attorney
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a
corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary,
in pursuance of authority granted by Article VI, Section 2, of the By-Laws of said CompHS are set forth on the
reverse side hereof and are hereby certified to be in full force and effect on the date h e s by nominate, constitute
and appoint Richard A. COON, Charles L. FLAKE, David L. CULB n OOD, all of
Anaheim, California, EACH its true and lawful agent and U ,9 d deliver, for, and on
its behalf as surety, and as its act and deed: any an o si ~n e . xecution of such bonds or
undertakings in pursuance of these prese ~1 as fully and amply, to all intents and
purposes, as if they had been d e.' t a th gularly elected officers of the Company at its office
in Baltimore Md. 91 , p er attorney revokes that issued on behalf of Richard A. COON,
Charles L. FLAKE, ew P. FLAKE, Lexie SHERWOOD, dated November 7, 2005.
The said Assistant ease eby certify that the extract set forth on the reverse side hereof is a true copy of Article VI,
Section 2, of the By-L s said Company, and is now in force.
IN WITNESS WHEREOF, the said Vice-President and Assistant Secretary have hereunto subscribed their names and
affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of
November, A.D. 2006.
ATTEST: FIDELITY AND DEPOSIT COMPANY OF MARYLAND
'gyp DEPOS
_ O G
By:
Eric D. Barnes Assistant Secretary William J. Mills Vice President
State of Maryland
City of Baltimore ss.
On this 15th day of November, A.D. 2006, before the subscriber, a Notary Public of the State of Maryland, duly
commissioned and qualified, came WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers
described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being
by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid,
and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of
the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above
written.
Constance A. Dunn Notary Public
My Commission Expires: July 14, 2015
POA-F 012-4150H
EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND
"Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice-President, or any of the Senior
Vice-Presidents or Vice-Presidents specially authorized so to do by the Board of Directors or by the Executive Committee,
shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident
Vice-Presidents, Assistant Vice-Presidents and Attorneys-in-Fact as the business of the Company may require, or to
authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations,
policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in
the nature of mortgages and to affix the seal of the Company thereto."
CERTIFICATE
I, the undersigned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify
that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that
the Vice-President who executed the said Power of Attorney was one of the additional Vice-Presidents specially authorized
by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By-Laws of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the
Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on
the 10th day of May, 1990.
RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically
reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or
hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and
binding upon the Company with the same force and effect as though manually affixed."
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said Company,
this 3RD day of FEBRUARY 2012
Assistant Secretary
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
ss.
County of
ll z°l~ `~(Ll
- - / before me, M
On Name and Tile of Officer (e.g., "Jane Doe, Nof~ry Public")
Date _y
personally appeared I'{Z Name(s) of Signer(s)
personally known to me
? proved to me on the basis of satisfactory evidence
to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that
TEr~ RI BR OEN he/she/they executed the same in his/her/their
Commission # 1924994 authorized capacity(ies), and that by his/her/their
aI. Notary Public California z signature(s) on the instrument the person(s), or the
= g... D
Orange County entity upon behalf of which the person(s) acted,
M Comm.. Expires Feb 10, 2015• executed the instrument.
WITNESS m and and off' ' seal
C ~
Place Notary Seal Above
Signature of Notary Public
OPTIONAL
document
Though the
prevent fraudulent removal law, it my prove
and reattachment of this form to another document.
and could
Description of Attached Document
Title or Type of Document:
Number of Pages:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
? Individual ? Individual
? Corporate Officer - Title(s): ? Corporate Officer - Title(s):
? Partner - ? Limited ? General - ? Partner - ? Limited ? General
? Attorney in Fact Top of thumb here El Attorney in Fact Top of thumb here
? Trustee El Trustee
? Guardian or Conservator ? Guardian or Conservator
? Other: ? Other:
Signer Is Representing: Signer Is Representing:
0 2004 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 Item No. 5907 Reorder: Call Toll-Free 1-600-676-6827