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SUPERIOR PAVING COMPANY, INC. DBA UNITED PAVING COMPANY
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 20111 SfP 29 AM !O; � I CITY Or SANTA ANA CLERK OF COUIW"'!l. Recorded in Official Records, Orange County Hugh Nguyen, Clerk- Recorder �IIIII�IIIIIII���IIIII�����IIIIIIIIIIIIIII�����IIIIIIIIIIIIIiI����III11I NO FEE *$ R 0 0 0 6 9 6 7 5 0 5$* 201400037415410:31 am 09116114 276 417 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 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 a construction of CITYWIDE RESIDENTIAL STREET REPAIR — PHASE 17 under contract o entered into on March 18, 2013, with SUPERIOR PAVING COMPANY, INC. DBA UNITED m w PAVING COMPANY, on which contract MERCHANTS BONDING, COMPANY (MUTUAL) w o is surety. The property on which such work improvement was placed is in the City of Santa Ana, m e w County of Orange, State of California, and described as Project No. 13 -7511 located at: aVARIOUS LOCATIONS. The work improvement on said property was accepted as completed o on June 12, 2014. ' o CITY OF SANTA �1 ICIPAL CORPORATION UD ° by ' ) Ta q 1liggi LS c� � a Dated: �� � �� Acting City Engineer TITLE VERIFICATION I, the undersigned, say: I am the Acting 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 / �� % J at Santa Anna, California (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 7, IT IF NF FC, REQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: APRIL 1, 2013 TITLE: CONTRACT AWARD FOR CITYWIDE RESIDENTIAL STREET REPAIR PHASE 17 (PROJECT NO. 137511) f.. CITY MANAGER CLERK OF COUNCIL USE ONLY: APPROVED 11-1'1,3 ICI As Recommended/ A3 4 ❑ As Amended ❑ Ordinance on I" Reading ❑ Ordinance on 2nd Reading ❑ Implementing Resolution ❑ Set Public Hearing For CONTINUED TO FILE NUMBER 1. Award a contract to the lowest responsible bidder, United Paving Company, in accordance with the Base Bid, totaling $704,724, for the construction of the Citywide Residential Street Repair Phase 17. 2. Approve the Funding Analysis as shown in Exhibit 1 for a total estimated construction phase cost of $879,500. DISCUSSION The City's Pavement Management System has identified the concrete residential streets shown in Exhibit 2 as a high priority for rehabilitation. The pavement has deteriorated due to weather, age, heavy usage, and poor drainage. Portions of the adjacent curb and gutter, driveway approaches, curb ramps, and sidewalks are either missing or in disrepair and require replacement. Improvements include reconstructing pavement and replacing damaged concrete curb and gutter, driveway approaches, sidewalk, and constructing new cross gutters. Once completed, these improvements will extend the life of the pavement and enhance the ride quality, surface drainage, and appearance of the street. This project is funded with Community Development Block Grant (CDBG) funds. To be eligible for CDBG funding the majority of the project area must be within a low- moderate - income neighborhood. City staff has reviewed the census tract information to confirm that this recommended service area meets the requirements. The Notice Inviting Bids was advertised on January 8 and 9, 2013, and bids were opened on February 20, 2013. The following tables summarize the bid invitations mailed, the bids received, and the bid results: Contract Award for Citywide Residential Street Repair Phase 17 April 1, 2013 Page 2 CONTRACTOR PARTICIPATION DATA Santa Ana contractors receiving notices: 12 Contractors requesting bidding documents: 21 Bids received: 6 Bids received from Santa Ana contractors: 1 BID RESUTS SUMMARY RANK BIDDER'S NAME LOCATION BASE BID 1 Hardy & Harper Santa Ana $602,000 2 United Paving Company La Mirada $704,724 3 All American Asphalt Corona $719,650 4 Silva Construction, Inc. Rancho Cucamonga $735,675 5 R.J. Noble Company Orange $739,459 6 Excel Paving Company Long Beach $789,090 A total of six bids were received and all were deemed responsive. Two days after the bid opening, Hardy & Harper, Inc. (HHI), requested to be relieved of their bid, stating that they had made a clerical error in filling out their bid. After examining HH's bid documents, staff found sufficient grounds to relieve HHI from their bid and therefore recommends HHI's bid be disregarded. United Paving Company (UPC) submitted good faith efforts documentation related to the required Annual Anticipated Disadvantaged Business Enterprise Participation levels. Staff examined UPC's documentation related to good faith efforts and concluded that the unmet participation levels are immaterial to their bid. Staff therefore determines that the irregularity is minor and recommends award to UPC. The lowest responsive bid by United Paving Company in the amount of $704,724 and the next bid are both within 10 percent of the Engineer's Estimate ($658,390) and, therefore, those two bid results are within the standard acceptable range. ENVIRONMENTAL IMPACT In accordance with the California Environmental Quality Act, the proposed project is exempt from future review. Categorical Exemption Environmental Review No. 2013 -5 will be filed for the project. Contract Award for Citywide Residential Street Repair Phase 17 April 1, 2013 Page 3 FISCAL IMPACT A project cost analysis shown in Exhibit 1 determines that the total funds needed to deliver the project, including construction administration, inspection, testing, and contingencies, is estimated to be $879,500. Funding is available to cover costs in the Gas Tax Residential Improvement account (No. 05817661 - 66220) and Community Development Block Grant account (No. 13518783 - 66220), Project No. 137511. Raul Godinez II Executive Directo Public Works Agency Nancy T. 150yards Interim Executive Director Community Development Agency RG/TC Exhibits: 1. Funding Analysis 2. Project Location Map APPROVED AS TO FUNDS AND ACCOUNTS: Francisco Gutierrez o� Executive Director Finance & Management Services Agency Exhibit 1 FUNDING ANALYSIS PROJECT NO. 13 -1175 CITYWIDE RESIDENTIAL STREET REPAIR PHASE 17 Construction Contract Contract Administration Inspection and Testing Survey Staking Contingencies $704,724 $38,300 $50,500 $15,504 $70,472 TOTAL ESTIMATED CONSTRUCTION COSTS 879 500 Exhibit 2 Description: The existing PCC pavement is approximately 8" thick. Replacing the PCC with PCC Pavement or AC Pavement is the most expensive repair. The most viable and economical rehabilitation is to remove the 8" of PCC, import 4 -5" of Crushed Miscellaneous Base and Cement treat it with the existing base and cap with 3" of AC. W u, to Z u w m y 5TH Sl Ll—sT--sJT L.-J L J L WAL 'UT ST C UHF2TNUT F-___1 d c M f u `v ST u� u. " a SANTA ANA EcTr Eo:xu:i� OONTRACT AWARD TO HARDY AND HARPER Foil THE aceNNfl CfPrM E RE81(7E"AL STREET REPAR PHASE 37. � ��NrTE (PR CT W3- 7661) uCF71L 1. 231A IPA 4 C? EXHBfT 2 THE REGISTER rls=•n =� "1 °.nn "s,I °me °my 625 N GRAND AVE, SANTA ANA, CA 92701 Telephone (714) 796 -7000 / Far (716) 7966059 PROOF OF PUBLICATION (2015.5 C.C.P.) State or California ) County of ORANGE ) ss Nonce Type: BID - NOTICE INVITING BIDS Ad Description Reeldential Street Repair- Phase 17 I am a citizen of the United States and a resident aline State of California; I am nuici fiw,xl nl'u,�'�O1e�" over the age of eighteen years, and not a party to or interested in the above ios �n "n�mn "..-u r r,O entitled matter. I am the principal clerk of do printer and publisher of the THE °I lt" +zrr ,,w "1 In. me. I", IM1° eln- REGISTER, a newspaper published in the English language in the city of g--r.e m:n -I cmor ilno Ins pro - SANTA ANA, cwa my of ORANGE, and adjudged a newspaper of general uo.ua comma 0111,n —tr 1" Inm. Tno t clrculatlon as defined by the lam of the State of California by the Superior wnb,d ..me, r Unit eroos7a ma Court of the County of ORANGE, State of California under late 11/19/1905, n tnm a° "a miter u" Caen That the notice, of which the annexed is a tl copy, has ished rmmAfr.d. city f,..... �emrre11 pub In been published In each regular and entire issue of saftl newspaper and not In apex Dios ism Io mica ony °r "u iv air th any supplement thereof on the following dates twig ob, uc —w, amore 01/002019,01/09120'13 Eeecmied em 0110 912 01 3 At SANTA ANA, Callfornle I certify (or doclme) under penalty of proury that the foregoing 1s true and 0orrecn �1 '� neLnimnl for dpi, 1 1h, II CZ(l' C:, �'r-y � necewr` N1 tl,, 11 IM1° °tare ° n°;1, Ga `v ; 11111Illllllllllllllllllllllllll 11Ell1111 ll ,,v mono ". .,nnn °m by tm cl v °I sm ,rrl 0 2 9 3 7 1 6 8 rt UNITED PAVING CO. "When Integrity Counts" 14660 Industry Circle, La Mirada, CA 90638 2013 FEB 20 P i 41 --ity of Santa Ana --ity Hall- Ross Annex z0 Civic Center Plaza Santa Ana, CA 92701 SEALED BID FOR: Citywide Residential Street Repair- Phase 17 Re ,r lied in Official Records, Orange County p'+., ea !Ill�lii fR�� a mirez, Assistant Clerk-Recorder III Iii NO FEE * R 0 0 0 5 5 3 9 2 5 0$ 201385000048 3:47 pm 01/24/13 256 82 Z01 0.00 50.00 0.00 0.00 0.00 0.00 0.00 0.00 ORANGE COUNTY CLERK4ECORDER DEPARTMENT By Y DEPVIY CITY MANAGER Paul M. Walters C11Y ATrORNEY Soma R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar From the Requirements of the California Environmental (duality Act (CEQA) Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK From: City of Santa Ana County of Orange Planning & Building Agency P.O. Box 238 20 Civic Center Plaza M-20 Santa Ana, CA 92702 Santa Ana, CA 92702 Project Title: Residential Street Repair -Phase 17 Date of Approval: 02 /19/2013 Project Number(s): PWA- 2013- 89 -CIP Project Location: 1 Citywide (Partial) City: Santa Ana County: Orange ER Number: . ER-2013-5 Project Description: Concrete Street Reconstruction with AC pavement and CTB base. Sidewalk, Curt: and Gutter, and Curb Ramps) Repair necessary to better Facility's ADA transportation and all pedestrian users in the referenced neighborhoods. Applicant Name: Sean Thomas, City of Santa Ana Applicant Address: 20 Civic Center Plaza M -36 SANTA ANA, CA 92702 Flame of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Ly, Mindy Exempt Status: Ministerial (.Sec. 15268) E7 Declared Emergency (Sec. 15269 (a)) • Emergency Project (Sec. 15269 (b through e)) • General Rule (Sec. 15061(b)(3)/(5)) • Statutory Exemption: • Categorical Exemption: Rehabilitation of existing street facilities Reasons) Why Project is Exempt From CEQA: Rehabilitation of existing street facilities City Contact: Sean Thomas Signature: Title: FILED .SAN 2 4 2013 4`RAA'd4iL- (:t)lr'dl Y C.LERR'RECORDER DEPAR7rMENT Al, Telephone: (714) 647 -5655 Assistant Engineer _ Date: 1/24/2013 U1, MAYOR tL Miguel A. Pulido "rEM MAYOR PRO - Sal Tinajero I` - COUNCIL MEMBERS Angelica Amezcua P. David Benavides Michele Martinez Roman A. Reyna Vincent F. Sam,lento CITY OF SANTA ANA PLANNING 8, BUILDING AGENCY 20 Civic Center Plaza (M -20) P.O. BOX 1988 . Santa Ana, California 92702 (714) 687 -2700 - Fax (714) 973 -1461 w .santaa ina.org NOTICE OF EXEMPTION ORANGE COUNTY CLERK4ECORDER DEPARTMENT By Y DEPVIY CITY MANAGER Paul M. Walters C11Y ATrORNEY Soma R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar From the Requirements of the California Environmental (duality Act (CEQA) Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK From: City of Santa Ana County of Orange Planning & Building Agency P.O. Box 238 20 Civic Center Plaza M-20 Santa Ana, CA 92702 Santa Ana, CA 92702 Project Title: Residential Street Repair -Phase 17 Date of Approval: 02 /19/2013 Project Number(s): PWA- 2013- 89 -CIP Project Location: 1 Citywide (Partial) City: Santa Ana County: Orange ER Number: . ER-2013-5 Project Description: Concrete Street Reconstruction with AC pavement and CTB base. Sidewalk, Curt: and Gutter, and Curb Ramps) Repair necessary to better Facility's ADA transportation and all pedestrian users in the referenced neighborhoods. Applicant Name: Sean Thomas, City of Santa Ana Applicant Address: 20 Civic Center Plaza M -36 SANTA ANA, CA 92702 Flame of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Ly, Mindy Exempt Status: Ministerial (.Sec. 15268) E7 Declared Emergency (Sec. 15269 (a)) • Emergency Project (Sec. 15269 (b through e)) • General Rule (Sec. 15061(b)(3)/(5)) • Statutory Exemption: • Categorical Exemption: Rehabilitation of existing street facilities Reasons) Why Project is Exempt From CEQA: Rehabilitation of existing street facilities City Contact: Sean Thomas Signature: Title: FILED .SAN 2 4 2013 4`RAA'd4iL- (:t)lr'dl Y C.LERR'RECORDER DEPAR7rMENT Al, Telephone: (714) 647 -5655 Assistant Engineer _ Date: 1/24/2013 U1, PROJECT LOCATION: ESTIMATED START OF CONSTRUCTION: CONSTRUCTION TRADE EMPLOYMENT OPPORTUNITIES: No. and Types of Trades Needed Experience Required _ ____ CONTRACT AND SUBCONTRACT OPPORTUNITIES: If your business is located in the City of Santa Ana, and/or you employ low- income individuals residing in or near the project area, you may qualify as a Section 3 Business Concern. Types of Construction Contract/Subcontract Opportunities: irtarr ` Cn\ye FyZK ML= iSt��Pi�P �CC>r��r 3L If you have work experience in the construction trades orjobs listed above, or you would like to inquire about contract opportunities, call Superior Paving Company, Inc. —417 on c8bo o at for an employment or bid application. (Conaaetor's or Subouxacror's Tel. No.) For additional information on the City of Santa Ana's Section 3 Economic Opportunities Plan, please call the City of Santa Ana Community Development Agency at (714)_"7-5360_ CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA Superior Paving Company, Inc. FROM: dba Iinited Palling Compart 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, 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 200 $ q'S $ Iciobb 2. Remove PCC Pavement* CY 3,500 $ 4°�A -z $ Ili% aG1 –yu 3. Crushed Miscellaneous Base (CMB)* TN 3,400 $ 1�6%9 $': ° bz(o 4. AC Pavement* TN 3,400 $ `ru7 e � $ 1.W6a)U 5. Cement Treated Base (CTB) 6% SF 180,000 $n +�DlS $ I G� Cement* 6. Additional 1% Cement for CTB As SF 180,000 $ $ 5 Needed* 7. Remove and Replace PCC Curb Ramp SF 500 $ 4. I LP $ 3� 8. Remove and Replace PCC Driveway SF 300 yy $ a1 $�1 9. Remove and Replace PCC Sidewalk SF 31300 $S.64 $ I ��L?�� 10. Remove and Replace PCC Cross SF 2,000 $ $ 1 3`y� Gutter* 11. Remove and Replace PCC Curb and LF 50 $ AWi 2 $ Gutter* TO BE INCLUDED IN BID PACKAGE BP 1 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued Item # Bid Item Unit Quantity Unit Price Amount 12. Remove and Replace PCC Curb Type LF 200 $ B -1 t3. Grind PCC* LF 50 $ 23,`5 Z $ �1C3 14. Adjust Manhole Frame and Cover to EA 23 $5� $� V Grade* 15. Furnish and Install Water Valve EA 16 $ $ Frame and Cover to Grade* 16. Root Shavc* EA 20 $ 1S 1 12A) $ M-4 17. Signing and Striping LS 1 $ 77tobG $ �A )b 18. Storm Water Pollution Prevention LS 1 Plan (SWPPP) TOTAL $ The lowest responsible bidder shall be selected based on the lowest bid. The City reserves the right to award the Base 'Bid, and any, all or none of the alternate Bid Items. * The quantity for this bid item is shown forbid 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. T This bid item is considered a Specialty Item per Section 2 -3.2 of the Standard Specifications. TO BE INCLUDED IN BID PACKAGE BP 2 of 30 t PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL & CONTRACT AGREEMENT BID PROPOSAL, continued PROJECT NO., TITLE & LIMITS BIDDER Superior Paving Company, Inc. Firm dba United Paving Company Address ! lfalPL) !rr�l1S$'�°1 O�v`C -k& l- Ga��'l�rGU'�G,rC,YI �1�1c,3g Phone Fax zA mac, Email +k-e `t'uv\*�A pct CCYn& l BIDDER Signature �r"�icAaa >+ BP 3 of 30 TO BE INCLUDED IN BID PACKAGE CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT LIST OF SUB- CONTRACTORS Section 4100 et. seq. of the Public Contract Code requires listing of all subcontractors with the bid for all subcontract work exceeding the following amount: - Streets, highways including bridge projects; '/2% of the bid or $10,000, whichever is greater - Buildings, parks, or other projects: ' /z% of the bid BIDDER proposes to subcontract certain portions of the work to the firms listed below: NAME C»-,, _a \lcari iv,sc �� ra , Ll G LOCATION PHONE �,�I b a2Ck TYPE OF WORK NAME lvrrkt,n C°r,r,Crp —A-f? \vtC . LOCATION 1V{�JY�\ Q , C_Pi PHONE lCj � \i TYPE OF WORKsh�ti NAME _ LOCATION PHONE TYPE OF WORK $ NAME LOCATION PHONE TYPE OF WORK NAME \ U.V Y2e C-"C \'%ran SMikOAME LOCATION H— y, cYar J LOCATION _ PHONE (ri ` 1� �Cy�a 2 — \ t i PHONE TYPE OF WORK $ TYPE OF WORK CAt l��S NAMEt C ��, u. C' Gear NAME LOCATION (} E k C—Y=1 LOCATION _ PHONE ( - (tj���et° L \S PHONE TYPE OF WORK ek) vJ- e(�,C TYPE OF WORK NAME Y LOCATION PHONE k- TYPE OF W of NAME _ LOCATION PHONE 5A -Ifk'4 $ �(j �..�— TYPE OF WORK �y�Ll iY'�G•�C \h.#�, e,}r:�i -f't% �'aau;vw.� (_'ompctvva.� Bid TO BE INCLUDED IN BID PACKAGE BP 4 of 30 CITE' OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL & CONTRACT AGREEMENT BIDDER'S STATEMENT BIDDER understands and agrees that this written proposal (or any part thereof specifically designated and accepted by the City of Santa Ana, hereinafter AGENCY) shall constitute the entire agreement between BIDDER and the AGENCY only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Public Works Agency Executive Director or his duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to BIDDER or deposited with the United States Postal Service properly addressed to the BIDDER with the correct postage affixed thereto. BIDDER further agrees that upon delivery (as defined above) of the accepted agreement he /she will furnish AGENCY all required bonds and certificate of liability insurance within ten (10) days (excluding Saturdays, Sundays and AGENCY'S legal holidays), or the funds, check, draft, or BIDDERS bond substituted in lieu thereof accompanying this proposal shall become the property of the AGENCY and shall be considered as payment of damages due to the delay and other causes suffered by AGENCY because of the failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered is difficult to ascertain; otherwise said funds, check, drafts, or BTDDER'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. Superior Paving Company, Inc. Name of Firm dbn United paving Company Signature of BIDDER Title 1%rp Y (if an individual, so state) BP 5 of 30 TO BE INCLUDED IN BID PACKAGE CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 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.) Superior Paving Company, Inc. dba United Paving Company a rtcvc --,c Awarded Co + 'I. on the basis of lowest responsible an4 esponsive bidder in the amount of $ oC?. ATTEST: ea CLERK OF THE COUNCIL APPROVED AS TO FORM: "0 CIGI`Y ATTORNEY ACTION OF COUNCIL: Date o� 20 BP 6 of 30 FOR THE CITY OF SANTA ANA: WORKS TO BE INCLUDED IN BID PACKAGE CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Superior Paving Company, Inc. The BIDDER dba United Paving Company proposed subcontractor hereby certifies that he has.,_, has not `X, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executi,,; e Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all,reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60- 1.7(b) (1)), and must be submitted by BIDDERS and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60 -1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO -1) is the only report required by the Executive Orders or their implementing regulations. Proposed Prime Contractors and Subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60- 1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. TO BE INCLUDED IN BID PACKAGE BP 7 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RF.SIIDENTIAL STREET REPAIR - PHASE l7 (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSE111fENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Superior Paving Company, Inc. The BIDDER db United Pavin Lorna arty proposed subcontractor a hereby certifies that he has , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executi 'e Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all-reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of ]Labor (41 CFR 60- 1.7(b) (l)), and must be submitted by BIDDERS and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60 -1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO -1) is the only report required by the Executive Orders or their implementing regulations, Proposed Prime Contractors and Subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60- 1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. TO BE INCLUDED IN BID PACKAUE 3P7of30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH AREA PART OF THIS PROPOSAL) Superior Paving Company, Inc. The BIDDER dba United Paving Company proposed subcontractor i`r�+rkicxn W , hereby certifies that he has __, has not X, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executi e Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all•reports dose under the applicable tilling requirements. Note. The above certification is required by the Equal 'Employment opportunity Regulations of the Secretary of Labor (41 CFR 60- 1.7(b) (l)), and mutt be submitted by BIDDERS and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60 -1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO- I) 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 -L7(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 BP 7 of 30 FROM (WED) FEB 20 2013 12;08/ST,12,07/No.5852073189 P 2 CITY OF SANTA ANA PROJECT NU. 13-7511 CITYWIDE RESIDtNTiAL STREET REPAIR - PHASE 17 (TIME BIDDER'S EXECUTION ON TH8 SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND F...XFCUTION OF THOSE CERTIFICATIONS WHICH ARF A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Paving Company, Lnc. The RIADE ' mu rnv111 -, proposed subcontractor iRU;i 6" t-jr /e�- e^jG 5` 4 r &-✓"S hereby cerbfies that he has �(,, hsa not participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executt •e Orders 10925, 11114, or 112467 and that, where required, he has filed with the Joint Reportatg Committee, the Director of'the Office of Federal Contract Compliance, a Federal Government contracting or adminiatcring agency, or the former President's Committee on Equal Employment Opportunity, all,reports due under the applicable filling requirements. Note, The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60.1.7(b) (1)), and must be submitted by BIDDERS and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts whicb are exempt from the equal opportunity clause are set forth in 41 CFR 60.1.5. (Generally only contracts or subconmets of $10,000 ur under are exempt,) Currently, Standard porm 100 (EE04) is the only report required by the Executive Orders or tbcir implementing regulations. Proposed Prime Contractors and Subcontractors who have participaud in a previous contract or subcontract subject to the Executive Orders and have not tiled the required reports should note that 41 CFR 60- 1.7(b) (1) prevents the award ofcontracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance; U.S. Department of Labor. BP 7 of 30 TO 13E INCLUDED 1N BID PACKAGE 02120/2013 12:05 7146396353 ocss PAGE 61101 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RFS)QF.NTIAL STRRET REPAIR - PIIASE 17 (THE' BIDDF,R'S — FXrCUTION ON TH,E SIGNATURE' PORTION OF THIS PROPOSAL SHALL ALSO CON$Tn.VTE AN ENDORSEMENT AND F_ATCUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The proposed subcontractor �' that he hasi� has not , opportunity clause;,, as required by Executi -e Orders 10925, 11114, or 11246, and that, whore required, he has filed with the Joint Reporting Committee, the Director of the Office of federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all-reports due under the applicable filling requirements. superior Paving Company, Itle. lc ( " OIN41 V(CL hereby aer ifies in a previous contractor subcontract subject to the equal Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 C.FR 60.1.7(b) (1)), and must be submitted by BIDDERS and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR, 601.5, ((enerally only contracts or subcontracts of $10,000 or under arcs exempt.) Currently, Standard Form 100 (FE0 1) is tl,e only report required by the Executive Orders or their implrmcnting 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 delinqucnt 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 DID PACICA(.�1i BP 7 of 30 02/20/2013 11:52 7149966057 TREESMITH PAGE el CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWD)F. RESIDENTIAL STREET REPAIR - PHASE 17 (THE BZDIiER,S r'X'EC'U770N ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO cONS,T1Til !, A1V ENDORSFAfENTAND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Paving, Company, Inc. The BIDDEn cilia nueuxavrus, VAL.to.., proposed subcontractor _ :Lirt - ^r I+h fe_itf -C.va? V, Xt__r /. c. , hereby Certifies that he has $0, as not ✓, participated in a previous5 couttact or subcontract subject to the equal opportunity ciausc�, as required by Executi': -e Orders 10925, 11114, or 11246, and that, where required, be has filed with the Joint Reporting Committee, tho J)irmtor of the) Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the farmer President's Committee on Equal Employment Opportunity, all - reports due under the applicable filling requirements. Note: The above certification is requited by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60- 13(b) (1)), and must be submitted by BIDDERS and proposed subcontractors only itt connection with contracts and subcontracts which arc subject to the equal opportunity clause. Contracts and subcontracts which arc exotopt from the equal opportunity clause are set forth in 41 CPR 60-1-5- (Generally only contracts or subcontracts of $ I,0,000 or under ate exempt.) Currently, Standard Corm ) 00 (E1 O.1) is the only report, required by the Exmcutivc Orders or their implementing regulations. Proposed Prime Contractors and SUbcontt'aeCora who have participated in a previous contract nr subcontract subject to the Executive Orders and have not filed the regtrired reports should note Char 41 CFR 60- i.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 P/ACKAUE BP7of30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 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, 1 965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Contractor shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his /her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1 u65, 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 BP 8 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 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) it 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 Titler',4 Superior Paving Company, Inc, Firm dba United Paving Company Date TO BE INCLUDED IN BID PACKAGE BP 9 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT WORKERS' COMPENSATION INSURANCE CERTIFICATION As required by California Labor Code Section 1860 and 1861, the Contractor certifies as follows: I am aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for worker's compensation or to undertake self - insurance in accordance with the provisions of the Code, and I will comply with such provisions before commencing the performance of the work of this contract. If I, as the Contractor, now or at any time during the course of this agreement, qualify as an employer under California Labor Code Section 3300, unless the hired employee(s) is (are) persons excluded by said Labor Code, I shall furnish the City of Santa' 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 �Sf A 6 Superior having Company, Inc. Firm Superior United Paving Company Date TO BE INCLUDED IN BID PACKAGE BP 10 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT REFERENCES The following arc the names, addresses, and telephone numbers for three public agencies for which BIDDER has performed similar work within the past two years. 1. Name and Address of Owner. Name and Telephon8 Number of person familiar with project. * 1-2-0 , '�0319 0 ( k l moy?)'4evv'kv -o-i- \ Z3 1 i:3 Contract Amount Type of Work Date Completed 2.1 Name and Address of owner. ' ' ATM Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 3. In Kar 1 Name and Address of owner. Name and Contract Amount Number of person familiar with project. Type of W Irk 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. N1,Q..rC..�Cnrot '2.1(Db Vl lz�r fir.) bras M c)iv-\.tl.�-, 1, 1 A-_. `� C�37 1 `fi 4 1S 1 nz-r) 1 t C osAr C' k-sc\ , C n 1cJ� 24.3 -` TO BE INCLUDED IN BID PACKAGE BP Ll of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT REGARDING APPRENTICESHIP REQUIREMENTS The undersigned BIDDER is familiar with the requirements of Section 1777.5 of the State Labor Code regarding employment of apprentices, and understands that contractors on contracts exceeding $30,000 or 20 working days shall: 1. Apply to the joint apprenticeship committee administering the apprenticeship standards of the craft or trade in the area of the site of the public work for a certificate approving the contractor under the apprenticeship standards for the employment and training of apprentices in the area or industry affected. 2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards. 3. Contribute to the fund or funds in each craft or trade in which he /she employs journeymen or apprentices on the public work, in the same amount or upon the same basis and in the same manner as the other contractors, except contractors not signatory to the trust agreement shall pay a like amount to the California Apprenticeship Council. Signed Title Superior Paving Company, Inc. Firm dbn United Paving Company Date j 9 I ! TO BE INCLUDED IN 'BID PACKAGE BP 12 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 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, farther, 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 that making a false certification may subject the certifier to criminal prosecution. Signed State of California County of Subscribed and sworn to (or appeared before me. Notary Public Signature NZD ,\1\ c� 0 �j��`G1tiC� v1 d), ore me on this day of , 20_, by ie on the basis of satisfactory evidence to be the person(s) who Notary Public Seal TO BE INCLUDED IN BID PACKAGE BP 13 of 30 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 _ ZSee Attached Document (Notary to cross out lines 1 -6 below) ❑ See Statement Below (Lines 1 -6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 State of Californi`af 1 County of Z (SOP_, ARIANA yILLEOAS 2 Commission k 1958D29 Notary Public - California Le- Riverside County Ex Ires Oct 20, 2015 Place Notary Seal Above Signature of Document Signer No.2 (if any) Subscribed and sworn to (or affirmed) before me on this 2.L3 day of C-ow 201-3, by Data Month L Year (1) saouy/Q:s —(� li 0 �11C Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeared before me (and Name of Signer proved to me on the basis of satisfactory evidence to be the person who appea 0 before me.) Signature Signature of ry Public OPTIONAL Though the information below is not required by law, it may prove vai to persons relying on the document and could prevent fraudulent remc and reattachment of this form to another document. Further Description of Any Attached Document Title or Type of Document: Document Date: Named Above: Number of Pages: RIGHT THUMBPRINT OF SIGNER #2 2010 National Notary Association • NationalNotary.org • 1- B00 -US NOTARY U- B00 -8]8 -882]) Item #5910 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 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 dba United Paving Company Date N TO BE INCLUDED IN BID PACKAGE BP 14 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR, PHASE 17 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. Superior Paving Company, Inc, Contractor's Name: dba United Paving Company Business Address: 1 Ll (_o CQC'> \ r rl i �V�� ( La I l rti � Y3 C.10(6 3S Telephone: - ZZ(JCa State Contractor's License No. and Class: loS�iiZ.�ZS C- }--- Expiration Date: lb I ✓:o I l3 Signed: Title: r en43cLS 3Dc \e a TO BE INCLUDED IN BID PACKAGE BP 15 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 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. 170lu (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 organization or representative of workers with which the contractor has a collective bargaining agreement or other understanding, if any, a notice advising the labor organization or w wkers' 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 and applicants for training and employment positions can see the notice. The notice shall describe the Section 3 preference, shall set forth minimum number and job titles subject to hire, availability of apprenticeship and training positions, the qualifications for each; and the name and location of the person(s) taking applications for each of the 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 finding that the subcontractor is in violation of the regulations in 24 CPR Part 135. The contractor will not subcontract with any subcontractor where the contractor has notice or knowledge oC 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 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 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 deba,ment 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 (1) preference and opportunities fox 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 7 (b) agree to comply with Section 3 to the maximum extent feasible, but not in derogation of compliance with Section 7(b). For the purpose of training and employment the rip .mart' 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 year 1996 -97, minimum goal for each project is 30 %. TO BE INCLUDED IN BID PACKAGE BP 17 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT SECTION 3 - CONTRACT CLAUSE continued The Contractor /Sub- contractor /Service Provider by the signature affixed 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. Signature Signature Signature Print Name and Title 1�e.cxe- Vak -v--4N Print Name and Title Print Name and Title III. %ii 3 Date TO BE INCLUDED IN BID PACKAGE BP 18 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT FEDERAL REQUIREMENTS FOR FEDERAL -AID CONSTRUCTION PROJECTS ,,�C)7' Ga_ - &)&wvk GIB: NERAL— Tbeworlc havnpgaosedvillbefimncedinwholeorinpatwith (This formneednotbe filled inifalljonrtven ture films are minority Federifliands, and therefore all ofthe statutes, lutes andregulaturispromulgetedby owned.) the Federal Govararnerrt and afTlicable to wodc financed in whole ca in put with FedaaAundswidapplybsudnwodc The`RegaiteclCorNadProvisiais,Federal- Aid Construction Contrails, Form FHWA 1273, are m kxkd m this Section 14. Whenever in said required contract p lmorns references are made to "SHA Contracting oflicer;" "SHA resident engineer," or "authorized a pesenlafive of the StW sudrreferences shall be construed to mean "Engineer" as defined in Section 1- 1.18ofthe Standard Speciticaticxrs. PERFORMANCE OF PREVIOUS CONTRACT - In addition m the provisions in Section 11, `Narndisoinvnatior," and Section Vll, "SuNdfnig or Assigning fire Conkr4' of the required ou nttact provisions, the Contractor shall canply wienthe following The BIDDER shall execute the CERTIFICATION WITH REGARD TO THE PERFORMANCE OF PREVIOUS CONTRACTS OR SUBCONTRACTS SUBJECT TO THE EQUAL OPPORTUNITY CLAUSE AND UIE FILING OF REQUIRED REPORTS lornted in the prgbsal. No request for subletting or assigning any portion of he contract in excess of$1 0, 000 will be considered uxkv die provisions ofScdion VUofflne required contract puvisic is unless such request is accompanied by the CERTTFfCAUONrefanedbAxyve ,exec>rzdbythepnposedsubam actor. NONLOLLUSION PROVISIONS - The provisions in this section are gThcable U all cmftacts except cmkac[s fcr.Fed�dlAid SemnduylLujecK 'fide 23, United States Code, Secim 112, requires as a condition pncoede nt to approval by the Federal Highway Administrator of die cartuact for this wvdc that mchBDDERfile a sworn statement cxec*dby, m onbcbalfof� die per ntn, finu, assoaation, or conpontfiort to whom sudz cnnhad is kn be awarlecf, catifying that Such prison, firm, assJciation. or coporddarl has not, eidus dirtxtly or indacdly, entered into any agrcanx% participated in any collusion or otherwise taken arty wJiminrushnftltcffiee=4)g titivebiddmgnicomecimnwtlhthe subnnttalbid.A form to tralce the nmrcollusim affidavit sfatarxat required by Section 112 as a adrtdic. ationunderpernaltyofpeUmyrathcrdm as a swonsGilmnentaspsnnittedby 28,USC,Sea 1746,isindudedintheproposal. PARTICIPATION BY DISADVANI:AGFD BUSINESS ENTERPRISES IN SUBCONTRACTING- Part26, Title 49, Code ofTederal Regulations supf)hes 0 this Federal -aid prgoa Pertinent sections of said Code are inanpotakxlinpatam ilsmfiretywilhinodwrsections oftlnesespeci- ldriwsiom. Schedule - hnfmnnatim for Determining Joint VentareElignbility. Attachment EAhnbitA -FRI SU7-W 1.Nameofjointventur p--�- '�`�. -� � P° J 2. Address ofjoin venture 3. Phone number ofjoint venture 4. Identify the firms which comprise thejoint venture. (The DBE partnermust complete Schedule A) a. Describe the role of the DBE farm in this jointventure. b. Describe very briefly the experience and business qualifications of each non -MBE j oint venture: 5. Nature of thejoint venture's business 6. Provide a copy of thejointventureagreement. 7. What is the claimed percentage of DBE owrncrship? 8. Ownership ofjoint venture: (This need not be filled in if described in thejoint venture agreement, provided by question (6). a. Profit and loss sharing b. Capital contributions, including equipment. a Other applicable ownership interests TO BE INCLUDED IN BID PACKAGE BP 19 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT 9. Control ofandparacipatoninthis contact. Ider i byname,cace, sex, and" fum "tlrose individuals (andtheirfides) who aereslxmsible for day-to-day nnanagennert and policy decision malting, inchdl% butnotivmtedto,th wthp me cesponsibilityfor aFmmcialdccisiong C Ar� lc c rv1 r\ � ��, F11_� r, t.�S �t - •, lard b. Management decisions, such as: 1.Fstrruatng` %.1 tAS -ru t \\ s \7YP \c bY1--t �t1° tFxArhiC.r1-lralo Superior Paving Company, Inc. dba United Paving Company NamebfFinn NaeneofFinn siganarre gnai Name Nam \yC�,1C�C °f1'� Tide Tide PUP IM 2.Madcelingandsalesij ^ rlt �P F'i11t�1'� Mi r\ ,) A1)%IA:S'%E Dare ''� 1 1 "L ( , 3. Hiring aui firing oft anagenient Shateof CP.ti t'` t °N M \9 Cotrryof 4. Purdlasing ofrajoritemsorsupplies i�iC,Y�lA3olmd� t(,F�1'ra1i� On this _ day of 20 befoe ;,a \cam 6 e ap .d (Wane) , e to me personally knon, who, being duly h did exearte the c. Son onoffield foregoing affidavit and did slate that he or she was ) 1 Mon _ 15Gi'r�tAY1/ }anpe1l au z� by (Name of firm toexecute$reafHdavitanddd shisoha five act and dced. Note: If; afterfifingthis Schedule Band before the counfalctfon ofthe jo"ventne'swodconthe cmtradcavmdbydvsreguladon,d=is any significant change in the it-fomiafion submitted, fiiejointventue must inform the grantee, either directly or dnrough the prune contactor if diejoint veilwe is a subomhwtor, Affidavit "flare undersigned swear that die foegoing statements are correct and include all material information necessary to identify and explain the terns and operation of our joircventwe and die intended paacipaton by each joint venturr in the nuhdertalting Further, fine undersigned covenant and agree to provide to grantee cuuenrt, complete and accurate inforina ion regarding actual joint venture wodc and thepaymerttherefore and arryfatuposed changes in arry of die joint vehtue arangemerrts and to pennit the andrt and exaniinaton of die books, records, and files of the joint venture, by authorized rgnzseamnlives of the grantee or the Federal turfing agency. Any material nnisquzsenlafion will be gourds for tenninatnng ary contact which may be awarded and for initiating action wide Federal or Stile laws concerning Use statancrrts.,, Attachment F -)M to -FR2 5-077 NolayPublic [Sea]] �e(" rMiP On this _ day of 20 before me appeared (Name to nhe personally known, who being sworn, did execute the foregoing davit and did stile mt; he or she was property authorized by (Ivhame of firm) exwutethe atfid,Mtaiddidso ashis orher free actanddeed. [Seal] TO BE INCLUDED IN BID PACI{AGE BP 20 of 30 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 ,"/See Attached Document (Notary to cross out lines 1 -6 below) ❑ See Statement Below (Lines 1 -6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 State of California p County of 1 ] ARIANA V S # 195 7 ",� Commission # 1958023 Notary Public • California z Riverside County n M Comm. Expires Oct 24, 2015 Place Notary Seal Above Signature of Document Signer No. 2 (If any) Subscribed and sworn to (or affirmed) before me on this day of HWQAA 20 , Date Month Year by (1) Name of Jigner proved to me on the basis of satisfactory evidence to be the person who appeared before me (and (2) Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeare efore me.) Signature Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document Title or Type of Document: Document Date: Named Above: Number of Pages: Top of thumb here 2010 National Notary Association • NationalNotary.org • 1- 800 -US NOTARY (t- 800 - 878 -6827) Item #5910 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 DEBARMENT AND SUSPENSION CERTIFICATION The BIDDER under penalty of perjury, certifies that except as noted below, he /she or any person associated therewith in the capacity of owner, partner, director, officer, manager: is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal agency within past three years; has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space Exceptions will not necessarily result in denial of award, but will be considered in determining BIDDERS responsibility. For any exception noted above, indicate below to whom it applies, initialing agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Superior Paving Company, Tue. Name of BIDDER dba L noted Paving Company Signature of BIDDER SCnGtS Cryyill& Date FED.8 -22 -88 TO BE INCLUDED IN BID PACKAGE BP 21 of 30 Exhibit 15 -G2 Local Agency Bidder DBE Information (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON APPENDIX H AGENCY: 1. �1T� "� LOCATION: SMICN�% Y-`FYV C]o �"� PROJECT DESCRIPTION: PROJECT NO. TOTAL FEDERAL CONTRACT AMOUNT: $_' :It C " a 7 Itoo BID DATE: 7.- 2-0 BIDDERS NAME: Superior Paving Company, Inc.. t a United Paving Company CONTRACT ITEM OF WORK AND DESCRIPTION Cott. No. of DBE NAME OF DBEs DOLLAR AMOUNT ITEM NQ OR SERVICES TO BE AND EXPIRATION (Must be certified an the date bide DBE SUBCONTRACTED OR MATERIALS DATE are opened - include DBE address TO BE PROVIDED �i and phone number) Total Claimed � For Local Agency to Complete: Local Agency Contract Number. participation ) Federal Aid Project Number: - Federal Share: too Contract Award Date: Local Agency certifies that all information is complete and accurate. �, { Signature of Bidder PrintName Signature Date Local Agency Representative (Area Code) Telephone Number: Date (Area Code) Tel, No. For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engincei Local Agency Bidder- DBE lnfomatim(Rev 3109) Distribution: (l) Copy —Fax or scan a copy to the Caltums District Local Assistance Engineer (DLAE) within 15 days of award. Failure to send a copy to the DUNE within 15 days of award may result in de- obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original — Local agency files TO BE INCLUDED IN BID PACKAGE BP 22 of 30 J CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT NONLOBBYING CERTIFICATION FOR FEDERAL AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influence or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in conmection with the awarding of any Federal contract, the making of any Federal grant, the malting of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriate fiords have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Fonn -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. BIDDER'S Signature Superior Paving Company, Inc, dha IInited Paving Company Firm tiz.sl�,� Date • Standard Form LLL may be obtained from Caltrans and FHWA offices TO BE INCLUDED IN BID PACKAGE BP 23 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbvin : activities pursuant to 31 U.S,C_ 1352 1. Type of Federal Action 2. Status of Federal Action 3. Report Type: ❑ a. Contract ❑ a. Bid/offer /application ❑ a. initial b. Grant b. initial award b. material change c. Corporate Agreement c, post -award d. Ban For Material Change only: e. Loan Guarantee Year quarter f. Loan Insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Narnc and Address of Prime: ❑ Prime ❑ Subwardee Tier , If known Congressional District, i 'krww , Cornressional District, if known 6. Federal Department/Agency: _ 7. Federal Program Name/Description CFDA Number, If applicable 8. Federal Action Number, ifknown 9. Award Amount, ifknown 10. a. Name and Address of Lobbying Entity b. Individual Performing Services (mchidmg acklty& Wc rmtfivm No. (okilurL,.al,lcoCnrm fuai,M/) ILl) (lastname,fostnww,Ml) attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply): 13. Type of Payment (check all that apply) $ ❑ Actual ❑ Planned ❑ a. retainer ❑ b. one -time fee ❑ c. commission 12. Form of Payment (check all that apply): ❑ a. cash ❑ d. contingent fee ❑ b. in-kind; specify: nature ❑ c. deferred value ❑ f. other, specil 14. Brief; Description of Services Perfomred or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment indicated in item 11: , attach Conk'mtatiun Sheets) ijnecessa 15. Continuation Shee s attached: ❑ Yes ❑ No 16. hilburnatiorriapesbifibroughthis furnisauthonzedbyTitle31USCSectiari CK 1 352.T lm( isJm= oflobbyingadpitiesisamataialrgxckntudonofWupm Signature winchrch&u waspbwdbytheticrk =whaithehmmwmw,sniadeciuheed -nl —T 1 E5 into. sdiselosi =kiu#Wptmdntto3lUSC1352 Thisinbunationwillbe Print Name %R)E� \ V\.j' reportedtolbeConpm,, alu- aruu& yandwillbeavdklefr%pubfichToction. ;°-y Anypo,3 o�iwtrofw6 ,tofiletlacmgtmeddsolosrnesbdbes edtoad0p=hyof Title `�(<?c,l(� notl essdia n$1 0, 000adnotmoiethan$100,0001breachsuchfiuturc �-Z'7jate Telephone No. Federal Use Only. Au,"onzecl "s Local Reproduction SC ndardFonn —LLL TO BE INCLUDED IN BID PACKAGE BP 24 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT BIDDER'S STATEMENT REGARDING REQUIRED FEDERAL CONTRACT PROVISIONS (Form FHWA -1273) The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the required Federal Contract Provision (Form FHWA -1273) as shown in the appendix of the special provisions of this project. Signed Title Superior Paving'Company, Inc. Finn dba United Paving Company Date TO BE INCLUDED IN BID PACKAGE BP 25 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT CERTIFICATION FOR FEDERAL AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal Agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of an Federal contract, grant, loan, or cooperative agreement., (2) if any funds other Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL *, "Disclosure of Lobbying Activities" in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 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 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. YUI"l ��lAbitiS��S,�t \ \l� BIDDER Signature ' Superior Paving Company, Inc. dha I Tnited anJng Company Firm zS I i 3 Date *Standard Form ILL B,]dy;be q;btatn�tY &,4,x?4 ltrana giv.FHWfla TO BE INCLUDED IN BID PACKAGE BP 26 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT BIDDER'S CERTIFICATE OF COMPLIANCE REGARDING "BUY AMERICA" REQUIREMENTS FOR STEEL OR MANUFACTURED PRODUCTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the " Buy America" requirements of Section 165 of the Surface Transportation Assistance A ct of 1982 and as shown in the special provisions of this project. Signed Title `sCnk=,C"`w \ sc \N \ \ 0 Superior Paving Company, Inc. Firm dba United Paving Company Date \ ! 1 � - TO BE INCLUDED IN BID PACKAGE BP 27 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the BIDDER hereby declares under penalty of perjury under the laws of the State of California that the BIDDER has _ , has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term 'BIDDER" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The BIDDER must place a check mark after "has" or "has not' in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. BIDDERS are cautioned that making a false certification may subject the certifier to criminal prosecution. Signed Title Firm dba United .Paving Company Date I I -Ls I � —S TO BE INCLUDED M BID PACKAGE BP 28 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 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. �IV�:) TO BE INCLUDED IN BID PACKAGE BP 29 of 30 CITY OF SANTA ANA PROJECT NO. 13 -7511 CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 17 PROPOSAL AND CONTRACT AGREEMENT PUBLIC CONTRACT CODE SECTION 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. BIDDERS are cautioned that malting a false certification may subject the certifier to criminal prosecution. Signed Title 'S(�L a c, " C ham. \i 10 Firm dba United Paving Company Date TO BE INCLUDED IN BID PACKAGE BP 30 of 30 THE AMERICAN INSTITUTE OF ARCHITECTS AIA DocumentA310 l i f .I Bond No. N/A KNOW ALL MEN BY THESE PRESENTS, that we Superior Paving Company, Inc. dba United Paving Co. 14660 Industry Circle La Mirada, CA 90638 (Here insert full name and address or legal title of Contractor) as Principal, hereinafter called the Principal, and Merchants Bonding Company (Mutual) a corporation duly organized under the laws of the State of 10wn bound unto City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 as Surety, hereinafter called the Surety, are held and firmly (Here inserl full name and address or legal title of Owner) as Obligee, hereinafter called the Obligee, in the sum of (10 %) Ten percent of the attached bid amount ( 10% of bid amount ) for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for City Wide Residential Street Repair Phase 17 (Here insert fill name, address aid dcsenption ofproject) NOW, TI- IEREPORE, 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 surely for the faithful performance of such Contract and for the prompt payment of labor and material famished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid then this obligation shall be null and void, otherwise to remain in full force arid effect. Signed and sealed n January 24, 2013 (Witness) i 1 t1�vLh1 +� U,11f y" f v6�CAra1 Superior Paving Company, Inc. dba United Paving Co. (Principal) (Seal) (Title) rochv-,7,aS _ 116, enmlcke'ff� hantg Bonding Company ( Mutua (Sea (Wim'I �kRic \h rdson (Title) Stephanie ang aA DOCUMENT A310 BID BOND AIA ,10 FEBRUARY 1970 ED THE AMERICAN INSTITUTE OF ARCHITECT'S, 1735 N.Y. AVE., N.W. WASHINGTON, D.C. 20006 WARNING: Unlicensed photocopying violates U.S. copyright laws and is subject to legal prosecution. CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA 11 County of Oranges On I .)- q I 13 before me, Irene Luong, Notary Public Date Here Insert Name and Title of the Officer personally appeared Stephanie Hoang Name(e) of Slynets) �,:�c .�.a r.:,.n �- � mom., x,.�•� Ll 1(7 �c y, l�y,��? IrtLIyG [ Comntl t, 4b' _ � lion tFC0838 Notary Public - Callfoi nia z °• My Orange County Coruna. Expires Mar 22, 2014 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(*) whose name(s) is /are subscribed to the within instrument and acknowledged to me that 4ieishe /thoy executed the same inhis/her/their authorized capacity( ee), and that by 1,k /her /their signature(s) on the instrument the person(&•), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and corre-` Witness n Signature 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 Signer(s) Other Than Named Capaeity(ies) Claimed by Signer(s) Signer's Name: Stephanie Hering Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑Limited ❑General R Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Signer's Name: ❑ Individual ❑ Corporate Officer— Title(s):: ❑ Partner — ❑. Limited ❑General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator Top of thumb here ❑ Other: Signer Is Representing: (C)200'1 National No1nry Aseochlion • 9350 De Soto Avo., RD. Do. 2402 Gpatswonn, CA 91812 -2402 • www.NationaVolary.org It ©ln 45907 14eordor Gall "I'oll -hoo 1-600-M-6827 MERCHANTS BONDING COMPANY., POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations duly organized under the laws of the State of Iowa (herein collectively called the "Companies "), and that the Companies do hereby make, constitute and appoint, individually, Eric Lowey; Mark Richardson; Shawn Blume; Stephanie Hoang Of Costa Mesa and State of CA their true and lawful Attorney -in -Fact, with full power and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety 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: SEVEN MILLION ($7,000,000.00) DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Companies, and all the acts of said Attorney -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 By -Laws adopted by the Board of Directors of the Merchants Bonding Company (Mutual) on April 23, 2011 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 24, 2011. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof. The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 27thday of February , 2012. ;- ,'q: STATE OF IOWA COUNTY OF POLK ss. •O��\�1P0,9 '09. C4 9f.Z�4 a H1= -e- p1: y; 1933 ; c; • ti. •:J6� • .......... MERCHANTS BONDING COMPANY (MUTUAL) MERCHANTS NATIONAL BONDING, INC. (/ President On this 27th day of February , 2012, before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. In Testimony Whereof, I have hereunto set my hand and affixed my Official Seal at the City of Des Moines, Iowa, the day and year first above written. �,wpc, MARANDA GREEN 1 f Lrt I�f ±� Commission Number 770312 �'•" My Commission Expires / °W" October 28, 2014 Notary Public, Polk County, Iowa STATE OF IOWA COUNTY OF POLK ss. I, William Warner, Jr., Secretary of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF- ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 24th day of January 2013 „ ,Nq,pry • „• ?Oyq�9y ; ti ; 4 -c: � /.e' �✓ �i , • y Z rr, . Li�2i.r.Cri z n' Z' Secretary 1933 : c: 2003 r 1yJ POA 0014 (11/11) d�HV' CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California Countyofa�IPr, e� On , before me, Ar a r�� ��I,as ,��lo-► ar.1 Data I Here Insert NZY and Title of the vincer personally appeared �)1 /1 AS _I _v 0 \\ y �IANu A V L EOAS� AR +►—( Commission # 1950023 Notary Public - California z Riverside County ' Lamy Coin ExPirres. ct 24, 2015 Place Notary Seal Above or aignegs, CIVIL CODE § 9189 who proved to me on the basis of satisfactory evidence to be the persons)' whose name,K is /pfe subscribed to the within instrument and acknowledged to me that he /syi2 /thy executed the same in his /h* /tl #ir authorized capacity(yes), and that by his /l)er /therir signature�s) on the instrument the person(s), or the entity upon behalf of which the person] o 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 sea Signature: Signs ure of No ary 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: Signer(s) Other Than Named Above Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Individual IMP ❑ Partner — ❑ Limited ❑ General Top, El in Fact Z El Trustee ❑ Guardian or Cor ❑ Other: Signer Is Number,ofPages Sign s Name: Corporate Officer — Title(s): ❑ Individual s 1*1 NO ❑ Partner — ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: zo io r,aaonai rvorary Hesoaanon • NanonalNotary.org • 1- U00 -US NO ANY (1- 800 -816 -6627) Item #5901 Company Profile Company Profile Company Search Company Search Results Company Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business Workers' Compensation Complaint and Request for Actlon /Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer COMPANY PROFILE Company Information MERCHANTS BONDING COMPANY (MUTUAL) 2100 FLEUR DRIVE DES MOINES, IA 50321 -1158 800 - 678 -8171 Old Company Names Agent For Service KAREN HARRIS C/O CORPORATION SERVICE COMPANY 2710 GATEWAY OAKS DRIVE, SUITE 150N SACRAMENTO CA 95833 -3505 Reference Information Effective Date NAIC #: 14494 California Company ID #: 2482 -8 Date Authorized in California: 01/27/1982 License Status: UNLIMITED- NORMAL Company Type: Property & Casualty State of Domicile: IOWA back to top NAIC Group List NAIC Group #: Lines Of Business 3479 Merchants Bonding Cc Grp The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. LIABILITY MISCELLANEOUS SURETY back to top © 2008 California Department of Insurance Page 1 of 1 http: / /interactive.web.insurance.ca. gov /companyprofile /companyprofile ?event= companyPr... 3/18/2013 Company Profile Company Profile Company Search Company Search Results Company Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business Workers' Compensation Complaint and Request for Action /Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer COMPANY PROFILE Company Information MERCHANTS BONDING COMPANY (MUTUAL) 2100 FLEUR DRIVE DES MOINES, IA 50321 -1158 800- 678 -8171 Old Company Names Agent For Service KAREN HARRIS C/O CORPORATION SERVICE COMPANY 2710 GATEWAY OAKS DRIVE, SUITE 15ON SACRAMENTO CA 95833-3505 Reference Information Effective Date NAIC #: 14494 California Company ID #: 2482 -8 Date Authorized in California; 01/27/1982 License Status: UNLIMITED - NORMAL Company Type: Property & Casualty State of Domicile: IOWA back to top NAIC Group List NAIC Group #: Lines Of Business 3479 Merchants Bonding Cc Grp The company Is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. LIABILITY MISCELLANEOUS SURETY back to top © 2008 California Department of Insurance Page 1 of 1 littp: // interactive. web. insurance, ca. gov /eornpanyprofile /companyprofile? event= companyPr... 2/28/2013 Compliance News Daily Focus Journal Publication Affidavit- Declaration of Publication -- State of California Superior Paving Company, Inc. dba United Paving, Co. is seeking certified and qualified DBE,Section 3 subs and/or suppliers to provide Concrete, Manhole Frames, Water Valve Frames, Striping, SWPPP, Trucking, Traffic Control for City of Santa Ana - City Wide Residential Street Repair Phase 17 in Santa Ana,CA We are an Employer. Contact: Mike Borja 14660 Industry Circle La Mirada,CA,90638 Phone:(714) 739 -2200 Fax:(714) 739 -2400 Email:elena@united-paving.com Bid Due on:01/29/2013 at 02:00 PM Solicitation Number: 13 -7511 The Superior Paving Company, Inc. dba United Paving, Co. Good Faith Effort ad has been published in both the Compliance News Internet and Hard -Copy publications. Located Online at: http:// www .compliancenews.condclassified_ daily The undersigned declares: I am over the age of 18 years and a citizen of the United States. I am the principal publisher of the Compliance News Monthly Trade Journal in the City of Long Beach, County of Los Angeles, and the State of California. The notice, a true copy of which is attached was published on Thu Jan 24 10:39:49 -0800 2013 I declare under penalty of perjury that the foregoing is true and correct. Executed at Long Beach, California Henry Sprague III Copyright 2005 Compliance News DVBE #0018455 All Rights Reserved MAYOR Miguel A. Pulido MAYOR PRO TEM Claudia C, Alvarez COUNCILME.MBf -RS David Denavidos Carlos Bustarnon(c Michole A4arllnoz Vlncenl F. Snrrnlonto Sal Twa oro January 22, 2013 ADDENDUM No. ONE CITY OF SANTA ANA PUBLIC WORKS AGENCY r.O. Box IM, M -36 Santa Anal, California 9270P INTERIM CITY MANAGER Feel Waiters CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D.Huizar SUBJECT: PROJECT NO. 13 -7511: CITYWIDE RESIDENTIAL STREET REPAIR i PHASE 17 The following changes have been made to Specifications for the subject project: Specifications i. Page iv, NOTICE INVITING BIDS, paragraph 1: Replace with the following: NOTICE IS HEREBY GIVEN that the City of Santa Ana, California will receive at City Hall -Ross Annex, (M-22), 20 Civic Center Plaza, Santa Ana, California 92701, the Public Works Aggp Thirst Floor Receptionist (see attached map), on or before the hour of 2:00 p.m. on Tuesday, January 29, 20113 sealed bids and /or proposals for... All other terms and conditions remain the same. FOR THE CITY OF SANTA ANA Edwin "William" G Ivy ez, I31. City Engineer fi GdAYOR NlIgue! A. PIINJO MAYOR PRO fEM Claudia C. Alvarez C0uIVCI1_MF ,IBERS David Br:navtdc s Cw;os Bustamantn Michele Nterlinez Vlncont F. Sa nnwrto Sal Twgoro January 24, 2013 ADDENDUM No. TWO CIITY OF SANTA ANA PUBLIC WORKS AGENCY P,oi Box 1988, M-36 Saaeita Ana, Califomia 92702 INTERIM C:1TY MANAGER Peal waltcrs C9JY AT'TORP.{ V Sonia R. CarvalPiio CLERK OP THE COUNCI I. Marla fJ.HCi zta, SUBJECT: PROJECT NO. 13.7511: CITYWiDIE RESIIDENTIIAL STREET REPAIR PHASE 17 The following changes have been made to Specifications for the subject project: Specifications 1. Page iv, NOTICE INVITING BIDS, paragraph 1: Replace with the following: NOTICE IS HEREBY GIVEN that the City of Santa Ana, California will (receive at City Hall -Ross Annex, (M -22), 20 Civic Center Plaza, Santa Aria, California 92701, the Public Works Agency Third Floor Receptionist (see attached map), on or before the hour of 2:00 p.m. on Wednesday, February 20, 2013 sealed bids and /or proposals for... All other terms and conditions remain the same. FOR THE CITY OF SANTA ANA ,r Edwin "William" Galvez, P.E. City Engineer F MEMORANDUM To: From: Subject: David Cavazos City Manager William Galvez, Interim Executive Director Public Works Agency Date: March 25, 2014 Project No. 13 -7511: RESIDENTIAL STREET REPAIR — PHASE 17 CHANGE ORDER NO. 1 CONTRACTOR: Superior Paving Company, Inc. 14660 Industry Circle La Mirada, CA 90638 PROJECT DESCRIPTION: 13 -7511: Residential Street Repair — Phase 17 CHANGE ORDER NUMBER: 1 CHANGE ORDER TOTAL: $ 41,620 ACCOUNTING UNIT - ACCOUNT - ACTIVITY NUMBER: 13518783-66220-13751101028 JUSTIFICATION a c-aa 1. On 6th Street from Bristol Street to Shelton, 5th Street from Bristol to Baker, and Baker Street from Santa Ana Boulevard to Civic Center Drive the contract documents call to remove the existing concrete (PCC) pavement, backfill with 6" of crushed miscellaneous base, cement treat a 9" section, and pave 6" of AC. However, after potholing the existing utilities, several water and gas service were found very shallow and therefore were in conflict with the proposed section. Therefore due to a significant time required to relocate these utilities, it was recommended to revise the street section. While removing the PCC pavement, the contractor encountered areas where the street sections were thicker than expected as well as a wet and unstable sub - grade. To ensure the integrity of the new pavement with the revised section, it required additional excavation, which is greater than the amount specified in the contract, and strengthening the sub -grade with additional base material. Since the additional work was not included in the original contract amount, staff requested a revised unit cost for quantities in excess of 125 %, in order to pay for the work. This change order provided compensation at a reduced cost for the additional unclassified excavation and base material required to treat the subgrade failures and construct the modified street section. Estimated Cost = $34,496 2. At Poinsettia Street from Civic Center Plaza to Santa Ana Boulevard, the contract documents call for a cement treated base (CTB) section. Subsequent to removing the street, staff discovered that the majority of existing AC is structurally sound and can be used in lieu of the CTB, as required by the contract. Therefore, Project 13 -7511 Request for Approval of Change Order No. 1 March 25, 2014 Page 2 of 3 Design Engineering requested the asphalt street be cold milled in lieu of the CTB. A unit price of $0.97/SF to cold mill 2- inches of AC, approximately 7,344 SF, was negotiated. Furthermore, Design Engineering requested to delete Pine Street from Raitt to AC -PCC transition west of Western Avenue from the contract. This will allow the contractor to complete the remaining street, Lacy from 1st street to 4th street and Shelton from 6th street to Civic Center Drive using the original cement treated section and stay within the contract contingency. Estimated Cost = $7,124 ACCOUNTING UNIT COST ANALYSIS: CCO Item Number Accounting Units Unit Costs Estimated Qty. Total Amount 1A 13518783- 66220 - 13751101028 $71.92 479.64* $34,496 1B 13518783 - 66220 - 13751101028 $0.97 7,344.00* $7,124 Total $41,620 ( *) -The quantities are an estimate; contractor will be paid for actual quantities of work completed. CONTRACT COST SUMMARY: I Contract Total Previous Approved CCO This Change Order Total CCO to date 724 % of Contract Amount % of Contract $0 0.00% $41,620 Increase 5.90% Adjusted Contract Total $746,344 SCHEDULE IMPACT: Increase 5.90% Increase contract time by 95 working days, due to utility relocations. Project 13 -7511 Request for Approval of Change Order No. 1 March 25, 2014 Page 3 of 3 APPROVED AS TO FUNDS AND ACCOUNTS: r � Jlw William Galvez, Interi xecutive Director Francisco Gutierrez, Executive Director Public Works Agency Finance & Management Services Agency 11-k K:Construction/Projects /13- 7511 /B.Change Orders /B /CO #01/13 -7511 MEM RFA CCO #01 CE' °Y OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number PROJECT NOS. 13 -7511: RESIDENTIAL STREET REPAIR Change Order Number 1 — PHASE 17 To Superior Paving Company, Inc. dba United Paving Company Contractor You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included In the plans and specifications on this contract. NOTE THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY COUNCILOR CITY MANAGER. Unless otherwise staled, rates fofrental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by Pl1Rl IC WnRKS AcaFNnv ADJUSTMENT OF COMPENSATION AT AGREED UNIT PRICES Item New Bid Item Unit Quantity Price Total A Unclassified Excavation CY 479.64* $71.92 $34,496 *The quantity of 479.64 CY is an estimate; contractor will be paid for actual quantity of work completed. B Cold mill AC Pavement SF 7,344* $0.97 $7,124 `T :-ra quantity of 7,344 SF is an estimate; contractor wiii be paid for actual quaTitity of work corrrpie'ted. Estimated Total MAR 2 5 $41,620 Cl Y OF SANTA ANA PUBLIC WORKS AGENCY CONTRACT CHANGE ORDER Project Number PROJECT NOS. 13 -7511: RESIDENTIAL STREET REPAIR — Change Order Number PHASE 17 To Superior Paving Company, Inc. dba United Paving Contractor Company You are hereby directed to make the herein changes from the plans and specifications or do the following described work not included in the plans and specifications on this contract. NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTILAPPROVED BY THE CITY COUNCIL OR CITY MANAGER. Unless otherwise staled, rates for rental of equipment cover only such time as equipment is actually used and no allowance will be made for idle time. Change requested by PUBLIC WORKS AGENCY The compensation both time and cost set forth in this change order comprises the total compensation due the Contractor, all Subcontractors, and all Suppliers for all work performed per this change order, including impact on unchanged work. By signing this change order, the Contractor acknowledges and agrees on behalf of himself, all Subcontractors, and all Suppliers, that the stipulated compensation includes payment for all work contained in this change order, plus all payment for interruption of schedules, extended field overhead, home office overhead, profit, delay, and all impact, ripple effect or cumulative impact on all other work under this Contract. The signing of this change order constitutes full mutual accord and satisfaction for all changes and work performed on this project, and that the time and cost paid per this change order constitutes the total equitable adjustments owed the Contractor, all Subcontractors, and all Suppliers for all work performed on this project. The Contractor on behalf of himself, all Subcontractors, and all Suppliers agrees to waive all rights, without exception or reservation of any whatsoever to file any further claim related to this project. TOTAL COST THIS CHANGE ORDER: DECREASE $ _ _ _ _ _ INCREASE $ 41,620 By reason of this order the CONTRACT TIME completion will be adjusted as follows: 110 working days We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal is approved, that we will provide all equipment, furnish all materials, except as may otherwise be noted above, and perform all service necessary for the work above specified, and will accept as full payment therefor the prices shown above. Accepted, Date Contractor Superior Paving Company, Inc. dba United Paving 1-7 —1 tt Company By 6k &14proval recommended by Date PUBLIC W02 S AGENCY EXE UT VE DIRECTOR < " ' G � /7//l Approved by Date CITYMANAGER Xy-