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HomeMy WebLinkAboutGREEN GIANT LANDSCAPE, INC. (5) Recording Requested By, Recorded in Official Records, Orange County And When Recorded Mail To: Hugh Nguyen, Clerk-Recorder Clerk of the Council,City of Santa Ana �1111 II[I�11 III III 1111�I 1�11�1111 III II I]II II III III NO FEE 20 Civic Center Plaza,P.O.Box 1988 * $ R 0 0 0 8 4 1 9 8 7 0 $ * Santa Ana,CA 92702 2016000247782 8:08 am 06102116 10 414 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIS SPACE FOR COUNTY RECORDERS USE ONLY NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN that the undersigned City of Santa Ana, California, a municipal corporation, with the address of City Hall, 20 Civic Center Plaza, Santa Ana, California, 92701, is the owner of the property hereinafter described, that said owner has caused construction of A MEMORIAL PARK SECURITY LIGHTING under contract entered into on 07/07/2015, with o GREEN GIANT LANDSCAPE, INC. on which contract PHILADELPHIA INDEMNITY wINSURANCE COMPANY is surety. The property on which such work improvement was placed is w c in the City of Santa Ana, County of Orange, State of California, and described as Project No.14-7514 zlocated at: MEMORIAL PARK. The work improvement on said property was accepted as completed z on 5/20/2016. A � D CCIT A,A MUNICIPAL CORPORATION by � z Dated: Principal Civil Engineer-Tyrone Chesanek Z TrFLE a ------------------------------------------------------------------------------------------- a VERIFICATION I, the undersigned, say: I am the City Engineer - Edwin"William" Galves 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 declaJ e under penalty of perjury that the facts therein stated are true. Executed on / , at Santa Ana,Ca ' mia (Signature of individual swearing that the contents of Notice of Completion are true.) THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN(10)DAYS AFTER COMPLETION REQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: JULY 7, 2015 TITLE: AWARD CONTRACT FOR CONSTRUCTION OF MEMORIAL PARK SECURITY LIGHTING (PROJECT 14-7515) (STRATEGIC PLAN NO, 6, 1B ,1G) RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVEDJU_ 0 7 2015 I/ As Recommended, aQ,3$ ❑ As Amended ❑ Ordinance on I" Reading ❑ Ordinance on Vd Reading ❑ Implementing Resolution ❑ Set Public Hearing For_ CONTINUED TO FILE NUMBER Award a contract to Green Giant Landscape Inc., the lowest responsible bidder, in accordance with the unit bid prices, totaling $334,500, for construction of the Memorial Park Security Lighting Project. 2. Approve the Project Cost Analysis for a total estimated project delivery cost of $430,415. DISCUSSION This action will allow construction of new security lighting in Memorial Park. The improvements include new pole foundations, electrical conduit and wiring, vandal -resistant security light concrete poles, and energy efficient LED fixtures. Memorial Park is a 17 -acre community park that includes a community center, swimming pool, lighted ballfields, picnic facilities, a tot lot, an outdoor venue, and volleyball, basketball, and handball courts. The park receives heavy use and the community has expressed concerns about adequate security lighting in the park. The current lighting system was installed over 50 years ago and is significantly deteriorated. Several of the existing wood poles have been severed and, due to the system's poor condition, maintenance costs have significantly increased. Therefore, staff recommends replacing the lighting system to improve visibility and security. A Notice Inviting Bids was advertised on May 1 and 2, 2015, and bids were opened on May 27, 2015, The following tables summarize the bid invitations made and the bids received: Contract Award July 7, 2015 Page 2 For Memorial Park Security Lighting Contractor Participation Data Santa Ana contractors receiving notices 6 Contractors requesting bidding documents 15 Bids received 6 Bids received from Santa Ana contractors 0 Bid Results Summanr RANK BIDDER'S NAME LOCATION BID 1 Green Giant Landscape, Inc. La Habra $334,500 2 Vido Samarzich Inc. Alta Loma $348,000 3 Metro Builders & Engineers Group, Ltd. Newport Beach $397,000 4 Minako America Corporation Gardena $507,700 5 Pacific Winds Building Inc. Irvine $504,000 6 Amtek Construction Whittier $889,088 A total of six bids were received and all were deemed responsive. Green Giant Landscape, Inc., submitted the lowest responsive bid in the amount of $334,500, which is consistent with the engineer's estimate of $304,000. Therefore, staff recommends award of this contract to Green Giant Landscape, Inc. STRATEGIC PLAN ALIGNMENT Approval of this item supports the City's efforts to meet Goal #6 Community Facilities & Infrastructure, Objective #1 (establish and maintain a Community Investment Plan for all City assets), Strategy B (equitably maintain existing streets and associated assets in a state of good repair so they are clean, safe, and aesthetically pleasing for all users), and Strategy G (develop and implement the City's Capital Improvement Program in coordination with the Community Investment Plan - e.g., neighborhood streets, traffic improvements, etc.). ENVIRONMENTAL IMPACT In accordance with the California Environmental Quality Act, the recommended actions are exempt from further review. Categorical Exemption Environmental Review No. ER 2015-56 has been filed for this project. In addition, a Certification of Categorical Exclusion and Statutory Worksheet have been prepared in accordance with the National Environmental Policy Act. Contract Award For Memorial Park Security Lighting July 7, 2015 Page 3 FISCAL IMPACT The Project Cost Analysis estimates project expenditures of $430,415, which include the construction contract, construction administration and inspection, as well as contingencies (Exhibit 2). The budget for Community Development Block Grant Funds will be carried forward from Fiscal Year 2014/15 to Fiscal Year 2015/16 for Project 14-7515 in Account No. 13518783- 66220 For expenditure in Fiscal Year 2015/16, NIr �-"- Fred Mousavipour Executive Director i Public Works Agency Gerardo Mouet V� r Executive Director Parks, Recreation & Community Services Agency Ke y Reen rs Executive rector Community Development Agency FM/EWG/KW Exhibits: 1. Location Map 2. Cost Analysis 3. Construction Contract APPROVED AS TO FUNDS AND ACCOUNTS: W6r CA Francisco Gutierrez G' Executive Director Finance & Management Services Agency J SAINT ANDREW LEGEND: PL 71j.�m� DERTRUDEP MEMORIAL.. . - PARK__ n 0 ANAHURST PL � Fc WARNER AV PROJECT LOCATION PROJECT LIMITS EXHIBIT 1 SANTA ANA CONTRACT AWARD FOR ■ P W A AGENDA DATE: MEMORIAL PARK SECURITY LIGHTING t� JULY 7,2015 PROJECT NO. 14-7515 PUBLIC WORKS AGENCY nn PAGE 1 OF 1 COST ANALYSIS PROJECT NO. 14-7515: MEMORIAL PARK SECURITY LIGHTING Exhibit 2 THE REGISTER I The space far hung etsap Drily 625 N GRAND AVE, SANTA ANA, CA 92701 Telephone (714) 796-7000 / Fax (714) 796-6059 CNS#; 2746902 NOTICE INVITING BIDS PROOF OF PUBLICATION. (°qpt°d a" rya -0 jeI n", ' M 22 ea la,Ane a0tomlay� - . - s270i 1dY (2015:5 C',C.P.) - k�pMLf,IgQv'NO iA 7tliB '„ MI CRIAL PARK 81111- State ®State of California) _ QUNI7Y'LIONPINd- County of ORANGE ) ss - scope of work, Includes re- moval of all 4xleting Ilgqht' eta dards and'replacinq with - ..NoticeType: BID- NOTICE INVITING BIDS no iddin1gp 1aa^late, fdd Ix Pal�j Wlrl g and,s is Ad Description: - Prior tb bldg opeMng DId'adrs ` must posse9a`. or Wall) 'r , Memorial Park Security Lighting - - vend cadlichii4 t.clarni "AP Cpntractarelip¢ns¢ Infarmatlon 'e,.&ding bid submission is lnciuded in the Contrast bodi'mtlnh', am a citizen of the United States and a resident of the State of California; I am orhe conhaot dbaumanls I- over the age of eighteen years, and not a party to or interested In the above O4re avalldble n.;pat format Ithe Public �orke Agenoy entitled matter. I am the principal clerk of the printer and publisher of the THE aeorraso FksPrf,ioorpo cla REGISTER, a newspaper published In the English language In the city of captor Plazsoa�nnox—, ^a9somACalirnia 701. SANTA ANA, county of ORANGE, and adjudged a newspaper of general r +_. circulation as defined by the laws of the State of California by the Superior Tlu,�aa� Ia subject to , appl Yno ItpNpp And .= 'Court of the County of ORANGE,. Slate of California, under date 11119/1905, onto pame rt ix ll . slate of': Case No. A21046, That the notice, of which the annexed is a printed co has Dell%mla gggqanmsnt of m P PR dyet(lal FbdEIons, pgr eeo• been published In each regular and entire Issue of said newspaper and not in tion 177x4 at.q contrao or any supplement dates, to-wlf or gvximrsClbr most.:Ud - Y. PP 9 regg�s xred Whh the DeppaM+, In9nt of Industrial neistIons r pylar to slIbmltUhg a Wit - . - In sopa i,rydhihelprW1_- siana of the;Call pa Labor,- ' - - code, prpvalling Wage; rates'-. spplYr 05101/2016, 05/02/2015 - As AbII invWvaa. Fad, eral ipnding assistance, Fed- . orad robot etai1dards, Includ" L-M702 acoriAat require, YExecuted on: 05/02/2015 o aaea3 - ' At. SANTA ANA; California I certify (or declare) under penalty of perjury, that the foregoing Is true and correct. - - * A DO 0 0 0 3 7 4 9 4 1 5 MAYOR Miguel A. Pulido MAYOR PRO TEM Vincent F. Sarmiento COUNCIL MEMBERS Angelica Amezcua P. David Benavides Michele Martinez Roman A. Reyna Sal Tinajero e" J CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar Project Title: Memorial Park Security Lightin Date of Approval: 07/07/2015 Project Number(s): PWA-2015-493-CIP Project Location: 2102 S. Flower St. City: Santa Ana County: Orange ER Number: ER -2015-56 Project Description: Construction will include complete removal and replacement of existing security lighting system. Applicant Name: Suzi Furjanic , City of Santa Ana Applicant Address: City of Santa Ana: 20 Civic Center Plaza M-36 SANTA ANA, CA 92701 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Furjanic, Suzi Exempt Status: ❑ Ministerial (Sec. 15266) ❑ Declared Emergency (Sec. 15269 (a)) ❑ Emergency Project (Sec. 15269 (b through e)) ❑ General Rule (Sec. 15061(b)(3)/(5)) ❑ Statutory Exemption: Categorical Exemption: 15301(c) Reason(s) Why Project is Exempt From CEQA: This is an improvement of existing facilities and will not increase capacity. City Contact: Suzi Furjanic Telephone: (714) 571-4241 Signature: Title: / 7 . % L 16r /hrY Date:' ` SANTA ANA CITY COUNCIL Miguel A. Pulido Vincent F. Sarmiento Michele Martinez Angelica Amazons P. David Benavides Roman Rayna Sal Tinajero Mayor Mayor Pro Tem, Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 Ward 6 MPullde Santa-ana org OBenav'des@Santa-ana ora $ggyrg9@sante-ana oro STina'ero@Sonia-ana qy PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M-20) P.O. BOX 1988. Santa Ana, California 92702 (714) 667-2700 - Fax (714) 973.1461 w .santa-ana.org NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) 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: Memorial Park Security Lightin Date of Approval: 07/07/2015 Project Number(s): PWA-2015-493-CIP Project Location: 2102 S. Flower St. City: Santa Ana County: Orange ER Number: ER -2015-56 Project Description: Construction will include complete removal and replacement of existing security lighting system. Applicant Name: Suzi Furjanic , City of Santa Ana Applicant Address: City of Santa Ana: 20 Civic Center Plaza M-36 SANTA ANA, CA 92701 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Furjanic, Suzi Exempt Status: ❑ Ministerial (Sec. 15266) ❑ Declared Emergency (Sec. 15269 (a)) ❑ Emergency Project (Sec. 15269 (b through e)) ❑ General Rule (Sec. 15061(b)(3)/(5)) ❑ Statutory Exemption: Categorical Exemption: 15301(c) Reason(s) Why Project is Exempt From CEQA: This is an improvement of existing facilities and will not increase capacity. City Contact: Suzi Furjanic Telephone: (714) 571-4241 Signature: Title: / 7 . % L 16r /hrY Date:' ` SANTA ANA CITY COUNCIL Miguel A. Pulido Vincent F. Sarmiento Michele Martinez Angelica Amazons P. David Benavides Roman Rayna Sal Tinajero Mayor Mayor Pro Tem, Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 Ward 6 MPullde Santa-ana org OBenav'des@Santa-ana ora $ggyrg9@sante-ana oro STina'ero@Sonia-ana qy CITY OF SANTA ANA SEP 2015 Construction Contract PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING This CONSTRUCTION CONTRACT is made and entered into this 7th day of July, 2015, by and between the CITY OF SANTA ANA, CALIFORNIA, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California, hereinafter referred to as "CITY" and GREEN GIANT LANDSCAPING, INC. hereinafter referred to as "CONTRACTOR". WITNESSETH: The CITY and the CONTRACTOR, for the consideration hereinafter named, mutually agree as follows: 1. CONTRACTOR agrees to perform all the work and furnish all the materials at its own cost and expense necessary to construct and complete in a good and workmanlike manner and to the satisfaction of the City Engineer of the CITY, the "Memorial Park Security Lighting Project" identified in and in accordance with the Contract Documents prepared by the City's Public Works Agency and approved by the City Council. 2. The complete Construction Contract consists of the "Contract Documents," as defined by the Standard Specifications for Public Works Construction and which include the following: • ...Notice Inviting Bids • ...Instructions to Bidders ...Bid Proposal ...Bid Bond • ...Contract Forms • ...Contract Bonds • ...General Provisions • ...Special Provisions ...Technical Provisions ... Project Plans • ...Appendices In case of conflict between the Contract Documents, the precedence of documents shall be as established in the Standard Specifications for Public Works Construction. 3. CITY agrees to pay and CONTRACTOR agrees to accept in full payment to complete "Memorial Park Security Lighting Project" the sum total amount not to exceed $334,500, as set forth and identified in the BID PROPOSAL. Page 1 of 3 CITY OF SANTA ANA Construction Contract PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING 4. CONTRACTOR agrees to complete the "Memorial Park Security Lighting Project" within the time specified in the Time for Completion of Improvements section of the BID PROPOSAL including commencing construction within the timeframe therein specified after issuance of a Notice to Proceed. S. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the "Memorial Park Security Lighting Project" a salary or wage at least equal to the prevailing salary or wage established for such work as set forth in the wage determinations for this work in accordance with applicable State and Federal law. 6. CONTRACTOR shall, after award of this Contract, furnish two bonds to be approved by the CITY, one in the amount of One Hundred Percent (100%) of the Contract price, to guarantee the faithful performance of the work (Performance Bond), and one in the amount of One Hundred Percent (100%) of the Contract price to guarantee payment of all claims for labor and materials furnished (Payment Bond). This Contract shall not become effective until such bonds are supplied to and approved by the CITY. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond equal to at least ten (10%) percent of the final Contract price or $1,000, whichever is greater (Warranty Bond). 7. CONTRACTOR shall, upon project completion as a condition of project acceptance, furnish a Warranty Payment and Performance bond to be approved by the CITY, in the amount of Twenty -Five Percent (25%) of the Contract price, to warrant the work done under said Contract Agreement against material or quality defects for a period of one year after acceptance by the AGENCY. s. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the CITY. // H Page 2 of 3 CITY OF SANTA ANA Construction Contract PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written. ATTEST: MARIA D. HUIZAR� Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney`) 1 Sandoval F Assistant Ci y Attorney CITY OF SANTA ANA DAVIDDAVICAVAZOS City Manager RECOMMENDED FOR APPROVAL: Frid Mousavipour, P.E. Executive Director, Public Works Agency CONTRACTOR: Green Giant an ing, Inc. Title: c _ Page 3 of 3 CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: Green Giant Landscape, Inc: REQUIREMENT: The undersigned bidder declares that they have carefully examined the location of the proposed work, that they have examined the Contract Documents in its entirety and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said plans (if any) and the specifications for the unit price(s) or lump sum(s) set forth in the following schedule: Item Description Quantity Unit Unit Price Amount 1 New Security Lighting System 1 LS $ y$ a3cl,soo -- / tr�7 3-3 4,,7 0 -- TOTALBID'05hLi 5VC),o(-_) The lowest BIDDER shall be selected on based on the lowest base bid. TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete said work within ninety (90) working days after the commencement date stated in the Notice to Proceed. The bidder also proposes to commence construction of the Work within fifteen (15) days after issuance of a Notice to Proceed, and to continue in a diligent and workman -like manner without interruption, and to complete the construction thereof within the time specified above. The liquidated damages amount shall be $250.00 per calendar day. CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING BIDDER'S STATEMENT BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent Construction Contract Agreement shall constitute the entire agreement between BIDDER and the AGENCY only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action 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) business days or the funds, check, draft, or BIDDERS bond substituted in lieu thereof accompanying this proposal shall become the property of the AGENCY and shall be considered as payment of damages due to the delay and other causes suffered by AGENCY because of the failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered is difficult to ascertain; otherwise said funds, check, drafts, or BIDDER'S bond substituted in lieu thereof shall be returned to the undersigned. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the bid schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. The BIDDER also certifies that the bid is a balanced bid. In accordance with Section 7028.15 of the California Business and Professions Code, the undersigned certifies under penalty of perjury that the foregoing is true and correct. Name Signat Title (if an individual, so state) (If a firm or co -partnership, state the firm name and give the names of all individual co-partners composing the firm. If a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof.) t� v�Je. erve . (ejo -- ` � GREEN GIANT LANDSCAPE INC. STATE LIC. AY C-27, 0 670478 CERTIFIED COPY OF RESOLUTIONS OF BOARD OF DIRECTORS OF GREEN GIANT LANDSCAPE, INCORPORATED "RESOLVED, that Donald L. Henderson, as President of Green Giant Landscape Incorporated, is authorized to enter into and sign all contracts on behalf of this Corporation." I, Rosie Toledo, the duly elected, qualified and acting Secretary of Green Giant Landscape Incorporated, an organized and existing California Corporation, do hereby certify that the foregoing is a full, true and correct copy of the resolution duly adopted by the Board of Directors of said corporation at a meeting thereof at which meeting a quorum of said Board was at all time present and acting; and that said resolution has not been modified or rescinded and is at the date of this Certificate in full force and effect. IN WITNESS WHEREOF, the undersigned has executed this Certificate and affixed the corporate seal of said corporation this Z day of 201_15. Rosie Toledo, Secret y 941-A Macy Street + La Habra, CA 90631-3400 (562) 690.6208 . Fax (562) 690-5029 E -Mail: greengiantinc@aol.com / greengiantoffice@aol.com CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING CONTRACTOR'S LICENSING and REGISTRATION STATEMENT The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and all his/her subcontractors are registered with the State of California Department of Industrial Relations (DIR), and that the following is true and correct. Contractor's Name: Green Giant LandsCBpe, Inc. Business Address: N - La &-P4 ty 4 "100-:f 1 Business E-Mail����������� Address: Telephone: 5(o - ((1 go - %fi g State Contractor's License No. and Class: b to q q � . a- 9L° License Expiration Date: 5_3 H State Dept. of Industrial Relations (DIR) Registration No.: pt. 05NIdlustrial Relations (DIR) ion Expira n Date: I Signed: Title: -t5-- CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT Contractor is aware of the requirements of California Labor Code Section 1720, et seq., as well as California Code of Regulations, Title 8, Section 16,000, et seq., ("Prevailing Wage Laws'), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Since the services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. The undersigned certifies that the foregoing is true and correct. Name of Firn Signature of Title I` YLP-5I d (if an individual, so state) CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGEq,°•D° )SS: �CIITTY 0FFSANT4 �(N�AI 1,41, -k' z --� ) te" being duly sworn, deposes and says: ❑ INDIVIDUAL That he/she is the party makingthe foregoing proposal: F PARTNERSHIP That he/she is a member of the co -partnership firm designated as: and who has been and is duly vested with the authority to make and execute instruments for the co -partnership by: who constitute the other members of the co -partnership. ,E CORPORATION Thatis of: a - �yE'� &4J- Green Giant Landscape, ane a corporation which is making the foregoing proposal: ❑JOINT VENTURE That he is of: one of the parties making the foregoing proposal as a joint venture, and the he/she has been and is duly vested with the authority to execute Instruments for an behalf of the parties making said bid who are: such a bid is genuine and not collusive or sham, and has not in any manner sought by cion to secure any advantage against the City of Santa Ana or any person interested in the c)Xd contract, for hi4self or any other person. Signature of Bider V Subscribed and sworn - of e this �% day 20 Signature of offii(ej--Kdr6i ist ri Oath Notary Public) NOW TOLEDO-HENDERSON� CommA 2086732 ,^ N 9 NOYLos PNOMS COUNTYNIA N LOM ANGELES COUNTY Mr COMM, EXP. Nov. 1�,ti0^S� CITY OF SANTA ANA PROPOSAL PROJECT NO.14.751b MEMORIAL PARK SECURITY LIGHTING KNOW ALL MEN BY THESE PRESENTS that, Green Giant Landscape Inc, as BIDDER, and _ Philadelphia Indemnity Insurance Company as SURETY, are held and firmly bound unto the CITYOF SANTA ANA, as AGENCY, in the penal sum of Y, oliars which is ten percent (100) of the total amount bid by BIDDER to AGENCY for the above -stated project, for the payment of which sum, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to submit a bid to AGENCY for the above -stated project, if said bid is rejected, or if said bid is accepted and a contract is awarded and entered into by BIDDER In the manner and time specified, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of AGENCY. IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 26th day of _ MaY 2,015. BIDDER* Green Giant Landscape, Inc. - 941-A Macy St, La Habra, CA 90631- (562)690-6208 SURETY* Insurance Company - 251 S. Lake Avenue, Suite 360, Pasadena, CA 91101 - 626-639-1321 Matthew J, CoatS''Mtomev in Fact Notary Public in and for the County of ��, State of_ this -_,___day of *Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1168 �rm.-.rcrr^C e.r:t:c_:.::ccKtxcrc-c,-c.ssrK:cz:rr:>�t„tYh.:;ti9rc:zc.�,rnhr..cxtisrrs,ccr.,as�.er,Rir:�::cr xcsissc�-a A notary, public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On bp 'y . )� before me, Date personally appeared Matthew d. Coats Summer L. Reyes, Notary Public Mere Insert Name and Title of the Officer Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons) whose name(s4 is/are subscribed to the within instrument and acknowledged to me that he/shell" executed the same in his/her/their authorized capacity(4we , and that by his/her/their signature(4on the instrument the persons}, or the entity upon behalf of which the person(&} acted, executed the instrument. SUMh4ER L. REYES N Commission 1966627 Notary Public - California z Orange County I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signaturer y SIgnatu14 of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(les) Claimed by Slgner(s) Signer's Name: ❑ Corporate Officer — Title(s): Partner — 11 Limited L7 General ❑ Individual ❑ Attorney in Fact CI Trustee ❑ Guardian or Conservator ']Other: _ Signer Is Representing: Signer's Name:_ _I Corporate Officer — 1 itle(s): ":; Partner — i:_i Limited r General ❑ Individual ❑ Attorney in Fact Trustee ❑ Guardian or Conservator —1 Other: _ Signer Is Representing: ..azRz, - c�.zca; c �r<x• - :e11zr ;c. . ©2014 National Notary Association - www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) item 65907 �` Pdy Comm. Expves JUI 29, 2016 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signaturer y SIgnatu14 of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(les) Claimed by Slgner(s) Signer's Name: ❑ Corporate Officer — Title(s): Partner — 11 Limited L7 General ❑ Individual ❑ Attorney in Fact CI Trustee ❑ Guardian or Conservator ']Other: _ Signer Is Representing: Signer's Name:_ _I Corporate Officer — 1 itle(s): ":; Partner — i:_i Limited r General ❑ Individual ❑ Attorney in Fact Trustee ❑ Guardian or Conservator —1 Other: _ Signer Is Representing: ..azRz, - c�.zca; c �r<x• - :e11zr ;c. . ©2014 National Notary Association - www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) item 65907 2368 PIHLADELPHIA INDEMNITY INSUR.ANC7i CONIPANY 231 St Asaph's Rd., Suite 100 Baln Cynwyd, PA 190040950 Power of Attorney KNOW ALL PERSONS BY THL'SB PRESENTS: that PIHI.ADELPHIA INDI;MNFFV INSURANCE COMPANY (the Company), a corporation organized and existing under the lawn of the Commonwealth of permsylvania, does hereby Constitute and appaim: Linda D. Coats and Matthew J. Coats of Coats Surety Insurance Services, Inc. Its true and Iogill Auonc:y(s) in fact with Intl authority to execute all its behalf bonds, undertakings. meognizauces and other contracts of indemnity and writings obligatory in the nature Iherenl', issued in the course of its business and to bind the Company thereby, in an amount not to exceed 525.000000.00 This Power of Attorney is granted and is signed and scaled by facsimile under and by the authority of the following Resolution adopted by the 13oard of Directors of PE ILADFLPH IA INDEMNITY INSURANCE COMPANY at IT meeting duly called the I' day ofJuly, 2011 RESOLVED: 'That the Board of Directors hereby authorizes the President or any Vice President of the Company to (1) Appoint Attorneys) in Pact and authorize the Aunn ey(s) in Pact to execute on behalf of the Company bonds and undertakings, contracts of indemnity and other writings obligatory in the mature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attorney -in -Pact and revoke the authority given. And, be it FURTHER RESOLVED: 'Thai the signatures of such ollicers and the seal of lire Company may be affixed to any such Power of Attorney or certificate relating thereto by faesimile, and lily such Power of Attomcy so executed and cern ied by faesimile signatures and facsimile seal shall be valid and biding upon the Company in the Entire with the respect to tiny bund or undertaking to which it is attached. IN FES "I'IMONY WIRALOF. PHILADFLPHIA INDI?MNfrY INSURANCE, COMPANY HAS CAUSED THIS INSIRUMEN"I' TO BF SIGNED AND i"1'S CORPORATF SBAL.TO BF. AFFIXED BY ITS AU I I IORIZFD OFFICE: 'I'TIES 7ra DAY OF FLBRUARY 2013. 327Z. . r,= (Seal) Robert D. O'Leary Jr, President R, CLO Philadelphia Indemnity Insurance Company On this 7"' day of February 2013, before me came the individual Who executed the preceding instrument, to me personally known, and being by me duly sworn said that he is the thm'cin deserihal and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY; that The seal affixed to slid instrument is the Corporate seal of said Company', that Ow said Corporate Seal and his signature were duly affixed, NO0 IALSEML: QA/1. +j11/���Ir�� �//} pANIEU.6NOPM111,Ndar7Pul0e - J`*x"' "`�'"'''� 4, 0: ..Meow Cous Comml�att ad 201 Notary Public: residing at: (Notary Seal) My commission expires'. 1. Craig P_ Keller, Fxccutivc Vice President, Chief Financial Officer and Secretary of PHILADELPHIA INDEMNIFY INSURANCE COMPANY, do herby certify that Elie foregoing resolution of the Board of directors Carl this Power of Anomcy issued pursuant thereto are tme and cancer and are still in full force and effect I do further certify that Robert D. O'Leary Jr., who executed the Power of Attorney as President, woos on the date of execution of the attached Power of Attorney the duly elected President of IIIIILADLLPHIA. INDEMNITY INSURANCE COMPANY. In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this dayol,� ,YA�'.-'�,— 20 Craig P Koller, F-Necutive Vice President, Chief Financial Officer R Secretary .3927 �4 1'HII.ADF.I.PB1A INDEN7Ltl11'Y INSURANCECOMPANY CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of County oflam' 8f Do, i On / 7th 1 5 e ore me, �= -Q /Oky re imam name i Uteo ea icer) personally appeared who proved I me on basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), 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 tr e and correct, WITNESS m ffcial seal. "sYROSIE TOLEDONENOERS0N CommA 2066732 I�pp NOTARY PUNLIC-CALIFORNIA W Los ANOWS COUNTY cww•e✓ Mr CaNN, ErP, Nov. 7E, Y018 •r Notary b' Sig u (Notary Public Seal) ADDITIONAL OPTIONAL INFORP DESCRIPTION OF THE ATTACHED DOCUMENT (Title or desorption of attached document) (Title or description of attached document corrinued) Pages _ Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other 01'S V s u .., r.! N i 3,, e n, INSTRUCTIO\S FOR COMPLETING THIS FORM Thisfornicobalieswidr cturrent Califonriastaltiles+'egardingnotmyirordingand, ifneedeg should be completed and attached fo the doetartenL,9eMronOedgrnents from other states may be completed for documents being sent to that state so long as the wording does not require lite California notary to violate Calf/ma notmy /me. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and than your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect Innis (i.e. helshekhey,—is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, reseal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. 4 Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING 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: o Streets, highways including bridge projects: Y2% of the bid or $10,000, whichever is greater o Buildings, parks, or other projects: Y:% of the bid Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State Dept. of Industrial Relations (DIR). BIDDER proposes to subcontract certain portions of the work to the firms listed below: Name 5-k u)NA License #/Exp. q0(0 A to DIR Reg. #/Exp. / OdYo --V,3712 Location j2iwa ( de� gam' Phone "). - 0 Type Of Work Q ( 1 Amount $ Name License #/Exp. DIR Reg.#/Exp. License # Location Phone Type Of Work Amount $ Name License #/Exp. DIR Reg.#/Exp. License # Location Phone Type Of Work Am t$ f Signature of Mcler 0-1T License #/Exp. DIR Reg.#/Exp. Location Phone Type Of Work Amount $ Name License #/Exp. DIR Reg.#/Exp. License # _ Location _ Phone _ Type Of Work Amount $ Name License #/Exp. DIR Reg.#/Exp. License # Location Phone Type Of Work Amount $ CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING The following are the names, addresses, and telephone numbers for THREE public agencies for which BIDDER has performed similar work within the past three years. 1. Name and Adddess of Owner. Name and Telephone Number of person familiar with project. Co�Amount Type of Work CCeZf Date Completed 2. & fop 01�1 to o zo r"ko.) ACS p../1/ iley la Name'and Address of owner. Ja 5e, l lJ 51P�-!2 a/2 -opoo Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 3. ele4l (1.1r', /�)Pl A 35 1 oee&x- ( R; 10.45 arA Name and Address of owner. ,2k u6 i74, d v5(,3 _520--05--Ll Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance and bonds. C)aa 5 st'vild'a-5 f� (,Ohl, j[16, 1 X- 133 -5/`) !A-•� rK u A)1!i0AJ1 6& Ph 5,1 rel 1 X- 133 -5/`) CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING ADDITIONAL REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER or Subcontractor has performed electrical work and site lighting in the past 5 years. 1. Name and Address f Owner. Name and Telephone umber of person familiar with project. Contract Amount Type of Work Date Completed 2. Name and Address of owner. Name and Telephone Number of person fa m ' with project. Contract Amount Typ4 of Wbrk Date Completed 3. Name and Address of owner. Name and Telephone Number o person familiar with project. Contract Amount Type of Work The following are the name , addresses, and telephone numbers of al from whom BIDDER intends o procure insurance and bonds. Date Completed s and sureties CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDDERS,.are cautioned that making a false certification may subject the certifier to criminal Signed State of Calif i County of su scri d a wor to (or affirmed) before me on this v day of 200�by i oved to me on the basis of satisfactor evid a to be the persons) who appeared,before me e Notary Put;lic Signatuye / - Notary Public Seal ROSE TOLEDO-HENNDERSON (� Q COMM. # 2086732 \\ NOTARY PUBLIC-CALIFORNIALos N `a RVOM` MY COMM, EXP, NOV. 15i 2018" CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING NON-DISCRIMINATION CERTIFICATE The undersigned contractor or corporate officer, during the performance of this contract, certifies as follows: 1. The Contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The Contractor shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The Contractor shall send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Contractor shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. S. The Contractor shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING 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. 7. The Contractor shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request that the United States enter into such litigation to protect the interests of the United States. 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, No discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any contractor of public wo ting this Section is subject to all the penalties imposed for a violation of the Signed: Title:'r�`a Firm; Green Giant Landscape, Inc. Date: L5- g-? -0 CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING 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 ina same ma er as the other contractors, except contractors not signatory to the trust agreknent,shall payV like amount to the California Apprenticeship Council. Title: tgY e5, cli-out Firm: Green Giant Landscape, Inc. Date: J/—)-,'7-1 S CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING 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 employ9d-MTFe_c—onstr,uctlon or repair of public work, to give up any part of the compensation to whi h he/she is other ise entitled. 14 Signed: Title:rd Ci Firm: Green Giant Landscape, Inc. Date: �f " / 5 CITY OF SANTA ANA PROPOSAL PROJECT NO. 14-7515 MEMORIAL PARK SECURITY LIGHTING PUBLIC CONTRACT CODE SECTION 10162 QUESTIONAIRE 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. MAYOR Miguel A. Pulido MAYOR PRO TEM Vincent F. Sarmiento COUNCILMEMBERS Angelica Amezeua P. David Benavides Michele Martinez Roman Rayne Sal Tinajero May 21, 2015 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza M-38 s P.D- Box 1988 M-38 Santa Ana, California 92702 wWw.sanla-ana.ora ADDENDUM No. ONE SUBJECT: PROJECT No. 14-7518 Memorial Park Security Lighting The following changes have been made to the plans and specifications of the subject project: Plans: 1, Replace sheet #E2.1 the revised attached sheet #E2.1. Specifications CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar 1. Sheet 31: revise 'TRENCH ING AND CONDUIT WORK", paragraph 2, to read as follows: "Trenches shall be backfilled level with surrounding grades when fully compacted. Trenches in lawn areas shall be seeded in accordance with Section 7-9 of the Standard Specifications": 2. Sheet 31: revise 'PULL BOXES", entire section, to read as follows: "Install pull boxes where and as noted on drawings." 3. Sheet 32, revise "FOUNDATIONS", paragraph 1, to read as follows: "Contractor shall excavate and install foundations for each pole as noted on drawings. All concrete shall be poured against undisturbed soil. Backfilling and compacting will not be approved:" 4. Sheet 33, Delete "PAYMENT" section in its entirety. All other terms and conditions remain the same. FOR THE ! Y F SANTA ANA William E. Galvez, PE City Engineer SANTA ANA Cl IY COUNCIL Miguel A. Pulido i Vincent F. Sarmiento i Michele Maninez i Angelica Amozouo i P. David aenacdes Roman Reyna Sal Tuojero Mayor Meyer Pro Tem, Ward Ward Ward? i Word Wards Ward6 MP.1imailsanla-ane oro 1 y5garyllertu@cagia-nno om i muLg saala-ana.om muarb]santa-ane qrq i a lviigg(DsanlH-ana,nm j RReynaOyanla-a la ern STina ofo!(I�santa-ane ora -Raoister _. Reg stration n, rvlew Pum, se or R,tr),istr;�tinn ire D,nta � JtH�Inf ormatlan Verify DUNS information '^' Badness InfonnaNmi IRS Consent C AGE or NCA GE Cede 'd7 CAGE Ownershhi C>etalls 'i� General Information Rnantlaf InfwrroUrn fdY Execnnve C,mpencatma Questlom 10 Prncedmgs Queshonc INf➢rman0lr Opt- Out Romew Core o t3 Asks1'ba115 110 and Lt�If11:dL 5 �!LLtF.9F �4�E3 iy�it_Ccrt'ificatiora RAC Y 70 TUCE R DASliBt7AI D SAN I System for Amid Meaagnnmt LQ System for Award Management _V,iew ase�3tanre far Com Dara—Verifv DUr,_,�ifom� iaa Donald Henderson Verify DUNS Information DUNS: 943425249 Page Description Please remew the Information retrieved from Dun & Bradstreet (D&S) for arruracy. If you dick "Save & Condnue," the information from D&B will appear in your entity's registration. If the information returned is incorrect, please click "Cancel" and make the recessary updates In D&E If you've received confirmation from D&B that your requested updates were completed over 24 hours ago, and that information Is not yet displayed under "Detalis returned from D&B", didcthe button to refresh yam data. Details Entered by the user DUNS: 943425249 Legal Business Name: Green Giant landscape, Inc. Doing Business As: (none) Address Line 1: 941•A Macy St. Address Une 2: City City. La Habra State: CA ZIP/Postal Code: 90631 Country. UNITED STATES CANCEL Details returned from D&B DUNS: 943425249 Legal Business Name: Green Gant landscape Inc Doing Business As: (none) Address Une 1: 941 A Macy St Address Una 2: City La Habra State: CA ZIP/Postal Code: 90631.3466 Country: UNITED STATES IBM vl.P.27.20150327-1711 Content Gla Core Data: DUNS/DoDAAC: Name: Address: WWW4 s Note to a9 m Users: This Is a Federal Government computer system. Use of this E 11 C (Y11' system constitutes consent to monitoring at all times.aNadMWAss - 3PNS rODABXdcACJgYXZhLc5mYWNIcy5wb3JtlbGVOYnJpZGdIUNUQVRFXOIEAAAAAQApdmlldzozMDEzNDhkZC11Y2QzLTQwMzQtoOfdMCOxMzNIYc3ZDA1YTEABll EXHIBIT 1 City of Santa Ana Section 3 Contract Clause These Clauses are to be inserted in all contracts A. The work to be performed under this contract number q-' rl `J 5 byf,amnd between the City of Santa Ana, hereinafter referred to as "City" and Green Tall all SCape' , 4l16inafter referred to as "Contractor", is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended 12 U.S.C. 1701u (section 3). The purpose of Section 3 is to ensure that employment and other economic opportunities generated HUD assistance or HUD -assisted projects covered by Section 3, shall, to the greatest extent feasible, be directed to low -and very low-income persons. B. The parties to this contract agree to comply with HUD's regulations in 24 CFR Part 135, which implement Section 3. As evidenced by their execution of this contract, the parties to this contract certify that they are under no contractual or other constraint that would prevent them from complying with the Part 135 regulations. C. The contractor agrees to send to each labor organization or representative of workers with which the Contractor has an agreement or other understanding, if any, a notice advising the labor organization or workers' representative of the Contractor's commitments under this Section 3 clause, and will post copies of the notice in conspicuous places at the work site where both employees 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 Dame 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 a Section 3 clause in every subcontract subject to compliance with regulations in 24 CFR Part 135, and agrees to take appropriate action, upon a finding that the subcontractor is in violation of the regulations in 24 CFR part 135. The Contractor will not subcontract with any subcontractor where the Contractor has notice or knowledge that the subcontractor has been found in violation of the regulations in 24 CFR Part 135. 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 to circumvent the Contractor's obligations under 24 CFR part 135. F. Noncompliance with regulations in 24 CFR Part 135 may result in sanctions, termination of this contract for default, and debarment or suspension from future HUD assisted projects. The Contractor by this signature affixed hereto declares under penalty of perjury: Contractor has read City requirements and accepts all its requirements contained therein for all of his/her operations within the City of Santa Ana. Sig'n'kt mrof OMractor Print Name and Title Date ONIS Al 6-11 013 �4a 5 a Contractor License Number & Designation Federal DUNS Number Project Name: 1- CNI 'roRO vProject Location:.)_IA r Street Contractor Name: EXHIBIT 2 City of Santa Ana Section 3 New Hire Calculation Form d VIAS! 5mw l City Green Giant Landscape, Inc. Contractor Contact: �Wb t' /K -w5 • l gg," Contractor Telephone Number: u l 10 " & ",)-() Contractor Email (' Section 3 Resident q)-7 State Zip M Trade/Craft I Number of New Hires Total Number of New Hires: I Total number of Section 3 resident new hires necessary to comply with contract: i Signa f Contractor Dae EXHIBIT 3 City of Santa Ana Section 3 Employment Opportunity Notice Pursuant to Section 3 of the Housing and Urban Development Act of 1968, as amended, 12, U.S.C. 170u, the City of Santa Ana is pleased to announce construction employment opportunities for low-income individuals residing in. the following area(s) of the City of Santa Ana: PROJECT(S) LOCATION(S): TRADE EMPLOYMENT OPPORTUNITIES: I' have w k experience n the construction trades listed above, and you live in the are aly3 listed Above, call c Yy�igi �r_ (contractor's or subcontractor's name), at Ute ' 6 iC� contractor's or subcontractor's telephone number) for an employment application. For additional information on the City of Santa Ana's Section 3 Economic Opportunities Plan, please call Community Development Agency, at 714-647-5445. Resident's Name: Resident's Address: EXHIBIT 4 City of Santa Ana SECTION 3 RESIDENT CERTIFICATION FORM (2014 INCOME GUIDELINES) I hereby certify that I am a Section 3 resident, based on the following qualification(s): 1. [ I am a Public Housing Resident (Specify Name of the Public Housing Unit): 2. ❑ I am a low-income resident in the County of , in which the Section 3 covered assistance is expended (Specify the Name of the Section 3 covered construction Check your household size, annual income level (from all sources), and specify racial and ethnic background: HOUSEHOLD SIZE INCOME LEVEL ❑ 1 $50,600 or less ❑ $50,600.01 or more ❑ 2 $57,800 or less ❑ $57,800.01 or more ❑ 3 ❑ $65,050 or less ❑ $65,050.01 or more 4 ❑ $72,250 or less ❑ $72,250.01 or more 5 ❑ $78,050 or less ❑ $78,050.01 or more 6 ❑ $83,850 or less ❑ $83,850.01 or more ❑ 7 ❑ $89,600 or less ❑ $89,600.01 or more ❑ 8 ❑ $95,400 or less ❑ $95,400.01 or more RACIAL BACKGROUND: Mark an "X" below, next to the category that best describes your origin: SINGLE CATEGORIES DOUBLE CATEGORIES Cl American Indian/Alaska Native American Indian or Alaska Native AND White ❑ Asian ❑ Asian AND White ❑ Black/African American ❑ Black or African American AND White ❑ Native Hawaiian/Other Pacific Islander ❑ American Indian or Alaska Native AND Black or African American ❑ White ❑ Other— for individuals not identified above. F.IDNIC BACKGROUND: Mark an "X" below, next to the category that best describes your ethnicity: K hispanic/Latino ❑ Not Hispanic/Latino THE UNDERSIGNED DECLARES THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT. 1,57 Signature of Section 3 Residelit Date To Be Completed by Employer The above-named person e"is a permanent full-time emolo eke or ❑ was hired on This perso / I b / Classification is Name of Employer: 1plo l� t � `f b4 � , , I To Be Completed by Local Contracting Agency Preference Category: ❑ Targeted Service Area ❑ Youth build ❑ McKinney Homeless ❑ Other Section 3 Income Level: ❑ Low ❑ Very Low Census Tract Number: EXHIBIT 5 City of Santa Ana Section 3 Business Concern Opportunity Notice Pursuant to Section 3 of the Housing and Urban Development Act of 1968, as amended, 12, U.S.C. 170u, the City of Santa Ana is pleased to announce building construction contract and/or subcontract opportunities for qualified Section 3 business concerns located in Santa Ana, or employing low-income Santa Ana Residents. If you reside in the City of Santa Ana, in or near the following Iocation(s), and/or employ low-income individuals residing in or near this area, you may qualify as a Section 3 business concern: PROJECT(S) LOCATION(S): CONSTRUCTION CONTRACT ACT/SUBCONTRACT ACT OPPORTUNITIES If you are, or would like to be, certified by the City of Santa as a e ,io 3 business concern, and provide contract SOT ig_the �gnstruction trades listed above, call Peri '11 KC. (contractor's name), at .%2— t� /i�'` La�O (contractor's telephone number) for contract or subcontract bidding information. For additional information on this project, call (City of Santa Ana, Project Manager), at (Project Manager's telephone number). For additional information on the City of Santa Ana's Section 3 Economic Opportunities Plan, please call the City's Community Development Department at EXHIBIT 6 City of Santa Ana Section 3 Business Concern Eligibility Certificate Name of Business: Green Giant Landscape. Inc. Address of Business: Telephone Number: Fax Number: s & q0 5 e)�) Type of Business: LI Corporation ❑Partnership ❑Sole Proprietorship ❑Joint Venture Section 3 Business Concern OualifvinQ Basis 1. 51 % owned by Section 3 low-income residents; or 2.__IZ Permanent, full-time employees that include at least 30% Section 3 low-income or very low- income residents; or 3. Written commitment to subcontract with more than 25 % of the dollar award of all subcontracts to be awarded to business concern(s) that meet either of the above (I or 2) Section 3 qualifications. Specify Ethnicity and Gender of Business Ownership (please check one): ❑ American Indian or Alaska Native ❑ Asian ❑ Native Hawaiian or Other Pacific Islander ❑ White ❑ American Indian or Alaska Native and White ❑ Asian and White ❑ ,Black or African American and White ❑ Black or African American ❑ encan Indian or Alaska Native and Black or African American L'1 Balance of individuals reporting more than one race 6'Meale I(� emale B this signatured hereto I declare under penalty of perjury that the above information is correct. c Signatu f 5, - BW ilss Owner Date Da i C N)6r Prin Name ?J1 I ecei ed by Date EXHIBIT 8 Contractor's Section 3 Affirmative Action Plan 11-1-`1516- M ~W Me, �awl-,6j U V® Project Number and Title The undersigned contractor agrees to implement the following affirmative action steps directed at increasing the utilization of lower income residents and business concerns located within the County of Orange. 1. Take affirmative action to ensure that employees or applicants for employment or training are not discriminated against because of race, color, religion, sex or national origin. 2. Send a notice of the contractor's Section 3 commitment to each labor organization or representative of workers and post a copy of the notice at a conspicuous place available to employees and applicants for employment or training. 3. To the greatest extent feasible, make a good faith effort to recruit for employment or training lower income residents from the County, and to award contracts to business concerns which are located in or owned in substantial part by persons residing in the County through use of: local advertising media, signs placed at the project site and notification to community organizations and public or private institutions operating within or serving the project area such as Service Employment and Redevelopment (SER), Opportunities Industrialization Center (OIC), Urban League, Contracted Employment Program, U.S. Employment Service, Chamber of Commerce, labor unions, trade associations and business concerns. 4. Maintain a file of all low-income area residents who applied for employment or training either on their own or on referral from any source, and the action taken with respect to each area resident. 5. Maintain a file of all business concerns located in the County who submitted a bid for work on the project, and the action taken with respect to each bid. 6. Maintain records, including copies of correspondence, memoranda, etc., which document that affirmative action steps have been taken. 7. Incorporate the Section 3 clause provisions in all Section 3 Affirmative Action Plan. Green Giant Landscape, Inc. Company Name Address: Street, Cit , State, Zip Printed Name DUNS Number Title and require subcontractor(s) to submit a Bidder's Name: EXHIBIT 9 City of Santa Ana Section 3 Contract Award Consideration Green Giant Landscape, Inc. Please check the numbered statement that is applicable to your business: 1,My business qualifies as a Section 3 business concern: If you have checked statement NUMBER I please read the attacked Section 3 Business Concern Preference - Bidding Requirements. (Please check the applicable qualification for statement number I) 51% owned by Section 3 residents; or 4ZPermanent, full-time employees include at least 30% Section 3 residents; or Will subcontract more than 25% of the dollar award of all subcontracts to be awarded to business concern(s) that meet either of the two preceding qualifications. Note: You are required to list all subcontractors and owner -operators in your bid statement. 2. _ My business does not qualify as a Section 3 business concern. Note: Section 3 business concern definitions are located in this project's Contract Documents & Specifications Manual within the sec ion ti led Section 3 Economic Opportunities Plan. Signatu o usinckOwner Date otic dwet%1 Prmt Name EXHIBIT 12 CITY OF SANTA ANA WOMEN OWNED/MINORITY BUSINESS OWNED ENTERPRISES (W/MBE) GOOD FAITH EFFORTS Pursuant to 24 CFR Part 85 § 85.36 (e) of Code of Federal Regulations, contractor must take all necessary affirmative steps to assure that minority business firms, women's business enterprises and labor surplus firms are used whenever possible. Contractor shall submit the following information to demonstrate that a goof faith effort has been made to comply with the above section of the Code of Federal Regulations. Submittal of this form, in and of itself, may not provide sufficient documentation to demonstrate that goof faith effort was made. Documentation such as copies of advertisement, letters of solicitation, telephone logs, rejected quotes, etc. should accompany this form. 1. The names and dates of advertisement of each newspaper, trade paper, and minority -focus paper in which a request for W/MBE participation for this project was placed by the bidder: 2. The names and dates of written notices sent to W/MBE soliciting bids for this project and methods used for following up initial solicitation to determine with certainty whether the W/MBE were interested. Names of W///MBE Solicited Dates of Solicitation Follow-up Methods and Dates /" M A e 'i tY F The items of work which the bidder made available to W/MBE firms, including, where appropriate, any breaking down of the contracts into economically feasible units to facilitate W/MBE participation, and the information furnished to W/MBE such as plans, specifications, and requirements for the work. Items of Work: Breakdown of Items: L✓� Information Furnished: 19 y,(„/�'i�v­;i F:%DOCS\PROPSVCSWUDFORMSIMBU5304AMB-SeMcn3Spew DOC EXHIBIT 12 (cont.) 4. Efforts made to assist W/MBE in obtaining bonding, lines of credit or insurance, and any technical assistance related to the plans, specifications and requirements for the work which was provided to W/MBE: 5. Any additional data to support a demonstration of good faith effort, such as contracts with W/MBE assistance agencies: I declare under penalty of perjury that the foregoing information is true and correct to the best of my knowledge. I understand that the City of Santa Ana and/or the U.S. Department of Housing and Urban Development may verify the information provided herein in connection with W/MBE compliance evaluation/audit activities and that failure to fuddy and truthfully complete this form may result in economic or other sanctions. Signature: Name: db0.a�- Title: y .. Date: 5 — - IS— Name of Contractor/Subcontractor: X 661 01AlLAG50� Y h oc �4,1,0 Contractor/Subcontractor Identification Number: (n cNe-,-4' 0110 LIVI Q (,m se Address (Street, City, State, Zip): (441-A d8,U '— uj ^cjr— . P6(41 Fja_cp•J L'0' ixt 4V)(0--31 L'0' 6 Business Racial/Ethnic/Gender Code: Circle the numeric code which indicates the racial/ethnic/gender character of the owner(s) and controller(s) of 51% of the business. When 51% or more is not owned and controlled by any single racial/ethnicity/gender category, circle the code which seems most appropriate. 10 White Americans 2 = Black Americans 3 = Native Americans Woman Owned Business: 4 = Hispanic Americans 5 = Asian/Pacific Americans 6 = Hasidic Jews Circle One: Yes or No F:\DOCS\PROPSVCS\HUDFORMS\MBU5BNAMB - SectloOSpece.DOC EXHIBIT 13 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Los Angeles Area Office, Region IX 1615 West Olympic Boulevard Los Angles, California 90015-3801 CERTIFICATION gFOR APPLICABLE FRINGEB"ENEFIT PAYMENTS Project Name: Project Number: — I515 Classification/Fringe Benefits Provided 1) Health and Welfare $ _ Pension $ Vacation $ Apprenticeship / Training $ 2) Health and Welfare $ Pension $ Vacation $ Apprenticeship / Training $ 3) Health and Welfare $ Pension $ Vacation $ Apprenticeship/ Training $ 4) Health and Welfare $ Pension $ Vacation $ Apprenticeship / Training $ OR: (CHECK IF APPLICABLE) Name, Address and Telephone Number of Plan/Fund Program P✓I certify that I do not make payments to approved fringe benefit lan funds, or programs. Green Giant Landscape, Inc. Contractor/Subcontractor Si ture J-1 (5' Date Title F,\DOCStPROPSVCS W UDFORMS\MSU6M4AMS - SectiOMSPem. DOC EXHIBIT 14 CERTIFICATION OF NON -SEGREGATED FACILITIES Federally Assisted Projects The Federally assisted construction contractor certifies that he does not maintain or provide for his employees any segregated facilities at any of his establishments, and that he does not permit his employees to perform their service at any location, under his control, where segregated facilities are maintained. The federally assisted construction contractor certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The Federally assisted construction contractor agrees that a breach of this certification is a violation of the Equal Opportunity clause in this contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national origin, because of habit local custom or otherwise. The Federally assisted construction contractor agrees that (except where he has obtained identical certifications from proposed subcontractor(s) for specific time periods) he will obtain identical certifications from proposed subcontractor(s) prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the equal Opportunity clause, and that he will retain such certifications in his files. NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001 Company: Green Tat Landscape, Inc. 0 Title: Date: r� d F:\DOCS\PROPSVCS\HUDFORMS\MBU5B04AMB - Sectlon3Spece.DOC EXHIBIT 15 NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the City of C ��y �(i� �4 ! a&. ✓ 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 other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Green Giant Landscape, Inc. Name of Contractor 11W 1-A W" t • (Ari, &.6 Address A / t Date F:\DOCS\PROPSVCS\HUDFORMS\MBU5B04AMS- SeUlon38pe..00C ll EXHIBIT 16 FEDERAL LOBBYIST REQUIREMENTS CERTIFICATION Name of Firm: Green Giant Landscape, Inc. e" r /� /n� Date: Address: yyoo � I G{ � - it���p State: Cot, d4m(r( zip Code: ri1a f Telephone: Slp iFc it Vit) Acting on behalf of the above-named firm as its Authorized Official, I make the following Certification to the Department of Housing and Urban Development (HUD) and the Community Development Commission, County of Los Angeles: 1) No Federal appropriated funds have been paid, by or on behalf of the above-named firm to any person for influencing or attempting to influence an officer or employee of any 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, loan, or cooperative agreement, and any extension, continuation, renewal, amendment, or modification thereof; and 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee or any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the above-named firm shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying" in accordance with its instructions; and 3) The above-named firm shall require that the language of this certification be included in the award documents for all sub -awards at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into the 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. Authorized Official: Name: Signature F:\DOCSIPROPSVCSUIUDFORMS\MSU5804AMB- Seclion3SpemDOC. Title: IT s I cA e.Ij— Date: G- - f EXHIBIT 17 CERTIFICATION OF UNDERSTANDING AND AUTHORIZATION Project Name: Proj ect Number: ! q ri 516 This is to certify that the principals and the authorized payroll officer, below, have read and understand the Minutes of the Preconstruction Conference and the labor standards clauses pertaining to the subject project. The following person(s) is designated as the payroll officer for the undersigned and is authorized to sign the Statement of Compliance, which will accompany our weekly certified payroll reports for this project: Printed Name t® p'Ie`g d h Title Date 0�0 Y117 Contractor/Subcontractor License No. DUNS Number F9DOCS\PROPSVCSIHUDFORMSIMBU58NAMB - SectioOSpecs. D0C "�'�"`"� CERTIFICATE OF LIABILITY INSURANCE L.,. - 7/10/2015' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. . IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER Tutton Insurance Services, Inc. 2913 S Pul3main Street License #0989376 Santa Ana CA 92705 CONTACT PHONE C Na: (949)261-1911 E (949)261-5335 - (IMAX. POLICYNUMSERMOIODOIYYYV INSURER(SAFFORDING COVERAGE NAM 0 INSURERA:.West American Insurance 44393 INSURED Green Giant Landscape, Inc. 941-A Macy Street La Habra CA 90631 INSURERS -Morcury Insurance Company INSURER C'AmeriCan Fire & Casualty Ins. 24066 INSURERD:Ins Conpany of the West INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER:14-15 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO MICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR OF INSURANCE ADPLITYPE INSR POLICYNUMSERMOIODOIYYYV rPFO ULl YY LIMITS 08NEML LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES Eaom, ne $ 500,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR aKWI556365248 0/9/2014 0/9/2015 MED EXP (Any one arson) $ 5,000 PERSONAL$ ADV INJURY $ 1,000,000 GENERAL. AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO 2,000,000 X POLICY PEO LOC $ AUTOMOBILE LIABILITY C aecddeot GL 1 000 000 9 X ANY AUTO ALL OWNEDSCHEDULED AUTOS AUTOS - X HIREDAUTOS X AUTCSNNEDr 040000000253 /4/2015 /4/2016 BODILY INJURY (Per person) $ BODILY INJURY (PerewideM) $ P.r cd TY $ Medical a encs $ 5.000 LIAR OCCUR - EACH OCCURRENCE $ 2,000,000 G. C XdUMBRELLA X EXCESS LIAO CLAIMS WADE AGGREGATE $ 2,000,000 DED I X I RETENTION 0 $ EUAS51345790 0/9/2014 0/9/2015 D MRHBRS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETORPARTNERIEXECUTIVE❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) IF yes, dsscm a untler DESCRIPTION OFOPERATIONS below NIA 0502347902 /1/2015 /1/2016 WC STAT U- OTH- XJQRYLIMITS E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE. $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES (Attach ACORD 161, Additional Remarks Schedule, If more space Is required) RE: 14-7515 Memorial Park Security Lighting The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California, 92702; its officers, employees, agents and volunteers are named as Additional Insured per CG2010 04/13 & CG2037. 10 day of notice cancellation of non-payment per attached CL0100 03/99. City of Santa Ana 20 Civic Center Plaza Ross Street Annex (M-22) Santa Ana, CA 92702 ACORD 25 (2010105) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED Tutton/RBURNS INS025 (20100401 The ACORD name and logo are registered marks of ACORD rinhlc rocurvmd POLICY NUMBER: BKW1656365248 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Blanket Additional Insured Agreed written contrct, agreement, permit 1371 Macy Street LA HABRA, CA 90631 Location(s) Of Covered Operations Any location(s) when Youhave agreed in a written contract, agreement or permit that person or organization be added as an additional insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to Include as an additional Insured the person(s) or organizatbri(s) shown in the Schedule, but only with respect to liability for 'bodily in- jury", "property damage" or "personal and advertising Injury" caused, in whole or In part, by: 1. Your acts or omissions; or 2. The acts or omisslons of those acting on your behalf; in the performance of your ongoing operators for the additional insured(s) at the location(s) designated above. However. 1. The Insurance afforded to such additional Insured only applies to the Went permit- ted by law; and 2. If coverage provided to the additional in- sured Is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 B. With respect to the insurance -afforded to these additional insureds, the following addi- tional exclusions apply: This Insurance does not apply to "bodily in- jury" or" property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to Its Intended use by any person or or- ganization other than another contractor or subcontractor engaged In performing operations for a principal as a part of the same project. d Insurance Services Office, Inc., 2012 Page 1 of 2 G C. With respect to the Insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance; If coverage provided to the additional Insured is -required by a contract or agreement, the most we will pay on behalf of the additional Insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not Increase the ap- plicable Limits of Insurance shown in the Dec- larations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 B a 9 POLICY NUMBER; BKWI566366248 COMMERCIAL GENERAL LIABILITY CO 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABIUTY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons) Or Organization(s) Blanket Additional Insured Agreed Written contrct, agreement, permit 1371 Macy Street LA HABRA, CA 90631 Location And Description Of Completed Operations Work described in writing in the contract, agreement or permit Location(s) at which You performed work described. in written contract, agreement or permit Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional Insured the persons) or'organizatlon(s) shown In the Schedule, but only with respect to liability for "bodily In- jury" or "property damage" caused, in whole or in part, by "your work" at the location des- ignated and described In the Schedule of this endorsement performed for that additional Insured and included In the 'products-com- plated operations hazard". However: 1. The Insurance afforded to such additional Insured only applies to the extent permit- ted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, the Insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional Insured is the amount of Insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever Is less. This endorsement shall not Increase the ap- plicable Limits of Insurance shown in the Dec- larations. 0 Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: BKW1556365248 AAIB CL 0100 03 99 Page 1 of 1 COMMON POLICY CONDITIONS 1. Assignment -- This policy may notbe as- signed without "our" written consent. 2. Cancellation -- "You" may cancel this policy by returning the policy to "us" or by giving "us" written notice and stating at what future date coverage is to stop. 3. Change, Modification, or Waiver of Policy Terms - - A waiver or change of the "terms" of this policy must be issued by "us" in writ - Ing to be valid. 4. "We" may cancel this policy, or one or more of its parts, by written notice sent to "you" at "your" last malling. address known to "us". If notice of cancellation is mailed, proof of mail - Ing will be sufficient proof of notice. If 'We" cancel this policy for nonpayment of premium, "we" will give "you" notice at least ten days before the cancellation Is effective. If 5• "W&' cancel this policy for any other reason, "we" will give "you" notice at least 30 days in advance of cancellation. The notice will state. the time that the cancellation Is to lake effecL "Your" return premium, if any, will be calcu- lated according to "our' rules. it will be re- funded to "you" with the cancellation notice or within a reasonable time. Payment or tender of the unearned premium is not a con- dition of cancellation. Inspections -- "We" have the right, but are not obligated, to Inspect "your" property and operations at any time. This inspection may be made by "us" or may be made on "our" behalf. An Inspection or its resulting advice or report does not warrant that. "your' property or operations are safe, healthful, or in compli- ance with laws, rules, or regulations. Inspec- tions or reports are for "our" benefit only.. Examination of Books and Records -- "We" may examine and audit "your" books and records that relate to this policy during the policy pedod and within three years after the policy has expired. CL 0100 03 99 Copyright, American Association of Insurance Services, Inc., 1998 Bond No.: PB 115104 00457 Premium: Included with Performance Bond 9 'Ir 10 I'M ?: 1-1.9 Attachment A CITY 01 .,°NT r1,y;p,,1 C r.Rii (� C01" CONTRACTOR'S PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS, THAT: WHEREAS, the City of Santa Ana, State of California, and Green Giant Landscape, Inc. (hereinafter designated as "Principal") have entered into an agreement whereby Principal agrees to install and complete certain designated public improvements, which said agreement, dated July 7, 2015 entitled " Project No. 14-7515; Memorial Park Security Lighting is hereby referred to and made a part hereof; and WHEREAS, under the terms of said agreement, Principal is required before entering upon the performance of the work, to file a good and sufficient Contractor's Payment Bond with the City of Santa Ana to secure the claims to which reference is made in Title 3, (commencing with Section 9000) of Part 6 of Division 4 of the Civil Code of the State of California. NOW THEREFORE, said Principal and the undersigned as corporate Surety, are held firmly bound unto the CITY OF SANTA ANA, and all contractors, subcontractors, laborers, materialmen and other persons employed in the performance of the aforesaid agreement and referred to in the aforesaid Civil Code, in the sum of Three hundred Thirty Four Thousand Five Hundred and 00110041OLLARS ($ 334,500.00 ), for materials furnished or labor thereon of any kind, or for amounts due under the Unemployment Insurance Act with respect to such work or labor or for any amounts required to be deducted, withheld and paid over to the Franchise Tax Board from the wages of employees of the Principal and his subcontractors pursuant to Section 18806 of the Revenue and Taxation Code, with respect to such work and labor; that said Surety will pay the same in an amount not exceeding the amount hereinabove set forth, and also in case suit is brought upon this Bond, will pay, in addition to the face amount thereof, costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by the City in successfully enforcing such obligation, to be awarded and fixed by the court, and to be taxed as costs and to be included in the judgment therein rendered. IT IS HEREBY EXPRESSLY STIPULATED AND AGREED that this Bond shall inure to the benefit of any and all persons, companies and corporations entitled to file claims Title 3, (commencing with Section 9000) of Part 6 of Division 4 of the Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this Bond. Should the condition of this bond be fully performed, then this obligation shall become null and void, otherwise it shall be and remain in full force and effect. H Bond No.: PB 115104 00457 The Surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of said agreement or the specifications accompanying the same shall in any manner affect its obligations on this Bond, and it does hereby waive notice of any such change, extension, alteration or addition. IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and Surety above named, on July 9, 2015 , 19 PRINCIPAL: Green Giant Landscape, Inc. (Type Company Name) By.ac'X'la Title: 0 Title: (Attach Acknowledgements of both Principal and Surety signatures) APPROVED AS TO FORM: ty Attomey Payment Bond - P.W. (except subdivisions) 02113 Ill SURETY: Philadelphia Indemnity Insurance Company (Type Company Name) By: ("�^ Title: Matthew J. t Attorney -in -Fact By: Title: CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the Identity of the individual who signed the document to which this certificate Is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Orange ) On IA4 0, W5 before me, Summer L. Reyes, Notary Public ate Here Insert Name and Title of the Officer personally appeared Matthew J. Coats Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person* whose names} is/we subscribed to the within instrument and acknowledged to me that he/sheftttey executed the same in his/her/their authorized capacity(les), and that by his/last/#heir signature(e}on the instrument the person*,, or the entity upon behalf of which the person(4acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature— Sigratur4fif Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Signer(s) Document date: Other Than Named Above: Capacity(ies} Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator C7 Other: Signer Is Representing: 02014 National Notary Association - www.NationaiNotary.org -1-800-US NOTARY (1-800-876-6827) Item #5907 SUMMER L. REYES # Commission 1906627 Notary Public • California z Orange County My Comm. [xpiras Jul 29, 2016 f I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature— Sigratur4fif Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Signer(s) Document date: Other Than Named Above: Capacity(ies} Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator C7 Other: Signer Is Representing: 02014 National Notary Association - www.NationaiNotary.org -1-800-US NOTARY (1-800-876-6827) Item #5907 2458 PHH.ADELP"IA INDEMNITY INSURANCE COMPANY 231 St. Asaph's Rd., Suite 100 Bala Cynwyd, PA 19004-0950 Power of Attorney KNOW ALL PERSONS BY THESE PRESENTS: that PHILADELPHIA INDEMNITY INSURANCE COMPANY (the Company), a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint: Linda D, Coats and Matthew J. Coats Of Coats Surety Insurance Services, Inc. Its hue and lawful Attorney(s) in fact with full authority to execute on its behalf bonds, undertakings, recognizances and other contracts of indemnity and writings obligatory in the nature thereof, issued in the course of its business and to bind the Company thereby, in an amount not to exceed $25,000,000.00 This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of PHILADELPHIA INDEMNITY INSURANCE COMPANY at a meeting duly called dre I" day of July, 2011. RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company to: (1) Appoint Attorney(s) in Fact and authorize the Attorney(s) in Fact to execute on behalf of the Company bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof mrd to attach the seal of the Company thereto; and (2) to remove, at any Gine, any such Attorney -in -Fact and revoke the authority given. And, be it FURTFIER RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to tiny such Power of Attorney or certificate relating thereto by facsimile, and any such Power of Attorney so executed and certified by facsimile signatures and facsimile seal shall be valid and biding upon the Company in the future with the respect to any bond or undertaking to which it is attached. IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 7TH DAY OF FEBRUARY 2013. i.. 4� ; m° w c (Seal) Robert H O'Leary Jr., President & CPA Philadelphia Indemnity Insurance Company On this 7°i day of February 2013, before me came the individual who executed the preceding instrument, to me personally known, and being by me duly sworn said that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY; that the seal affixed to said instrument is the Corporate seal of said Company; that the said Corporate Seal and his signature were duly affixed. t�wonwets owwe�rwern NOTARIALMU DANIELLEPOPATN, "rYPUND LowarMrabn ., hlontgomgqyy GnuntY n Wmmim mladl2 �9 Alm -,-•-n Notary Public i! (Notary Seal) residing at. My commission expires: I, Craig P. Reller, Executive Vice President, Chief Financial Officer and Secretary of PHILADELPHIA INDEMNTY INSURANCE COMPANY, do herby certify that the foregoing resolution of the Board of Directors and this Power of Attorney issued pursuant thereto are true and correct mid are still in full force and effect. I do further certify that Robert D, O'Leary .Jr, who executed the Power of Attorney as President, was on the date of execution of the attached Power of Attorney the duly elected President of PHILADELPHIA INDEMNITY INSURANCE COMPANY, In Testimony Whereof I have subscribed my nano and affixed the facsimile seal of each Company this q r� day ofrJ(��_-__e�20� Via Be v"r •. q Craig P. Keller, Executive Vice President, Chief Financial Officer & Secretary S. x s", a fix : ¢_ PHILADELPHIA INDEMNITY INSURANCE COMPANY 1927 >r. Bond No.: PB 115104 00457 Premium: $6,690.00 Attachment B BOND FOR FAITHFUL PERFORMANCE KNOW ALL MEN BY THESE PRESENTS THAT: WHEREAS, The City of Santa Ana, State of California, and Green Giant Landscape, Inc. (hereinafter designated as "Principal") have entered into an agreement whereby Principal agrees to install and complete certain designated public improvements, which said agreement, dated July 7, 2015 entitled" Project No. 14-7515; Memorial Park Security Lighting is hereby referred to and made a part hereof; and WHEREAS, said Principal is required under the terms of said agreement to furnish a Bond for Faithful Performance of said agreement. NOW, THEREFORE, we, the principal and Philadelphia Indemnity Insurance Company as Surety, are held and firmly bound unto the City of Santa Ana (hereinafter called "City"), in the penal sum of Three hundred Thirty Four Thousand Five Hundred and 001100s DOLLARS (S 334,500.00 ) lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, successors, executors and administrators, jointly and severally, firmly by these presents. The condition of this obligation is such that if the above bounded Principal, his or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and provisions in the said agreement and any alteration thereof made as therein provided, an his or their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless City, its officers, agents and employees, as therein stipulated, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. As part of the obligation secured hereby and in addition to the face amount specified therefor, there shall be included costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by City in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered. 1 Bond No.: PB 115104 00457 The Surety hereby stipulates and agrees that no change- extension of time, alteration or addition to the terms of the agreement or to the work to be performed thereunder or the specifications accompanying the same shall in anywise affect its obligations on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the agreement or to the work or to the specifications. IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and Surety above named, on July 9, 2015 PRINCIPAL: Green Giant Landscape, Inc. SURETY: Philadelphia Indemnity Insurance Company (Type Company Name) (Type Company Name) Title J �® By Title: (Attach acknowledgements of both Principal and Surety signatures) APPROVED AS TO FORM: Attorney 6/02 M BY / I C Title: Matthew J. C& Attorney -in -Fact By Title: CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1188 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Orange ) On before me, Summer L. Reyes, Notary Public Date Here Insert Name and Title of the Officer personally appeared Matthew J. Coats Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(e) whose names} is/ere subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/kw/their authorized capacity(4e4, and that by his/ger/tM* signature(4an the instrument the person*,. or the entity upon behalf of which the person* acted, executed the instrument. ------------------ „m, SUMMER L REYE6 Commission # 1986627 a :wee .� Notary Public - California n Z '` Orange County My Comm, Expires W129 2016 Place Notary Seal Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph Is true and correct. WITNESS my hand and official seal. Signature Signat of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signers) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: ©2014 National Notary Association - www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 2459 PHILADELPHIA INDEMNITY INSURANCE COMPANY 231 St. Asaph's Rd., Suite 100 Bala Cynwyd, PA 19004-0950 Power of Attorney KNOW ALL PERSONS BY THESE PRESENTS: that PHILADELPHIA INDEMNITY INSURANCE COMPANY (the Company), a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint: Linda D. Coats and Matthew J. Coats Of Coats Surety Insurance Services, Inc. Its true and lawful Attorney(s) in fact with full authority to execute on its behalf bonds, undertakings, recognizances and other contracts of indemnity and writings obligatory in the nature thereof, issued in the course of its business and to bind the Company thereby, in an amount not to exceed $25.000.000.00 This Power of Attorney is granted and is signed mid sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of PHILADELPHIA INDEMNITY INSURANCE COMPANY at a meeting duly called the 1"day of July, 2011. RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company to: (1) Appoint Attorney(s) in Fact mid authorize the Attorney(s) in Fact to execute on behalf of the Company bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attorney -in -Fact and revoke the authority given. And, be it FURTHER RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by facsimile, and any such Power of Attorney so executed and certified by facsimile signatures and facsimile seal shall be valid mid biding upon the Company in the future with the respect to any bond or undertaking to which it is attached. IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 7 T DAY OF FEBRUARY 2013,. ,10",'Ni i ,t 1927 :i (Seal) .. eaw"°a' • Robert D. O'Leary Jr., President & CEO Philadelphia Indemnity Insurance Company On this 7"' day of February 2013, before me came the individual who executed the preceding instrument, to me personally known, and being by me duly sworn said that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY, that the seal affixed to said instrument is the Corporate seal of said Company; that the said Corporate Seal and his signature were duly affixed. COMmMWEAL tlKP XL HOTMIAI9EAh` a DANIELLE PDRAIH, NotaryPUND L6YRf MatjaaT Rloalgem OWlitf n /I MwfwmrNsetm ImsMndIi2016 Notary AJIU- Public: J (Notary Seal) residing at: My commission expires: I, Craig P. Keller, Executive Vice President, Chief Financial Officer and Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY, do herby certify that the foregoing resolution of the Board of Directors and this Power of Attorney issued pursuant thereto are true and correct and are still in full force and effect. I do further certify that Robert D. O'Leary Jr., who executed the Power of Attorney as President, was on the date of execution of the attached Power of Attorney the duly elected President of PHILADELPHIA INDEMNITY INSURANCE COMPANY, In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this _q=—day of 141 2015 111-11.11 `'f'rz'` '`cV Craig P. Keller, Executive Vice President, Chief Financial Officer & Secretary {.; a = 1927 PHILADELPHIA INDEMNITY INSURANCE COiVIPANY d. aps