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EBS GENERAL ENGINEERING INC.
NOI.LTMW00 213IJV SAVCI(01)NEI NIHJLIM Q9Q1I0032I 99 ISAW N0113'IdW00 d0 901LON SIHj- (•aur}ate uogasdwoa jo aoPoN JO s;uaauaa aqi lute$?Uuvoms[snp!n!pu!3o amnmdiS) -P oj!jeD `euv ujuus lv ` I � uo pa}noaxH •anal ox? polnls utalOgl slo7'j aql lvgl fxnfxad jo Xllnuad xapun ainloop I put, 'joazagl slualuoa agl Mo" put, aoilou PIES PU0.1 an>iq I 'mV ujuuS jo Xpo a p jo liounoD XIt3 aql jo uoiluUoginE Xq uoilaxodioo ptvs jo 3lugoq uO uoileogPan sigl 07LU I `•paquosop uiangj Xpodoxd oql jo xaumo aql jo jingaq uo Sullou uOilaldwoD jo aoiloN 5uioi?axoj agl palnoaxo I t1uxoJIJUD `U V 12JUPS JO XJID Oql JO ZanIBD 4UMTII!A1„uiMpH - .laau• uH 11D oql wr I Nits `pougislapun aql `I NOI.LVD141 IUA ------------------------------------------------------------------------------------------- 91111 n �IauL'sagD auO J-1OaWpbold000vs-em 1d _ I :PaILQ o o e � Noun-do"03'IVdloiN[nw V `V •9i0Z IZ UagoLDO uo palpjduioolxadoxd pres uo luauianoxduii lioM age, 3 z 'Q00H2I0SHJI3N H'ildfl S NO.I DMHSVM lu p011;ooi £ZgL-91 'ON loafoxd s13 pogixosop pue `ujuiojilvD jo i1viS `oSuvjo jo XlunoD `nuV ujuvS jo KI!D aql ui si paould &BM luaulanolduii o n lxonn Bans gotgnn uo Xlxadoxd OgL -Xloans si AI�IVdwoo HjNwflsNi DH L 2II1S lo�iluoo a gOIgM uo ` DNI JNI2IHHNIJNH 'I`—dgNH'J S9H gllm `910Z Z A-avfl'HSH3 uo Olur paxaluO w lonxluoo iapun dlVdaa ,LHH2I.LS `PdI.LNHQISH?I H?IVn S NO,LJNIHSVAA Jo uoilon4suoo posmo stq.iauMo pins lvgl `paglzosop xaIj-Buiaaaq Xvadoxd aql jo aauMo Ogl si `TOLZ{ `u uxoiiliaD `nuV VIMS ` Zeld 131u3D oiniD OZ `11M ilia JO ssaxppL' Ogl glint `uoiltlxodzoo Indioiunw v `viuiojijvD `nuV 'eIuvS 3o X11D pauOisiopun aql lvgl NHAIJ ASH2I3H SI 90I10N Noila'Idwoa 30 ID LON "V`y 00.0 00.0 00`0 00.0 00.0 00'0 00.0 00.0 6 E 6d Z M V 4V 8V MLMO wB 4CU V90OZ000OI4OZ $ 6 € 6l III 8 6 6 8 l 0I 0y o `a $ 3�A ON I II I II I IIII II1I I I IIII IIIII IIIII I I II 8861 xog a d`uzejd1ua0 aini0 OZ japJooeM-jla910 'u9Anf N WBnH euv Lnurg jo Rit3`jjouno0 aqi Jo 3I1110 A4unoo aBucio 'spioaab leiol.40 ul papiooaa :os jjuw papl000g uogm pud f `Xg pa;sonba-a gmpjooag 7� THE REGISTER 625 N GRAND AVE, SANTA ANA, CA 92701. Telephone (714) 796-7000 / Fax (714) 796-6059 PROOF OF PUBLICATION (2015.5 C.C.P) State of California ) County of ORANGE ) ss i Notice Type. BID - NOTICE INVITING SIDS r i i Ad Description: 16-7523: Washington Res St Repair j 1 am a citizen of the United States and a resident of the State of California; I am over the age of eighteen years, and not a party to or interested in the above entitled matter. I am the principal clerk of the printer and publisher of the THE .REGISTER, a newspaper published in the English language in the city of r -SANTA ANA, county of ORANGE, and adjudged a newspaper of general 1 circulation as defined by the laws of the Stale of California by the Superior. Court of the County of ORANGE, State of California, under. date 11/19/1905, i Case No.. A21046. That the notice, of which the annexed is a printed copy, has been published in each regular and entire issue of said newspaper and not in any supplement thereof on the following dates, to -wit: 12/08/2015 Executed on: 12/08/2015 At SANTAANA,CA I certify (or declare) underpenalty of perjury that the foregoing is true and correct. Signature III I II II II II IIII IIIII IIIIII � II * A 0 0 0 0 0 3 9 5 8 9 5 8 CNS#: 2822860 space ror ruing stamp only THE REGISTER Thi: apace for Nling:ramp only 625 N GRAND AVE, SANTA ANA, CA 92701 Telephone (714) 796-7000 / Fax (714) 796-6059 PROOF OF PUBLICATION (2015.5 C.C.P.) State of California ) County of ORANGE ) ss Notice Type: BID - NOTICE INVITING BIDS Ad Description: WASHINGTON SQUARE RSDNTL ST REPAIR I am a citizen of the United States and a resident of the State of California; I am over the age of eighteen years, and not a party to or interested in the above entitled matter. I am the principal clerk of the printer and publisher of the THE REGISTER, a newspaper published In the English language in the city of SANTA ANA, county of ORANGE, and adjudged a newspaper of general circulation as defined by the laws of the State of California by the Superior Court of the County of ORANGE, State of California, under date 11/19/1905, Case No. A21046. That the notice, of which the annexed is a printed copy, has been published in each regular and entire issue of said newspaper and not in any supplement thereof on the following dates, to -wit: 12/15/2015 Executed on: 12/15/2015 At SANTA ANA,CA I certify (or declare) under penalty of perjury that the foregoing is true and correct. III I II II II II II II I I I I I I II III III * A 0 0 0 0 0 3 9 5 5 3 0 1 Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder II II 11 II II II IIIIIIIIII IIII II NO FEE *$ R 0 0 0 7 9 9 9 9 7 5 $ 201585001168 2:34 pm 12/02/15 214 304 Z01 0,00 50.00 0.00 0.00 0.00 0.00 0.00 0100 From the Requirements of the California Environmental Quality Act (CEQA) Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK From: City of Santa Ana County of Orange Planning & Building Agency P.O. Box 238 20 Civic Center Plaza M-20 Santa Ana, CA 92702 Santa Ana, CA 92702 Project Title: Res. St. Repair FY 15/16 Washington Square Date of Approval: 12/15/2015 Project Number(s): PWA-2015-1170-CIP Project Location: 1 CityWide (Partial) City: Santa Ana County; Orange ER Number: ER -2015-117 Project Description: Removing existing localized concrete pavement and replacing with new concrete pavement including dowels, asphalt concrete pavement, crack seal, replacement of damaged curb, sidewalk, curb ramps, driveway approach, and construction of new cross gutters. Applicant Name: Mindy Ly , City of Santa Ana Applicant Address: 20 Civic Center Plaza, Third floor Ross Annex Santa Ana, CA 92701 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Ly, Mindy Exempt Status: ❑ Ministerial (Sec. 15268) ❑ Declared Emergency (Sec. 15269 (a)) ❑ Emergency Project (Sec. 15269 (b through e)) ❑ General Rule (Sec. 15061(b)(3)/(5)) ❑ Statutory Exemption: L Categorical Exemption: 15301 (c) Reason(s) Why Project is Exempt From CEQA: Existing Street Facility City Contact: Sean Thomas Signature: Title: �— Title: i DEC 0 2 2015 0RAM3E000NtYCLFRK-R- 0 ER DLPARTMFNT BY DEPUTY POSTED HUGH NGUYE N, CLARK- ,ECORDER By; DEPUTY Telephone: (714) 647-5655 Assistant Engineer SANTA ANA CITY COUNCIL Date: 12/2/2015 Migual A. Pulido Vincent F, Sarmiento Michele Martinez Angelica Amezcua P. David Benavides Roman Reyna Sal Tinajero Mayor Mayor Pro Tem, Ward 1 Ward 2 Ward 3 Ward4 Ward 5 Ward 6 jvUpyWKdoralsanta-onaorg VSarmento@sonta-ana om artinez2dsanta-ana ornQBly,®, yUaroysantaana oro DBenavidee(nlsanta-anaorc RR vn Col nta-a ro ST' aj n t - g MAYOR Miguel A. Pulido`^-=5 CIN MANAGER David Cavazos MAYOR PRO TEM Vincent F. 5armianto CITY ATTORNEY Sonia R. Carvalho COUNCIL MEMBERS CLERK OF THE COUNCIL Angelica Amezcua°. Maria D. Hulzar P. David Benavides Michele Martinez Roman A. Reyna Sal Tinajero CITY OF SANTA ANA PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M-20) P.O. BOX 1988 -Santa Ana, California 92702 (714) 667-2700 • Fax (714) 973.1461 VAM.santa-ana.org NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK 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: Res. St. Repair FY 15/16 Washington Square Date of Approval: 12/15/2015 Project Number(s): PWA-2015-1170-CIP Project Location: 1 CityWide (Partial) City: Santa Ana County; Orange ER Number: ER -2015-117 Project Description: Removing existing localized concrete pavement and replacing with new concrete pavement including dowels, asphalt concrete pavement, crack seal, replacement of damaged curb, sidewalk, curb ramps, driveway approach, and construction of new cross gutters. Applicant Name: Mindy Ly , City of Santa Ana Applicant Address: 20 Civic Center Plaza, Third floor Ross Annex Santa Ana, CA 92701 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Ly, Mindy Exempt Status: ❑ Ministerial (Sec. 15268) ❑ Declared Emergency (Sec. 15269 (a)) ❑ Emergency Project (Sec. 15269 (b through e)) ❑ General Rule (Sec. 15061(b)(3)/(5)) ❑ Statutory Exemption: L Categorical Exemption: 15301 (c) Reason(s) Why Project is Exempt From CEQA: Existing Street Facility City Contact: Sean Thomas Signature: Title: �— Title: i DEC 0 2 2015 0RAM3E000NtYCLFRK-R- 0 ER DLPARTMFNT BY DEPUTY POSTED HUGH NGUYE N, CLARK- ,ECORDER By; DEPUTY Telephone: (714) 647-5655 Assistant Engineer SANTA ANA CITY COUNCIL Date: 12/2/2015 Migual A. Pulido Vincent F, Sarmiento Michele Martinez Angelica Amezcua P. David Benavides Roman Reyna Sal Tinajero Mayor Mayor Pro Tem, Ward 1 Ward 2 Ward 3 Ward4 Ward 5 Ward 6 jvUpyWKdoralsanta-onaorg VSarmento@sonta-ana om artinez2dsanta-ana ornQBly,®, yUaroysantaana oro DBenavidee(nlsanta-anaorc RR vn Col nta-a ro ST' aj n t - g VWA%,l,Aacfion CZ) MAR 2 1 2016 CITY OF SANTA ANA RE -BID CONSTRUCTION CONTRACT AGREEMENT PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR This CONSTRUCTION CONTRACT is made and entered into this 2" d day of February, 2016, 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 EBS General Engineering 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 Washington Square Residential Street Repair Project, hereinafter referred to as the "Work of Improvement", 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 • Information to Bidders • Bid Proposal • Bid Bond • Contract Form • Contract Bonds • General Provisions • Special 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 the Work of Improvement the sum total amount not to exceed $984,925.00, as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A". The BID PROPOSAL contains a schedule of unit price(s) or lump sum(s) based on approximate quantities only, and the City does not expressly or by implication agree that the actual amount of work will correspond therewith, but reserves the right to increase or decrease the amount of any class or portion of the work or to omit portions of the work as may be deemed necessary or advisable. 1 of 3 CITY OF SANTA ANA RE -BID CONSTRUCTION CONTRACT AGREEMENT PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 4. CONTRACTOR agrees to complete the Work of Improvement within the time specified in the Time for Completion of Improvements section of the BID PROPOSAL (Exhibit "A") including commencing construction within the timeframe therein specified after issuance of a Notice to Proceed. 5. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the Work of Improvement 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. H 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). 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. 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. // 2 of 3 CITY OF SANTA ANA RE -BID CONSTRUCTION CONTRACT AGREEMENT PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written. ATTEST: - C --m&-4 Z"), MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Atrome BY J se al Sandov 'val of Assistant City Attorney 3of3 CITY OF SANTA ANA: DAVID C_AVAZOS City Manager RECOMMENDED FOR APPROVAL: ve Director, Public Works Agency CONTRACTOR: EBS GENERAL ENGINEERING INC By: Title: JOSEPH A NANCI,PRESIDENT CITY OF SANTA ANA RE -BID INSTRUCTIONS TO BIDDERS PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR acceptable documentation of the quantity and value of any foreign steel prior to incorporating such materials into the work. CERTIFICATIONS STATEMENTS FORMS AND QUESTIONNAIRES The City of Santa Ana, as AGENCY, will require prior to the award of any non-exempt, Federally assisted construction contract or subcontract that each prospective contractor and subcontractor submit the following Certifications, Statements, Forms and Questionnaires, which are included in Appendix H (CDBG Requirements) of the Contract Documents: • Equal Employment Opportunity Certification • Debarment and Suspension Certification • Bidder's Certificate of Compliance Regarding "Buy America" Requirements for Steel or Manufactured Products • Public Contract Code Section 10285.1 Statement 4V • Public Contract Code Section 10162 Questionnaire • Public Contract Code Sectioq 10232 Statement ✓ • Section 3 Contract Clause J J • Section 3 New Hire Calculation Form ✓ • Section 3 Employment Opportunity Notice ✓ • Section 3 Resident Certification Form J • Section 3 Business Concern Opportunity Notice • Section 3 Business Concern Eligibility Certification • Section 3 Contractor Compliance Report J • Section 3 Affirmative Action Plan R7 '✓ • Section 3 Contract Award Consideration • Women Owned/Minority Business Owned Enterprises (W/MBE) Good Faith Efforts J ✓ • Certification for Applicable Fringe Benefit Payments • Certification for Non -Segregated Facilities ✓• Noncollusion Affidavit 3 • Federal Lobbyist Requirements Certification J• Certification of Understanding and Authority • ,Proof of registration in the System for Award Management (wm4,,s m.vo to be filed by contractor • Proof of registration in the D&B Data Universal Numbering System (littm.,Ilivadate dnb rom/iUDdate/Com2any/ookuo.ht.mj CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: EBS GENERAL ENGINEERING 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 Unit Qty Unit Price Amount 1 Mobilization (Not to Exceed 10% of Total Contract) LS 1 $ V '«B $ ,_ C% �Qd r 0) 2 Unclassified Excavation* Cy 500 L? $caC $7 / 3 AC Pavement* TN 120 IQj :5 r CV % $ 9 V G✓ 4 Aggregate base* TN 960 $ .J e l✓i✓° $ 3 5 Removal of 6" PCC at Various Locations* Cy 1,200 $ "a) V $ V N C0 w 6 Construct 6" PCC with (3 -day) Cure including Dowels* Cy 1,100 $ lo a) $ �2 2l ow,,,; �GJ/^y 7 Crack Seal with Decry Super Gray* LF 43,000 $"3 + CC7 J�)O' 8 Construct PCC Curb Ramp* SF 6,800 $ $ 9 Construct PCC Driveway Approach (T=6") SF 4,500 $ /_ $+ 10 Construct PCC Curb (13-1) * LF 300 $ 00 $ �`) 0 r 11 Construct PCC Curb and Gutter(A-2-6) * LF 1,800 $ `) r�� $ ' 61 0( 0 12 Construct PCC Cross Gutter* SF 7,900 $ % 50 r 13 Construct PCC Sidewalk* SF 5,000 $ J 7s $ /Jp'9r1r�1r 14 Grind PCC* LF 600 $C/, $�I P-1 of P-25 9V .'V dd CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR Item Description Unit Qty Unit Price Amount 15 Root Shave* EA 80 $ 00 $ �(✓(J, �f V 16 Adjust Sewer Manhole Frame and Cover to Finished Grade* EA 20 $ "C" j $ - 17 Furnish and Install Water Valve Frame and Cover to Grade* EA 20 $ y� .� ,J,Ws $ (J J 70 18 Signing and Striping IS 1 $$ sC $3)boo f C1b 19 Temporary Construction Sign EA 2 20 SWPPP LS 1 $ ,. Cr $, r� TOTAL BASE BID $ The lowest responsible bidder shall be selected based on the total base bid. The City reserves the right to award the Base Bid, and any, all, or none of the add -alternate bid items (if any). * The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the "25%" limit as stated in Section 3-2 of the Standard Specifications. The actual amount for this item will be dictated by the actual quantity used, and the Agency reserves the right to increase or decrease the quantity of this item accordingly. TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within forty (50) working days after the commencement date stated in the Notice to Proceed. The bidder also proposes 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, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be $1,500 per calendar day. Name of Firm EBS GENERAL ENGINEERING INC Signature of BIDDER —4 Title JOSEPH A NANCI, (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.) P-2 of P-25 California All -Purpose Acknowledgement State of California } County of Orange On l Z . Z�j '' 1� before me, William B. Ellis, Jr. , a Notary Public personally Joseph A. Nanci WWILLIAM E. ELLIS JR. i Commission #F 2127998 9 a -w Notary Public - California z Orange County My Comm. s Tres Oct 23 2019+ Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) 0 Individual 0 Corporate Officer: 0 Partner - 0 Limited 0 General 0 Attorney -in -Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the personN) whose nameXis/are subscribed to the within instrument and acknowledged to me that he/ s@ executed the same in hisi=rMteie authorized capacity(ies), and that by his/hm*herr signatureN on the instrument the personK or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature of Pages: OPTIONAL 0 Individual 0 Corporate Officer: 0 Partner - 0 Limited 0 General O Attorney -in -Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer is Representing: CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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/her 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, 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 of Firm EBS GENEML ENGINEERING INC Signature of BIDDER Title JOSEPH A NANCI, ISI DENT (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.) P-3 of P-25 California All -Purpose Acknowledgement State of California } County of Orange On 0— 71l (< before me personally Joseph A. Nanci WILLIAM E. ELLIS JR. Commission k 2127998 " r Notary Public - California > Orange County M COMM. 'x Ires Oct 23 2019♦ Notary Public Seal Description of Attached Document Title or Type of Document: E. Ellis, Jr. ,a Notary Public who proved to me on the basis of satisfactory evidence to be the person() whose nameXis/are subscribed to the within instrument and acknowledged to me that he/ executed the same in hisft=*heir authorized capacity(I&Q, and that by histherf heir signatureN on the instrument the persons. or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature Document Date: Number of Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee IJ Guardian or Conservator ❑ Other: Signer is Representing: OPTIONAL ❑ Individual ❑ Corporate Officer: ❑ Partner - O Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee O Guardian or Conservator D Other: Signer is Representing: CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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: EBS GENERAL ENGINEERING INC Business Address: 1320 E SIXTH ST, STE 100 CORONA CA 92879 Business E -Mail Address: BIDS@EBS-INCUS Telephone: 951-279-6869 State Contractor's License No. and Class: License Expiration Date: 3/31/16 State Dept. of Industrial Relations (DIR) Registration No.: State Dept. of Industrial Relations (DIR) Registration Expiration Date: Signed: Title: JOSVPXA NANCI, PRESIDENT 720016 A 1000005295 6/30/16 P-4 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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 Firm EBS GENERAL ENGINEERING INC Signature of BIDDER Title JOSEPH A NAN&Y PRESIDENT (if an individual, so state) P-5 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE ) SS: CITY OF SANTA ANA ) JOSEPH A NANCI , being duly sworn, deposes and says: ❑ INDIVIDUAL That he/she is the party malting the foregoing proposal: ❑ PARTNERSHIP That he/she is a member of the co -partnership firni 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. CORPORATION That he is of: EBS GENERAL ENGINEERING INC a corporation which is making the foregoing proposal: ❑ JOINT VENTURE That he is of: one of the parties malting 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 on behalf of the parties making said bid who are: that such a bid is genuine and not collusive or sbam, and has not in any manner sought by collusion to secure any advantage against the City of Santa Ana or any person interested in the propose contract, forhimself or any other person. Signa e of Bidder Subscribed and sworn to before me this 23 day of 12 2015 Signature of officer Administering Oath (Notary Public) P-6 of P-25 California All -Purpose Acknowledgement State of California } County of Orange On_ \?,-'%/-0°(K before me, William E. Ellis, Jr. ,a Notary Public personally Joseph A. Nanci WILLIAM E.ELLIS- Commission N 212212 799 99 0 z • Notary Public - California s Orange County M9 Comm. Ex ices Oct 23, 2019 Notary Public Seal Description of Attached Document who proved to me on the basis of satisfactory evidence to be the person) whose nameXis/ar)6 subscribed to the within instrument and acknowledged to me that he/ shekhey executed the same in hisff crkheir authorized capacity(t&Q, and that by histerftheis signaturcK on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 4M I� Ctuf� rg� C�� Notary Public Signature Title or Type of Document: Y^ � — G Document Date: Number of Pages: Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ID Individual ❑ Corporate Officer: ❑ Partner - Q Limited I] General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator C3 Other: Signer is Representing: OPTIONAL ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited U General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 BOND# 3-B WASHINGTON SQUARE RESIDENTIAL STREET REPAIR PREMIUM: NIL C � C• � KNOW ALL PRESENT that, EBS GENERAL ENGINEERING, INC. as BIDDER, and SURETEC INSURANCE COMPANY as SURETY, are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of _ TEN PERCENT OF AMOUNT BID Dollars ($ 109 ), which is ten percent (10%) 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 17TH day of DECEMBER ,2015. BIDDER* EBS GENERAL ENGINEERING, INC. / 1320 E. SIXTH STREET, STE. 100, CORONA, CA 92879 PH: (951) 2.79-6869 BY: E COMPANY / 3033 5TH AVE., STE. 300, SANDIEGO, CA 92103 PH: (619) 400--4100 BY: CHARLES L. FLAKE,ATTORNEY-IN-FACT Subscribed and sworn to before me 120. Signature: 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. AGENT: CULBERTSON INSURANCE SERVICES, INC. 5500 E. SANTA ANA CANYON RD. 11201 ANAHEIM, CA 92807 (714) 921-0530 P-7 of P-25 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 ,rc-.ccL.�.�,cfs;.c` ".;.,cS"aRP�ccY�.cc;u.CiscxciC:cCte£,rccY.cc.cie.c;S',cer.Y,cF�f��ccc.sr,.�fces:Ocfcec�.c,F�eY.�R�Y'�T,�fti ❑ See Attached Document (Notary to cross out lines 1-6 below) See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) 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 LEXIS SHERWOOD eq COMM. # 2031782 NOTARY PUeUC+CALIFORNIA00 n `'� ORANGE COUNTY Comm. Exp. JULY 27,2017 Seal Place Notary Seal Above Subscribed and sworn to (or affirmed) before me on this 17TH day of DECEMBER 20 15 by Date Month Year CHARLES L. FLARE (and (2) �-\ ), Names) of Signer(s) proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. -- ---Signature /I Signature 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: Document Date: Number of Pages: Signer(s) Other Than Named Above: 02014 National Notary Association • www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5910 POA y; 510123 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles L. Flake, David L. Culbertson, Richard A. Coon, Spencer Flake its true and lawful Attomey-in-fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00I100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force until 10131/2016 y and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the time of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such. Attomey-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adapted at a meeting held on 200 of April, 1999) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 18th day of May A.D.. 2015 SURETEC INSURANCE COMPANY wN x 9 p By: _ iw 6 1 John ox Jr. resident State of Texas ss: County ofHaris '^�•"'' „„w a`y .+ On this lath day of May , A.D. 2015 before me personally came John Knox Jr., to me known; who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his time thereto by like order. �1,rr>u JACQUELYN MALDONADO Notary Public State of Texas El Mycomnr exp. 511x12017 �tlJacq elynMaldonado,NotaryPublic 11 My commission expires May 18, 2017 1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 17TH day of DECEMBER _ 201.5 _, A.D. Aire Beatyl Assistant ceretary Any Instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 3:00 pm CST. California All -Purpose Acknowledgement State of California } County of Orange On C�`Z u`(� before me, William E. Ellis, Jr. a Notary Public personally Joseph A. Nanci WILLIAM E. ELLIS JR. 7Commission # 2127998 �.Orange Notary Public • California aM Comm t�s Oct 23, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: who proved to me on the basis of satisfactory evidence to be the person) whose nameXis/armsubscribed to the within instrument and acknowledged to me that he/ -sheAh@3, executed the same in hisfherfthein authorized capacity(ie.Q, and that by his/hm*he r signatureN on the instrument the person(S),, or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. u .'� � Notary Public Signature Document Date: Number of Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) 0 Individual D Corporate Officer: ❑ Partner - D Limited ❑ General ID Attomey-in-Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: OPTIONAL Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited ❑ General U Attorney -in -Fact 0 Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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: '/z% of the bid or $10,000, whichever is greater o Buildings, parks, or other projects: ''/z% of the bid Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State Department of Industrial Relations (DIR). BIDDER proposes to subcontract certain portions of the work to the firms listed below: Name License �q DIR Reg �R V Location 1� Phone Type Of Amount Name JQ(? J C License #/Exp. DIR Reg. #/Exp. � ("�000 l CK-3 �ry Location V \// Phone d C' , _. Type Of Work 5' Amount $ co .190 Name I ,[aa L License # xp. 32V(n©!J DIR Reg. #/Exp. �L.irensg-#R Name License #/Exp. DIR Reg. #/Exp. Location Phone Type Of Work Amount $ Nannie License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Amount $ Name License #/Exp. DIR Reg. #/Exp. License # _ Location ~ r i� d�r l fh J7 d Location _ Phone �q _ y f, -0-� S'G �� 3/(a Phone _ Type Of Wor �� �- �_ Type Of Work Amount $ / Q �, �2 Amount $ — A - Signa eofBidder P-8 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROTECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER has performed similar work within the past three years. 1. SEE ATTACHMENT Name and Address of Owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 2. Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 3. Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance and bonds. CULBERTSON INSURANCE SERVICES 5500 E SANTA ANA CANYON RD, STE 201 ANAHEIM CA 92807 (714)921-0530 INVENSURE INSURANCE BROKERS 17991 COWAN IRVINCE CA 92614 (949) 756-4100 P-9 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR ADDITIONAL REFERENCES The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER or Subcontractor has performed street improvement work in the past 5 years. L SEE ATTACHMENT Name and Address of Owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 2. Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed 3. Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance and bonds. SEE INFO ON P-9 P-10 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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. BIDDERS are cautioned that making a false certification may subject the certifier to criminal prosecution. Signed State of G County of Subscribed and sworn to (or affirmed) before me on this 23 day of 12 2015 by proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me Notary Public Signature Notary Public Seal P-11 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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. 5. The Contractor shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. P-12 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR The Contractor shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request that the United States enter into such litigation to protect the interests of the United States. 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, no discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any contractor of public works violating this Section is subject to all the penalties imposed for a violation ofth Chapter. Signed: Title: P (DENT Firm: EBS GENERAL ENGINEERING INC Date: 12/23/15 P-13 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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: Apply to the joint apprenticeship committee administering the apprenticeship standards of the craft or trade in the area of the site of the public work for a certificate approving the contractor under the apprenticeship standards for the employment and training of apprentices in the area or industry affected. 2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards. 3. Contribute to the fund or funds in each craft or trade in which he/she employs journeymen or apprentices on the public work, in the same amount or upon the same basis and in the same manner as the other contractors, except contractors not signatory to the trust agreement shall pay a like amount to the California Apprenticeship Council. Signed: Title: RESIDENT Firm: EBS GENERAL ENGINEERING INC Date: 12/23/15 P-14 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR STATEMENT REGARDING "ANTI -KICKBACK" REQUIREMENTS The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that each contractor or subcontractor shall be prohibited from inducing, by any means, any person employed in the construction or repair of public work, to give up any part of the compensation to which he/she is otherwise entitled. Signed: / I / L/ Title: PRESIDENT Firm: EBS GENERAL ENGINEERING INC Date: 12/23/15 P-15 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE 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. P-16 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR SECTION 3 CONTRACT CLAUSE A. The work to be performed under this contract number 16-7523 by and between the City of Santa Ana, hereinafter referred to as "City" and EBS GENERAL ENGINEERING INC hereinafter 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 name and location of the person(s) taking applications for each of the positions; and the anticipated date the work shall begin. D. The Contractor agrees to include 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 1.35. 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 17IUD assisted projects. P-17 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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. +igneo Contractor 720016 A Contractor License Number & Designation JOSEPH A NANCI, PRESIDENT Print Name and Title P-18 of P-25 12/23/15 Date 83-939-1232 Federal DUNS Number CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR SECTION 3 NEW HIRE CALCULATION FORM Project Name: WASHINGTON SQUARE RESIDENTIAL STREET REPAIR Project Location: Street City State Zip: SANTA ANA, CA Contractor Name: EBS GENERAL ENGINEERING INC Contractor Contact: JOSEPH A NANCI Contractor Telephone Number: 951-279-6869 Contractor Email Address: BIDS@EBS-INC.US Section 3 Resident Hiring Goals Trade/Craft I Number of New Hires I Total Number of New o 1 Total number of Section 3 resident new hires necessary to comply with contract: 12/23/15 Sign re of Contractor Date P-19 of P-25 California All -Purpose Acknowledgement State of California } County of Orange Onkj W before me, William E. Ellis, Jr. a Notary Public personally Joseph A. Nanci WILLIAM E ELLIS JH Commission # 2127998 G..'=d Notary Public - California i Z Orange County My Comm. Ex Tres Oct 23, 2019 Notary Public Seal Description of Attached Document who proved to me on the basis of satisfactory evidence to be the persons) whose nameXis/are subscribed to the within instrument and acknowledged to me that he/ she,Vlaoy executed the same in hisfheritheir authorized capacity(teQ, and that by hisftwrftbei= signaturexon the instrument the person(vs), or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. vj( Aam � U 4 Notary Public Signature Title or Type of Document: _ P_ , I ° l'i P-1 'p- 1 `f . Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual J Corporate Officer: ❑ Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: of OPTIONAL ❑ Individual ID Corporate Officer: ❑ Partner - IJ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee O Guardian or Conservator ❑ Other: Signer is Representing: CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR SECTION 3 AFFIRMATIVE ACTION PLAN 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 subcontracts, and require subcontractor(s) to submit a Section 3 Affirmative Action Plan. EBS GENERAL ENGINEERING INC Company Name gigt&fure of Contractor 1320 E SIXTH ST, STE 100 CORONA CA 92879 JOSEPH A NANCI Address: Street, City, State, Zip Printed Name 83-939-1232 PRESIDENT DUNS Number Title P-20 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR SECTION 3 CONTRACT AWARD CONSIDERATION Bidder's Name: EBS GENERAL ENGINEERING 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 attached Section 3 Business Concern Preference - Bidding Requirements. (Please check the applicable qualification./or statement number 1) 51% owned by Section 3 residents; or Permanent, 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 concerns) that meet either of the two preceding qualifications 2. _ZMy business does not qualifies as a Section 3 business concern Note: Section 3 business concern definitions are located in this project's Contract Documents & Specifications Manual within the section titled Section 3 Economic Opportunities Plan. Si at e of Business Owner JOSEPH A NANCI Print Name 12/23/15 Date P-21 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR WOMEN OWNED/MINORITY BUSINESS OWNED ENTERPRISES (,W/MBE,) GOOD FAITH EFFORTS Project Name: EBS GENERAL ENGINEERING INC Project Number: 16-7523 Project Location: I CITY OF SANTA ANA 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: Names of Newspaper Date of Advertisement 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 Dates of Follow-up Methods W/MBE Solicited Solicitation and Dates 3. 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: Information Furnished: P-22 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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 fully and truthfully complete this form may result in econ tc or other sanctions. 12/23/15 Si re Date Name: Title: JOSEPH A NANCI Name of Contractor/Subcontractor: EBS GENERAL ENGINEERING INC Contractor/Subcontractor Identification Number: Address (Street, City, State, Zip): 33-0634599 1320 E SIXTH ST, STE 100 CORONA CA 92879 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. = White American 2 =Black Americans 3 = Native Americans Woman Owned Business: Circle One: Yes 4 = Hispanic Americans 5 = Asian/Pacific Americans 6 = Hasidic Jews or No P-23 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR FEDERAL LOBBYIST REQUIREMENTS CERTIFICATION Name of Finn: EBS GENERAL ENGINEERING INC Date: 12/23/15 Address: 1320E SIXTH ST, STE 100 CORONA State: CA Zip Code: 92879 Telephone: 951-279-6869 Acting on behalf of the above-named firth 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: JOSEPH A NANCI Name Sig, re PRESIDENT Title 12/23/15 Date P-24 of P-25 CITY OF SANTA ANA RE -BID PROPOSAL PROJECT NO. 16-7523 WASHINGTON SQUARE RESIDENTIAL STREET REPAIR CERTIFICATION OF UNDERSTANDING AND AUTHORIZATION 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: KATHY FAIRWEATHER Payroll Officer's Name Payroll Officer's Signature EBS GENERAL ENGINEERING INC Contractor/Subcontractor by /, Sight are JOSEPH A NANCI Printed Name PRESIDENT Title 12/23/15 Date 720016 Contractor/Subcontractor License Number 83-939-1232 DUNS Number P-25 of P-25 3 Year References (2012-2015) Public Works 1. Proiect Raise Manholes to Grade & Sewer Lateral Replacement Project Address Various Streets — Riverside Owner Name City of Riverside Contact familiar with project Phone Steve Howard (951) 712-3904 Price of contract Type Of Work Date Complete $21,500 R&R Curb and Gutter 08/2015 to On -Going 1. Proiect Sewer Replacement Various Locations Project Address Various Locations - Fullerton Owner Name and Address City of Fullerton Contact familiar with project Phone: Eric Villagracia 714-738-6853 Price of contract Type Of Work Date Complete $998,151 Sewer 1/2012 to 2/2013 3. Project 2014/2015 Citywide Curb, Gutter, Sidewalk, Driveway Repairs Project Address City Wide - Riverside Owner Name City of Riverside Contact familiar with project Phone: Steve Howard (951)712-3904 Price of contract Type Of Work Date Complete $407,628 Street Improvement 11/2014 to 02/2015 3 Year References (2012-2015) Public Works 4. Proiect Miller Ave and Alder Ave Traffic Signal and Street Improvements Project Address Miller Ave and Alder Ave Owner Name City of Fontana Contact familiar with project Phone: Alfred Girardot 909-350-6647 Price of contract Type Of Work Date Complete $390,355 Traffic Signal and Street Improvements 07/2012 to 06/2013 S. Proiect Annual Concrete Repair FY 2014-15 Project Address Various Locations — Rancho Santa Margarita Owner Name City of Rancho Santa Margarita Contact familiar with proiect Phone: Terry Gregory 949-635-1800 Price of contract Type Of Work Date Complete $53,550 Street Improvements 04/2015 to 05/2015 6. Proiect Improvement of Broadway Street Proiect Address Between Termino Ave and Livingston Dr Owner Name City of Long Beach Contact familiar with project Phone Charles Ramey 562-570-6383 Price of contract Type Of Work Date Complete $922,794 Street Improvements 11/2011 to 12/2013 Federally Required Documents to be Submitted with Your Bid Proposal Packet Specific federal requirements must be met for this U.S. Department of Housing and Urban Development (HUD) funded project. The City of Santa Ana's Contact: Community Development Agency City of Santa Ana 20 Civic Center Plaza, M-25 Santa Ana, CA 92701 Phone(714)647-5445 Fax(714)647-6549 www.sania-ana.org/ 11161 - -MRL WKI -MODIMbIXTO "to) oil] K" 0 to I W1091 lki *11" 1 R QIUV I DOOM The following document(s) MUST be fully filled out and submitted with the bid nro on sal ac a e: • Proof of registration in the System forAward Management(www, sam.eov) to be filed by contractor • Proof of registration in the D&B Data Universal Numbering System (httoc /�tdo[late dub cam/iUardate%amnatlNdaok • Section 3 Contract Clause (Exhibit 1). To be filed by contractor. • New Hire Calculation Form (Exhibit 2). To be filed by contractor. • Contractor's Section 3 Affirmative Action Plan (Exhibit 8) with proof of publication. To be filed by contractor. • Section 3 Contract Award Considerations (Exhibit 9) with progf of publication. Tobe filed by contractor. • Women/Minority Business Owned Enterprises Goof Faith Ef%orts (Exhibit 12). To be filed by contractor. • Noncollusion Affidavit (Exhibit 15). To be filed by contractor. • Federal Lobbyist Requirements Certification (Exhibit 16). To be filed by contractor. • Certification and Understanding ofAuthorization (Exhibit 17). To be filed by contractor and subcontractor(s). • *Additional Wage Rate Classification.' If the contractor needs an additional job classification, the contractor must submit with the bid package a written, signed request naming the work classification(s) and the wage rate(s), including any fringe benefits that are proposed. The following document(s) shall be completed by the contractor and/or subcontractor(s), as specified, and filed with the City's Labor/Section 3 Contact prior to award of contract on the project: • Proof if registration in the System for Award Management(www yam wi to be filed by subcontractor(s) • Section 3 Contract Clause (Exhibit 1). To be filed by subcontractor • Project Wage Rate Sheet. To be filed by contractor and any subcontractor(s). • Section 3 Employment Opportunity Notice (Exhibit 3). To be filed by contractor and any subcontractor(s). • Section 3 Resident Certification Form (Exhibit 4). To be filed by contractor and subcontractor(s). Federally Required Documents to be Submitted with Your Sid Proposal Packet or prior to award of contract (Continued) • Section 3 Business Concern Opportunity Notice (Exhibit 5). To be filed by contractor. • Section 3 Business Concern Eligibility Certificate (Exhibit 6). T o be filed by contractor and subcontractor(s). • Certification for Applicable Fringe Benefit Payments (Exhibit 13). To be filed by contractor and any subcontractor(s). • Certification of Non -Segregated Facilities (Exhibit 14). To be filed by contractor and any subcontractor(s). • Certification with Regard to the Performance of Previous Contracts or Subcontracts Subject to the Equal Opportunity Clause and the Filing of Required Reports. To be filed by contractor and any subcontractor(s). Note: The prime contractor is responsible.for the.full compliance of all employers (subcontractors) in regard to labor standards Section 3 provisions, and W/MBE provisions applicable to this project. NOTICE, "This is a federally assisted construction project (CDBG funded) and Federal standards, including i requirements, will be enforced." Cristina Whitcher From: Kathy Fairweather Sent: Monday, December 28, 2015 8:39 AM To: Cristina Whitcher Subject: FW: Registration Activated for ELITE BOBCAT SERVICE, INC / 839391232 / 5NX95 Kathy Fairweather EBS General Engineering, Inc. 1320 E. Sixth St. #100 Corona, Ca. 92879 951 279-6869 951 279-6832 -----Original Message ----- From: samadminoasam.Rov [mailto:samadminosam.aov] Sent: Thursday, December 24, 2015 7:50 AM To: Kathy Fairweather Cc: Kathy Fairweather Subject: Registration Activated for ELITE BOBCAT SERVICE, INC / 839391232 / 5NX95 This email was sent by an automated administrator. Please do not reply to this message. Dear Kathy Fairweather, Congratulations! The registration for ELITE BOBCAT SERVICE, INC / 839391232 / 5NX95 is now active in the U.S. federal government's System for Award Management (SAM). If you did not provide a CAGE code during the registration process, one has been assigned and is provided above. You are now eligible for contracts, assistance awards, and to do business with the federal government as determined by your Entity's profile. Important: The Periodic Update Requirement Date for the registration is 21 -DEC -16. You must renew the registration by this date to remain active. In addition, you may continue to invite additional users by following the below steps: * Login to SAM using a valid Username and Password * Select "Manage Entity Users" from the left-hand navigation menu * Select "Invite User" from the left-hand navigation menu * Select the desired Entity * Provide invitee's email address * Assign Role(s) to be associated with the user account * Click Submit All invitees will receive an email message from SAM with instructions on how to complete the process. For assistance, please contact the Federal Service Desk at www.fsd.gov or by telephone at 866-606-8220 (toll free) or at 334-206-7828 (internationally). Thank you, The System for Award Management (SAM) Administrator ${EMAIL_URL_TO_SAM_HOMEPAGE} 1 12/28/2015 Dun & Bradstreet - Update Welcome Kathleen Fairweather I i�I1,Qg{ I F0.,QS I Print; Dun & Bradstreet IUpdate Technical Assistance: 866-794-15]] Speak with a Dun & Bradstreet Credit Advisor 888-814-1435 Update Ht,oln Manu CFve7mew WvlkrY 6: OP,v Coes "tuysraemts Ranking Pa F9nronce, palltl€C M'[ oqs This Do . c& zc", rra t report I, Pmvld._'; 'P, , f L , sn Aa e, �c mel reg. , a. R +ay pro, U us Cl for a Alms qum pt se of snoreei, Business Summary About Business Summary © Dun & Bradstreet, Inc., 2000-2015. All rights reserved. Business Directory I Business Credit Basics I FAQs I Privacy Policy https:/fiupdate,dnb.comfiUpdate/viewOverVimReport.htm 1/1 i NUMBER: 839391232 Company Name: EBS GENERAL ENGINEERING, INC. Physical Address: 1320 E 6th St Ste 100 Click e e to print a copy of Physical City: Corona your entire report. Physical State: CA Adclitmna l scrvlt-es Co n"cPt tar and Physical Zip: 92879 b11i1ci yrrv; (3un & HruClscreet fikra azo Telephone: 951 279 .6869 availaom:nrou<;iz Dun t'L BrFadctrEot''. Fax 9512796832 Cr'Bs.I " iltarI sermc<'. Good crodl1 5. ;Ire lifeline vow cus'ttres>. 1; Chief executive: JOE NANCI, PRESIDENT e>tat I"M1 you Ct3 r)r .§t(: 1'p;r; ittf> itir Year started: 1994 tlarn F liK"' exn;tn ;l'w r?, c,aui4,ar! Employs: 80 k`xlaaumloll=.es, raseat:h 'Ind daeel<rpm:ffl' an"! skalfirlg. To 613w:'t.1k History: CLEAR i+rthv ;a Creli€t tidvl>¢p2 ?cr.9 f,` .zpl Financing: SECURED SIC: 1611 Line of business: Highway/street construction © Dun & Bradstreet, Inc., 2000-2015. All rights reserved. Business Directory I Business Credit Basics I FAQs I Privacy Policy https:/fiupdate,dnb.comfiUpdate/viewOverVimReport.htm 1/1 California All -Purpose Acknowledgement State of California ) County of Orange On �2`�t`� before me, William E. Ellis, Jr. a Notary Public personally appeared Joseph A. Nanci WILLIAM JR. Commission M 2127998 Notary public • Calitornia Orange County Comm. Ex fres Oct 23, 2019 r Notary Public Seal Description of Attached Document who proved to me on the basis of satisfactory evidence to be the person() whose nameXis/are subscribed to the within instrument and acknowledged to me that he/ she,4@3 executed the same in his/herf teir- authorized capacity0e,Q, and that by his/hm*heit signature('ss), on the instrument the person, or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) 0 Individual 0 Corporate Officer: 0 Partner- 0 Limited 0 General 0 Attorney -in -Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer is Representing: of Pages: OPTIONAL 0 Individual 0 Corporate Officer: 0 Partner - 0 Limited 0 General 0 Attorney -in -Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer is Representing: EXHIBIT 1 City of Santa Ana Section 3 Contract Clause These Clauses are to be inserted in all contracts PROJECT NO. 16-7523 A. The work to be performed under this contract number by and between the City of Santa Ana, hereinafter referred to as "City" and EBS GENERAL ENGINEERING INC _, hereinafter 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. 170lu (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 name and location of the person(s) taking applications for each of the positions; and the anticipated date the work shall begin. D. The Contractor agrees to include 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. JOSEPH A NANCI, PRESIDENT 12/22/15 Signature ontractor Print Name and Title Date 720016 A 83-939-1232 Contractor License Number & Designation Federal DUNS Number California All -Purpose Acknowledgement State of California } County of Orange On before me, William E. Ellis, Jr. a Notary Public personally Joseph A. Nanci . WILLIAM E. ELLIS JR. Commission # 2127999 Notary Public - California z orange County M Comm. Expires Oct D, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: ❑ Partner - D Limited ❑ General D Attorney -in -Fact D Trustee U Guardian or Conservator ❑ Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the person(N) whose nameXis/are subscribed to the within instrument and acknowledged to me that he/ shs/#h€y executed the same in hisHrerhheir- authorized capacity(ios,), and that by his/hm*heir signatureX on the instrument the personK or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature of Pages: OPTIONAL ❑ Individual ❑ Corporate Officer: L1 Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee a Guardian or Conservator ❑ Other: Signer is Representing: Project Name: _ Project Location: EXHIBIT 2 City of Santa Ana Section 3 New Hire Calculation Form WASHINGTON SQUARE RESIDENTIAL STREET REPAIR SANTA ANA CA Street City State Zip Contractor Name: EBS GENERAL ENGINEERING INC Contractor Contact: JOSEPH A NANCI Contractor Telephone Number: 951-279-6869 Contractor Email Address: JANANCI@EBS-INC.US Section 3 Resident Hiring Goals Trade/Craft I Number of New Hires Total Number of New Hires: Total number of Section 3 resident new hires necessary to comply with contract: 12-22-15 Signatur f Contractor Date California All -Purpose Acknowledgement State of California ) County of Orange On I before me, William E. Ellis, Jr. a Notary Public personally Joseph A. Nanci ....moo.. WILLIAM E. ELLIS JR Commisslon # 2127999 " .- Notary Public - California z Z Orange County n Z My Comm. Ez ires Oct 23, 2019' Notary Public Seal Description of Attached Document Title or Type of Document: who proved to me on the basis of satisfactory evidence to be the personN) whose nameXis/arr subscribed to the within instrument and acknowledged to me that he/ shekhey executed the same in hisfiror/theii- authorized capacity(, and that by hisJltetttheir signatureX on the instrument the persons, or the entity upon behalf of which the persons acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature Document Date: Number of Pages: Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) D Individual Corporate Officer: ❑ Partner - ❑ Limited ❑ General 0 Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator Other: Signer is Representing: OPTIONAL ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 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): WASHINGTON SQUARE, CITY OF SANTA ANA CONSTRUCTION TRADE EMPLOYMENT OPPORTUNITIES: CONCRETE MASON, GENERAL LABORER, OPERATING ENGINEER If you have work experience in the construction trades listed above, and you live in the area(s) listed above, call EBS GENERAL ENGINEERING INC (contractor's or subcontractor's name), at 951-279-6869 (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. EXHIBIT 4 City of Santa Ana SECTION 3 RESIDENT CERTIFICATION FORM (2014INCome GUIDBLINe3) Resident's Name: Resident's Address: 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 ❑ Americanlndian/AlaskaNative ❑. 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. ETHmCBACKGROUND: Mark an "Y' below, next to the category that best describes your ethnicity: ❑ Hispanic/Latino ❑ Not Hispanic/Latino THE UNDERSIGNED DECLARES THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT. Signature of Section 3 Resident Date To Be Completed by Employer The above-named person ❑ is a permanent full-time employee or ❑ was hired on This person's Job Classification is Name of Employer: 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 location(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): WASHINGTON SQUARE, CITY OF SANTA ANA CONSTRUCTION CONTRACT ACT/SUBCONTRACT ACT OPPORTUNITIES If you are, or would like to be, certified by the City of Santa Ana as a Section 3 business concern, and provide contract services in the construction trades listed above, call EBS GENERAL ENGINEERING INC( contractor's name), at 951-279-6869 (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 714-647-5445 Name of Business: EXHIBIT 6 City of Santa Ana Section 3 Business Concern Eligibility Certificate EBS GENERAL ENGINEERING INC Address of Business: 1320 E SIXTH ST, STE 100 CORONA CA 92879 Telephone Number: 951-279-6869 Fax Number: 9551-279-6832 Type of Business: Corporation ❑Partnership ❑Sole Proprietorship ❑Joint Venture Section 3 Business Concern Oualifyine Basis 1. 51% owned by Section 3 low-income residents; or 2. 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 (1 or 2) Section 3 qualifications. Specify Ethnicity and Gender of Business Ownership (please check one): ❑ American Indian or Alaska Native ❑ Native Hawaiian or Other Pacific Islander ❑ American Indian or Alaska Native and White ❑ Black or African American and White ❑ American Indian or Alaska Native and Black or African American ❑ Balance of individuals reporting more than one race Gender: Ef Male ❑ Female ❑ Asian White ❑ Asian and White ❑ Black or African American By this signature affixed hereto, I d larc'under penalty of perjury that the above information is correct. 12/22/15 Signatur& Business Owner Date JOSEPH A NANCI Print Name Received by Date California All -Purpose Acknowledgement State of California ) County of Orange On \L C��(�� before me, William E. Ellis, Jr. ,a Notary Public personally Joseph A. Nanci -.1 ILL10 JR commission— ja212 9' Notary Public 2127999 Orange Coanatornia ri� Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual Cf Corporate Officer: ❑ Partner- ❑ Limited ❑ General D Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator Q Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the personN) whose nameXis/atesubscribed to the within instrument and acknowledged to me that he/ sheAhoy executed the same in his/ltcrftheir authorized capacity0e,Q, and that by his/ftmYtheir signatureX on the instrument the person( or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature of Pages: OPTIONAL ❑ Individual ❑ Corporate Officer: 0 Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: EXHIBIT 7 City of Santa Ana Section 3 Contractor Compliance Report 1. Name and Address of Reporting Entity 2. Dollar Amount of Award 5. Reporting Period: (Contractor or Subcontractor): EBS GENERAL ENGINEERING INC 3. Contact Person: 6. Date Report Submitted: JOE NANCI 4. Phone (include area code): 951-279-6869 Part I: Employment and Training Performance Part II: Contract Award to Section 3 Businesses (Contractors, Subcontractors, Suppliers, Vendors or Service Providers) Racial/Ethnic Codes: I = White 2 = American Indian or Alaska Native 3 = Asian 4 = Black or African American 5 = Native Hawaiian or Other Pacific Islander 6 = American Indian or Alaska Native and White 7 = Asian and White 8 = Black or African American and White 9 = American Indian or Alaska Native and Black or African American 10 = Balance of individuals reporting more than one race EXHIBIT 7 (cont.) Instructions This form is to be used to report accomplishments regarding employment, training and contracting opportunities provided to low- and very low-income persons under Section 3 of the Housing and Urban Development Act of 1968. 1. Reporting Entitv: Enter the name and address of the recipient, contractor, or subcontractor(s), as appropriate. 2. Dollar Amount of Award: Enter the dollar amount, rounded to the nearest dollar, received by the contractor, or subcontractor(s). 3. & 4. Contact Person/Phone: Enter the name and telephone number of the person with knowledge of the contractor's and/or subcontractor's Section 3 Implementation Plan. 4. Reporting Period: Indicate the time period this report covers (this would be the length of the construction project). 5. Date Report Submitted: Enter the appropriate date. Part I: Employment and Training Performance 6. Job Category: Report job categories of newly hired employees. 7. Total New Hires: Report number of new hires by job category. 8. Section 3 New Hires: Report number of Section 3 new hires by job category. 9. Percentage of Asgregate Hires who are Section 3 Hires: Enter the percentage of Section 3 new hires for each category. 10. Racial/Ethnic Code: Enter the number of Section 3 new hires under appropriate racial/ethnic code (1 - 5). Part II: Contract Award to Section 3 Businesses (Contractors, Subcontractors, Suppliers, Vendors or Service Providers) 11. Name of Section 3 Business Concern: Enter the name of each Section 3 business concern who received a contract award. 12. Construction or Non -construction Contract: Specify if the Section 3 business concern is a construction or non - construction contractor. 13. Contract Amount: Enter the contract amount awarded to a Section 3 business concern. 14. Racial / Ethnic Code: Enter the number of Section 3 business concerns under appropriate racial/ethnic code (1 - 6) reflecting business ownership. EXHIBIT 8 Contractor's Section 3 Afftnnative Action Plan PROJECT NO. 16-7523; WASHINGTON SQUARE RESIDENTIAL STREET REPAIR 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. 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. 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 subcontracts, and require subcontractor(s) to submit a Section 3 Affirmative Action Plan. EBS GENERAL ENGINEERING INC Company Name 1320 E SIXTHT ST, STE 100 CORONA CA Address: Street, City, State, Zip 83-939-1232 DUNS Number ZI Sign re of Contractor 79 JOSEPH A NANCI Printed Name PRESIDENT Title California All -Purpose Acknowledgement State of California } County of Orange On before me, William E. Ellis, Jr. a Notary Public personally Joseph A. Nanci ------------ WILLIAM E. ELLIS JR. Commission N 2127998 :-w Notary Public - Calitornia Orange County > NIX Comm. Ex 4ims Oct 23 2019 Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee 0 Guardian or Conservator ❑ Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the personN) whose nameXis/are subscribed to the within instrument and acknowledged to me that he/ shekhey executed the same in hist =Aheie authorized capacity(laQ, and that by his/har/their signatureK on the instrument the personl`s)„ or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 019261, 2- 6a' ° Notary Public Signature of Pages: OPTIONAL • Individual ❑ Corporate Officer: ❑ Partner - 0 Limited ❑ General CI Attorney -in -Fact Trustee • Guardian or Conservator ❑ Other: Signer is Representing: Bidder's Name: EXHIBIT 9 City of Santa Ana Section 3 Contract Award Consideration EBS GENERAL ENGINEERING 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 1 please read the attached Section 3 Business Concern Preference - Bidding Requirements. (Please check the applicable quali/icationfor statement number 1) 51% owned by Section 3 residents; or Permanent, 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 concem(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 section titled Section 3 Economic Opportunities Plan. 12/22/15 Signature orBusiness Owner Date JOSEPH A NANCI Print Name California All -Purpose Acknowledgement State of California } County of Orange On I -L-2- °Cx:::� before me, William E. Ellis, Jr. ,a Notary Public personally Joseph A. Nanci WILL w E`..�y.•dr�. 41-1111 Commission S 2127998Notary Public -California nZOrange county My comm. Ez fres oct 23 2019! Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) 0 Individual 0 Corporate Officer: 0 Partner - 0 Limited 0 General 0 Attorney -in -Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the person) whose nameXis/arc subscribed to the within instrument and acknowledged to me that he/ she4ko3 executed the same in hisfherftheir authorized capacity(ioQ, and that by hist tmY*air signatureX on the instrument the personK or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature of Pages: OPTIONAL 0 Individual 0 Corporate Officer: 0 Partner - 0 Limited 0 General 0 Attorney -in -Fact 0 Trustee 0 Guardian or Conservator 0 Other: Signer is Representing: EXHIBIT 10 2014 Income Eligibility Chart for Section 3 Residents Family Size Income Cap* 1 $50,600 2 $57,800 3 $65,050 4 $72,250 5 $78,050 6 $83,850 7 $89,600 8 $95,400 * The official adjusted low income (80%) figures are calculated from the national median family income level by HUD requirement for HUD programs. EXHIBIT 11 Efforts to Offer Training and Employment Opportunities to Section 3 Residents and Contracts to Section 3 Business Concerns Training and Employment Opportunities for Section 3 Residents • Advertising training and employment positions by distributing flyers (which identify the positions to be filled, the qualifications required, and where to obtain additional information about the application process) in the neighborhood where the Section 3 covered project is located. • Contacting neighborhood councils, resident management corporations, or other resident organizations, where they exist, in the neighborhood where the Section 3 project is located in order to notify residents of the training and employment positions to be filled. • Sponsoring (scheduling, advertising, or financing) a job informational meeting to be conducted by a contractor or representatives at a location in the neighborhood of the Section 3 covered project. • Arranging assistance for completing job applications for Section 3 residents. • Arranging for a location in the neighborhood of the project, where job applications may be delivered to and collected by the contractor or representatives. • Conducting job interviews at the location of the neighborhood where the Section 3 covered project is located. • Consulting with State and local agencies administering training programs funded through JTPA or JOBS, probation and parole agencies, unemployment compensation programs, community organizations and other officials or organizations to assist with recruiting Section 3 residents for contractor's training and employment positions. • Advertising the jobs to be filled through the local media, such as community television networks, newspapers of general circulation, and radio advertising. • Employing a job coordinator, or contracting with a business concern that is licensed in the field of job placement (preferably one of the Section 3 business concerns identified in part 135), that will undertake, on behalf of the contractor, the efforts to match eligible and qualified Section 3 residents with the training and employment positions that the contractor intends to fill. • Where there are more qualified Section 3 residents than there are positions to be filled, maintaining a file of eligible qualified Section 3 residents for future employment positions. • Undertaking job counseling, education and related programs in association with local educational institutions. • Undertaking such continued job training efforts as may be necessary to ensure the continued employment of Section 3 Residents previously hired for employment opportunities. • After selection of bidders but prior to execution of contracts, incorporating into the contract a negotiated provision for a specific number of Section 3 residents to be trained or employed on the Section 3 covered project. Efforts to Award Contracts to Section 3 Business Concerns Contacting business assistance agencies, minority contractors associations and community organizations to inform them of contracting opportunities and requesting their assistance in identifying Section 3 businesses which may solicit bids or proposals for contracts for work in connection with Section 3 covered assistance. EXHIBIT 11 (cont.) • Providing written notice to all known Section 3 business concerns of the contracting opportunities. This notice should be in sufficient time to allow the Section 3 business concerns to respond to the bid invitations or request for proposals. • Following up with Section 3 business concerns that have expressed interest in the contracting opportunities by contacting them to provide additional information on the contracting opportunities. • Advertising the contracting opportunities through trade association papers and newsletters, and through the local media, such as community television networks, newspapers of general circulation and radio advertising. • Developing a list of eligible Section 3 business concerns. • Establishing numerical goals (number of awards and dollar amount of contracts) for award of contracts to Section 3 business concerns. EXHIBIT 12 CITY OF SANTA ANA WOMEN OWNED/NIINORITYBUSINESS OWNED ENTERPRISES (W/MBE) GOOD FAITH EFFORTS Project Name: Project Number: Project Location: 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 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: Information Furnished: F:\DOCS\PROPSVCS\HUDFORMS\MBU5B04AMB- Section3Spem 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 ofperjury 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 fully and truthfully complete this form may result in economic or other sanctions. Signature: Name: Title: PRFSinFNT Date: 12/22/15 Name of Contractor/Subcontractor: EBS GENERAL GENERAL ENGINEERING IN Contractor/Subcontractor Identification Number: Address (Street, City, State, Zip): 1320 E SIXTH ST, STE 100 CORONA CA 92879 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. bite Americans 2 = Black Americans 3 = Native Americans Woman Owned Business: Circle One: Yes or 4 = Hispanic Americans 5 = Asian/Pacific Americans 6 = Hasidic Jews F'.\DOCS\PROPSVCSWUDFORMS\MBU5B04AMB-Sedion3S,mDOC California All -Purpose Acknowledgement State of California } County of Orange On 0 Z ' 2 `>' (S before me, William E. Ellis Jr. a Notary Public personally Joseph A. Nanci WILLIAM . ELLIS JH. # 2127998Notary 411._ Cornmisslon Public-Calltorna orange County M Comm. Ex Tres Oct 23.2019 Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: Cl Partner - ❑ Limited ❑ General ❑ Attomey-in-Fact ❑ Trustee ❑ Guardian or Conservator 0 Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the persons) whose nameXis/are subscribed to the within instrument and acknowledged to me that he/ she/they executed the same in hisffittAheir authorized capacity(isQ, and that by his/herftheir signature(s), on the instrument the personK or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. A" Notary Public Signature Of OPTIONAL ❑ Individual ❑ Corporate Officer: ❑ Partner - Cl Limited D General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: EXHIBIT 13 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Los Angeles Area Office, Region IX 16t5 West Olympic Boulevard Los Angles, California 90015-3801 CERTIFICATION FOR APPLICABLE FRINGE BENEFIT PAYMENTS Project Name: WASHINGTON SQUARE RESIDENTIAL STREET REPAIR Project Number: Classification/FringeBenefits 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 I certify that I do not make payments to approved fringe benefit plans, funds, or programs. EBS GENERAL ENGINEERING INC Contractor/Subcontractor 12/22/15 Date F'.\DOCS\PROPSVCS\HUDFORMS\MBU5BD4AMB - Sectlan3Spece. DOC PRF4IDFNT Title California All -Purpose Acknowledgement State of California ) County of Orange On � 2 - 1 `8 - i <_ before me, William E. Ellis, Jr. , a Notary Public personally Joseph A. Nanci Commission * 2127998 Notary Vuolic - California ()(ange County^ Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual Corporate Officer: IJ Partner - ❑ Limited ❑ General Ci Attorney -in -Pact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the personN) whose nameXis/are' subscribed to the within instrument and acknowledged to me that he/ she/thoy executed the same in hisffrm*heir- authorized capacityot sQ, and that by his/herhheir signatureX on the instrument the person(s)„ or the entity upon behalf of which the person'N acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature of Pages: OPTIONAL ❑ Individual 0 Corporate Officer: ❑ Partner - O Limited ❑ General ❑ Attorney -in -Fact D Trustee • Guardian or Conservator ❑ Other: Signer is Representing: 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 $10,000 which are not exempt from the provisions of the equal Opportunity clause, and that he will retain such certifications in his files. NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001 Company: By: EBS GENERAL ENGINEERING INC Title: PRESIDENT Date: 12/22/15 F9 OCS\PROPSVCS\HUDFORMSMBU$BB4AMB- Sectian3Specs. DOC California All -Purpose Acknowledgement State of California ) County of _ Orange On_ (2.--L-?s'(� before me, William E. Ellis, Jr. ,a Notary Public personally Joseph A. Nanci ]]+mow. WILLIAM E. EL IS in. ' Commission # 2127998 =w Notary Public • California a z Orange County n M Comm. Expires Oct 23, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: Ll Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact 0 Trustee Ll Guardian or Conservator Ll Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the persons) whose nameXis/are'subscribed to the within instrument and acknowledged to me that be/ sheAhe3 executed the same in hisH=Vteir authorized capacity(Ie,Q, and that by hislherhheir signatureX on the instrument the personK or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ✓{ f is Notary Public Signature umber of Pages: OPTIONAL L1 Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact Ll Trustee 0 Guardian or Conservator ❑ Other: Signer is Representing: EXHIBIT 15 NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the City of SANTA ANA DEPARTMENT OF PUBLIC WORKS In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106, the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any 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 infonnation 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. EBS GENERAL ENGINEERING INC Name of Contractor 1320 E SIXTH ST, STE 100 CORONA CA 92879 Address PRESIDENT ignature and Title 12/22/15 Date F\DOCS\PROPSVCS\HUDFORMS\MBU5BC4AMB- Section35pecs.DOC California All -Purpose Acknowledgement State of California } County of Orange On before me, William E. Ellis, Jr. a Notary Public personally Joseph A. Nanci WILLIAM E. ELLIS JR. "'- commission # 2127998 z ; w Notary Public - California n z Orange County My Comm. Ex fres Oct 23, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: who proved to me on the basis of satisfactory evidence to be the person) whose nameXis/atmsubscribed to the within instrument and acknowledged to me that he/ sheAoy executed the same in hisHrcrkheie authorized capacityoes�, and that by his/her/their signaturcK on the 'instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature Document Date: Number of Pages: Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: Cl Partner - 0 Limited ❑ General Cl Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: OPTIONAL ❑ Individual ❑ Corporate Officer: Q Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: EXHIBIT 16 FEDERAL LOBBYIST REQUIREMENTS CERTIFICATION Name of Firm: EBS GENERAL ENGINEERING INC nate: Address: State: 1320 E SIXTH ST, STE 100 CA 12/22/15 Zip Code: 92879 Telephone: 951-279-6869 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 malting 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: JOSEPH A NANCI Title: PRESIDENT Signature: 4 �.Date: F:\DOCS\PROPSVCS\HUDFORMS\MBU5BC4AMB-S.d.n3Spe.,DOC 12/22/15 California All -Purpose Acknowledgement State of California } County of Orange r' On 12."� • (� before me, William E. Ellis, Jr. a Notary Public personally Joseph A. Nanci WILLIAM E. ELLIS JR. Commission # 2127999 cgo Notary Public - Californiav Orange County M Comm. Ex Ires Oct 23, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited O General ❑ Attorney -fir -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the person(N) whose nameXis/arEsubscribed to the within instrument and acknowledged to me that he/ sheAhey executed the same in his/fimAheie authorized capacity0e,Q, and that by his/timYflieir signatureX on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature of Pages: OPTIONAL ❑ Individual D Corporate Officer: ❑ Partner - O Limited D General ❑ Attorney -in -Fact Trustee Q Guardian or Conservator ❑ Other: Signer is Representing: EXHIBIT 17 CERTIFICATION OF UNDERSTANDING AND AUTHORIZATION Project Name: WASHINGTON SQUARE RESIDENTIAL STREET REPAIR Project Number: 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: KATHY FAIRWEATHER Payroll Officer's Name Payroll Officer's Signature EBS GENERAL ENGINEERING INC Contractor/ ubcontractor by Sig at�r e JOSEPH A NANCI Printed Name PRESIDENT Title 12/22/15 Date 720016 Contractor/Subcontractor License No. 83-939-1232 DUNS Number F\DOCS\PROPSVCS\HUDFOFMS\MBU5BO4AMB-SectiorOSpec DOC California All -Purpose Acknowledgement State of California ) County of Orange On k-2-- 2-,s ' C before me, William E. Ellis, Jr. a Notary Public personally Joseph A. Nanci WILLIAM E. ELLIS JR. Commission B 2127998 a "_® Notary Public - Calitornia z. z orange County M Comm. Ex ires Oct 23, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: Document Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) U Individual ❑ Corporate Officer: ❑ Partner - 0 Limited ❑ General 0 Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: who proved to me on the basis of satisfactory evidence to be the personN) whose nameX Ware subscribed to the within instrument and acknowledged to me that he/ she/theyy executed the same in hisHierhheir• authorized capacityo,aQ, and that by histher/their signatureN on the instrument the personC`s), or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. L l Notary Public Signature ll of Pages: OPTIONAL ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited 0 General ❑ Attorney -in -Fact D Trustee ❑ Guardian or Conservator • Other: Signer is Representing: 12/22/2015 Dashl- a Entity Record Core Data a Assertions .. a REDS & Certs EMS Report r Service Contract Reoort e Bio Preferred ReDon; i Exclusions r Active Exclusions r Inactive Exclusions t Excluded Family Members SAM I System for Award Management 1.0 Entity Overview I System for Award Management ELITE BOBCAT SCRUICE, 7N,- DUN&: 8753+34232 CAGE Caste: 8MXS5 Status; SuUmitted EviciroNon Geteu Not Am A3sui Purpose or Registration; All Aw&mis Entity Overview Entity Information DUNS: 839391232 Name: ELITE BOBCAT SERVICE, INC Business Type: Business or Organization PDC Name: Kathy Fairweather Registration Status: Submitted Registration is undergoing IRS TIN Matching. This averages -. two business days. If it takes longer than one week, contact '.. the Federal Service Desk (www.fsd.00v). Exclusions Active Exclusion Records? No Note to all Users: This is a Federal Government computer system. Use of this system constitutes consent to monitoring at all times. IBM v1.P.40.20151201-1827 WWW4 Kathy Fairweather ;.32® v 5TH AT :TE 1,110 COROUN, CA, 92879-1785, UNITED STATE -4 https://www.sam.gov/portal/SAM/?navigationalstate=JBPNS_rOOABXdcACJgYXZheC5mYW NIcy5wb3JObGVOYnJpZGdILINUQVRFXOIEAAAAAQApdmlldzp... 1/1 �k 2 �}�■� § \ �\ :e Eƒ N __� to� \ � \ b \ U) 0 -- ti7�® La le >1m02] f7%%$ _