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CALIFORNIA PROFESSIONAL ENGINEERING, INC. (7)
Recording Requested By, And When Recorded Mail To: Clerk of the Council,City of Santa Ana 20 Civic Center Plaza,P.O.Box 1988 Santa Ana,CA 92702 THIS SPACE FOR COUNTY RECORDERS USE ONLY NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN that the undersigned City of Santa Ana, California, a municipal corporation, with the address of City Hall, 20 Civic Center Plaza, Santa Ana, California, 92701, is the owner of the property hereinafter described, that said owner has caused a construction of TRAFFIC SIGNAL MODIFICATIONS: 17TH AT ENGLISH ST. y MACARTHUR BOULEVARD AT PLAZA DRIVE EDINGER AVENUE AT SULLIVAN N ST., WESTMINSER AVENUE AT CLINTON ST. under contract entered into on AUGUST 2, Wo 2016, with CALIFORNIA PROFESSIONAL ENGINEERING, INC..on which contract ALLIED H H WORLD INSURANCE COMPANY is surety. The property on which such work improvement cwas placed is in the City of Santa Ana, County of Orange, State of California, and described as Project No. 15-6834 HSIPL 5063056) located at: 17Tn AT ENGLISH ST., MACARTHUR BLVD. AT PLAZA DR., EDINGER AVE. AT SULLIVAN ST., WESTMINSTER AVE. AT w v CLINTON ST. The work improvement on said property was accepted as completed on w o SEPTEMBER 1, 2017. wF z A CITY A, A MUNICIPAL CORPORATION a � y Dated: U ' - �' Princi Civil Engineer-Tyrone Chesanek TITLE ------------------------------------------------------------------------------------------- VERIFICATION 1, the undersigned, say: I am the City Engineer - Edwin"William" Galvez of the City of Santa Ana, California; I executed the foregoing Notice of Completion acting on behalf of the owner of the property therein described; I make this verification on behalf of said corporation by authorization of the City Council of the City of Santa Ana; I have read said notice and know the contents thereof; and I declare under penalty of perjury that the facts therein stated are true. Executed on , at Santa Ana, California (Signature of individual swearing that the contents of Notice of Completion are true.) THIS NOTICE OF COMPLETION MUST BE RECORDED WITHIN TEN(10)DAYS AFTER COMPLETION REQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: SEPTEMBER 20, 2016 TITLE: APPROPRIATION ADJUSTMENT AND AWARD CONTRACT TO CALIFORNIA PROFESSIONAL ENGINEERING, INC., FOR INSTALLATION OF GRANT -FUNDED TRAFFIC SIGNAL MODIFICATIONS AT FOUR LOCATIONS (PROJECT NO. 156834) (STRATEGIC PLAN NO. 6, 1B & 1G) r 'CITY MANAGE RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED SEP 2 0 2016 , ao D ® As Recommended ❑ As Amended ® Ordinance on 9 ®t Reeding ❑ Ordinance on 2Rd Reading ❑ Implementing Resolution ❑ Set Publlo Hearing For„ CONTINUED TO IJI11114killil lX I 1. Approve an appropriation adjustment for Fiscal Year 2016/2017 to recognize $104,456 from the Highway Safety Improvement Program funds into the Federal Aid Safety Program revenue account and appropriating the same to the Federal Aid Safety Program expenditure account. 2. Award a contract and authorize the City Manager and Clerk of the Council to execute a construction contract to California Professional Engineering, Inc., the lowest responsible bidder, in accordance with the base bid in the amount of $872,755, for the term beginning upon execution of the contract and ending upon project completion, for construction of the Traffic Signal Modifications at Four Locations project, subject to nonsubstantive changes approved by the City Manager and City Attorney. 3. Approve the Project Cost Analysis for a total estimated project delivery cost of $1,090,945, which includes the contract base amount, administration, inspection, testing, and an authorized contingency of $87,280. DISCUSSION The Traffic Signal Modifications at Four Locations project consists of installing left turn arrows and enhancing the signage at the intersections of 17th Street at English Street, MacArthur Boulevard at Plaza Drive, Edinger Avenue at Sullivan Street, and Westminster Avenue at Clinton Street (Exhibit 1). Once completed, these improvements will increase the safety of pedestrians while promoting more walking and bicycling at these locations with protected movements as well as the motor vehicles making left turns. Award Contract For Traffic Signal Modifications at Four Locations August 2, 2016 Page 2 An additional $104,456 in Highway Safety Improvement Program (HSIP) grant funds has been awarded to this project. The City qualified for this incentive funding from Caltrans for projects that are ahead of schedule and ready for construction. By appropriating these HSIP funds, a portion of the previously budgeted Measure M2 funds will be made available as a City match for future projects. A Notice Inviting Bids was advertised on April 13, 2016, and April 20, 2016; bids were opened on May 4, 2016. The following is a summary of the bid invitations made and the bids received: Contractor Participation Data Santa Ana contractors receiving notices 10 Contractors requesting bidding documents 12 Bids received 4 Bids received from Santa Ana contractors 0 Bid Results Summary RANK BIDDER'S NAME LOCATION BID 1 California Professional Engineering, Inc. La Puente $872,755.00 2 As lundh Construction Corp. Anaheim $882,423.50 3 Belco Elecnor Group Chino $923,960.00 4 Minco Construction Gardena $1,166,940.00 A total of four bids were received and all were deemed responsive. California Professional Engineering, Inc., submitted the lowest responsive bid (Exhibit 2) in the amount of $872,755 and that bid is comparable to the engineer's estimate of $835,330. Based on an analysis of the bids received, staff recommends award of this contract to California Professional Engineering, Inc. (Exhibit 3). STRATEGIC PLAN ALIGNMENT Approval of this item supports the City's efforts to meet Goal #6 - Community Facilities & Infrastructure, Objective #1 (establish and maintain a Community Investment Plan for all City assets), Strategy B (equitably maintain existing streets and associated assets in a state of good repair so they are clean, safe and aesthetically pleasing for all users) and Strategy G (develop and implement the City's Capital Improvement Program in coordination with the Community Investment Plan [e.g., neighborhood streets, traffic improvements, park facilities, bike master plan, etc.]). Award Contract For Traffic Signal Modifications at Four Locations August 2, 2016 Page 3 ENVIRONMENTAL IMPACT In accordance with the California Environmental Quality Act, the recommended actions are exempt from further review. Categorical Exemption Environmental Review No. 2014-18 was filed for this project. FISCAL IMPACT The Project Cost Analysis estimates project expenditures of $1,090,945, which include the construction contract, construction administration and inspection, as well as contingencies (Exhibit 4). The additional HSIP grant funds will be recognized into the Federal Aid Safety Program Fund revenue account (No. 14717002-52001) and appropriated into the Federal Aid Safety Program Fund expenditure account (No. 14717611-66220). With the approval of the appropriation adjustment, funds in the amount of $1,044,556 will be available in the Federal Aid Safety Program Fund (Account No. 14717611-66220) and $46,389 in the Measure M2 Local Fair Share Fund (Account No. 03217662-66220) for expenditure in Fiscal Year 2016-17. I J rrep nnousavipour Executive Director Public Works Agency FM/EWG/TC/MO Exhibits: 1. Location Map 2. Bid 3. Construction Contract 4. Cost Analysis APPROVED AS TO FUNDS AND ACCOUNTS: Francisco Gutierrez Executive Director Finance & Management Services Agency We Tr-, E< Tr Traffic Signal SANTA ANA � City Council P� Agenda Date PUBLICWGRKS AGENCY August 2. 2016 Project No. 15-6834: Traffic Signal Modifications on: 171h St at English St MacArthur Blvd at Plaza Dr Edinger Ave at Sullivan St Westminster Ave at Clinton St Exhibit 1 Exhibit 2 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17..1 STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: H51PL, 5063(156) BID PROPOSAL, TO: CI'T'Y COUNCIL OFTHE CITY OF SANTA ANA FROM: California Professional 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 entirely 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 Q01 Unit Unit Price Amount I Traffic Signal Modification on 17� ` Sit — I LS $ $ English St ,�J ,� 1�0i 10(6(p 1 ?n' IL 2 Traffic Signal Modification on MacArthur I LS $ $ Blvd at Plaza Dr �ci�tl3�LP 3 Traffic Signal Modification on Edinger I LS $1/Itryl $ Ave at Sullivan St �p 4 Traffic Signal Modification on I LS $ $ Westminster Ave at Clinton St q 5 Temporary Overhead Wiring ofTraftic Signals, Including Communications 4 EA $f \�%I�(��-Li $ 6 ATSSA Certified Flaggers During Traffic Signal Shutdown Periods1 I LS $ IJQQ $ �( ow `> t 7 GTT' OPticom Emergency Vehicle I LS $ $ Preemption System at Wesuninister Ave I and Clinton St 8 GTTOpticom Emergency Vehicle Preemption System at MacArtlmr Blvd and I LS $ I D I Com) 1010W Plaza Dr 9 Install 2" PVC Conduit Per Plan " 635 LF $ 10 Install 3" PVC Conduit Per Plan " 1,180 LE $ $d P -I of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17T11 STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL. PROJECT NO; HSIPL 5063(156) Item Description Qty Unit Unit Price Amount 11 Install 4" PVC Conduit Per Plan* 1,155 LF $ ,,- $ _ 2 Install No. G Pull Bax 20 EA 1 0I Ll w (;L0 13 Install Traffic Rated No, 6 Pull Box 3 EA $ 14 Install Large Pull Box Per Plans 3 EA $ $� 15 Install Traffic Signal Loop Detector (Type E Loop)..�� 63 EA $ $ 16 install Bicycle Loop Detector (Type D Circular Loop) 40 EA ? q 17 Install IP Communication System For 17th St. at English St I LS $$(� q 1 � � 1 1� 18 Install lPCommunication System'for MacArthur Blvd at Plaza Dr I LS $ woo $� cr1 19 Install IP Communication System for Edinger Ave at Sullivan St04Urow I LS $ $ C�0J(,(7 20 IPSmaII 1P Communication Systemfor Westminster Ave at Clinton Stj.�/i(k-% I LS $ $ 21 Install 24 Stand Singlemode Fiber Optic Cable' mm 5,570 LF $$ $ 22 Install Fiber Optic Splice Enclosure I EA $ $ �--� 23 Fusion Splice I Strand of Singlemode Fiber Optic 204 EA $ LtU $ t1 I 24 Construct 4" PCC Sidewalk* 47 SF $ $ d -(DCI 25 Construct PCC Curb Ramp " 2,630 SF S !_\ $. 1wl �j 26 Signing and Striping at Edinger Ave tit Sullivan St I LS $ 1!�1 $ 1 P-2 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17"" STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) Item Description Qty Unit Unit Price Amount 27 Pothole for Utilities Not Shown on Plans 10 EA $ _ 1�1�� $ 1 y 28 Pothole for Traffic Signal Equipment Utility Conflict * _ 27 EA $ � 115T .✓ ^-' $ 41 29 AC Pavement * 105 TN $ ., � $Y 1�1 30 Unclassified Excavation * 115 Cy $ $ TOTAL BASE BID $ �� 1 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 acid -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, This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications. P-3 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL, MODIFICATIONS: If" STREET AT ENGLISH STREET, MACART14UR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT'NO: HSIPL 5063(156) 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 one hundred and sixty (160) working dates after the commencement date stated in the Notice to Proceed, The bidder also proposes to commence construction of the Work within ten (10) working days after issuance of a Notice to Proceed, and to continue in a diligent and workman -like manner without interruption, and to complete the construction thereof within the time specified above. 'The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be $1,000 per calendir day. Name of Firm California Professional-Enailkrina. Inc. SignatureofBIDDER V . Title President, Secretary, and (Ifan individual, so state. 11'a firm or co -partnership, state the firm name and give the names of all individual co-partners composing the firm. tf a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof.) P-4 of P-40 CITY OF SANTA ANA PROPOSAL PROJECTNO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17"u STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: FISIPL 5063(156) 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 f''ailure to furnish the necessary bonds and because it is distinctly agreed that the proof of clainages 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 California Signature of BIDDER W �--- Title president, Secretary and Treasurer (If an individual, so state. If a firm or co -partnership, stat the Finn 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-5 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17Trr STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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: California Professional Engineering, Inc Business Address: 929 Otterbein Ave Unit E, La Puente, CA 91748 Business E -Mail Address: van@cpengineeringine.com Telephone: 626-810-1338 State Contractor's License No. and Class: License Expiration Date: 04/30/2017 State Dept. of Industrial Relations (DIR) Registration No.: State Dept, of Indn3trial Relation (DIR) Registration Expiration Date: Signed: ✓ Title: President 793907, A, C-10, C-20 1000001980 P-6 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL, MODIFICATIONS: 17111 STREET AT ENGLISH STREET. MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(t 56) 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, ctseq., ("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 cornply 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 waft, 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 California Prpf s 'onal Enginulering/fnc. Signature of BIDDER Title President (if an individual, so state) 11-7 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17"' STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECTNO: HSIPL 5063(156) OWNERSHIP AFFIDAVIT S PATE OF CALIFORNIA COUNTY OF ORANGE CITY OF SANTA ANA Van Nguyen ❑ INDIVIDUAL ❑ PARTNERSHIP Xj CORPORA'I JON SS: being duly sworn. deposer; and says: That he/she is the Party making the foregoing proposal: Thathe/she is a member or the co -partnership firm designated as: and who has been and is duly vested Irith the paruneship by: the other members of the co -partnership, to make and execute instruments for the co - That he is of: President of California Professional Engineering, Inc. a corporation which is making the foregoing proposal: ❑ JOINT VENTURE ghat he is o one of the parties making the foregoing proposal as a joint centmc, and the he/she Inas been and is duly vested with tine authority to execute instromenta for an on hehnlforthe parties making said bid odial are: that such a bid is genuine andoot collusive or sham, and has not in any manner sought by collusion to secure any a, antage against tl e City of Santa Ana or any person interested in the proposed contract, for himselfot ani o`iIm", Signature of Subscribed and sworn to beforeltne this i day of 1'"''iQ� 20 Imo. 6'r Signature of officer Administering Oath (Notary Public) P-8 of P-40 JURAT $ A.13.S,L'NT SICNJ,,R (PRINCIPAL) IS REPRESENTING: loci, HT N NAMFOFITRSON(S) OR N'i'IT YOIs) ,� THUMBPRINT 10 California Professional Engineering, Ina OF __.. SIGNER 1''.; ✓y .y jW111108 NO'1ARY110ND8, SUPPLIES AND FORMSAT i ITTP/1WWWVAUI:Y_SWRRA. CO,vj dJ2no'.20n8 bAI_Ln1'SIFRRA INS[RANCE $ $ State of California os Angeles S5. $ Lel $ County of -- g 4 Subscribed and sworn to (or affirmed) 'before me on this day of 2016 by $ --41h.—.,- -, ------ _, —Van Nguyen,proved to me on the basis of satisfactory evidence ® to be the person(xa who appeared before Inc. i $ b $ 4 CORMYP1i2042313 L09 hNGGlF6 C6UN7Y � -5 NOTARY SION.KI'URL _ 8 $ $ Anotary public or other office completing this certificate verifies only the Identity of the individual who signed the document 0 to which this certificate is attached. and not the truthfulness. accuracv. or validity of that document. (k PI.ACIF NO IARYSHAI, IN ABOVE, SI'AUB $ OPTIONAL INk"ORMATION $ $ @ The information' below is optional. However, it may provee valuable and could prevent fraudulent attachment of this forin to an unauthorized docurnent. $ $ $ $ CAPACITY CLAiME'D By SIGNER (PRINCIPAL) DESCRIPTION OFATN'ACIiED DOCUMENT 4 $$ FJ [NDIV1Dl'AL � CQRPORATE Ot^I=CC'Lai p_LS1dearaary—Treasurer, Manager TC'fLE OR TYPE OF DOCUMENT q $ [l C'Al2TN6R(S) THUM � $ ❑ All ORNEY-CN-FAC"i'-- $ ❑ TRUST'EFE(S) NUMBER OF PAGES $ $ GUARDIANICONSERVA['OR $ $ O111CR: DA'TF. OI DC7( I-MEN't pE� �, $ N OTHER —_ 4 $ A.13.S,L'NT SICNJ,,R (PRINCIPAL) IS REPRESENTING: loci, HT N NAMFOFITRSON(S) OR N'i'IT YOIs) ,� THUMBPRINT 10 California Professional Engineering, Ina OF __.. SIGNER 1''.; ✓y .y jW111108 NO'1ARY110ND8, SUPPLIES AND FORMSAT i ITTP/1WWWVAUI:Y_SWRRA. CO,vj dJ2no'.20n8 bAI_Ln1'SIFRRA INS[RANCE D.:DDER: CITY QIP SANTA ANA PROPOSAL PROJECT NO.. 19-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 �" STREET AT HNGI,ISH & REE'(, MACARTIIUR BOULEVARD AT PLAZA DRIVE. EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: 11SIPL 5063(156) BID BONI) KNOW ALC, PRESENT that. cal .-fornix-_Brofessiozzal,_Eng nesring. Inc. as BIDDER, and Allied World Insurance Company _ _ as SURETY, are held and firmly hound unto the CITY OF SANTA ANA, as AGI"sNCY, in the penal soul of rex n5eeercr or TOTAL alo Anlo Dr DoIlars ��i 10°s _), Wh1C}I is t81'1 percent (10%) Oi'the total aiT70U1]t bid by BIDDER to AGENCY for the above -stated project, for the payment of which stun, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents. THE: CONDITIONS Oh THIS OBLIGATION ARE SUCK that, whereas BIDDER is about to submit a bid to AGF,NC'Y 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 shrill remain in full force and effect in favor of AGENCY. IN WI'T'NESS WI IEREOP the parties hereto have set their names, titles, hands, and seal this day of__AR&U , 20_16. f3lDi)ER* SURETY" Subscribed and sworn to before me , 20-_. Signature: Notary Public in and for the County of_. State of M4W this day of Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative.. SURETY AG.UT: Casa Emmfa nxefens.ional 5npinr:vxin9 ]nc. Alliod Ylorld:n m, ce Company 'ME SONO EXCHANGE AND INSURANCE AGENCY 939 O[,-na Neiu Av=,x� , S11. E, Lx Puen[m, CA 93748 550 S. Hope 9n5.hl 1815, Loa Alrye ,, CA 90011 26800 CDR1GAN1'A Di, 0160. MISSION YIeSO, CP 926'1 ,uE51 310-1:OU Il] -61G 189 349-hG 1-1000 P-9 of P-40 ALL-PURPOSE ACKNOWLEDGMENT State of California Coultty of Los Angeles On May 4, 2016 RAIL personally appeared Van Nguyen before me, SS. Diem Chu- _ — —' Notary Public, who Proved to Ire on the basis of satisfactory evidence to he the persontlF><) whose name(v is/gR'g subscribed to the within instrument and acknowledged to me that he/miso kqv executed the same in his,Ax,xaJx m authorized capacity(iixs:), and that by his/fm�Atix signaturcp%) on the instrumunt the person(, or t'he entity upon behalf' of which tlie person(Q acted, executed the instaurnent. I certify under PENALTY OF PERJURY under the laws of' the State of California that the foregoing paragraph is true and correct. [)IgM CNU WITNESS m hand and ot'hcial seal. .. sI 00NIM,4 2042313 y e INO1ARY Pa0r10.CALIFORNIA � LC5 Aepprps CouNrr `" NO A - SM N\TORP A notary public or other office completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness. accuracv, or validity of that document. PLM e no rARY SEAI. INABovE srnce - OPTIONAL INF'OlLlMATION The information below is optional. However, it may prove valuable and could prevent fraudulent attachment of this form to an unauthorized document. CAPACITY CLAIMED BY SIGNER(PRINCIPAL) DESCRIPTION OBAIT,ACIIE) DOCUMENT [] INDIVIDUAL F CORPORAT E OFHCtiR President,. Searetary,Tr'easurer, Manager 1 I I I t IJR I Yf I OF DOC'UN:Ih N'r ❑ PA RNER(,S) rm.L(SI ATTORNEY-IN-FACT- Nl,'MnL.i2 (JI-P1GES TRl.J `iTGG(S) ❑ GUARDIAN/(.'ONSk.iRVATOR ❑ Ol t wlR: ---I----- — - DAl ti OF DlH.tl TNI O"i'HFJL SIC,N ER (PRINC II PM,) IS Rt I RESGNI'INGi NAV11 0I 14.160M IOt! Il NIII y fS) RIQiIT California Professional Engineering, Inc, THUMBPRINT -- .._. _..... _....__ ...-. - OF SIGNER \J41'_'011 V01 VKt BUND) SI PI'l.W; AIMM 01 MNAI n'I IP %W W8 A.I I Y LII RRAX I'M 150] -�) .1 �ALt I IMI RRA IN I'KANCI CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT' A notary public or nfier officer completing this certificate verifies only the identity of the individual who signed the docurrient to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document, STATE OF CALIFORNIA County of T In �O a .. On April 29,2016 before me., Rob R Ka - . ....... .. rQe2........ ..... - ............ Notary Public, Uwe Inset NMI', of Notmy exndly oa It Aippears or Ujo riffklul "I personallyappeared , 70-D who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) iWare subscribed to the within instrument and acknowledged to me that helshelthey executed the same in his/hen'their authorized capacjty(les), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify Linder PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my han official seal Signa Race N,Amy Soal AbLvm Ro6y6 ------ - OPTIONAL '1 "hough the information below is not required by law, it may prove valuable to persons relying an the document and could prevent fraodulent removal and reattachment of the form to another document. Description of Attached Document Title or Type of Document: Document Date: . . .. ...... ...... . . ... . .................. Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Cialmed by SigoI Signer's Name: I Individual Ll Psitner 1--lUrnited (General F-1 Attorney in Fact [.-] I FL[SteO Lj Guardian or Conservator Oihor� Signer is ReII Signer's Name: 0 Individual E] Corporate Officer —Title($): El Partner 0 United E I General [I Attorney In Fact [] Trustne, E] Guardian or Conservator F7 Other Signer is Representing. Allied World Surety Division of Allied World Insurance Company 30 S 17' St., Suite 810 Philadelphia, PA 19103 POWER OP' ATTORNEY Issue Date: April 1, 2016 No. 32826-A1244 Single Transaction Lunit: $10,000,000 KNOW ALL MEN BY THESE PRESENTS: Allied World Insurance Company, a NewHampshire corporation (the'Company) doeshereby appoint NAME(s): James W. Mollanen Yung T. Mullick 'FIRM: The Bond Exchange & Insurance Agency 24800 Chrisanta Drive Suite 160 Mission Viejo, CA 92691 Its true and lawful Attomey(s)-in-Fact, with full authority to execute on its behalf bonds, undertakings, recognzances and other contracts of indemnity and writings obligatory in the nature thereof, issued in the course of its business, and to bind the Company thereby. This Power of Attorney shall remain In full force and effect for one year from the issued date above -referenced and shall expire on close of business of the first anniversary of such Issue Date. IN WITNESS WHEREOF, ALLIED WORLD INSURANCE COMPANY has caused these presents to be executed by the officer named below, Who is duly authorized and empowered to execute on the Company's behalf. This 1st day of April, 2016Commonvow-ALTROP, AIOIU ErdN�Yr vaHu NOTAAfAC SEAL ELI�isBE iHiC.6fELLt, NWS 9 pert c;.y�Pauta�fatl�.Pt,�a. t9Dn� h1y�,+5fiRlt5;wit Fr A D$l f, i0f8 Title: SeniorV[ce President -Surety State of Pennsylvania ) County of Philadelphia On this lst day of April,2016, before me came the above-named officer ofALLIED WORLD INSURANCE COMPANY, to me personally known to be the Individual and officer described herein, and acknowledged that he executed the foregoing instrument and affixed the seals Notary of said corporation thereto by authority of his office. - : My Commission Expires: 08/05/2018 CERTIFICATE Excerpt of Resolution adopted by the Board of Directors of the ALLIED WORLD INSURANCE COMPANY (the "Corporation', on December 31, 2012: RESOLVED, that the proper o8kere of the Corporator, the head of the surely business floe forme Corporation and thelrappointed designees (each an "Authorized Officer and collectively, the 'Authorized O(fll be, and each hereby is, Authorized to Appoint am or more AllomeyaminFarol to Fairmont act for and on behalf Arne Corporation in thetramacLbn of hat Cemparys emery business to execute (under the common seal of the Corporation, Ifappmpdate) bonds, undWatkings, naoagrlfeanoas and otherconiradsof Indemnity and writings obligatory in the nature thereof. RESOLVED, that in ceromfan wilh the CotporaWs Transection of surety business, the slgnalwes and atlesterons of the Authorized Officers and the seal of the Corporation may tie affixed to any such Power of Attorney or to any well to relating thereto by fa„ Imre, and any such Power of Attorney or certificate hearing such faulm7e signatures a facsimile seal shall be valid and binding upon the Corporation when so Affixed with reseectInanybend undertaking, recognizance orothercourmotofindemnity orwringobligatory In the nature thereof RESOLVED that In connection with the corporation's l ansacilon of surely business, the facsimte or medlankally mprodocad signature of any Authorized Officer whether made heretofore a hereafter; wherever appeanrg upon a copyof any Power of Morey of the Comoraibn,MITI 91matures affixed As next above noted, shall be valid and binding upon the Corpomina Win the same force and effect as though manually affixed. RESOLVED. [hat in coinrwllon with N Corrosions transaction of surety business; any such AlmoytoFastdetivedng a secretarial or other ceff atlon that the foregoing resoWibrsstill be in Affect may !marl in such certification the date thereof, said date to be not laky than the Ate ofdelivery thereof by won Ailaney-m-Fact. RESOLVED, that the Authorized Officer; be, and each hereby U, w homed to execute (under We common seal of the Corporation, if appropriate, make, file and deliver in the name and on behalf of the Corporation any and all consents, cerificates, agresmenls, amendments, supplements, Instruments and other documents whatsoever, and do any and all other things whatse ner in connection with the Coipmatbn'S Isnsacron of surely business, as such Authorized Officer shag in itis or her absolute discretion dorm or determine appropriate and my of the faegdng molul[or s, the transactions conlemptated thereby And any ar dllery matters thereto andla,tocarry out the purposes and intent thereof, such deeming ordetemrinak n to be condusivey evdernced by any such execution athe taking of any siichAction bysuch Authorized Offlosr.: - I, Timothy J. Curry, Secretary of the ALLIED WORLD INSURANCE COMPANY, do here by ccalfy that the foregoing excerpts of Resolution adopted bythe Bcerd of Directors of this corporation, and the Power of Attorney issued pursuant III Arctic, are true and correct, and that both the Resalunon and the Power of Atto may are in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile spat of the corporation; thlagday of 22a 20-. 111mothy-1. Curry, Secretary SUR 00046 00(3/2013) - Na, 3186-4 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE SAN FRANCISCO Amended Certificate of Authority THIS IS TO CH.RT ,Yr that, pursuant to tlae Insurance Code ofthe,Stade ofCeybrnla, Allied World Insurance Company ufNeW Flampshlrc, organized under the law s ofNaw Hampshire, subject to its Articles of Ineorporation or ot7zcmfundanacntal organizational documents, is hereby mathorized to transact within this,9tatc, subject to all provisions of this Cerflflcate, the following classes of insurance: Fire, Marine, Surety, Plate Claes, Liability, Workers' Compeneaiion, Common Carrier liability, Boller and Machinery, Burglary, Credit, Sprinkler, Team and Vehicle, Automobile, Aire raft, and Miscellaneous as such classes are now or mrry hereafter be defined in the Inswranee Laws trfthe State of California, #HIS CERTIFICATE is expressly conditioned upon the holder hereofnow andheregfa'er bong in full compliance with all and not in tookalion ofany, ofthe applicable laws and lmvful requirements made under authority of the irAl+s 01 the of Cal rornia as Fong as such laws or requirements are in effect grad applicable, and as such laws and requirements now m•e, or may hereafter be changed or amended, IN WITNESS WHLREOF, effective or ofthe 221' day ofbicly, 2013, !have hereunto set my hand and caused my official seal to be gfflxed this 22ad day oflBaty, 2013. Dave Jones l+vur<rvnm Cnm+nfsxtmmr BySuem J. Stapp i for NeWo Hoge ChiefDepeh• Nt1TTM Qualification with Is Secretary of State must be acuomplished as regniCcd by trio Calii'omia Corporadons Code promptly agar Issuance o£flais CcrriGcata oCAalhariry, Fmhue to do so will be a violation o£Utsnrauce Codesection 701 and Mllbegreunds for eevoleing this CertiCimnto of Authority pursuant to the covenauts made in the application therefor and the oordlitora coutuhied horeur, CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 o -r S'I'REEI" A'F ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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: '/2% 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 Ut PU License #/Exp. DIR Reg. #/Exp. Location Phone Type Of Work Amount $ Name 0'01noe 1)\9P('i LA14 License #/Exp. DIR Reg. #/Exp. (�UOI)jrj ie 15 (p�3} c?Jj(r License # Location �301iPS ¢Cic.VC1iRv1 f0 Phone ilr.L Utl-� I C Type Of Work OiZI� Amount $ D_ 0W _ Name License #/Exp, DIR Reg. #/Exp. License Location Phone Name )k( A JC�� License #/Exp. DIR Reg. #/Exp. Location Phone Type Of Work Amount $ Name License #/Exp.`lo]_ ?,QA DIR Reg. #/Exp. !()000001151T (p -W mo i License # Location A7_ Cl', 191810dMV Phone (p2tn1-i1 Type Of Work (l�yf SZ (�g73 CS Amount $ U1 . Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Type Of Work Amount $ Amount $ Signature of Bidder P-10 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 T11 STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLI 14TON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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, Please See Attached 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 Name and Address of owner. Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed v The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance and bonds. Please See Attached P-11 of P-40 929 Otterbein Ave., Unit E La Puente, CA 91748 Ph: (626) 810-1338 Fax: (626) 810-1322 www.cpengineering!nc.com uescrii Traffic Signal -Job References PROJECTS: Traffic Signal Improvements at Pasadena Ave & Walnut St Amount: $110,684.96 Owner: City of Pasadena Owner Address: 100 N. Garfield Ave Pasadena, CA 91109 Project Manager: John Ramey Contact Phone M (626) 744-6912 Fax #: (626) 396-7986 Status: Completed Approximate Start/End Dates: August 2015 -Jan 2016 of Supplies, Equipment, or Services Provided: Installation of Conduit, Pull Boxes, Loop Detectors and Bicycle Loop Detectors, Traffic Signal & Poles, Cabinet & Controller. Traffic Signal Modification Raitt Street at Adams Street Amount: $707,855.63 Owner: City of Santa Ana owner Address: 20 Civic Center Plata Santa Ana, CA 92701 Project Manager: Edward Torres Contact Phone #: (714) 647-5029 Fax #: (714) 647-5622. Status: Completed Approximate Start/End Dates: April 2015 -Aug 2015 Description of Supplies, Equipment, or Services Provided: Installation of Conduit, Pull Boxes, Communication Equipment, Loop Detectors, Fiber Optic, Cable, Preemption System, Cabinet & Controller, Access Ramps, and Striping & Markings. Lincoln Avenue and Westchester Drive Traffic Signal System Improvement Pro ect Amount: $227,460.00 Owner: City of Anaheim Page 1 of 2 Document Last Updated 41512016 Owner Address: 200 South Anaheim Blvd Anaheim, CA 92805 Project Manager: RobertPolaeologus Contact Phone #:714-765-5285 Status: Completed Approximate Start/End Dates: September 2014— November2014 Description of Supplies, Equipment, or Services Provided: Installation of Conduit, Pullboxes, Traffic Signal, Poles, illuminated Street Name Signs, HPS Luminaires, Loop Detectors, LED Countdowns, Cabinet & Controller, Access Ramps, Median Nose, Striping & Markings. Page 2 of 2 Document Last Updated 111512016 929 Otterbein Ave., Unit E La Puente, CA 91748 Ph: (626) 810-1338 Fax: (626) 810-1322 www.cpengineeringinc.com California Professional Engineering, Inc. We intend to procure all bands from: The Hanover Insurance Company Yung T. Mullick, Attorney -In -Fact 24800 Chrisanta Drive, Suite 160 Mission Viejo, CA 92691 949 -461 -7000 -office # 949 -461 -7725 -fax # ymtillick@thelioiid-exchange.com We intend to procure all auto liabiligl certificates from: We intend to procure all general/access li.abiliry certificates from: Grosslight Insurance, Inc. George Duran, Agent 9381 Haven Ave Rancho Cucamonga, CA 91730 909 -204 -3629 -office # 909 -204 -3679 -Pax # ReoreeLcb.grossligilt.com We intend to procure all workers' compensation certificates from: BBSI Magdalena Gilane, Agent 1950 Surtwest Lane, Suite 250 San Bernardino, CA 92408 909 -890 -0100 -office # 909 -890 -0120 -fax # magdalena.gilanc@bbsihq.com Page 1 of t Uocamem Lasl Updaled s. 24.15 . .w..,,, . .....,y: - .-.RK CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6334 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHQR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) A D TIIQ AL REFERL'M The following are the names, addresses, aird'tele,phone numbers for T R1tiX public agencies for which the BIDDEER ar Subcontractor has performed street improvem/ent�w_o/rk in the: pastJ5 years. 1 l 41A 7) J 1 f1^Q �I �i8,li l �1 J7 I �?rHC 1� 90;7_C-0 Name and Telephone Number of vers n f miller with project. snow e) o /Contract Amount Type of work 2. C�a� �•P,L,/an Nam and lddress ow o Name and Tel h ne Nt:mbar o,�f tp�e�rson familiar With project. Contract Amount Type of Work 3. S /2-0 LC_ Date Completed qora1 Date Completed ' zgol, t� oto Contract Amount Type of L Iork 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. P-12 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 171,11 STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) fn 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 er b�Shall aEso J,,istitute signature of this Non -collusion Affidavit. BIDDERS are cautioned that al iug a false c,p i„cation may subject the certifier to criminal prosecution. Signed State of California County of Los Angeles Subscribed and sworn to (or affirmed) before me on this day of , 20 , by proved to me on the basis of satisfactory evidence to be the persons) who appeared before me / * Notary Public Signature Notary Public Seal P-13 of P-40 JURAT State of California County of Los Angeles SS. me on this 4th day of may by Subscribed and sworn to (or affirri-red) before 2016 Van Nguyenproved to me on the basis of satisfactory evidence it to be the porson0a who appeared before me. DIEM C U N)Up # 2042313 NOTARr P68LIC CALIFORNIA L6sAGnEiC&JNTy MYCOMM UP Sir AR 3 GINATUfW SIGNATURI notary public or (other office completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached. and not the truthfulness. accuriov. or validity of that document. OPTIONAL INFORMATION The information'below is optional. However, it may prove valuable and could prevent fraudulent attachment (.)['this form to an unauthorized document. (,APACITY CLAIMED BY SIGNER (PRINCIPAL) DESCRIPTION ()FXrTACIIED DOCUMENT INDIVIDUAL CORPORATE OFFICER Manager TrILE OR TYPF, OF DOCUMFNT PARTNERS) ATFORNFI�Y-[N-FACF . ..... N1 11APER OF PAGES TRUSTEE(S) GUARDIAN/CONSERVNI'OR Ej DXFE OF DOCUMENT %BSFN'I'Sl(;NlSIZ(PRINCIPAl,) IS RI PRESENTING: RICHT NAME( 16014(S)OR Wnlyfli S1 THUMBPRINT California Professional Engineering, Inc. OF ------- SIGNER 4 4^-4`� +r 0 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) NON-DISCRIMINATION CERTIFICATE The undersigned contractor or corporate officer, during the performance of this contract, certifies as follows: 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 inay 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 1.1246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. P-14 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17"" STREET AT ENGLISI-I STREET, MACARTI-IUR BOULEVARD AT PLAZA DRIVE, E'DINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL, PROJECT NO: HSIPL 5063(156) 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, sept as provided in Section 1420, and any contractor of public works violating this Section is subj t to -tb"esna4 ' s z 4posed for a violation of the Chapter. Signed: Title: President Firin: California Professional Engineering, Inc. Date: 05/04/2016 P-15 of P-40 CITY OF SANTA ANA PROPOSAL PRO.IECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 1711 STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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 clays shall: 1. Apply to the joint apprenticeship committee administering the apprenticeship standards of the craft or trade in the area of the site of the public work for a certificate approving the contractor under the apprenticeship standards for the employment and training of apprentices in the area or industry affected. 2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards. 3. Contribute to the fund or funds in each craft or trade in which he/she employs journeymen or apprentices on the public work, in the same amount or upon the same basis and in the same manner as the other contractors, except contractors not signatory to the trust agreement shall pay a like amount to the California Apprenticeship Council, Signed: Title: Firm California Professional Engineering, Inc. Date: 05/04/2016 P-16 of P-40 CITY OF SANTA ANA PROPOSAL, PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17711 STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE" EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL. PROJECT NO: I-ISIPL 5063(156) STATEMENT REGARDING "ANT( -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 compeiisation to which he/she is otherwise entitled. Signed: Title: President Firm: California Professional Engineering, Inc. Date: 05/04/2016 P- 17 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17Tn STREET AT ENGLISH STREET, NIACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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 X If the answer is yes, explain the circumstances in the following space. P-18 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT" NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 1711' STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) BIDDER'S STATEMENT REGARDING REQUIRED FEDERAL. CONTRACT PROVISIONS (FORM FIWA-1273) The undersigned, is submitting this proposal fpr performing by contract the work required by these bid documents, agrees to comply with the required rederal Contract Provision (Form FHWA-1273) as shown in the appendix of the Special Ptr sio 'ns of thip Oroject. Signed Title President Firm California Professional Engineering, Inc. Date 05/04/2016 P-19 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: '17D1 S'T'REET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder_ California Professional—E.iagi.ne.ering Inc. , proposed subcontractor _ hereby certifies that he has X , has not ____, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 1 1 t 14, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal Opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts ar' subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO -1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (I) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by t,le; Federal Highway Administration or by the Director, Office of Federal Contract Corrintiance, U.S. Deva0ment of Labor. Signed Title President Firm California Professional Engineerinq, Inc. Date 05/04/2016 P-20 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL, MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: IISIPL 5063(156) PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Conti -act Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not 4been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section l 101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285. L Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier t criminal proserutign. Signed Title President Firm California Professional Engineering Inc. Date 05/04/2016 P-21 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6334 TRAFFIC SIGNAL MODIFICATIONS: 17"" STREET AT ENGLISH STREET. MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE ATCLINTON STREET FEDERAL PROJECT NO: HSIPL 5063056) PUBLIC CONTRACT CODE SECTION 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are Cautioned that making a false Certification may subject the certifier to criminal prosecution. / Signed Title President Firm ,California Professional Enaineerina Inc Date P-22 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17ru STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) TITLE 44. CODE OF ('EDERAL REGULATIONS PART 29 DEBARMENT AND SUSPENSION CERTIFICATION The bidder under penalty of perjury, certifies that except as noted below, he/she or any person associated therewith in the capacity of owner, partner, director, officer, manager: is not currently wider suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal agency within past three years; has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space Exceptions will not necessarily result in denial of award, but will be considered in determining bidders responsibility. For any exception noted above, indicate below to whom it applies, initialing agency, and dates of action. Note: Providing false information may result in Crim The above certification is part constitute signature of this Cei Signed Title President Firm California Professional Engineering, Inc. Date 05/04/2016 prose<:ution or administrative sanctions. this Proposal on the signature portion thereof shall also P-23 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) NON -LOBBYING CERTIFICATION FOR FEDERAL. AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influence or attempting to influence aft offieer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriate funds have been paid or will be paid to any person for influencing or attempting to influence au officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure of Lobbying Activities." in accordance with its instructions, This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into, Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, l'itte 31, U.S. Code. Any person who fails to file the required certification sliall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each Such failure. The prospective participant also agrees by sub hitting his or her bid or proposal that he or she shalt require that the language of t is certification b it (luded in all lower tier subcontracts, which exceed $1ia .00,000 and that all such su{-sec nt�s-shall• -,oegt�f and disclose accordingly. Signed Title Firm California Professional Engineering Inc. Date 05/04/2016 Standard Form LLL may be obtained frmn Caltrans and FHWA offices. P-24 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17"" STRET'T AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WES'T'MINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: IISIPL 5063(156) DISCLOSURE OF LOBBYING ACTIVITIES DISCLOSURE OF LOBBYING ACTIVITIES ,appeste011Ytnt6 Complete this Corm to disoloss lobbying activities pursuant tb 31 U.S.C. 1332 utd*-;i t5 ria a evn rry .,Nin i,.nMan eiicnLaenra r 1. Type of Federal Action: 2. Status of Fedora: Aogon: 3, Report Type: a. ormhaot ❑a. bidfotferFaPPlicatidn a, Initial Filing El b. grant h. Initial award b'. materiel change o. Cooperative- agreement o. post award For Material Change Only: d. loan year quader a. loan guarantee date of last report _ f. loan insurance d. Name and Address of Reporffng Entity: 5. IrReporiinU FntRy in No_ A is a Sobawar ¢, Enter Nam¢ © Paine ❑ suaawamaa and Address of Prime: Tmr_�. Bknaren: Con. ressional District.. ifkrrown: Can rtssional District.. known: S. Federal €YepartmentlAgeney: nescripfion; T. Federal Pr1,fqpp#—'1Nez CFDANumb 8. Federal Action Number, if known: 9. Award;�pdomnk. it knoxm: 5 99. a Home and Address of Lobbying Entity b.In' iduais Performing Services (inefvding address if (Windivktual. fast name. first neove. 0141),t "in hdo. ova) (fest narne. first name. Ml): arcaa, cm,- sSF4,UAuaracase3 11. Amount of Payment (ohcck all fhaf espfy): 13. Typo of Payment (chock all that apply):. 5 0aches Q rod ❑ a. retainer [] b. ars-firm tae ❑ c. carvnaaaur 12. Farm of Paymanl (check aN that a Y)' ['] a caeb [] a conlaagani tea b.lo-klnd; apaary:. nature 1_I a. counted value 01. other, apoclry: --- 14. Brief Description of Se 'cos P¢rtarmed or to be Performed and Date(s) of Service, including of fens), employeets), or Mem r(sI contacted, far Payment Indicated in Horn 11: aftamCanBntia//ar 8Ya5 s &FLtJ.A Xllat� 15. Cont{nuati n Sheet(s) SF-LLLA attached. I IYM No 16.fx5GW[kns.nw4w M da u rr.ac....... Signature: im res. . YWIYyNy «ear x . aYxxc rnrrrcYsnd d its Print Name:_ etC�YY, Yr n+Yr u ,eSt t1a Yliw a,xar.« s �ralW pe.uwc m 51 UStY 1iY2 'MY 7ftie: Pro Gj�nt _. NY" Wrrrn.Yrma. W,c�,hNr.Y.Y Ytl Mlb h2Ywb SJ Y:. 4y{x,a�Wne tiO,afln l., .,qut1�6M.a�Y.i +r ruv d�Y p.+Yy urrW Mw Y�Y roman nenN exn, n,n YI W.,Nb M Talephane No:: 6�6-8'�Q-,�i� Data:OE(1(,3-4t2DJE- l.ccai ReproN.rmd Federal Use Only:knl�aaaaaia 5(a!idartl Fdrn L t owy. 7� P-25 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) INSTRUCTIONS FOR COMPLETION OF SF -LL, DISCLOSURE OF LOBBYING ACTIVITIES IFYS4I$d1AGa1&7MS'FaM '. CCMdMPLEiBtTk#I'AYF &-I.LI.. [%1 'CIAb1.0.ftE OF HiO[fi INGAM'MIE'S 11. AinWdl& ma.aKaWVm+iRa PaM1ernl tn�RYl 9x1"�11�111d'�F,y1rM9%M`414Y[�"I6anmWY'11�IIk�1CmW+MLtl � b101NmR1r".:ntY%�mWa11.'gta.9CNW6�'3 F411CY�L'i9.ikr4 d'.: p'enl LIM dt=mdmwddCrs[sCFederd Maxim 3. 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Oei9 t!n 0.iMg(IMG. &iodic sErywn99. itteden fig-dtic enl�%bm d'1nlninldfdm IE 09dldkTkettlMp'wV9Pa�M!'e5P %INa695 per Ta9pdwa, Hddurlk9J'nlme.bwlbiealiylnednbnOMB. 59aRMrxj Cklsdg �msddices, �Lirenr'gari6 rn�nEdnnrgdi9d� P+'antatR.*wrd exargimd!xw: a7d rari1,9xAiva,m9i+iwrcdmrnmFdatr'.manda. �rNw pxnnarlei nsu�adl;Mw HLle bufdml.esn�Or styotlrrs aeP9d tirmM5 cdlLWYare dl Y1k9matwn.ticPrd�exjganmsTor m_r6a�g.Ws.nwdea;do tlr9 tNqo9cf Mdal69rrxaiEand &rNY14t=y+kPeewdK ITertrdlicn izreled 1d�'-Ua:'W`brLd�tl6w�4 P-26 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: I7Tll STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EXHIBIT t S -G CON91'11I1C"1'ION CONTRACT DBE CommITMIENT 1. Local Agency: City of Santa Ana 2, Contract DBE Goal: 6.63 Traffic Signal Modifications on: 17" St at English St, MacArthur Blvd at Plaza Dr, Edinger Ave at Sullivan, 3. Project Description: Westminster Ave at Clinton St 17" St at English St, MacArthur Blvd at Plaza Dr, Edinger Ave at Sullivan, Westminster Ave at Clinton St 4. Project Location: in the City of Santa Ana California Professional Engineering, Inc.7. Bid 2 --7 5. Bidder's Name: 6. PI !me Certified DBE: l/ Amount: �U� t r�� 8. Total Dollar Amount for ALL Subcontractors.ig (R%7417 50 9, Total Number of ALL Subcontractors: 10. Bid Item 11, Description of Work, Service, or Materials 12. DBE Certification 13. DBE Contact Information (Must be certified on the dale bids are 14, DBE Dollar Numbet(rrh Supplied Number opened) Amount 31,CLIA`{ 1615'rrltc6l�n r� "JI��-% Vyou Gi. � (�y"� . cAcdt � ✓6eQ.�I�! IriC / Local Agency to Complete this Soction $ 7? 21. Local Agency Contract Number: 15. TOTAL CLAIMED DBE PARTICIPATION _I^� 22. Federal -Aid Project Number: HSIPL 5063(156) !h' q 23. Bid Opening Date: 24. Contract Award Date: IMPORTANT: Identify all DBE firms being claimed for credit, regardless of tier, Names of the First Tier DBE T Subcontractors and their respective item(s) of work listed above must be consistent, where applicable with the names anditem f the work in he "Subcontractor List" submitted Local Agency certifies that all DBE certifications are valid and information on with your to ,Xti4tten firmation of each Ilsted DBE is this form is complete and accurate. requ 'ed 05/04/2010 25. Local Agency Representative's Signature 26. Date 16. pfepai Sig lure 16�2�a10-1338 Van Nguyen 27. Local Aqency Representative's Name 28. Phone 18. Preparer's Nat ie 19. Phone President 29. Local Agency Representative's Title 20, Preparer's Title DISTRIBUTION'. 1. Ongims - Lnaal Agency 2. Copy - Caltrans District Local Assistance Engineer ml-Ae. Failure to submit to DLAE within 30 days of contract execution may result In de -obligation of federal fund: on conlracl. Include addde al copy with award package. ADA Noticw Forwd,viduels with sensory disabilities, this document is available lnaitematelarmais. For information call (916)850.6410 or TDD(916)654-3660 orwite Records and Fomts Management 1120 N Street. MS69. Sacramento, CA 95ai4. P-27 d P-40 v15b CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 T STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) INSTRUCTIONS — CONSTRUCTION CONTRACT DBE COMMITMENT CONTRACTOR SECTION 1. Locnl Agency - Enter the name of the ]coal or regional agency that is funding the contract. 2. Contract DBE Goal - Enter the contract DBE goal percentage as it appears on the project advertisement. 3. Project Location - Enter the project location as it appears on the project advertisement, 4. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab, Overlay, Widening, etc). - 5. Bidder's Name - Enter the contractor's firm name. 6. Prime Certified DBE - Check box if prime contractor Is a certified DBE. 7. Bid Amount - Enter the total contract bid dollar amount for the prime contractor. 8. Total Dollar Amount for ALL Subcontractors —Enter the total dollar amount for all subcontracted contractors. SUM = (DBEs + all Non - DBEs). Do not include the prinne contractor information in this count. 9. Total number of AA L subcontractors — Enter tite total number of all subcontracted contractors, SUM = (DBEs+ all Non -DBEs). Do not include the prime contractor information in this count. 10. Bid Item Number - Enter bid item number for work, services, or materials supplied to be provided. 11. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials to be provided. Indicate all work to be performed by DBEs Including work performed by the prime contractor's own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by hire DBE. See LAW Chapter 9 to determine how to count the participation of DBE firms. 12. DBE Certification Number- Enter the DBE's Certification Identification Number, All DBEs must be certified on the date bids are opened. 13. DBE Contact information - Enter the name, address, and phone number of all DBE subcontracted contractors. Also, enter :he prime con'tractor's name and phone number, ifthe prime is n,DBE. 14. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service to be provided. Include the prime contractor if the prime is a DBE. See LAPM Chapter 9 for how to count full/partial participation. 15. Total Claimed DBE Participation - $: Enter the total dollar amounts entered in the "DBE Dollar Amount" column. %: Enter the total DDE participation claimed ("'Total Claimed DBE Participation Dollars" divided by iter "Bid Amotmt"). Ifthe total "/. claimed is less than item "Contract DBE Goal," an adequately documanted Good Faith Effort (GF,PJ is required (see Exhibit 15-H DBE Inibrmation - Good Faith Efforts of the LAPNI). - 16, Preparer's Signature - The person completing the DBE comntittnent'form on behalf of the contractor's firm must sign their name. 17. Date - Enter the date the DBE, commitment form is signed by the contractor's proparcr. 18. Preparer'.s Name - Enter the name ofthe person preparing and signing the contractor's DBE commionord form, 19. ,Phone - Enter the •urea code and pliers number ofthe person signing the contractor's DBE commitment form. 20, Preparer's Title - Enter the posiflon/title of the person signing the contractor's DBE eommitruent form, LOCAL AGENCY SECTIC)N 21. Local Agency Contract Number - Enter the Local Agency contract number or identiver. - 22. Federal -Aid Project Number - Enter the Federal -Aid ProjectNmnber. 23. ,Bid Opening Date - Enter the dote contract bids were opened. 24. Contract Award Date- Enter the date the contract was executed. 25, Local Agency Representative's Signature - The person completing this section of tlro form for the Local Agency must sign their came to certify that the information in this and the Contractor Section of this form is complete and aromatic. 26. Date - Enter the date the DBE commitment form is signed by the Local Agency Representative. 27. Local Agency Representative's Name - Enter the name of the Local Agency Representative certifying the contractor's DBE commitment form. 28. Phone -Enter the area code and phone comber of dw person signing the contractor's DBE commitment form. - - 29. Local Agency Representative Title -Enter the position/titlo of the Local Agency Representative certifying the contractor's DBE conuniament form, P-28 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL, MODIFICATIONS: 17rrr STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL. PROJECT NO: HSIPL 5063(156) EXHIBIT 15 -II DBE INFORMATION -GOOD FAITH EFFORTS DISE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. JAS 75 -cu lit°) Bid Opening Date 05/04/2016 The ! tMlrc( IM Cit. emrlL" ofl established a Disadvantaged Business Enterprise (DBE) goal of p�% for this proje he information provided herein shows that a good 'faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to docurnent adequate good 'faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE 'firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DISE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment- of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation' for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and elates of written notices sent to certified DBEs soliciting bids for this project and the elates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation WE ARE DBE P-29 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) C. The items of work which the bidder made available to DBE firms including, where appropriate, any Breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) Of (y/N) Contract WE ARE DBE D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a .DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: WE ARE DBE Names, addresses and phone numbers of firms selected for the work above: P-30 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 TI STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN S'T'REET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: WE ARE DBE F. Efforts made to assist interested. DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE, subcontractor purchases or leases from the prime contractor or its affiliate: WE ARE DBE G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc,): Name of Agency/Organization Method/Date of Contact Results WE ARE DBE lI. Any additional data to support a demonstration of good 'faith efforts (use additional sheets if necessary): WE ARE DBE NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. P-31 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 171" STREET AT ENGLISII STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET. WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (BBE AND NON -DBE) PAICI I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Nine/ Address/ City, Skate, Zll' phone! Fa` Annual Gross Receipts Description of Portion of Work to be Performer) Local Agency Use - ,Only (Certified DBE.) StanveA•u- Phone "ILPoO ❑<$1 million ❑<$5million _ <$IOmiifion �`>j� _ _-- �. __._ - OYBS. ❑NO: If YES lislDBE fl. 4drres•.c `-.) <$15 million million a,0rio A e of [tirnt NameO N4'k,' u' S-rp.CFQki fl Phone 'T U�' _ ❑ <$1 million l r �� _ __— ❑YES --- <$5 million _ -- -- FINO _ tddre.s -$IOmillion IflESlisIDBE?: Faxll L�3�1 3 ❑ <$15 million — Age of Firm (Yrs.) C"1N Slate Z 11 YlA-nl� e CTI ❑ > $15 million - Nanne ,t�@V�Ih1j' e Icnr �R t(l )11�C3 Phra_ 1 [�f <$1 million I(\1l _ ❑YES. <$Smillion j]NO ❑<$IOmillion ... �ytf- ❑a.m_l_oni _-.__- .....__ _/�YESJ ..sID7Fax7," ndC±ciir?t%i+�l.5SY`n�� ❑>$15million ._....--—.-_-- AgeofFirntYts.) Na/nrCCZ45�"hn PhoJv 1 (921 tr 3 ❑ < $1 million _ _...._,__ _-..N�__ _ ,1 �� __O?51G.,.. _ OYES $5 million Iiilion Nb . �Iddress <$IO If YESUs7DBE it: h�jlo F iY71p (plrty-( <$15 million _..,._._.__._..___.__._.._...__.._._.__..__-.__...._._.__. S' Z11,, Cr%)XlcreZlP>$15million ��S�17Ltr� C�' Age ofFirm (Yrs. P-32 of P-40 CITY OF SANTA ANA PROPOSAL, PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECTNO: HSIPL 5063(156) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) PART 11 The bidder shall list all subcontractors who provided a quote or hid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49, Section 26 of the Code of Federal Regulations. Photocopy this form for additional firms. firm Name/ Address/ City, State, ZIP PhOae/ Fix Annual Gross Receipts ___, Description of Portion of Work to be Performed Local Agency Use Only: (Certified DBE?) ,Vame(�1�>S Addtcss— ]]'hone GI51j P❑<$O ❑<$1million `,�.._.-I ---.._.._._.._. ❑YES ❑ <$5 million --- — ts1DBE 4: If YES _._ llion -----_—..-_--_NO I Di1Ufbg' City Stale ZIP C Em a <$15million =>S15 million Age ofFirm Yrs. _ — gWrote Y Prone _ 5tn�Fj �sE <$1 million <$S million t iQ N� — ...--- —..-- ----- ---- ---QNO ❑,YES - :.. ... ;Ic/cG-c.es million /YES ]tsfDBF. #: ptA <$15 million Ci1S1Ile ZIP 2,U A & ❑'$15 nvllroit Age of Pirie rs� _ 'Vane Phone ❑<$1 million ❑YES er $.5 million .---..._..._—_�/❑NO Acldress <$10milh0n yLESlist DBE s. Ectr I<$15 million ..__...._.__..__ _—..... -.._ 6ty.State ZIP > $15 million Name Phone ❑<$1 million ❑ <: $5 million _—._._. ..._— ❑NO _T_ IfIESlistDBER, _ fddre•ss e$10million F'ar <$15 million __-.—._. .__ Cilp Slcrte "LIP > $1.5 million P-33 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17ru STREET AT ENGLISIi STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EiDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) PROMPT PAYMENT OF FUNDS WITHHELD TO SUBCONTRACTORS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the following: The agency shall hold retainage from the prime contractor and shall make prompt and regular incremental acceptances of portions, as determined by the agency, of the contract work, and pay retainage to the prime contractor based on these acceptances. The prime contractor, or subcontractor, shall return all monies withheld in retention from a subcontractor within 30 days after receiving payment for work satisfactorily completed and accepted including incremental acceptances of portions of the contract work by the agency. Federal law (49CFR26.29) requires that any delay or postponement of payment over 30 days may take place only for good cause and with the agency's prior written approval. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall riot be construed to limit or impair any contractual, administrative, or judicial rented iiys otherwise available to the prime contractor or subcontractor in the event of a dis rte involving ate payment or nonpayment by the prime contractor, deficient subconua�t p%noncompliance by a subcontractor. Signed Title President Firm California Professional Engineering, Inc. Date 05/04/2016 P-34 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE, AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EXHIBIT 16-I3 -SUBCONTRACTING REQUEST Local Assistance Procedures Maim sit STATE OP CALIFORNIA - DEPART,M BN'T OF 111ANSPORTATION SUBCO;,N't RACI'ING RP:QUEST DC -CEM -1201 (RFV. 11/94) (OLD 1'IC-45) (AT 7541-35147 EXHIBIT I&B TRONT See Instructions On Back Page 14EQI-IEST NUMBER CON'1'R�Y.6'id1INA111afi Professional Engineering, Inc. Y. S1I �/C�yU^^}}CI��N,T�ffY ViK71'NYJ`� RcwTE "IN ES.S ADDRESS CONTRACT NO. 3 ,Z n -Ave tmr6- 2. CIU I`IN'T TE ZIP CODE 3. FEDERAL AID PROAI;C' NO, (Bran Spe ial LA 1 , vw f/� 4. 'Fold (lines 2+3),. . ........._.... .. ............... _... ............ .... Proxinions)(�j 5. Contractormust perform seithown forcesdines l minus4)x___ `Yo....._..__ ...... ..... ....._.___. 6. Bid ltentspreviously subcontiacwd......... .___..._.............._...,.,......_..................$ SUBCONTRACTOR BID ITENI %OF CHECK IF: DESCRDIEWORK S (,Name, Business Address, NUMBER($ BID (See Categories Below)(1) WHEN LESSTHAN 106h, OF WORK IS AMOUNT (LASED Phone) ITEM (2) (3) SUBBED ON u s —'IUK?�G14s'{ Pafhrd. 21 -II SUBBED -v%'✓ tIa`-a',tki, BIDS AMOUNT vAvif% B. L9Jf HoYnl!brestci blCtltRvitE (p I�✓6�.t A hHt;¢.fF R7{.�p Ukt" pion F• `° , to �t,t �-�i-aGs,a�i.�,� iuo v .. ctvlt� ,,u ylesSevwVi ti'4a3 DI++2 S -I Tazw'ntrfE� (e CIF ry_ t X37 Ic'v"ju ✓ t;Fxlu.tapslc, i5,5a1 d�a16tn�-pit4s Dr Ics o I+5, 356ox"Si- (,atioI1Svecialty 2) Listed Under Fair Practices Act 3)Certified DBE/MBF/WBEIDVBP. • "The Standard Provisions for labor set turth in the contract apply to the subconti aead. work. • lfapplirnblc, CI'ednral Aid Projects only) Section IA (federal Requirements} oi'thc Speoisl Provisions have been inserted in the subcontracts and shall be incorporated in any lower -ties subpgntraet. Written contracts hnve been executed for the above noted subcontractcd trurk. N O'f I camp ictcd b the Resident E'ngmeet Pcxtdeol 611d itconbe .... ........ ,. _....... ..,...., _..,..__. -r.1.11. ........ ." $,_ 2. Specialty items (Previously requested) ....__... ._._ _................ ..... .$_--___.__.__---_ 3. Specialty benls(this reque,a)., . .... ,.._...... . ..... _....,_.,. ._.. _-$ 4. 'Fold (lines 2+3),. . ........._.... .. ............... _... ............ .... _._...� 5. Contractormust perform seithown forcesdines l minus4)x___ `Yo....._..__ ...... ..... ....._.___. 6. Bid ltentspreviously subcontiacwd......... .___..._.............._...,.,......_..................$ 7. Bid iteloS SIAbla looicted t this request)... __. ..... ...........___.........-.,...,......... _. S. 'fotal(lilies 6+7)....... .,....__.__ - ...... _..,..... ._..,......$__. 9. Balance ofworkC'ontractor to perionn(lilies l minus 8).....,.._ ... ........... _...._...5 3.(,1- Inwlals, tabor COInoll91N Oama J Co1111Xor s lnl6,mnaeu t -Py Pebnu, 1• PAS 11-35 of P-40 Paye 1651 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 FEDERAL PROJECT NO: HSIPL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET EXHIBIT 16-B Local Assistance Procedures Manual Subcontracting Request INSTRUCTIONS FOR COMPLETING SUBCONTRACTING REQUEST FORM All First-tier subcontractors must be included on a subcontracting request. Submit in accordance with Section 8-1.01 of the Caltrans Standard Specifications, Type or print requested information. Information copy is to be retained by the contractor. Submit other copies to project's Resident Engineer. After approval, the original will be returned to the contractor. When an entire item is subcontracted, the value to be shown is the contractor's bid price. When a portion of an hem is subcontracted, describe the portion., and show the % of bid item and value. THIS FORM IS NOT TO BE USED FOR SUBSTITUTIONS. Prior to submittal of Form CEM; 1201 involving a replacement Subcontractor, submit a separate written request for approval to substitute a listed subcontractor. Section 4107 of the Government Code covers the conditions for substitution. Submit a separate written request for approval of any DBE/MBE/WBE/DVBE substitution. Include appropriate backup information and state what efforts were made to accomplish the same dollar value of work by other certified DBE/MBL/WBC/D'VB[ s. NOTE: For contractors who will be performing work on railroad property, it is necessary for the contractor to complete and submit the Certificate of Insurance (State Form DH -OS -A 10A) naining the subcontractor as insured. No world shall be allowed{ which involves encroachment on railroad property until the specified insurance has been approved. Page 16-52 October 5, 2012 LPP 12 P-36 of P-40 Back CITY OF SANTA ANA PROPOSAL PROJECT NO,: 15-6834 FEDERAL PROJECT" NO: HS1PL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17"'n STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET DIFFERING SITE CONDITIONS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the following: it. Contractor's Noiffication Promptly notify the Agency's Engineer if you find either of the following conditions: 1. Physical conditions differing materially from either of tile following: • Contract documents • Job site examination 2. Physical conditions of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent in the work provided for in the Contract Include details explaining the information you relied on and the material differences you discovered. If you fail to promptly notify the Engineer, you waive the differing site condition claim for the period between your discovery of tine differing site condition and your notification to the Engineer. If you disturb the site after discovery and before the Engineer's investigation, you waive the differing site condition claim. h. Engineer's Investigation and Decision Upon your notification, the Engineer investigates job site conditions and: 1. Notifies you whether to resume affected work 2. Decides whether the condition differs materially and is cause for an adjustment Of tioleApayh%Qt, or Signed Title President Date 05/04/2016 P-37 of P-40 CITY Or SANTA ANA PROPOSAL PROJECT NO.: 15-6834 FEDERAL., PROJECT NO: HSIPL 5063(156) TRAFFIC SIGNAL. MODIFICATIONS: 17In STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE. AT CLINTON STREET BIDDER'S CERTIFICATE OF COMPL,IANCE-., REGARDING "BUY AMERICA" REQUIREMENTS FOR STEEL OR MANUFACTURED PRODUCT'S The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the " Buy America" requirements of Section 165 of the Surface Transportation Assistance - et of 1982 and s shown in the special provisions of this project. � I�2 Signed Title President Firm California Professional Engineering, Inc. Date 05/0412016 P-38 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO,: I5-6834 FEDERAL PROJECT NO: HSIPL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17"" STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE. AT SULLIVAN STREET, WESTMINSTER AVENUE AT CUNTON STREET NEPA COMPLIANCE FOR FEDERAL AID CONTRACTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the Categorical Exemption/Categorical Exclusion Determination Form including and not limited to the NationalEnvironmental Policy Act (NEPA) requirenei is and environmental eotJ �rni'ti ents founcdintie pendix of the Contract Documents of this project. �j�� Signed Title Firm California Professional Engineering, Inc. 05/04/2016 Date P-39 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 FEDERAL PRO.IECTNO: HSIPL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17"" STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE. EDINGER AVENUE AT SULLIVAN S'T'REET, WESTMINSTER AVENUE AT CLINTON STREET TMP COMPLIANCE FOR FEDERAL AID CONTRACTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply ith the Traffic Ma agement Plan (TMP) commitments found in the appendix of the Contra(* D4&��s of thisjprect. Signed Title President 9 Finn California Professional Engineering,lnc. Date 05/04/2016 P-40 of P-40 I d E 0 L L x o c � Q N 14N a Co L14 � Leo -Q ro m C-3 ML C13C14 E�- c CPO v L3 ro L3 C 1 cc My Q9 tj m + C3 - ra >/ C/3 ia r L v s � V3 3 W d M CM C3LIS M � C M Q Z C003 V v 1:M o m L L 0 Z CITY OF SANTA ANA Exhibit 3 CONSTRUCTION CONTRACT PROJECT NO. 1S-6834 TRAFFIC SIGNAL MODIFICATIONS AT 17TH ST. AT ENGLISH ST., MACRTHUR BLVD. AT PLAZA DR., EDINGER AVE. AT SULLIVAN ST., AND WESTMINSTER AVE. AT CLINTON ST. This CONSTRUCTION CONTRACT is made and entered into this 201h day of September, 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 California Professional 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 Traffic Signal Modifications at 17th St. at English St., MacArthur Blvd. at Plaza Dr., Edinger Ave. at Sullivan St., and Westminster Ave. at Clinton St. 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 • Technical Provisions and 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 $872,755 — Eight Hundred Seventy-two Thousand Seven Hundred Fifty-five Dollars and no cents , as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A." Page 1 of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT NO. 15-6834 TRAFFIC SIGNAL MODIFICATIONS AT 17TH ST. AT ENGLISH ST., MACRTHUR BLVD. AT PLAZA DR., EDINGER AVE. AT SULLIVAN ST., AND WESTMINSTER AVE. AT CLINTON ST. 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. 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. 6. CONTRACTOR shall, after award of this Contract, famish 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 fiunished (Payment Bond). This Contract shall not become effective until such bonds are supplied to and approved by the CITY. 7. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond (Warranty Bond). Said Warranty Bond shall also be required as a condition of project acceptance. For projects up to $500,000, the Warranty Bond amount shall be the greater of $10,000 or 20% of the final contract price. For projects above $500,000, the Warranty Bond amount shall be the greater of $100,000 or 10% of the final contract price. S. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the CITY. Page 2 of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT NO. 15-6834 TRAFFIC SIGNAL MODIFICATIONS AT 17TH ST. AT ENGLISH ST., MACRTHUR BLVD. AT PLAZA DR., EDINGER AVE. AT SULLIVAN ST., AND WESTMINSTER AVE. AT CLINTON ST. IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written. ATTEST: MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney B os Sandoval ief Assistant City Attorney CITY OF SANTA ANA: DAVID CAVAZOS City Manager RECOMMENDED FOR APPROVAL: Fred Mousavipour Executive Director, Public Works Agency CONTRACTOR: mm Page 3 of 3 CITY OF SANTA ANA Exhibit PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17""' STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE„ EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL, PROJECT NO: HSIPL 5063(156) BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: California Professional Engineering, Inc. REQUIREMENT: The undersigned bidder declares that they have carefully examined tlae 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 ht 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 Deseription Qty Unit Unit Price Amount I Traffic Signal Modification on I7" St at 1 LS $ English St }i kCt G?o 2 Traffic Signal Modification on MacArthur 'I LS Blvd at Plaza Dr 3 Traffic Signal Modification on Edinger 1 LS $ VtJ $ -_.-4 Ave atSullivan st j�r �I(} _ ..Traffic Signal Modification on---� i--LS$cv.�^ $ Westminster Ave at Clinton St rfJ6"� 13C)i 5 Temporary Overhead Wiring of Traffic Signals, Including Communications 4W FA A U 1(' oo tct( 6 ATSSA Certified Plaggers During Traffic Signal Shutdown Periods I LS $ /ow $ �� t )L3 7 GTT Optician Emergency Vehicle Preemption System at Westminister rive- I LS $ � Q $ (� wo � r and Clinton St ff..i'? �8 GTT Opticorn Emergency Vehicle Preemption System at MacArfhnr Blvd andI 1 LS $ C $ � ow Plaza Dr I 9 Install 2"'PVC Conduit Per Pian * 635 LF $ $ 10 Install 3" PVC Conduit Per Plan * -------------- 1,180 LF $ $ P -I of P-40 CITY OF SANTA ANA Exhibit A PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17T" STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: H'S1PI, 5063(156) Item Description Qty Unit Unit Price Amount I I Install 4" PVC Conduit. Per Plan *� 1,155 �LF S ,.- AFD $ 12 Install No. 6 Pull Box * 20 EA $ II0��O $ 9..)I .c 13 Install Traffic stated No. 6 Pull Box 3 EA $ $ 14 Install Large Pull BoxPer Plans 3 EA $ �'y� 1.h-) $ 15 Install Traffic Signal Loop Detector (Type 63 EA $ $ E hoop) (� �+ t 16 Install Bicycle Loop Detector (Type D Circular Loop) 40 EA , („,,Ii' { - 17 Install IP Communication System for 17th St. at English "at I LS S (3 { p \ $ q 13 Install 11'Communication System for MacArthur Blvd at Plaza Dr I LS $ q f , m S a4 19 Install IP Communication System for Edinger Ave at Sullivan St I LS $ toyul $ ow ) —20 istall IP hCommunication System for Westminster Ave at Clinton St 1 LS $ iI ow $ Mi 21 lnsta1124 Strand Singlentode Fiber Optic Cable* 5,570 LF $ ye $ ' 1 f(') 22 Install Fiber Optic Splice Enclosure I EA $ q -r,-,0 $ ) 23 Fusion Splice l Strand of Singlemode Fiber Optic 204 EA $ t $ t j t I 24 Construct4” PCC Sidewalk* 47 SF $ $ �� i 25 Construct PCC Curb Ramp * 2,630 SF $ 26 Signing land Striping at Edinger Ave at Sullivan St 1 I LS 11 $ 11 $ CW P-2 of P-40 CITY OF SANTA. ANA Exhibit A PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17i" STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) Item Description Qty Unit Unit Price Amount 27 Pothole for Utilities Not Shown on Plans * l0 EA $ $ 28 Pothole for Traffic Signal Equipment . UtilityConflict 27 EA $ �1 $ J 7 29 AC Pavement * 105 TN $ 30 Unclassified Excavation * 115 CY $ I i $ 1c 1 L( P -6 - TOTAL BASE BID $ i"Ir.— F) 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 'stem 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. r This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications. P-3 of P-40 CITY OF SANTA ANA Exhibit A PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 ru STREET A'T" ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(1.56) TIME FOR COMPLETION OF IMPROVEMENTS A'ND LTOUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within one hundred and after the commencement date stated in the Notice to Proceed. The bidder also proposes to commence construction of the Work within ten (l0�work days after issuance of a Notice to Proceed, and to continue in a diligent and workman -like manner without interruption, and to complete the construction thereof within the time specified above. The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be $1,000 per calendar day. ff j Name of Firm California Rrofessional• ngirring, Inc. Signature of BIDDER Title President, Secretary, and Treasurer (if an individual, so state. If a firm or co-partnersjtip, 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-4 of P-40 COST ANALYSIS CONSTRUCTION OF THE PROJECT NO. 15-6834: TRAFFIC SIGNAL MODIFICATIONS AT FOUR LOCATIONS Construction Contract $ 872,755.00 Contract Administration $ 49,270.00 Inspection and Testing $ 81,640.00 Contingencies $ 87,280.00 TOTAL ESTIMATED CONSTRUCTION COSTS $ 1,090,945.00 EXHIBIT 4 REQUEST FOR APPROPRIATION ADJUSTMENT Appropriation Adjustment No: 2010- 0A Date: September 20, 2016 Department: Public Works TYPE OF ADJUSTMENT Transfer of Funds (No Council Action Required) Transfer of Funds (Council Action Required) Council Action Date SEF 2 0 20160 aof) Approved: Yes F-1 No Clerk of the Council From: FEDERAL AID SAFETY PROGRAM to FEDERAL AID SAFETY PROGRANr Accounting Unit - Account # - Description Amount Accounting Unit - Account # - Description Amount 14717002 52001 Federal Gant-Indimot 104,456 14717611 66220 bnprovem is btlia'Phan Building 104,456 'fond 104,456 'total 104,456 JUSTIFICATION FOR REQUEST: Receipt of Federal Highway Safety and Improvement Program grant funds- from the California Department of Transportation for Proiect 15-6834. RFCA Dated 09/20/16. Department ad Accounting APPROVED A. " FUNDS ANU ACCOUN'1"S. Al'OV,EE �c h. Assistant Direeicx Finance Date City Manager Date PRIEPARATION. V Submit original with department head signature to Finance/Accounting M-17, and a control number will be assigned. Upon approval from the Assistant Director of Finance and the City Manager, a photocopy of the signed original will be forwarded to the department THE REGISTER This space for filing stamp 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: Traffic Signal Modifications at 4 Intersections 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: 04/13/2016, 04/20/2016 Executed on: 04/20/2016 At SANTA ANA ,CA I certify (or declare) under penalty of perjury that the foregoing is true and correct. w Y Signat re III III II II II III I I II I I II III I I III * A 0 0 0 0 0 4 0 6 3 7 5 1 CNS#: 2867077 CITY MANAGER David Cavazos CITYATTORNEY Sonia R, Carvalho CLERK OF THE COUNCIL Marla D. Huizar FILED MAR 1 1 20% ORANGE COUNTY CLERK-RECOROER DEPARTMENT eY; DEPUTY NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK County of Orange P,0, Box 238 Santa Ana, CA 92702 Project Title: Edinger Avenue at Sullivan Str Project Number(s): PWA -2014 -260 -CITY Project Location: 1 CityWide(Partial) From: City of Santa Ana Planning & Building Agency 20 Civic Center Plaza M-20 Santa Ana, CA 92702 Date of Approval: 07/15/2013 City: Santa Ana County: Orange ER Number: ER -2014-16 Project Description: The construction will install new traffic signal poles, foundations, conduits, detection, minor concrete work - on the sidewalk and minor signal cabinet work. TED Applicant Name: City of Santa Ana Applicant Address: 20 Civic Center Plaza M-43 SANTA ANA, CA 92702 Name of Public Agency Approving Project; City Council Name of Person or Agency Carrying Out Project: Kekula, Zdenek 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: 0 Categorical Exemption: 15301(b) Reason(s) Why Project is Exempt From CEQA: 15301(b) consists of repair/maintenance of exisitng public facilities. MAR 1 9 2094 HUGH NGUYEN, CLERK -RECORDER DEPUTY Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder IIIIIIII�IIilllllllllilllllllllllllllllllllllllllllllllllllllllllllllllillll NO FEE * $ R 0 0 0 6 5 5 7 2 5 6$ 201455000210 3:43 pm 03/11/14 281 OR02 Z01 0.00 50.00 0.00 0.00 0.00 0.00 0.00 0.00 City Contact: Zdenek Kekula Telephone: (714) 647-5606 Signature: '1%7Annao VL YLILL Title: CT . Pit n4 C 1 t f_ F7Y.I Date: SANTA ANA CITY COUNCI L Girl Miguel A. Palido $al Tinajero Vincent F. Sarmiento Michele Martinez An9ellca Amezcua P. David Bonavides Roman Rayne Mayor Mayor Pro Tom, Ward 6 Ward 1 Ward 2 Ward 3 Ward A Ward 5 MPulidorrosanla-ana.org 611nelermcxanla-ana.om VSarmientmd..ma-ane oro MMauine¢folsantaana ora Mmazceat&sanla-ane ory DB tl A 1 - RRevna(o sante-ane aro MAYOF Migue, Pulido+ MAYOR PRO TEM Sal Tinajero COUNCILMEMBERS - Angelica Amezcua P. David Benevides Michele Martinez Roman A. Rayne Vincent F. Sarmlento CITY OF SANTAANA PLANNING & BUILDING AGENCY 20 Civic Canter Plaza (M-20) P.O. BOX 1988. Santa Ana, California 92702 (714) 667-2700 • Fax (714) 073-1461 www.eanta-ana.org CITY MANAGER David Cavazos CITYATTORNEY Sonia R, Carvalho CLERK OF THE COUNCIL Marla D. Huizar FILED MAR 1 1 20% ORANGE COUNTY CLERK-RECOROER DEPARTMENT eY; DEPUTY NOTICE OF EXEMPTION From the Requirements of the California Environmental Quality Act (CEQA) Fee Exemption per California Government Code Section 6103 To: COUNTY CLERK County of Orange P,0, Box 238 Santa Ana, CA 92702 Project Title: Edinger Avenue at Sullivan Str Project Number(s): PWA -2014 -260 -CITY Project Location: 1 CityWide(Partial) From: City of Santa Ana Planning & Building Agency 20 Civic Center Plaza M-20 Santa Ana, CA 92702 Date of Approval: 07/15/2013 City: Santa Ana County: Orange ER Number: ER -2014-16 Project Description: The construction will install new traffic signal poles, foundations, conduits, detection, minor concrete work - on the sidewalk and minor signal cabinet work. TED Applicant Name: City of Santa Ana Applicant Address: 20 Civic Center Plaza M-43 SANTA ANA, CA 92702 Name of Public Agency Approving Project; City Council Name of Person or Agency Carrying Out Project: Kekula, Zdenek 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: 0 Categorical Exemption: 15301(b) Reason(s) Why Project is Exempt From CEQA: 15301(b) consists of repair/maintenance of exisitng public facilities. MAR 1 9 2094 HUGH NGUYEN, CLERK -RECORDER DEPUTY Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder IIIIIIII�IIilllllllllilllllllllllllllllllllllllllllllllllllllllllllllllillll NO FEE * $ R 0 0 0 6 5 5 7 2 5 6$ 201455000210 3:43 pm 03/11/14 281 OR02 Z01 0.00 50.00 0.00 0.00 0.00 0.00 0.00 0.00 City Contact: Zdenek Kekula Telephone: (714) 647-5606 Signature: '1%7Annao VL YLILL Title: CT . Pit n4 C 1 t f_ F7Y.I Date: SANTA ANA CITY COUNCI L Girl Miguel A. Palido $al Tinajero Vincent F. Sarmiento Michele Martinez An9ellca Amezcua P. David Bonavides Roman Rayne Mayor Mayor Pro Tom, Ward 6 Ward 1 Ward 2 Ward 3 Ward A Ward 5 MPulidorrosanla-ana.org 611nelermcxanla-ana.om VSarmientmd..ma-ane oro MMauine¢folsantaana ora Mmazceat&sanla-ane ory DB tl A 1 - RRevna(o sante-ane aro MAYOR,,, Miguel A. Pulido MAYOR PRO TEM -Sal Tlrrajero COUNCIL MEMBERS --s Angelico Amezcua- R David Benavides Michele Martinez Roman A. Reyna Vincent F. Sarmiento 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 www.santa-ana.org NOTICE OF EXEMPTION CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Humor I i i ORANGE COUNTY C ORDER DEPARTMENT BY; DEPUTY From the Requirements of the California Environmental Quality Act (CEQA) To: COUNTY CLERK From: City of Santa Ana County of Orange Planning & Building Agency P.O. Box 238 20 Civic Center Plaza M-20 Santa Ana, CA 92702 Santa Ana, CA 92702 Project Title: MacAthur Boulevard at Plaza Dr Date of Approval: 07/15/2013 Project Number(s): PWA -2014 -263 -CITY Project Location: 1 CityWide (Partial) City: Santa Ana County: Orange ER Number: ER -2014-18 Project Description: The construction will install new traffic signal poles, foundations, conduits, detection, minor concrete work on the sidewalk and minor signal cabinet work. "i ' 1 R d O e Count Applicant Name: City of Santa Ana Applicant Address: 20 Civic Center Plaza M-43 SANTA ANA, CA 92702 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Kekula, Zdenek 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: [a Categorical Exemption: 15301(b) Reason(s) Why Project is Exempt From CEQA: 15301(b) consists of repair/maintenance of existing public facilities. City Contact: Zdenek Kekula Recorded 1n O taa ecor s, rang y Hrll►h I lull II II Irl I I IorIIIFIi II II II NO FEE *$ R 0 0 0 6 5 5 7 2 4 4$ 201485000209 3:41 pm 03/11/14 214 304 Z01 0.00 50.00 0.00 0.00 0.00 0.o0 0.00 0.00 ,a l ORANGE COUNTY CLERRKEC DER DEPARTMENT BY: --DEPUTY Telephone: (714) 647-5606 Signature:"2AN19-- Title: AC'.,rz,rsJkwlLQJG Date: 7�I5(ILi SANTA ANA CITY COUNCIL Miguel A. Puldo Sal Tlnajero Vincent F. Sarmiento - Michele Martinez Angelica Amezrua P. David Benavides Roman Reyna Mayor Mayor Pro Tem, Ward e Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 MPulidofiDsantaana ro g STinalLnsanta-ana org VSarm'e igga anta-ana orq MMarlinezColsanta-ana org [j,4mezcueCcDsanta-ena.org Deenavid� ana s nt - na oro MAYOR Miguel A. Pulido MAYOR PRO TEM Sal rinalem COUNCIL MEMBERS Angelica Amezcua P. David Benevides Michele Martinez Roman A. Reyna Vincent F, Sarmiento 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 www.santa-ana.org NOTICE OF EXEMPTION CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Huizar T ED ORANGE COUNTY CLERK -RECORDER DEPARTMENT BY: DEPUTY 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: Westminster Avenue at Clinton Date of Approval: 07/15/2013 Project Number(s): PWA -2014 -264 -CITY Project Location: 1 CityWide (Partial) City: Santa Ana County: Orange ER Number: ER -2014-19 Project Description: The construction will install new traffic signal poles, foundations, conduits, detection, minor concrete work on the sidewalk and minor signal cabinet work. Applicant Name: City of Santa Ana Applicant Address: 20 Civic Center Plaza M-43 SANTA ANA, CA 92702 Name of Public Agency Approving Project: City Council Name of Person or Agency Carrying Out Project: Kekula, Zdenek 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: R1 Categorical Exemption: 15301(b) Reasons) Why Project is Exempt From CEQA: 15301(b) consists of repair/maintenance of existing public facilities. City Contact: Zdenek Kekula Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder II I I II II II II I I I I III I III I II NO FEE *$ R 0 0 0 6 5 5 7 2 0 8$ 201485000207 3:35 prn 03/11/14 214 304 Z01 0.00 60.00 0.00 0.00 0.00 0.00 0.00 0.00 MAR 1 1 201 ORANGE' COUNTY CLERK -RECORDER DEPARTMENT BY:, _ t7l--- DEPUTY Telephone: (714) 647-5606 Signature: Title: Act - i'z tyk - i' Iv l t C N6 Date: Is 1111 SANTA ANA CITY COUNCIL Miguel A. Pulido Sal Tinajero Vincent F. Sarmiento Michele Martinez Angelica Amezcua P. David Benavides Roman Reyna Mayor Mayor Pro Tem, Ward 6 Ward 1 Ward 2 Ward 3 Ward 4 Ward 5 MPulide@Santa-ana org Sn alergCa Santa-ana ora MMartRzzAspjs -aa na org,AAmezcua rf�i Santa-ana ora pBenavides@sanfa- na ora Rte. a a sant--ana ory MAYOR CITY MANAGER Miguel A, Pulido P.O. BOX 1988. Santa Ana, California 82702 David Cavazos MAYOR PRO TEM ORANGE COUNTY CL�RUQRDEPARTMENT CITYATTORNEY Sal Tlnajaro NOTICE OF EXEMPTION Sonia R. Carvalho COUNCIL MEMBERS CLERK OF THE COUNCIL AnBellca Amezcua Marla D. Hulzar P. David Benavldes Michele Martinez Roman A. Reyna - q Vincent F, Sarmiento CITY OF SANTAANA 1p1� 9 PLANNING & BUILDING AGENCY 20 Civic Center Plaza (M-20) j ��� ���' P.O. BOX 1988. Santa Ana, California 82702 (714) 66727000 - Fax973-1461 ORANGE COUNTY CL�RUQRDEPARTMENT NOTICE OF EXEMPTION BY'�"V_--DEPUTY From the Requirements of the California Environmental Quality Act (CEQA) To: COUNTY CLERK County of Orange P.O. Box 238 Santa Ana, CA 92702 Project Title: 17th Street at English Street Project Numbeds): PWA -2014 -261 -CITY Project Location: 1 Citywide (Partial) City: Santa Ana Project Description: Applicant Name: Applicant Address: From: City of Santa Ana Planning & Building Agency 20 Civic Center Plaza M.20 Santa Ana, CA 92702 Date of Approval: 07/15/2013 County; Orange ER Number: ER -2014-17 The construction will install new traffic signal poles, foundations, conduits, detection, m® on r°w�r'k on the sidewalk and minor signal cabinet work. 8 O& TED of Santa Ana 20 Civic Center Plaza M-43 SANTA ANA, CA 92702 Name of Public Agency Approving Project: Name of Person or Agency Carrying Out Project: Exempt Status: ❑ Ministerial (Sec. 15268) ❑ Declared Emergency (Sec. 15269 (a)) ❑ Emergency Project (Sec. 15269 (b through e)) ❑ General Rule (Sec. 15061(b)(3)/(5)) City Council Kekula, Zdenek ❑ Statutory Exemption: El Categorical Exemption; 15301(b) Reason(s) Why Project is Exempt From CEQA: 15301(b) consists of repair/maintenance of existing public facilities. City Contact: Zdenek Kekula r ut HUGH NGUYEN, C ,7K -RECORDER eY:DEPUTY Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder II l l II !� II �� I I I I III Ilillll li NO FEE *$ R 0 0 0 6 5 5 7 2 2 2$ 201485000208 3:37 pm 03/11/14 281 OR02 Z01 0.00 50.00 0.00 0.00 0.00 0.00 0.00 0.00 ,��^77 p Telephone: (714) 647-5606 Signature: ` C. r'.tLOlYC2 �C��_ Title: n -r' 1 (d- Ir.1X Iv t t_. e N6 Date: � `� ) LI SANTA ANA CITY COUNCIL M iguel A. Pulido Sal'rinajero Vincent F. Sarmiento Michele Martinez Angelica Amezcua P David Benavdes Rcman Rayne Meyer Mayor Pro Tem, Ward 6 Ward t Ward 2 Ward 3 Ward 4 We'd 5 MPulidoRJsanta-ena.ora STnalerofiilsanta-one oro VSarmienlc@sanla-ana orq MMarllnez(o)senla-ana.oro Mgmezcua(alsanka-one oro DB id Gil 1- RRne(�sanla-anad, i 2 8 2016 CITY OF SANTA ANA CONSTRUCTION CONTRACT Exhibit 3 PROJECT NO. 15-6834 TRAFFIC SIGNAL MODIFICATIONS AT 17TH ST. AT ENGLISH ST., MACRTHUR BLVD. AT PLAZA DR., EDINGER AVE. AT SULLIVAN ST., AND WESTMINSTER AVE. AT CLINTON ST. This CONSTRUCTION CONTRACT is made and entered into this 20`' day of September, 2016 , by and between the CITY OF SANTA ANA, CALIFORNIA, a charter city and Municipal corporation organized and existing ander the Constitution and laws of the State of California, hereinafter referred to as "CITY" and California Professional 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 Traffic Signal Modifications at 17t" St. at English St.. MacArthur Blvd. at Plaza Dr.. Edineer Ave. at Sullivan St.. and Westminster Ave, at Clinton St. 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 Band • Contract Form • Contract Bonds • General Provisions • Special Provisions • Technical Provisions and 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. 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 $872,755 — Eight Hundred Seventy-two Thousand Seven Hundred Fifty-five Dollars and no cents , as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A." Page I of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT NO. 15-6834 TRAFFIC SIGNAL MODIFICATIONS AT 17TH ST. AT ENGLISH ST., MACRTHUR BLVD. AT PLAZA DR., EDINGER AVE. AT SULLIVAN ST., AND WESTMINSTER AVE. AT CLINTON ST. The BID PROPOSAL contains a schedule of unit price(s) or lump surn(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. 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. 6. CONTRACTOR shall, after award of this Contract, furnish two bonds to be approved by the CITY, one in the amount of One Himmdred Percent (100%) of the Contract price, to guarantee the faithful performance of the work (Performance Bond), and one in the amoimt 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. 7. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond (Warranty Bond). Said Warranty Bond shall also be required as a condition of project acceptance. For projects up to $500,000, the Warranty Bond amount shall be the greater of $10,000 or 20% of the final contract price. For projects above $500,000, the Warranty Bond amount shall be the greater of $100,000 or 10% of the final contract price. 8. 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. Page 2 of 3 CITY OF SANTA ANA CONSTRUCTION CONTRACT PROJECT NO. 15-6834 TRAFFIC SIGNAL MODIFICATIONS AT 17T" ST. AT ENGLISH ST., MACRTHUR BLVD, AT PLAZA DR., EDINGER AVE. AT SULLIVAN ST., AND WESTMINSTER AVE. AT CLINTON ST. IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written. ATTEST: fJ MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney E os Sandoval l ief Assistant City Attorney CITY OF SANTA ANA: DAV CAVAZOS City Manager RECOMMENDED FOR APPROVAL: i Wed M usavip ur Executive Director, Public Works Agency CO NTR ACT`()R Page 3 of 3 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: California Professional 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 Qty Unit Unit PriceAmount 1 Traffic Signal Modification on 17" St at 1 LS $^r� $ English St llp.. C)UO 1 2 Traffic Signal Modification on MacArthur 1 LS $ $ Blvd at Plaza Dr JU7 13-1 LP 10-71;2"](A 3 Traffic Signal Modification on Edinger 1 LS $ .J $ Ave at Sullivan St 0(o qO-L�- 4 Traffic Signal Modification on 1 LS $ $ Westminster Ave at Clinton St � l j �di C)j� q 1 5 Temporary Overhead Wiring of Traffic Signals, including Communications 4 EA $ U $� 4T�I fad 6 ATSSA Certified Flaggers During Traffic Signal Shutdown Periods 1 LS $ $ 7 GTT Opticom Emergency Vehicle 1 LS $ $ Preemption System at Westminister Ave ow cw and Clinton St I i 8 GTT Opticom Emergency Vehicle Preemption System at MacArthur Blvd and 1 LS $` r��� I D (Iyk\, $ Plow Plaza Dr I 9 Install 2" PVC Conduit Per Plan * 635 LF $ $ 10 Install 3" PVC Conduit Per Plan * 1,180 LF $$ '3a $ P-1 ofP-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 TI STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) Item Description Qty Unit Unit Price Amount 11 Install 4" PVC Conduit Per Plan * 1,155 LF $ / $ _ 12 Install No. 6 Pull Box * 20 EA i r� ry I $� (' y qac O' 13 Install Traffic Rated No. 6 Pull Box 3 EA $ $ 14 Install Large Pull Box Per Plans 3 EA $ ( $� 15 Install Traffic Signal Loop Detector (Type 63 EA $ $ E Loop) 00-10 I ?�' f 'l�() f� 16 Install Bicycle Loop Detector (Type D Circular Loop) 40 EA $ � �L $ q � VVV ��� t 17 Install IP Communication System for 17th St. at English St 1 LS $ q I $ q I� 18 Install IP Communication System for MacArthur Blvd at Plaza Dr 1 LS $ lsF..�✓ $ 19 Install IT Communication System for Edinger Ave at Sullivan St 1 LS $ cp0i $ oqoJ Lw 20 Install IP Communication System for Westminster Ave at Clinton St I LS $ &Uf $ 21 Install 24 Strand Singlemode Fiber Optic Cable 5,570 LP $ ,� $ rl 22 Install Fiber Optic Splice Enclosure 1 EA $�j $ 23 Fusion Splice I Strand of Singlemode Fiber Optic 204 EA $ $ 24 Construct 4" PCC Sidewalk * 47 SF $ $ 25 Construct PCC Curb Ramp * 2,630 SF $ I $ I„IMf' 26 Signing and Striping at Edinger Ave at Sullivan St 1 LS $ i�I�� $ P-2 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17'x' STREET AT ENGLISH STREET MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) Item Description Qty Unit Unit Price Amount 27 Pothole for Utilities Not Shown on Plans * 10 EA $� $' ,� N 28 Pothole for Traffic Signal Equipment Utility Conflict * 27 EA $ �� $ r%� 29 AC Pavement * 105 TN $ $ 30 Unclassified Excavation * 115 CY $ $ TOTAL BASE BID $ ? —], i 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. This bid item is considered a Specialty Item per Section 2-3.2 of the Standard Specifications. P-3 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET. MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) TIME FOR COMPLETION OF IMPROVEMENTS AND LIOUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within one hundred and sixty (160) working days after the commencement date stated in the Notice to Proceed. The bidder also proposes to commence construction of the Work within ten (10) working days after issuance of a Notice to Proceed, and to continue in a diligent and workman -like manner without interruption, and to complete the construction thereof within the time specified above. The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be $1,000 per calendar day. Name of Firm California Professional-�ngir�e ring, Inc. Signature of BIDDER Title President, Secretary, and Treasure (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-4 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) BIDDER'S STATEMENT BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent Constriction 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 California ProfVs�bnalEngineerirjg,Inc Signature of BIDDER 'II Title President, Secretary and Treasurer (If(If an individual, so state. If a firm or co -partnership, stat 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-5 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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: California Professional Engineering, Inc Business Address: 929 Otterbein Ave Unit E, La Puente, CA 91748 Business E -Mail Address: van@cpengineeringinc.com Telephone: 626-810-1338 State Contractor's License No. and Class: 793907, A, C-10, C-20 License Expiration Date: 04/30/2017 State Dept. of Industrial Relations (DIR) Registration No.: State Dept. of Industrial Relation (DIR) Registration Expiration Date: Signed: _-- Title: President `111111Z1I1I171 P-6 of P-40 0019,0 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACA,RTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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 California Prpf4wonal Enginriering/(ne. Signature of BIDDER Title President (if an individual, so state) P-7 of P40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17' STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE ) SS: CITY OF SANTA ANA ) Van Nguyen 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 firm designated as: and who has been and is duly vested with the authority to make and execute instruments for the co- partnership by: who constitute the other members of the co -partnership. ® CORPORATION That he is of President of California Professional Engineering Inc. a corporation which is making the foregoing proposal: ❑ JOINT VENTURE That lie is of: one of the parties making the foregoing proposal as a joint venture, and the he/she has been and is duly vested with the authority to execute instruments for an on behalf of the parties making said bid who are: that such a bid is genuine andot collusive or sham, and has not in any manner sought by collusion to secure any a vantage against t e City of Santa Ana or any person interested in the proposed contract, for himself or. an o Signature Subscribed and sworn to before -le this Hday of 20(LQ Signature of officer Administering Oath (Notary Public) P-8 of P-40 JURAT State of California County of _Lo, Angeles M Subscribed and sworn to (or affirmed) before tire on this 4th day of — - May—, 2016 , by Van Nguyen —, proved to me on the basis of satisfactory evidence to be the person(k� who appeared before me, DIEM CHU � 13P); " N 0 CT�'R 'Y 8! 1 20EB I'V 0 R X I A C NOTARY'SMNSFUSE A notary public or other office completing this certificate verifies only the identify of the individual who signed the document to which this certificate is attached, and not the truthfulness. accuracv, or validity of that document, Pf,ACIiNOTARY S17ALINAI3()VLSPACE OPTIONAL INFORMATION mmmmwwwm� The information below is optional. However, it may prove valuable and could prevent fraudulent attachment of this 1`01-111 to all UNAUth0dZed dOCUMCm. CAPACITY CLAIMED BY SIGNER (PRINCIPAL) DESCRIPTION OFATTACIIED DOCUMENT INDIVIDUAL CORPORATE OFFICER T-r�s-tdcaSere a y, Treasurer, Manager U'rt,r. OR TYPE OF DOCUMENT PARTNER(S) rrlr.ks) ATTORNEY-IN-FACT TRUSTEE(S) NUMBER OF PAOPS GUARDIAN/CONSERVATOR OTI-IER; DAM OF DOCUMENT OTHER ABSENT SIGNER (PRINCIPAL) IS REPRESENTING: RIGHT NAMFIOFPERSON(S}OR FNTITYMS) TI-fUMBPRINT OF California Professional Engineering„ Inc. SIGNER 0 - .� -* 1O1*4' 0 0,01,P vV0-0- -*1 00400 4,0 0 *'� 0 101/2008 NOTARY BONDS, SUPPLIES AND FORMS Af JITTP:/fWWW,VALI-LYSIEIU2A.CON4 02005-2008VAI-LnY-STEI(RAINSURANC.E CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17" STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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 AI License #/Exp. DIR Reg. #/Exp. Location Phone c_ Type Of Work Amount $ Name YY,t11d1"iiti(>1e u�l'iPGhw(4 bol—o l lilo License #/Exp. 'filai®�5�1,4-3)-aLMI DIR Reg. #/Exp. U-15 (o- O-6�OU License # Location lam' J2Ky i Olh Aeric I .11C Ry1 b 0V Phone 'AX -01 4 .;-i Type Of Work ftp2(I e) Amount $ 2-2E ou) Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Name OIWCIIE (COUNtq Y�k1P(NE &VkiCC,IAty License#/Exp. �g1A�q.�;- 3'31-a--c)n DIR Reg. #/Exp. 1 UUck00BVt�{ -50-&Q Location 1B2 N' �N Si; (> �Il Y CLQ Phone Type Of Work2l �IN13 Amount $ I i HCl 5 Name (' un-\)NAi License #/Exp. 2hle Cq ? 2U1(p DIR Reg. #/Exp. 1()b00007 1IT (p ;0-2CA(o License # Location ± I[v pII1% IRWsi Ic�6 Phone (per RJB- (Ad4 Type Of Work�7p Og�CS Amount $ Name License #/Exp. DIR Reg. #/Exp. License # Location Phone Type Of Work Type Of Work Amount $ Amount $ Signature of Bidder P-10 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 T11 STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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. I. Please See Attached ►13 3. Name and Address of Owner. Name and Telephone Number of person familiar with project. Contract Amount Name and Address of owner. Type of Work Name and Telephone Number of person familiar with project. Contract Amount Nane and Address of owner. Type of Work Name and Telephone Number of person familiar with project. Contract Amount Type of Work Date Completed Date Completed 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. Please See Attached P-11 of P-40 929 Otterbein Ave., Unit E La Puente, CA 91748 Ph: (626) 810-1338 Fax: (626) 810-1322 www.cpengineeringinc.com California Professional Engineering, Inc. Traffic Signal -Job References Traffic Signal Improvements at Pasadena Ave & Walnut St Amount: $110,684.96 Owner: City of Pasadena Owner Address: 100 N. Garfield Ave Pasadena, CA 91109 Project Manager: John Ramey Contact Phone #: (626) 744-6912 Fax #: (626) 396-7986 Status: Completed Approximate Start/End Dates: August 2015 -Jan 2016 Description of Supplies, Equipment, or Services Provided: Installation of Conduit, Pull Boxes, Loop Detectors and Bicycle Loop Detectors, Traffic Signal & Poles, Cabinet & Controller. Traffic Signal Modification Raitt Street at Adams Street Amount: $707,855.63 Owner: City of Santa Ana Owner Address: 20 Civic Center Plaza Santa Ana, CA 92701 Project Manager: Edward Torres Contact Phone #: (714) 647-5029 Fax #:(714)647-5622 Status: Completed Approximate Start/End Dates: April 2015 -Aug 2015 Description of Supplies, Equipment, or Services Provided: Installation of Conduit, Pull Boxes, Communication Equipment, Loop Detectors, Fiber Optic, Cable, Preemption System, Cabinet & Controller, Access Ramps, and Striping & Markings. Lincoln Avenue and Westchester Drive Traffic Signal System Improvement Proiect Amount: $227,460.00 Owner: City of Anaheim Page 1 of 2 Document Last Updated 41512016 Owner Address: 200 South Anaheim Blvd Anaheim, CA 92805 Project Manager: Robert Polaeologus Contact Phone #: 714-765-5285 Status: Completed Approximate Start/End Dates: September 2014 — November 2014 Description of Supplies, Equipment, or Services Provided: Installation of Conduit, Pullboxes, Traffic Signal, Poles, Illuminated Street Name Signs, HPS Luminaires, Loop Detectors, LED Countdowns, Cabinet & Controller, Access Ramps, Median Nose, Striping & Markings. Page 2 of 2 Document Last Updated 41512016 929 Otterbein Ave., Unit E La Puente, CA 91748 Ph: (626) 810-1338 Fax: (626) 810-1322 www.cpengineeringinc.com California ProfessionalEngineering, Inc. We intend to procure all bonds from: The Hanover Insurance Company Yung T. Mullick, Attorney -In -Fact 24800 Chrisanta Drive, Suite 160 Mission Viejo, CA 92691 949 -461 -7000 -office # 949 -461 -7725 -fax # yinullicic@thebond-exchange.com We intend to procure all auto liability certificates from: We intend to procure all general/access liability certificates from: Grosslight Insurance, Inc. George Duran, Agent 9381 Haven Ave Rancho Cucamonga, CA 91730 909 -204 -3629 -office # 909 -204 -3679 -fax # eorgena grosslight.com We intend to procure all workers' compensation certificates from: BBSI Magdalena Gilane, Agent 1950 Sunwest Lane, Suite 250 San Bernardino, CA 92408 909 -890 -0100 -office # 909 -890 -0120 -fax # magdalena.gilane@bbsihq.com Page 1 of 1 Docutuent Las[ Updated 8.24.1 S MFW CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6334 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTI-TUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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 past55 years. 1. l 4U 71 C A� A (A- 91) 7.<—n of Owner. wdv Name and Telephone Number o erspn familiar with pr ject. ". Rr_rr. 5I2o1S Contract Amount Type of Work Date Completed 2. Ci -k62 rig one r�ck0Sk,�r0,AVo,C Nang and Address aver. ttu My n �10 12 Name and Telt h ne Number of person familiar with project, Z Hca A%viy / Contract Amount Type of Work Date Completed a owner Name and Te'Wphone Nun 2,�Ip1,G2ap.c�U Contract Amount S v ) Go `f — 311 �' 7" oPperson familiar with project. --R�g Type of Work a to j20f�- 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. P-12 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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 herhall afire stitute s nature of this Non -collusion Affidavit. BIDDERS are cautioed that al ing a false c�r�i cation ;ay subject the certifier to criminal prosecution. Signed State of California County of Los Angeles Subscribed and sworn to (or affirmed) before me on this day of , 20 , 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-13 of P-40 JURAT State of California County of Los Angeles Subscribed and sworn to (or affirmed) before me on this 4th - day of May 2016 , by Van Nguyen proved to me on the basis of satisfactory evidence to be the person(m� who appeared before me. q� 'S C TARY PHLImm M C113 In 3� 0 .0 2042 NOC � CALIFORNIA my LOS ANGELSS COUNTY �su A notary public or other office completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached. and not the truthfulness. accuracv. or validity of that document, ?T,AD1',NGrARYST,'.Af, INABOVIESPACE 11 11 ---- - 1 OPTIONAL INFORMATION The information below is optional. However, it may prove valuable and could prevent fraudulent attachment of this form to an unauthorized document. CAPACITY CLAIMED BY SIGNER (PRINCIPAL) DESCRIPTION OFATTACHED DOCUMENT [] INDIVIDUAL Wxj CORPORKII,'OFFICER T I Manager TITI F, OR TYPE OF DOCUMENT PARTNER(S) nn ,(s) E] ATFORNEY-IN-FACT 0 TRUSTEE(S) NEJM M B ER 0 17 RAC I [] (WARDIANICONSERVNI'OR [ OTHER: DAth OF DOCUMENT ABSENT SIGNER (PRINCIPAL) IS REPRESENTING: NAMEO['PFVSON(S) OR FNTrTrY(IIHS) California ProfessionallEngineering, Inc. RIGHT THUMBPRINT OF SIGNER OTHER fi 9 *�A * w* 0 0<0 X410 10101*00 -014*0 1# 0 10, .410 0 Idl, 0 1* 0* B * * -01 0 %P OF ** J 0 MOW NOTARY BONDS, SUPPLM3 AND FORMS Al'TITTP:/fW\VW.VALLfY-Slr,,RRA.(70M 02005-2009 VAI.LUY-SIERRA INS UIRANCE CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17Trr STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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. Stich 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 invoiced 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-14 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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, Rcept as provided in Section 1420, and any contractor of public works violating - this Section is subj0 t o -a h"Onal ' s i posed for a violation of the Chapter. Signed: Title: President Firm: California Professional Engineering, Inc. Date: 05/04/2016 P-15 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17Th STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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. 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: President Firm: California Professional Engineering, Inc. Date: 05/04/2016 P-16 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) STATEMENT REGARDING "ANTI -KICKBACK" REQUIREMENTS The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that each contractor or subcontractor shall be prohibited from inducing, by any means, any person employed in the construction or repair of public work, to give up any part of the compensation to which he/she is otherwise entitled. Signed: Title: President Firm: California Professional Engineering, Inc. Date: 05/04/2016 P-17 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 H STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) 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 X If the answer is yes, explain the circumstances in the following space. P-18 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) BIDDER'S STATEMENT REGARDING REQUIRED FEDERAL CONTRACT PROVISIONS (FORM FHWA-1273) The undersigned, is submitting this proposal ff r performing by contract the work required by these bid documents, agrees to comply with the required Tederal Contract Provision (Form FHWA-1273) as shown in the appendix of the Special Pkr'sions of thip Project. Signed Title President Firm California Professional Engineering, Inc. Date 05/04/2016 P-19 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder California Professional Engineering Inc proposed subcontractor , hereby certifies that he has X , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CPR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO -1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified byto Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Debap(went of Labor. Signed Title President Firm California Professional Engineering, Inc. Date 05/04/2016 P-20 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has notbeen convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier toocriminal prosequtign. Signed Title President Firm California Professional Engineering, Inc. Date 05/04/2016 P-21 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) PUBLIC CONTRACT CODE SECTION 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Signed Title President Firm California Professional Engineering, Inc Date 05/04/2016 P-22 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17Tn STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 DEBARMENT AND SUSPENSION CERTIFICATION The bidder under penalty of perjury, certifies that except as noted below, he/she or any person associated therewith in the capacity of owner, partner, director, officer, manager: is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal agency within past three years; has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space Exceptions will not necessarily result in denial of award, but will be considered in determining bidders responsibility. For any exception noted above, indicate below to whom it applies, initialing agency, and dates of action. Note: Providing false information may result in The above certification is part constitute signature of this Cei Signed Title President Firm California Professional Engineering, Inc. Date 05/04/2016 prosecution or administrative sanctions. this Proposal on the signature portion thereof shall also P-23 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) NON -LOBBYING CERTIFICATION FOR FEDERAL AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influence or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriate funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for malting or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by sub sitting his or her bid or proposal that he or she shall require that the language of t is certification 'b i eluded in all lower tier subcontracts, which exceed $100,000 and that all such suk- ee' ie-nt--shal�r f and disclose accordingly. Signed Title President Firm California Professional Engineering Inc. Date • Standard Form LLL may be obtained from Caltrans and FHWA offices. P-24 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) DISCLOSURE OF LOBBYING ACTIVITIES USCLOSURE ETF LOBBYING ACTIVMES Jygao ammy ems Complete this haam to dtsdnse kal Wng aot"es pursaant to 31 U.S.C.. 1352 (See reararse for Pubile bu adisokmure-) -Type of Federaf Action. 2 -Status of Federal Actina: 3, Report. Type: ct. FiflWatfling �b. F la- ©ort kbv�6,�w9yasaaa�rrlpikmabwi h'. al change, c, icooperatiae agreement c. post-awanf:. Foc'ffttmrig Cfaang Only: rl.. ban year. gmortar e. loan Su date ''las#report l:. Toon irmsance 4,. Name and. Address. of Reporting Entfiy:: 5:.. g Reporting Entify. in Mo -4 is a SUbamra . , Eater name ❑pow o submunwo and Address of Prune:. Ter_ afknown: Cormares.sional District, iikrwrwn: t-gressronaf Dlstrimf,/krmrrra_ r. Federal' DepartmerallAgency: T. Federal Praffram Description: CFDA Number appfimat+le- 9.. Federal Action gmnlaer, ifkmawem: 9.. Award.. unt,. Wimunmr: 19. a flazsae audAddress mf Lotaaying Entit7r 5. f .. iduats Pe garvicrds (tP adafimss ri (iruo&VM Wm last norne. Fnstaur'rae. WY there Atm. lea) jhmf nannA, festmanre, ANY Adtmb s' 11, Amount ofPayroent(r . aff Dud apply):. 13. Type xf Payment (oheckaGUral app4,): ❑ adm ❑. ❑ a_rotaarar ❑ barna-llwwaae Ela, wrxmgekn U. Form of Payment (check a#!leak Y): ❑ a: ¢wort ❑ m eoftbaum ue a ❑ n as una; alae y:. hoa ❑ a mooned uaire ❑tohwr apom, M Brief Description of Seryifies, Perfe med or to be Perfomred and Datels) of Seradcc, iaduding rdtiaer(s), employee(s). orAferm s)coutacted, for Payment kidimmied'. in hewn 11. «sTM Win' .'�ktruk a' M Guarm, as 5 .3F4-LLAa1tadsadt Oyer Wm 49-brn-.`.... tawpfrkY lmn&.�+mu+a nr a>w 2r +kaC. +.w.s Ss� re. natu axx aw. eau+>,aap aK+a.e w...:....:.. w.+ursue arrax "a + 0c, Print Kk e: j/,�p., Tatle: President .ar.e�pa+se6ma..r.�.wwy+..+.+s�•+ry ww .w .maa��aaauaeua+.»waj+dnrwwarx �. aHrtiwl0.bnM uLl ar, ---------- Tateptmna No.: 626-810-13m Caate:05/04/2016 Federal use Cray. .narfwafacdfnrtaca. sSndwd Ram LIL FbM F 5 P-25 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17Tx STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) INSTRUCTIONS FOR COMPLETION OF SF -LL, DISCLOSURE OF LOBBYING ACTIVITIES f. 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Coca at trbt fAig;.ap".. a Wea, epcady Mh6 dA. MWOWea 4=41 c At PManeaaecalpmas 'ro 3dMIF. D1JU9eP�� SPWI ft Wkwtnce�efea[apera. kkm&mOW Fe*xal kWff; emfw- wP. dllclleaft. at prapaam aM etatea admny, and JusC lam anti: m t warn o anh Feuaaa omcuts.. b6aAroj 6rrx F4Cleeat mr' �tp�l+a:emxLasLsveaine+dt+�flsl,.emptgeeds), cr Memmzr{s)art;raa�cuw;.�tcwn&xtm_ 15.. COO&V1wUw dN'aYAYi'sF-Le ea.. adye*s)%alta~: }B. Taeaffwv maglad shm w9n a" a*et49um pmt NSA" a,. tb-- ata dalepmene rtl8wtpa:.. P-26 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: City of Santa Ana 2. Contract DBE Goal: 6.53% Traffic Signal Modifications on: 17" St at English St, MacArthur Blvd at Plaza Dr, Edinger Ave at Sullivan, 3. Project Description: Westminster Ave at Clinton Sl 17t" St at English St, MacArthur Blvd at Plaza Dr, Edinger Ave at Sullivan, Westminster Ave at Clinton Sl 4. Project Location: in the City of Santa Ana California Professional Engineering, Inc 7. Bide 5. Bidder's Name: 6. Prime Certified DBE: Amount: f 8. Total Dollar Amount for ALL Subcontractors. t ICAJ C'I1 _50 9. Total Number of ALL Subcontractors: 10. Bid 11Description of WorkServiceor Materials . , , 12. DBE 13. DBE Contact Information 14. DBE Item Supplied Certification (Must be certified on the date bids are Dollar Number Number opened) Amount �— -4 i� �' Ig rn' I Irw�t Cl Cun �J� �� 7 CAA tt (0 2nt �i oFesn on IYSi r nen G rr r�eP 2lvl lVl( I vw-A1'z I CR ,q I l W Local Agency to Complete this Section 21 Local Agency Contract Number 22. Federal -Aid Project Number 15. TOTAL CLAIMED DBE PARTICIPATION HSIPL 5063(156) 23. Bid Opening Date: 24. Contract Award Date: IMPORTANT: Identify all DBE firms being claimed for credit, regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed above must be consistent;'where applicable with the names and item*f the work in the "Subcontractor List" submitted Local Agency certifies that all DBE certifications are valid and information on with your bl ,Zxltielr firmation of each listed DBE is this form is complete and accurate. room ed. 05/04/2016 25. Local Agency Representative's Signature 26.: Date 16. eparer's Sip ture 1 Date �26-810-1338 Van Nguyen 18. Preparer's Narbe 19. Phone 27. Local Agency Representative's Name 28. Phone President 29. Local Agency Representative's Title 20, Preparer's Title DISTRIBUTION: 1. original —Local Agency 2, Copy — Caltrans District Local Assistance Engineer (DLAE), Failure to submit to DLAE within 30 days of contract execution may result in de -obligation of federal funds on contract. Include additional copy with award package. ADA Notice: For Individuals with sensory disabilities, this document Is available In alternate formats. For information call (916) 654-6410 or TDD (916) 654-3080 or write Records and Farms Management, 1120 N Street, MS -89, Sacramento, CA 95814. P-27 of P-40 150 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TI1 STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) INSTRUCTIONS — CONSTRUCTION CONTRACT DBE COMMITMENT CONTRACTOR SECTION 1. Local Agency - Enter the name of the local or regional agency that is firming the contract. 2. Contract DBE Goal - Enter the contract DBE goal percentage as it appears on the project advertisement. 3. Project Location - Enter the project location as it appears on the project advertisement. 4. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab, Overlay, Widening, etc). 5. Bidder's Name - Enter the contractor's firm name. 6. Prime Certified DBE - Check box if prime contractor is a certified DBE. 7. Bid Amount - Enter the total contract bid dollar amount for the prime contractor. 8. Total Dollar Amount for ALL Subcontractors — Enter the total dollar amount for all subcontracted contractors. SUM — (DBEs + all Non - DBEs). Do not include the prime contractor information in this count. 9. Total number of ALL subcontractors — Enter the total number of all subcontracted contractors. SUM = (DBEs + all Non -DBEs). Do not include the prime contractor information in this count. 10. Bid Item Number - Enter bid item number for work, services, or materials supplied to be provided. 11. Description of Work, Services, or Materials Supplied - Enter description ofwork, services, or materials to be provided. Indicate all work to be performed by DBEs including work performed by the prime contractor's own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 12. DBE Certification Number - Enter the DBE's Certification Identification Number. All DBEs must be cer ilied on the date bids are opened. 13. DBli Contact Information - Enter the name, address, and phone number of all DBE subcontracted contractors. Also, enter the prime contractor's name and phone number, if the prime is a DBE. 14. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service to be provided. Include the prime contractor if the prime is a DBE. See LAPM Chapter 9 for how to count fi ll/partial participation. 15. Total Claimed DBE Participation - $: Enter the total dollar amounts entered in the "DBE Dollar Amount" column. %: Enter the total DBE participation claimed ("Total Claimed DBE Participation Dollars" divided by item "Bid Amount"). If the total % claimed is less than item "Contract DBE Goal," an adequately documented Good Faith Effort (GIT) is required (see Exhibit 15-H DBE Information - Good Faith Efforts of the LAPM). 16. Preparer's Signature - The person completing the DBE commitment form on behalf of the contractor's firm must sign their name. 17. Date - Enter the date the DBE commitment farm is signed by the contract'or's preparer. 18. Preparer's Name -,Enter the name of the person preparing and signing the contractor's DBE commitment form. 19. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 20. 'Preparer's Title - Enter the position/title of the person signing the contractor's DBE commitment form. LOCAL AGENCY SECTION 21. Local Agency Contract Number -Enter the Local Agency contract number or identifier. 22. Federal -Aid Project Number - Enter the Fedcral-Aid Project Number. 23. Bid Opening Date - Enter the date contract bids were opened. 24. Contract Award Date - Enter the date the contract was executed. 25. Local Agency Representative's Signature - The person completing this section of the form for the Local Agency must sign their name to certify that the information in this and the Contractor Section of this form is complete and accurate. 26. Date - Enter the date the DBL commitment form is signed by the Local Agency Representative. 27. Local Agency Representative's Name - Enter the name ofthe Local Agency Representative certifying the contract'or's DBE commitment form. 28. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 29. Local Agency Representative Title - Enter the position/title of the Local Agency Representative certifying the contractor's DBE commitment form. P-28 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17Tx STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EXHIBIT 15-H DBE INFORMATION —GOOD FAITH EFFORTS DBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. 7�0 Bid Opening Date 05/04/2016 The Zsav44c( ill Cit 1 , of) established a Disadvantaged Business Enterprise (DBE) goal of (p % for this prcje she information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation WE ARE DBE P-29 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17Ti STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) C. The items of work which the bidder made available to DBE 'firms including, where appropriate, any Breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items (S) Of (Y/N) Contract WE ARE DBE D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: WE ARE DBE Names, addresses and phone numbers of firms selected for the work above: P-30 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: WE ARE DBE F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: WE ARE DBE G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results Iritr�:7�7�� H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): WE ARE DBE NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. P-31 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ Address/ City, State, ZIP Phone/ Fax Annual Gross .Receipts Description of Portion of Work to be. Performed Name>'htA- Phone '151 -7, p '1yuo ❑ < $1 millionvxra`t ❑ < $5 million ❑<$10million ..._... ........ ....... .. 2t 1; as ,,�{11d ress VO.gO(Gj F 1,> ❑<$15million a fk Ci State ZIP r�na $15 millionU; iA „SSr'1}Ie t° s " sy; �..rt Name O C CJ F3� STRCQMCO Addressdgr Phone 1 L _ Li ❑<$Imillion <$5 million -.— _ _. .— :z <$10million lll 1 3 % 1,ax)) q L�3� a53 ❑ <$15 million Cit State ZAP �N�e Lig F]> $15 million ��,���r .��.�, �,r� aY �.� �_�•.�<.���:� Name&o. IReclon PP�itl)W Phoe ��o- aLI —/010 <$1million ❑ <$5 million ❑ <$10 million p;ZINL —. � ctx �H P d1 h, Address �315�p, Pax7W `( - 9L O?- ❑ <$15 million Cat State ZIP nctr�R�nt CR ❑ > $15 million MRITMIRMIMMM---._.._— NamcCV635twN Phony (P2LA �2 ❑.<$1million ❑<$5million �. Address El <$10 million ��x A16�,� , dJila3l� a Fa:024P '6I 9- �p�U�)u ❑ < $15 million ,._. _...,,,,... City Sjza e ZIP RWfVIA Cil > $15 million P-32 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) PART II The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49, Section 26 of the Code of Federal Regulations. Photocopy this form for additional firms. Firm Name/ Phone/" vffIICfif"IBtI*QhIY Address/ Fax Annual Oross Receipts Description of Portion of \Vorlc to be Performed City, State, ZIP 3 (,97{7L' at.aLv..., NameMS Phone ❑ <$1 million U1 OL - PC& --ryl ❑ < $5 million ❑ <$10 million Address �%CoS�'• Fax ❑ <$15 million City State ZIP ® > $15 million ` af3i x tame Phone <$1 million 06'Dt I Address 10 million T15jW. !' 1"Z, Ff 2 J-1 ^�� ot6;�= <$15 million City Stade F]> $15 million Or N�k O xrerd3 Name Phone ❑ <$1 million ❑ < $5 y®�,i.,'° million ❑ <$10 million Address Fax I ❑ <$15 million r�� N City Stale ZIP E]> $15 million Name Phone ❑ <$l millionst��I`�`4y . ❑ <$5 inillion Address ❑ <$1.0 million Fax ❑ < $15 million City State ZIP II > $15 million `�,rQ' 41i+�. K .�SIM P-33 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17 TI STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) PROMPT PAYMENT OF FUNDS WITHHELD TO SUBCONTRACTORS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the following: The agency shall hold retainage from the prime contractor and shall make prompt and regular incremental acceptances of portions, as determined by the agency, of the contract work, and pay retainage to the prime contractor based on these acceptances. The prime contractor, or subcontractor, shall return all monies withheld in retention from a subcontractor within 30 days after receiving payment for work satisfactorily completed and accepted including incremental acceptances of portions of the contract work by the agency. Federal law (49CFR26.29) requires that any delay or postponement of payment over 30 days may take place only for good cause and with the agency's prior written approval. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or judicial remedi s otherwise available to the prime contractor or subcontractor in the event of a dis to involving ate payment or nonpayment by the prime contractor, deficient subcontract p r' f noncompliance by a subcontractor. Signed Title President Firm California Professional Engineering, Inc. Date 05/04/2016 P-34 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) EXHIBIT 16-B - SUBCONTRACTING REQUEST Local Assistance Procedures Manual STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION SUBCONTRACTING REQUEST DC -CEM -1201 (REV. 4/94) (OLD HC -45) CT# 7541-3514-7 EXITIBIT I6 -B FRONT See Instructions On Back Page REQUEST NUMBER CONTR T NAME - i orma Professional Engineering, Inc. Total of bid items ....... ............... ................ A ........ COUNTY l7 1W&1t-- ROUTE U SSADDRESS �D-Ave (mrC 3, CONTRACT NO. _ 3 ,......,.,..... $ CITY/ST 1'E LCA C�- ZIP CODE(''� I b FEDERAL AID PROJECT NO. (FSp ial Provisions) 13,14 C SUBCONTRACTOR BID ITEM (Name, Business Address, NUMBER(S) Phone) ru -TW-y N�. WlA M V0 1'130 I X15110 tFSYeetei Ilmi k al prf1� 11-11 % BID ITEM SUBBED '•-to7o CHECK (Sec Categories Below)(1) (3) IF: DESCRIBE WORK WHEN LESS THAN (2) 100%OFWORK IS SUBBED w L, AArD,W0. $ AMOUNT BASED ON BID $ AMOUNT g cu ALL tMit I Wrr r -leo E. ' at 1-^) Io-NsLo, I.. �I1e53yVW1A 5'fWb DI -T 6'} T—WIMe-L ep WYv8+9—tel�a3 Cc,�s1i-&-Ip,N 18.3UN.<q�lxex-ysY t71'blm94rH Lig Y ��501'v 17-37/ .�:: a-� 1uoD ICJJwiu !�>t'k `� Y 8. Total (lines 6+7).. .................. .................. ............... .......- C,tv t— FA-eA tyif-- 31�'1'PtN� r (51<1-1 115,3Gt� Categories: 1) Specialty 2) Listed Under Fair Practices Act 3) Certified DBE/MBE/WBE/DVBE • The Standard Provisions for labor set forth in the contract apply to the subcontracted work • If applicable, (Federal Aid Projects only) Section 14 (Federal Requirements) of the Special Provisions have been inserted in the subcontracts and shall be incorporated in any lower -tier subplhnnact. Written contracts have been executed for the above noted subcontracted work CONTRACTOR'S SIGNATURE NOTE: This section is to be completed by the Resident Engineer UA 11, 1. Total of bid items ....... ............... ................ A ........ ..........,....... ............. ..................$ 2. Specialty items (previously requested).................................................................$ 3, Specialty items (this request) ........ ......-............... ..,.,.,.,.... ,....... ,......,.,..... $ 4. Total (lines 2+3). .........._..... ........,.._.. _....._............ ...........$ 5. Contractor must perform with own forces (lines l minis4)x %........ ........ _.........._.....____$ 6, Bid items previously subcontracted._.................................................................$ 7. Bid items Subcontracted ( this request) ......... .... ._..... ......... ........... ..- .................. $ 8. Total (lines 6+7).. .................. .................. ............... .......- ....... $ 9. Balance of work Contractor to perform (lilies l minus 8) .... ......._........,.,_..,.,._$ RESIDENT ENGINEER'S SIGNATURE I DATE 3. Copy- local agcocy Leber Conolienec Offccr 4 Coptoctor'6TnPonnatioo Copy FOLnmry I, 1998 P-35 of P-40 E. Page 16-51 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 FEDERAL PROJECT NO: HSIPL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET EXHIBIT 16-B Local Assistance Procedures Manual Subcontracting Request INSTRUCTIONS FOR COMPLETING SUBCONTRACTING REQUEST ,FORM All First-tier subcontractors must be included on a subcontracting request. Submit in accordance with Section 8-1.01 of the Caltrans Standard Specifications. Type or print requested information. Information copy is to be retained by the contractor. Submit other copies to project's Resident Engineer. After approval, the original will be returned to the contractor. When an entire item is subcontracted, the value to be shown is the contractor's bid price. When a portion of an item is subcontracted, describe the portion, and show the % of bid item and value. THIS FORM IS NOT TO BE USED FOR SUBSTITUTIONS. Prior to submittal of Form CEM -1201 involving a replacement Subcontractor, submit a separate written request for approval to substitute a listed subcontractor. Section 4107 of the Government Code covers the conditions for substitution. Submit a separate written request for approval of any DBE/MBE/WBE/DVBE substitution. Include appropriate backup information and state what efforts were made to accomplish the same dollar value of work by other certified DBE/MBE/WBE/DVBEs. NOTE: For contractors who will be performing work on railroad property, it is necessary for the contractor to complete and submit the Certificate of Insurance (State Form DH-OS-AIOA) naming the subcontractor as insured. No work shall be allowed which involves encroachment on railroad property until the specified insurance has been approved. Page 16-52 October 5, 2012 LPP 12 P-36 of P-40 Back CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 FEDERAL PROJECT NO: HS,IPL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET DIFFERING SITE CONDITIONS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the following: a. Contractor's Notir1cation Promptly notify the Agency's Engineer if you find either of the following conditions: 1. Physical conditions differing materially from either of the following: • Contract docurnents • Job site examination 2. Physical conditions of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent in the work provided for in the Contract Include details explaining the information you relied on and the material differences you discovered. If you fail to promptly notify the Engineer, you waive the differing site condition claim for the period between your discovery of the differing site condition and your notification to the Engineer. If you disturb the site after discovery and before the Engineer's investigation, you waive the differing site condition claim. b. Engineer's Investigation and Decision Upon your notification, the Engineer investigates job site conditions and: 1. Notifies you whether to resume affected work 2. Decides whether the condition differs I i iaterially and is cause for an adjustment of timeflpayhse�nt, or bot Signed Title President Mwinno M1. Una r0Rr6r1F1191T*Tr1T—=71§Nr1� Date 05/04/2016 P-37 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 FEDERAL PROJECT NO: HS�IPL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET BIDDER'S CERTIFICATE OF COMPLIANCE REGARDING "BUY AMERICA" REQUIREMENTS FOR STEEL OR MANUFACTURED PRODUCTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the " Buy America" requirements of Section 165 of the Surface Transportation Assistance ct of 1982 andr shown in the special provisions of this project. k Signed Title President Firm California Professional Engineering, Inc. Date 05/04/2016 P-38 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 FEDERAL PROJECT NO: HSIPL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17TH STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET NEPA COMPLIANCE FOR FEDERAL AID CONTRACTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply with the Categorical Exemption/Categorical Exclusion Determination Form including and not limited to the NationFP nvironmental Policy Act (NEPA) requirements and environmental col. end is found inJhleendix of the Contract Documents of this project. -- 7 I Signed Title President I Firm California Professional Engineering, Inc. 05/04/2016 Date P-39 of P-40 CITY OF SANTA ANA PROPOSAL PROJECT NO.: 15-6834 FEDERAL PROJECT NO: HS1PL 5063(156) TRAFFIC SIGNAL MODIFICATIONS: 17' STREET AT ENGLISH STREET, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET TMP COMPLIANCE FOR FEDERAL AID CONTRACTS The undersigned, is submitting this proposal for performing by contract the work required by these bid documents, certify to comply Kith the Traffic Ma,agement Plan (TMP) commitments found in the appendix of the ContratDjc'trnnts of this r ject. Signed Title President Firm California Professional Engineering, Inc. Date m/nA/9niR P-40 of P-40 PROPOSAL PROJECT NO,; 15-6834 TRAFFIC SIGNAL MODIFICATIONS: t71"'STRF-ETATENGLIStiS-rREE'r, MACARTHUR BOULEVARD AT PLAZA DRIVE, EDINGER AVENUE AT SULLIVAN STREET, WESTMINSTER AVENUE AT CLINTON STREET FEDERAL PROJECT NO: HSIPL 5063(156) RID BOND KNOW ALI, PRESENT that, California FKRLeasa_iqnal Engineering Inc as BIDDER, and Allied World insurance Company ._............. . as SURETY, are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal slim of _TEN PERCENT -D TOTAL I. _—omT Dollars --------- J, which is ten percent (10%) of the total amount bid by BIDDER to AGENCY for the above -stated project, for the payment of which slim, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents. THEI CONDITIONS OF TI B$ 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 shot[ remain in full force and effect in favor of AGENCY. IN WITNESS WHEREOF the patties hereto have set their names, titles, hands, and seal this &Y Of 2016; 1_3fDDF'R* Van SURETY* Subscribed and sworn to before me this --day of 20 Signature: Notary Public in and for the County of State of Provide BIDDER/ SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative, BIDDER: SURETY: AGENT: California Profcaaivroal Engineering Inc. Jklliod CT.Cld InInlHoo. Company THE BOND EXCHANGE AND INEHH�CE AGENCY 929 Cat..b.i. Avenue, S11. A, la Pao.,e, C. 91748 510 B. Hol. n.ao, Sniff Ca.,, I,, An,,l,e, CA 90071 B 4 000 CICRISANTA DC, #160, MJSBTC. VIE,10,CA 92691 626) 810-13I8 213-416-1453 949-�61-7000 P-9 of P-40 ALL-PURPOSE ACKNOWLEDGMENT State of Calitornia County of_ Los Angeles M, Oil May 4, 2016 before me Diem Chu Notary Public, DAM personally appeared _ van Nguyen__ .._. _ who'pxoved to me on the basis of satisfactory evidence to be the personal whose name- is/W)? subscribed to the within instrument and acknowledged to me that he/x&1Akty executed the same in hlsAiwixkIeir authorized capacity( }, and that by his/irdtWxxr, signature(a) on the instrument the person(ji�, or the entity upon behalf of which the person( acted, executed the instrument. I certify under PENALTY OF PF,RdiJRI' under the laws of the State of California that the foregoing paragraph is true and correct. CIM CHU ` WITNESS my hand and official seal. COMM,# 2042313 �nn ° NC1tAM P10.I0-OALIFOANIA W 605 Moms COUNTY X17COMM Ur SEP. 21. 2017c -'i M)TAll RY'S AA notary public or other office completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracv, or validity of that document. PLACE. NOT ARY UAL.IN ABOVE. APACE OPTIONAL INFORM ATION The information below is optional. Flow -ever, it may prove valuable and could prevent fraudulent attachment of this form loan unauthorized document. CAPACICYCLAIMED BY SIGNER(PRINCIPAL) DESCRIPTION OF KITACHED DOCUMENT INDIVIDUAL CORPORATE OFFICER President,_ Secretary Treasurer, Manager TITLE OR I YPF. OF DOCUMENT PARTNER(S) nTI V(s) [] ATTORNEY-IN-FACT ❑ 9 Rt J8'11148) NUMB R OF FAGES _.._�..._.. GUARDIANJCO;NS'E';RVAFOR 0111GR, --m.. ------- . ...._ DA1T? OF DOCl1 Ml -,NT SIGNER (PRINCIPAL) IS REPRESENTING: NANIF OF PF.RSON(S)ORI;N IFVff',,) California Professional Engineering, Inc. RIGIIT T13UMBPRINT OF SIQNER AI+AU2017 hOTAIIY [iONOS,SUI"PLINSANUPOIi,VSSATkITiPd1WW\Y.VAL[1'}.g7gRRA.COAI S�?005-7.V08 VAld I;Y-51CiRAAINSURhNCE 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 ...... I I ..... I ................. ........... - — ...................... I ................ - . . . . ..................... On -April 29, 20-16111 _ before me, _-Robyn .,.,R,..,Ka,-r,-g.ar.i...,, ................ --- ... . ...................................... Notary Public, Dais I risert Name of Notary exactly as it appears on the official seal personally appeared Yung T. Mullick ................. ....... - ....................... ........................................... . ... .... Narrie(s) of Signeroi) who proved to me on the basis of satisfactory evidence to be the personi whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the pei 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 mZyhan; official searol official '9e I Signature Peal Above nga ri -- Place ................ a�Notpy are Robvr R. Ka I Though the information below is not required by law it May Prove Valuable to persons relying on the document and could prevent fraudulent removal and reattachment of the form to another docurnent. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: E] Individual Corporate Officer Partner [] Limited [--lGeneral Attorney in Fact Trustee Guardian or Conservator [] Other Signer is Representing: Number of Pages: Signer's Name: El Individual E] Corporate Officer --- I fle(s): El Partner E Limited ❑I General El Attorney in Fact L] Trustee ❑ Guarder or Conservator ❑ Other Signer i, Representing: Title: Senior Vice President -Surety Excerpt of Resolution adopted by the Board of Directors of the ALLIED WORLD INSURANCE COMPANY (the "Corporation"), on December 31, 2012 RIt§UVl-,U,Jhpt the imperqdhl online. Corporation, the hadd of the surely business the for thepCorponabon and theirpppoinded deaffinew {eaCb,aw'AuJbcjipxf.Qffipdr andmoled0[y,a "Au 0 th th arrideach hereby 0 -iate) kdct, undertaldn'gs,10- 5pirkand0a a6dotherenthrpds 'of incibunni d ..... .. . fi b thavOorron seal o � E�Go ralji fiagyfopli mplindsoblg8spyJ RESOLVED, that in connection with the Corporation's tdansactlon of purely business, the signatures and allestallons of the Authorized Officers and the seal of the Corporation may be affixed to any such Power of Attorney or to any cul-Kcate relating thereto by facsimile, and any such Power of Attorney or certificate heading such facstinfie signatures or facsimile seal shall be valid and binding upon the -Co7 -affixed with reepsajo anyAd,undqqa",ji�cognizanoe�orotherwntractpfindemnityorMhnaobligaIM, r tho nature therwf.-.3- .01qwhemso -at nmade-ligotolopq or hW RESOLVED, finafin a rl� "Tuced signature of anYXiniQbfi4r, Where'v'era'poeariong uo6fl'a copy of Pow6(ofAi0m4joQhe Coffic'nifloi, with iihnalures affixed- knex'tmtxrve noidd, shall be valid and lblndingdpcm thii Corporthon with the same force and Aet as though manually affixed. SUR.0,00.4 00 (3/2Qj 0, No. 3186-4 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE SAN FRANCISCO Amended Certificate of Authority THIS IS TO CERTIFY that, pursuant fu the Insurance Code ofthe State of California, Allied World Insurance Company ofNew Hampshire, organized under the laws ofNew Hampshire, setbject to its Articles of Incorporation ar otlier• fundanxental organizationai documents, is hereby authorized to transactwithin this State, subject to all provisions of this Certificate, the following classes of insurance: Fire, Marine, Surety, Plate Class, Liability, Workers' Compensation, Common Carrier Liability, Boiler and Machinery, Burglary, Credit, Sprinkler, Team and Vehicle, Automobile, Aircraft, and Miscellaneous as such classes are now or may hereafter be defined in the .Insurance Lows of the State of California. THIS CERTIFICATE, is expressly conditioned upon the holder hereof now and hereafter being in Ail compliance with all, and not in violation ofany, ofthe applicable laws and lawful requirements made under authority of the laws of'the Slate of California as long as such laws or requirements are in effect and applicable, and as such laws and requirements now are, or may hereafter be changed or amended. IN WITNESS WFIEREOF, effective as ofthe 22nd day, ofMay, 2013, I have hereunto set my hand and caused my official seal to be affixed this 22nd day gfMay, 2013. Dave Jones huuranne Corgmfs•ionur / I iLv ���✓' �— 2 ji�Y By Susan J. Stapp for Ne%Q Hoge ChiefDepWy NOTICE: Qualification with Cita Secretary of State must be accomplished as roghtted by the Cali'fornin Corpore[lons Code pronyrtly after Issuance of this Certificate ofAunuejly. Failurc to do so will be a violation of Insurance Code section 70I and wilt be grounds for revolting this Certificate of Authority pursuant to the covenants made no the application therefor and the conditions contained heroin. C7� T d -'a C13 p o r/3� C CG Co �. CM Co n � C-3 , C3_ ® ari N r o o rri ro MI Lrl O en�F I _ cm Z 2m W C77 L -.-� C7 ® d � n ]� O CA CO�_ o. m _ -0 O W c 00 Cp C- m G I VJ ® • r L2 C77 v m =' � Cal ro r CJI CA rF =3 CM co n �O T C 7 n va' T iN O o n -7 CR] rh ri �. ] ' C3 CO Em C/A C7 5 1� m n = a i,I"7 Q] . rt d] rf. S;pa r� -3 w a a a �..� C13 N O C7 t � O ai C3 c d t.R;3 N N C7 e C7 a GN7 =3 C� X Z C-3 C7 •0 M Z x rm rri C a r� 8 LL� r