January 2022
F-51
Local Assistance Procedures Manual Exhibit 12-G
Required Federal-Aid Contract Language
each potential sub-applicant or supplier shall be notified by CONTRACTOR of the CONTRACTOR'S obligations under this Agreement and the Regulations relative to nondiscrimination on the grounds of race, color, or national origin.
Information and Reports: CONTRACTOR shall provide all information and reports required by the Regulations, or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the recipient or FHWA to be pertinent to ascertain compliance with such Regulations or directives. Where any information required of CONTRACTOR is in the exclusive possession of another who fails or refuses to furnish this information, CONTRACTOR shall so certify to the recipient or FHWA as appropriate, and shall set forth what efforts CONTRACTOR has made to obtain the information. e. Sanctions for Noncompliance: In the event of CONTRACTOR's noncompliance with the nondiscrimination provisions of this agreement, the recipient shall impose such agreement sanctions as it or the FHWA may determine to be appropriate, including, but not limited to:
i. withholding of payments to CONTRACTOR under the Agreement within a reasonable period of time, not to exceed 90 days; and/or
il. cancellation, termination or suspension of the Agreement, in whole or in part. f. Incorporation of Provisions: CONTRACTOR shall include the provisions of paragraphs (1) through (6) in every sub-agreement, including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto.
CONTRACTOR shall take such action with respect to any sub-agreement or procurement as the recipient or FHWA may direct as a means of enforcing such provisions including sanctions for noncompliance, provided, however, that, in the event CONTRACTOR becomes involved in, or is threatened with, litigation with a sub-applicant or supplier as a result of such direction, CONTRACTOR may request the recipient enter into such litigation to protect the interests of the State, and, in addition, CONTRACTOR may request the United States to enter into such litigation to protect the interests of the United States.
APPENDIX B
CLAUSES FOR DEEDS TRANSFERRING UNITED STATES PROPERTY
The following clauses will be included in deeds effecting or recording the transfer of real property, structures, or improvements thereon, or granting interest therein from the United States pursuant to the provisions of Assurance 4:
NOW THEREFORE, the U.S. Department of Transportation as authorized by law and upon the condition that the recipient will accept title to the lands and maintain the project constructed thereon in accordance with Title 23 U.S.C., the regulations for the administration of the preceding statute, and the policies and procedures prescribed by the FHWA of the U.S. Department of Transportation in accordance and in compliance with all requirements imposed by Title 49, Code of Federal Regulations, U.S. Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Non-discrimination in Federally-assisted programs of the U.S. Department of Transportation pertaining to and effectuating the provisions of Title VI of the Civil Rights Act of 1964(78 Stat. 252; 42 U.S.C. § 2000d to 2000d-4), does hereby remise, release, quitclaim and convey unto the recipient all the right, title and interest of the U.S. Department of Transportation in and to said lands described in Exhibit A attached hereto and made a part hereof. (HABENDUM CLAUSE)
TO HAVE AND TO HOLD said lands and interests therein unto the recipient and its successors forever, subject, however, to the covenants, conditions, restrictions and reservations herein contained as follows, which will remain in effect for the period during which the real property or structures are used for a purpose for which Federal financial assistance is extended or for another purpose involving the provision of similar services or benefits and will be binding on the recipient, its successors and assigns. The recipient, in consideration of the conveyance of said lands and interest in lands, does hereby covenant and agree as a covenant running with the land for itself, its successors and assigns, that (1) no person
January 2022
F-52
Local Assistance Procedures Manual Exhibit 12-G
Required Federal-Aid Contract Language
will on the grounds of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination with regard to any facility located wholly or in part on, over, or under such lands hereby conveyed [,] [and]* (2) that the recipient will use the lands and interests in lands and interest in lands so conveyed, in compliance with all requirements imposed by or pursuant to Title 49, Code of Federal Regulations, U.S. Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Non-discrimination in Federally-assisted programs of the U.S. Department of Transportation, Effectuation of Title VI of the Civil Rights Act of 1964, and as said Regulations and Acts may be amended, and (3) that in the event of breach of any of the above-mentioned non-discrimination conditions, the Department will have a right to enter or re-enter said lands and facilities on said lands, and that above described land and facilities will thereon revert to and vest in and become the absolute property of the U.S. Department of Transportation and its assigns as such interest existed prior to this instruction].*
(*Reverter clause and related language to be used only when it is determined that such a clause is necessary in order to make clear the purpose of Title Vl.)
APPENDIX C
CLAUSES FOR TRANSFER OF REAL PROPERTY ACQUIRED OR IMPROVED UNDER THE
ACTIVITY, FACILITY, OR PROGRAM
The following clauses will be included in deeds, licenses, leases, permits, or similar instruments entered into by the recipient pursuant to the provisions of Assurance 7(a):
A. The (grantee, lessee, permittee, etc. as appropriate) for himself/herself, his/her heirs, personal representatives, successors in interest, and assigns, as a part of the consideration hereof, does hereby covenant and agree [in the case of deeds and leases add "as a covenant running with the land"] that:
1. In the event facilities are constructed, maintained, or otherwise operated on the property described in this (deed, license, lease, permit, etc.) for a purpose for which a U.S. Department of Transportation activity, facility, or program is extended or for another purpose involving the provision of similar services or benefits, the (grantee, licensee, lessee, permittee, etc.) will maintain and operate such facilities and services in compliance with all requirements imposed by the Acts and Regulations (as may be amended) such that no person on the grounds of race, color, or national origin, will be excluded from participation in, denied the benefits of, or be otherwise subjected to discrimination in the use of said facilities.
B. With respect to licenses, leases, permits, etc., in the event of breach of any of the above Non- discrimination covenants, the recipient will have the right to terminate the (lease, license, permit, etc.) and to enter, re-enter, and repossess said lands and facilities thereon, and hold the same as if the (lease, license, permit, etc.) had never been made or issued.*
C. With respect to a deed, in the event of breach of any of the above Non-discrimination covenants, the recipient will have the right to enter or re-enter the lands and facilities thereon, and the above described lands and facilities will there upon revert to and vest in and become the absolute property of the recipient and its assigns.*
(*Reverter clause and related language to be used only when it is determined that such a clause is necessary to make clear the purpose of Title VI.)
January 2022
F-53
Local Assistance Procedures Manual Exhibit 12-G
Required Federal-Aid Contract Language
APPENDIX D
CLAUSES FOR CONSTRUCTION/USE/ACCESS TO REAL PROPERTY ACQUIRED UNDER THE
ACTIVITY, FACILITY OR PROGRAM
The following clauses will be included in deeds, licenses, permits, or similar instruments/agreements entered into by the recipient pursuant to the provisions of Assurance 7(b):
A. The (grantee, licensee, permittee, etc., as appropriate) for himself/herself, his/her heirs, personal representatives, successors in interest ,and assigns, as a part of the consideration hereof, does hereby covenant and agree (in the case of deeds and leases add, "as a covenant running with the land") that (1) no person on the ground of race, color, or national origin, will be excluded from participation in, denied the benefits of, or be otherwise subjected to discrimination in the use of said facilities, (2) that in the construction of any improvements on, over, or under such land, and the furnishings of services thereon, no person on the ground of race, color, or national origin, will be excluded from participation in, denied the benefits or, or otherwise be subjected to discrimination, (3) that the (grantee, licensee, lessee, permittee, etc.) will use the premises in compliance with all other requirements imposed by or pursuant to the Acts and Regulations, as amended, set forth in this Assurance.
B. With respect to (licenses, leases, permits, etc.) in the event of breach of any of the above of the above Non-discrimination covenants, the recipient will have the right to terminate the (license, permits, etc., as appropriate) and to enter or re-enter and repossess said land and the facilities thereon, and hold the same as it said (license, permit, etc., as appropriate) had never been made or issued.* C. With respect to deeds, in the event of breach of any of the above Non-discrimination covenants, the recipient will there upon revert to and vest in and become the absolute property of the recipient and its (*Reverter clause and related language to be used only when it is determined that such a clause is necessary to make clear the purpose of Title VI.)
APPENDIX E
During the performance of this contract, the contractor, for itself, its assignees, and successors in interest (hereinafter referred to as the "contractor") agrees to comply with the following non-discrimination statutes and authorities, including, but not limited to:
Pertinent Non-Discrimination Authorities:
• Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), prohibits discrimination on the basis of race, color, national origin); and 49 CFR Part 21. • The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. § 4601), (prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or Federal-aid programs and projects);
• Federal-Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), prohibits discrimination on the basis of sex; • Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended, (prohibits discrimination on the basis of disability); and 49 CR Part 27; • The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.), prohibits discrimination on the basis of age);
• Airport and Airway Improvement Act of 1982, (49 U.S.C. § 471, Section 47123), as amended, (prohibits discrimination based on race, creed, color, national origin, or sex); • The Civil Riahts Restoration Act of 1987, (PL 100-209), (Broadened the scope, coverage and applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms "programs or activities" to include all of the programs or activities of the Federal-aid recipients, sub-recipients and contractors, whether such programs or activities are Federally funded or not);
January 2022
F-54
Local Assistance Procedures Manual Exhibit 12-G
Required Federal-Aid Contract Language
• Titles Il and Ill of the Americans with Disabilities Act, which prohibit discrimination of the basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and certain testing entities (42 U.S.C. §§ 12131 - 12189) as implemented by Department of Transportation regulations 49 C.F.R. parts 37 and 38; • The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. § 47123) (prohibits discrimination on the basis of race, color, national origin, and sex); • Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations, which ensures discrimination against minority populations by discouraging programs, policies, and activities with disproportionately high and adverse human health or environmental effects on minority and low-income populations; • Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency, and resulting agency guidance, national origin discrimination includes discrimination because of limited English proficiency (LEP). To ensure compliance with Title VI, you must take reasonable steps to ensure that LEP persons have meaningful access to your programs (70 Fed. Reg. at 74087 to 74100); • Title IX of the Education Amendments of 1972, as amended, which prohibits you from discriminating because of sex in education programs or activities (20 U.S.C. 1681 et seq).
14. USE OF UNITED STATES-FLAG VESSELS (CARGO PREFERENCE ACT) The CONTRACTOR agrees-
1. To utilize privately owned United States-flag commercial vessels to ship at least 50 percent of the gross tonnage (computed separately for dry bulk carries, dry cargo liners, and tankers) involved, whenever shipping any equipment, material, or commodities pursuant to this contract, to the extent such vessels are available at fair and reasonable rates for United States-flag commercial vessels.
2. To Furnish within 20 days following the date of loading for shipments originating within the United State or within 30 working days following the date of loading for shipments originating outside the United States, a legible copy of a rated "on-board" commercial ocean bill-of-lading in English for each shipment of cargo described in paragraph (1) of this section to both the Contracting Officer (through the prime contractor in the case of subcontractor bills-of-lading) and to the Division of National Cargo, Office of Market Development, Maritime Administration, Washington, DC 20590.
3. To insert the substance of the provisions of this clause in all subcontracts issued pursuant to this contract.
Federal Trainee Program Special Provisions
(to be used when applicable)
15. FEDERAL TRAINEE PROGRAM
For the Federal training program, the number of trainees or apprentices is This section applies if a number of trainees or apprentices is specified in the special provisions.
As part of the prime contractor's equal opportunity affirmative action program, provide on-the-job training to develop full journeymen in the types of trades or job classifications involved.
The prime contractor has primary responsibility for meeting this training requirement.
If the prime contractor subcontracts a contract part, they shall determine how many trainees or apprentices are to be trained by the subcontractor. Include these training requirements in each subcontract.
Where feasible, 25 percent of apprentices or trainees in each occupation must be in their 1st year of apprenticeship or training.
Distribute the number of apprentices or trainees among the work classifications on the basis of the prime contractor's needs and the availability of journeymen in the various classifications within a reasonable recruitment area.
Before starting work, the prime contractor shall submit to the City/County of_ :
January 2022
F-55
Local Assistance Procedures Manual Exhibit 12-G
Required Federal-Aid Contract Language
1. Number of apprentices or trainees to be trained for each classification
2. Training program to be used
3. Training starting date for each classification
The prime contractor shall obtain the City/County of approval for this submitted information before the prime contractor starts work. The City/County of _credits the prime contractor for each apprentice or trainee the prime contractor employs on the job who is currently enrolled or becomes enrolled in an approved program.
The primary objective of this section is to train and upgrade minorities and women toward journeyman status.
The prime contractor shall make every effort to enroll minority and women apprentices or trainees, such as conducting systematic and direct recruitment through public and private sources likely to yield minority and women apprentices or trainees, to the extent they are available within a reasonable recruitment area anc show that they have made the efforts. In making these efforts, the prime contractor shall not discriminate against any applicant for training.
The prime contractor shall not employ as an apprentice or trainee an employee:
• In any classification in which the employee has successfully completed a training course leading t ourneyman status or in which the employee has been employed as a journeyma
2. Who is not registered in a program approved by the US Department of Labor, Bureau of Apprenticeship and Training
The prime contractor shall ask the employee if the employee has successfully completed a training course leading to journeyman status or has been employed as a journeyman. The prime contractor's records must show the employee's answers to the questions.
In the training program, the prime contractor shall establish the minimum length and training type for each classification. The City/County of and FHWA approves a program if one of the following is met:
1. It is calculated to:
• Meet the your equal employment opportunity responsibilities * Qualify the average apprentice or trainee for journeyman status in the classification involved by the end of the training period
2. It is registered with the U.S. Department of Labor, Bureau of Apprenticeship and Training and it is administered in a way consistent with the equal employment responsibilities o Federal-aid highway construction contracts
The prime contractor shall obtain the State's approval for their training program before they start work involving the classification covered by the program.
The prime contractor shall provide training in the construction crafts, not in clerk-typist or secretarial-type positions. Training is allowed in lower level management positions such as office engineers, estimators, and timekeepers if the training is oriented toward construction applications. Training is allowed in the laborer classification if significant and meaningful training is provided and approved by the division office. Off-site training is allowed if the training is an integral part of an approved training program and does not make up a significant part of the overall training.
The City/County of reimburses the prime contractor 80 cents per hour of training given an employee on this contract under an approved training program:
1. For on-site training
2. For off-site training if the apprentice or trainee is currently employed on a Federal-aid project and prime contractor does at least one of the following:
a. Contribute to the cost of the training
b. Provide the instruction to the apprentice or trainee c. Pay the apprentice's or trainee's wages during the off-site training period
3. If the prime contractor complies with this section.
January 2022
F-56
Local Assistance Procedures Manual Exhibit 12-G
Required Federal-Aid Contract Language
Each apprentice or trainee must:
1. Begin training on the project as soon as feasible after the start of work involving the apprentice's or trainee's skill
2. Remain on the project as long as training opportunities exist in the apprentice's or trainee's work classification or until the apprentice or trainee has completed the training program The prime contractor shall furnish the apprentice or trainee with a copy of the program that the prime contractor will comply with in providing the training.
16. PROHIBITION OF CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE EQUIPMENT AND
SERVICES
In response to significant national security concerns, the agency shall check the prohibited vendor list before making any telecommunications and video surveillance purchase because recipients and subrecipients of federal funds are prohibited from obligating or expending loan or grant funds to:
• Procure or obtain;
• Extend or renew a contract to procure or obtain; or
• Enter into a contract (or extend or renew a contract) to procure or obtain equipment, services, or systems that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system.
The prohibited vendors (and their subsidiaries or affiliates) are:
• Huawei Technologies Company;
• ZTE Corporation;
• Hytera Communications Corporation;
• Hangzhou Hikvision Digital Technology Company;
• Dahua Technology Company; and
• Subsidiaries or affiliates of the above-mentioned companies.
In implementing the prohibition, the agency administering loan, grant, or subsidy programs shall prioritize available funding and technical support to assist affected businesses, institutions and organizations as is reasonably necessary for those affected entities to transition from covered communications equipment and services, to procure replacement equipment and services, and to ensure that communications service to users and customers is sustained.
January 2022
F-57
SECTION G
FEDERAL AID CONTRACT EXHIBITS
STIMSON AVENUE GRADE CROSSING
IMPROVEMENT
CONTRACT NO. CITY-1480
EXHIBITS 12-B BIDDER'S LIST OF SUBCONTRACTOR (DBE AND NON-DBE) EXHIBITS 12-H SAMPLE BID
EXHIBITS 15-G CONSTRUCTION CONTRACT DBE COMMITMENT
EXHIBITS 15-H PROPOSER/CONTRACTOR GOOD FAITH EFFORTS
G-1
Local Assistance Procedures Manual Exhibit 12-
Bidder's List of Subcontractors (DBE and Non-DB
Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 1 As of March 1, 2015 Contractors (and sub-contractors) wishing to bid on public works contracts must be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at https://www.dir.ca.gov/Public-Works/Contractor- registration.htmi. The local agency will verify registration of all contractors and subcontractors on public works projects at bid and thereafter annually i ssure that yearly registration is maintained throughout the life of the projec in accordance with Title 49, Section 26.11 of the Code of Federal Regulations, and Section 4104 ofthe Public Contract Code of the State of California, as amended, the following information is required for each sub-contractor who will perform work amounting to more than one half of one percent (0.5%) of the Total Base Bid or $10,000 (whichever is greater).
FEDERAL PROJECTNUMBER:
Photocopy this form for additional firms.
Subcontractor Name & Location Line Item & Description Subcontract Percentage of Contractor License Number DBE DBE Cert Number Annual Gross Receipt:
Amount Bid Item (YN)
Subcontracted DIR Reg Number
NAME
25- < $1 million
99112Z < $5 million
CatTracking In striping 12,450.00 1.8%0 X< $10 million
City, State тецкіна y 43242 < $15 million
Riverside, CA markus 1000011750 Age of Firm in 10
years
NAME
< $1 million
27-33 < $5 million
-OS Angels Scana 25,525 3.4 858974
city, State Long. Inc Electreal X<$10 million
Y 35670 < $15 million
San Dimas, CA (000005664 Age of Firm in
years
NAME
11-23 < $1 million
932798 N < $5 million
EBSUtilities Adi. Adjust 0.75 < $10 million
City, Stale Inc 5,275.00
utilitais Xi=315 million
Corona, CA 10000042866 Age of Firm in 25
years
NAME
14- < $1 million
905954 < $5 million
Hardy Landscape. Install 34,110.80 5.1
City, State 39543 X<510 million
Y < $15 million
Diamond Bas Ca Cobble 1000042805 Age ofFirm in 20
years
NAME
< $1 million
< $5 million
< $10 million
City, State
< $15 million
Age of Firm in
years
NAME
< $1 million
_ < $5 million
City, State < $10 million
1<515 million
Age of Firm in
years
NAME < St million
< $5 million
City, State < $10 millis
1<515 million
Age of Firm in
years
NAME
< $1 million
< $5 million
Clly, State 1< $10 million
< 515 million
As of Fism in
NAME Fst milfion
< $5 million
< $10 million
City, State < $15 million
Age of Firm in
years
Distribution - Original: Local Agency File; Copy: DLAE w/Award Package G-2 Page 1 of 2
September 2021
Local Assistance Procedures Manual Exhibit 12-B
Bidder's List of Subcontractors (DBE and Non-DBE)
Exhibit 12-B: Bidder's List of Subcontractor (DBE and Non-DBE) - Part 2 In accordance with Title 49, Section 26 of the Code of Federal Regulations, the Bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project.
FEDERAL PROJECT NUMBER:
Photocopy this form for additional firms.
Subcontractor Name & Location Percentage of Contractor License Number DBE Annual Gross Recepts Line Item & Description Subcontract DBE Cert Number
Amount Bid Item (YIN)
Subcontracted DIR Reg Number
NAME ] < $1 million
27-33 < $5 million
Electrical 36,940.00 754309 < $10 million
K. < $15 million
truindale, CA 1000000/55 A offin 15 years
NAME T<‹ $1 million
27-33 < $5 million
For He Construction 1032550 < $10 million
City, State Electrical 25,444.00 x-515 million
Berna Park, CA 1000054450 A Gram in so
NAME < $1 million
25. < 55 million
Chreis Co. 374600 X < 510 million
tapine ] < $15 million
City, State 17,984.00 N
Bloomungton. CA 1000000306 Age of Firm in 22
years
NAME [=51 million
PCI 415-490 < $5 million
Stening < $10 million
City, State 24,980 N x <515 million
Markine
Azusa, CA markis 100813574 As farm in 130
< $1 milli
27-33 N < $5 millic
Comet Electre 36,343 681827 < $10 million
City, State Electreal *< 515 million
Chatsworth, LA ge of Firm il 35
NAME < S1 million
27-33 793907 < $5 million
Califorpia Professind Electrial 24,800 31277 X < $10 million Y < $15 millior
La Ponte, CA 1000371609 Age of Firm in 20
years
NAME < $1 million
MSL Electru 21-33 422450 < $5 million
< $10 million
City, State Electrical 24,870 N X = 515 milion
Analuim, CA 1000000550 Ase of are in 15
NAME 25-,
Sterndahl Ent. 21,000 421823 < $10 million
City, State N K < $15 million
Sun Valley, CA markers 1000913938 As ofF in 30
NAME <51 million
Pavement 25- < $5 million
774304 : < $10 mili
Supera kings Strepune 15,000 N < $15 millia
Cypress, CA 1000001474
Distribution - Original: Local Agency File; Copy: DLAE w/Award Package G-3 Page 2 of 2
September 2021
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
EXHIBIT 12-H SAMPLE BID
CITY / COUNTY OF City of Industry
DEPARTMENT OF PUBLIC WORKS
BID
FOR
(PROJECT DESCRIPTION)
IN
(LOCATION)
Notice to bidders and Special Provisions dated:
Project Plans approved:
Standard Specifications dated:
Standard Plans dated:
Contract No. CITX-1480, Project No. 480
Federal Aid Project No. STPLR-7500 (258)
Bid Opening Date: August 17, 2022 @ 10:00 AM
LPP 18-01 Page 1 of 22
G-4 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
(DO NOT DETACH)
PROPOSAL TO THE CITY / COUNTY OF _Industry
DEPARTMENT OF PUBLIC WORKS
CONTRACTNO. - CITY-1480 Project No. 480
Federal Project No. STPLR-7500 (258)
NAME OF BIDDER Sully-Miller Contracting Company
BUSINESS P.O. BOX
CITY, STATE, ZIP
BUSINESS STREET ADDRESS 135 S. State College Bivd., Suite #400 Brea, CA 92821 (Please include even if P.O. Box used)
CITY, STATE, ZIP
TELEPHONE NO: AREA CODE ( ) 714/578-9600
FAX NO: AREA CODE ( ) 714/578-9672
CONTRACTOR LICENSE NO. #747612
The work for which this proposal is submitted is for construction in conformance with the special provisions (including the payment of not less than the State general prevailing wage rates or Federal minimum wage rates), the project plans described Depart inet of Trans podida standard lans, 5a dare spect, an, also in abor archari and Equi aent Rental Rates in effect on the date the work is accomplished.
The special provisions for the work to be done are dated (Insert advertisement date) and are entitled:
CITY / COUNTY OF _ City of Industry
DEPARTMENT OF
NOTICE TO CONTRACTORS AND SPECIAL PROVISIONS FOR
(Description of Work)
IN
(Location)
The project plans for the work to be done were approved and are entitled:
LPP 18-01 Page 2 of 22
G-5 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
CITY / COUNTY OF _
• DEPARTMENT OF
PROJECT PLANS FOR
(Description of Work)
IN
(Location)
ids are to be submitted for the entire work. The amount of the bid for comparison purposes will be the total of all item he bidder shall set forth for each unit basis item of work a unit price and a total for the item, and for each lump sum item In case of discrepancy between the unit price and the total set forth for a unit basis item, the unit price shall prevail, except as provided in (a) or (b), as follows:
If the amount set forth as a unit price is unreadable or otherwise unclear, or is omitted, or is the same as the amount of the entry in the item total column, then the amount set forth in the item total column for the item shall prevail and shall be divided by the estimated quantity for the item and the price thus obtained shall be the unit price; (b) (Decimal Errors) If the product of the entered unit price and the estimated quantity is exactly off by a factor of ten, one hundred, etc., or one-tenth, or one-hundredth, etc. from the entered total, the discrepancy will be resolved by using the entered unit price or item total, whichever most closely approximates percentage-wise the unit price or item total in the CITY/COUNTY OF 's Final Estimate of cost.
If both the unit price and the item total are unreadable or otherwise unclear, or are omitted, the bid may be deemed irregular.
Likewise if the item total for a lump sum item is unreadable or otherwise unclear, or is omitted, the bid may be deemed irregular unless the project being bid has only a single item and a clear, readable total bid is provided.
Symbols such as commas and dollar signs will be ignored and have no mathematical significance in establishing any unit price or item total or lump sums. Written unit prices, item totals and lump sums will be interpreted according to the number of digits and, if applicable, decimal placement. Cents symbols also have no significance in establishing any unit price or item total since all figures are assumed to be expressed in dollars and/or decimal fractions of a dollar. Bids on lump sum items shall be item totals only; if any unit price for a lump sum item is included in a bid and it differs from the item total, the items total shall prevail.
The foregoing provisions for the resolution of specific irregularities cannot be so comprehensive as to cover every omission, inconsistency, error or other irregularity which may occur in a bid. Any situation not specifically provided for will be determined in the discretion of the CITY/COUNTY OF _, and that discretion will be exercised in the manner deemed by the CITY/COUNTY OF to best protect the public interest in the prompt and economical completion of the work. The decision of the CITY/COUNTY OF respecting the amount of a bid, or the existence or treatment of an irregularity in a bid, shall be final.
If this proposal shall be accepted and the undersigned shall fail to enter into the contract and furnish the 2 bonds in the sums required by the State Contract Act, with surety satisfactory to the CITY/COUNTY OF _ within 8 days, not including Saturdays, Sundays and legal holidays, after the bidder has received notice from the CITY/COUNTY OF that the contract has been awarded, the CITY/COUNTY OF may, at its option, determine that the bidder has abandoned the contract, and thereupon this proposal and the acceptance thereof shall be null and void and the forfeiture of the security accompanying this proposal shall operate and the same shall be the property of the CITY / COUNTY OF
The undersigned, as bidder, declares that the only persons or parties interested in this proposal as principals are those named herein; that this proposal is made without collusion with any other person, firm, or corporation; that he has carefully examined the location of the proposed work, the annexed proposed form of contract, and the plans therein referred to; and he roposes, and agrees if this proposal is accepted, that he will contract with the CITY/COUNTY OF _ in the form of the copy of the contract annexed hereto, to provide all necessary machinery, tools, apparatus and other means of construction, and to do all the work and furnish all the materials specified in the contract, in the manner and time therein LPP 18-01 Page 3 of 22
G-6 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION
The bidder X- Sully-Miller Contracting Company → proposed subcontractor _ hereby certifies that he has V, 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 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.)
Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations.
Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor.
LPP 18-01 Page 6 of 22
G-7 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
PUBLIC CONTRACT CODE
PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT
In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has , has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the Califomia 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 checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE
In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire:
Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation?
Yes No
If the answer is yes, explain the circumstances in the following space.
LPP 18-01 Page 7 of 22
G-8 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
PUBLIC CONTRACT CODE 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.
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.
LPP 18-01 Page 8 of 22
G-9 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
DEBARMENT AND SUSPENSION CERTIFICATION
TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29
The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other 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 been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years;
does not have a proposed debarment pending; and
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 bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action.
Notes: Providing false information may result in criminal prosecution or administrative sanctions.
The above certification is part of the Proposal. Signing this Proposal on the signature portion thereo hall also constitute signature of this Certificatior
IPP 18-01 Page 10 of 22
G-10 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
NONLOBBYING CERTIFICATION
FOR FEDERAL-AID CONTRACTS
The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that:
(I) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee 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 conformance with its instructions.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly.
IPP 18-01 Page 11 of 22
G-11 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
DISCLOSURE OF LOBBYING ACTIVITIES
COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract Ta. bid/offer/application Ta. initial
b. grant b. initial award b. material change
c. cooperative agreement
d. loan For Material Change Only:
e. loan guarantee N/A yet of last arter-
f. loan insurance
4. Name and Address of Reporting Entity If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime:
Prime Subawardee
Tier _, if known
Congressional District, if known Congressional District, if known
6. Federal Department/Agency: 7. Federal Program Name/Description:
CEDA Number, if applicable
8. Federal Action Number, if known: 9. Award Amount, if known:
10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI address if different from No. 10a) (last name, first name, MI)
(attach Continuation Sheets) if necessary)
11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) actual planned a. retainer
b. one-time fee
12. Form of Payment (check all that apply): c. commission a. cash d. contingent fee
b. in-kind; specify: nature e deferred
value f. other, specify
Brief Description of Services Performed or to be performed and Date(s) of Service, includin officers), employee(s), or member(s) contacted, for Payment Indicated in Item 11 (attach Continuation Sheets) if necessary)
15. Continuation Sheets) attached: Yes No
16. Tile 3 U.S. Section 1352. this i stren eyes Of Saltert.
Signature:
Print Name: Jeff Galterio
reported to Congress semiannually and will be available for Title: Assistant Secretary public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than Date: 8/11/22 $10,000 and not more than $100,000 for each such failure. Telephone No.: 714/578-9600 Authorized for Local Reproduction
Federal Use Only: Standard Form - LLL
LPP 18-01 Page 12 of 22
G-12 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
INSTRUCTIONS FOR COMPLETION OF SF-LLL,
DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence ar officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known.
Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g.,
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action.
(b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI).
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item) 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made.
12. Check the appropriate box. Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment.
13. Check the appropriate box. Check all boxes that apply. If other, specify nature.
14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officers) or employee(s) contacted or the officers) employee(s) or Members) of Congress that were contacted.
15. Check whether or not a continuation sheets) is attached.
16. The certifying official shall sign and date the form, print his/her name title and telephone number.
Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev. 06-04-90«ENDIF» LPP 18-01 Page 13 of 22
G-13 January 2019
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
Accompanying this proposal is Bidder's Bond
(NOTICE: INSERT THE WORDS "CASH(S _," "CASHIER'S CHECK," "CERTIFIED CHECK," OR "BIDDER'S BOND," AS THE CASE MAY BE.) in amount equal to at least ten percent of the total of the bid.
The names of all persons interested in the foregoing proposal as principals are as follows:
IMPORTANT NOTICE: If bidder or other interested person is a corporation, state legal name of corporation, also names Stie pat can sec camp orange, ander se there face pere ep steel ane gos and a ame ali.
Please see attached Certificate of Incumbency and Resolution Licensed in conformance with an act providing for the registration of Contractors, License No. #747612 Classifications) A
ADDENDA
This Proposal is submitted with respect to the changes to the contract included in addenda number/s 1,2
(Fill in addenda numbers if addenda have been received and insert, in this Proposal, any Engineer's Estimate sheets that were received as part of the addenda.)
foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). By my signature on this proposal I further certify, under penalty of perjury under the laws of the State of California and the United States of America, that the Noncollusior ffidavit required by Title 23 United States Code, Section 112 and Public Contract Code Section 7106: and the Title 49 Coc f Federal Regulations, Part 29 Debarment and Suspension Certification are true and corres Date: 08/11/2022
Sully-Miller Contracting Company
Sign
CAsalters
(Title)
Here Asst. Secretary
Signature and Title of Bidder
Business Address 135 S. State College Blvd., Suite #400 Brea, CA 92821 Place of Business 135 S. State College Blvd., Suite #400 Brea, CA 92821 Place of Residence
LPP 18-01 Page 14 of 22
G-14 January 2019
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Orange
On_08/11/2022 before me, _ Maria L. Ruiz, Notary Public Date Here Insert Name and Title of the Officer
personally appeared Jeff Galterio
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
MARIA L. RUIZ WITNESS my hand and official seal.
Notary Public - California
Orange County
Commission # 2400140
My Comm, Explres Apr 8, 2026
Place Notary Seal Above
- OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Signature Page _ Document Date: . 08/11/22 Number of Pages: . , Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: _Jeff Galterio Signer's Name:
X Corporate Officer - Title(s): Assistant Secretary • Corporate Officer - Title(s):
• Partner - O Limited • General • Partner - • Limited • General • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: Signer Is Representing:
Sully-Miller Contracting Company
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 /m
SULLY-MILLER CONTRACTING CO.
License 747012A
135 S. State College Bivdl., STE. 400 • Brea, CA 92821 • PHONE 714-578-9600 License Certificate
I certify under penalty of perjury under the laws of the State of California that the following is true and correct:
CSLB:
747612-A Jeff Galterio, Assistant Secretary
CONTRACTORS
dca STATE LICENSE BOARD
DEPARTMENT CE CONSUMER AFFAIRS ACTIVE LICENSE
License Number 747612 Entty CORP
Bualness Name SULLY - MILLER CONTRACTING
COMPANY
Classifications) A CSLB
Expiration Date 03/31/2024 www.csib.ca.gov
CERTIFICATE OF INCUMBENCY AND RESOLUTION
I, Anthony L. Martino, II, do hereby certify that I am the Secretary of Sully-Miller Contracting Company, a Delaware corporation, and that as such I have access to and custody of the corporate records and minute books of said corporation.
And I do hereby further certify that the following persons are duly elected officers of said corporation.
TITLE NAME
Chairman Of The Board John Harrington
President William Joseph Thomas Boyd
Vice President, CFO, Treasurer Christopher Winter
and Assistant Secretary
Vice President and Assistant Secretary Scott Bottomley
Secretary Anthony L. Martino, II
Assistant Secretary Curtis Weltz
Assistant Secretary Jeff Galterio
I further certify that the following is a true and correct copy of a resolution duly adopted by the Board of Directors of said Company at a meeting held on December 3, 2020, and that this resolution has not been in any way rescinded, annulled, or revoked but the same is still in full force and effect:
"BID TENDERS: GENERAL
RESOLVED, that any officer of the Corporation be and they hereby are authorized in the name and on behalf of the Corporation, under its corporate seal or otherwise (i) to prepare proposals and bids for the supplying of construction materials and the performance by itself or in joint venture, of work of whatsoever nature in connection with the construction or paving of highways, roads and airports and in connection with earthworks and civil engineering projects of all kinds, together with all work incidental thereto, (ii) to execute and submit any and all such proposals and bids to any governmental authority, instrumentality, or agency of the United States, its several states, territories and possessions, including without limitation, any municipality or other political or corporate subdivision thereot, and to any corporation, partnership, sole proprietorship, or other business entity, (iii) in connection with any such submission, to deliver bid deposits or bonds as may be required and (iv) to execute and deliver definitive agreements binding the Corporation to perform work in accordance with any proposals and bids authorized hereby."
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seal this 1st day of June, 2021.
7422
(SEAL) Anthony L. Martino, II
Secretary
Sully-Miller Contracting Company
135 S. State College Blvd., Ste. 400
Brea, CA 92821
MIR State of California
Department of
EST. 1927 Industrial Relations
Contractor Information
Legal Entity Name
SULLY-MILLER CONTRACTING COMPANY
Legal Entity Type
Corporation
Status
Active
Registration Number
1000003664
Registration effective date
7/1/2022
Registration expiration date
6/30/2024
Mailing Address
135 S STATE COLLEGE BLVD, SUITE #400
BREA, CA 92821
Physical Address
135 S STATE COLLEGE BLVD, SUITE #400
BREA, CA 92821
Email Address
[email protected]
Trade Name/DBA
License Number (s)
CSLB -747612
/m
SULLY-MILLER CONTRACTING CO.
License 747612A
135 S. STATE COLLEGE BLVD., SUITE 400 • BREA, CA 92821 • PHONE 714-578-9600 August 30, 2022
City of Industry
15625 Mayor Dave Way
City of Industry, CA 91744
Attn: Joshua Nelson, City Manager
Re: Stimson Avenue Grade Crossing Improvement
Contract No. CITY-1480, Project No. 480, STPLR-7500(258) Bid Date: August 17, 2022 @ 10:00 a.m.
Subject: Public Contract Code Section 10285.1
Dear Gentlepersons:
Please find attached a corrected Public Contract Code Section 10285.1 for the above-mentioned project's bid proposal.
Due to a clerical error, the wrong line of "has" was inadvertently checked off instead of the "has not", as Sully-Miller Contracting Company has not been convicted within the preceding three years of any offenses referred to in this section of Public Contract Code.
Please feel free to call our office with any questions or comments you may have.
Thank you.
Tanager
Sully-Miller Contracting Company
Local Assistance Procedures Manual Exhibit 12-H
Sample Bid
PUBLIC CONTRACT CODE
PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT
In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has —, has not _ been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1.
The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution.
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 govemment project because of a violation of law or a safety regulation?
Yes No
If the answer is yes, explain the circumstances in the following space.
LPP 18-01 Page 7 of 22
G-8 January 2019
EXHIBIT C
Contractor's State of California and Department of Industrial relations License Detail [Attached]
Home Contractors STATE License BOArD
•Contractor's License Detail for License # 747612
DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. • CSLB complaint disclosure is restricted by law (B&P.7124.6) If this entity is subject to public complaint disclosure click on link that will appear below for more information. Click here for a definition of disclosable actions. • Only construction related civil judements reported to CoLB are disclosed (B&P 7071.17) * Arbitrations are not listed unless the contractor fails to comply with the terms. • Due to workload, there may be relevant information that has not yet been entered into the board's license database.
Data current as of 8/30/2022 2:53:45 PM
Business Information
SULLY - MILLER CONTRACTING COMPANY
135 SOUTH STATE COLLEGE BLVD
SUITE 400
BREA, CA 92821
Business Phone Number:(714) 578-9600
Entity Corporation
Issue Date 03/30/1998
Expire Date 03/31/2024
License Status
This license is current and active.
All information below should be reviewed.
Classifications
A - GENERAL ENGINEERING
Bonding Information
Contractor's Bond
This license filed a Contractor's Bond with LIBERTY MUTUAL INSURANCE COMPANY.
Bond Number: 014012431
Bond Amount: $15,000
Effective Date: 01/01/2016
Contractor's Bond History
Bond of Qualifying Individual
This license filed Bond of Qualifying Individual number 014075631 for JOHN RYAN HARRINGTON in the amount of $12,500 with LIBERTY MUTUAL INSURANCE COMPANY.
Effective Date: 05/17/2017
Workers' Compensation
This license has workers compensation insurance with the LM INSURANCE CORPORATION Policy Number:WC5631510805032
Effective Date: 04/01/2022
Expire Date: 04/01/2023
Workers' Compensation History
Other
• Personnel listed on this license (current or disassociated) are listed on other licenses.
Back to Top Conditions of Use Privacy Policy Accessibility Accessibility Certification
EXHIBIT D
Notice of Exemption
[Attached]
NOTICE OF EXEMPTION
To: County Clerk From: City of Industry
County of Los Angeles 15625 Mayor Dave Way, Suite 100
Environmental Filings City of Industry, CA 91744
12400 East Imperial Highway #2001
Norwalk, CA 90650
Project Title: CITY-1480 - Stimson Avenue Grade Crossing Improvements Project Location - Specific: Stimson Avenue Crossing at LA Subdivision Project Location-City: City of Industry Project Location-County: Los Angeles Description of Project: The improvements include the reconstruction of concrete sidewalk in each of the four approach quadrants, installation of detectable warning surfaces on all sidewalk approaches, and the reconstruction of approximately 150 feet of asphalt pavement.
Name of Public Agency Approving Project: City of Industry Name of Person or Agency Carrying Out Project: City of Industry Exempt Status: (check one)
• Ministerial (Sec. 21080(b)(1); 15268);
Declared Emergency (Sec. 21080(b)(3); 15269(a));
Emergency Project (Sec. 21080(b)(4); 15269(b)(c));
M Categorical Exemption. State type and section number: 15301 Class 1 (c) Statutory Exemptions. State code number:
Reasons why project is exempt: The proposed project is exempt from the California Environmental Quality Act ("CEQA") per Section 15301 Class 1 of the CEQA Regulations in which the minor alteration of existing public or private structures or facilities involve negligible or no expansion of existing use. This project will remove the existing deteriorated AC pavement and aggregate base; and will replace with the new asphalt concrete pavement including the reconstruction of concrete sidewalk. The project will not expand the existing use of the roadway but improve the traffic movement and safety.
Improvements to the roadway will be limited to reconstruction of deteriorated existing street components with no expansion of existing use.
Lead Agency
Contact Person: Mathew Hudson Telephone: (626) 333-2211 Signature: Date: September 22, 2022
Title: Engineering Manager
CITY COUNCIL
ITEM NO. 6.1
OF
CITY OF INDUSTRY
ANGELES CO
MEMORANDUM
TO: Honorable Mayor Moss and Members of the City Council FROM: Joshua Nelson, City Manager M
STAFF: Sam Pedroza, Assistant City Manager
DATE: September 22, 2022
SUBJECT: Consideration of Resolution No. CC 2022-40, nominating Cathy Marcucci as an alternate member on the Board of the San Gabriel Basin Water Quality Authority
Background:
The San Gabriel Basin Water Quality Authority ("WQA") is empowered by the State of California to protect and promote the beneficial use of groundwater supplies in the San Gabriel Valley. Their work focuses on coordinating and facilitating actions by local, state and federal agencies to contain and clean up groundwater contamination and prevent its spread.
Discussion:
The WQA is governed by a Board of Directors composed of seven (7) members, one of which is elected by cities with pumping rights in the San Gabriel groundwater basin. In addition to the seven members, there is an alternate seat for the cities with pumping rights. There is currently a vacancy in the alternate position, and the Board is accepting nominations to fill the vacancy. The City would like to nominate Cathy Marcucci to represent the City as an alternate board member for the cities with pumping rights.
Fiscal Impact:
No fiscal impact.
Recommendation:
Staff recommends that the City Council adopt Resolution No. CC 2022-40, nominating Cathy Marcucci as an alternate member of the Board of the San Gabriel Basin Water Quality Authority.
Exhibit:
A. Resolution No. CC 2022-40
JN/SP:yp
15625 Mayor Dave Way • City of Industry, California 91744 • 626.333.2211 • www.cityofindustry.org
EXHIBIT A
Resolution No. CC 2022-40
[Attached]
RESOLUTION NO. CC 2022-40
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
INDUSTRY, CALIFORNIA, NOMINATING COUNCILMEMBER
CATHERINE MARCUCCI TO REPRESENT CITIES WITH
PRESCRIPTIVE WATER PUMPNG RIGHTS AS AN ALTERNATE
MEMBER ON THE BOARD OF THE SAN GABRIEL BASIN WATER
QUALITY AUTHORITY
RECITALS
WHEREAS, the San Gabriel Basin Water Quality Authority ("WQA") is governed by a Board of Directors composed of seven (7) members, one of which is elected by cities with pumping rights in the San Gabriel groundwater basin; and WHEREAS, in addition to the seven members, there is an alternate seat for the cities with pumping rights. There is currently a vacancy in the alternate position, and the Board is accepting nominations to fill the vacancy; and WHEREAS, the WQA Board of Directors has declared the position of alternate director representing cities with pumping rights to be vacant and has called a special election for the purpose of filling the vacancy in the office of alternate member representing cities with pumping rights; and
WHEREAS, the City is one of the cities in the San Gabriel Basin with pumping rights, entitled to vote for an alternate member representing cities with pumping rights; and
WHEREAS, the City may, by resolution submitted to the San Gabriel Basin Water Quality Authority before October 20, 2022, nominate a candidate for the office of alternate member representing cities with pumping rights; and
WHEREAS, all legal prerequisites to the adoption of this Resolution have occurred.
NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF INDUSTRY DOES HEREBY FIND, DETERMINE, AND RESOLVE AS FOLLOWS:
SECTION 1: The City Council finds that all of the facts set forth in the Recitals are true and correct and are incorporated herein by reference.
SECTION 2: The City Council hereby nominates Cathy Marcucci, as a candidate for the office of alternate member of the San Gabriel Basin WQA representing cities with pumping rights.
SECTION 3: The City Clerk shall officially notify the San Gabriel Basin WQA and forward this Resolution.
SECTION 4: The City Manager is hereby authorized and directed to take such other and further action consistent with this Resolution, in order to implement this Resolution on behalf of the City.
SECTION 5: The provisions of this Resolution are severable and if any provision, clause, sentence, word or part thereof is held illegal, invalid, unconstitutional, or inapplicable to any person or circumstances, such illegality, invalidity, unconstitutionality, or inapplicability shall not affect or impair any of the remaining provisions, clauses, sentences, sections, words or parts thereof of the Resolution or their applicability to other persons or circumstances.
SECTION 6: That the City Clerk shall certify to the adoption of this Resolution and that the same shall be in full force and effect.
PASSED, APPROVED AND ADOPTED by the City Council of the City of Industry at a regular meeting held on September 22, 2022, by the following vote:
AYES: COUNCIL MEMBERS:
NOES: COUNCIL MEMBERS:
ABSTAIN: COUNCIL MEMBERS:
ABSENT: COUNCIL MEMBERS:
Cory C. Moss, Mayor
ATTEST:
Julie Gutierrez-Robles, City Clerk