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state Callfomla 3.
Secretary ofState
Statement of Information 6388157
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1. CORPORATENAME ° 5“ “m“
ONYXPAVINGCOMPANY. INC.
JAN-032020
2. CALIFORNIAconvom‘ra NUMBER
01659073
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CERTIFICATE OF REPORTED COMPLIANCE
OF ROAD DIESEL VEHICLE REGULATION
is issued to
ON NG C0 NY, NC.
2694
W3 cemflcate Intimates that the ?eet lasted abave has reported oftroau (1,9591 vehiclesto the Gaélfarma Au Resources Boyd and has certi?edthey 329 in comphance w t‘wmle 13 COR sechon 244$ M apohcabw vehiclesowned by the Indmduaf company;or agency must Eve repo?eo‘ and eabeled:32 mm in Secllcn 24119,wnh all pcsslhle cnmg’?ets?essi else {ms nemesis: :8 null and ma Certi?cate expires 2 / 28/ 2025 ‘l V “envy ”up sulfa y 01 this gam?caw «mm m: number n
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17.D
resgonsible
Will not be
CDBGACCESSIBLESlDEWALK/ADAPROJECT
CIP No. 5768 BIDDER'SPROPOSAL
The undersigned hereby proposes to furnish any and all labor, materials, and equipment for the CDBG Accessible Sidewalk/ADAProject, CIP No. 5768, and appurtenant work in connection therewith, said work to be done and materials to be furnished in strict conformity with the Contract Documents, including but not limited to the Notice Inviting Bids, Instructions to Bidders, every Addendum, plans, specifications, General Conditions, Special Provisions, General Provisions, Greenbook 2018 as amended and supplemented, technical references, all other referenced documents, all codes, permit conditions and regulations, for the total amount(s) and any unit prices and additive/deductiveitems shown on this proposal.
The undersigned has examined the location of the proposed work and all local and physical conditions and challenges presented by the Project site, is familiar with the plans, specifications, Contract Documents (particularly as delineated above) and the requirements of the Public Works Contract, and also understands that the Project shall be completely constructed in turn-key condition acceptable to the Owner within the Project time requirements for the price of the proposal, including all fees and sales and/oruse tax upon any materials so furnished, including any unit prices and additive/deductiveitems. The undersigned has also carefully checked all of the figures given and understands that the Agency for any errors or omissions on the part of the undersigned in submitting this proposal.
Contractor confirms that his/her/its bid is submitted with respect to the changes to the Contract and/orContract Documents included in all addenda issued by the Owner.
In addition to reaffirming that the changes and information contained in the addenda have been integrated into their proposal, Contractor acknowledges receipt of Addenda No.(sl 1
The undersigned has examined the current State of California schedule of prevailing wage rates for the types of work to be done on this project (and the Davis—BaconAct if the Agency uses federal funds for the Project) and agrees to pay not less than these rates.
17.D
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CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
BIDSCHEDULE
BASEBID- CDBGACCESSIBLESlDEWALK/ADA PROJECT, CIP No. 5768
EXTENDED
ITEM ESTIMATED UNIT
DESCRIPTION UNIT ITEM
No QUANTITY PRICE AMOUNT
1 Mobilization not to exceed 5% LS 1 5‘!000. 00 o o
2 Traffic and Pedestrian Control LS 1
3 Temporary Construction Project
Identification EA 2 ~—\ 00 7— %70. OO
4 Water Qua Control L8 1 (e “Mooo éo?‘lvlopo
Adjust Ex. Manhole to New F.S
5 per Owner Agency Std. &
EA 1
7,910.00 1.110-00
5 Remove & relocate existing
mailbox EA 10 0-00 ‘5 .(oo. 00
7 Adjust Ex. Water Meter
Box/Traff. Box to finish surface EA 6 000. 00
8 Relocate Ex. 8 ns and Posts. EA 17 010 - 00 Beta . oo 9 Remove and Replace Exist ADA
Ram Std EA 29 t 0.00 0 um
10 Construct 4" thick PCC sidewalk
r C Std SF 12000 0 oo
11 Construct PCC Driveway SF
roach r C Std 1025 41.00 H
12 Remove, Uproot and dispose EA
ex. Tree/tree stum 8 \so .00 o
13 Remove & relocate existing LF
fen 450 00 7973.00
Remove Ex. PCC/AC &
14 Construct New PCC driveway SF
roach r C Std 520 7,1
15 Remove & Dispose Ex. Masonry
Wall/Pilaster EA 4 ’los’. o o 2 oo
15 Construct type "A"Curb and
Gutter erC Std LF 225 04.00 so
EH
H
‘1qo.00
QuowOO
17.D
)8 ,0)
‘ a Fat»
04,
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
BASEBID — CDBGACCESSIBLESIDEWALK/ADA PROJECT, CIP No. 5768
EXTENDED
I152“ DESCRIPTION UNIT IiiIIIIIAnIIVeT-IS
:3ch ITEM
AMOUNT
TOTAL BASEBID numbers ’04 614;
***************H***'k*************** END OF BASE BID ITEMS ************************************ ADDITIVEA BID ITEMS AS FOLLOWS:
ITE EXTENDED ESTIMATED
M DESCRIPTIONOF ITEMS U?" :R'II'ICTE ITEM
NO QUANTITY AMOUNT
A1
TOTAL BIDADDITIVEA (numbers) ,6
******************************** END OF ADDITIVEA BID ITEMS ******************************** BASEBIDTOTAL(inwords)€‘b\"t I-wwmzeo rweur ouw Tacos ND we mum-ca $106" oowmza A‘
ND
Contractor's Initials
ADDITIVEA BID ITEMSTOTAL (in words) “/3“
Contractor's Initials
In the event of a n between the unit price and extended total, the unit price will be used and the corrected extension will be considered as the amount bid. If the bid is illegible and cannot be reconciled it will be considered non-responsive and will not be considered for award.
If an additive and/oralternate bid schedule is called for in the Contract Documents, the lowest bid will be determined on the basis of the base bid schedule(s) only unless otherwise Specified in the Notice Inviting Bids or by Addenda if issued to supersede the Notice Inviting Bids on this specific issue.
For a Contract where a deductive bid schedule is called for, the lowest bid will be determined by the total of all bid schedules including the deductive bid schedule(s).
17.D
Engineering,
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
Regardless of whether the additive/deductiveor alternates bid items will be considered in determining the low bid, the Agency may elect to include any or none of the additive/ deductive or alternate bid items/schedules, or to otherwise add or remove certain work from the scope of Work. Accordingly, Contractor warrants that each bid item contains a proportionate share of profit, overhead and other costs and expenses, which willbe incurred by the Contractor for the Project.
If equal low bids are received from responsible and responsive bidders the selection shall be made by drawing lots, or other similar random blind method selected by the Agency. If only one responsive bid is received from a responsible bidder the award shall not be made unless the price can be determined to be reasonable based on an analysis by the Agency. The Agency’s determination as to the reasonableness of any such bid shall be final.
The Agency reserves the right to reject any or all bids, to waive any irregularity(ies), and to take all bids under advisement for a period of sixty (60) calendar days after the date the bids are publicly opened. Bidder acknowledges that all costs incurred as a result of preparing the proposal shall be the sole responsibility of Bidder. The Notice Inviting Bids and Instructions to Bidders does not create or impose any obligation upon the Agency to enter into a contract.
Allbids received shall be recorded on an abstract (tabulation) of bids, and then made availabl e
for public inspection within two business days of bid opening.
The quantities listed in the bid proposal are provided to give a general indication of the scope of the work and for the comparison of bids. No warranty is made, either expressed or implied, that the actual quantities of work to be done will correspond therewith. Item numbers followed by ”(S)” are designated as specialty items which will not be included towards the calculation of minimum of 50 percent of work to be performed by Contractor’sown forces.
By signing and submitting this bid the Contractor confirms that they are familiar with the wor k
site and all existing conditions that may affect their work and that they have read and agree to all the terms, conditions and requirements contained or referenced herein or in the Contract Documents and that all the aforementioned has been included in the bid prices listed above, including items of work that may not have a specific pay line item and that there shall be n o
additional costs to the Agency.
WARNING: If an addendum or addenda have been issued by the Agency and not noted above as being received by the bidder, this Bidmay be rejected.
Complete the following:
EBS General Inc. 1000005295 720016
Legal name of the business, DIRReg. and Contractor License Nos.
Rev. 8
February 2020
17.D
Thomas and
oseph _ WV,
SI
MD
atu id r
Ioseph Nanci) ice President
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
Corporation
Business Type (Corporation, Partnership, Sole Proprietor DBA(if any)
N
Name and title of the owner
I Nanci
Name and title of second partner or officer
1345 Quarry St, Ste 101 Corona CA 92879
Business Address
091- 70—6260
Telephone number
951
Facsimilenumber
Ioseph Nanci [email protected]
Name and Email address of primary contact
Company web address
8/22/24
re of Date
V
Print name and title
Signature of Bidder
Print name and title
(Ifthe Bidder is a corporation two signatures ofcorporate o?‘icersare required.) Date
-279-6832
Rev.0
Fequarv
17.D
BOARD OF DIRECTORS
ATTES'FATION
ACTION AND RESOLUTION BY
THE BOARD OF DIRECTORS OF
EBS GENERAL ENGINEERING, INC.,
A CALIFORNIA CORPORATION
The Board of Directors of EBS General Engineering,Inc. (the "Corporation"), desiring to insurethat all the proper and authorized individuals who have corporate authority to bind the Corporation to any and all contracts executedby such authorizedindividuals have been approve by the Board of Directors of the Corporation (the "Board"), held a meeting on July 26, 2019. d The Board, following a review of the foregoing matter and upon motion made and seconded,hereby determinesand votes unanimouslyas follows:
BE IT THEREFORE RESOLVED that either Thomas E. Nanci or Joseph D.
Nanci, acting alone, in his capacity as an of?cer of the Corporation, is hereby designated, authorized and empowered to be duly authorized with all the attendant powers and authorization related thereto, to bind, obligate and commit the Corporation to any and all contracts executed by and between the Corporation and any other contracting party.
There being no ftu'ther or pending businessbefore the Board, the meeting was adjourned.
Dated: July 26, 2019
Sole Director
1, being the Secretary of the above-referencedCorporation.do hereby certifyVthat the above resolution is the resolution of the Corporation.
Dated: July 26, 2019
, Secretary
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[_ula_—_]
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
CERTIFICATEREGARDINGCONTRACTOR'SLICENSE
1 Contractor is required to possess one of the following State Contractor's License State of California [ 720016 ] Contractor’s License
Combination of Specialty Class Contractor’sLicenses
2. A failure to (1) possess the required license, (2) truthfully set forth the following information, and/or (3) execute this Certificate may render the proposal nonresponsive and permit the City to reject the proposal. (Business and Professions Code Section 7028.15)
3. Contractor declares, under penalty of perjury, that he/she/it possesses the required Contractor's |icense(s) which:
a Bears the license number(s): 720016
b Expires on: 3/31/26
8/22/24
Date Signature of Bidder Date
Vice President
Print name and title Print name and title
(Ifthe Bidder is a corporation two signatures ofcorporate officersare required.) This required license determination has been made by the Agency. Any Contractor holding a different license who feels he is qualified to bid on this work must so advise the Agency at least seven (7) days prior to the bid opening. The Agency may conduct a review of the contemplated work to re—evaluatethe required license determination. The Agency may in its sole discretion maintain or change the required license determination; Agency’s decision as to the required license will be final.
17.D
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
BIDSECURITYFORM FOR CHECK
NOTE: THE FOLLOWINGFORM SHALLBE USEDINTHECASEOF CHECKACCOMPANYINGBID Accompanying this proposal is a Certified Check or Cashier's Check payable to the order of the City of Hemet, hereinafter referred to as "Agency", for dollars ($ ), this
amount being 10 percent (10%) of the total amount of the bid. This check shall be returned to the undersigned only if either of the following occurs:
A. Ifsaid Bid shall be rejected by the Agency;
B. If said Bid shall be accepted by the Agency and the Undersigned shall execute and deliver a Contract in the form attached hereto (properly completed in accordance with said Bid) and shall furnish bonds required for his/her/itsfaithful performance of said Contract and for the payment of all persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the Contract created by acceptance of said Bid.
Otherwise, said check shall become the property of the Agency.
Said check shall also become the property of the Agency if the Undersigned shall withdraw his/her/itsbid within the period of sixty (60) calendar days after the date set for the opening thereof, unless otherwise required by law, and notwithstanding the award of the Contract to another bidder.
Signature of Bidder Date Signature of Bidder Date
Print name and title Print name and title
(Ifthe Bidder is a corporation, two signatures ofcorporate officersare required.)
17.D
/_
Witness
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
BIDSECURITYFORM FOR BOND
KNOW ALLBYTHESEPRESENTS:
That the undersigned
EBSGeneral Engineering, Inc.
(Name of Contractor)
as Principal and the undersigned as Surety are held and firmly bound unto Owner, CITYOF HEMET, a political subdivision of the State of California, as oblige, in the penal sum of Ten Percent (10%) of Total Amount Bid
Dollars (S 10% TAB ) lawful money of the United States of America being at least ten percent (10%) of the aggregate amount of said Principal’s base Bid,for the payment of which, well and truly to be made, we bind ourselves, our successors, executors, administrators, and assigns, jointly and severally, firmly by these presents.
WHEREAS,said Principal is submitting a Bidfor [PROJECTNAMEAND DESCRIPTION] CDBGFunded AccessibleSidewalk/ADAProject
THE CONDITION OF THIS OBLIGATIONIS SUCH that if the Bid submitted by the said Principal be accepted and the Contract be awarded to said Principal and said Principal shall within the required periods enter into the Contract so awarded and provide the required Construction Performance Bond, Construction Labor and Material Payment Bond, insurance certificates, and all other endorsements, forms, and documents required under the Instructions to Bidders, then this obligation shall be void, otherwise to remain in full force and effect.
IN WITNESS WHEREOF, the above bounden parties have executed this instrument this 20th day of August 20 24.
(Month)
(Corporate Seal) J Na VicePresiden
t
Company
Surety cCa r., Attorney-in-Fact
(Corporate Seal) By
Liam Hackett,
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?bvelsideCounty 5. _ cammlsmnnmauz
‘ Mycomm.ExpiresAar|0.ZOZS
CALIFORNIAACKNOWLEDGMENT CIVILCODE § 1189
Anotary publicorother of?cercompletingthiscertificateverifiesonlythe identityofthe individualwhosignedthe document to whichthis certi?cate is attached, and not the truthfulness, accuracy, or validityofthat document.
State of California } County of Riverside
8/22/2024
Date
On before me.
personally appeared J°seph ”and
Cristina Whitcher.Notary Public
Here Insert Name and Title of the Officer
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.
IVNN
Place Notary Seal and/or Stamp Above
I certify under PENALTYOF PERJURYunder the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and of?cial seal.
Signature
Signature of Notary Public
OPTIONAL
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
I] Corporate Of?cer — Title(s):
1] Partner— El Limited El General
El Individual D Attorney in Fact
El Trustee El Guardianor Conservator
D Other:
Signer ls Representing:
@2018 National Notary Association
Number of Pages:
Signer‘s Name:
El Corporate Officer — Title(s):
1] Partner— I:I Limited El General
El Individual El Attorney in Fact
E1 Trustee El Guardianor Conservator
El Other:
Signer is Representing:
17.D
N T R KN WED MENT
202,
OAYAC O L GE
State of Texas
County of Dallas
On this the day before me, Ashlyn Simchik (name of
notary), personally appeared known to me (or satisfactorily proven) to be the person(s) whose name(s) is(is or are) subscribed to the within instrument and acknowledged that (he/she/they) executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand.
Notary Public NOTARYPUBLlC
Print Name: Ashlyn Simchik My COMME
Notary ID113433618-2
My Commission Expires:
7
17.D
Gre Midwe In uranc mp
of?oe
Sean . r.. .
other
writings
MIDWEST
Resolved.that the President.or any of?cer, he and hereby is. authorized to appoint and empower any representative of the Company or other person or persons as Attorney»ln-Fact to execute on behalf of the Company any bonds. undertakings, policies. contracts of Indemnity or other writings obligatory in nature of a bond not to exceed Twenty»Five Milliondollars ($5,000,000.00). which the Company might execute through its duly elected of?cers. and af?x the seal of the Company thereto, Any said execution of such documents by an Attorney~ln—Factshall be as binding upon the Company as ifthey had been duly executed and acknowledged by the regularly elected of?cers of the Company. Any Attornean-Fact.so appointed, may be removed in the Company's sole discretion and the authority so granted may be revoked as speci?ed in the Power of Attorney Resolved, that the signature of the President and the seal of the Company may be af?xed by facsimile on any power of attorney granted. and the signature of the Secretary, and the seal of the Company may be af?xed by facsimile to any certi?cate of any such power and any such power or certi?cate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certi?cate so executed and sealed shall, with respect to any bond of undertaking to which it is attached, continue to be valid and binding on the Com
its
M M;
th
that
the
as
S .
Shaunty
”WARNI claim
fraudulent
POWER OF ATTORNEY
at st s 6 Co any
KNOW ALLMENBYTHESE PRESENTS, that GREAT MIDWEST INSURANCE COMPANY.a Texas Corporation, with its principal In Houston, TX, does hereby constitute and appoint:
McCauley J Sam Duckett, Jeff Scott, Bridget Truxillo, Sarah Timmons, Ashlyn Simchik, Jarrod Yost, Alex Rausch Liam Hackett, Sterling Ward
its true and lawful Attorney(s)—ln-Factto make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or obligatory in nature of a bond This authority is made under and by the authority of a resolution which was passed by the Board of Directors of GREAT NSURANCE COMPANY, on the 1Stday of October, 2018 as follows:
Pany
IN WITNESS THEREOF, GREAT MIDWEST INSURANCE COMPANY, has caused this instrument to be signed by its President, and Corporate Seal to be af?xed this 11th day of February, 2021.
GREAT MIDWEST INSURANCE COMPANY
CORPORATE SEAL BY
Mark W. Haushill
President
ACKNOWLEDGEMENT
On this 11th day of February, 2021, before me, personally came Mark W. Haushill to me known, who being duly sworn, did depose and say that he is the President of GREAT MIDWEST INSURANCE COMPANY, the corporation described in and which executed the above instrument; at he executed said instrument on behalf of the corporation by authority of his of?ce underthe By-Iaws of said corporation.
CHRISTINABISHOP
Public, State of Tax: BY
Comm. Expires 04-14-2026 Christina Bishop
ID131090488 Notary Public
CERTIFICATE
l, the undersigned, Secretary of GREAT MIDWEST INSURANCE COMPANY, A Texas Insurance Company, DO HEREBY CERTIFY original Power of Attorney of which the foregoing is a true and correct copy, is in fullforce and effect and has not been revoked and the resolutions set forth are now in force.
20th f August 20 24 . igned and Sealed at Houston, TX this Day 0
CORPORATESEAL BY
Leslie K.
Secretary
NG: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance of containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits insurance act, which is a crime and subjects such person to criminal and civil penalties.
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DARTM T INURANE
ity
Vmsd/zzzx
No. 5780-2
STATE OF CALIFORNIA
EP EN OF S C
SAN FRANCISCO
Amended
Certi?cate of Author
THIS IS TO CERTIFY, That,pursuant to the Insurance Code ofthe State ofCalifornia, Great Midwest Insurance Company
ofTexas, organized under the laws ofTexas, subject to its Articles ofIncorporation or otherfundament al organizational documents, is hereby authorized to transact withinthis State, subject to allprovisions ofthis Certi?cate,thefollowing classes ofinsurance:
Fire, Marine, Surety, Disability, Plate Glass, Liability, Workers’ Compensation, Common Carrier Liability, Boiler and Machinery, Burglary, Credit, Sprinkler, Team and Vehicle, Automobile, and Aircraft as such classes are now or may hereafterbe de?nedin the Insurance Laws oftheState ofCalifornia.
THIS CERTIFICATE is expressly conditionedupon the holder hereofnow and hereafterbeing in fullcompliance withall, and not in violation ofany, ofthe applicable laws and lawfulrequirements made under authority ofthe laws ofthe State ofCaliforniaas long as such laws or requirements are in e??ctand applicable, and as such laws and requirements now are, or may hereafterbe changed or amended INWITNESSWHEREOF, e?‘ectiveas ofthe 4‘hdayofAugust,2015, I have hereunto set my hand and caused my o?icialseal to be a?ixed this 4‘hday ofAugust, 2015.
Dave Jones
Insurance Commissioner
By Valerie Sarfaty
forNettie Hoge
ChiefDeputy
NOTICE:
Quali?cationwith the Secretary of State must be accomplished as required by the California Corporations Code promptly a?er issuanceofthis Certi?cate ofAuthority. Failureto dosowillbe a violationofInsuranceCodesection701 andwillbe groundsfor revoking this Certi?cate of Authority pursuant to the covenants made in the application therefor and the conditions contained
17.D
/22/24 [
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i a reaiBi de
I an
' ' e Pre idem
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont'd)
NON-COLLUSIONAFFIDAVIT
PUBLICCONTRACTCODESECTION7106
NON-COLLUSIONDECLARATIONTO BEEXECUTEDBYBIDDERANDSUBMITTEDWITHBID The undersigned declares
I am the of the party making the
foregoing bid.
The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. All statements contained in the bid are true. 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, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.
Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on date], at Corona [city], CA [state].
22/24
S gn Date Signature of Bidder Date
Print name and title Print name and title
(Ifthe Bidder is a corporation, two signatures ofcorporate of?cersare required.) EBS General Engineering, Inc.
Vice President
17.D
attached
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
CONTRACTOR’SREFERENCELIST
Attach to this bid a list of three (3) projects in the past five (5) years on which the bidder and his subcontractor(s) have successfully constructed and completed projects with the same type (elements), size and complexity of work. The Agency Engineer will make the final determination of whether the projects listed here are of the same type, size and complexity as this project.
Failure of bidder to supply sufficient documentation of similar electric, telephone, cable and sanitary sewer underground facilities experience shall be considered grounds for a non-responsive bid and, at the Agency’s discretion, said bid will be disqualified.
Project Name reference list
Contract Price: Date of Completion:
Name, Address, and Telephone Number of Owner's Representative:
Project Name:
Contract Price: Date of Completion:
Name, Address, and Telephone Number of Owner‘s Representative:
Project Name
Contract Price Date of Completion:
Name, Address, and Telephone Number of Owner's Representative:
(Attach additional pages as necessary)
17.D
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP N0. 5768
Name of Subcontractor
and Location of Place
of Business
\la‘E‘?u fume
Ofl?‘t \ (k
(350 Lyn}
S‘uND/V?." , :1“,
Hr...” . {A’
3‘71““ YMMV
BIDDER'SPROPOSAL(cont’d)
DESIGNATIONOF SUBCONTRACTORS
Description and Subcontractor’s
Percentage of Work License No.
Heb me?
‘00.]. “M di’VL/ WA’SDU
III. hl'n‘ bi;
5“” L6H
2 'l. Maw»
5v” / {4“7" ‘17uwv
\00 7- “GM%
\ 1' “Li‘ biA/
(Bidder to attach additional sheets if necessary)
(PUBLICCONTRACTCODE §4100 ETSEQ.)
DIRRegistration
Number
\ 0 0000M3U
\oaowls33
\ 0 0000”"! b
17.D
Rav‘ 0
February 2010
CDBGACCESSIBLESIDEWALK/ADA PROJECT
ClP No. 5768 BIDDER'SPROPOSAL(cont’d)
BIDDERCERTIFICATIONS
TO BEEXECUTEDBYALLBIDDERSAND SUBMITTEDWITHBID
The undersigned Bidder certifies to Owner as set forth in sections 1 through 10, below
STATEMENTOF CONVICTIONS
By my signature hereunder, I hereby swear, under penalty of perjury, that no more than one final, unappealable finding of contempt of court by a Federal Court has been issued against Bidder within the past two years because of failure to comply with an order of a Federal Court or to comply with an order of the National Labor Relations Board.
CERTIFICATIONOF WORKER’SCOMPENSATIONINSURANCE
By my signature hereunder, as the Contractor, I certify that I am aware of the Labor Code Section 3700, which requires every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the work of this Contract.
Please note that the submittal of this certificate does not relieve Contractor from complying with all of the insurance requirements of the Public Works Agreement and Contract Documents.
CERTIFICATIONOF PREVAILINGWAGE RATESAND RECORDS
By my signature hereunder, as the Contractor, I certify that I am aware of Labor Code Section 1773, which requires the payment of prevailing wage on public projects. Contractor and any subcontractors under the Contractor shall comply with Labor Code Section 1776 regarding wage records, and with Labor Code Section 1777.5 regarding the employment and training of apprentices. Contractor is responsible to ensure compliance by any and all subcontractors performing work under this Contract.
CERTIFICATIONOF COMPLIANCEWITH PUBLICWORKSCHAPTEROF LABORCODE By my signature hereunder, as the Contractor, I certify that I am aware of Labor Code Sections 1777.1 and 1777.7 Code, and Contractor and Subcontractors are eligible to bid and work on public works projects.
CERTIFICATIONOF NON-DISCRIMINATION
By my signature hereunder, as the Contractor, I certify that there will be no discrimination in employment with regard to race, color, religion, gender, sexual orientation, age or national origin; that all federal, state, and local directives and executive orders regarding non—discrimination in employment will be complied with; and that the principal of equal opportunity in employment will be demonstrated positively and aggressively.
17.D
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
CERTIFICATIONOF NON-DISQUALIFICATION
By my signature hereunder, as the Contractor, I swear, under penalty of perjury, that the below indicated Bidder, any officer of Bidder, or any employee of Bidder who has a proprietary interest in such Bidder, has never 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 safety regulation, except as indicated on the separate sheet attached hereto entitled "Previous Disqualifications." If a statement of ”Previous Disqualifications” is attached, please explain the circumstances.
CERTIFICATIONOF ADEQUACYOF CONTRACTAMOUNT
By my signature hereunder, as the Contractor, pursuant to Labor Code Section 2810(a), I certify that, if awarded the Contract based on the undersigned’s Bid, the Contract will include funds sufficient to allow the Contractor to comply with all applicable local, state, and federal laws or regulations governing the labor or services to be provided. I understand that Owner will be relying on this certification if it awards the Contract to the undersigned.
CERTIFICATIONREGARDINGDIRCONTRACTOR/ SUBCONTRACTORREGISTRATION By my signature hereunder, as the Contractor, I certify that Contractor, and all listed Subcontractors are the subject of current and active contractor registrations pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code.
Contractor’s registration number is [please complete] 1000005295 Subcontractors’ registration numbers are as indicated in Document 00 4314.
CERTIFICATIONREGARDINGPREQUALIFICATIONINFORMATION [OPTIONAL] By my signature hereunder, as the Contractor, I certify as follows:
a. Contractor prequalified for this Project by submitting its Statement of Qualifications, dated (500)-
b. [Please complete or strikeout the following as inapplicable] Subsequently, on or about and Contactor submitted
further information supplementing for foregoing Statement of Qualifications. c. Allinformation described above is referred to as the "Qualification Information." d. Contractor has carefully reviewed all of the foregoing Qualification Information. e. [Please check and/orcomplete one ofthe following]
All Prequalification Information remains true and correct in all material respects as of the date hereof, as if such information were actually being submitted to Owner as of the date hereof.
Except as otherwise expressly set forth in separate Additional Prequalification Information, submitted with the Bid, all Prequalification Information remains true and correct in all material respects as of the date hereof, as if such information were
17.D
dditio
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
actually being submitted to Owner as of the date hereof. [Contractor must provide A no! Prequalification Informationas described above ifthis item is checked. ]
CERTIFICATIONOF N/A
[Insert other Owner-specific certifications, if applicable. Otherwise, delete.] BIDDER
Sign Date Signature of Bidder Date
Print name and title Print name and title
(Ifthe Bidder is a corporation, two signatures ofcorporate officersare required.)
17.D
(H
SPECIAL FEDERAL PROVI ION
P O
mmnD mnB n
City of Hemet
Housing & Workforce Solutions WS)
S S
CONSTRUCTION BID DOCUMENT
rojects ver $200,000
C0 11 ity evelop e t lock Gra t
C0 str ction Activ ies
Last Date of Revision: July 2024
17.D
General Information
_—_—’———
Bid Forms
Must be completed by all Subcontractors
(Reggired
Post-Award Forms
SPECIAL FEDERALPROVISIONS
DOCUMENT INDEX
1. General Summary
2. Hold HarmlessClause and AdditionalInsured-InsuranceRequirements
3. B-l FederalLabor Standards Provisions(HUD 4010)
4. B—2FederalPrevailing Wage Decision(CA20240025mod. 7)
5. B-3 Project Sign (SAMPLE)
6 B-5 City of Hemet Section 3 Af?rmativeActionPolicy (Applicable for Projects $200,000 or more) 7 AdditionalFederalRequirements
8. B-4 Certi?cation of Bidder Regarding Non-segregatedFacilities(Required for all Projects)
9. B-6 Bidder’sCerti?cation for Section 3 Compliance(Required for Projects $200,000 or more)
10. B-6(SUB) SubcontractorCerti?cationfor Section3 Compliance (Required for Projects $200,000 or more)
11. B-7 Bidder’sCerti?cation on FederalContractRequirements(Required for all Projects)
12. B-8 QuestionnaireRegarding Bidders(Requiredfor all Projects)
13. B-9 List of Subcontractors and Suppliers(Required for all Projects)
14. B-10 SubcontractorCerti?cationfor Section3 Compliance for Projects $200,000 or more)
15. PA-l PerformanceBond (100% of contract price) (Required for Projects $200,000or more)
16. PA-2 Payment Bond (Required for Projects $200,000 or more)
17. PA-3 SubcontractorQuestionnaire(Required for all Projects)
18. PA—4SubcontractorCerti?cationRegardingNon-segregatedFacilities(Required for all Projects)
19. PA—SSection3 Summary Report (Required for Projects $200,000 or more)
20. PA-6 Davis-BaconClassi?cations and Pay Rates (Required for all Projects)
17.D
EXHIBITB-4
AggesgibleSidewalkandADAProjec
General Engineering.
mployees any segregated facilities at any of my
mit my employees to perform their services at
segregated facilities are maintained.As used
ted facilities” means any waiting rooms, work
locker rooms or other dressing areas, parking lots, drinki fountains, recreation or entertainment areas, transportation, and housing cilities provided for employees which are segregated by explicit directive or are fact segregated on the Signatnr
(Print): 05 Ci
/
Required Bid Form
CERTIFICATION OF BIDDER
REGARDING NONSEGREGATED FACILITIES
ProjectName: t
Name of Bidder: EBS Inc.
The above namedBidder hereby certi?es that:
I do not maintain or provide for my e
establishments, and that I do not per
any location, under my control, where
in this certi?cation, the term “segrega
areas, rest rooms, wash rooms, restaurants and other eating areas, time clocks, ng
fa
in
basis of race, color, religion, national origin, or because of habits, local customs, or otherwise.
I further agree to obtain identical certi?cations from all proposed subcontractors prior to the award of subcontracts exceeding $10,000.
Name I
Title: Vice President
8/22/24
17.D
Project ,
K
I. Employment Ongortunities
detailed
, . v 06,
. w ‘rivcojobsnrg
EXHIBIT 3-6
$200,000 or more
BIDDER CERTIFICATIONFOR SECTION 3 COMPLIANCE
(Housing and Community Development Act of 1968)
Project Title: AccessibleSidewalkand ADA Amount of Bid: 3 “c <K The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all construction contracts over $200,000.
I understandand agree that in the event that I am awardedthis contract, and in the event that any new employmentopportunitiesare createdas a resultof this CDBG-fundedproject, I will:
a. Contact theUS. Department of Housing and UrbanDevelopment(HUD) Section3 websiteat to rev1ew the list of certi?ed Section 3 persons, withinCity of Hemet, to be for available employment opportunities;and HUD Section 3 Opportunity Initial Here
at:
Forward to the Department of Housing & Workforce Solutions all job descriptions for new employment opportunitiesand Section 3 reports, in a and at a time as directedby the Department of Housing & Workforce Initial Here Present a list, of the number of total labor hours, Section 3 and Targeted Section 3 worker labor hours expectedto be generated from initial contract and a list of of availablepositions,to include job descriptionsand wage rates.
Initial Here
3 contractor interests regarding employment of Section 3 prior to Initial Here
Submit a list of (including administrative, clerical, other positions pertinent constructiontrades) at the time of contact Initial Here
positions and advertise Section 3 workers openings
Initial Here
Section 3 Plan. Initial
your proposed project below
17.D
J 013 CATEGORY
PROFESSIONALS
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTION BY
TRADE
TRADE Laborers
Masons
Operators
TRADE
APPRENTICE
TRAINING
OTHER
TOTAL
CURRENT
POSITIONS
10 15
NUMBER OF
NEW HIRES
IF
AWARDED
BID
NUMBER OF NEW HIRES
PROPOSED TO BE
SECTION 3 RESIDENTS
% OF NEW HIRES TO BE
SECTION 3
100
TRADE
TRADE
TRADE
17.D
w
I]. Subcontracting Ongortunities
I under agree th I subcontracting opportunitiesthat
from(h fundedp act the US. Department of Housing
www.hud.gov/section3
subminal.
www.hud.govlsection3
clerical,
ward. nitial
ngs \vwwxivcojobsnrg
BIDDERCERTIFICATIONFOR SECTION3 COMPLIANCE
a. stand and at for any and al may result
is CDBG- roject, Iwill cont andUrban
Development (HUD) Section 3 website at to review the list of certi?ed Section 3 Businesses, within City of Hemet, to be consideredfor available subcontracting opportunitiesprior to selecting any subcontractorfor my bid Initial Here
b. I understandand agree that any and all sub-contracts and sub-tier agreements resulting from this CDBG-fundedproject are also subjectto Section 3 compliance,and therefore, as the General/PrimeContractor, I am responsible to ensure compliance from subcontractors. Initial Here
i. Contact the US. Department of Housing and Urban Development (HUD) Section3 websiteat to review the list of certi?ed Section 3 persons, withinCity of Hemet, to be consideredfor availableemployment HUD Section 3 OpportunityPortal at: Initial Here
j. Forward to the Department of Housing Solutions all detailedjob descriptions for new employment opportunitiesand reports, 1n a form, at a place, and at a time as directed by the of Housing & WorkforceSolutions.
Initial Here
k. number of total labor hours, Section 3 worker labor hours, and Targeted worker labor hours expected to be generated from the initial contract and a list of numberof availablepositions, to includejob descriptions and wage rates Initial Here
Section 3 of contractor interestsregarding employment of Section 3 workers prior to Initial Here m. Submit a (including administrative, and other positions pertinent to the constructiontrades) at the time of contact a Here
11. positions and advertise job Section 3 workers at:
Here
17.D
Complete your bcontrac?ng proj
Making:
, , , Eggineering,
Su Plan for this ect below:
15 THE SUBCONTRACTOR IF SUBCONTRACTORIS SECTION 3, INDICATE AMOUNT OF SECTION 3 ELIGIBLE? IGmLE STATUS.
TRADE
SUBCONTRACT(S) YES OR NO
EL
51% OWNER / 30% EMPLOYEE
035$ Luv-RA{May ma 7'; W 00 N0
\1 anQ Tue 52¢qu a,, Ma No
Schn'vCwav‘y 0141,?) NO
* Add additionalsheetsif necessary
Bidder (Company)Name; EBS General Inc.
Authorized (Type Name): Insenh nnri
Signature:
17.D
EXHIBIT B-7
w
Engineering,
2/—
REF ; oseghNanci (Type
SIGNATURE:
Required Bid Form
CITY OF HEMET
CDBG PROGRAM
BIDDER CERTIFICATION ON
FE ERAL CONTRACT QUIREMENTS
PROJECT NAME; AccessibleSidewalkand ADA Project
CE
I hereby certify that I have reviewed and understandthe diversi?ed Federal constructioncontract related requirementsimposedon the Contractor(s) of HUD— fundedconstructionprojects,including but not limitedto the following:
1 The subject project is being ?nanced with Community Development Block Grant funds (24 CFRPart 570);
2 This project and all related constructioncontracts are subject to the US.
Department of Housing and Urban Development’sFederalLabor Standards Provisions(HUD 4010 — revised06/2009); and
1 This project is subject to all applicablelaws and regulations as listed in the General Summary of these SpecialFederalProvisions; and
2. If my bid is $200,000 or more, thisprojectandallrelatedcontracts willsubject to Section 3 requirements(12 U.S.C.l701u).
CONTRACTOR’SNAME: EBS General Inc.
CONTRACTOR’SLICENSENO.: 720016
ADDRESS 1345 Quarry St., Ste 101 Corona CA 92879
AUTHORIZED Name)
17.D
um
EBSGermralEngineering Inc ,
' [26/95
1345Quarry Street, Ste 101 Corona CA 92879
Beeau project is Fed ly—funded, ary to laininformatinn nceming minori other participation statistical The S Department Housing and minority enterprise de?ned by the edexalGovernment as a siness that is ?fty-one pert:
more “minority-ow :1”, Pleaseehec applicable bax concemi the ownership ofyoux busi 47 United Departnl Hall g and Urban Dev: "lent uthnrized soli infer cited in rm by Vll‘ Title UnitedSink: Code, clion and other gull t will Required Bid Form
QUESTIONNAIREREGARDING BIDDERS
Bidderhas been engaged in the contracting businessunderthe present name of since 1 (Date)
Present business address is:
Federal Tax ID: 33-0634599 Amount of Bid $
California Contractor's License No.: 720016 Expiration Date: 3/31/26 UEI Number: LD7IGH3ZIKB5 or CAGE Code:
se this eral it is necess ob co ty and
group for purposes. U. of Urban
Development(HUD) uses thisinformationto determinethe degree to whichits programs are being utilized by minority business enterprises and targeted group contractors.
A is F bu cut (51%)
or ne k ng ness:
El American Indianor Native Alaskan
El Asian or Paci?c Islander/NativeHawaiian
CI Black/AfricanAmerican
El Hispanic
White
El Hasidic Jews
Cl Other
A woman-ownedenterprise is de?ned by the Federal Government as a business that is ?ftypercent (50%) or more woman-owned.Please check applicablebox concerning the ownershipof your business:
E] Woman/Femaleowned ale owned
A Section 3 Contractor or Subcontractor is a business concern that is more than ?fty-one percent (51%) ownedby a low or very low-income person, or a business concern that provides economicopportunities to low and very low-incomeresidents. Please check applicable box concerning the ownership of your business:
II] Section3 Businessconcern Non-Section3 Businessconcern The States ent of sin lop (HUD) is a to cit the mation
requ this to tue of 12, Se 1701 et seq., re tions. I not be disclosed or released outside of HUD without your consent, except as required or permitted by law.
17.D
EXHIBIT 13—9
OmLN} Suuw, \ Epk ”1
, ‘T‘m,,
V Maxanmm} Mxk?? ’5 ‘5 Y? ?, .
Required Bid Form
LIST OF SUBCONTRACTORS
SUBCONTRACTOR FED. I.D.# AMOUNT ADDRESS/PHONENO.
(Tm)
17L Uao Mk A). MI. SJ-0v 0 023 ’11-'0
Va 1:, QM”, 5000 7-0 30* 5750 law“! ( 7“) 117' ”0'5
0M], “m, C as: C-‘!
\7""5 (1 ma '5 "I l"
S UP P LIER5
NAME OF SUPPLIER ADDRESS/PHONENO. CONTRACTAMOUNT
Robertson'sReadvMix 200 S Main St #200, Corona (800) 834-7557 k m mm This form is to be completed and submitted with the bid package.
17.D
1. Name
. ,
7 Contact
W, , Contract
Work
H.
,,,Name
Contact
Contract
Work
V
7, ,,,Na.‘.-
Phone
Phone
Contact
Contract
._L - .. ......
, ,, Contact
ntract
Work
2 YEARREFERENCES- PUBLICWORKS
Proiect
Design-BuildServices for City of Long BeachCurb Ramps
Owner
City of Long Beach
Princinal
Ross Cruz, Engineering Bureau (562) 570-7949
Price of Dates
$9,850,550.00 10/2021— On-Going
Tvne of
Design and Construction of Non-Compliant Ramps Citywide Proiect
Easton Street Sidewalk Improvement Project
Owner
City of Rialto
Princinal
Terry Renner, P.E (951) 680-0440
Price of Dates
$688,719.43 8/2021— 3/2022
Tvne of
Minor PCC — Sidewalk, ResidentialDriveways, Ramps, Cross-Gutter, Curb & Gutter, Retaining Wall, PCCSwale, Pilaster with Mortar Cap
Proiect me ADAImprovements at PacificBlvd& Vernon Ave
Owner
City of Vernon
Principal Phone
Margarita Beltran, Associate Engineer (323) 974-1735
Price of Dates
$108,610.15 1/2022— 2/2022
Tvnn nf Wnrk
Minor PCC — Sidewalk, Ramps, Curb & Gutter, Asphalt Paving Proiect Name
Northeast Colony SABINANeighborhood Improvements — Ph Ill Owner
City of Anaheim
Princinal Phone
Joel Jordan, Construction Project Manager (714) 765-5052 Price of Co Dates
$5,317,919.39 12/2021— 12/2022
17.D
Contact
ame
Contact
Phone
Phone
Work
Name
Contact
V _ ntract
Contact
Contract
ne
2 YEARREFERENCES— PUBLICWORKS
Minor PCC— Curb, Curb & Gutter, Driveway, Cross—Gutter, PCCPavement; Domes, Asphalt Paving
Proiect Name
Vision Zero — Phase 2D
Owner
City of Los Angeles
Princinal
Jesus Arellano, Transportation Engineer Asc. (213) 972-8623 Price of Contract Dates
$1,027,225.00 07/2020— On-Going
Tvne of Work
Minor PCC- Curb, Curb & Gutter, Driveway, Cross-Gutter, Ramps, PCCPavement; Domes, Asphalt Paving, Curb-O—Let
Proiect N
2018-2019 SB-1 Maintenance &Traffic Improvements
Owner
City of Riverside
Principal
Steve Howard, Construction Project Manager (951) 826-5708 Price of Contract Dates
$5,238,400 8/2019— 4/2021
Tvne of
Street Maintenance: Minor PCC,Asphalt Grind& Pave, UtilityAdjusting Proiect
Omnibus Concrete Repair
Owner
City of Santa Ana
Princinal Pho
MichaelOrtiz, Construction Project Manager (714) 647-5624 Price of Co Dates
$1,357,230.06 6/2020— 3/2021
Tvne of Work
Minor PCC— Ramps, Sidewalk, Curb & Gutter, Driveways
Proiect Name
Gas Tax LocalStreet Improvements & Flower Street Sewer Manhole Improvements Owner
City of Santa Ana
Principal Phone
MichaelOrtiz, Construction Project Manager (714) 647-5624 Dates
17.D
Project Name
Principal H,
Project , ,,
Principal -- ___.
of
of”,
Proiect Name
Prlncipal ________
10. 11.
2 YEARREFERENCES- PUBLICWORKS
$2,546,154 1/2020— 5/2021
Tvne of Work
Street Maintenance: ARHMAsphalt, Coldmill, Minor PCC(V-Gutter, Sidewalk, Driveway Approach, Ramp, Curb & Gutter), UtilityAdjusting
WildCanyon BlockWall Project
Owner
City of Colton
Contact Phone
Jess Soto, P.E. (909) 370-5551
mica of Cnntract Dates
$54,936.00 9/2021- 10/2021
Tvne of Wnrk
BlockWall, Perforated Drain, Sidewalk Under Drain
Name
Mid-BlockCrosswalk InstallationProject
Owner
City of Redlands
Contact Phone
KyleWagner, Construction Project Manager (909) 253-8698 Price Contract Dates
$103,499.01 8/2021— 10/2021
Tvne Work
Minor PCC— Ramps, Sidewalk
ResidentialStreet Repair Program & Alley Improvement
Owner
City of Santa Ana
Contact Phone
MichaelOrtiz, Construction Project Manager (714) 647-5624 Price of Contract Dates
$1,210,079.64 6/2019— 6/2020
Tvne of Work
PCC—Curb & Gutter, Driveways, Sidewalk, Ramps, Cross Gutter
17.D
W
evelopme
I. Employment Ogyortunitios
www. ud ov/section3
can?d
lit!
for new employment opportunities and Section 3 reports, in a form, at an ce, and at a time directed by the Department of Housing & Workforce Solutions Initial Here Present a list, of the number of total labor hours, Section 3 worker labor hours, and Target projec number ofuvailable positions,to in
Initial Here
1!. Not Section 3 Coordi of contractor
workers prior to hiring.% Initial Her
e. Submit a list of core emp oyees (includin dministrative clerical, amingzand other hudl ov/O orrunit Portal/
pasiti the time of (2 mac:aw Initial
Here
Post a ilahle positions and advertisejob Secti 3 worker www.rivco'obs,org ?gInitial Here Complete
Si th Section
your proposed
3 Plan. Initial
workforBeer-2% plan for thi reject bel
5‘“?own-‘1';o-i—ur -. CzSeLanaiSvmyuhj,Inc.
$200,000 or more
BIDDERCERTIFICATION FOR SECTION3 COMPLIANCE
(Housing and Community Development Act of 1968)
ProjectTitle: AccessibleSidewalk ADA Protect Amount ofBid: ’17-.we The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community D nt Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all construction contracts over $200,000.
I understandand agree that in the event thatI am awarded this contract, and in the event that any new employment opportunities are created as a result of this CDBG—fundedproject, I will:
a.
my
Contact the US Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be for available employment opportunities;and HUD Section 3 Opportunity Portal. Initial Here
at:
Forwardto the Department of Housing & Workforce Solutionsall detailedjob descriptions as
ed
Section 3 worker labor hours expected to be generated from the initial contract and a list of elude job descriptions and wage rates.
interestsregarding employment of Section 3
e
.g a , p1
ons pertinent to the construction trades) at o ard
on s openingsat:
s p ow.
17.D
“(0leon
Suweying,
Completeyour proposed workforce plan for this project below:
NUMBEROF
JOB CATEGORY CURRENT NEW "ms NUMBEROF‘NEWms
% OF NEW HIREs TO BE rosmONs IF PROPOSEDTO BE
AWARDED “mom SECTION3RESIDENTS
BID
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTIONBY
TRADE
TRADE NIA;
FieldSurveyor mfe?'fmpmd N/A N/A
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE
1 TRAINING
1 OTHER
TOTAL
2 Subcontractor(Company) Case Land Inc.
d Name): Larry V. Case, President
17.D
II. Subcontracting Ongortu '
'es
www.hud.gov/section3
certi?ed Section Busin ses, within City of Hornet, to sidcred availab e subcontracting op rtuniti priorto selecting any subcontra my bid minalt % ?'om this CDBG—fundedproject ubject ectio iance, and therefo as
subcontractors.
the General/PrimeContract respo e to ompliance from %
www.hud.govlsection3
be consideredfor availableemploymentopportunities; and HUD Sectio at: httgsz/Ihudagps.hud.gov/OpportunigPonal/4] Initial Here Forwardto the Department of Housing ScWorkforc
by the Dep nt of Housing 8cWorkforceSolutio
Initial Here
Present a list, of the number of total labor hours,
proj d numberof availablepositions, to includejob
Initial Here
L Notify Section 3 Co inatorof contractor interestsr
prior to hiring Initial Here
in. Submit a list of core employees(includingadministrative. clerical, p nnin and other positions pertinent to the constructiontrades) at of contact award. ilial Here Post ailable positions and advertis ction 3 workers 0
' gs a www.rivco'ohs.org 4?Initial Here
EXHIBIT B-6
BIDDER CERTIFICATION FOR SECTION 3 CONIPLIANCE
I understand and agree that for any and all subcontracting opportunities that may result from this CDBG-fundedproject, I will contact the US. Departmentof Housing and Urban Development (HUD) Section 3 website at to review the list of 3 es be con for 1
p0 es ctor for sub
Initial Here
. I understandand agree that any and all sub-contracts and sub-tier agreements resulting are also 5 to S n 3 compl re,
or, I am nsibl ensure c all
Initial Here
Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to n 3 Opportunity Portal
e Solutions all detailedjob descriptionsfor
new employmentopportunities and Section3 reports, in a form, at a place, and at atime as directed ns.
Section 3 worker labor hours, and Targeted
Section 3 worker labor hours expected to be generated from the initial contract and a list of descriptionsandwage rates.
egarding employmentof Section 3 workers
g,
the time In
e job Se t:
17.D
Complete your Subcontraciing Plan for this prgjwt below:
IS THE SUBCONTRACTOR AMOUNT OF IF SUBCONTRACI‘OR Is SECTION 3, INDICATE SECI‘ION 3 ELIGIBLE? _ E
SUBCONTRACT($) YES OR NO
ELIGIBLE STATUS
51% OWNER / 30%EMPLOYEE
Surveying $22,600.00 N/A
* Addadditionalsheetsif necessary
Bidder (Company) Name: Case LandSurveying
Authorized Representative (Type Name): AlvssaMiller
Signature: Ala/1MMam
8/26/24
17.D
MUSTBE COMPLETEDBYALL SUBCONTRACTORS
www.hud,gov/section3
review of certi?ed Section 3 pers with be
conside available employmentoppo tics; ?
EX?IBJT Ell)
Required Bid Form for bids
$200,000 or more
SUBCONTRACTORCERTIFICATIONFOR SECTION3 COMPLIANCE
(Housing and Community Development Act of 1968)
Project Title: Accessible Sidewalk &ADA Project
Subcontractor: Case Land Surveying, Inc.
, EBSGeneral En ineerin ,lnc. Contractor/Bldder: g g
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all prime construction contracts over $200,000:
a. I understand and agree that in the event that I am awarded a subcontract, and in the event that any new employment opportunities are created as a result of this CDBG-funded proj ect, I will contact the US Department of Housing and Urban Development (HUD) Section 3 website at to
the list ons, in City of Hemet, to
red for rtuni
InitialHere
b. I will forward to the Department of Housing & Workforce Solutions all detailedjob descriptions and Section 3 reports, in a form, at a place, and at a time as directedby the Department of Housing & Workforce Solutions. % Initial
17.D
onttactor .Case Land Surveying, Inc.
ype
Completeyour proposed workforce plan for this project below:
NUMBEROF
JOB CATEGORY CURRENT “WEIR“W???i??nmn s
%0FN'EWEIRESTO BE POSITIONS
AWARDED SECTION3RESIDENTS “mom
BID
PROFESSIONALS
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTIONBY
TRADE
TRADE
FieldSurveyor N/A N/A
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE
TRAINING
OTHER
TOTAL
Subc (Company) Name
Authorized Name) Larry V. Case, President
hltes amlolpaled
17.D
Em" B—G
N04?agsmA/e Sicém/?’ fwm/M?
I. Employment Ongortuni?es
www.hud ov/seetianS
considered
ham/[hudaggs?udi gov/gMgmmigl’gml/
for new employment opportunitiesand Section3 reports, in a form, at a place,and at a timeas directedby the Department ochrnsing £1.Workforce Solutions Initial Here Present a list, of the number oftatal labor hours, Section3 worker abor hours, and Targeted enerate
proj tednumber of available positions, to in
Initial Here
d. Noti Section 3 Conrdinat of contractor
workersprior to hiring Initial He
2. Submit a list of_core employees(includi dministrative, cleri planning, and posi the time of contact ard. (3)2 1
Her
Posrv ilable positions and advertisejob 36:50 3 work www,|'ivcoiabs.urg Initial Here
4 Signthe Section 3 Plan. lnmal Hen g Complete your proposed workforce p an for this reject b Snbwnl-vwlvr:V1 E Tree Suvr‘oe,
$100,000 or more
BIDDER CERTIFICATION FOR SECTION3 COMPLIANCE
(Housing andCommunityDevelopmentAct of 1968)
ProjectTitle: Amount
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 AffirmativeAction Program as well as Section 3 of the Housing and Community Development Act of1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all construction contractsover $200,000.
I understandand agree that in the event that I am awardedthis contract, and in the event that any new employmentopportunities are created as a result of thisCDBG-fundedproject, I will:
a ContacttheUS. Department of HousingandUrbanDevelopment (HUD) Section3 websiteat to review the list of certi?ed Section3 persons, withinCity ofHemet, to be for available employmentopportunities;and HUD Section 3 Opportunity Portal. Initial Here
at:
b. Forward to the Department of Housing & Workforce Solutions all detailedjob descriptions Section 3 worker labor hours expectedto be g d from the initial contract and a list of eludejob descriptionsand wage rates.
interests regarding employment of Section 3
re
ng 21 cal, other
tions pertinent to the constructiontrades) at aw uitial e
f. n ers openings at:
p elow.
.=-c.=
0
17.D
PROPOSE
ado
JOB CATEGORY
PROFESSIONALS
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTIONBY
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE
TRAINING
TRADE
OTHER
TOTAL
CURRENT
POSITIONS
Q
U
fa
NUMBEROF
NEW HIRES
IF
AWARDED
BID
Q)
(7
NUMBEROF NEW BIKES
I) TO BE
SECTION 3 RESIDENTS
C)
% OF NEW I-IlRESTOBE
SECTION 3
f)
OR)
(2
U
17.D
II. Subcontracting Ognortunities
www.hud.gov/section3
www.hudlgov/section3
consideredfor availableemploymentopportuniti ; andHUD Seeu‘on htt ://hudn srhud. ov/O onuni Portal/ (Z?Initial?erc
De en: Housin olutio §% rial He
ours,
projec numberof availablepositions,to inc
Initial Here
1. Notig Section 3 Con dinator of contractor in
prior to hiring, ( Initial Here
pertinentto the constructiontrades)at the timeof contractaward EXHIBIT13-5
i
L
Initial Here
Submit a list of core employees(includingadministrative,clerical‘pgng. and otherpositions Post available positions and advertisejob Section 3 workers open gs at: www.1-ivco'nbs.org Initial Here
BIDDER CERTIFICATIONFOR SECTION3 COMPLIANCE
a. I understandand agree that for any and all subcontracting opportunitiesthat may result fromthis CDBG—?indedproject,I will contact the U.S. Department of Housing andUrban DevelOpment(HUD) Section 3 website at to review the list of certi?ed Section3 Businesses, within City of Hemet, to be consideredfor available ‘ subcontractingopportunitiesprior to selecting any subcontractorfor my bid submittal. lnltlal Here
b. I understand and agree that any and all sub-contractsand sub-tier agreements resulting from this CDBG-?inded project are also subjectto Section 3 compliance,and therefore, as the General/Prime Contractor, I am responsible to ensure compliance from all subcontractors.
Initial Here
i. Contact the U.S. Department of Housing and Urban Development (HUD) Section3 websiteat to review thelist of certi?ed Section 3 persons, within City of Hemet,to be 3 OpportunityPortal
at:
j. Forward to the Department of Housing & Workforce Solutionsall detailedjob descriptionsfor new employmentopportunitiesand Section 3 reports, in a form, at a place,and at a time.as directed by the of g & WorkforceS ns.
Ini re
k. Present a list, of the number of total labor h Section 3 worker labor hours, and Targeted Section 3 workerlabor hours expected to be generated from the initial contract and a list of ludejob descriptionsandwage rates.
terests regardingemployment of Section 3 workers
17.D
MAA(I1155//)/t3 E’c/ma/I’lqgrommmk
J [?ees/w ’caJ/W.
"E,
Develapm
www.hud.gov/section3
Required BidForm for bids
$200,000or more
SUBCONTRACTORCERTIFICATIONFOR SECTION 3 COMPLIANCE
MUST BE COMPLETED BY ALL SUBCONTRACTORS
(Housing and CommunityDevelopmentAct of 1968)
Project Title:
Subcontractor:
Contractor/Bidder: 535 General Engineeri Inc.
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community ent Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all prime construction contracts over $200,000:
a. I understandand agree that in the event thatI am awardeda subcontract,and in the event that any new employment opportunitiesare created as a resultof this CDBG-?mdedproject, I willcontact theUS. Department of Housing and Urban Development (HUD) Section 3 website at to
review the list of certi?ed Section 3 persons, within City of Hemet, to be considered for available employmentopportunities; ga
g
InitialHere
b. I will forward to the Department of Housing & WorkforceSolutionsall detailedjob descriptionsand Section 3 reports, in a form, at a place, andat a time as directedby the Department of Housing & Workforce Solutions. ' % InitialHere
EXHIBIT B-10
17.D
O
@VV/ééuww.
Repr entative (Type \TOAH£4£017 (22%;:
Complete your proposed workforce plan for this project below:
NUMBEROF
JOB CATEGORY CURRENT NEWHIRES ER OF NEW 5
"/aOF NEW HIRES TO BE
1F PROPOSEDTO BE POSIT‘ONS SECTION3
AWARDED sncuom RESIDENTS
mo
PROFESSIONALS C)
TECHNICIANS
OFFICE/CLERICAL
CONSPRUCI'ION BY 0’ TRADE
ngqéorer /Z 0
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE 3
TRAINING
OTHER 0
TOTAL K;
Subcontractor (Company)NameAuthorizcd Name):
8/26/24
QQQ
(/16—
QC
0 O
{m
17.D
LINK—”?
MUST BE COWLETED BYALL SUBCONTRACTORS
CDBGFunded Accessible Sidewalk/ADAPro‘ect Ca ital Im rovement PrejecfN e 5765
Superior Pavement Markings, inc.
Housing unity evelopment I968, certi?
adoption erenc 0, said pro d cer nding
in the event employment opportuuit s are creat as a resu this CDBG- t, I willcontact the US. epartment Housing
www.hud.g0v/section3
EXHIBIT 3—10
$200,000 or more
SUBCONTRACTORCERTIFICATIONFOR SECTION3 COMPLIANCE
(Housing and Community Development Act of 1968)
Project Title:
Subcontractor:
Contractor/Bidder:
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the and Comm D Act of and further es
of, and adh e t gram, an ti?es understa of
the following for all prime construction contracts over $200,000:
a. I understandand agree that in the event that I am awardeda subcontract, and that any new ie ed lt of
fundedprojec D of and
Urban Development (HUD) Section 3 website at to
review the list of certi?ed Section 3 persons, within City of Hemet, to be consideredfor availableemployment opportunities; N/A
Initial Here
b. I will forward to the Department of Housing & Workforce Solutions all detailedjob descriptions and Section3 reports, in a form, at a place, and at a time as directedby the Department of Housing & Workforce Solutions.
EBSGeneral Engineering, Inc.
Initial Here
17.D
Superior Pavement Markings, Inc‘
08/26/2 _ _ .
Complete your proposed workforce plan for this project below:
NUMBER OF
JOB CATEGORY CURRENT
NEW HIRES IBER OF NEW HIRES % OF NEW I-lIRES TO BE
POSITIONS
1F PROPOSED TO BE SECTION 3
AWARDED SECTION 3 RESIDENTS
BID
3 4
OFFICE/CLERICAL
16 CONSTRUCTION BY
TRADE
TRADE
. 41
Pavement Strlper
TRADE
TRADE
APPRENTICE 3
TRAINING
OTHER
67 Subcontractor (Company)Name:
AuthorizedRepresentative(Type Name): Rebecca Parra
Signature: Pebecca39am;
024
PROFESSIONALS
TECHNICIANS
TRADE
TRADE
TRADE
17.D
resgonsible
Win "at be
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL
The undersigned hereby proposes to furnish any and all labor, materials, and equipment for the CDBG Accessible Sidewalk/ADAProject, CIP No. 5768, and appurtenant work in connection therewith, said work to be done and materials to be furnished in strict conformity with the Contract Documents, including but not limited to the Notice Inviting Bids, Instructions to Bidders, every Addendum, plans, specifications, General Conditions, Special Provisions, General Provisions, Greenbook 2018 as amended and supplemented, technical references, all other referenced documents, all codes, permit conditions and regulations, for the total amountls) and any unit prices and additive/deductiveitems shown on this proposal.
The undersigned has examined the location of the proposed work and all local and physical conditions and challenges presented by the Project site, is familiar with the plans, specifications, Contract Documents (particularly as delineated above) and the requirements of the Public Works Contract, and also understands that the Project shall be completely constructed in turn-key condition acceptable to the Owner within the Project time requirements for the price of the proposal, including all fees and sales and/oruse tax upon any materials so furnished, including any unit prices and additive/deductiveitems. The undersigned has also carefully checked all of the figures given and understands that the Agency for any errors or omissions on the part of the undersigned in submitting this proposal.
Contractor confirms that his/her/itsbid is submitted with respect to the changes to the Contract and/orContract Documents included in all addenda issued by the Owner.
In addition to reaffirming that the changes and information contained in the addenda have been integrated into their proposal, Contractor acknowledges receipt of Addenda No.(s 1
The undersigned has examined the current State of California schedule of prevailing wage rates for the types of work to be done on this project (and the Davis-Bacon Act if the Agency uses federal funds for the Project) and agrees to pay not less than these rates.
Rex» 0
February 2020
17.D
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
BIDSCHEDULE
BASEBID- CDBG ACCESSIBLESIDEWALK/ADA PROJECT, CIP No. 5768 EXTEND
ITEM ESTIMATED UNIT ED DESCRIPTION UNIT ITEM
No QUANTITY PRICE AMOUNT
1 Mobilization (not to exceed 5%L LS 1
2 Traffic and Pedestrian Control LS 1
3 Temporary Construction Project
Identification Sign EA 2
4 Water Qualitv Control L8 1
Adjust Ex. Manhole to New F.S
5 per Owner Agency Std. &
Specs. EA 1
5 Remove & relocate existing
mailbox EA 10
7 Adjust Ex. Water Meter
Box/Traff. Box to finish surface EA 6
8 Relocate Ex. Signs and Posts EA 17
9 Remove and Replace Exist ADA
Ramp per City Std. EA 29
10 Construct 4" thick PCC sidewalk
per City Std. SF 12000
11 Construct PCC Driveway SF
Approach per City Std. 1025
12 Remove, Uproot and dispose EA
ex. Tree/tree stump. 8
13 Remove & relocate existing LF
fence/gate 450
Remove Ex. PCC/AC &
14 Construct New PCC driveway SF
approach per City Std. 520
15 Remove & Dispose Ex. Masonry
Wall/Pilaster EA 4
15 Construct type "A" Curb and
Gutter per City Std. LF 225
$38,000.0C $38,000.00
$46,000.00
$2,300.00
$46,000.00
$4,600.00
$18,000.00 $18,000.00
$1,650.00
$450.00
$730.00
$450.00
$13,600.00
$14.00
$30.00
$1,200.00
$115.00
$32.00
$3,000.00
$101.00
$1,650.00
$4,500.00
$4,380.00
$7,650.00
$394,400.00
$168,000.00
$30,750.00
$9,600.00
$51,750.00
$16,640.00
$12,000.00
$22,725.00
17.D
(numbers)
n?AWI-AWQMMM
(nu
$830,645.00
n/a
eight hundred thirty thousand six hundred forty-five dollars
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont'd)
BASEBID— CDBGACCESSIBLESIDEWALK/ADA PROJECT, CIP No. 5768
EXTENDED
ITEM ESTIMATED UNIT
DESCRIPTION UNIT ITEM
No QUANTITY PRICE AMOUNT
TOTALBASEBID
************************************ END OF BASE BID ITEMS ADDITIVEA BID ITEMS AS FOLLOWS:
ITE EXTENDED ESTIMATED
M DESCRIPTIONOF ITEMS ”I?" P‘IIIIICIE
ITEM
No QUANTITY AMOUNT
A1
TOTAL BIDADDITIVEA mbers)
******************************** END OF ADDITIVEA BID ITEMS ******************H************ BASE BIDTOTAL (in words)
Contractor's
ADDITIVEA BID ITEMSTOTAL (in words)
Contracto
In the event of a variation between the unit price and extended total, the unit price willbe used and the corrected extension will be considered as the amount bid. If the bid is illegible and cannot be reconciled it will be considered non-responsive and will not be considered for award.
If an additive and/oralternate bid schedule is called for in the Contract Documents, the lowest bid will be determined on the basis of the base bid schedule(s) only unless otherwise specified in the Notice Inviting Bids or by Addenda if issued to supersede the Notice Inviting Bidson this specific issue.
For a Contract where a deductive bid schedule is called for, the lowest bid will be determined by the total of all bid schedules including the deductive bid schedule(s).
Rev. 0
February 2020
B.G
17.D
CDBG ACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont'd)
Regardless of whether the additive/deductiveor alternates bid items will be considered in determining the low bid, the Agency may elect to include any or none of the additive/ or alternate bid items/schedules, or to otherwise add or remove certain workdeductive from the scope of Work. Accordingly, Contractor warrants that each bid item contains a proportionate share of profit, overhead and other costs and expenses, which will be incurred by the Contractor for the Project.
If equal low bids are received from responsible and responsive bidders the selection shall be made by drawing lots, or other similar random blind method selected by the Agency. If only one responsive bid is received from a responsible bidder the award shall not be made unless the price can be determined to be reasonable based on an analysis by the Agency. The Agency’s determination as to the reasonableness of any such bid shall be final.
The Agency reserves the right to reject any or all bids, to waive any irregularitylies), and to take all bids under advisement for a period of sixty (60) calendar days after the date the bids are publicly opened. Bidder acknowledges that all costs incurred as a result of preparing the proposal shall be the sole responsibility of Bidder. The Notice Inviting Bids and Instructions to Bidders does not create or impose any obligation upon the Agency to enter into a contract.
All bids received shall be recorded on an abstract (tabulation) of bids, and then made available for public inspection within two business days of bid opening.
The quantities listed in the bid proposal are provided to give a general indication of the scope of the work and for the comparison of bids. No warranty is made, either expressed or implied, that the actual quantities of work to be done will correspond therewith. Item numbers followed by ”(S)” are designated as specialty items which will not be included towards the calculation of minimum of 50 percent of work to be performed by Contractor’s own forces.
By signing and submitting this bid the Contractor confirms that they are familiar with the work site and all existing conditions that may affect their work and that they have read and agree to all the terms, conditions and requirements contained or referenced herein or in the Contract Documents and that all the aforementioned has been included in the bid prices listed above, including items of work that may not have a specific pay line item and that there shall be no additional costs to the Agency.
WARNING: If an addendum or addenda have been issued by the Agency and not noted above as being received by the bidder, this Bid may be rejected.
Legal name of the business, DIRReg. and Contractor License Nos.
Complete the following:
Gentry General Engineering, Inc
17.D
entrygene
“but M ”?at
CDBG ACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
Business Type (Corporation, Partnership, Sole Proprietor) Name and title of the owner
Facsimile number
Name and Email address of primary contact
Company web address
Date
Print name and title Print name and title
(if the Bidder is a corporation two signatures ofcorporate officersare required.) Rev. 0
February 2020
Corporation
Brenton Gentry - Secretary, Treasurer, and Manager
Brenton Gentry g ra|@gmail.com
August 26. 2024 August 26. 2024
DBA(if any)
Brenton Gentry - President/CEO
Name and title of second partner or officer
320 W. Tropica Rancho Rd. Colton, CA 92324
Business Address
Telephone number
Signature of Bidder
Brenton Gentry - President/CEO
Signature of Bidder Date
Brenton Gentry - Secretary, Treasurer, and Manager
17.D
’?ut ”?at
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
CERTIFICATEREGARDINGCONTRACTOR'SLICENSE
1. Contractor is required to possess one of the following State Contractor's License:
State of California Contractor’s License
Combination of Specialty Class Contractor’s Licenses
2. A failure to (1) possess the required license, (2) truthfully set forth the following information, and/or (3) execute this Certificate may render the proposal nonresponsive and permit the City to reject the proposal. (Business and Professions Code Section 7028.15)
3. Contractor declares, under penalty of perjury, that he/she/it possesses the required Contractor's |icense(s) which:
a. Bears the license number(s)
b. Exp
Date
Print name and title Print name and title
(If the Bidder is a corporation two signatures ofcorporate o?‘icersare required.) This required license determination has been made by the Agency. Any Contractor holding a different license who feels he is qualified to bid on this work must so advise the Agency at least seven (7) days prior to the bid opening. The Agency may conduct a review of the contemplated work to re-evaluate the required license determination. The Agency may in its sole discretion maintain or change the required license determination; Agency’s decision as to the required license will be final.
Signature of Bidder Date
Brenton Gentry - Secretary, Treasurer, and Manager
Class A
August 26, 2024
974279
06/30/2026
August 26, 2024
Signature of Bidder
Brenton Gentry - President/CEO
17.D
who proved to me on the basis ofsatisfactory evidence to be the person )whose name(;i)isl¥e . -
subscribed to the within instrument and acknowledged to me that he/s ey executed the same ' .
his/h?r/tyeir authorized eapacity?qé),and that by his/th/théirsignature(§) on the instrument the - person(s). or the entity upon behalf of which the person“) acted, executed the instrument. 1 ANDREANICOLESCARBROUGH
‘ _ Maury mu; - Camarm
SanaemardinaCounty E
’ Cammissim1 2mm -
Myemu.Expim my M2016
ACKNO LE ENT
A notary public or other of?cer completing this . certi?cate veri?es only the identityof the individual who signed the document to which this certi?cate is
attached, and not the truthfulness, accuracy, or
validity of that document. 1 State of California
County of San Bernardino )
me. AndreaScarbrough, Notary Public
(insert name and title of the of?cer)
On
personally appeared Brenton Gentry
In
I certify under PENALTYOF PERJURYunder the laws ofthe State of Californiathat the foregoing paragraph istrue and correct
WITNESS my hand and of?cial seal.
Signature (Seal)
17.D
Gentry Engineering
(S
Ian re
Bond N0. CSBA28176
CDBGACCESSIBLESIDEWALK/ADA PROJECT w
cwNo. 5768 BIDDER'SPROPOSAL(cont’d) 5*
BIDSECURITYFORM FOR BOND
KNOWALLBYTHESEPRESENTS:
That the undersigned
General Inc.
(Name of Contractor)
as Principal and the undersigned as Surety are held and firmly bound unto Owner, CITYOF HEMET, a political subdivision of the State of California, as oblige, in the penal sum of Ten Percent of the Amount Bid
Dollars 10% I lawful money of the United States of America being at least ten percent (10%) of the aggregate amount of said Principal’s base Bid, for the payment of which, well and truly to be made, we bind ourselves, our successors, executors, administrators, and assigns, jointly and severally, firmly by these presents.
WHEREAS,said Principal is submitting a Bidfor [PROJECTNAMEAND DESCRIPTION]* *CDBG Funded Accessible Sidewalk/ADAProject Capital Improvement Project No. 5768 THE CONDITIONOF THIS OBLIGATIONIS SUCH that if the Bid submitted by the said Principal be accepted and the Contractbe awarded to said Principal and said Principal shall within the required periods enter into the Contract so awarded and provide the required Construction Performance Bond, Construction Labor and Material Payment Bond, insurance certificates, and all other endorsements, forms, and documents required under the Instructions to Bidders, then this obligation shall be void, otherwise to remain in full force and effect.
IN WITNESSWHEREOF, the above bounden parties have executed this instrument this 23rd day of August , 2024.
(Month)
Gentry General Engineering, Inc.
(Corporate‘Seal) By
Principal
By The Ohio Casualty Insurance Company
Surety
(Corporate Seal) BY
La II,Attorney—in-Fact
17.D
person“ name( is! e .'
he/sfp May “’2saie
his/hq???irsignaturem
person(y)acted executed
mam NICOLEmucus" ‘ Maury mu: - Ca?fumia
in autumn Cnunly i
Enmnnsslm» 2mm
HYComm.ExpiresMI!‘7, 2026
AC N0 LE ENT
A notary public or other of?cer completing this
certi?cate veri?es only the identityof the individual
who signed the document to which this certi?cate is
attached, and not the truthfulness, accuracy, or
of that document. I
State of California
County of San Bernardino \
AndreaScarbrough, Notary Public
(insert name and title of the of?cer)
On before me,
personally appeared Brenton Gentry
who proved to me on the basis of satisfactory evidence to be the Whose subscribed to the within instrument and acknowledged to me that executed in , h ir authorized on the instrument the
p or the entity upon behalf of which the , the instrument.
Icertify under PENALTYOF PERJURYunder the laws ofthe State of Californiathat the foregoing paragraph is true and correct.
WITNESS my hand and of?cial seal.
Signature (Seal)
upacity(i ), and that by
17.D
ACKNOWLEDGMENT
A notary public or other of?cer completing this
certificate verifies only the identity of the individual who signed the document to which this certi?cate is
attached, and not the truthfulness, accuracy, or
valid of that document.
State of California
County of Orange )
On 08/23/2024 before me, Melissa Ann Vaccaro, Notary Public (insert name and title of the of?cer)
personally appeared Adrian Lanorell
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 i n 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 PENALTYOF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
MELISSAANNVACCARO
COMM.#2401942
Notary Public-California
ORANGECOUNTY
Comm.ExpiresMay12,
WITNESS my hand and official seal
FR53 FR53
Sign (Seal)
17.D
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SURETY
1912
1912
1919
1919
1991
1991
Bond No. CSBA—28176
Ceni?caieN0 82090294363561
Lib ty Mutual.
ThisPowerofAttorneylimitsthe acts ofthose named herein, and they have no authorityto bind the Companyexcept in the manner and to the extentherein stated.
Libeny Mutual Insurance Company
The Ohio Casualty Insurance Company
West American. Insurance Company
POWER OF ATTORNEY
KNOWNALL?ERSONSBYTHESEPRESENTS:ThatTheOhioCasuattyinsurance companyis a corporation dutyorganized underthe lawsof the Stateof NewHampshire. ma merry t MutualInsuranceCompanyis a corporanonduly organized under the Lawsofthe StateofMassachusetts. and West AmericanInsuranceCompany 5 a corporation duty organize d underthelaws of theStateo! Indianathereinnotiecn'vetyCritter: the 'Comoantes'). pursuant to and byauthorityherart set forth.does hereby name, constitute and appoint Anuro at:ofthemyot Cranes
execute.seal.acknowledgeanddeliver.forandon
of these presents and shall be as bindinguponthe Companiesas iftheyhave been dulysignedby the pregnantand attestedby the srxretary oi the Companiesin theirownprope r persons
It:WrTNESSWHEREOF. this Powerof Attorneyhas beensubscnbaj by anau?sortzeo ethos!orof?cialof the Compantesand the corporate seals0!theComoanies have seen affixe d
theretothis “list day of 2023 , LtberryMutualInsurance Company TheOhioCasualtyinsurance Company
West tnsuranceCompany
Secretary
of PENNSYLVANIASS 01MONTGOMERY
2023 peters mepersonallyaopeareoDar-inhf Carey.whoacknowledgedhimsetto be 5% AssistantSecretary ofLipeyryMutual and WestAmericanInsurance Company and the: he. as such.hang autnonzedso to do, executethe toregpinginstrumentfor the thereincontained bySigningonDenalior'the corporau‘unsby himselfas a outyauthorizedof?cer mWITNESSWHEREOF.Ihavehereuntosubscribedmynameand af?xeomynotanatseat at PtymooinMeeting.Pennsytrania. on theday andyeart‘irstabovewritten, Pasteita.Notary
This Powerof Attorney is made and wanted pursuant to and by authority of the tottowéngBy—Iawsare AUIHDI‘IZBDGFIS of TheOhioCasuattyInsuranceCompany botany Mutu at‘ InsuranceCompany,oneWestArnencanInsurance Companywhichresolutionsare nowin feltforceand effectreadingas follows:
'
ARTICLEIV~0FFt€ERSz Section12 PowerofAttorney.
Any of?ceror other amoralof the Coroorationauthorized for that purpose In wrthngby LheChairmanor the President.and subtazlto such IImitationas the Chairmanor the Freedommay prescribe,shall appoint such attorneys-intact,as may he necessary to act in behalfat the Cameramanto mate. execute. seal.acknowledgeand rtetweras surety anyand at unoertatungs bonds, recognizances and othersurety obligations SUCHattorneys-Intactsubiectto the timitatms set formin they respectivepowersorattorney shal l have lullWe? 10DINGthe Corporationby theirSignature and executionf any such instrumentsand to attachmeretothe seat oi the Corporation Whenso executed suc h anstnjmehts shalt be as blndi?gas it signed by the Presidentand attested to by the Secretary Any poweror authority granted to any representative or attorney-intactunder the monstrousofthe amte may be revokedat any tune by the BURZTL the Chairmanthe Presrcentor by the officeror of?cersgranting such poweror aulhcrrty, ARTICLEXIII—Execution 0!Contracts: Section5.SuretyBondsand undertakings Anyofficerof the Companyauthorized forthat purposein writingby the chairman or the president.and subtract to such iirrii‘tali’ons as the ohainnanor the preséoent mayprescrioe . shallappointsuch attorneys intact as maybe necessaryto act in behalfof the Companyto make execute sea! acknowledge and deliveras surety any and anundertaktngs , tends. recorgntzancesand othersurety obligationsSuchattorneysansfactsubject to thetimélations set font:intheirrespectivepowersof attorney. manhave fullpower to bindth e CompanyoytheirSignature and executronof any such instruments and to attach theretothe seat of theCorneanyWhenso executedsuch instrumentsshatt be as bindingas I f Signedby the president and attested by thesecretary
Certi?cateofDesignation—ThePresidentofthe Company.actingpursuant to theBylawsofthe Company authorizesDamnM Carey,AssistantSecretarytoaopcentsoch attorneysin factas maybe necessaryto act on behalfoi theCompanyto make execute.seal.acknowledgeand deliveras surety any amall undertakings. normrecognizames andothersurety
OUIIQEBOHS
Authorization- ByunanimousconsentoftheCompany’sBoardofBéreotors the CompanyconsentsthatfacsimileorrnerjianicattyreproducedSignature of anyassistantsecretary ofthe Companywherever appoan'rig upon a certifiedcopyoranypowerofattorneyowed by theCompanyIn connectionwithsuretybards.shaltt2 vai'tdand tundirlgupontheCompanywit h
the sameforceand effectas thoughmanuaiiyaffixed
l.ReneeC Llewellyn)the undersigned. AssistantSecretary,The OhioCasualty Insurance Company,Liberty MutualInsuranceCompany and West AmericanInsuranceCompanydo herebycertifythat the onginalpowerof attorney ofwhichthe toregoingis a foil.true and correct copyofthePowerofAttorneyexecutedby saidCompantes,5 in fullforceand e?ect and has not been revoked
INTESTIMONYWHEREOF. t have hereuntoset myhand and af?xedthe seats at said Companiesthis 23rd dayof August .2024 (30
Tutu Swirl; vary PAPA: Morth-(ry Quit,
‘1‘.cm‘rmm cxzmwatn 2! 2925
17.D
August 25‘2024
[ [state] ,
mam: at
Rev, 8
February 2028
CDBGACCESSIBLESlDEWALK/ADA PROJECT
cwNo. 5768 BIDDER'SPROPOSAL (cont’d)
NON-COLLUSIONAFFIDAVIT
PUBLICCONTRACTCODESECTION7106
NON-COLLUSIONDECLARATIONTO BEEXECUTEDBYBIDDERANDSUBMITTEDWITHBID The undersigned declares:
I am the party making the
foregoing bid
The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. All statements contained in the bid are true. 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, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.
Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on [date], at city],
Signature of Bidder Date Signature of Bidder Date
Print name and title Print name and title
{Ifthe Bidder is a corporation, two signatures ofcorporate o?icersare required.) President/ CEO Gentry General Engineering. lnc.
Colton California
- August 26. 2024 August 26, 2024
- President/CEO Brenton Gentrv - Secretary, Treasurer, and Manager
17.D
VH2U,i
‘
‘
person( name(g)is/afe;
sybscnbeqto the wlthlnIns1rument and acknowledged to me that helsU ey the ' hIs/hérlt Ir authorized apacity?ps). and that by hislhaf/thg?rsignature ) person( ), or the entity upon behalf of which the person(;oacted. exec ed 1 ANDREANICOLESCARBROUGH
‘‘ Maury Public- GNOME
Sin kmr?no Caunly E
comnnsmnmm -
MyComm.ExplresMir17,1016
ACKNO LE ENT
A notary public or other of?cer completing this . certi?cate veri?es only the identityof the individual who signed the document to which this certi?cate is
attached, and not the truthfulness, accuracy, or
validitvof that document. 1
State of California
County of San Bernardino )
Andrea Scarbrough, Notary Public
(insert name and title of the of?cer)
On
personally appeared Brenton Gentry
who proved to me on the basis of satisfactory evidence to be the Whose executed same In
on the instrument the
the instrument.
I certify under PENALTYOF PERJURYunder the laws ofthe State of Californiathat the foregoing paragraph istrue and correct
WITNESS my hand and of?cial seal.
Signature (Seal)
before me,
17.D
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
CONTRACTOR'SREFERENCELIST
Attach to this bid a list of three (3) projects in the past five (5) years on which the bidder and his subcontractor(s) have successfully constructed and completed projects with the same type (elements), size and complexity of work. The Agency Engineer will make the final determination of whether the projects listed here are of the same type, size and complexity as this project.
Failure of bidder to supply sufficient documentation of similar electric, telephone, cable and sanitary sewer underground facilities experience shall be considered grounds for a non-responsive bid and, at the Agency’s discretion, said bid will be disqualified.
Project Name:
Contract Price: ate of Completion:
Name, Address, and Telephone Number of Owner's Representative Project Name:
Contract Price: Date of Completion:
Name, Address, and Telephone Number of Owner's Representative:
Project Name:
Contract Price: Date of Completion
Name, Address, and Telephone Number of Owner's Representative:
(Attach additional pages as necessary)
17.D
R EN NEERIN
C er?baldwinParkLam
HFurdQDPWSBCounLgov
KarlgimngWUHSDog
SStanton@CityofMontclaimrg
Tl’re‘oQCLUglandcaUs
GI G
2013 — $34,500.00
City of Fontana
Damaged Street/Sidewalk
Asphalt & Concrete R&R
8353 Sierra Ave
Fontana, Ca 92335
Jason Jojola: No EmailAddress
909.350.6636
2014 — $30,000.00
City of Rancho Cucamonga
Solar Shade Structure
8794 Lion St.
Rancho Cucamonga, Ca 91730
909.477.2730 (No EmailAddress)
2015 — $495,000
City of Whittier
Fire Loop/FireSprinkler Repair
9401Painter Ave
Whittier, Ca 90605
KarlaEmbry:
562.332.9303
2015 — $41,000
City of Glendora
Water Improvement
116 E. Foothill Blvd.
Glendora, Ca 91741
Carlos Cigneros: No EmailAddress
626.786.1285
Prior Projects
2016 — $504,420
City of BaldwinPark
Alleyway Street/Sidewalk
Asphalt & Concrete R&R
14403 Pacific Ave
Baldwin Park, Ca 91706
Chase Fidler:
626.960.4011
2016 — $619,075
City of Bloomington
ADARamp — Repair/Maintenanee/Replaced
825 E. 3rdStreet
San Bernardino, CA92415
Haile Ford:
909.387.7936
2016 — $173,604
City of Montclair
Alleyway Street/SidewalkAsphalt & Concrete
5111 Benito St
Montclair, Ca 91763
Steve Stanton:
909.625.9444
2017 - $325,000
City of Upland
Damaged Street/Sidewalk
Asphalt & Concrete R&R
1370 North Benson Ave
Upland, Ca 91785
Tony Trejo:
909.631.3918
off: 909.330.1128
fax: 909.330.1129
gentrygeneral@gmail.
320 W Tropica RanchoRd
Colton,CA92324
17.D
MSaralya@CigofPasadenamet
VsoQSama-Ana.o[g
JGatzaQTorranceCa.gov
BarmGhaemiQCoronacagov
KTogkinsQBarstowCa.gov
MCavanQHARCOIncMs
‘winterburn@balfourbeamusxom
SFurukawaQTorranceCa.guv
rsalathermosabchorg
2017 — $624,688 2018 — $547,950
Santa Ana City of Pasadena
Repair Maintenance/Replaced MiscellaneousConcrete Repair Damaged Street/Sidewalk 100 Garfield Ave
Asphalt & Concrete R&R Pasadena, Ca 91101
20 CivicCenter Plaza Morley Saralya:
Santa Ana, Ca 92701 626.744.3703
Victor So:
714.647.5076 2018 — $2.2 Million
City of Torrance
2017 — $694,000 Downtown Torrance Active Transportation City of Corona Improvements
Miscellaneous Concrete Repair 20500 Madrona Ave
400 S. Vicentia Ave, Ste. 210 Torrance, Ca 90503
Corona, Ca 92882 Justin Gatza:
Barry Ghaemi: 310.618.3032
951.739.4961
2019 - $288,974
2017 — $30,000 City of Barstow
City of San Diego Water Treatment Plant Dewatering Pad & Wall Demo/Backfill/Compact Existing 2200 Riverside Dr.
Vault Location Barstow, Ca 92311
422 W. Washington St. Kody Topkins:
San Diego, Ca 92103 760.252.2538
Matt Cavan:
951.684.1909 2019 — $544,342
Torrance Unified School District
2018 - $1.2 Million Anza, Arnold and HickoryESSite Drainage City of Torrance 21400 EllinwoodDr
Damaged Street/Sidewalk Torrance, CA90503
Asphalt & Concrete R&R Joe Winterburn:
20500 Madrona Ave
Torrance, Ca 90503 (949) 502—4000
Shin Furukawa:
310.618.3073 2019 - $714,000
City of Hermosa Beach
8thStreet Improvements Project
8thStreet
Hermosa Beach, CA 90254
Reed Salan:
(310) 318-0229
320 WTropica RanchoRd off: 909.330.1128
Colton,CA92324 fax: 909.330.1129
gentrygeneral@gmail.
17.D
rhamersQrobhamers.com M'aramillonelterra,com
'osemQCityoffullerton com sfurukawa @torranceca.gov
acaraveo
csmethursthontan rg
mmccany?toak org
tlngeerkagroug.com
Danny.true@wuhs rg
2019 - $267,000
Costa Mesa Sanitary District
Indus Sewer Main Replacement
20122 Santa Ana Ave
Newport Beach, CA92660
Rob Hamers:
(949) 548-1192
2019 - $285,744
City of Fullerton
Curb/Gutterand Sidewalk Reconstruction
Fullerton, CA92831
Jose Medina:
(714) 738-6863
2019 - $141,312 ($139,573 original bid; work
limits increased)
City of Irvine
Ranch Park BikeTrail Rehabilitation
Irvine, CA92618
Anthony Caraveo:
(949) 724-7365
2019 - $644,763
City of Thousand Oaks
Concrete Replacement and Sidewalk Repair
Program
Thousand Oaks, CA91320
Michelle McCarty:
(805) 449-2477
2019 - $14,800.00
Whittier Unified School District (Whittier CHS)
Refurbish Long Jump Pits
9401 S. Painter Ave.,
Whittier, CA90605
Danny True —
(562) 237-0795
2019 — $210,000
Lynwood Middle School (USD)
Storm Drain Improvements
11321 BullisRoad
Lynwood, CA90262
ManuelJaramillo:
(323)447-0996
2020 - $1,369,000
City of Torrance
Sidewalk Repair for Handicap Accessibility
Torrance, CA90505
Shin Furukawa:
(310) 781-6900
2020 - $19,546
City of Fontana
San Bernardino at Cypress Driveway
Improvements
Fontana, CA92335
Christopher Smethurst:
(909) 350-6649
2020 - $158,338 ($149,835 original bid;
additional grading work performed)
City of Walnut
Butterfield Park Trail Rehabilitation
21201 La Puente Rd
Walnut, CA91789
Tony Lopez:
(909) 594-9702
off: 909.330.
1128 fax: 909.330.
1129 gentrygeneral@gmail.
320 WTropica RanchoRd
Colton,CA92324
17.D
asantos?lagunabeachcity?et
erodriguezQimindaleca.gov
asantosQlagunabeach g at
erodriguezQlrwindaleca.gov
sam sousanhinoklZLa‘us
[email protected]
W3
mlbeneshQrobhame cm
2020 - $29,820
City of Irwindale
Peppertree Bus Shelter Removal and Foothill
Column
5050 N Irwindale Ave
Irwindale, CA91706
Elizabeth Rodriguez —
(626) 430-2211
2020 — $5,565
City of Irwindale
Arrow Bus Shelter Roof Repair
5050 N Irwindale Ave
Irwindale, CA91706
Elizabeth Rodriguez —
(626) 430-2211
2021 - $22,000
Whittier Unified School District
Collapsed Storm Drain Repair
9401 S. Painter Ave.,
Whittier, CA90605
Danny True —
(562) 237-0795
2021 - $29,999
Costa Mesa Sanitary District
Manhole Surface Repairs Phase 7
290 Paularino Ave
Costa Mesa, CA92626
Michael Benesh —
(949) 548-1192
2021 - $366,732
City of Laguna Beach
Zones 2 and 3 Street Concrete Improvements
505 Forest Ave
Laguna Beach, CA92651
Alpha Santos-Guinto —
(949) 497-07 29
2021 — $221,318 ($211,965 original bid; extra
work added)
City of Laguna Beach
Ramona Alley Decorative Paving Replacement
505 Forest Ave
Laguna Beach, CA92651
Alpha Santos-Guinto —
(949) 497-0729
2021 - $198,420
Chino Valley Unified School District
Briggs K-8Waterline Upgrades
11880 RoswellAve
Chino, CA 91710
Sam Sousa —
(909) 628-1201 x1490
2021 - $125,400
Torrance Unified School District
Seaside Elementary Site Drainage Improvement
2335 Plaza Del Amo
Torrance, CA90501
Ryan Palmer —
(310) 972-6240
320 WTropica RanchoRd off: 909.330.
1128 Colton,CA92324 fax: 909.330.
1129 gentrygeneral@gmail.
17.D
[email protected]
glerbuiQCVdeaterLcm
[email protected]
carlosseaneszpw.sbcoung.gov
syanagiharaQanaheimmet
asantos?Iagunabeachcitynet
rmcbride?éllea com
2021 - $252,796
City of Rancho Cucamonga 2022 - $88,066
Citywide Concrete Repair Cucamonga Valley Water District 10500 CivicCenter Dr Nitrate Facility Retaining Wall
Rancho Cucamonga, CA91730 10440 Ashford St
Ernie Ruiz — Rancho Cucamonga, CA91730
Tyler Bui —
(909) 774-4108
(909) 483-7455
2021 - $41,750
State of California 2022 - $148,029
Moro State Deck and ADAAccess County of San Bernardino
715 P Street Laurel Ave/RandallAve Drainage Improvement Sacramento, CA94296 825 E3'dSt
Michelle Humphrey — San Bernardino, CA92415
Carlos Seanez —
(949) 366-8533
(909) 486-0227
2021 - $1,924,055
City of Anaheim 2022 — $98,050
Alley Sanitary Sewer Improvement City of Laguna Beach
200 5 Anaheim Blvd Citywide Guardrails
Anaheim, CA92805 505 Forest Ave
Scott Yanagihara — Laguna Beach, CA92651
Alpha Santos-Guinto —
(714) 231-4696
(949) 497-0729
2022 - $9,010,551 ($8,449,000 original bid;
plans/specs revised post-award) 2022 - $121,318 ($111,000 original bid; work State of California limits extended)
Doheny State Beach Projects A, Band C City of Orange
715 P Street Chapman Ave Alley Improvement
Sacramento, CA95832 300 EChapman Ave
Ryan McBride — Orange, CA 92866
KarlSchmidt —
(714) 833-1792
(714) 744-5562
320 WTropica RanchoRd off: 909.330.1128
Colton,CA92324 fax: 909.330.1129
gentrygeneral@gmail.
17.D
msimonthorranceca‘gov
Ph g nega?cityof s
Richardfavelanlgofrcus
frivera@e|segundc.ovg
gsantos?lagu na beachcitymet
'flath@ baliourbeattyus‘com
2022 - $1,085,610.50
City of Torrance
Citywide Sidewalk Repair for Disabled
Accessibility
3031 Torrance Blvd
Torrance, CA90503
Marc Simons —
(424) 399-3193
2022 - $7,997 2022 - $426,472 ($508,372 original bid; some City of Rancho Cucamonga bid schedule items deleted from work) Citywide Fence Repair County of San Bernardino
8794 Lion St Ridgecrest RdSidewalk and Ramps
Rancho Cucamonga, CA91730 825 E3rdSt
Phillip Ortega — San Bernardino, CA 92415
Carlos Seanez —
(909) 477-2730
(909) 486-0227
2022 - $206,496 ($200,010 original bid; design
revisions) 2022 - $48,606
City of ElSegundo City of Rancho Cucamonga
W Mariposa Ave and W Pine Ave Sidewalk Calle Carabe Sidewalk Repair Construction 8794 Lion St
350 Main St Rancho Cucamonga, CA91730
ElSegundo, CA90245 Richard Favela — Floriza Rivera —
(909) 774-4107
(310) 524-2361
2022 — $128,695
2022 — $413,420 City of Laguna Beach
Temecula Valley Unified School District Peppertree Parking Lot Rehabilitation Vintage HillsElementary School Modernization 505 Forest Ave 31350 Rancho Vista Rd Laguna Beach, CA92651
Temecula, CA92592 Alpha Santos-Guinto —
Jim Flath —
(949) 497-0729
(951) 501-9594
320 WTroplca RanchoRd off: 909.330.1128
Colton,CA92324 fax: 909.330.1129
gentrygenera|
2022 — $5,700
City of Rancho Cucamonga
Way Finder Monument Sign Replacement
8794 Lion St
Rancho Cucamonga, CA 91730
Phillip Ortega -
(909) 477-2730
frc.us
17.D
'ricerlmantecaga Ph 9 neganityofrc.us
kkaQelmonteca.gov
Richard‘Favelagcigo Jenny‘HanlonQCityufrcus
Richard.Favela@cit¥ofrc.us
carlosseaneszgwsbcountygov
2022 — $529,424 ($489,075 bid value;
quantities/limits increased)
City of ElMonte
Sidewalk and Curb Ramp Reconstruction
11333 Valley Blvd
ElMonte, CA91731
John Rico —
(626) 258-8833
2022 - $142,591
City of Rancho Cucamonga
Heritage Community Park Pedestrian Trai
l Rehabilitation
8794 Lion St
Rancho Cucamonga, CA 91730
Richard Favela —
(909) 774—4107
frc.us
2022 - $47,522 ($44,236 bid value; additional
signage added to scope)
City of ElMonte
City HallParking Lot ADAImprovements
11333 Valley Blvd
ElMonte, CA91731
Kevin Ko —
(626) 580-2058
2022 - $15,600
City of Rancho Cucamonga
Carnelian BlockWall Repair
8794 Lion St
RanchoCucamonga, CA91730
Richard Favela —
(909) 774-4107
320 WTropica RanchoRd
Colton,CA92324
2022 - $8,922
City of Rancho Cucamonga
Guardrail Replacement at Woodruff and
Highland
8794 Lion St
Rancho Cucamonga, CA91730
Phillip Ortega —
(909) 477—2730
2022 — $176,450 ($138,925 bid value;
limits/quantities increased)
City of Orange
Chapman and Yorba Sidewalk Construction
300 EChapman Ave
Orange, CA 92866
Eric Perez —
(714) 744-4107
2022 - $109,208 ($99,420 bid value; scope of
work increased
City of Rancho Cucamonga
Construction of PickleballCourts at RedhillPark
8794 Lion St
Rancho Cucamonga, CA91730
Jenny Hanlon —
(909) 774-2343
2022 - $181,909.90 (original bid $186,155;
actual quantities less than bid schedule)
County of San Bernardino
City Creek Guardrails
825 E3mlSt
San Bernardino, CA92415
Carlos Seanez —
(909) 486-0227
off: 909.330.
1128 fax: 909.330.
1129 gentrygeneral@gmail.
17.D
sonny rod guech yofrc s
emunronfontan org
jgascualQhermosa beachgov
'meuQcityo?aguna gue org
'QascuaIQhermosabeacgov
‘gascualQhermosabeach gov
balemanQdowneyc rg
kswanner?uglandc gov
2022 — $240,528 ($233,440.68 bid value; limits
extended)
City of Fontana
Foothill-Alder Curb Ramp
8353 Sierra Ave
Fontana, CA 92335
Estephany Monroy
(909) 350-6642
2023 - $163,771.34 ($200,000 bid value; on-call
contract)
City of Laguna Niguel
Citywide Concrete Infrastructure Repair
30111 Crown Valley Pkwy
Laguna Niguel, CA92677
Jeff Metz
(949) 362-4344
2023 - $281,019 ($207,793 bid value; locations
added and scope of work increased)
City of Hermosa Beach
Prospect Ave Curb Ramps, Longfellow Sidewalk
Improvements and ADAImprovements
1315 Valley Dr
Hermosa Beach, CA90254
Jonathan Pascual —
(310) 318-0252
2023 - $646,577.87 (original bid $552,252)
City of Downey
Annual Miscellaneous Concrete Repairs
11111 Brookshire Ave
Downey, CA 90241
Brian Aleman —
(562) 904-7110
320 WTropica RanchoRd
Colton,CA92324
2022 - $101,192.76
City of Rancho Cucamonga
Emergency Trail Repairs
8794 Lion St
Rancho Cucamonga, CA 91730
Sonny Rodriguez —
(909) 477-2730
2023 - $46,793.44
City of Hermosa Beach
Clark Field Restroom Plumbing Upgrades and
Site Improvements
1315 Valley Dr
Hermosa Beach, CA 90254
Jonathan Pascual —
(310) 318-0252
2023 - $26,800.00
City of Hermosa Beach
South Park Restroom Plumbing Upgrades and
Site Improvements
1315 Valley Dr
Hermosa Beach, CA90254
Jonathan Pascual —
(310) 318-0252
2023 - $2,664,896.83 (original bid
$2,696,271.90; actual quantities lessthan bid
schedule)
City of Upland
17thSt Water Main Replacement and Street
Rehabilitation
460 N EuclidAve
Upland, CA 91786
KirkSwanner —
(909) 291-2938
off: 909.330.1128
fax: 909.330.
1129 gentrygenera|
17.D
‘gascual?hermosabeachgov
aangnda?sogateorg
2023 - $206,328.96 (original bid $194,031;
locations added to scope)
City of Hermosa Beach
City Sidewalk Improvements
1315 Valley Dr
Hermosa Beach, CA90254
Jonathan Pascual —
(310) 318-0252
2023 - $298,889 (original bid $194,500;
significant redesigns and scope increases)
City of South Gate
Citywide Valve Replacement
8650 CaliforniaAve
South Gate, CA 90280
Ana Ananda —
(323) 563-5769
320 WTropica RanchoRd off:909.330.
1128 Colton,CA92324 fax: 909.330.
1129 gentrygeneral@gmail.
17.D
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
DESIGNATIONOF SUBCONTRACTORS
Name of Subcontractor
and Location of Place Description and Subcontractor’s DIRRegistration of Business Percentage of Work License No. Number
(Bidder to attach additionalsheets if necessary)
(PUBLICCONTRACTCODE §4100 ETSEQ.)
Rev, 0
February 1020
V&ETree Service tree and misc plant removal C allge. Cl ‘
17.D
CDBG ACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
BIDDERCERTIFICATIONS
TO BE EXECUTEDBYALLBIDDERSAND SUBMITTEDWITH BID
The undersigned Bidder certifies to Owner as set forth in sections 1 through 10, below
STATEMENT OF CONVICTIONS
By my signature hereunder, I hereby swear, under penalty of perjury, that no more than one final, unappealable finding of contempt of court by a Federal Court has been issued against Bidder within the past two years because of failure to comply with an order of a Federal Court or to comply with an order of the National Labor Relations Board.
CERTIFICATIONOF WORKER'SCOMPENSATIONINSURANCE
By my signature hereunder, as the Contractor, I certify that I am aware of the Labor Code Section 3700, which requires every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the work of this Contract.
Please note that the submittal of this certificate does not relieve Contractor from complying with all of the insurance requirements of the Public Works Agreement and Contract Documents.
CERTIFICATIONOF PREVAILINGWAGE RATESAND RECORDS
By my signature hereunder, as the Contractor, I certify that I am aware of Labor Code Section 1773, which requires the payment of prevailing wage on public projects. Contractor and any subcontractors under the Contractor shall comply with Labor Code Section 1776 regarding wage records, and with Labor Code Section 1777.5 regarding the employment and training of apprentices. Contractor is responsible to ensure compliance by any and all subcontractors performing work under this Contract.
CERTIFICATIONOF COMPLIANCEWITH PUBLICWORKSCHAPTEROF LABORCODE By my signature hereunder, as the Contractor, I certify that I am aware of Labor Code Sections 1777.1 and 1777.7 Code, and Contractor and Subcontractors are eligible to bid and work on public works projects.
CERTIFICATIONOF NON-DISCRIMINATION
By my signature hereunder, as the Contractor, I certify that there will be no discrimination in employment with regard to race, color, religion, gender, sexual orientation, age or national origin; that all federal, state, and local directives and executive orders regarding non—discrimination in employment will be complied with; and that the principal of equal opportunity in employment will be demonstrated positively and aggressively.
Pew. 6
3 ab: ‘31}E
17.D
CDBG ACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
CERTIFICATIONOF NON-DISQUALIFICATION
By my signature hereunder, as the Contractor, I swear, under penalty of perjury, that the below indicated Bidder, any officer of Bidder, or any employee of Bidder who has a proprietary interest in such Bidder, has never 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 safety regulation, except as indicated on the separate sheet attached hereto entitled ”Previous Disqualifications.” If a statement of ”Previous Disqualifications” is attached, please explain the circumstances.
CERTIFICATIONOF ADEQUACYOF CONTRACTAMOUNT
By my signature hereunder, as the Contractor, pursuant to LaborCode Section 2810(3), I certify that, if awarded the Contract based on the undersigned’s Bid, the Contract will include funds sufficient to allow the Contractor to comply with all applicable local, state, and federal laws or regulations governing the labor or services to be provided. I understand that Owner will be relying on this certification if it awards the Contract to the undersigned.
CERTIFICATIONREGARDINGDIRCONTRACTOR/ SUBCONTRACTORREGISTRATION By my signature hereunder, as the Contractor, I certify that Contractor, and all listed Subcontractors are the subject of current and active contractor registrations pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code.
Contractor’s registration number is [please complete]
Subcontractors’ registration numbers are as indicated in Document 00 4314.
CERTIFICATIONREGARDINGPREQUALIFICATIONINFORMATION[OPTIONAL] By my signature hereunder, as the Contractor, I certify as follows:
a. Contractor prequalified for this Project by submitting its Statement of Qualifications, dated (500)-
b. [Please complete or strikeout the following as inapplicable] Subsequently, on or about and Contactor submitted
further information supplementing for foregoing Statement of Qualifications. c. Allinformation described above is referred to as the "Qualification Information." d. Contractor has carefully reviewed all of the foregoing Qualification Information. e. [Please check and/orcomplete one ofthe following]
All Prequalification Information remains true and correct in all material respects as of the date hereof, as if such information were actually being submitted to Owner as of the date hereof.
Except as otherwise expressly set forth in separate Additional Prequalification Information, submitted with the Bid, all Prequalification Information remains true and correct in all material respects as of the date hereof, as if such information were
17.D
”@245: “?at
CDBG ACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
actually being submitted to Owner as of the date hereof. [Contractor must provide Additional Prequalification Informationas described above ifthis item is checked.]
CERTIFICATIONOF
[Insert other Owner-specific certi?cations, if applicable. Otherwise, delete.] BIDDER:
Date
Print name and title Print name and title
(Ifthe Bidder is a corporation, two signatures ofcorporate officersare required.) Rev. 0
Februai'y 2020
Signature of Bidder Date
Brenton Gentry - Secretary, Treasurer, and Manager
August 26, 2024 August 26, 2024
Signature of Bidder
Brenton Gentry - President/CEO
17.D
MW
personally appeared Brenton Gentry
who prevedto me ohthebasis of satisfactory evldenoe to be the person( whose namemis/apér. sgbscnbeqtn the \Alllhln Instrument and acknowledged to me that helsl'le ey executed the same hIs/hér/telr authonzed capacity?es), and that by hislhérlthpir signature( on the instrument the person( ). or the entlty upon behalf of which the person(s') acted, executed the instrument, 1 ANDREANICOLESCAEBRCUGN[ , Notify Puhlic- Cilifnrnli
Sm hmraina com, §
Enmmlsswn,
1mm '
V MyComm,milesMar17.am
ACK 0 LE ENT
A notary public or other of?cer completing this _ certi?cate veri?es only the identityof the individual who signed the document to whichthis certi?cate is
attached, and not the tmthfulness, accuracy, or
validitv of that document.
State of California _ County of San Bernardlno ,
AndreaScarbrough, Notary Public On before me,
(insert name and title of the of?cer)
in
,
I certify under PENALTYOF PERJURY under the laws ofthe State of Californiathat the foregoing paragraph is true and correct.
WlTNESS my hand and of?cial seal.
Signature (Seal)
17.D
EXHIBIT B-4
Required Bid Form
CERTIFICATION OF BIDDER
REGARDING NONSEGREGATED FACILITIES
Proj
The above named Bidder hereby certi?es that:
I do not maintain or provide for my employees any segregated facilities at any of my establishments, and that I do not permit my employees to perform their services at any location, under my control, where segregated facilities are maintained. As used in this certi?cation, the term “segregated facilities” means any waiting rooms, work areas, rest rooms, wash rooms, restaurants and other eating areas, time clocks, locker rooms or other dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated 0n the basis of race, color, religion, national origin, or because of habits, local customs, or otherwise.
I further agree to obtain identical certi?cations from all proposed subcontractors prior to the award of subcontracts exceeding $10,000.
Signature:
Name (Print):
CDBG Accessible Sidewalk/ADA
Gentry General Engineering, Inc
Brenton Gentry
August 26, 2024
17.D
I. Employment Opportunities
www‘hud.govlscction3
hnsz/hudagpshud.gov/Omnunigl’ort
BG
nning, and
BG I
05! av wwwxivco‘obs‘org
BG
eBG
EXHIBIT 3-6
$200,000 or more
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
(Housing and Community Development Act of 1968)
Project Title: Amount of Bid:
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all construction contracts over $200,000.
Sidewalk/ADA see bid schedule
I understand and agree that in the event that I am awarded this contract, and in the event that any new employment opportunities are created as a result of this CDBG-funded project, I will:
a.
pros
Contact the US Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be considered for available employment opportunities; and HUD Section 3 Opportunity Portal. Initial Here
at:
Forward to the Department of Housing & Workforce Solutions all detailed job descriptions for new employment opportunities and Section 3 reports, in a form, at a place, and at a time as directed by the Department of Housing & Workforce Solutions. Initial Here Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of projected number of available positions, to include job descriptions and wage rates.
Initial Here
Notify Section 3 Coordinator of contractor interests regarding employment of Section 3 workers prior to hiring. Initial Here
Submit a list of core employees (including administrative, clerical, pla other positions pertinent to the construction trades) at the time of contact award. nitial Here
P ailable positions and advertise job Section 3 workers openings at:
Initial Here
Sign the Section 3 Plan. Initial Her
Complete your proposed workforce plan for this project below.
BG
BG
al/
BG
17.D
JOB CATEGORY
PROFESSIONALS
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTION BY
TRADE
TRADE
TRADE
APPRENTICE
TRAINING
OTHER
TOTAL
CURRENT
POSITIONS
NUMBER OF
NEW HIRES
IF
AWARDED
BID
NUMBER OF NEW HIRES
PROPOSED TO BE
SECTION 3 RESIDENTS
% OF NEW HIRES TO BE
SECTION 3
0-3
0-100%
100%
67-100%
TRADE Operating
Engineer
TRADE
TRADECement
TRADE Cement
Mason App.
17.D
II. Subcontracting Opportunities
www.hud.gov/section3
www.hudngov/sectign3
h“ps:[/hgdaggs.hud.guv/ngnunigf’unall
BG
www.rivc 'obs.or
EXHIBIT B-6
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
a. I understand and agree that for any and all subcontracting opportunities that may result from this CDBG-?mded project, I will contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 Businesses, within City of Hemet, to be considered for available subcontracting opportunities prior to selecting any subcontractor for my bid submittal.
Initial Herc
b. I understand and agree that any and all sub-contracts and sub-tier agreements resulting from this CDBG—fundedproject are also subject to Section 3 compliance, and therefore, as the General/Prime Contractor, I am responsible to ensure compliance from all subcontractors.
Initial Here
Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be consideredfor available employment opportunities; and HUD Section 3 Opportunity Portal at: Initial Here
Forward to the Department of Housing & Workforce Solutions all detailed job descriptions for new employment opportunitiesand Section 3 reports, in a form, at a place, and at a time as directed by the Department of Housing & Workforce Solutions.
Initial Here
Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of projected number of available positions, to include job descriptions andwage rates.
Initial Here
Notify Section 3 Coordinator of contractor interests regarding employment of Section 3 workers prior to hiring. Initial Here
. Submit a list of core employees (including administrative, clerical, planning, and other position s pertinentto the construction trades) at the time of contact award. Initial Here Post available positions and advertise job Section 3 workers openings at:
Here
BG
BG
BG
BG
BG
17.D
[1M ?an;
K[4/Slzl-Ld/K" J?mm?? _
I. Emulnyment Omommi?es
www.hud. ov/sec?cn3
to be considered for available employment opp
Pom}. W Initial Here
at: hmsjmudaggshud.gav/Qggnmmigl’oml/
action3 mp0 at ; ace, and
Workforce V7)?” Initial
projectegl number
Initill
Notify Section dinatng of
workersprim co 0.“.
dminismm've planning. and nth
the time of: am, M 1m
Pos’c/agailable positions and advertisejob Sech'o 3 workers WWW—.HVCOijs?g // Initial Here Sign theSection 3 Plan. Iniml Hm 47/“,
Completeyour proposed workforce planfor this mjucl belo
EXHIBIT M
$200,000 or more
BIDDER CERTIFICATIONFOR SECTION3 COMPLIANCE
(Housing and CommunityDevelopmentAct of 1968)
ProjectTitle: 0
The undersigned hereby certi?es that lie/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and CommunityDevelopment Act of1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all construction contracts over $200,000.
I understand and agree that in the event thatI am awarded this contract, andin the event that any new employmentopportunities are created as a result of this CDBG-?lndedproject, I will:
a. ContacttheUS. Departmentof Housingand UrbanDevelopment(HUD) Section3 websiteat C.
Fa.“
to reviewthe list of certi?ed Section 3 persons, within City ofHemet ortum'ties;and HUD Section 3 Opportunit , y
Forward to the Department of Housing & Workforce Solutions all detailed job description fornew employment opportunities and S rts, in a form, pl sat a timeas directedby the Department of Housing& Solutions. Here Present a list, of the numberof total labor hours, Section 3 worker laborhours,and Targete Section 3 worker labor hours expectedto be generatedfrom the initial contract andda list of of available positions,to includejob descriptionsand wage rates.
Here
3 Coor contractor interests regarding employment of Section 3 hiring. Initial Here
Submit a list of , core employees(including a , clerical, er positions pertinent to the construction trades) at ontact aw :
Here 11
n openingsat:
p w.
I
17.D
0 Q
U ,7
O
JOB CATEGORY
PROFESSIONALS
TECHNICIANS
OFFICEICLERICAL
CONSTRUCTION BY
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE
TRAINING
OTHER
CURRENT
POSITIONS
NUMBEROF
NEW HIRES
IF
AWARDED
BID
NUMBEROF NEW HIRES
PROPOSED TO BE
SECTION 3 RESIDENTS
% OF NEWHIRES TO B
SECTION3 E
(j
17.D
II. Subcontracting Ognortuni es
www.hmigov/section3
certi?ed Section 3 Busines
www.hud.gov/scction3
considered for available employment opportunities; andHUD htt szl/hudn sfhudt ov/O orluni Portal/ Inillal
Housing &
tial Here
project number of availablepositions,to inc 3%Ini?ul Here l. Noti Section 3 Co dinalor of contractor inter:
priorto hiring. (1 Initial Here
Submit a list of core employees (includingadministrative, clerical, p pc?lnent to theconstruction trades) at the time of contact award.
Post availablepositions and advertisejob Section 3 workers open V Initial Here
he considered for availn e
subcontractingopportunities ctor for my bid submittal.
' , and other positions
Initial Here
ngs at: www.mco'absorg
EXHIBIT3-6
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
a. I understandand agree that for any and all subcontracting opportunitiesthat may result from this CDBG-?mded project,I will contact the US. Departmentof Housing andUrban Development (HUD) Section 3 website at to review the list of ses, within City of Hemet, to bl
prior to selectingany subcontra
lnltlal Here
b. I understand and agree that any and all sub-contracts and sub-tier agreements resulting from this CDBG-funded project are also subject to Section 3 compliance,and therefore, as the General/Prime Contractor, I am responsible to ensure compliance from all subcontractors.
Initial Here
i. Contact the US. Department of Housing and Urban Development(HUD) Section3 websiteat to review the list of certi?ed Section3 persons, within City of Hemet,to be Section 3 OpportunityPortal
at: Here
j. Forward to the Department of Housing & Workforce Solutions all detailedjob descriptionsfor new employmentopportunitiesand Section 3 reports, in a form, at a place, andat a time as directed by the Dep ent of Workforce Solutions. g? Ini
1:. Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of ludejob descriptionsand wage rates.
sts regardingemployment of Section 3 workers
17.D
RE
EXHIBIT B—7
Required Bid Form
CITY OF HEMET
CDBG PROGRAM
BIDDER CERTIFICATION ON
FEDERAL CONTRACT REQUI MENTS
CERTIFICATION:
I hereby certify that I have reviewed and understand the diversi?ed Federal construction contract related requirements imposed on the Contractor(s) of HUDfunded construction projects, including but not limited to the following:
1 The subject project is being ?nanced with Community Development Block Grant funds (24 CFR Part 570);
2 This project and all related construction contracts are subject to the US.
Department of Housing and Urban Development’s Federal Labor Standards Provisions (HUD 4010 — revised 06/2009); and
This project is subject to all applicable laws and regulations as listed in the General Summary of these Special Federal Provisions; and
2. If my bid is $200,000 or more, this project and allrelated contracts willsubject to Section 3 requirements (12 U.S.C.1701u).
CONTRACTOR’S NAME
CONTRACTOR’S LICENSE NO.:
ADDRESS
AUTHORIZED REPRESENTATIVE: (Type Name)
CDBG Accessible Sidewalk/
Gentry General Engineering, Inc
974279
320 W. Tropica Rancho Road Colton, CA 92324
Brenton Gentry
N...
August 26, 2024
17.D
ly-fundad, formation ing minor
statistical partment sing and
EXHIBIT B-8
Required Bid Form
QUESTIONNAIREREGARDING BIDDERS
Bidder has been engaged in the contracting businessunder the present name of .since (Date).
Present business address is:
Federal Amount
California Expiration Date:
UEI Number: or CAGE Code
Because this project is Federal it is necessary to obtain in concern ity and other group participation for purposes. The US. De of Hou Urban Development (HUD) uses this information to determinethe degree to which its programs are being utilized by minority business enterprises and targeted group contractors.
A minority enterprise is defined by the Federal Government as a businessthat is fifty-one percent (51%) or more “minority-owned”. Please check applicablebox concerning the ownership of your business:
American Indian or Native Alaskan
Asian or Paci?c Islander/NativeHawaiian
Black/African American
Hispanic
White
HasidicJews
Gentry General Engineering, Inc June 26. 2012
320 W. Tropica Rancho Road Colton, CA 92324
June 30 2026
47-3813252 $ see bid schedule
No.: 974279
A woman-owned enterprise is de?ned by the Federal Government as a business that is ?ftypercent (50%) or more woman-owned.Please check applicablebox concerning the ownershipof your business:
El Woman/Female owned Male owned
A Section 3 Contractor or Subcontractor is a business concern that is more than ?fty-one percent (51%) owned by a low or very low-income person, or a business concern that provides economic opportunitie s
to low and very low-income residents. Please check applicablebox concerning the ownership of your business:
El Section 3 Business concern Non-Section 3 Business concern The United States Department of Housing and Urban Development (HUD) is authorized to solicit the information requested in this form by virtue of Title 12, United States Code, Section 1701 et seq., and other regulations. It will not be outside of HUD without your consent, except as required or permitted by law.
D
17.D
Suppl eta upon ity pending approval.
EXHIBIT B-9
Required Bid Form
IJSTOFSUBCONTRACTORS
ADDRESS/PHONE NO.
SUPPUERS
NAME OF SUPPLIER ADDRESS/PHONENO. CONTRACT AMOUNT
This form is to be completed and submitted with the bid package.
SUBCONTRACTOR FED. I.D.# AMOUNT
$24,800.00 PO Box 3280, Orange, CA 92865
(714) 997-0903
to be d rmined based availabil at the date of order, submittal
17.D
MA 14156551,“: (/MI/fjfpVUV?/?é?k
Subcontractor: f/v’f’?ae?lm/kc17/:
5‘ 3, ml ghee/3‘9
-
www.hud.gov/sec?on3
review the erti?ed Section 3 persons, within
considered able employment opportunities;
be
.QL
EXHIBIT3-10
Required BidForm for bids
$200,000or more
SUBCONTRACTORCERTIFICATION FOR SECTION3 COMPLIANCE
MUST BE COMPLETED BY ALL SUBCONTRACTORS
(Housing and Community DevelopmentAct of 1968)
Project Title:
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all prime construction contracts over $200,000:
a. I understand and agree that in the event that I am awardeda subcontract,and in the event that any new employment opportunitiesare createdas a result of this CDBG-fundedproject, I will contact theU.S. Department of Housingand Urban Development (HUD) Section 3 websiteat to
list of 0 City of Hemet, to
for avail
Initial Here
b. I will forward to the Department of Housing & WorkforceSolutionsall detailedjob descriptionsand Section 3 reports, in a form, at a place, andat a time as directedby the Department of Housing & Workforce Solutions. ' Initial Here
EXHIBIT B-IO
9N}
“n
Jnc
17.D
o o
O
0 m. o
3 O U
O O
O C] O
K O
Name: V[3 WISE? Key171'?11/?!
Rep: entative(Type \TO/r‘fa?U/I @4?y
J
V
I9“;:k 1
Complete your proposed workforce plan for this project below:
NUMBEROF
JOB CATEGORY CURRENT NEW mus "UMBER OF NEW mus
% OF NEW HIRES TO B
E
IF PROPOSEDTO BE POSITIONS szcnom AWARDED SECTIONS RESIDENTS BID
PROFESSIONALS
TECHNICIANS
OFFICEICLERICAL
CONSTRUCTION BY
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE
TRAINING
OTHER
TOTAL
Subcontractor (Company)
Authorized Name):
TRADE €fn§0r
17.D
AEPP NDIX1
17.D
resgonsible
W."I Not be
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL
The undersigned hereby proposes to furnish any and all labor, materials, and equipment for the CD36 Accessible Sidewalk/ADAProject, CIP No. 5768, and appurtenant work in connection therewith, said work to be done and materials to be furnished in strict conformity with the Contract Documents, including but not limited to the Notice Inviting Bids, Instructions to Bidders, every Addendum, plans, specifications, General Conditions, Special Provisions, General Provisions, Greenbook 2018 as amended and supplemented, technical references, all other referenced documents, all codes, permit conditions and regulations, for the total amount(s) and any unit prices and additive/deductiveitems shown on this proposal.
The undersigned has examined the location of the proposed work and all local and physical conditions and challenges presented by the Project site, is familiar with the plans, specifications, Contract Documents (particularly as delineated above) and the requirements of the Public Works Contract, and also understands that the Project shall be completely constructed in turn—key condition acceptable to the Owner within the Project time requirements for the price of the proposal, including all fees and sales and/or use tax upon any materials so furnished, including any unit prices and additive/deductiveitems. The undersigned has also carefully checked all of the figures given and understands that the Agency for any errors or omissions on the part of the undersigned in submitting this proposal.
Contractor confirms that his/her/itsbid is submitted with respect to the changes to the Contract and/orContract Documents included in all addenda issued by the Owner.
In addition to reaffirming that the changes and information contained in the addenda have been integrated into their proposal, Contractor acknowledges receipt of Addenda No.(s 1
The undersigned has examined the current State of California schedule of prevailing wage rates for the types of work to be done on this project (and the Davis-Bacon Act if the Agency uses federal funds for the Project) and agrees to pay not less than these rates.
17.D
ODD
(170 we
D‘LTU
l4, LTD—0
UO
L/VU 0 UD
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
BIDSCHEDULE
BASEBID- CDBGACCESSIBLESIDEWALK/ADA PROJECT, CIP No. 5768
EXTENDE
D ":2" DESCRIPTION UNIT ?LmTT-I'Ef :3; ITEM
AMOUNT
1 Mobilization (not to exceed 5%) LS 1
2 Traffic and Pedestrian Control LS 1
3 Temporary Construction Project
Identification Sign EA 2
4 Water Quality Control LS 1
Adjust Ex. Manhole to New F.S.
5 per Owner Agency Std. &
Specs. EA 1
5 Remove & relocate existing
mailbox EA 10
7 Adjust Ex. Water Meter
Box/Traff. Box to finish surface EA 6
8 Relocate Ex. Signs and Posts EA 17
9 Remove and Replace Exist ADA
Ramp per Citv Std. EA 29
10 Construct 4" thick PCC sidewalk
Der CitvStd. SF 12000
11 Construct PCC Driveway SF
Approach per City Std. 1025
12 Remove, Uproot and dispose EA
ex. Tree/tree stump. 8
13 Remove & relocate existing LF
fence/gate 450
Remove Ex. PCC/AC &
14 Construct New PCC driveway SF
approach per City Std. 520
15 Remove & Dispose Ex. Masonry
Wall/Pilaster EA 4
15 Construct type "A"Curb and
Gutter per CitvStd. LF 225
[‘6 7./0(o
70,875
17.D
404.2%"
tn-A-tin?n-?mprga-t*H?khtitngntnt
[\[NL HM Fnul 77WU39‘VC 'TWu H
FWM~S4V<[DON/MS (ML 3% W:
L
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
BASEBID- CDBGACCESSIBLESIDEWALK/ADA PROJECT, CIP No. 5768
EXTENDED
”:2" DESCRIPTION UNIT lizml?fg:33; ITEM
AMOUNT
TOTAL BASEBID(numbers)
******H**************************** END OF BASE BID ITEMS ************************************ ADDITIVEA BID ITEMS AS FOLLOWS:
ITE UNI ESTIMATED UNIT
EXTENDED
M DESCRIPTIONor ITEMS T PRICE
ITEM
N° QUANTITY AMOUNT
A1
TOTAL BIDADDITIVEA (numbers)
******it************************* END OF ADDITIVEA BID ITEMS BASEBIDTOTAL (in words)
Contractor's Initials
ADDITIVEA BIDITEMSTOTAL (in words)
Contractor's Initials
In the event of a variation between the unit price and extended total, the unit price will be used and the corrected extension will be considered as the amount bid. If the bid is illegible and cannot be reconciled it will be considered non-responsive and will not be considered for award.
If an additive and/oralternate bid schedule is called for in the Contract Documents, the lowest bid will be determined on the basis of the base bid schedule(s) only unless otherwise specified in the Notice Inviting Bids or by Addenda if issued to supersede the Notice Inviting Bids on this specific issue.
For a Contract where a deductive bid schedule is called for, the lowest bid will be determined by the total of all bid schedules including the deductive bid schedule(s).
MI
(/11;
17.D
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
Regardless of whether the additive/deductiveor alternates bid items will be considered in determining the low bid, the Agency may elect to include any or none of the additive/ deductive
or alternate bid items/schedules, or to otherwise add or remove certain work from the scope of Work. Accordingly, Contractor warrants that each bid item contains a proportionate share of profit, overhead and other costs and expenses, which will be incurred by the Contractor for the Project.
If equal low bids are received from responsible and responsive bidders the selection shall be made by drawing lots, or other similar random blind method selected by the Agency. If only one responsive bid is received from a responsible bidder the award shall not be made unless the price can be determined to be reasonable based on an analysis by the Agency. The Agency’s determination as to the reasonableness of any such bid shall be final.
The Agency reserves the right to reject any or all bids, to waive any irregularity(ies),and to take all bids under advisement for a period of sixty (60) calendar days after the date the bids are publicly opened. Bidder acknowledges that all costs incurred as a result of preparing the proposal shall be the sole responsibility of Bidder. The Notice Inviting Bids and Instructions to Bidders does not create or impose any obligation upon the Agency to enter into a contract.
All bids received shall be recorded on an abstract (tabulation) of bids, and then made available for public inspection within two business days of bid opening.
The quantities listed in the bid proposal are provided to give a general indication of the scope of the work and for the comparison of bids. No warranty is made, either expressed or implied, that the actual quantities of work to be done will correspond therewith. Item numbers followed by ”(S)” are designated as specialty items which will not be included towards the calculation of minimum of 50 percent of work to be performed by Contractor’sown forces.
By signing and submitting this bid the Contractor confirms that they are familiar with the work site and all existing conditions that may affect their work and that they have read and agree to all the terms, conditions and requirements contained or referenced herein or in the Contract Documents and that all the aforementioned has been included in the bid prices listed above, including items of work that may not have a specific pay line item and that there shall be no additional costs to the Agency.
WARNING:If an addendum or addenda have been issued by the Agency and not noted above as being received by the bidder, this Bidmay be rejected.
Complete the following:
CT&TConcrete Paving Inc. ; DIR No. 1000025154 ; License No. 875627 Legal name of the business, DIRReg. and Contractor License Nos
17.D
QQWCM
CQ
CDBGACCESSIBLESlDEWALK/ADA PROJECT
ClP No. 5768 BIDDER'SPROPOSAL(cont’d)
Corporation
Business Type (Corporation, Partnership, Sole Proprietor) N/A
DBA(if any)
Jose Carvaial, President & Secretarv
Name and title of the owner
Jackie Carvajal, Treasurer
Name and title of second partner or officer
324 8. Diamond Bar Blvd, PMB 275, Diamond Bar, CA 91765 Business Address
909-629-8000
Telephone number
909-629-8001
Facsimile number
Jose Carvaial, [email protected]
Name and Email address of primary contact
www.cttconcretepaving.com
Company web address
8/26/24 8/26/24
of er Date of Bidder Date
Jose Carvajal, President Jackie Carvajal, Treasurer
Print name and title Print name and title
(Ifthe Bidder is a corporation two signatures ofcorporate officersare required.) Signature
17.D
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CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
CERTIFICATEREGARDINGCONTRACTOR'SLICENSE
1 Contractor is required to possess one of the following State Contractor's License State of California A Contractor’s License
Combination of Specialty Class C8 012 Contractor’s Licenses
2. A failure to (1) possess the required license, (2) truthfully set forth the following information, and/or(3) execute this Certificate may render the proposal nonresponsive and permit the City to reject the proposal. (Business and Professions Code Section 7028.15)
3. Contractor declares, under penalty of perjury, that he/she/itpossesses the required Contractor's |icense(s) which:
a. Bears the license number(s): 875627
b. Expires on: 04/30/2026
8/26/24
Signature of Bidder Date of Bidder Date
Jose Carvajal, President Jackie Carvajal, Treasurer
Print name and title Print name and title
I
(Ifthe Bidder is a corporation two signatures ofcorporate o?icersare required.) This required license determination has been made by the Agency. Any Contractor holding a different license who feels he is qualified to bid on this work must so advise the Agency at least seven (7) days prior to the bid opening. The Agency may conduct a review of the contemplated work to re-evaluate the required license determination. The Agency may in its sole discretion maintain or change the required license determination; Agency’s decision as to the required license will be final.
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CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
BIDSECURITYFORM FORCHECK
NOTE:THE FOLLOWINGFORM SHALLBEUSEDINTHECASEOF CHECKACCOMPANYINGBID Accompanying this proposal is a Certified Check or Cashier’sCheck payable to the order of the City of Hemet, hereinafter referred to as "Agency", for dollars (S this
amount being 10 percent (10%) of the total amount of the bid. This check shall be returned to the undersigned only if either of the following occurs:
A. Ifsaid Bidshall be rejected by the Agency;
B. If said Bid shall be accepted by the Agency and the Undersigned shall execute and deliver a Contract in the form attached hereto (properly completed in accordance with said Bid) and shall furnish bonds required for his/her/itsfaithful performance of said Contract and for the payment of all persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the Contract created by acceptance of said Bid.
Otherwise, said check shall become the property of the Agency.
Said check shall also become the property of the Agency if the Undersigned shall withdraw his/her/itsbid within the period of sixty (60) calendar days after the date set for the opening thereof, unless otherwise required by law, and notwithstanding the award of the Contract to another bidder.
Signature of Bidder Date Signature of Bidder Date
Print name and title Print name and title
(If the Bidder is a corporation, two signatures ofcorporate officersare required.)
17.D
CDBGACCESSIBLESIDEWALK/ADA PROJECT Rev. 9
CIP No. 5768 BIDDER'SPROPOSAL(cont’d) febmary 2929
BIDSECURITYFORM FOR BOND
KNOWALLBYTHESEPRESENTS
That the undersigned
CT&TConcrete Paving, Inc.
(Name of Contractor)
_ . _
* CoptractorsBonding and InsuranceCompany
as Prrncrpal and the undersrgned as Surety are held and firmly bound unto Owner, CITYOF HEMET, a political subdivision of the State of California, as oblige, in the penal sum of Ten Percent of the Total Bid Amount
Dollars($ 10% of Total Bid lawful money of the United States of America being at least ten percent (10%) of the aggregate amount of said Principal’s base Bid,for the payment of which, well and truly to be made, we bind ourselves, our successors, executors, administrators, and assigns, jointly and severally, firmly by these presents.
WHEREAS,said Principal is submitting a Bidfor [PROJECTNAMEANDDESCRIPTION] CDBG ACCESSIBLE SIDEWALKIADAPROJECT; CIP No. 5768
THE CONDITIONOF THIS OBLIGATIONIS SUCH that if the Bid submitted by the said Principal be accepted and the Contract be awarded to said Principal and said Principal shall within the required periods enter into the Contract so awarded and provide the required Construction Performance Bond, Construction Labor and Material Payment Bond, insurance certificates, and all other endorsements, forms, and documents required under the Instructions to Bidders, then this obligation shall be void, otherwise to remain in full force and effect.
IN WITNESSWHEREOF, the above bounden parties have executed this instrument this 20th day of August 20 24.
(Month)
CT&TConcrete Paving, Inc.
(Corporate Seal) By
Principal
By ntractors Insurance
Surety
(Corporate Seal) By
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L|F RNI A L PURPO E
ERTIFI FA KN W EDGMEN
Augu?£43510‘7'
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otary
(Hm mm mm Ind We 0' mamum)
étory
CAO AL- S
C CATEO COL T
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 Los Angeles }
On before me, Daniel A. Butler A N Public ,
personally appeared
who proved to me on the basis of satisfa evidence to be the person(s) whose name(s)@are subscribed to the within instrument and acknowledged to me that -he/they executed the same in?iiiher/theirauthorized capacity(ies), and that by @ier/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.
. . DANIELA.BU?|'LER WITNESS my hand and offrcralseal. Commission#2402807 NotaryPublic- California
toe-AngelesCounty
MyComm.ExpiresMay2.2026
Public Signature (Notary Public Seal)
INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION This-formcomplies with current Californiastatutes regarding riotaiji'wording and.
DESCR'PT'ONOFTHEATTACHEDDOCUMENT ifneeded.should be completed and attached to the document Acknowledgments fromother states may be completedjbr documents being sent to that state so long as the wording does not require theCalifornianotary to violate Californianotary law
(Titleordescriptionofattacheddocument) - State and County in'lfonnationmust be the State and County where the document signerts) personally appeared before the notary public for acknowledgment. - Date oi’notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgmentis completed, - The notary public must print his or her name as it appears within his or her (Titleor descriptionofattacheddocumentcontinued)
NumberOfPages _ DocumentDate— commission followed by a comma and then your title (notary public).
I Print the namets) of documentsigner(s) who personally appear at the time 0 notarlzatton 1‘
CAPACITYCLAIMEDBY THE SIGNER - Indicate the correct singular or plural fonns by crossing ol‘fincorrectfbm'is (i.e . . he/she/t-l-‘rey:islei-re) or circlingthe correct forms Failure to correctly indicatethis Ind'V'dual(S) .
information may lead to rejection of document recording Corporate Officer o The notary seal impression must be clear and photographically reproducible Impression must not cover text or lilies If seal impression smudges,. re-seal if a (Title) sufficient area pennits, otherwisecomplete a different acknowledgment form Parmer(s) o ?tgnaturp otithke notary public must match the signature on file with the office of ' 1e coun y c er . Attorney'm'FaCt 4. Additional information is not required but could help to ensure this Trustee(s) acknowledgment is not misused or attachedto a different document. _ Other ’2' indicate title or type of attached document, number of pages and date. '3 Indicate the capacity claimed by the signer. If the claimed capacity is a corporate of?cer, indicatethe title (i e CEO, CFO, Secretary) www.NotaryC|asses.com 800—873-9865 - Securely attach this documentto the signed document with a staple
17.D
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who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the withininstrument and acknowledged to me that helshe/they executed the same in his/her/theirauthorized capacity?es). and that by his/her/their signalure(s) on the instrument the person(s)‘ or the entity upon behalf of which the person(s) acted. executed the instrument.
ENALTY 0F ERJURY
fornia that th foregoing
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CALIFORNIAALL-PURPOSEACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individualwho 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 }
before me, Thao Nguyen Luu , Notary Public,
I certify under P P under the laws of
the State of Cali e paragraph is true
and correct.
Witness my hand and official seal.
Signature W
OPTIONAL
Though the info ion be no red by law, it rove valuabl re on the document and c preve du moval and re ment of the he ument.
Description of Attached Document
Title or Type of Document:
Document Date Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer’s Name Signer’s Name:
Individual Individual
Corporate Officer —Title(s) Corporate Officer —Title(s):
Signer is Representing:
0n AUG20 2024
Date
personallyappeared
Place Notary Seal Above
Partner Limited
Attorney in Fact
Trustee
Guardian or Conservator
Other:
General
insert Name of Notary exactly as it appears on the of?cial seal Topofthumbhere
Name(s) of Signer(s)
Signature of Notary Public
Partner Limited General
Attorney in Fact
Trustee
Guardian or Conservator Topofthumbhere
Other:
Signer is Representing:
RIGHTTHUMBPRINT RIGHTTHUMBPRI
OFNTSIGNER
17.D
P0 F TTORNE
Yunz T. MullickJames W Moilanen F. AustinNeff Irene Luonz Emilie George DanielleHansun Christine Woulford AlexanderR.
Mi i011Vigil: California
25 .00
Sr. Vice President
Cnmpany
Bonding mi ins nce
0n Ibis—mm elf—JM?L- beforeme. a Notary Public, 1, Hit: undelslgned of?cer of Ru Insurance Cnmpnny and/or personally appeared M, who being by me duly swam, Cnnimmrs Bonding and Insurance Cnmpnny, do hareby canify acknowledged Ilia! ha signed Ihe above Power of Altomey as meaforesaid ihal meanachcd Power of Anomey is in full force and effect and is of?cer of the RM Insurance Camp-?y and/or Conn-trons Bondlng Ind irrevocable; and ruruierrnnre, rim msResolutionof maCompany as Insnrnnce Cnmpnny and acknowledged said insimmcm to he the voluninry m {min in mePower of Attorney, is now in force. In iesiimony whercof. I have herclinlo set my hand and Ike mi of the Ru hum-lice Cnmpnny and/or Conn-mars Bondlu and Insurnnee
Company this 20m day of August 2 24 .
bk
WERO A Y
RLI Insurance Company
Contractors Bonding and Insurance Company
9025 N. Lindbergh Dr. Peoria, IL 61615
Phone: 800—645-2402
Know All Men by These Presents:
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approvingof?cer if desired.
That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation,(separately and together, the "Company") do hereby make, constitute and appoint:
Holsheimer. Thao
in the City of State of its true and lawful Agent(s) and Attorney(s)in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakingsin an amount not to exceed Twentv Five Million Dollars for any single obligation.
The acknowledgmentand execution of such bond by the saidAttorney in Fact shall be as binding upon the Company as if suchbond had been executed and acknowledgedby the regularly elected of?cers of the Company.
RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certi?ed that the following is a true and exact copy of a Resolution adoptedby the Board of Directors of each such corporation,and is now in force, to-wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporationshall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other of?cers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signatureof any such of?cer and the corporate seal may be printedby facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executedby its respective with its corporate seal af?xed this 1st day of July , 2024 . RLI Insurance
Contractors Company
,—
r
Eric Raudins Sr. Vice President
State of Illinois } Cmm-W0f P601713 CERTIFICATE
act and deedof said corporation.
By:
4‘ RLI Insurance Company
Jill A. Scott Notary Public Contractors Bonding and Insurance Company By: D
T.1111, inin?v nr severallv
SEAL;
SS
JILLA SCOTT Notary Pub": State of Ohlo My Comm. Expires Jeffrey Corporate Secretary September 22. 2025
A0058D19
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0456659020212
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STATE OF CALIFORNIA
DEPARTMENT OF INSURANCE
SAN FRANCISCO
Amended
Certi?cate of Authority
Contractors Bonding and Insurance Company
Fire, Marine, Surety, Plate Glass, Liability,
Boiler and Machinery, Burglary, Sprinkler,
Team and Vehicle, Automubile, Legal, and Miscellaneous
No. 3000-7
THIS IS TO CERTIFYthat.pursuant to the Insurance Codeofthe State ofCali?Jrnia. ofIllinois,organized underthelawsofIllinois,subjectto its ArticlesofIncorporation or other?mdame organizational documents, is herebyauthorizedto transact Within ntal thisState,subjectto allprovisions ofthis Certificate. thefollowing classesofinsurance:
as such classes are now or may hereafterbede?nedin the InsuranceLaws ofthe State ofCalifornia THIS CERTIFICATEis expresslyconditionedupon the holderhereofnow and hereafter being in ?rllcompliance withall, and not in violation ofany, ofthe applicable lawsand law?drequirements made under authority ofthe lawsoftheState ofCaliforniaas long as such lawsor requirements are in e?'ectand ble, and as such laws and requirements now are, or may hereafterbe changed or amended IN WITNESS WPIEREOF,e?ectiveas ofthe 20‘”day ofMarch,
2015.I have hereuntoset my hand and causedmy o?‘icialseal to be a?ixed this 20’”day ofMarch, 2015.
Dave Jones
Insurance Commissioner
By Valerie Sarfaty
forNettieHogs
ChiefDepury
NOTICE:
Quali?cationwith the Secretary of Statemust be accompIishcdas requiredby the CaliforniaCorporationsCode promptly a?er issuance of this Certi?cateof Authority, Failureto do so willban violationofInsuranceCode section 701 andwillbe grounds fo r revoking this Certi?cate of Authority pursuant to the covenants mad: in the applicationtherefor and the conditions containe herein. d V’dh
51905730.
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CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
NON-COLLUSIONAFFIDAVIT
PUBLICCONTRACTCODESECTION7106
NON-COLLUSIONDECLARATIONTO BEEXECUTEDBYBIDDERANDSUBMITTEDWITHBID The undersigned declares:
I am the President of President the party making the
foregoing bid.
The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. Allstatements contained in the bid are true. 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, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.
Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 08/26/24 date], at pgmgna [city], California state]
08/26/24
re of Bidder Date ature of Bidder Date
Jose Carvajal, President Jackie Carvajal, Treasurer
Print name and title Print name and title
(If the Bidder is a corporation, two signatures ofcorporate officersare required.)
17.D
$607,850.00
Date
CDBGACCESSIBLESlDEWALK/ADAPROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
CONTRACTOR’SREFERENCELIST
Attach to this bid a list of three (3) projects in the past five (5) years on which the bidder and his subcontractor(s) have successfully constructed and completed projects with the same type (elements), size and complexity of work. The Agency Engineer will make the final determination of whether the projects listed here are of the same type, size and complexity as this project.
Failure of bidder to supply sufficient documentation of similar electric, telephone, cable and sanitary sewer underground facilities experience shall be considered grounds for a non-responsive bid and, at the Agency’s discretion, said bid will be disqualified.
Project Name: CIP 106, Citywide Sidewalk Repairs & Concrete Construction Proiect Contract Price: Date of Completion 05/08/2024
Name, Address, and Telephone Number of Owner's Representative:
City of Laguna Hills, 24035 El Toro Road, Laguna Hills, CA 92683 Contact: Joe Ames, 949-707-2655
project Name: FY23-24 ADA Curb Ramp Installation, CDBG
Contract Price $128 199-75 of Completion; 1/19/2024
Name, Address, and Telephone Number of Owner's Representative City of Rancho Santa Margarita, 22112 El Paseo, Rancho Santa Margarita, CA 92688 Contact: Wilson Leung, 949-635-1800, ext. 6506
Project Name: Concrete Rehabilitation Proiect FY 22-23
Contract Price: $471,295-00 Date of Completion: 11/18/23 Name, Address, and Telephone Number of Owner's Representative:
City of Rancho Cucamonga, 10500 Civic Center Drive, Rancho Cucamonga, CA 91730 Contact: Kenneth Fung, 909-477-2730, ext. 4139
(Attach additional pages as necessary)
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CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont'd)
DESIGNATIONOF SUBCONTRACTORS
Name of Subcontractor
and Location of Place Description and Subcontractor’s DIRRegistration of Business Percentage of Work License No. Number
(Bidder to attach additional sheets if necessary)
(PUBLICCONTRACTCODE §4100 ETSEQ.)
17.D
Rev. D
Fabrualy mzo
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
BIDDERCERTIFICATIONS
TO BEEXECUTEDBYALLBIDDERSAND SUBMITTEDWITHBID
The undersigned Bidder certifies to Owner as set forth in sections 1 through 10, below.
STATEMENTOF CONVICTIONS
By my signature hereunder, I hereby swear, under penalty of perjury, that no more than one final, unappealable finding of contempt of court by a Federal Court has been issued against Bidder within the past two years because of failure to comply with an order of a Federal Court or to comply with an order of the National Labor Relations Board.
CERTIFICATIONOF WORKER’SCOMPENSATIONINSURANCE
By my signature hereunder, as the Contractor, I certify that I am aware of the Labor Code Section 3700, which requires every employer to be insured against liability for worker‘s compensation or to undertake self-insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the work of this Contract.
Please note that the submittal of this certificate does not relieve Contractor from complying with all of the insurance requirements of the Public Works Agreement and Contract Documents.
CERTIFICATIONOF PREVAILINGWAGE RATESAND RECORDS
By my signature hereunder, as the Contractor, I certify that I am aware of Labor Code Section 1773, which requires the payment of prevailing wage on public projects. Contractor and any subcontractors under the Contractor shall comply with Labor Code Section 1776 regarding wage records, and with Labor Code Section 1777.5 regarding the employment and training of apprentices. Contractor is responsible to ensure compliance by any and all subcontractors performing work under this Contract.
CERTIFICATIONOF COMPLIANCEWITH PUBLICWORKS CHAPTEROF LABORCODE By my signature hereunder, as the Contractor, I certify that I am aware of Labor Code Sections 1777.1 and 1777.7 Code, and Contractor and Subcontractors are eligible to bid and work on public works projects.
CERTIFICATIONOF NON-DISCRIMINATION
By my signature hereunder, as the Contractor, I certify that there will be no discrimination in employment with regard to race, color, religion, gender, sexual orientation, age or national origin; that all federal, state, and local directives and executive orders regarding non-discrimination in employment will be complied with; and that the principal of equal opportunity in employment will be demonstrated positively and aggressively.
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CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
CERTIFICATIONOF NON-DISQUALIFICATION
By my signature hereunder, as the Contractor, I swear, under penalty of perjury, that the below indicated Bidder, any officer of Bidder, or any employee of Bidder who has a proprietary interest in such Bidder, has never 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 safety regulation, except as indicated on the separate sheet attached hereto entitled ”Previous Disqualifications." If a statement of ”Previous Disqualifications” is attached, please explain the Circumstances.
CERTIFICATIONOF ADEQUACYOF CONTRACTAMOUNT
By my signature hereunder, as the Contractor, pursuant to Labor Code Section 2810(a), I certify that, if awarded the Contract based on the undersigned’s Bid, the Contract will include funds sufficient to allow the Contractor to comply with all applicable local, state, and federal laws or regulations governing the labor or services to be provided. I understand that Owner will be relying on this certification if it awards the Contract to the undersigned.
CERTIFICATIONREGARDINGDIR CONTRACTOR/ SUBCONTRACTORREGISTRATION By my signature hereunder, as the Contractor, I certify that Contractor, and all listed Subcontractors are the subject of current and active contractor registrations pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code.
Contractor’s registration number is [please complete] 1000025154 Subcontractors’ registration numbers are as indicated in Document 00 4314.
CERTIFICATIONREGARDINGPREQUALIFICATIONINFORMATION [OPTIONAL] By my signature hereunder, as the Contractor, I certify as follows:
a. Cont ualified for this Project by submitting its Statement of Qualifications, dated (500)
b. [Please complete or strikeout the following as inapplicable] Subsequently, on or about and Contactor submitted
further information sup ementing for foregoing Statement of Qualifications. c. Allinformation described above is referred to as the ”Qualification Information." d. Contractor has carefully reviewed all of the foregoing Qualification Information. e. [Please check and/or complete one ofthe following]
All Prequalification Information remains true and correct in all material respects as of the date hereof, as if such information were actually being submitted to Owner as of the date hereof.
Except as otherwise expressly set forth in separate Additional Prequalification Information, submitted with the Bid, all Prequalification Information remains true and correct in all material respects as of the date hereof, as if such information were
17.D
Slgna ure Bid U
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont'd)
actually being submitted to Owner as of the date hereof. [Contractor must provide Additional Prequalification Informationas described above ifthis item is checked.]
CERTIFICATIONOF
[Insert other Owner-specific certifications, if applicable. Otherwise, delete.] BIDDER:
8/26/24 8/26/24
of Bidder Date of der Date
Jose Carvajal, President Jackie Carvajal, Treasurer
Print name and title Print name and title
(Ifthe Bidder is a corporation, two signatures ofcorporate o?‘icersare required.)
17.D
General Informa?on
Must be completed I)! all Subcontractors
‘ $200,000
SPECIAL FEDERAL PROVISIONS
DOCUMENT INDEX
1. General Summary
2. Hold HarmlessClause and AdditionalInsured-InsuranceRequirements
3. B-l Federal Labor Standards Provisions (HUD 4010)
4. B-2 Federal Prevailing Wage Decision (CA20240025 mod. 7)
5. B-3 Project Sign (SAMPLE)
6. B-5 City of Hemet Section 3 Af?rmative Action Policy (Applicable for Projects $200,000 or more)
7. Additional Federal Requirements
Bid Forms
8. B-4 Certi?cation of Bidder RegardingNon-segregated Facilities(Required for all Projects)
9. 3-6 Bidder’s Certi?cation for Section 3 Compliance (Required for Projects $200,000 or more)
10. B-6(SUB) Subcontractor Certi?cation for Section 3 Compliance (Required for Projects $200,000 or more)
11. B-7 Bidder’s Certi?cation on Federal Contract Requirements (Required for all Projects)
12. B-8 QuestionnaireRegarding Bidders (Required for all Projects)
13. B—9List of Subcontractors and Suppliers(Required for all Projects)
14. B-lO Subcontractor Certi?cation for Section 3 Compliance (Required for Proiects or more) Post-Award Forms
15. 16.
17. 18.
19. 20
PA—l Performance Bond (100% of contract price) (Required for Projects $200,000 or more) PA-2 Payment Bond (Required for Projects $200,000 or more) PA-3 Subcontractor Questionnaire(Required for all Projects) PA-4 Subcontractor Certi?cation Regarding Non-segregated Facilities(Required for all Projects) PA—5Section 3 Summary Report (Required for Projects $200,000 or more) PA-6 Davis-Bacon Classi?cations and Pay Rates (Required for all Projects)
17.D
ject
EXHIBIT B-4
Required Bid Form
CERTIFICATION OF BIDDER
REGARDING NONSEGREGATED FACILITIES
Project Name: Accessible Sidewalk and ADA Pro - CDBG Funded Name ofBidder; CT&T Concrete Paving Inc.
The above named Bidder hereby certi?es that:
I do not maintain or provide for my employees any segregated facilities at any of my establishments, and that I do not permit my employees to perform their services at any location, under my control, where segregated facilities are maintained. As used in this certi?cation, the term “segregated facilities” means any waiting rooms, work areas, rest rooms, wash rooms, restaurants and other eating areas, time clocks, locker rooms or other dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, national origin, or because of habits, local customs, or otherwise.
I further agree to obtain identical certifications from all proposed subcontractors prior to the award of subcontracts exceeding $10,000.
Signature
Name (Print): Jose Carvaial
Title: President
Date, 08/26/24
17.D
EXHIBIT B-5
CITY OF EMET
AFFlRMATIVE ACTION PROGRAM
ECONOMIC OPPORTUNITIESFOR SECTION 3 RESIDENTS
AND
SECTION 3 BUSINESS CONCERNS
The work to be performed under this contract is subject to the requirements of section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (section 3). The purpose of section 3 is to ensure that employment and other economicopportunitiesgenerated by HUD assistance or HUD-assistedprojects covered by section 3, shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly persons who are recipients of HUD Assistance for housing.
17.D
AFFIRMATIVE ACTION POLICY STATEMENT
The City of Hemet, as the Community Development Block Grant Administrator, shall take Af?rmative Action to insure to the greatest extent feasible that:
1. Contracts for work (involving both construction and non-construction projects) funded from Community Development moneys be awarded to business located in and/or owned in substantial part by persons residing within the Section 3 covered project area.
2. Lower income residents of said project area are to be provided, to the greatest extent feasible, employment and training opportunities emanating from such contracts.
It will be established policy to:
1. Enlist the support of community agencies, schools and unions in the recruitment, hiring and training of low income persons residing within Section 3 project areas.
2 Insure that project area business are afforded a maximum feasible opportunity to bid on contracts.
3. Insure that contractors understand and comply with their obligations under the Act (24 CFR Part 75).
4. Providea system to periodically monitor and evaluate the effectiveness with which the plan is being carried out.
To insure that we continue to meet our obligations and commitments we have developed a Section 3 A?rmativeAction Program. All contractors and sub-contractors are expected to demonstrate a spirit of support and cooperation in the implementation of this program.
The Executive Director of the Community Development Agency will be responsible for the implementation, administration, and monitoring of our policy and program.
Date: February 8, 1988 Supervisor Walt P. Abraham Chairman, Board of Supervisors
17.D
ems-acting
onu‘ac‘or
DEFINITION OF TERMS
1 Business concerns located within the Section 3 covered project area: Means those individuals or ?rms located within the relevant Section 3 covered project area as determined, pursuant to 24 CFR 135.5.
2. Business concerns owned in substantialpart by persons residingin the Section 3 covered project area: Means those business concerns which are ?fty-one (51) percent or more owned by persons residing within the relevant Section3 coveredproject as determined pursuant to 24 CFR 135.5.
3 C party: Means any entity which contracts with a contractor for the performance of work in connectionwith a Section3 covered project.
4 C :Means any entity which performswork in connectionwith a Sectioncovered project.
5 Lower income residentof the area: A person residing in the Community Development Block Grant project area of the City of Hemet whose annual family income does not exceed eighty (80) percent of the median income. (Calculations are to be based on the median income level as reported by HUD).
6. Project area: In most cases the project area will be bounded by the City limits (or participants'City limits as applicable).However, priority shall be given to persons living within the City's Impact Areas.
III
SPECIFIC AFFIRMATIVE ACTION STEPS
In order to comply with Section 3 regulations af?rmative actionmust be taken.This af?rmative action will be at least as extensive and speci?c as the following:
Each contractor and sub-contractorshall incorporate in all contracts for work in connection with a Section 3 covered project the following Section 3 Clause:
Every applicant, recipient, contracting party, contractor, and subcontractor shall incorporate, or cause to be incorporated, in all contracts for work in connection with Section 3 covered project, the following clause (referred to as a Section 3 Clause):
The work to be performed under this contract is on a project assisted under a program providing direct Federal ?nancial assistance from the Department of Housing and Urban Development, and is subject to the requirements of Section 3 of the Housing and Urban Development act of 1968, as amended, 12 US. C. I 701u. Section 3 requires that to the greatest extent feasible opportunitiesfor training and employment be given to lower income residents of the project area and contracts for work in connection with the project be awarded to business concerns which are located in, or owned in substantialpart by persons residing in the area of the project.
17.D
The parties to this contract will comply with the provisions of said Section 3 and the regulations issued pursuant thereto by the Secretary of Housing and Urban Development set forth in 24 CFR 570, and all applicablerules and orders of the Department issued hereunder prior to the execution of this contract. The parties to this contract certify and agree that they are under no contractual or other disability which would prevent them from complying with these requirements.
The contractor will send to each labor organization, or representativeor workers, with which he has collective bargaining agreement or other contract, or understanding, if any, a notice advising the said labor organization or workers; representativeof his commitmentsunder this Section 3 Clause and shall post copies of the notice in a conspicuous place available to employees and applicantsfor employment or training.
The contractor will include this Section 3 Clause in every sub-tier contract for work in connection with the project and will, at the direction of the applicant for, or recipient of, the Federal ?nancial assistance, take appropriate action pursuant to the sub-tier contract upon ?nding that the subcontractor is in violation of the regulations issued by the Secretary of Housing, and Urban Development, 24 CFR 570. The contractor will not enter into any subtier contract with any subcontractor where it has notice or knowledge that the latter has been found in violation of regulations under 24 CFR 570 and will not let any subcontract unless the subcontractor has ?rst provided it with a preliminary statement of ability to comply with the requirements of these regulations.
Compliance with the provisionsof Section 3, the regulations set forth in 24 CFR 570, and all applicable rules and orders of the Department issued thereunder prior to the execution of the contract, shall be a condition of the Federal ?nancial assistance provided to the project binding upon the applicant or recipient for such assistance, its successors, and assigns.
Failure to ful?ll these requirements shall subject the applicant or recipient, its contractors and subcontractors, its successors, and assigns to those sanctions speci?ed by the grant or loan agreement or contract through which Federal assistance is provided, and to such sanctions as are speci?ed by 24 CFR 135.
All contractors and their subcontractors shall include as part of their bid proposal a copy of their Section 3 Af?rmative Action Plan. The Plan should include the following:
1. A preliminary statement of workforce needs (skilled, semi-skilled, unskilled labor and trainees by category).
2 Goals (in percentage) relative to utilization of lower income persons in project area.
3 Goals relative to the project dollar amount of subcontractors to be awarded to project area business.
17.D
idemifying , proj
IV
DISSEMINATION OF SECTION 3 PROGRAM POLICY
In orderthat all contractors of the City of Hemet have a full understanding of the City's positionregarding this Section 3 Af?rmative Action Plan the following procedureswill be initialed:
1 All advertisementsand invitationsto bid will includethe City's Section 3 Af?rmative Action Plan requirements.
2 All Community Development Block Grant contracts will include the City's Section 3 Af?rmative Action Plan.
3. The Section 3 Grievance Procedureand signs shall be placed at construction sites the project as a Section 3 covered ect.
V
PROGRAM EVALUATION
Pursuant to Section 3 requirements (24 CFR 135.72,) the City of Hemet, as Block Grant Administrator, shall assist and actively cooperate with the Department of Housing and Urban Development in insuring the compliance of our contractors and subcontractors.
All contractors shall:
1 Maintain a list of all lower income area residents who have appliedwhether on their own or on referral from any source.
2 Set forth evidence, acceptable to the Executive Director or the Community Development Agency that its actions were not an attempt to circumvent program requirements, if vacant apprentice or trainee positions in its organization are ?lled immediately prior to undertaking work pursuant to a Section 3 covered project.
VI
COMPLAINT PROCEDURE
Who may ?le a complaint?
The following individuals and business concerns may, personally or through an authorized representative,?le with the Assistant Secretary a complaint alleging noncompliancewith section 3:
1. Any Section 3 resident on behalf of himself or herself, or as a representative of persons similarly situated, seeking employment, training or other economic opportunitie s generated from the expenditure of Section 3 covered assistance with a recipient or contractor, or by a representative who is not a section 3 resident but who represents one or more Section 3 residents;
17.D
2. Any Section 3 business concern on behalf of itself, or as a representativeof other section 3 business concerns similarly situated, seeking contract opportunitiesgenerated from the expenditure of Section 3 covered assistance from a recipient or contractor, or by an individualrepresentativeof Section 3 business concerns.
Where to file a complaint?
A complaint must be ?led with the:
Assistant Secretary for Fair Housing and Equal Opportunity Department of Housing and Urban Development
Washington, DC, 20410.
Questionsregarding Section 3 compliance, procedures for ?ling a complaint, or the City of Hemet’s Af?rmative Action Program, shouldbe addressedto:
Department of Housing & Workforce Solutions
CDBG Program Administrator — Section 3 Program
3403 10thStreet, Suite 300
Riverside, CA 92501
(951) 955-5933
17.D
Accessible Sid
I. Employment Opportunities
www‘hud ggxlsection}
?
htt s://huda s.hud‘ ov/ onunit Porta
Workforce ons.
hours, Sec worker labor h
L
k
n
L
www.rivco'obs.org
T? Initial Here
g. Sign the Section 3 Plan. Initial Her: 36-
EXHIBIT 3-6
$200,000 or more
BIDDER CERTIFICATIONFOR SECTION 3 COMPLIANCE
(Housing and Community Development Act of 1968)
Project Title: ewaIk and ADAProject - CDBG Funded Amount of Bid:
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all construction contracts over $200,000.
I understand and agree that in the event that I am awarded this contract, and in the event that any new employment opportunitiesare created as a result of this CDBG-fundedproject, I will:
0100,9409“
Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be considered for available employment opportunities;and HUD Section 3 Opportunity Portal. Initial Here
at:
Forward to the Department of Housing & Workforce Solutions all detailed job descriptions for new employment opportunitiesand Section 3 reports, in a form, at a place, and at a time as directed by the Department of Housing & Soluti Initial Here Present a list, of the number of total labor tion 3 ours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of projected number of available positions, to include job descriptions and wage rates.
Initial Here
. Notify Section 3 Coordinator of contractor interests regarding employment of Section 3 workers prior to hiring. Initial Here
Submit a list of core employees (includi .g administrative, clerical, planning, and other positions pertinent to the construction trades) at the time of contact award. Initial Here
Post available positions and advertise job Section 3 workers openings at:
Complete your proposedworkforce plan for this project below. l/
17.D
W 3 0
Cat/W W
MAW/V 0
WW 2 O
LTD
JOB CATEGORY
PROFESSIONALS
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTION BY
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE
TRAINING
OTHER
TOTAL
CURRENT
POSITIONS
NUMBER OF
NEW HIRES
IF
AWARDED
BID
NUMBER OF NEW HIRES
PROPOSED TO BE
SECTION 3 RESIDENTS
% OF NEW HIRES TO BE
SECTION 3
TRADE
17.D
II. Subcontracting Opaortunities
www,hud.gov/section3
www.11gd‘gov/section3
ht: :l/ a s.hud.ov/O onuni Ponal/ ‘&
_£
www.1‘ivco‘obs‘org
EXHIBIT B-6
BIDDER CERTIFICATIONFOR SECTION 3 COIVIPLIANCE
a. I understand and agree that for any and all subcontracting opportunitiesthat may result from this CDBG—fundedproject, I will contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 Businesses, within City of Hemet, to be considered for available subcontracting opportunitiesprior to selecting any subcontractor for my bid submittal.
Initial Here
b. I understand and agree that any and all sub-contracts and sub-tier agreements resulting from this CDBG—fundedproject are also subject to Section 3 compliance, and therefore, as the General/Prime Contractor, I am responsible to ensure compliance from all subcontractors. Initial Here
i. Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be considered for available employment opportunities;and HUD Section 3 Opportunity Portal at: Initial Here
j. Forward to the Department of Housing & Workforce Solutions all detailed job descriptions for new employment opportunitiesand Section 3 reports, in a form, at a place, and at a time as directed by the Department of Housing & Workforce Solutions.
Initial Here
k. Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of projectednumber of available positions, to include job descriptions and wage rates.
Initial Here
1. Notify Section 3 Coordinator of contractor interests regarding employment of Section 3 workers prior to hiring. Initial Here m. Submit a list of core employees (including administrative, clerical, planning, and other positions pertinent to the constructiontrades) at the time of contact award. Initial Here n. Post available positions and advertise job Section 3 workers openings at:
Initial Here
17.D
Complete your Subcontracting proj
av A/
frw W 2% /V
“PM” mm5 M
(Type : __é_’_—
Plan for this ect below:
IS THE SUBCONTRACTOR IF SUBCONTRACTORIs SECTION 3, INDICATE SECTION 3 ELIGIBLE? ELIGIBLE STATUS.
YES OR NO
AMOUNT OF
SUBCONTRACT($)
TRADE
51% OWNER / 30% EMPLOYEE
* Add additionalsheets if necessary
Bidder (Company)Name: CT&TConcrete Paving Inc
AuthorizedRepresentative Name) Jose caNaial
Signature:
Date: 08/26/24
5WVa4
d5
22, {y
{5133
17.D
MAHat?? 1/71“ SI'C/cwa/?" jgplvl/?me?
Subcontractor: [pf/rec \Wa/I'IoeJ/Ii!'
c 1 com '1_ ‘
He
www.hud. ov/sec?onB
_Q?__
Mill-L0
Required BidForm for bids
$200,000or more
SUBCONTRACTORCERTIFICATIONFOR SECTION3 COMPLIANCE
MUST BE COMPLETED BY ALL SUBCONTRACTORS
(Housing and CommunityDevelopmentAct of 1968)
Project Title:
Contractor/Bidder:
The undersigned hereby certi?es that he/she has read and understands City of met's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of ’ the following for all prime construction contracts over $200,000:
a. I understandand agree that in the event that I am awardeda subcontract,and in the event that any new employment opportunitiesare created as a resultof this CDBG-fundedproject, I willcontact the US. Department of Housingand Urban Development (HUD) Section 3 website at to
review the list of certi?ed Section 3 persons, within City of Hemet, to be considered for available employmentopportunities;
InitialHere
b. I will forward to the Department of Housing & WorkforceSolutionsall detailedjob descriptions and Section 3 reports, in a form, at a place, and at a time as directed by the Department of Housing & Workforce Solutions. ' ___9—._._
W
Initial Here
EXHIBIT 3-10
17.D
M.
Name: l/ ziV'W'eaKet/I/IZ lf/vz.
Repr sentative \J a
'%)/’I
7( Mi—
Complete your proposed workforce plan for this project below:
JOB CATEGORY
PROFESSIONALS
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTIONBY
TRADE
Tm?(1'50I (2r
TRADE
mm:
TRADE
TRADE
TRADE
APPRENTICE
TRAINING
OTHER
TOTAL
CURRENT
POSITIONS
O
O
C)
O
Subcontractor (Company)
Authorized
NUMBEROF
NEW HIRES
IF
AWARDED
BID
0 0
(Type Name):
NUMBER OF NEW EIRES
PROPOSED TO BE
SECTION3 RESIDENTS
C)
d
0 '0
O
% OF NEW HIRES TO BE
SECTION3
O
17.D
AM air é?/a/iSic/umcl/I’ Imxw?é?r:
I. Emglnxment Ongortunit-les
w. n ov/section3
to be considered for available employment opp
Portal. 09'” Initial Here
at: htgpg:[zhudagps.hud.gov[_QpportunigPortall
for new employment opportun ction 3 repo a form,at a pin directedby the Department of Workforce ans. 5
proje tednumber description wage rates
[/74Inltlll
Notify Sectio 3 Coordinator of contra regnrding oyment of workers prior hjn'ng. (/1) Initial Here
Submit a list f core emialoyees(including a nist‘rau've planning, and 0211 ex) at time oft: ard. CV Initi
fl
Pos vailablepositions and advertisejob Sectio www.rivcoiobsl9rg , Initial Here ‘
Sign the Section 3 Plan. Inlthl Here 0';
Complete your proposed workforceplanfor this
Project Title:
Required Bid Form for bids
$200,000 or more
BIDDER CERTIFICATIONFOR SECTION3 COMPLIANCE
(Housing and Community DevelopmentAct of 1968)
Amount ofBid: P7215m00
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of1968, and further certifies adoption of, and adherence to, said program, and certi?es understanding of the following for all construction contracts over $200,000.
I understandand agree that in the event thatI am awarded this contract, andin the event that any new employment opportunities are created as a result of this CDBG-fundedproject, I will:
a. Contact the US. Department of Housingand Urban Development (HUD) Section 3 websiteat Free
to review the list of certi?ed Section 3 persons, within City of Hemet, ortunities; and HUD Section 3 Opportunity
Forward to the Department of Housing & Workforce Solutions all detailed job descriptions ities and Se rts, in cc, and at a timeas
Housing & Soluti Initial Here
Present a list, of the number of total labor hours, Section 3 worker iaborhours, and Targeted Section 3 worker labor hours expectedto be generated from the initial contract and a list of of available positions,to includejob 5 and
Here
n tctor interests empl Section 3
to
o dmi , clerical, er
positions pertinent to the construction trad the ontact aw o1 Here
n 3 workers openingsat:
project below.
17.D
0 JOB CATEGORY
PROFESSIONALS
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTIONBY
TRADE
TRADE /
.
. (1/0 0w: V
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE
TRAINING
OTHER
TOTAL
CURRENT
POSITIONS
Q
(J
0 NUMBER OF
NEWHIRES
IF
AWARDED
BID
0 NUMBEROF NEW HIRES
PROPOSED TO BE
SECTION 3 RESIDENTS
0 O
O
% OF NEW HIRES TO B
SECTION3 E
U
17.D
II. Subcontracting Opportunities
www.hud. ovlsection3
J?
wwwgudigov/sectionil
consideredfor available employment opportunitis; and
htt :l/hurla shud. ov/O ortuni Portal] hiI
project d number of availablepositions, to inc
Initial Here
I. Noti Section 3 C00 dinator of contractor int:
prior to hiring Initial Here
Submit a list of core employccs(including administrative,clerical, pin ’ g. and other positions partinentto the consmiction trades) at the time of contact award. Initial Here Post available positions and advertise job Section 3 workers openings at: wwwirivcu'obsorg if Initinl Here
LXH—lBIJl-é
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
a. I understandand agree that for any and all subcontracting opportunitiesthat may result fromthis CDBG-fundedproject,I will contact the US. Department of HousingandUrban Development(HUD) Section 3 website at to review the list of certi?ed Section 3 Businesses, within City of Hemet, to be consideredfor available subcontracting opportimitiespriorto selecting any subcontractorfor my bid submittal. lnltlal Here
b. I understandand agree that any and all sub-contracts and sub-tier agreements resulting from this CDBG—?mdedproject are also subject to Section 3 compliance,and therefore, as the General/Prime Contractor, I am responsible to ensure compliance from all subcontractors.
Initial Here
i. Contact the US. Department of Housing and Urban Development (HUD) Section3 websiteat to review the list of certi?ed Section 3 persons, withinCity of Hemet,to be HUD Section 3 OpportunityPortal
at: nitial Here
j. Forward to the Department of Housing & Workforce Solutions all detailedjob descriptionsfor new employmentopportunitiesand Section3 reports, in a form, at a place,and at a time as directed by the Depa ent of Housing & Workforce Solutions. §_%Initial Here k. Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of ludejob descriptionsandwage rates.
rests regardingemployment of Section 3 workers
17.D
MUST BECOMPLETEDBYALL SUBCONTRACTORS
9‘ "Jr )m‘ .
www.hud.goV/section3
ed Section 3 be
employment ?
Required Bid Form for bids
$200,000 or more SUBCONTRACTORCERTIFICATION FOR SECTION 3 COMPLIANCE (Housing and Community Development Act of 1968)
Project Title: Accessible Sidewalk &ADA Project
Subcontractor: Case Land Surveying, Inc.
The undersigned hereby certifies that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certifies adoption of, and adherence to, said program, and certi?es understanding of the following for all prime construction contracts over $200,000:
a. I understand and agree that in the event that I am awarded a subcontract,and in the event that any new employment opportunities are created as a result of this CDBG-?mded project, I will contact the U.S. Department of Housing and Urban Development (HUD) Section 3 website at to
review the list of certi? persons, within City of Hemet, to considered for available opportunities;
Initial Herc
b. I will forward to the Department of Housing & Workforce Solutions all detailed job descriptions and Section 3 reports, in a form, at a place, and at a time as directed by the Department of Housing & Workforce Solutions.
InitialHere
EXHIBIT B-10
Contractor/Bidder: OVA Cot/[wok
17.D
Completeyour proposed workforce plan for this project below:
NUMBER OF
JOB CATEGORY CURRENT NEW "IRES NUMBEROF NEW”IRES
% OF NEWHIRES To BE POSITIONS IF PROPOSEDTo BE
AWARDED SECTION3 SECTION3 RESIDENTS
BID
PROFESSIONALS
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTIONBY
TRADE
TRADE NIA:
FieldSurveyor mgegeglmdpaledN/A N/A
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE
1 TRAINING
1 OTHER
TOTAL
2 Subcontractor(Company)N Case Land Sun/eylng. Inc.
Authorized Name): LarryV. Case, President
17.D
I. Employment Opportunities
www.hud,gov/section3
h s a s.hud. ov/ ortnni Portal/
for new employmentopportunitiesand Section 3 reports, in a form, at a co, and at a time directed by the Departmentof Housing & Workforce Solutions Initial Here Present a list, of the number of total labor hours, Section 3 worker labor hours, and Target projec number of available positions,a: in
Initial Here
d. Not Section 3 Coordin of commoto
workers priorto hiring.% Initial He
e. Submit a list of core emp oyees (includi‘ dministrativ annin and other the time of .4 Initial
1’. Post a ilablepositions and advertise job Se www.rivco‘obs.org Initial Here
g. Sig th Section 3 Plan. Initial Hag 11. Complete your proposed workfo plan for EXHIBIT 13-6
$200,000 or more
BIDDERCERTIFICATION FOR SECTION3 COMPLIANCE
(Housing and Community Development Act of 1968)
Project Title: AccessibleSidewalkand ADA Proiect Amount of Bid:
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certifies adoption of, and adherence to, said program, and certifies understanding of the following for all construction contracts over $200,000.
I understand and agree that in the event that I am awarded this contract, and in the event that any new employment opportunities are created as a result of this CDBG—?indedproject, I will:
a. Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be for available employment opportunities; and HUD Section 3 Opportunity Portal. Initial Here
at:
b. Forward to the Department of Housing & Workforce Solutions all detailedjob descriptions as
0. ed
Section 3 worker labor hours expected to be generated ?om the initial contract and a list of clude job descriptions and wage rates.
I interests regarding employment of Section 3
re
ng a e, clerical, p1
positions pertinentto the construction trades) at contact award Here
ction 3 workers openings at:
this project below.
17.D
I]. Subcontracting Ongortunities
www.hud.gov/section3
certi?ed S sidered e
subcantrac my bid #
\vww,hudlgov/section3
consideredfor available emplayment opponunities; and HUD Section hn s://l1uda s.hud. ov/O orluni Ponal/ Initial Here
rward to the Department of Housing & Workforce Solutions all deta Dep n! of Housing & 1 Initial Here
proj d number of available positions, to incl
Initial Here
1. Notify Section 3 Co dinator of contractor inte
prior to hiring‘ Initial Here
in. Submit a list of core employees(including administrative, clerical, 1) ing, and other positions pertinent to the constructiontrad me of contact award. ? Initial Here Post ailable positions and ad Section 3 workers 0 nings at: www.rivco‘obs,org Initial Here
EXHIBIT B-6
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
a. I understand and agree that for any and all subcontracting opportunities that may result from this CDBG-?mdedproject, I will contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of ection 3 Businesses, within City of Hemet, to be con for availabl ting opportunitiesprior to selecting any subcontractorfor submittal.
Initial Here
b. I understand and agree that any and all sub-contracts and sub—tieragreements resulting ?‘omthis CDBG—?mdedproject are also subject to Section 3 compliance, and therefore, as the General/Prime Contractor, I am responsible to ensure compliance from all subcontractors.
Initial Here
i. Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be 3 Opportunity Portal
at:
j. Fo iled job descriptionsfor
new employmentopportunities and Section 3 reports, in a form, at a place, and at atime as directed by the Workforce Solutions.
k. Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of ude job descriptionsand wage rates.
rests regarding employment of Section 3 workers
es) at the ti
n. vertise job
17.D
I. Employment Opportunities
www,hud.gov/scction3
hugs://hudapps.hud.gov/OpgortunityPona
www.rivcoiobs.org
Superior Pavement Markings, Inc.
EXHIBIT 3-6
$200,000 or more
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
(Housing and Community Development Act of 1968)
Project Title: AccessibleSidewalkand ADA Proiect Amount of Bid: $1 1.723.00 The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all construction contracts over $200,000.
I understand and agree that in the event that I am awarded this contract, and in the event that any new employment opportunitiesare created as a result of this CDBG-funded project, I will:
Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be considered for available employment opportunities; and HUD Section 3 Opportunity Portal. D V Initial Here
at:
Forward to the Department of Housing & Workforce Solutions all detailed job descriptions for new employment opportunities and Section 3 reports, in a form, at a place, and at a time as directed by the Department of Housing & Workforce Solutions. D V Initial Here Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of projected number of available positions, to include job descriptions and wage rates.
D V Initial Here
Notify Section 3 Coordinator of contractor interests regarding employment of Section 3 workers prior to hiring. D V Initial Here
Submit a list of core employees (including administrative, clerical, planning, and other positions pertinent to the construction trades) at the time of contact award. D V Initial Ilere
Post available positions and advertise job Section 3 workers openings at:
D V Initial Here
Sign the Section 3 Plan. Initial Here D V
Complete your proposedworkforce plan for this project below. 1/
17.D
Superior Pavement Markings, Inc
TRADE
Pavement Striper
OTHER
16 41
JOB CATEGORY
PROFESSIONALS
TECHNICIANS
OFFICE/CLERICAL
CONSTRUCTION BY
TRADE
TRADE
TRADE
TRADE
APPRENTICE
TRAINING
TRADE
CURRENT
POSITIONS
NUMBER OF
NEW HIRES
IF
AWARDED
BID
NUMBER OF NEW HIRES
PROPOSED TO BE
SECTION 3 RESIDENTS
% OF NEW HIRES TO BE
SECTION 3
17.D
II. Subcontracting Oggortunities
www.hud.gov/section3
www.hud.gov/scction3
hlms:llhudamas,hudgov/Opnorlunitvl’oMll
www.rivco'obs.org
Superior Pavement Markings, Inc.
EXHIBIT 3-6
m.
n.
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
I understand and agree that for any and all subcontracting opportunities that may result from this CDBG-fundedproject, I will contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 Businesses, within City of Hemet, to be considered for available subcontracting opportunitiesprior to selecting any subcontractor for my bid submittal D V Initial Here
I understand and agree that any and all sub-contracts and sub-tier agreements resulting from this CDBG-funded project are also subject to Section 3 compliance, and therefore, as the General/Prime Contractor, I am responsible to ensure compliance from all D V subcontractors.
Initial Here
Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be considered for available employment opportunities;and HUD Section 3 Opportunity Portal at: D V Initial Here
Forward to the Department of Housing & Workforce Solutions all detailed job descriptions for new employment opportunitiesand Section 3 reports, in a form, at a place, and at a time as directed by the Department of Housing & Workforce Solutions.
D V Initial Here
Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of projected number of available positions, to include job descriptions and wage rates.
D V Initial Here
Notify Section 3 Coordinator of contractor interests regarding employment of Section 3 workers prior to hiring. D V Initial Here
Submit a list of core employees (including administrative, clerical, planning, and other positions pertinent to the construction trades) at the time of contact award. D V Initial Here Post available positions and advertise job Section 3 workers openings at:
D V Here
17.D
Complete your Subcontracting Plan for this prol'Lect below:
15 THE SUBCONTRACTOR IF SUBCONTRACTORIS SECTION 3, INDICATE SECTION 3 ELIGIBLE? ELIGIBLE STATUS.
YES OR NO
AMOUNT OF
SUBCONTRACT($)
TRADE
51% OWNER / 30% EMPLOYEE
* Add additional sheets if necessary
Bidder (Company) Name Superior Pavement Markings, lnc.
Authorized Representative (Type Name): Darren Veltz, Chief Financial Officer Signature:
17.D
MUST BE COMPLETED BY ALL SUBCONTRACTORS
, BG Fu Access ewalk/ Pro'ect Cagital lmgrovement
Project No. 5768
www.hud.gov/secti0n3
Required Bid Form for bids
$200,000 or more
SUBCONTRACTORCERTIFICATIONFOR SECTION 3 COMPLIANCE
(Housing and Community Development Act of 1968)
Project Title: CD nded ible Sid ADA
Subcontractor: Superior Pavement Markings, Inc.
Contractor/Bidder:
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all prime construction contracts over $200,000:
a. I understandand agree that in the event that I am awarded a subcontract, and in the event that any new employment opportunitiesare created as a result of this CDBG—fundedproject, I will contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to
review the list of certi?ed Section 3 persons, within City of Hemet, to be consideredfor available employment opportunities; 9 V
Initial Here
b. I will forward to the Department of Housing & Workforce Solutions all detailedjob descriptions and Section 3 reports, in a form, at a place, and at a time as directed by the Department of Housing & Workforce Solutions.
D V
Initial Here
EXHIBIT B-10 Page 391 of 552
17.D
Markings,
S 'or Pave nt Markin | c.
Complete your proposed workforce plan for this project below:
NUMBER OF
JOB CATEGORY CURRENT
NEW “IRES NUMBER OF NEW “IRES % OF NEW HIRES TO BE
POSITIONS
IF PROPOSED To BE SECTION 3
AWARDED SECTION 3 RESIDENTS
BID
PROFESSIONALS 3
TECHNICIANS 4
OFFICE/CLERICAL
16 CONSTRUCTION BY
TRADE
TRADE
. 41
Pavement Stnoer
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE 3
TRAINING
OTHER
TOTAL
67 Subcontractor (Company) Name Superior Pavement Inc.
Authorized Representative (Type Name):
Signature:
08/26/2024
17.D
Pavement MKBring
8/23/24
Re: Section 3 Resource Participation Certification
To Whom it may concern,
Superior Pavement Markings, Inc is a part of the Parking and highway Improvement Stripers Union, Local1184. We hire all employees through the Union.
Thank you,
Darren Veltz, CFO
5312 Cypress Street Contractor’s State License No. 776306 Cypress, CA90630 DIRNo. 1000001476
(714) 995-9100 Page 393 of 552
17.D
W
EXHIBIT B-7
Required Bid Form
CITY OF HEMET
CDBG PROGRAM
BIDDER CERTIFICATION ON
FEDERAL CONTRACT QUI MENTS
PROJECT NAME: Accessible Sidewalk and ADA Project - CDBG Funded I hereby certify that I have reviewed and understand the diversi?ed Federal construction contract related requirements imposed on the Contractor(s) of HUDfunded constructionprojects, including but not limited to the following:
1 The subject project is being ?nanced with Community Development Block Grant funds (24 CFR Part 570);
2. This project and all related construction contracts are subject to the US Department of Housing and Urban Development’s Federal Labor Standards Provisions (HUD 4010 — revised 06/2009); and
1 This project is subject to all applicable laws and regulations as listed in the General Summary of these SpecialFederal Provisions; and 2 If my bid is $200,000 or more, this project and all related contracts will subject to Section 3 requirements (12 U.S.C.1701u).
CONTRACTOR’S NAME: CT&T Concrete Paving Inc.
CONTRACTOR’S LICENSE NO 875627
ADDRESS: 324 8. Diamond Bar Blvd, PMB 275 Diamond Bar, CA 91765 AUTHORIZED REPRESENT J°Se Calval'a' Name)
SIGNATURE:
08/26/2024
17.D
324 S. Bar Blvd, .Diamond 765
EXHIBIT B-8
Required Bid Form
QUESTIONNAIREREGARDING BIDDERS
Bidder has been engaged in the contracting business under the present name of CT&T Concrete P Inc. since 03/05/2006 (Date).
Present business address is: Diamond PMB 275 Bar CA 91
Federal Tax ID: 202642225 Amount of Bid $
California Contractor's License No. 875627 Expiration Date: 04/30/2026 A woman-owned enterprise is de?ned by the Federal Government as a business that is ?ftypercent (50%) or more woman-owned.Please check applicablebox concerning the ownership of your business:
[I Woman/Femaleowned Kl Male owned
A Section 3 Contractor or Subcontractor is a business concern that is more than ?fty-one percent (51%) owned by a low or very low-income person, or a business concern that provides economic opportunities to low and very low-income residents. Please check applicable box concerning the ownership of your business:
[I Section 3 Business concern IXINon-Section 3 Business concern The United States Department of Housing and Urban Development (HUD) is authorized to solicit the information requested in this form by virtue of Title 12, United States Code, Section 1701 et seq., and other regulations. It will not be or released outside of HUD without your consent, except as required or permitted by law.
Number: [oéq CAGE Code:
Because this project is Federally-funded, it is necessary to obtain information concerning minority and other group participation for statistical purposes. The US. Department of Housing and Urban Development (HUD) uses this information to determine the degree to which its programs are being utilized by minority business enterprises and targeted group contractors.
A minority enterprise is de?ned by the Federal Government as a business that is fifty-one percent (51%) or more “minority-owned”. Please check applicable box concerning the ownership of your business:
CI American Indian or Native Alaskan
Asian or Paci?c Islander/Native Hawaiian
Black/African American
Hispanic
White
Hasidic Jews
17.D
(“m/<2 LAMASu‘vwgmay d> 55”“ WW [2?
Tm ww? 424,500 P0504 52 ,cvma m”/
M07 PM‘WJ ,chmwi 9455. P0 W 27? W?‘w/
ADDRESS/PHONE NO.
[W N. ff $1, 0
EXHIBIT B—9
Required Bid Form
LIST OF SUBCONTRACTORS
SUBCONTRACTOR FED. I.D.# AMOUNT
S UP P L ERS
NAME OF SUPPLIER ADDRES S/PHONE NO. CONTRACT AMOUNT
This form is to be completed and submitted with the bid package. \/&E v
5v
HOHI' M £00k
22, W0
80 A w
Mm Nagoya/1 Ale/gUVWM/
?m—‘MZ—IS’?g
164 93
77 5
TED
7W—‘147~
99-oC/05 {454797
17.D
APPENDIX1
17.D
Accessible Sidewalk and ADAProject - CDBGFunded -
0&ADeadline August 79, 2024 3:00 PM (P07
Set 1 Released via Addendum 1 08/07/20241134 AM(PDT)— 1 question
1.1 Please provide the Engineer's estimate
Answer $150,000 budgeted
17.D
will not be
resgonsible
integr
)_!_——-
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL
The undersigned hereby proposes to furnish any and all labor, materials, and equipment for the CD36 Accessible Sidewalk/ADAProject, CIP No. 5768, and appurtenant work in connection therewith, said work to be done and materials to be furnished in strict conformity with the Contract Documents, including but not limited to the Notice Inviting Bids, Instructions to Bidders, every Addendum, plans, specifications, General Conditions, Special Provisions, General Provisions, Greenbook 2018 as amended and supplemented, technical references, all other referenced documents, all codes, permit conditions and regulations, for the total amountls) and any unit prices and additive/deductiveitems shown on this proposal.
The undersigned has examined the location of the proposed work and all local and physical conditions and challenges presented by the Project site, is familiar with the plans, specifications, Contract Documents (particularly as delineated above) and the requirements of the Public Works Contract, and also understands that the Project shall be completely constructed in turn-key condition acceptable to the Owner within the Project time requirements for the price of the proposal, including all fees and sales and/oruse tax upon any materials so furnished, including any unit prices and additive/deductiveitems. The undersigned has also carefully checked all of the figures given and understands that the Agency for any errors or omissions on the part of the undersigned in submitting this proposal.
Contractor confirms that his/her/its bid is submitted with respect to the changes to the Contract and/orContract Documents included in all addenda issued by the Owner.
In addition to reaffirming that the changes and information contained in the addenda have been ated into their proposal, Contractor acknowledges receipt of Addenda No.(s
The undersigned has examined the current State of California schedule of prevailing wage rates for the types of work to be done on this project (and the Davis-Bacon Act if the Agency uses federal funds for the Project) and agrees to pay not less than these rates.
17.D
fay
1War)”
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
ITEM
No
10 11
12 13
14 15
16 BID SCHEDULE
BASEBID — CDBG ACCESSIBLESIDEWALK/ADA PROJECT, CIP No. 5768
DESCRIPTION
Identification Sign
Water Quality Control
per Owner Agency Std. &
Specs.
mailbox
Adjust Ex. Water Meter
Ramp per City Std.
per City Std.
Construct PCC Driveway
Approach per City Std.
ex. Tree/tree stump.
fence/gate
Remove Ex. PCC/AC &
approach per City Std.
Wall/Pilaster
Gutter per City Std.
UNIT
Mobilization (not to exceed 5%) LS
Traffic and Pedestrian Control LS
Temporary Construction Project
EA
LS
Adjust Ex. Manhole to New F.S
EA
Remove & relocate existing
EA
Box/Traff. Box to finish surface EA
Relocate Ex. Signs and Posts EA
Remove and Replace Exist ADA
EA
Construct 4" thick PCC sidewalk
SF
SF
Remove, Uproot and dispose EA
Remove & relocate existing LF
Construct New PCC driveway SF
Remove & Dispose Ex. Masonry
EA
Construct type "A"Curb and
LF
ESTIMATED
QUANTITY
10 17
29 12000
1025
450
520
225
EXTENDED
UNIT ITEM
PRICE AMOUNT
34m 30/yo
u; I6’,0W”
I my 3W0” g090
may a
N V}
r {0a0 10W
W W
7%f
7,500/
{’0033 3,000:3
a a I 9
300- IZW’
‘620/- L167, 379,-
? if
’10 " 1‘1/,C
W
309-9 30799”
3,{pop/0
H019 Imp/13
39% 19,gaff”
hoof—9“1,
0095! I50?! 36/0000!
;
17.D
*"nuqxnm?uMnxi?ndut:
M
Hz» ”In! I: M» '44 In 1 h x n .'
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
BASEBID — CDBGACCESSIBLESIDEWALK/ADA PROJECT, CIP No. 5768
EXTENDED
ITEM ESTIMATED UNIT
DESCRIPTION UNIT ITEM
No QUANTITY PRICE AMOUNT
99 TOTAL BASEBID numbers) 373/275
************************************ END oF BASE BID ITEM3 ************************************
ADDITIVEA BID ITEMS AS FOLLOWS:
ITE EXTENDED ESTIMATED
M DESCRIPTIONOF ITEMS
UNI UNIT ITEM
T QUANTITY PRICE
N0 AMOUNT
A1
TOTAL BIDADDITIVEA (numbers) I/
******************************** END OF ADDIT'VEA BID ITEMS BASEBIDTOTAL (in words) a m Mu;
Contractor's Initials M L
ADDITIVEA BID ITEMSTOTAL (in words)
Contractor's Initials ”L
In the event of a variation between the unit price and extended total, the unit price will be used and the corrected extension will be considered as the amount bid. If the bid is illegible and cannot be reconciled it willbe considered non-responsive and will not be considered for award.
If an additive and/oralternate bid schedule is called for in the Contract Documents, the lowest bid will be determined on the basis of the base bid schedule(s) only unless otherwise specified in the Notice Inviting Bids or by Addenda if issued to supersede the Notice Inviting Bids on this specific issue.
For a Contract where a deductive bid schedule is called for, the lowest bid will be determined by the total of all bid schedules including the deductive bid schedu|e(s).
17.D
Knjban.Lu Iomaz 72: 507550
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
Regardless of whether the additive/deductiveor alternates bid items will be considered in determining the low bid, the Agency may elect to include any or none of the additive/ or alternate bid items/schedules, or to otherwise add or remove certain workdeductive from the scope of Work. Accordingly, Contractor warrants that each bid item contains a proportionate share of profit, overhead and other costs and expenses, which will be incurred by the Contractor for the Project.
If equal low bids are received from responsible and responsive bidders the selection shall be made by drawing lots, or other similar random blind method selected by the Agency. If only one responsive bid is received from a responsible bidder the award shall not be made unless the price can be determined to be reasonable based on an analysis by the Agency. The Agency’s determination as to the reasonableness of any such bid shall be final.
The Agency reserves the right to reject any or all bids, to waive any irregularity(ies), and to take all bids under advisement for a period of sixty (60) calendar days after the date the bids are publicly opened. Bidder acknowledges that all costs incurred as a result of preparing the proposal shall be the sole responsibility of Bidder. The Notice Inviting Bids and Instructions to Bidders does not create or impose any obligation upon the Agency to enter into a contract.
Allbids received shall be recorded on an abstract (tabulation) of bids, and then made available for public inspection within two business days of bid opening.
The quantities listed in the bid proposal are provided to give a general indication of the scope of the work and for the comparison of bids. No warranty is made, either expressed or implied, that the actual quantities of work to be done will correspond therewith. Item numbers followed by ”(S)” are designated as specialty items which will not be included towards the calculation of minimum of 50 percent of work to be performed by Contractor’s own forces.
By signing and submitting this bid the Contractor confirms that they are familiar with the work site and all existing conditions that may affect their work and that they have read and agree to all the terms, conditions and requirements contained or referenced herein or in the Contract Documents and that all the aforementioned has been included in the bid prices listed above, including items of work that may not have a specific pay line item and that there shall be no additional costs to the Agency.
WARNING: If an addendum or addenda have been issued by the Agency and not noted above as being received by the bidder, this Bid may be rejected.
Complete the following:
Legal name of the business, DIRReg. and Contractor License Nos.
17.D
M/A
DegrakFund
S‘vmf/u
.77 . {hm . .. .. [6]..
7 S
Whirl/C ,
7” (UM
Ka/bam'nt . (om
WW“ 4 Bidder
mwcwMace mm
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont'd)
or
Business (Corporation, Partnership, Sole Proprietor)
DBA(if ny)
Name nd title of the owner
ki'ra'J— ‘01
Name and title of second partner or officer
26450 km. Pr Av: #201 $54M 6 Wm r/I 7/350
Business Address
(218) 50‘!- to;
Telephone number
( m) 504/4047
Facsimile number
?it/?rm.“ Ln knMaw/5156040].
Name and Email address of primary contact
Company web address
-zz-z (M W ‘k . @‘22-2‘!
Signature of Date Signature of Bidder Date
’ V’86 k.'n'+ {ommik " C F0
Print name and title Print name and title
(Ifthe Bidder is a corporation two signatures of corporate of?cersare required.)
17.D
[ 7 c/nA 1
25 CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont'd)
CERTIFICATEREGARDINGCONTRACTOR'SLICENSE
1. Contractor is required to possess one of the following State Contractor's License:
State of California 50 550 a Contractor's License
Combination of Specialty Class [ [1A ] Contractor’s Licenses
2. A failure to (1) possess the required license, (2) truthfully set forth the following information, and/or(3) execute this Certificate may render the proposal nonresponsive and permit the City to reject the proposal. (Business and Professions Code Section 7028.15)
3. Contractor declares, under penalty of perjury, that he/she/itpossesses the required Contractor's license(s) which:
a Bears the license numberls) [5'0 0
b Expireson 3‘31-20
5’21 Mud?at. <z-zzature of der Date Signature of Bidder ztlDate MAI-[WV Ki'n'i'Sofa-Nola -CFO
Print name and title ?’QSO/QA')“ Print name and title
(Ifthe Bidder is a corporation two signatures ofcorporate of?cersare required.) This required license determination has been made by the Agency. Any Contractor holding a different license who feels he is qualified to bid on this work must so advise the Agency at least seven (7) days prior to the bid opening. The Agency may conduct a review of the contemplated work to re-evaluate the required license determination. The Agency may in its sole discretion maintain or change the required license determination; Agency’s decision as to the required license will be final.
17.D
W M
W
?aw/ma 5,,,,,
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
BID SECURITYFORM FOR CHECK
NOTE:THE FOLLOWINGFORM SHALLBEUSED INTHE CASEOF CHECKACCOMPANYINGBID Accompanying this proposal is a Certified Check or Cashier’s Check payable to the order of the City of Hemet, herei referred to as "Agency", for
dollars ($ , this
amount being 10 percent (10%) of the total amount of the bid. This check shall be returned to the undersigned only if either of the following occurs:
A. Ifsaid Bid shall be rejected by the Agency;
B. If said Bid shall be accepted by the Agency and the Undersigned shall execute and deliver a Contract in the form attached hereto (properly completed in accordance with said Bid) and shall furnish bonds required for his/her/itsfaithful performance of said Contract and for the payment of all persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the Contract created by acceptance of said Bid.
Otherwise, said check shall become the property of the Agency Said Check shall also become the property of the Agency if the Undersigned shall withdraw his/her/itsbid within the period of sixty (60) calendar days after the date set for the opening thereof, unless otherwise required by law, and notwithstanding the award of the Contract to an her bidder
fig Z (kmmx 342—
Signature of Bidder Date Signature of Bidder 2?Date
WWW v ce m,» -40
Print name and title #55I Print name and title
(Ifthe Bidder is a corporation, two signatures ofcorporate officersare required.)
17.D
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont'd)
BID SECURITYFORM FOR BOND
KNOW ALLBYTHESEPRESENTS:
That the undersigned
Kalban, Inc.
(Name of Contractor)
as Principal and the undersigned as Surety are held and firmly bound unto Owner, CITYOF HEMET, a political subdivision of the State of California, as oblige, in the penal sum of Ten Percent of Total Amount Bid------ Dollars($ 10% 0f Bid"“ I lawful money of the United States of America being at least ten percent (10%) of the aggregate amount of said Principal’s base Bid,for the payment of which, well and truly to be made, we bind ourselves, our successors, executors, administrators, and assigns, jointly and severally, firmly by these presents.
WHEREAS,said Principal is submitting a BidforTPROJECT NAMEANDDESCRIPTION] * CDBG FUNDED ACCESSIBLE SIDEWALKIADA PROJECT, CIP NO. 5768 THE CONDITIONOF THIS OBLIGATION lS SUCH that if the Bid submitted by the said Principal be accepted and the Contract be awarded to said Principal and said Principal shall within the required periods enter into the Contract so awarded and provide the required Construction Performance Bond, Construction Labor and Material Payment Bond, insurance certificates, and all other endorsements, forms, and documents required under the Instructions to Bidders, then this obligation shall be void, otherwise to remain in full force and effect.
IN WITNESS WHEREOF, the above bounden parties have executed this instrument this let day of Auaust 20_2_4.
(Month)
Inc.
Principal W, V; 66[7va Everest National Insurance Company Bv
(Corporate Seal)
Surety Rebecca Haas-Bates, Attorney-in-Fact
(Corporate Seal) By
(3/!
17.D
th
‘ Losmos Cnun
Cmmlulon12161579 “
l
. MyComm.ExplmJun 16, 2025!
CALMFOIRNHA NOWLEDGIMENT CIVIL CODE § 1189
Anotary publicorother officercompletingthis certificateverifiesonlythe identityofthe individualwho signedthe document to whichthis certificateis attached, and not the truthfulness, accuracy, or validityofthat document.
State of California
County of
On 6-22" 202‘1 before me,
Date Here Insert Name and Title of Of?cer
personally appeared ‘H' em/ LAM/ring
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.
WITNESS my hand and official seal.
Signature
Place Notary Seal and/or Stamp Above Signature of Notary Public
OPTIONAL
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer’s Name Signer's Name:
Corporate Officer — Title(s): Corporate Officer — Title(s):
Partner — Limited General Partner — Limited General
3 Individual El Attorney in Fact Individual Attorney in Fact El Trustee Guardianor Conservator El Trustee Guardianor Conservator Other: Other:
Signer is Representing Signer is Representing
@2019 National Notary Association
17.D
Namefs?ofSigns/(s;
bra
subscribed to the within instrument and acknowledged to me that he/she/Ihey executed the same in his/harm authorized capacity?as),and that by Why/their signaturebwn the instrument the personfs).
ALMAKARENHERNANDEZ
Maurymu: - Camornla , OlangeCounty 3
Commission: mom ‘
MyComm.ExpiresJan vs,2026
%
Rebecca H as-Bates
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individualwho signed the document to whichthis certificateis attached.and not the truthfulness. accuracy, or validityofthat document.
State of California
County of Orange
On 08/21/2024 before me, Alma Karen Hernandez, Notary Public Date Here Insert Name and Title of the Of?cer
personally appeared Rebecca Haas-Bates
WITNESS my hand and official seal.
Signature
Signature of Notary Public
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Bid Bond Document Date: 03/21/2024 Number of Pages: OnegI) Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer’s Name:
Corporate Officer — Title(s): :l Corporate Officer — Title(s):
Partner — :1 Limited General :| Partner — Limited General Individual ZAttorney in Fact 1: Individual _ Attorney in Fact Trustee Guardian or Conservator l: Trustee Guardian or Conservator Other: Cl Other:
Signer ls Representing: Signer ls Representing:
Everest National Insurance Comoanv
@2014 NationalNotaryAssociation- www.NationalNotary.org- 1-800-US NOTARY(1-800-876-6827) item#5907 who proved to me on the basis of satisfactory evidence to be the person whose name is or the entity upon behalf of which the person acted, executed the instrument.
I certify under PENALTYOF PERJURY under the laws
of the State of California that the foregoing paragraph correct.
17.D
[Aéverest w
POWER OF ATTORNEY
EVEREST REINSURANCE COMPANY and EVEREST NATIONAL INSURANCE COMPANY KNOW ALL PERSONS BY THESE PRESENTS: That Everest Reinsurance Company and Everest National Insurance Company, corporations of the State of Delaware ("Company”) having their principal of?ces located at Warren Corporate Center, 100 Everest Way. Warren.New Jersey, 07059. do hereby nominate.constitute, and appoint:
William Syrkin, Rebecca Haas-Bates, Megan Hilke, Richard Adair itstrue and lawful Attorney(s)—in-facto make, execute, attest, seal and deliver for and on its behalf, as surety, and as its act and deed, where required, any and all bonds and undertakings in the nature thereof.for the penal sum of no one of which is in any event to exceed UNLIMITED, reserving for itself the fullpower of substitution and revocation.
Such bonds and undertakings, when duly executed by the aforesaid Attorney(s)-in-fact shall be binding upon the Company as fully and to the same extent as ifsuch bonds and undertakings were signed by the President and Secretary of the Company and sealed with its corporate seal.
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Board of Directors of Company (“Board") on April21. 2016:
RESOLVED, that the President. any Executive Vice President, and any Senior Vice President are hereby appointed by the Board as authorized to make. execute, seal and deliver for and on behalf of the Company, any and all bonds, undertakings, contracts or obligations in surety or co-surety with others and that the Secretary or any Assistant Secretary of the Company be and that each of them hereby is authorized to attest to the execution of any such bonds, undertakings, contracts or obligations in surety or co-surety and attach thereto the corporate seal of the Company.
RESOLVED, FURTHER, that the President, any Executive Vice President, and any Senior Vice President are hereby authorized to execute powers of attorney qualifying the attorney named in the given power of attorney to execute, on behalf of the Company, bonds and undertakings in surety or co-surety with others, and that the Secretary or any Assistant Secretary of the Company be, and that each of them is hereby authorized to attest the execution of any such power of attorney, and to attach thereto the corporate seal of the Company.
RESOLVED, FURTHER, that the signature of such of?cers named in the preceding resolutions and the corporate seal of the Company may be af?xed to such powers of attorney or to any certi?cate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile seal shall be thereafter valid and binding upon the Company with respect to any bond, undertaking, contract or obligation in surety or co-surety with others to which it is attached.
INWITNESS WHEREOF, Everest Reinsurance Company and Everest National Insurance Company have caused their corporate seals to be af?xed hereto, and these presents to be signed by their duly authorized of?cers this 10lhday of October 2023.
Everest Reinsurance Company and Everest National Insurance Company By: Anthony Romano, Senior Vice President
On this 22"" of March 2023, before me personally came Anthony Romano.known to me, who, being duly sworn, did execute the above instrument:that he knows the seal of said Company; that the seal af?xed to the aforesaid instrument is such corporate seal and was af?xed thereto; and that he executed said instrument by like order.
LINDAROBINS Notary Public. State of New York ‘
' ,) No 01R06239736 f9 Vega:1
,2
Quali?ed In Queens County Term Expires April 25, 2027 Linda Robins. Notary Public I, Sylvia Semerdjian, Assistant Secretary of Everest Reinsurance Company and Everest National Insurance Company do hereby certify that l have compared the foregoing copy of the Power of Attorney and af?davit, and the copy of the Section of the bylaws and resolutions of said Corporation as set forth in said Power of Attorney. withthe ORIGINAL S ON FILE INTHE HOME OFFICE OF SAID CORPORATION, and that the same are correct transcripts thereof.and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in fullforce and effect.
INWITNESS WHEREOF, I have hereunto set my hand and af?xed the seal of said Company, this Zist day of August 202i . 55“ SEAL
1973 1985
*
at By: Sylvia Semerdjian, Assistant Secretary
17.D
MthIw Laww ~W¢ ?rm/«M
b/é?n TMC
St te of California Dim 8122127
W541.
kin"!- CoroL-rhr'a—C0
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
NON-COLLUSIONAFFIDAVIT
PUBLICCONTRACTCODESECTION7106
NON-COLLUSIONDECLARATIONTO BEEXECUTEDBYBIDDERANDSUBMITTEDWITHBID The undersigned declares:
I am the I/llf? Pra’?thk of the party making the
foregoing bid.
The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. All statements contained in the bid are true. 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, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.
Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder.
I declare under penalty of perjury under the laws of the that the foregoing is true and correct and that this declaration is executed [date], at San-MCLn'M[city], (A [state
2 SEE-Z‘/
Signature of Bidder Date Signature of Bidder Date
Print name and title Print name and title
(Ifthe Bidder is a corporation, two signatures of corporate of?cersare required.)
17.D
02/ e n '/ 4'- I’Ia‘z,‘ 2)
: $120 922 Date
5:; 01‘ A/hmm m j. F/m 9 MN“, (+4130!
[n m ‘an a ”Jew Ik I'rr or Dink/ml
24QM 000 i
, ,
Li}! 01‘Tmamr 5'! ?rmware3/1/91;Bum”: [I- 70503
flu. .. ~13- VukwkyCHM/(?. 4 735
1&5‘0090 D
A r/ Frtmn} A! unlit 71" 2
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont'd)
CONTRACTOR’SREFERENCELIST
Attach to this bid a list of three (3) projects in the past five (5) years on which the bidder and hi s
subcontractor(s) have successfully constructed and completed projects with the same type (elements), size and complexity of work. The Agency Engineer will make the final determination of whether the projects listed here are of the same type, size and complexity as this project.
Failure of bidder to supply sufficient documentation of similar electric, telephone, cable and sanitary sewer underground facilities experience shall be considered grounds for non-responsive bid and, at the Agency’s discretion, said bid will be disqualified.
Project Name: a L. 1'4
Contract Price 2 of Completion: (2072)
Name, Address, and Telephone Number of Owner's Representative (62;) $70— 4067 [ob/r4 BI‘aJ
Project Name:
Contract Price: Date of Completion: (12023)
Name, Address, and Telephone Number of Owner's Representative:
3 O
filo) me— 307; a. PM but
Project Name:
Contract Price: 0 ate of Completion: fZOZ 3)
Name, Address, and Telephone Number of Owner's Representative:
(€62) $67“ [/76 Laum £0:de
(Attach additional pages as necessary)
17.D
CDBGACCESSIBLESlDEWALK/ADA PROJECT
cw No. 5768 BIDDER'SPROPOSAL (cont’d)
DESIGNATION OF SUBCONTRACTORS
Name of Subcontractor
and Location of Place Description and Subcontractor's DIR Registration of Business Percentage of Work License No. Number
Vow}5 Tree
12/ ‘ WN‘ a 1.9 A, 651/925 [000001736
(Bidder to attach additional sheets if necessary)
(PUBLICCONTRACTCODE§4100 ETSEQ.)
17.D
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
BIDDERCERTIFICATIONS
TO BEEXECUTEDBYALLBIDDERSANDSUBMITTEDWITHBID
The undersigned Bidder certifies to Owner as set forth in sections 1 through 10, below
STATEMENT OF CONVICTIONS
By my signature hereunder, I hereby swear, under penalty of perjury, that no more than one final, unappealable finding of contempt of court by a Federal Court has been issued against Bidder within the past two years because of failure to comply with an order of a Federal Court or to comply with an order of the National Labor Relations Board.
CERTIFICATIONOF WORKER'SCOMPENSATION INSURANCE
By my signature hereunder, as the Contractor, I certify that I am aware of the Labor Code Section 3700, which requires every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the work of this Contract.
Please note that the submittal of this certificate does not relieve Contractor from complying with all of the insurance requirements of the Public Works Agreement and Contract Documents.
CERTIFICATIONOF PREVAILINGWAGE RATESAND RECORDS
By my signature hereunder, as the Contractor, I certify that I am aware of Labor Code Section 1773, which requires the payment of prevailing wage on public projects. Contractor and any subcontractors under the Contractor shall comply with Labor Code Section 1776 regarding wage records, and with Labor Code Section 1777.5 regarding the employment and training of apprentices. Contractor is responsible to ensure compliance by any and all subcontractors performing work under this Contract.
CERTIFICATIONOF COMPLIANCEWITH PUBLICWORKS CHAPTEROF LABORCODE By my signature hereunder, as the Contractor, I certify that I am aware of Labor Code Sections 1777.1 and 1777.7 Code, and Contractor and Subcontractors are eligible to bid and work on public works projects.
CERTIFICATIONOF NON-DISCRIMINATION
By my signature hereunder, as the Contractor, I certify that there will be no discrimination in employment with regard to race, color, religion, gender, sexual orientation, age or national origin; that all federal, state, and local directives and executive orders regarding non-discrimination in employment will be complied with; and that the principal of equal opportunity in employment will be demonstrated positively and aggressively.
17.D
10 272}
use 0 he a Iicable] MA Mi /‘77A’
State's V
. . . F "E IT I f I ',
2 check d/ar mplete one fallowin
Prequa catio nformation ns true a materia
were a bmitted
herwi par ditio Preq
subm cati rmat emai
CDBGACCESSIBLESIDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL(cont’d)
CERTIFICATIONOF NON-DISQUALIFICATION
By my signature hereunder, as the Contractor, I swear, under penalty of perjury, that the below indicated Bidder, any officer of Bidder, or any employee of Bidder who has a proprietary interest in such Bidder, has never 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 safety regulation, except as indicated on the separate sheet attached hereto entitled ”Previous Disqualifications." If a statement of ”Previous Disqualifications" is attached, please explain the circumstances.
CERTIFICATIONOF ADEQUACYOF CONTRACTAMOUNT
By my signature hereunder, as the Contractor, pursuant to Labor Code Section 2810(a), I certify that, if awarded the Contract based on the undersigned’s Bid, the Contract will include funds sufficient to allow the Contractor to comply with all applicable local, state, and federal laws or regulations governing the labor or services to be provided. I understand that Owner will be relying on this certification ifit awards the Contract to the undersigned.
CERTIFICATIONREGARDINGDIRCONTRACTOR/ SUBCONTRACTORREGISTRATION By my signature hereunder, as the Contractor, I certify that Contractor, and all listed Subcontractors are the subject of current and active contractor registrations pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code.
Contractor’s registration number is [please complete]
Subcontractors’ registration numbers are as indicated in Document 00 4314.
CERTIFICATIONREGARDINGPREQUALIFICATIONINFORMATION[OPTIONAL] By my signature hereunder, as the Contractor, I certify as follows:
a. Contractor prequalified for this Project by submitting its Statement of Qualifications, dated _ __ [L2A ISOQ)
[Ple mplete or strikeout following as in Subsequently, on or about . and Contactor submitted further information supplementing for foregoing ment of Qualifications. c. Alliniermat
d. Contractor has carefully reviewed all of the foregoing QualificationInformation. e. [ Ieas an cc ofthe g]
All lifi n | remai nd correct in all | respects as of
the date hereof, as if such information ctually being su to Owner as of the date hereof.
NZISExcept as ot se expressly set forth in se ate Ad nal ualification Information, itted with the Bid, all Prequalifi on Info ion r ns true and correct in all material respects as of the date hereof, as if such information were
17.D
ddil’io Prequalification
wne -S
__ . “Jam: ..- ?grwlmi
(kn-am 2‘!
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
actually being submitted to Owner as of the date hereof. [Contractor must provide A no] Informationas described above ifthis item is checked.]
CERTIFICATIONOF
[Insert other pecific certifications, if applicable. Otherwise, delete.] BIDDER:
$~22—2tr ‘K. - 22-
Signature of Bidder Date Signature of Bidder Date
Math/$11... I ~ Vt'r’ in}. '4- ‘ yOth.9L " f: F0
Print name and title Print name and title
(Ifthe Bidder is a corporation, two signatures of corporate officersare required.)
17.D
CD {I'/ TIVIM/
(01/ m
EXHIBIT B-4
Required Bid Form
CERTIFICATION OF BIDDER
REGARDING NONSEGREGATED FACILITIES
Project Name: a y 254’-
Name of Bidder: a
The above named Bidder hereby certi?es that:
I do not maintain or provide for my employees any segregated facilities at any of my establishments, and that I do not permit my employees to perform their services at any location, under my control, where segregated facilities are maintained. As used in this certi?cation, the term “segregated facilities” means any waiting rooms, work areas, rest rooms, wash rooms, restaurants and other eating areas, time clocks, locker rooms or other dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, national origin, or because of habits, local customs, or otherwise.
I further agree to obtain identical certi?cations from all proposed subcontractors prior to the award of subcontracts exceeding $10,000.
Signatu
Name (Print): ?mHA/w Human/f
Title: M‘r e pr’r/‘n/rn 4—
‘(
17.D
CDE6 Accgm‘blg{1'1ka [Pl Pit/Err
I. Emgloyment Opportunities
wwwhud‘ gov/section3
available
tial Here
hmszl/hudapgs.hud‘gov/Opportunityl’on
for new ction 3 repo
directed Workforce
employees eluding nistrativ
e construct trades) time of
Pos‘t/available positions
Initial Here
Sign the Section 3 Plan
plannin , and
ard. [EEK/I
wwwlrivcoiobsorg
EXHIBIT 3-6
$200,000 or more
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
" (Housing and Community Development Act of 1968)
Project Title: Amount of Bid: 37% I Z?é 2!
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adeption of, and adherence to, said program, and certifies understanding of the following for all construction contracts over $200,000.
I understand and agree that in the event that I am awarded this contract, and in the event that any new employment opportunities are created as a result of this CDBG—fundedproject, I will:
a.
We
Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be considered for employment opportunities; and HUD Section 3 Opportunity Portal. Ml/ Ini
at:
Forward to the Department of Housing & Workforce Solutions all detailed job descriptions employment opportunities and Se rts, in a form, at aplace, and at a time as by the Department of Housing & Solutions. Initial Here
Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of projected number of available positions, to include job descriptions and wage rates.
Initial Here
Notify Section 3 Coordinator of contractor interests regarding employment of Section 3 workers prior to hiring. [?l/ Initial Here
Submit a list of core (in admi e, clerical, other
positions pertinent to th ion at the contact aw nitial
Here
and advertise job Section 3 workers openings at:
Initial Her»1/
Complete your proposedworkforce plan for this project below. al/
17.D
TRADE
TRADE M9W5
JOB CATEGORY NUMBER OF NUMBER OF NEW HIRES
l RRE
0 1:: 0 SITI (1):; NEW HIRES PROPOSED TO BE
6 OFN53333
:?
TO BE
IF SECTION 3 RESIDENTS
AWARDED
BID
PROFESSIONALS
TECHNICIANS
CONSTRUCTION BY
TRADE
T?iur?rf H O
Afar; q 0
TWMM‘ 5“ 0
g;
APPRENTICE Z ///O 47)
OTHER
OFFICE/ CLERICAL
TRADE
TRADE
TRAINING
17.D
contracting , ,
www.hud.gov/section3
www,hud.gov/seclian3
considered for available employment opportunities;and HUD hmas://hudapps.hudlgov/Qpportunirvl’ortal/ML Initial
Housing &
tial Here
projected number
M 1/ Initial
list of moreemployees eluding administrative, cleri al, lanning, to the construction trad at the time of contact award aL In wwwlrivcoiobsiorg
?lnitial
EXHIBIT 3-6
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
II. Sub Opportunities
m.
I1.
I understand and agree that for any and all subcontracting opportunitiesthat may result from this CDBG-fundedproject, I will contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 Businesses, within City of Hemet, to be considered for available subcontracting opportunities prior to selecting any subcontractor for my bid submittal.
Initial Here
I understand and agree that any and all sub-contracts and sub—tieragreements resulting from this CDBG—fundedproject are also subject to Section 3 compliance, and therefore, as the General/Prime Contractor, I am responsible to ensure compliance from all fl) L subcontractors.
Initial Here
Contact the US. Department of Housing and Urban Development (HUD) Section 3 website at to review the list of certi?ed Section 3 persons, within City of Hemet, to be Section 3 Opportunity Portal
at: Here
Forward to the Department of Housing & Workforce Solutions all detailed job descriptions for new employment opportunitiesand Section 3 reports, in a form, at a place, and at a time as directed by theDelft; ent of Workforce Solutions. is,Ini
Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of of available positions, to includejob descriptions and wage rates.
IIere
Notify Section 3 Coordinator of contractor interests regarding employment of Section 3 workers prior to hiring. MM4 Initial Here
Submit a (in c and other positions
pertinent es) . itial Here
Post available positions and advertise job Section 3 workers openings at:
17.D
AMmad/sswam/4’ ?nally/mi
I. Emglnyment Oggartnniu'es
www.hudlgov/section3
to be considered for available employment opp
Portal. (I? Initial Here
at: htgs?/hudappsrhud.gov/Qggortunigl’onal/
.373;5170
for new employment opportun union3 repo a form, at}.place, directedby the Department of Workforce ons.
lify Secli 3 Coordinatorof
rkers prio hiring. C.”
Submit list of core dministrative
position pertinent to th the time of c
Pos/t/gyailable posirians and advertisejob Sectio 3 workers // Initial Here
(1” Sigmhe Section 3 Plan. Initial Here /
Complete your proposed workforce planfor this roject belo 5%” Ini
www.rivcoiobs.org
EXHIBIT3-6
$200,000 or more
BIDDER CERTIFICATION FOR SECTION3 COMPLIANCE
(Housing and Community Deve10pmentAct of 1968)
Project Title:
The undersigned hereby certi?es that lie/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all construction contracts over $200,000.
I understand and agree that in the event that I am awarded this contract, and in the event that any new employment opportunities are created as a result of this CDBG-fundedproject, I will:
a. COntactthe US. Departmentof Housing and UrbanDevelopment (HUD) Section 3 websiteat F!“
to review the list of certi?ed Section 3 persons, within City of Hemet, ortunities; and HUD Section 3 Opportunity
Forward to the Department of Housing & Workforce Solutions all detailedjob descriptions ities and Se rts, in and at a timeas
Housing & Soluti tial Here
Present a list, of the number of total labor hours, Section 3 worker laborhours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of projectednumber of available positions, to includejob descriptions and wage rates. [/55 Initial Here No
H on contractor interests regarding employment of Section 3 we r to Initial Here
a employees(including a , clerical, planning, and other s 6 construction trades) at ontact award. GE Initial
Here W
n openings at:
p w.
17.D
0 7
U
(J
C)
U
TRADE «
/ L‘!!;0.~:V
JOB CATEGORY
PROFESSIMAIS
TECHNICIANS
OFFICEICLERICAL
CONSTRUCTION BY
TRADE
TRADE
TRADE
TRADE
TRADE
TRADE
APPREN'I'ICE
TRAINING
OTHER
CURRENT
POSITIONS
NUMBER OF
NEW "IRES
IF
AWARDED
BID
NUMBER OF NEW "IRES
PROPOSED TO BE
SECTION 3 RESIDENTS
96 OF NEWIIIRES TO B
SECTION3 E
O U
U
U
17.D
H. Subcontracting Oman-tunities
www.hu¢igov/secu'on3
www.hud.gov/sec§ion3
consideredfor available employment oppon
hugs?/hudapgsthud.gov/ngormnigl’nrtal/
projeg d number of availablepositions, to inc
(f Initial Here
1. NotifySection 3 Co dinator of contractor inte
print to hiring. ( Initial Here
ubmit a list of core employees(including administrative,c cal, pla ' g, and other positions eninent to the constructiontrades) at the time ofcoutaclaw t f '
Initial Here
05: available positions and advertise jab Section 3 work openings at: W ”J Initial Here
i
EXHIBIT8-6
53 gel
BIDDER CERTIFICATION FOR SECTION 3 COMPLIANCE
I understand and agree that for any and all subcontracting Opportunitiesthat may result from this CDBG-?mdedproject, I will contact the US. Departmentof HousingandUrban Development(HUD) Section 3 website at to review the list of certi?ed Section 3 Businesses, within City of Hemet, to be considered for available ' subcontractingopportunities priorto selectingany subcontractorfor my bid submittal.
Initial Here
I understand and agree that any and all sub-contracts and sub-tier agreements resulting from this CDBG-?mded project are also subjectto Section 3 compliance,and therefore, as the General/Prime Contractor, I am responsible to ensure compliance from all subcontractors.
Initial Here
Contact the US. Department of Housing and Urban Development (HUD) Section3 websiteat to review the list of certi?ed Section 3 persons, withinCity of Hemet,to be unities;and HUD Section 3 Opportunity Portal
at: Initial Here
Forward to the Department of Housing & Workforce Solutions all detailedjob descriptionsfor new employmentopportunitiesand Section 3 reports, in a form, at a place, and at a time as directed by the Depa ent of Housing 85Workforce Solutions. ag Initial Here Present a list, of the number of total labor hours, Section 3 worker labor hours, and Targeted Section 3 worker labor hours expected to be generated from the initial contract and a list of ludejob descriptionsand wage rates.
rests regardingemployment of Section 3 workers
S leri
p ard
P ers
17.D
D RE
C25(’2‘ ?agefp‘ék Sv‘v’tM/k(/194-If";
; lax/AMa;
:26 Arr 2! r' 0
REPRESENTA§IVE2 gammy [Mdff‘lé(pm gm
EXHIBIT B-7
Required Bid Form
CITY OF HEMET
CDBG PROGRAM
BID ER CERTIFICATION ON
FE ERAL CONTRACT QUIREMENTS
PROJECT NAME: .60,
CERTIFICATION
I hereby certify that I have reviewed and understand the diversi?ed Federal construction contract related requirements imposed on the Contractor(s) of HUDfunded construction projects, including but not limited to the following:
1 The subject project is being ?nanced with Community Development Block Grant funds (24 CFR Part 5 70);
2. This project and all related construction contracts are subject to the US.
Department of Housing and Urban Development’s Federal Labor Standards Provisions (HUD 4010 — revised 06/2009); and
1 This project is subject to all applicable laws and regulations as listed in the General Summary of these Special Federal Provisions; and 2 If my bid is $200,000 or more, this project and all related contracts willsubject to Section 3 requirements (12 U.S.C.l701u).
CONTRACTOR’S NAME
CONTRACTOR’S LICENSE NO.: 507 5 50
ADDRESS 0
AUTHORIZED 'H Name)
SIGNATURE
$22
17.D
2.6920 mam» Aw 4? 5m « CHI/94 (A 4/
52$ 225
S
L
EXHIBIT B-8
Required Bid Form
QUESTIONNAIREREGARDING BIDDERS
Bidder has been engaged in the contracting business under the present name of Kn/ban 2“C since I q 37 (Date)
Present business address is: 20/ 4 757
Federal Tax ID: ‘75- '-I08170 5 Amount of Bid $ 9’0
California Contractor' License No.2 '507 5 50 Expiration Date: 3 - 3/’2025
UEI Number: N or CAGE Code: 0502 0
Because this project is Federally-?anded,it is necessary to obtain information concerning minority and other group participation for statistical purposes. The US. Department of Housing and Urban Development (HUD) uses this information to determine the degree to which its programs are being utilized by minority business enterprisesand targeted group contractors.
A minority enterprise is de?ned by the Federal Government as a business that is ?fty-one percent (51%) or more “minority-owned”. Please check applicablebox concerning the ownership of your business:
American Indian or Native Alaskan
Asian or Paci?c Islander/NativeHawaiian
Black/African American
Hispanic
White
Hasidic Jews
Other
A woman-owned enterprise is de?ned by the Federal Government as a business that is ?ftypercent (50%) or more woman-owned.Please check applicablebox concerning the ownership of your business:
[I Woman/Female owned EI/Maleowned
A Section 3 Contractor or Subcontractor is a business concern that is more than ?fty-one percent (51%) owned by a low or very low—incomeperson, or a business concern that provides economicopportunities to low and very low—incomeresidents. Please check applicablebox concerning the ownership of your business:
I] Section 3 Business concern Mon-Section 3 Business concern The United States Department of Housing and Urban Development (HUD) is authorized to solicit the information requested in this form by virtue of Title 12, United States Code, Section 1701 et seq., and other regulations. It will not be disclosed or released outside of HUD without your consent, except as required or permitted by law.
17.D
SU'BCONT ACTOR iED, /
V E
‘ m V ”0.50:; 323‘!Quay: (A ‘7215
o
DDRESS/P
I.am ”‘3’"; m 231-! 12?,000
27m l mu
, é?bullbw?. 1A Gig/M917;:L‘s/o?tizzlesoz ?; ”)9 /7
EXHIBIT B-9
Required Bid Form
LIST OF SUBCONTRACTORS
r/ AMOUNT 99 ADDRESS/PHONENO.
' 1 My 7
475135957“ (7M) 777- ‘703
S UP P LlERS
NAME OF SUPPLIER A HONE NO. CONTRACT AMOUNT
“(0/ A»: WM (/3
[206}; 6,4 417 86
I z/
This form is to be completed and submitted with the bid package.
17.D
MUST BE COMPLETED BY ALL CONTRAC
MA fiatasSA/y/t; SIC/(«41%Zm/UI/z’me/ (
// f‘7/ 5km Jr!-
www.hud‘gov/section3
#5—
EXHIBIT13-10
Required BidForm for bids
$200,000or more
SUBCONTRACTORCERTIFICATIONFOR SECTION3 COMPLIANCE
SUB TORS
(Housing and Community DevelopmentAct of 1968)
Project Title:
Subcontractor:
Contractor/Bidder:
The undersigned hereby certi?es that he/she has read and understands City of Hemet's Section 3 Af?rmative Action Program as well as Section 3 of the Housing and Community Development Act of 1968, and further certi?es adoption of, and adherence to, said program, and certi?es understanding of the following for all prime construction contracts over $200,000:
a- I understand and agree that in the event that I am awarded a subcontract,and in the event that any new employment opportunities are created as a resultof this CDBG—fundedproject, I will contact the US. Department of Housingand Urban Development (HUD) Section 3 website at to
review the list of certi?ed Section 3 persons, within City of Hemet, to be considered for available employment opportunities;
Initial Here
b. I will forward to the Department of Housing & WorkforceSolutionsall detailed job descriptions and Section 3 reports, in a form, at a place, and at a time as directedby the Department of Housing & Workforce Solutions.
Initial Here
EXHIBIT B-10 Page 426 of 552
17.D
O 0 0' O
< O O 0
o 0 C)
0 50 /i_
//a
. 7/: <12. m?
Rep! sentative awn/am (9%“
3[Z?2’22
Complete your proposed workforce plan for this project below:
NUMBER 0!“
JOB ammo“ CURRENT NEW mans "UMBER OF NEW m asor NEW31mm B IF E
Pnorosnn'romz POSITI szcnom
AWARDED SECTION 3 RESIDEN'IS
BID
PROFESSIONALS
TECHNICIANS
OFFICEICIJ-IRICAL
CONSTRUCI‘ION BY
TRADE
TRADE
, Cf ( (’r
TRADE
TRADE
TRADE
TRADE
TRADE
APPRENTICE
Cg
TRAINING O
OTHER
TOTAL 0
Subcontractor (Company) N
Authorized (Type Name):
$45:
17.D
LEM
M
(S)
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP N0. 5768 BIDDER'SPROPOSAL
The undersigned hereby proposes to furnish any and all labor, materials, and equipment for the CDBG Accessible Sidewalk/ADAProject, CIP No. 5768, and appurtenant work in connection therewith, said work to be done and materials to be furnished in strict conformity with the Contract Documents, including but not limited to the Notice Inviting Bids, Instructions to Bidders, every Addendum, plans, specifications, General Conditions, Special Provisions, General Provisions, Greenbook 2018 as amended and supplemented, technical references, all other referenced documents, all codes, permit conditions and regulations, for the total amount(s) and any unit prices and additive/deductiveitems shown on this proposal.
The undersigned has examined the location of the proposed work and all local and physical conditions and challenges presented by the Project site, is familiar with the plans, specifications, Contract Documents (particularly as delineated above) and the requirements of the Public Works Contract, and also understands that the Project shall be completely constructed in turn-key condition acceptable to the Owner within the Project time requirements for the price of the proposal, including all fees and sales and/or use tax upon any materials so furnished, including any unit prices and additive/deductiveitems. The undersigned has also carefully checked all of the figures given and understands that the Agency for any errors or omissions on the part of the undersigned in submitting this proposal.
Contractor confirms that his/her/its bid is submitted with respect to the changes to the Contract and/orContract Documents included in all addenda issued by the Owner.
In addition to reaffirming that the changes and information contained in the addenda have been integrated into their proposal, Contractor acknowledges receipt of Addenda No.
The undersigned has examined the current State of California schedule of prevailing wage rates for the types of work to be done on this project (and the Davis-Bacon Act if the Agency uses federal funds for the Project) and agrees to pay not less than these rates.
17.D
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
BIDSCHEDULE
BASE BID — CDBGACCESSIBLESIDEWALK/ADA PROJECT, CIP No. 5768
EXTENDE
ITEM ESTIMATED UNIT D DESCRIPTION UNIT ITEM
No QUANTITY PRICE AMOUNT
1 Mobilization(not to exceed 5%) LS 1
2 Traffic and Pedestrian Control LS 1
3 Temporary Construction Project
Identi?cation Sign EA 2
4 Water Quality Control L8 1
Adjust Ex. Manhole to New F.S
5 per Owner Agency Std. &
Specs. EA 1
5 Remove & relocate existing
mailbox EA 10
7 Adjust Ex. Water Meter
Box/Traff. Box to finish surface EA 6
8 Relocate Ex. Signs and Posts EA 17
9 Remove and Replace Exist ADA
Ramp per City Std.
7 EA 29
1o Construct 4" thick PCC sidewalk
per City Std. SF 12000
11 Construct PCC Driveway SF
Approach per City Std. 1025
12 Remove, Uproot and dispose EA
ex. Tree/tree stump. 8
13 Remove & relocate existing LF
fence/gate 450
Remove Ex. PCC/AC &
14 Construct New PCC driveway SF
approach per City Std. 520
15 Remove & Dispose Ex. Masonry
Wall/Pilaster EA 4
15 Construct type "A"Curb and
Gutter per City Std. LF 225
$ 30,000.00
$ 39,000.00
$ 4,000.00
$ 17,000.00
$ 14,000.00
$ 2,000.00
$ 3,000.00
$ 515.00
$ 13,800.00
$ 18.00
$ 53.00
$ 1,500.00
$ 43.00
$ 70.00
$ 6,200.00
$100.00
$ 30,000.00
$ 39,000.00
$ 8,000.00
$ 17,000.00
$ 14,000.00
$ 20,000.00
$ 18,000.00
$ 10,455.00
$ 400,200.00
$ 218,000.00
$ 59,450.00
$ 12,000.00
$ 19,350.00
$ 36,400.00
$ 24,800.00
$ 22,500.00
17.D
(numbers)
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N/A
$ 947,155.00
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIPNo. 5768 BIDDER'SPROPOSAL(cont’d)
BASEBID — CDBGACCESSIBLESIDEWALK/ADA PROJECT, CIP No. 5768
EXTENDED
l1:2" DESCRIPTION UNIT Egan‘s-:3PURIIIC
TE
ITEM
AMOUNT
TOTAL BASEBID
************************************ END OF BASE BID ITEMS ADDITIVEA BID ITEMS AS FOLLOWS:
ITE EXTENDED
UNI ESTIMATED UNIT
M DESCRIPTIONOF ITEMS T PRICE
ITEM
No QUANT'TY AMOUNT
A1
TOTAL BIDADDITIVEA (numbers)
******************************** END OF ADDITIVEA BID ITEMS ******************************** BASEBIDTOTAL (in words)
Contractor's Initials
ADDITIVEA BID ITEMSTOTAL (in words)
Contractor's Initials
In the event of a variation between the unit price and extended total, the unit price will be used and the corrected extension will be considered as the amount bid. If the bid is illegible and cannot be reconciled it will be considered non-responsive and will not be considered for award.
If an additive and/or alternate bid schedule is called for in the Contract Documents, the lowest bid will be determined on the basis of the base bid schedule(s) only unless otherwise specified in the Notice Inviting Bids or by Addenda if issued to supersede the Notice Inviting Bids on this specific issue.
For a Contract where a deductive bid schedule is called for, the lowest bid will be determined by the total of all bid schedules including the deductive bid schedule(s).
Nine Hundred Forty-Seven Thousand , One Hundred Fifty-Five Dollars
17.D
CDBGACCESSIBLESlDEWALK/ADA PROJECT
CIP No. 5768 BIDDER'SPROPOSAL (cont’d)
Regardless of whether the additive/deductiveor alternates bid items will be considered in determining the low bid, the Agency may elect to include any or none of the additive/ or alternate bid items/schedules, or to otherwise add or remove certain workdeductive from the scope of Work. Accordingly, Contractor warrants that each bid item contains a proportionate share of profit, overhead and other costs and expenses, which will be incurred by the Contractor for the Project.
If equal low bids are received from responsible and responsive bidders the selection shall be made by drawing lots, or other similar random blind method selected by the Agency. If only one responsive bid is received from a responsible bidder the award shall not be made unless the price can be determined to be reasonable based on an analysis by the Agency. The Agency’s determination as to the reasonableness of any such bid shall be final.
The Agency reserves the right to reject any or all bids, to waive any irregularity(ies), and to take all bids under advisement for a period of sixty (60) calendar days after the date the bids are publicly opened. Bidder acknowledges that all costs incurred as a result of preparing the proposal shall be the sole responsibility of Bidder. The Notice Inviting Bids and Instructions to Bidders does not create or impose any obligation upon the Agency to enter into a contract.
Allbids received shall be recorded on an abstract (tabulation) of bids, and then made available for public inspection within two business days of bid opening.
The quantities listed in the bid proposal are provided to give a general indication of the scope of the work and for the comparison of bids. No warranty is made, either expressed or implied, that the actual quantities of work to be done will correspond therewith. Item numbers followed by ”(S)” are designated as specialty items which will not be included towards the calculation of minimum of 50 percent of work to be performed by Contractor’s own forces.
By signing and submitting this bid the Contractor confirms that they are familiar with the wor k
site and all existing conditions that may affect their work and that they have read and agree to all the terms, conditions and requirements contained or referenced herein or in the Contract Documents and that all the aforementioned has been included in the bid prices listed above, including items of work that may not have a specific pay line item and that there shall be no additional costs to the Agency.
WARNING:If an addendum or addenda have been issued by the Agency and not noted above as being received by the bidder, this Bid may be rejected.
Legal name of the business, DIRReg. and Contractor License Nos.
Complete the following:
HZS Engineering Inc Dba HZS Constructio Lic -1039476
17.D
MWorn/771L
CDBGACCESSIBLESIDEWALK/ADA PROJECT
ClP No. 5768 BIDDER'SPROPOSAL (cont’d)
Name and title of the owner
Business Address
Telephone number
Facsimilenumber
Name and Emailaddress of primary contact
Company web address
Date Signature of Bidder Date
Print name and title Print name and title
(If the Bidder is a corporation two signatures ofcorporate of?cersare required.) Corporation
N/A
(949) 415 9556
Hamid Shekaramiz [email protected]
Business Type (Corporation, Partnership, Sole Proprietor) HZS Engineering Inc Dba HZS Construction
DBA(if any)
Name and title of second partner or of?cer
1403 N. Batavia St Unit 108 , Orange, CA. 92867
Signature of Bidder
Hamid Shekaramiz