12100-0001\2654178v1.doc
City of MB Form
B-1
BID
CITY OF MANHATTAN BEACH
Polliwog Park Fitness Station Replacement Project
TO THE HONORABLE MAYOR AND CITY COUNCIL OF THE CITY OF MANHATTAN BEACH:
The undersigned, as Bidder, declares that: (1) this Bid is made without collusion with any other person and that the only persons or parties interested as principals are those named herein; (2) the undersigned has carefully examined the Contract Documents (including all Addenda) and the Project site; and (3) the undersigned has investigated and is satisfied as to the conditions to be encountered, the character, quality and quantities of Work to be performed, and the materials to be furnished. Furthermore, the undersigned agrees that submission of this Bid shall be conclusive evidence that such examination and investigation have been made and agrees, in the event the Contract be awarded to it, to execute the Contract with the City of Manhattan Beach to perform the Project in accordance with the Contract Documents in the time and manner therein prescribed, and to furnish or provide all materials, labor, tools, equipment, apparatus and other means necessary so to do, except as may otherwise be furnished or provided under the terms of the Contract Documents, for the following stated unit prices or lump-sum price as submitted on the Bid herein.
This Bid is made with the full knowledge of the kind, quantity, and quality of the materials and Work required and, if it is accepted by the City, the Bidder shall enter into a Contract and furnish the bonds, insurance, and other documents as required by the Contract Documents within ten calendar days after award of the Contract. The Bidder agrees that failure to execute and return the Contract or the required faithful performance bond, labor and materials payment bond, warranty bond, and insurance certificates to the City within the ten calendar day period shall be sufficient cause for the rescission of the award and forfeiture of the Bid Security to the City to the extent permitted by law.
Accompanying this Bid is cash, a cashier’s check, a certified check or a Bid Bond in an amount equal to at least ten percent of the total aggregate Bid price based on the quantities shown and the unit prices quoted. The undersigned further agrees that, should it be awarded the Contract and thereafter fail or refuse to execute the Contract and provide the required evidence of insurance and Bonds within ten calendar days after delivery of the Contract to the undersigned, then the cash, check or Bid Bond shall be forfeited to the City to the extent permitted by law.
City of Manhattan Beach
Polliwog Park Fitness Station Replacement Project (E1290-24C), bidding on 02/01/2024 11:00 AM (PST)
Printed 02/01/2024
PlanetBids
12100-0001\2654178v1.doc
City of MB Form
B-2
CITY OF MANHATTAN BEACH
BID SCHEDULE FOR
Polliwog Park Fitness Station Replacement Project
Bidder’s Name:
Bidder’s Address:
To the Honorable Mayor and Members of the City Council:
In compliance with the Notice Inviting Bids, the undersigned hereby agrees to execute the Contract to furnish all labor, materials, equipment and supplies for the Project in accordance with the Contract Documents to the satisfaction and under the direction of the City Engineer, at the following prices:
Base Bid Items as Follows:
BASE BID SCHEDULE:
ITEM
NO.
CODE
DESCRIPTION
UNIT ESTIMATED
QUANTITY
UNIT
PRICES
EXTENDED
AMOUNT
1 %
Mobilization (10%
maximum of Total Bid
Price)
LS 1 $
$
2 %
Stormwater Pollution
and Erosion Control
Best Management
Practices (BMP)
LS 1 $ $
3 %
Traffic control, site
security, project
phasing and maintain
all pedestrian access
to/from park areas for
the duration of the
Work
LS 1 $ $
4 %
Temp. Construction
Fencing and Protection
of Excavation for the
duration of the Work
LS 1 $ $
5 C
Cap and relocate
existing irrigation.
Coordinate with City
staff. Join existing,
where occurs
LS 1 $ $
6 S,%
Construction Surveying
and Third Party
Material Testing
LS 1 $ $
7 C
Remove and legally
dispose of existing
rubber mulch, fitness
LS 1 $ $
Oppenheimer National
31878 Del Obispo STE 118510 San Juan Capo CA 92675 17,000.00
17,000.00
6875.00
6875.00
4875.00
4875.00
5875.00
5875.00
5375.00
5375.00
8875.00
8875.00
12000.00
12,000.00
12100-0001\2654178v1.doc
City of MB Form
B-3
equipment, posts,
foundations, signs, and
all related work per
plan. Over-excavate
and re-compact
subgrade per plan
8 C
Remove and dispose
of existing concrete
mow curb
LS 1 $ $
9 C
Remove and dispose
of existing chain link
fencing
LS 1 $ $
10 Remove and dispose
of existing concrete
sidewalk
SF 550 $ $
11 Remove existing
perimeter turf and soil,
as required to establish
finish grade
SF 650 $ $
12 Grading for slab and
fitness station area SF 1,150 $ $
13 Construct fitness court
6” reinforced concrete
slab over gravel base
per current
manufacturer (NFC)
drawings and
specifications
SF 1,150 $ $
14 Construct PCC
sidewalk per City MB
Std Plan MBSI-112A
SF 850 $ $
15 Compact perimeter soil
to finished grade and
replace grass turf
SF 400 $ $
16 Construct 4” PVC pipe
and NDS drain and all
related work
EA 4 $ $
17 Prep and Prime Coat
and Paint existing
canopy steel posts and
sign post
EA 5 $ $
18 C
Inventory, Pickup from
City Yard and Deliver
fitness station
equipment to project
site
LS 1 $ $
19 S, C
Install City Furnished
fitness area tile and
equipment per current
manufacturer (NFC)
drawings, instructions,
and specifications, and
LS 1 $ $
6875.00
6875.00
4375.00
4375.00
10.68 5874.00
6.73 4374.50
5.98 6877
13.73 15789.50
8.80 7480.00
12.20 4880.00
718.75
2875.00
1175
5875.00
4875.00
4875.00
12,575.00
12,575.00
12100-0001\2654178v1.doc
City of MB Form
B-4
all related work
20 C
Special project site
maintenance and
public convenience and
safety (see Section 3-
12)
LS 1 Not-to-
Exceed $ 5,000
TOTAL BASE BID SCHEDULE (ITEMS 1 – 20): $
ADDITIVE ALTERNATE BID SCHEDULE A: ADDITIONAL PARK AREA SIDEWALK
ITEM
NO.
CODE
DESCRIPTION
UNIT ESTIMATED
QUANTITY
UNIT
PRICES
EXTENDED
AMOUNT
21 Remove and dispose
of existing asphalt
sidewalk
SF 1,300 $ $
22 Remove existing
perimeter turf and soil,
as required to establish
finish grade
SF 1,000 $ $
23 %
Temp. Construction
Fencing and Protection
of Excavation for the
duration of the Work
LS 1 $ $
24 C
Cap and relocate
existing irrigation.
Coordinate with City
staff. Join existing,
where occurs
LS 1 $ $
25 Construct PCC
sidewalk per City MB
Std Plan MBSI-112A
SF 1,500 $ $
26 Compact perimeter soil
to finished grade and
replace grass turf
SF 1,000 $ $
TOTAL ADDITIVE ALTERNATE BID SCHEDULE A (ITEMS 20 – 26): $
NOTES:
1) In the CODE column (S) denotes a specialty item, (%) denotes progress payments for that lump sum item will be allowed based on the percentage of completion in each pay period, and (C) denotes payments will be made after the completion of the lump sum item.
See Subsection 9-2.1 of the General Provisions for details.
2) In the UNIT column (LS) denotes a lump sum item. See Section 9 of the General Provisions for details.
4.77 3.70
3700.00
6201.00
1500
1500.00
8 12,000.00
5.50 5500.00
148,600.00
$1400.00
$1400.00
30,301.00
City of Manhattan Beach
Polliwog Park Fitness Station Replacement Project (E1290-24C), bidding on 02/01/2024 11:00 AM (PST)
Printed 02/01/2024
PlanetBids
City of Manhattan Beach
Polliwog Park Fitness Station Replacement Project (E1290-24C), bidding on 02/01/2024 11:00 AM (PST)
Printed 02/01/2024
PlanetBids
12100-0001\2654178v1.doc
City of MB Form
B-5
3) Estimated quantities are for the purpose of Bid comparison only; payments will be made on the basis of actual measurement of Work completed, except for lump sum (LS) items.
For lump sum items, see Note 1. The Bid Price shall include, but not limited to, sales tax and all other applicable taxes and fees.
4) Items may be adjusted or deleted. Therefore, regardless of total actual volume (percentage) compared to estimated quantities, the unit prices provided above by the Bidder shall be applied to the final quantity when payment is calculated for these items.
No adjustment in the unit prices will be allowed. The City reserves the right to not use any of the estimated quantities; and if this right is exercised, the Contractor will not be entitled to any additional compensation. Cost of all export of material shall be included in the above unit costs; no additional compensation will be granted for such expenses.
Total Bid Price = Base Bid Schedule Amount Plus (+) All Additive Bid Schedule Amounts
SIGNATURE PAGE TO FOLLOW
12100-0001\2654178v1.doc
City of MB Form
B-6
TOTAL BID PRICE IN DIGITS: $
TOTAL BID PRICE IN WORDS:
The undersigned certifies to have a minimum of three consecutive years of current experience in the type of Work related to the Project and that this experience is in actual operation of the firm with permanent employees performing a part of the Work as distinct from a firm operating entirely by subcontracting all phases of the Work. The undersigned also certifies to be properly licensed by the State as a contractor to perform this type of Work. The undersigned possesses California Contractor’s License
Number , Class
, which expires on .
Signature: Title: Date:
Signature:
Title:
Date:
1095956
A&B
08/31/2024
Vice President
1/31/24
1/31/24
CFO
178,901.00
One Hundred Seventy Eight Thousand and Nine Hundred and one Dollar 12100-0001\2654178v1.doc
City of MB Form
B-7
BIDDER’S PROPOSAL – CONTRACTOR’S STATEMENT
Polliwog Park Fitness Station Replacement Project
Fill out all of the following information. Attach additional sheets if necessary.
(1) Bidder’s Name:
(2) If the Bidder’s name is a fictitious name, who or what is the full name of the registered owner? If the Bidder’s name is not a fictitious name, write “N/A” in the response to this question. If you are doing business under a fictitious name, provide a copy of the filed valid Fictitious Business Name Statement.
(3) Business Address:
(4) Telephone: Email:
(5) Type of Firm – Individual, Partnership, LLC or Corporation:
(6) Corporation organized under the laws of the State of:
(7) California State Contractor’s License Number and Class:
Original Date Issued: Expiration Date:
(8) DIR Contractor Registration Number:
(9) List the name and title of the person(s) who inspected the Project site for your firm:
(10) Number of years’ experience the company has as a contractor in construction work:
(11) List the names, titles, addresses and telephone numbers of all individuals, firm members, partners, joint ventures, and company or corporate officers having a principal interest in this Bid:
(12) List all current and prior D.B.A.’s, aliases, and fictitious business names for any principal having interest in this Bid:
Oppenheimer National
N/A
31878 Del Obispo STE 118510 San Juan Capo CA 92675 949 264- 2640
[email protected]
Corporation
California
1095956
A&B
08/30/2022
08/31/2024
1000975733
Tee Teymoorian - Vice President
3 Rusteen Hadjilou CEO Teerun Teymoorian Vice President Abtin Teymoorian Director Arman Fard-Ghassemi CFO
Shayan Teymoorian Secretary
N/A
12100-0001\2654178v1.doc
City of MB Form
B-8
(13) List the dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in this Bid:
(14) For all arbitrations, lawsuits, settlements and the like (in or out of court) that the company or any principal having an interest in this Bid has been involved with in the past five years:
a. List the names, addresses and telephone numbers of contact persons for the parties:
b. Briefly summarize the parties’ claims and defenses:
c. State the tribunal (e.g., Superior Court, American Arbitration Association, etc.), the matter number, and the outcome:
(15) Has the company or any principal having an interest in this Bid ever had a contract terminated by the owner or agency? If yes, explain.
N/A
N/A
N/A
N/A
NO
12100-0001\2654178v1.doc
City of MB Form
B-9
(16) Has the company or any principal having an interest in this Bid ever failed to complete a project? If yes, explain.
(17) Has the company or any principal having an interest in this Bid ever been terminated for cause, even if it was converted to a “termination of convenience”? If yes, explain.
(18) For projects that the company or any principal having an interest in this Bid has been involved with in the last five years, did you have any claims or actions:
a. By you against the owner? Circle one: Yes No
b. By the owner against you? Circle one: Yes No
c. By any outside agency or individual for labor compliance? Circle one: Yes No
d. By Subcontractors? Circle one: Yes No
e. Are any of these claims or actions unresolved or outstanding? Circle one: Yes No
If your answer is “yes” to any part or parts of this question, explain.
(19) Has the company or any of its principals ever been debarred by any agencies? Is yes, please explain.
NO
No
N/A
N/A
12100-0001\2654178v1.doc
City of MB Form
B-10
10 (
20) For all public agency projects in excess of $15,000.00 that you are currently working on or have worked on in the past two years, provide the following information:
Project 1 Name/Number
P
roject Description
A
pproximate Construction Dates From: To:
Agency Name:
Contact Person: Telephone:
Address:
Original Contract Amount: $ Final Contract Amount: $
If final amount is different from original amount, please explain (change orders, extra work, etc.).
Did you or any Subcontractor, file any claims against the Agency? Circle one: Yes No
Did the Agency file any claims against you? Circle one: Yes No If you answered yes to either of the above two questions, please explain and indicate outcome of claims.
Project 2 Name/Number
P
roject Description
A
pproximate Construction Date From: To:
Agency Name:
Contact Person: Telephone:
Address:
Original Contract Amount: $ Final Contract Amount: $
If final amount is different from original amount, please explain (change orders, extra work, etc.).
Acacia Park City of Fullerton
Park Improvements
Dec 2023
Sep 2023
City of Fullerton
Joseph Hernandez
714-773-0049
303 W Commonwealth Ave Fullerton CA 92832
238,665.50
$258,200.65
Minor change orders and requested extra work and additonal fencing N/A
Laguna Hills Sports Complex Site Improvements
Park and complex Improvements
Oct 2023
Jan 2024
City of Laguna Hills
Joe Ames
949-707-2655
197,709.80
262,894.60
Alternate bid items per request of the city
25555 Alicia Parway Laguna Hills CA 92653
12100-0001\2654178v1.doc
City of MB Form
B-11
11 Di
d you or any Subcontractor, file any claims against the Agency? Circle one: Yes No
Did the Agency file any claims against you? Circle one: Yes No If you answered yes to either of the above two questions, please explain and indicate outcome of claims.
Project 3 Name/Number
P
roject Description
Approximate Construction Dates From: To:
Agency Name:
Co
ntact Person: Telephone:
Address:
Original Contract Amount: $ Final Contract Amount: $
If final amount is different from original amount, please explain (change orders, extra work, etc.).
Did you or any Subcontractor, file any claims against the Agency? Circle one: Yes No
Did the Agency file any claims against you? Circle one: Yes No If you answered yes to either of the above two questions, please explain and indicate outcome of claims.
Project 4 Name/Number
P
roject Description
Approximate Construction Dates From: To
N/A
English Springs R&R
remove and restore cocnrete for park pathway
Nov 2023
Dec2023
City of Chino Hills
Luther Martin
909-364-2849
14000 city center Dr Chino Hills Ca 91709
96,750.00
$101,400.00
Change Order for extra work
N/A
La Puente Park Coffee Kiosk Installation
Coffee Kiosk Installation Concrete and site work
April2023
May2023
12100-0001\2654178v1.doc
City of MB Form
B-12
Agency Name:
Contact Person: Telephone:
Address:
Original Contract Amount: $ Final Contract Amount: $
If final amount is different from original amount, please explain (change orders, extra work, etc.).
Did you or any Subcontractor, file any claims against the Agency? Circle one: Yes No
Did the Agency file any claims against you? Circle one: Yes No
If you answered yes to either of the above two questions, please explain and indicate outcome of claims.
Project 5 Name/Number
Project Description
Approximate Construction Dates From: To:
Agency Name:
Contact Person: Telephone:
Address:
Original Contract Amount: $ Final Contract Amount: $
If final amount is different from original amount, please explain (change orders, extra work, etc.).
Did you or any Subcontractor, file any claims against the Agency? Circle one: Yes No
Did the Agency file any claims against you? Circle one: Yes No City of La Puente
Juan Galvan
626-855-1538
15900 east main st La Puente Ca 91744
64,425.80
74,000.00
Change Order for extra work
N/A
Cypress Citywide Park improvments 310D
Park Improvements along park and benches
June 2023
June2023
City of Cypress
Baruc Bravo
714 -229-6747
5275 Orange Avenue Cypress, CA 90630
34,080.00
37,759.00
Change order for extra concrete pad
12100-0001\2654178v1.doc
City of MB Form
B-13
If you answered yes to either of the above two questions, please explain and indicate outcome of claims.
Project 6 Name/Number
Project Description
Approximate Construction Dates From: To:
Agency Name:
Contact Person: Telephone:
Address:
Original Contract Amount: $ Final Contract Amount: $
If final amount is different from original amount, please explain (change orders, extra work, etc.).
Did you or any Subcontractor, file any claims against the Agency? Circle one: Yes No
Did the Agency file any claims against you? Circle one: Yes No
If you answered yes to either of the above two questions, please explain and indicate outcome of claims.
[Continue to Next Page]
N/A
Cypress Citywide Park improvments 310E
Demo current park drinking fountains , furnishing and installing new drinking fountains Dec 2023
Dec 2023
City of Cypress
Baruc Bravo
714-229-6747
5275 Orange Avenue Cypress, CA 90630
$33,750.00
$33,750.00
N/A
N/A
12100-0001\2654178v1.doc
City of MB Form
B-14
Upon request of the City, the Bidder shall furnish evidence showing a notarized financial statement, financial data, construction experience, or other additional information.
Failure to provide truthful answers to the questions above or in the following References Form may result in the Bid being deemed non-responsive.
Urban Runoff Certification. The Bidder certifies to the City that he/she has trained his/her employees and Subcontractors, if any, for Urban Runoff management and has included sufficient sums in the Bid Price to cover such costs of training as stipulated in the most current Regional Water Quality Control Board requirements, including the Municipal Separate Storm Sewer System National Pollutant Discharge Elimination System (NPDES) Permit. The Contractor is responsible for all clean up and payment of all fines levied as a result of any illegal discharge (as defined in NPDES permit) occurring as a result of the Contractor’s Work and/or operations.
I, the undersigned, certify and declare that I have read all the foregoing answers to the Bidder’s Proposal – Contractor’s Statement and know their contents. The matters stated in the Bidder’s Proposal – Contractor’s Statement answers are true of my own knowledge and belief, except as to those matters stated on information and belief, and as to those matters I believe them to be true. I declare under penalty of perjury under the laws of the State of California that the foregoing is correct.
Company
Signature:
Name:
Title:
Date:
Signature:
Name:
Title:
Date:
Tee Teymoorian
Vice President
1/31/24
Arman Fard-Ghassemi
CFO
1/31/24
12100-0001\2654178v1.doc
City of MB Form
B-15
DE
SIGNATION OF SUBCONTRACTORS
[Public Contract Code Section 4104]
Polliwog Park Fitness Station Replacement Project
L
ist all Subcontractors who will perform Work or labor or render service to the Contractor in or about the construction of the Work or improvement, or a Subcontractor licensed by the State of California who, under subcontract to the Contractor, specially fabricates and installs a portion of the Work or improvement according to detailed drawings contained in the Plans and Specifications, in an amount in excess of one-half of one percent of the Contractor’s total Bid or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one-half of one percent of the Contractor’s total Bid or $10,000.00, whichever is greater. If all Subcontractors do not fit on this page, attach another page listing all information for all other Subcontractors.
Name under which
Subcontractor is
Licensed
and Registered
CSLB License
Number(s) and
Class(es)
DIR
Contractor
Registration
Number
Address and Phone Number Type of Work
(e.g., Electrical)
Percentage of Total
Bid (e.g., 10%)*
*T
he percentage of the total Bid shall represent the “portion of the work” for the purposes of Public Contract Code Section 4104(b).
T&M Surveying
1000053063
LS9309
531 E. TRENTON ST ORANGE CA 92867
Survey
4%
TT
Bond No. N/A ----
BID BONO
Polliwog Park Fitness Station Replacement Project
KNOW ALL PERSONS BY THESE PRESENTS that
WHEREAS the City of Manhattan Beach ("City"), has issued an invitation for Bids for the Work described as follows: Installation of fitness slab and fitness equipment for a city park WHEREAS Oppenheimer National of 31878 Del Obispo St. San Juan Capistrano, CA 92675 (Name and address of Bidder)
("Principal"), desires to submit a Bid to City for the Work.
WHEREAS, Bidders are required to furnish a form of Bidder's security with their Bids.
NOW, THEREFORE, we, the undersigned Principal, and Old Republic Surety Company of 445 S. Moorland Rd. Suite 200, Brookfield, WI 53005
(Name and address of Surety)
("Surety"), a duly admitted surety Insurer under the laws of the State of California, as Surety, are held and firmly bound unto the City in the penal sum of ten percent (10%) of the total bid amount Dollars($ ________ ), being not less than ten percent of the total Bid price, In lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal is awarded the Contract for the Work by the City and, within the time and In the manner required by the bidding specifications, enters Into the written form of Contract included with the bidding specifications, furnishes the required Bonds (one to guarantee faithful perfomiance and the other to guarantee payment for labor and materials), and furnishes the required insurance coverage, then this obligation shall become null and void; otherwise, it shall be and remain In full force and effect.
In case suit is brought upon this instrument, Surety further agrees to pay all court costs incurred by the City in the suit and reasonable attorneys' fees In an amount fixed by the court. Surety hereby waives the provisions of Civil Code Section 2845. 12100-0001126S4178v1 .doc
City of MB Fonn
B-16
IN WITNESS WHEREOF, this instrument has been duly executed by Principal and Surety, on the date set forth below, the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representatlve(s} pursuant to authority of its governing body.
Dated: February 1st, 2024
"Principal"
Name: OPPENHEIMER NATIONAL
Address: 31878 Del Obispo St.
San Juan Capistrano, CA 92675
Telephone No.
::r
Q
Signature: �z -=-
P�nt Name: f:- c,e ·Jii y•. 0r;.--
T1tle: v,·c.,. trrs}.A--Dato: li'.'i\�
Signature:--�----..-:;.""""'---,,---
Print Name: 4hc::so r"'.2.0 ,4.�-;.,,"V"\-
Title: c..1-�
Date: , rs I /'L '1
"Surety"
OLD REPUBLIC
Company Name: SURETY COMPANY
Address: 445 s. Moorland Rd, Suite 200
Brookfield, WI 53005
Telephone No.: 800-217�1792
Signatur��
Print Name: Zachary Mefferd
Title: Attorney-in-Fact
Date: February 1st. 2024
:s
NOTE: This Bond must be dated, all signatures must be notarized, and evidence of the authority of any parson signing as attomay-ln-fact must be attached.
12100-0001\21S4178v1 .doc
City of MB Foffll
B-17
Notary Certificat_e
Attached
12100-0001\2654178v1.doc
City of MB Form
B-18
NO
NCOLLUSION DECLARATION FORM
TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID
[Public Contract Code Section 7106]
Polliwog Park Fitness Station Replacement Project
T
he 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 directly or indirectly colluded, conspired, connived, or agreed with any Bidder or anyone else to put in a sham Bid, or to refrain from bidding. 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], [state].
S
ignature:
Printed Name:
S
ignature:
Printed Name:
Date: Date:
Tee Teymoorian
01/31/24
01/31/24
Arman Fard-Ghassemi
Vice President
Oppenheimer National
01/31/24
san juan capistrano
California
12100-0001\2654178v1.doc
City of MB Form
B-19
A
DDENDA ACKNOWLEDGMENT FORM
Polliwog Park Fitness Station Replacement Project
B
idder’s Name:
The Bidder shall signify receipt of all Addenda here, if any:
Addendum Number Date Received Signature
I
f there are more Addenda than there is room in the chart above, attach another page acknowledging receipt of the Addenda.
Oppenheimer National
N/A