CITY OF MARYSVILLE July 13, 2023
2023 MEASURE C / SB-1 PAVEMENT PROJECT Addendum No. 3
CONTRACT NO. 23-01
THE CITY OF MARYSVILLE
MARYSVILLE, CA
ADDENDUM NO. 3
CITY OF MARYSVILLE
2023 MEASURE C / SB-1 PAVEMENT PROJECT
CONTRACT NO. 23-01
The purpose of this Addendum No. 3 is to notify Bidders of clarifications to the Project Plans for the above project. This Addendum shall be attached to and become a part of said Contract Documents.
THIS ADDENDUM SHALL BE SIGNED BY THE BIDDER, DATED AND SUBMITTED WITH THE PROPOSAL FOR THE PROJECT.
Bidder Questions / Clarifications:
1. Question: Bid schedule A item 11 “Install Accessible Ramp” is listed as 7 EA, but the ramp at the southwest corner of Hansen Street has a double ramp, is this correct? Response: Yes, the Install Accessible Ramp item each was intended for each corner or location, so the detail D2 ramp double ramp would count as one each.
2. Question: Bid schedule D item 4 “'HMA 1/2" is listed as 500 tons, is significantly low, is it correct?
Response: No, the correct tonnage is 830 tons, see revised bid schedule in the attached revised proposal.
3. Question: Additive Bid schedule 2 item 2 “Micro-Mill 0.10' Minimum Depth" is listed as 92,000 square feet is much greater than the plan area of 60,620 square feet, is it correct? Response: No, the correct area is 61,000 square feet, this also affects Additive Bid schedule 2 items 5 & 6 quantities see revised bid schedule in the attached revised proposal.
4. Question: Additive Bid schedule 3 item 6 “'HMA 1/2" is listed as 370 tons, seems high, is it correct?
Response: It is correct the section for this segment should be listed as 4”.
Bid proposal Time & Date:
The time that Sealed proposals will be received at the City Clerk’s Office, City of Marysville, located at City Hall, 526 C Street, Marysville, California, 95901, has been revised to until 2:00 P.M. on Monday, July 17, 2023, at which time they will be publicly opened and read aloud CITY OF MARYSVILLE July 13, 2023
2023 MEASURE C / SB-1 PAVEMENT PROJECT Addendum No. 3
CONTRACT NO. 23-01
Attachments: Revised proposal with page 4 revised.
BIDDER: PREPARED BY:
NAME CITY OF MARYSVILLE
DATED: July 13, 2023
ADDRESS
SIGNATURE
Bid opening date has been revised to July 17,
DATE: 2023 and time are not changed from 2 PM by
this Addendum No. 3
PROPOSAL TO THE PUBLIC WORKS DEPARTMENT
CITY OF MARYSVILLE
NAME OF BIDDER:
TITLE:
SIGNATURE OF BIDDER:
COMPANY NAME:
CONTRACTOR LICENSE NO. CLASSIFICATION
BUSINESS ADDRESS:
TELEPHONE NO.: AREA CODE ( )
PLACE OF RESIDENCE:
The work to be done and referred to herein is in Marysville, State of California, and shall be constructed in accordance with the Special Provisions (including the payment of not less than the minimum wage rates set forth therein) and the contract annexed hereto and also in accordance with the Standard Plans dated 2022, the Standard Specifications dated 2022, the wage rates of the General Prevailing Wage Rates of the Department of Transportation, and the equipment rental rate and labor surcharge portions of the publication entitled “Labor Surcharges and Equipment Rental Rates.”
The work to be done in accordance with the Special Provisions entitled:
2023 MEASURE C / SB-1 PAVEMENT PROJECT
Bids are submitted for the entire work. The amount of the bid, for comparison purposes, will be the total of all items. The total of unit basis items will be determined by extension of the item price on the basis of the estimated quantity set forth for the item.
The bidder shall set for each item of work, in clearly legible figures, an item price and a total for the item in the respective spaces provided for this purpose. In the case of unit basis items, the amount set forth under the “Total” column shall be the extension of the item price bid on the basis of the estimated quantity for the item.
In case of discrepancy between the item price and the total set forth for the item, the item price shall prevail; provided, however, if the amount set forth as an item price is ambiguous, unintelligible or uncertain for any cause or is omitted, or in the case of unit basis items is the same amount as the entry in the “Total” column, then the amount set forth in the “Total” column for the item shall prevail in accordance with the following:
1. As to lump sum items, the amount set forth in the “Total” column shall be the item price.
2. As to unit basis items, the amount set forth in the “Total” column shall be divided by the estimated quantity for the item and the price thus obtained shall be the item price.
If this proposal shall be accepted and the undersigned shall fail to enter into the contract and to furnish the two bonds in the sums to be determined as aforesaid with surety satisfaction to the City of Marysville, within fifteen (15) days, not including Sundays and legal holidays, after the bidder has received notice from the Director of Public Works that the contract has been awarded, the City of Marysville may, at its option, determine that the bidder has abandoned the contract, and thereupon this proposal and the acceptance thereof shall be null and void and the forfeiture of such security accompanying this proposal shall operate and the same shall be the property of the City of Marysville.
The undersigned, as bidder, declares that he/she has received Addendum Nos. ____, ____, ____, ____, ____, ____, ____.
The undersigned, as bidder, declares that the only persons or parties interested in this proposal as principals are those named herein, that this proposal is made without collusion with any other person, firm, or corporation, and in submitting this proposal the undersigned bidder agrees that if it is determined that he is the successful bidder, he will execute the attached non-collusion affidavit, that he has carefully examined the location of the proposed work, the annexed proposed form of contract, and the plans therein referred to, and he proposes and agrees, if this proposal is accepted, that he will contract with the City of Marysville in the form of the copy of the contract annexed hereto, to provide all necessary machinery, tools, apparatus and other means of construction, and to do all the work and furnish all the materials specified in the contract, in the manner and time therein prescribed, and according to the requirements of the Engineer as therein set forth, and that he will take in full payment therefor the following item prices, to wit:
2023 MEASURE C / SB-1 PAVEMENT PROJECT
CONTRACT 23-01
Item
No. Item Description Estimated Quantity Unit Unit Price ($/Unit) Amount
($)
Bid Schedule A - E. 22nd St. (Cheim Blvd. to State Route 20) - FDR-C / Overlay 1 Full Depth Reclamation (FDR-C) - Pulverize Existing
Section (12-inch Depth) Cement Treat, Grade, & Compact 66,400 SF 2 Demolish Existing Planter 920 SF
3 Cement (5% FDR-C) 199 TON
4 HMA 1/2" 1,660 TON
5 Adjust Utility Manhole Covers to grade 8 EA
6 Adjust Utility (Valve /Cleanout) Covers to grade 1 EA 7 Adjust Centerline Monument Covers to grade (Protect
monument in place) 3 EA
8 Adjust Drain inlet covers for Curb Ramps 2 EA
9 Replace Existing Driveway 4 EA
10 Install Accessible Ramp 7 EA
11 Minor Concrete (6 Inch Curb) 900 LF
12 Minor Concrete (Roundabout Rolled Curb) 160 LF
13 Minor Concrete (Roundabout -7 Inch thick) 720 SF
14 Concreted Cobble in Planters 3,350 SF
15 Roundabout Traffic Signs- Aluminum Symbol Sign 21 EA 16 Pavement Delineation (Detail 39 / 39A) 1,100 LF
17 Pavement Delineation (Buffered Bike lane - Detail 39 / Diagonal) 4,400 LF
18 Pavement Delineation (Detail 21 ) 160 LF
19 Pavement Delineation (Bike Lane Symbol w/ Arrow) 5 EA 20 Pavement Delineation (TYPE VII Arrow) 7 EA
21 Pavement Delineation ("STOP" Legend and Stop Bar) 4 EA 22 Pavement Delineation Crosswalk (Detail A24F) 320 LF
23 Parking Stall Markers 1 LS
24 Roadside Signs - One Post 25 EA
25 Fire Hydrant Markers 2 EA
Total Bid Schedule A =
Bid Schedule B - Cheim Blvd. (E. 22nd St to Nadene Dr.) - Micro-Mill / Overlay 1 Micro-Mill 0.10' Minimum Depth 129,300 SF
2 Pavement Repair (4" HMA) 13,000 SF
3 Minor Concrete - Remove & Replace Curb & Gutter 12 LF 4 Geosynthetic Pavement Interlayer (Paving Fabric with Oil) 14,400 SY 5 HMA 1/2" (2" Min. Overlay) 1,620 TON
6 Adjust Utility Manhole Covers to grade 19 EA
7 Adjust Utility (Valve /Cleanout) Covers to grade 5 EA 8 Adjust Centerline Monument Covers to grade (Protect
monument in place) 7 EA
9 Pavement Delineation (Buffered Bike lane - Detail 39 / Diagonal) 6,500 LF
10 Pavement Delineation (Detail 21 ) 1,461 LF
11 Pavement Delineation (Bike Lane Symbol w/ Arrow) 11 EA 12 Pavement Delineation ("STOP" Legend and Stop Bar) 16 EA 13 Fire Hydrant Markers 3 EA
Total Bid Schedule B =
Item
No. Item Description Estimated Quantity Unit Unit Price ($/Unit) Amount
($)
Bid Schedule C - Del Pero St. (Rideout Way to Toddwick Ave.) - FDR-C / Overlay 1 Full Depth Reclamation (FDR-C) - Pulverize Existing
Section (12-inch Depth) Cement Treat, Grade, & Compact 81,000 SF 2 Cement (5% FDR-C) 243 TON
3 HMA 1/2" 1,500 TON
4 Adjust Utility Manhole Covers to grade 8 EA
5 Adjust Utility (Valve /Cleanout) Covers to grade 4 EA 6 Adjust Centerline Monument Covers to grade (Protect
monument in place) 2 EA
7 Pavement Delineation (Detail 39 / 39A) 6,300 LF
8 Pavement Delineation (Detail 21 ) 1,500 LF
9 Pavement Delineation ("STOP" Legend) 5 EA
10 Pavement Delineation (24" Wide Yellow Ladder Bar) 230 LF 11 Pavement Delineation (12" Wide Yellow Stripe) 125 LF 12 Pavement Delineation (Bike Lane Symbol w/ Arrow) 9 EA 13 Fire Hydrant Markers 2 EA
Total Bid Schedule C =
Bid Schedule D - E. 19th St (Covillaud St. to Sampson St.) - FDR-C / Overlay 1 Full Depth Reclamation (FDR-C) - Pulverize Existing
Section (12-inch Depth) Cement Treat, Grade, & Compact 44,200 SF 2 Cement (5% FDR-C) 99 TON
3 HMA 1/2" 830 TON
4 Adjust Utility Manhole Covers to grade 3 EA
5 Adjust Utility (Valve /Cleanout) Covers to grade 4 EA 6 Pavement Delineation (Detail 39 / 39A) 2,770 LF
7 Pavement Delineation (Detail 21 ) 690 LF
8 Pavement Delineation ("STOP" Legend) 2 EA
9 Pavement Delineation (12" Wide White Stripe) 250 LF
10 Pavement Delineation (Bike Lane Symbol w/ Arrow) 4 EA 11 Fire Hydrant Markers 2 EA
Total Bid Schedule D =
Bid Schedule E - 14th St. (Phase 1 - Levee to Railroad Overcrossing) - FDR-C / Overlay 1 Full Depth Reclamation (FDR-C) - Pulverize Existing
Section (12-inch Depth) Cement Treat, Grade, & Compact 39,400 SF 2 Cement (5% FDR-C) 118 TON
3 HMA 1/2" 740 TON
4 Adjust Utility Manhole Covers to grade 5 EA
5 Adjust Utility (Valve /Cleanout) Covers to grade 7 EA 6 Pavement Delineation (Shared Bike Lane Symbol) 9 EA
7 Pavement Delineation (Diagonal Parking) 1 LS
8 Pavement Delineation (Detail 21) 850 LF
Total Bid Schedule E =
Item
No. Item Description Estimated Quantity Unit Unit Price ($/Unit) Amount
($)
Bid Schedule F - Johnson Ave. (Cheim Blvd. to Hall St.) - Micro-Mill / Overlay 1 Micro-Mill 0.10' Minimum Depth 112,080 SF
2 Pavement Repair (4" HMA) 7,000 SF
3 Minor Concrete - Remove & Replace Curb & Gutter 65 LF 4 Minor Concrete - Remove & Replace Sidewalk 260 SF
5 Geosynthetic Pavement Interlayer (Paving Fabric with Oil) 12,450 SY 6 HMA 1/2" (2" Min. Overlay) 1,400 TON
7 Adjust Utility Manhole Covers to grade 7 EA
8 Adjust Centerline Monument Covers to grade (Protect
monument in place) 5 EA
9 Pavement Delineation (Detail 39 / 39A) 3,280 LF
10 Pavement Delineation (Detail 21 ) 1,250 LF
11 Pavement Delineation ("STOP" Legend and Stop Bar) 8 EA 12 Pavement Delineation (Shared Bike Lane Symbol) 9 EA
13 Fire Hydrant Markers 4 EA
Total Bid Schedule F =
Bid Schedule G - Nadene Dr. (Cheim Blvd. to Hall St.) - Micro-Mill / Overlay 1 Micro-Mill 0.10' Minimum Depth 99,120 SF
2 Pavement Repair (4" HMA) 17,240 SF
3 Geosynthetic Pavement Interlayer (Paving Fabric with Oil) 11,010 SY 4 HMA 1/2" (2" Min. Overlay) 1,240 TON
5 Adjust Utility Manhole Covers to grade 7 EA
6 Adjust Centerline Monument Covers to grade (Protect
monument in place) 5 EA
7 Pavement Delineation ("STOP" Legend and Stop Bar) 1 EA 8 Fire Hydrant Markers 5 EA
Total Bid Schedule G =
Base Bid Items
BB1 Base Bid Mobilization / Demobilization 1 LS
BB2 Prepare and Implement Temporary Traffic Control Plan with construction area signs and SWPPP 1 LS
Total Base Bid Items =
Total Base Bid (Items + A + B + C +D + E + F +G + Bid Items ) = Item
No. Item Description Estimated Quantity Unit Unit Price ($/Unit) Amount
($)
Additive Bid Schedule 1 - E. 22nd St. (Hall St. to Cheim Blvd.) - FDR-C / Overlay 1 Bid Schedule Mobilization 1 LS
2 Full Depth Reclamation (FDR-C) - Pulverize Existing
Section (12-inch Depth) Cement Treat, Grade, & Compact 63,900 SF 3 Cement (5% FDR-C) 192 TON
4 HMA 1/2" 1,600 TON
5 Adjust Utility Manhole Covers to grade 6 EA
6 Adjust Utility (Valve /Cleanout) Covers to grade 2 EA 7 Adjust Centerline Monument Covers to grade (Protect
monument in place) 3 EA
8 Adjust Drain inlet covers for Curb Ramps 6 EA
9 Install Accessible Ramp 6 EA
10 Minor Concrete - Remove & Replace Curb & Gutter 270 LF 11 Minor Concrete - Remove & Replace Sidewalk 1,050 SF
12 Prepare and Implement Temporary Traffic Control Plan with construction area signs and SWPPP 1 LS
13 Pavement Delineation (Detail 39 / 39A) 3,720 LF
14 Pavement Delineation (Buffered Bike lane - Detail 39 / Diagonal) 1,960 LF
15 Pavement Delineation (Bike Lane Symbol w/ Arrow) 13 EA 16 Pavement Delineation (Detail 21 ) 875 LF
17 Pavement Delineation ("STOP" Legend and Stop Bar) 3 EA 18 Pavement Delineation Crosswalk (Detail A24F) 231 LF
19 Fire Hydrant Markers 1 EA
Total Additive Bid Schedule 1 =
Additive Bid Schedule 2 - 14th St. (H St. to F St.) - Micro-Mill / Overlay 1 Bid Schedule Mobilization 1 LS
2 Micro-Mill 0.10' Minimum Depth 61,000 SF
3 Pavement Repair (4" HMA) 2,400 SF
4 Minor Concrete - Remove & Replace Curb & Gutter 260 LF 5 Geosynthetic Pavement Interlayer (Paving Fabric with Oil) 6,800 SY 6 HMA 1/2" (2" Min. Overlay) 760 TON
7 Adjust Utility Manhole Covers to grade 10 EA
8 Adjust Utility (Valve /Cleanout) Covers to grade 16 EA 9 Adjust Centerline Monument Covers to grade (Protect
monument in place) 3 EA
10 Prepare and Implement Temporary Traffic Control Plan with construction area signs and SWPPP 1 LS
11 Pavement Delineation (Detail 39 / 39A) 2,000 LF
12 Pavement Delineation (Detail 21 ) 940 LF
13 Pavement Delineation (12" Wide White Stripe) 600 LF
14 Pavement Delineation ("STOP" Legend and Stop Bar) 8 EA 15 Pavement Delineation (Bike Lane Symbol w/ Arrow) 6 EA 16 Fire Hydrant Markers 2 EA
Total Additive Bid Schedule 2 =
Item
No. Item Description Estimated Quantity Unit Unit Price ($/Unit) Amount
($)
Additive Bid Schedule 3 - A St. (4th St. to 6th St.) - FDR-C / Overlay 1 Bid Schedule Mobilization 1 LS
2 Full Depth Reclamation (FDR-C) - Pulverize Existing
Section (12-inch Depth) Cement Treat, Grade, & Compact 14,900 SF 3 Cement (5% FDR-C) 45 TON
4 Geosynthetic Pavement Interlayer (Paving Fabric with Oil) 400 SY 5 Micro-Mill 0.10' Minimum Depth 3,200 SF
6 HMA 1/2" 370 TON
7 HMA 1/2" (2" Min. Overlay) 40 TON
8 Adjust Centerline Monument Covers to grade (Protect
monument in place) 2 EA
9 Adjust Utility Manhole Covers to grade 2 EA
10 Adjust Utility (Valve /Cleanout) Covers to grade 4 EA 11 Prepare and Implement Temporary Traffic Control Plan with construction area signs and SWPPP 1 LS
12 Pavement Delineation ("STOP" Legend and Stop Bar) 1 EA Total Additive Bid Schedule 3 =
Additive Bid Schedule 4 - Olson Ct. - Micro-Mill / Overlay 1 Bid Schedule Mobilization 1 LS
2 Micro-Mill 0.10' Minimum Depth 16,400 SF
3 Pavement Repair (4" HMA) 700 SF
4 Geosynthetic Pavement Interlayer (Paving Fabric with Oil) 1,800 SY 5 HMA 1/2" (2" Min. Overlay) 210 TON
6 Adjust Utility Manhole Covers to grade 1 EA
7 Adjust Utility (Valve /Cleanout) Covers to grade 1 EA 8 Adjust Centerline Monument Covers to grade (Protect
monument in place) 2 EA
9 Prepare and Implement Temporary Traffic Control Plan
with construction area signs and SWPPP 1 LS
10 Fire Hydrant Markers 1 EA
Total Additive Bid Schedule 4 =
Additive Bid Schedule 5 - Glen St. (Hobart Dr. to Nadene Dr.) - FDR-C / Overlay 1 Bid Schedule Mobilization 1 LS
2 Full Depth Reclamation (FDR-C) - Pulverize Existing
Section (12-inch Depth) Cement Treat, Grade, & Compact 44,800 SF 3 Cement (5% FDR-C) 134 TON
4 HMA 1/2" 840 TON
5 Adjust Utility Manhole Covers to grade 5 EA
6 Adjust Centerline Monument Covers to grade (Protect
monument in place) 5 EA
7 Prepare and Implement Temporary Traffic Control Plan
with construction area signs and SWPPP 1 LS
8 Pavement Delineation ("STOP" Legend and Stop Bar) 5 EA 9 Fire Hydrant Markers 4 EA
Total Additive Bid Schedule 5 =
CITY OF MARYSVILLE
PUBLIC WORKS DEPARTMENT
BIDDER’S BOND
2023 MEASURE C / SB-1 PAVEMENT PROJECT
CONTRACT NO. 23-01
We, __________________________, as Principal, and _________________________, as Surety, are bound unto the City of Marysville, PUBLIC WORKS DEPARTMENT, hereafter referred to as “Obligee,” in the penal sum of ten percent (10%) of the total amount of the bid of the Principal submitted to the Obligee for the work described below, for the payment of which sum we bind ourselves jointly and severally.
THE CONDITION OF THIS OBLIGATION IS SUCH, THAT:
WHEREAS, the Principal is submitting a bid to the Obligee for 2023 MEASURE C / SB1 PAVEMENT PROJECT for which bids are to be opened at Marysville, California, on _______________________________.
NOW, THEREFORE, if the Principal is awarded the contract and, within the time and manner required under the Notice to Contractors, Special Provisions, Proposals, and Contract for this work, after the prescribed forms are presented to him for signature, enters into a written contract, in the prescribed form, in accordance with the bid, and files two bonds with the Obligee, one to guarantee faithful performance of the contract and the other to guarantee payment for labor and materials is provided by law, then this obligation shall be null and void; otherwise, it shall remain in full force.
In the event suit is brought upon this bond by the Obligee and judgment is recovered, the Surety shall pay all costs incurred by Obligee in such suit, including a reasonable attorney’s fee to be fixed by the court.
Dated: _______________________, 2023
By:
By:
THE BIDDER’S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL
SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL.
EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION
The bidder __________________________________________, proposed subcontractor ____________________________________, hereby certifies that he has ___ has not ___, participated in a previous contract or subcontract subject to the equal opportunity clause, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President’s Committee on Equal Employment Opportunity, all reports due under the applicable filing requirements.
Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor [41 CFR 60-1.7(b)(1)], and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations.
Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S.
Department of Labor.
PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE
In accordance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire:
Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation?
Yes _______ No _______
If the answer is yes, explain the circumstances in the following space:
PUBLIC CONTRACT CODE SECTION 10232 STATEMENT
In accordance with Public Contract Code Section 10232, the Contractor hereby states, under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two (2) year period because of the Contractor’s failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board.
PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT
In accordance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares, under penalty of perjury under the laws of the State of California, that the bidder has ___ has not ___ been convicted within the preceding three (3) years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any State or Federal Antitrust Law in connection with the bidding upon, award of or performance of any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term “bidder” is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1.
Note: The bidder must place a check mark after “has” or “has not” in one of the blank spaces provided.
NON-COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER
AND SUBMITTED WITH BID
_________________________________, being first duly sworn, deposes and says that he/she is _________________________ of __________________________________, the party making the foregoing bid, that the bid is not made in the interest of or on behalf of any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract or anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his/her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid.
CERTIFICATION
(LABOR CODE SECTION 1861)
STATE OF CALIFORNIA )
) SS
COUNTY OF YUBA )
I, the undersigned, do hereby certify:
That I am aware of the provisions of Section 3700 of the Labor Code of the State of California, which requires every employer to be insured against liability for Workers’ 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.
Executed at
On
(Date)
I CERTIFY under the penalty of perjury that the foregoing is true and correct.
Signature of Contractor-Employer
DEBARMENT AND SUSPENSION CERTIFICATION
TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29
The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager:
• Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency;
• Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years;
• Does not have a proposed debarment pending; and
• Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years.
If there are any exceptions to this certification, insert the exceptions in the following space.
Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action.
Note: Providing false information may result in criminal prosecution or administrative sanctions.
The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification.
NONLOBBYING CERTIFICATION
FOR FEDERAL-AID CONTRACTS
The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that:
(l) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure of Lobbying Activities,” in accordance with its instructions.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub-recipients shall certify and disclose accordingly.
DISCLOSURE OF LOBBYING ACTIVITIES
COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract a. bid/offer/application a. initial
b. grant b. initial award b. material change
c. cooperative agreement c. post-award
d. loan For Material Change Only:
e. loan guarantee year ____ quarter _________
f. loan insurance date of last report __________
4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime:
Prime Subawardee
Tier _______, if known
Congressional District, if known Congressional District, if known
6. Federal Department/Agency: 7. Federal Program Name/Description:
CFDA Number, if applicable ____________________
8. Federal Action Number, if known: 9. Award Amount, if known:
10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including address if (If individual, last name, first name, MI) different from No. 10a) (last name, first name, MI)
(attach Continuation Sheet(s) if necessary)
11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $_____________ actual Planned a. retainer
b. one-time fee
12. Form of Payment (check all that apply): c. commission a. cash d. contingent fee
b. in-kind; specify: nature______________ e deferred
value _____________ f. other, specify__________________________
14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officers(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11:
(attach Continuation Sheet(s) if necessary)
15. Continuation Sheet(s) attached: Yes No
16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress
semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Signature: ________________________________________
Print Name: _______________________________________
Title: ____________________________________________
Telephone No.: ____________________ Date:___________
Authorized for Local Reproduction
Federal Use Only: Standard Form - LLL
INSTRUCTIONS FOR COMPLETION OF SF-LLL,
DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action.
Attach a continuation sheet for additional information if the space on the form is inadequate.
Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action.
2. Identify the status of the covered federal action.
3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action.
4. Enter the full name, address, city, state, and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in Item 4 checks “Subawardee,” then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known.
6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard.
7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments.
8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., “RFP-DE-90-001.”
9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, state, and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter last name, first name and middle initial (Ml).
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made.
12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment.
13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.
14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials.
Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted.
15. Check whether or not a continuation sheet(s) is attached.
16. The certifying official shall sign and date the form, and print his/her name title and telephone number.
Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503.
Following is the name and location of the mill, shop, or office of each subcontractor who will perform work or labor or render services to the above-signed bidder. Failure of the bidder to specify a subcontractor for any portion of the work to be performed under the contract constitutes an agreement by the bidder to perform that portion of the work himself.
LABOR OR SERVICES
NAME AND ADDRESS TO BE PERFORMED SUBCONTRACTOR
OF SUBCONTRACTOR AND VALUE THEREOF LICENSE # CLASS
(1)
$
(2)
$
(3)
$
(4)
$
(5)
$
(6)
$
(7)
$
(8)
$
IF ADDITIONAL SPACE IS REQUIRED, PLEASE CONTINUE ON BACK OF THIS PAGE.
THIS LIST MUST BE SUBMITTED WITH BID PROPOSAL.
PROPOSAL CERTIFICATION
Accompanying this proposal is a certified or cashier’s check, or bidder’s bond, in the amount of ten percent (10%) of the total bid price, executed by an admitted surety insurer made payable to the City of Marysville for an amount equal to at least ten percent (10%) of the bid amount.
State if bidder is an individual, corporation, or partnership. If bidder is a corporation, state legal name of the corporation, state of incorporation, and the name of the president, secretary, and treasurer. If the bidder is a partnership, list the names of all the partners.
By my signature on this proposal, I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232, and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2, of the California Administrative Code). By my signature on this proposal, I further certify, under penalty of perjury under the laws of the State of California and the United States of America, that the Non-collusion Affidavit required by Title 23 United States Code, Section 112, and Public Contract Code Section 7106, and the Title 49 Code of Federal Regulations, Part 29, Debarment and Suspension Certification, are true and correct.
Date:
Signature:
Name of Bidder:
Title:
Corporate Seal