Agenda packet — Placentia City Council, October 6, 2026 (part 2 of 4)

(Use of City Bond Form is Required)

LABOR AND MATERIAL PAYMENT BOND

PUBLIC WORK (CALIFORNIA)
KNOW ALL MEN BY THESE PRESENT:

WHEREAS, CTBT Concrete Paving, Inc , as Principal, has
entered into a contract dated November 18, 2025 . with the City of Placentia (Obligee) referred to and made a part hereof to perform the following work, GOLDEN AVENUE BRIDGE REPLACEMENT PROJECT FED PROJECT NO. BRLS-5269 (025) and all appurtenant work in accordance with PROJECT NO. 1801 which requires Principal to file this bond to secure claims made in relation to the project.

NOW THEREFORE, we, CTBT Concrete Paving, Inc. as Principal, and Contractors Bonding and Insurance Company a corporation organized under the laws of Illinois and duly authorized to transact business in the State of California, as Surety, are held firmly bound unto the City of Placentia, as Obligee, and all sub- contractors, laborers, material persons and other persons employed in the performance of the referenced agreement, in the sum of Four Million Six Hundred Eighty Seven Thousand Ten and 501100 Dollars ($4.587,010.50) lawful money of the United States of America, for the payment whereof well and truly to be made the Principal and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents.

If the above bounden PRINCIPAL, his or its heirs, executors, administrators, successors, assigns, or any of his or its sub -contractors, fails to pay for any materials, provisions, provender, or other supplies, or teams, implements or machinery, used in, upon, for or about the performance of the work contracted to be done, or for any work or labor to persons named in Section 9100 or the Civil Code, thereon of any kind, or for amounts due under the Unemployment Insurance Code with respect to such work or labor deducted, withheld and paid over to the Employment Development Department from the wages of employees of the contractor and sub -contractors pursuant to Section 13020 of the Unemployment Insurance Code, that the SURETY on this bond will pay the same, in an amount not exceeding the sum specified in this bond, AND ALSO, in case suit is brought upon this bond, a reasonable attorney's fee, which shall be awarded by the court to the prevailing party in said suit, said attorney's fee to be taxed as costs in said suit and to be included in the judgment herein rendered.

As part of the obligation secured hereby, the SURETY shall not be exonerated or released from the obligation of the bond by any change, alteration, or modification in or of any contract, plans, specifications, or agreement pertaining or relating to any scheme or work of improvement or pertaining or relating to the furnishing of labor, materials, or equipment therefor, nor by any change or modification of any terms of payment or extension of the time for any payment pertaining or relating to any scheme of work of improvement, nor by any rescission or attempted rescission of the contract, agreement or bond, nor by any conditions precedent or subsequent in the bond attempting to limit the right of recovery of claimants otherwise entitled to recover under

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE §1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document, State of California
County of Los Angeles
on 11/07/2025
Date
before me, Eduardo Flores-Najera, Notary Public
Here Insert Name and Title of the Officer
Personally appeared Jose Guadalupe Carvajal
Name(s) of Slgnerfs)
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)ad that by h1s/her/theirsgnature(s) on the instrumenttheperson(s}, or the entity upon behalf of which the persons) acted, executed the Instrument.

EDUAA00 FLORES•NAJE A
Notary Public • California L
Los Anseles County
Commission #2519450
my Comm, Expires May 4, 2029
certify under PENALTY OF PERJURY under the Taws of the
State of California that the foregoing paragraph is true and correct.

WITNESS my hand and official seal
Signature
Signature of Notary Publfc
Place Notary Seal Above
»-- OPTIONAL--_._..�._�._- -----
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Description of Attached Document
Title or Type of Document Document Date
Number of Pages Signer(s) Other Than Named Above
Capacity(les) Claimed by Signer(s)
Signer's Name _ Signer's Name
Corporate Officer—Title(s) Corporate Office —Title(s)
Partner Limited General Partner Limited General
Individual Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other Other
Signer Is Representing Signer is Representing
el 2014 National NotaryAssociation • www,NationalNotarv.are,*1-80C-US NOTARY (1-800.876-6927) (tern Pt5,907

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

STATE OF CALIFORNIA
County of Orange
On NOV 0 b 2(J2 before me,
Date
personally appeared Emilie Young
Tt1�0 HGUYfN 1.1AI
Notary Public - Celll9rnl■ }
6ransa Coons.

Commission N 11 O4
My Corm. respires Jul r 8, 3017
Place Notary Seal Above
}
Theo Nguyen Luu
Insert Name of Notary exactly as II appears an the official Sial (garnets) of Signer(s)
, Notary Public,
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 Taws of
the State of California that the foregoing paragraph is true and correct,
Witness my hand and official seal.

Signature
signature Of Notary Pudic

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Document Date;
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Signer's Name:
❑ Individual
❑ Corporate Officer—Titte(s):

O Partner ['Limited ❑ General
O Attorney in Fact
• Trustee
❑ Guardian or Conservator
❑ Other
Signer is Representing:

RIGHT THUMBPRINT

OF SIGNER
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Number of Pages:

Signer's Name:

I=1 Individual
❑ Corporate Officer—Tftle(s):
❑ Partner 0 Limited Q General
D Attorney in Fact
❑ Trustee
© Guardian or Conservator
❑ Other:

Signer is Representing:

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OF SIGNER
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POWER OF ATTORNEY
RLI Insurance Company
Contractors Bonding and Insurance Company
9025 N. Lindbergh Dr Peoria, IL 61615
Phone: 800-645-2402
Knorr 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 approving officer 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:

Yana T. Mullick. P. Austin Neff Irene Luone. Emilie Younrf_ IianielleHanson. Christine Wootford. AlexanderR. Holshelmer. Theo Luu. Joseph P. k'lcC.radv., iointly eeseverally
in the City of Missi,gtt Viejo - , State of California its true and lawful Agent(s) and Attorney(s) in Feet, 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 undertakings in an amount not to exceed _ - Twenty give Million Dollars ( $25.000.QAQ.QQ
) for any single obligation_
Theacknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company.

RLI Insurance Company and/or Contractors Bonding and Insurance Company, ns applicable, have each further certified that the following is atrue and exact copy of a Resolution adopted by the Board of Directors ofeach such corporation, and is now in force, to -wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall 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 officers is the Board of Directors may authorize- The President, any Vice President, Secretary. any Assistant Secretary, or the Treasurer n -ay 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 signature of any such officer and the corporate seal may be printed by facsimile.' IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and insurance Company, as applicable, have Sr. Vice President with its corporate seal affixed this 9th day of caused these presents to be executed by its respective
September , 2025 .

Stale of Ohio
SS
County of -Cuyahoga
s R9/ r.0"9"44
=SEAL!
il.GO
On this _9th day of _ September 2025 before me, a Notary Public, personalty appeared ric Rnydins who being by me duly sworn, acknowledged that he signed the above Pn v r of Attorney as the aforesaid officer of the RLI Insurance Company and/or Contractors Bonding and Insurance Company and acknowledged said instrument to be the voluntary act and deed of said corporation
By. ( 64
Jill A. Scott
JILL A scar
Ir.i,v Rays :VII err 9
I 1!, Ge14,41.6M1@,s IN
4470
Notary Public
alterfeettee:

RLI Insuronce Ccmpitny
Contractors Bonding and llnt uytnce Company
By:

Eric Raudins

CERTIFICATE
Sr. Vice President
1, the undersigned officer of RLI insurance Company and/or Contractors Bonding and Insurance Company, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable: and furthermore, that the Resolution of the Company as set forth in the Power of Attorney, is now in force. In testimony whereof. ! have hereunto set my hand and the seal of the RLI Insurance Company and/or Contractors Bonding and Insurance Company this 5th day of November . 2025 -
KJ Insurance Company
Contractors Bonding and Insurance Com p.sny
By:
01 Christ inn Dean Corporate Secretary
AC0S8a19

No. 3000-1

STATE OF CALIFORNIA

DEPARTMENT OF INSURANCE

SAN FRANCISCO
Amended
Certificate of Authority
THIS IS TO CERTIFY that, pursuant to the Insurance Code ofihe State ofcafj/eiruln.

Contractors Banding and Insurance Company
rJllllnufs, organized order the latus op/Mots, subject to its Arlicles ofhIcorporafion or otherltindonrenial organisational edocumenis, is hereby authorised to transact within this Slate, subject malt prnwsinnsalihis Certificate, ilia fallowing classes of insurance
Firc, Marine, Surety, Plate Glass, Liability,
Moiler and Machinery, Burglary, Sprinkler,
Team and Vehicle, Autnmobilc, Legal, and Misccilaneoua
as such classes are now nr may hereafter be Wined m the insurance Laws of the Stole o1 California.

THIS CERTIFICATE is expressly conditioned upon the holder hereof' now and herea/ier being in fill compliance with nil, and nal in violation of any, of the applicable laws and lawful requirements made under authority of Nit lows Odle Stare of California as long as such !mil or requirements nrr rn u!jreci and appllcabk and es srrch laws and requirements nun are, or pray hereafter be changed or emended IN WITNESS WHEREOF, effeefr'e as of the 2tJ' da) of March, 2015, I hove hereunto ser my hand and caused my official smut ter he q/jlscd this 20ih day of Hardt. 2015.

By.

IJvc Jones
Wienorr 1 •anrwra
`'tY
Valerie Sarfaty
for Nettie 1 Iogc
cool %inn,
NOTICT:

Qualiflealion wish the Secretary of Sute must ba accompluhod m rag -nisei! by the California Curporation Coda promptly alter iasuanct orthis CcalAcAra of esulhoricy. ?ilium in da su w/1 Iv a •iolutimr of imtpuce Code section ia1 ant wlllbc irmunds r4 evoking slim Cenilleam of Authority purulent 10 due cownema made in rbe appheat inn therefor and the c0ndainns committed herein.

Project No. 1801

Page 1 of 1 ends

(Use of City Form is Required)

SUPPLEMENTAL INFORMATION TO BE COMPLETED BY PRINCIPAL
If an individual, so state. If a firm or co -partnership, state the firm and give the names of all individual co-partners composing the partnership. If a Corporation, state legal name of corporation; state also the names of the president, secretary, treasurer and manager thereof.

CTBT Concrete Paving Inc,
Jose Carvajal, President & Secretary
Jackie Carvajal, Treasurer
Business Address:
324 S. Diamond Bar Blvd, PMB 275
Diamond Bar, CA 91765
Telephone Number:

Date:

Print Name:

Signature:
909-629-8000
11/06)2025
rncipal
President
Title

Project No. 1801

TAX IDENTIFICATION NUMBER

Page 1 of 1 ends

(Use of City Farm is Required)
The Tax Equity and Fiscal Responsibility Act of 1982 requires the payer (City of Placentia) to report to the Internal Revenue Service taxable payments to payees.

You (as a payee) are required by law to provide us with your Taxpayer Identification Number (if an individual or partnership, your Social Security Number). If you do not provide us with your correct identification number, you may be subject to a penalty imposed by the Internal Revenue Service. The payments subject to withholdings may include, but are not limited to, interest, dividends, or other payments the City of Placentia and/or the Placentia Redevelopment Agency made to you. Other payments may include rents, royalties, commissions and fees for service of non -employees.

If you are exempt from income tax, we are still required, by law, to maintain a Tax Identification Number on file. PLEASE PROVIDE YOUR TAX IDENTIFICATION NUMBER next to the appropriate listing below, sign, date and return to:

CITY OF PLACENTIA FINANCE DEPARTMENT
401 E. Chapman Ave
Placentia, CA 92870
Exempt: Yes_ No X Telephone ( 969) 629-8000
CORPORATION; CT&T Concrete Paving Inc. - 20-2642225
U.S.A. OR ANY AGENCIES THEREOF: NIA
IRS CODE #501 TAX-EXEMPT ORGANIZATIONN/A
A NON-COMMISSIONED CITY OF PLACENTIA EMPLOYEE: N/A
SOLE PROPRIETOR: N/A
A PARTNERSHIP:A/A
OTHER: N/A (Explain)
Signature/Title: Date: 11/6/25
ase Carvajal, President

PREMIUM SUBJECT TO CHANGE BASED ON FINAL CONTRACT AMOUNT PREMIUM: $33,075.00
Project No. 1801

CITY OF PLACENTIA

PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENT: That,
BOND NO. RCB0060130

EXECUTED IN TRIPLICATE
WHEREAS, the CITY OF PLACENTIA (hereinafter called the "City") has awarded to CT&T Concrete Paving, Inc. , a California corporation (hereinafter "Principal"), an Agreement, dated November 18,20 25 ("Agreement"), whereby Principal agreed to provide construction services including GOLDEN AVENUE BRIDGE REPLACEMENT PROJECT FEDERAL PROJECT NO. BRLS-5269 (025) CITY PROJECT NO. 1801
WHEREAS, the Public Work to be performed by the Principal is more particularly set forth in the Agreement which is incorporated herein by reference and made a part hereof; and WHEREAS, said Principal is required under the terms of the Agreement to furnish a bond for the faithful performance of the Agreement;
Contractors Bonding and
NOW, THEREFORE, we, CT&T Concrete Paving, Inc. , as Principal, and Insurance Company as Surety, are held and firmly bound unto the City in the sum of Four Million Six Hundred Eighty Seven Thousand Ten and 50/100 Dollars ($ 4,687,010.50 ), this amount being not less than one hundred percent (100%) of the total contract price under Agreement, lawful money of the United States of America for payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors jointly and severally, firmly by these presents.

THE CONDITION OF THIS OBLIGATION IS SUCH THAT, the obligation shall become null and void if the above -bounded Principal, his or its heirs, executors, administrators, successors, or assigns, shall in all things stand to and abide by well and truly keep and perform all the undertakings, terms, covenants, conditions, and agreements in the said Agreement and any alteration thereof, made as therein provided, all within the time and in the manner therein designated and in all respects according to their true intent and meaning, and shall indemnify and save harmless the City, its officer, agents and employees, as therein stipulated; otherwise it shall be and remain in full force and virtue.

As a part of the obligation secured hereby, and in addition to the face amount specified, costs and reasonable expenses and fees shall be included, including reasonable attorneys' fees, incurred in successfully enforcing the obligation on the bond, all to be taxed as costs and included in any judgment rendered.

The said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or modification of the Agreement, the contract documents or of the work to be performed thereunder, shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extensions of time, alteration or modification of Agreement, the contract documents or of the work to be performed thereunder.

Surety's obligation shall be a guarantee of payment and performance and shall not be diminished by any bankruptcy or reorganization in bankruptcy or liquidation or the result of the foregoing or otherwise of Principal. Accordingly, the filing of any petition in bankruptcy or for rearrangement or reorganization or liquidation (or proceedings similar in purpose or effect) of Principal under any Federal or State laws ("Insolvency Case") will not toll or delay the date due for payment or performance hereunder as more particularly specified in of the Construction Management Agreement. The City shall be not be required to await the outcome of an Insolvency Case or to enforce any of their respective rights under the Agreement, respectively, prior to

Project No 1801
obtaining payment in full from Surety. If for any reason payment received by the City in respect of the obligations of the Principal under the Agreement guaranteed pursuant to this bond is rescinded or must be returned or restored by the City, this bond shall be automatically reinstated and shall continue to be in effect as if such payment had not been made.

Collection of liquidated damages by City due to Principal's failure to timely achieve Substantial Completion shall not limit, modify, or act as an offset or credit against Surety's obligation to arrange for or cause the completion of the Public Work as and when required by the Agreement.

IN WITNESS WHEREOF three (3) identical counterparts of this instrument, each of which shall for all purposes be deemed an original thereof, have been duly executed by the Principal and Surety named herein, on the 5tn day of November , 20 25 , the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative pursuant to authority of its governing body. (Seal) (Seal)
Contractors Bonding and
SURETY..., Insurance Company PRINCIPAL
By CM1., By
r
Emilie Young, Attorney -in -Fact
9025 N Lindbergh Drive
CT&T Con rete Paving, Inc.

X
lose Car vayv_I Aresic1ev,:t 4seCr9t&►1
Peoria, IL 61615 324 S. Diamond Bar Blvd, PMB 275 Diamond Bar, CA 91765

ADDRESS

ADDRESS
APPROVED:

CITY ATTORN Y

INSTRUCTIONS
Two (2) Notarized Signatures required
from all Corporations.
1 The above bond must be executed by both the Principal and the Surety. 2, If the Principal is a corporation, the bond must be executed in the corporate name and signed by the President or a Vice -President and the Secretary or Assistant Secretary, and the corporate seal affixed. If the Principal is a partnership, all partners must sign it. If the Principal is an individual doing business under a fictitious name, it must be signed by ail persons having an interest in the business, and the fictitious name must be signed also, The bond must be notarized by both the Principal and the Surety.

3. The City Attorney of the City of Placentia must approve the bond. 4, The bond, after approval, must be filed with the City Clerk of the City of Placentia.

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE §1189
m."4:ecmcc% .-.2r rseeedfrh.>•0 .(.4,. r„'
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 11/07/2025
Date
}
}
before me, Eduardo Flores-Najera, Notary Public
Here Insert Nome and Title of the Officer
Personally appeared Jose Guadalupe Carvajal
Narne(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hls/her/theirauthorized capacity(ies),and thatbyhis/her/theirsignature(s}on the instrumenttheperson(s), or the entity upon behalf of which the person() acted, executed the instrument,
` ...y MAR=FLORES•NAJERA
""- Notary Public California
Las Angeles County
Cam miss ion # 1#19450
My Comm. Expires aMy 4, 2029
Place Notary Seal Above
'certify under PENALTY OF PERJURY underthe laws of the
State of California that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Signature" ' _
Signature orTetary P
OPTIQNA[-..- -- ---- -- - _._� ...�------- -
Though rhis section is optional, convicting this information can deter alteration of the document or fraudufent reattachment of this form to on unintended document, Description of Attached Document
Title or Type of Document
Number of Pages
Capacity(ies) Claimed by Signer(s)
Signer's Name
Corporate Officer—Titles)
Partner
Individual
Trustee
Other
Document Date
Signers)OtherThan Named Above
Limited General
Attorney in Fact
Guardian or Conservator
Signer Is Representing
Signer's Narne
Corporate officer—Titles)
Limited General
Attorney in Fact
Guardian or Conservator
Partner
Individual
Trustee
Other
Signer Is Representing
©2014 Na tionalNotaryAssociation • www.NationalNotarvore.+1-800-175 NOTARY {1-800-876-613271 item 45907

STATE OF CALIFORNIA
County or Orange
On NOV 0 5 fl )i before me,
Date
personally appeared Emilie Young
TH#0 NGUYEN LUU
Notary PUhlie - [rfrrrarryt■
Cance County
L'Ty-11 Commission N 21jM;
AY Comm, expires ]u1 ia. 2417
Taco Notary Seel Above
}
Thao Nguyen Luu
Insert Mama of notary woolly as II appears an the Okla! use' Name(s) 4f Slgrteris)
, Notary Public,
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 capaclty(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 _ `I7. +•
Signatwe of !Votary Pubfic

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Description of Attached Document
Title or Type of Document:

Document Date; Number of Pages,
Signer(s) Other Than Named Above:

Capacity(les) Claimed by Signer(s)
Signer's Name:

D Individual
❑ Corporate Officer —Title('s).

O Partner ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:

Signer is Representing:

Tap of thumb here
Signer's Narne:

O Individual
❑ Corporate Officer—Tille(s):

O Partner 0 Limited 0 General
O Attorney In Fact
❑ Trustee
❑ Guardian or Conservator
O Other
Signer is Representing:

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OF SIGNER
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POWER OF ATTORNEY
RLI Insurance Company
Contractors Bonding and Insurance Company
9025 N. Lindbergh Dr. Peoria, IL 61 615
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 approving officer if desired_
That RLI Insurance Company and/or Contractors Bonding end Insurance Company, each an Illinois corporation, (separately and together, the "Company") do hereby make. constitute and appoint:

Yunv T. Mullick, P, Austin Nei IreneLuona. Emilie Yonne. DarttelHe Hanson. Christine Woolford_ Alexander R. Holsheimer. Thio fit, .losenh P. Ivi firndv. ioirnly orle_verally
in the City of Orli ion Vieio , State of California its true and lawful Agent(s) and Attorney(s) in Fact, with full power and authority hereby confened, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five MIn Dollars ( S25.00O ?Qa OD_) for any single obligation.

The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company.

RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by 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 tete corporation shall 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 officers 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 signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective Sr Vice President with its corporate seal affixed this 9th day of ,Sentembeer 2025 .

State of Ohio
County of Cuyahoga
} Ss
SEAL
On this 9th day of Sentcmjr , 2025 . before me, a Notary Public, personalty appeared F audinw , who being by me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of the RLI Insurance Company and/or Contractors ponding and Insurance Company and acknowledged said instrument to be the voluntary act and deed of said corporation.
/(/Vt
Jill A. Scott •
. 1
;tL .S Leen
if kJ'.r. CI 0,7
6W P•d'ot. 41 :'90
Notary Public
a.1ssllssyra2ra
RLI Insurance Company
13/Contractors inand I9:IA5ance Company
Erle Raudins
By:

CERTIFICATE
Sr_ Vice President
1, the undersigned officer of RLI Insurance Company and/or Contractors Bantling and Insurance Company, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable; and furthermore. that the Resolution of the Company as set forth in the Power of Attorney, is now in farce. In testimony svhereof, I have hereunto sel my hand and the seal of the RLI Insurance Company and/or Contractors Bonding and Insurance Company this 5th day of November ,
RLI Insurance Company
Contractors Bonding and Insurance Company
Ey. 6.1116.14440.144.

Christina Dean Corporate Secretary
AO058D19

Project No. 1$01

BID GUARANTEE

TO THE CITY OF PLACENTIA
PROJECT NO, 1801
As a material inducement to the City to award the contract for Project No. 1801 to CT&T Concrete Paving Inc. , the undersigned ("Guarantor") has agreed to enter Into this guarantee. The Guarantor hereby unconditionally guarantees to the fullest extent allowed by law the following work included in this project: Golden Ave Bridge Replacmern Project ("the work").

Guarantor guarantees that the materials and equipment used by itself and its subcontractors will be free from defects and that the work will conform to the plans and specifications. Should any of the materials or equipment prove defective or should the work as a whole, or any part thereof, prove defective for any reason whatsoever (except due to intentional torts by the City), or should the work as a whole or any part thereof fail to operate properly or fail to comply with the plans and specifications, Guarantor will, at the City's sole election: 1) reimburse the City, upon written demand, for all of the City's expenses incurred replacing or restoring any such equipment or materials, including the cost of any work necessary to make such replacement or repairs; or 2) replace any such defective material or equipment and repair said work completely, all without any cost to the City. Guarantor further guarantees that any such repair work will conform to the plans and specifications for the project. This guarantee will remain in effect for five years from the date on which the contracted for work is accepted for use by the City.

Guarantor understands and agrees that the City shall have the unqualified option to make any replacements or repairs itself or to have such replacement, repair, performed by the undersigned.

The City shall have no obligation to consult with Guarantor before the City proceeds to perform any repair, replacement, or work Itself. If the City elects to have Guarantor perform said repair, replacement, or work, Guarantor agrees that the repair, replacement, or work shall be performed within 15 days after receipt of a written demand from the City.

If the City elects to perform the replacement, repairs itself, Guarantor agrees to make reimbursement payment within 15 days after receipt of a written demand for payment from the City.

If the Guarantor fails or refuses to comply with this guarantee, the City shall be entitled to al! costs and expenses, including attorneys and expert fees, reasonably incurred by reason of Guarantor's failure or refusal.

Guarantor
Date 11)06/2025
Contractor: CTBT Concrete Paving Inc. By:

Title: Jose Carvajal, President

Project No. 1801

STATEMENT OF NON COLLUSION BY CONTRACTOR
The undersigned who submits herewith to the City of Placentia a bid or proposal does hereby certify:
a. That all statements of fact in such bid or proposal are true, b. That such bid or proposal was not made in the interest of or on behalf of any undisclosed person, partnership, company, association, organization or corporation. c. That such bid or proposal is genuine and not collusive or sham. d. That said bidder has not, directly or indirectly by agreement, communication or conference with anyone, attempted to induce action prejudicial to the interest of the City of Placentia or of any other bidder or anyone else interested in the proposed procurement. e. Did not, directly or indirectly, collude, conspire, connive or agree with anyone else that said bidder or anyone else would submit a false or sham bid or proposal, or that anyone should refrain from bidding or withdraw his bid or proposal.
f. Did not in any manner, directly or indirectly seek by agreement, communication or conference with anyone to raise or fix the bid or proposal price of said bidder or of anyone else, or to raise or fix any overhead, profit or cost element of his bid or proposal price, or that of anyone else.

Did not, directly or indirectly, submit his bid or proposal price or any breakdown thereof, or the contents thereof, or divulge information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member agent thereof, or to any individual or group of individuals, except to the City of Placentia, or to any person or persons who have a partnership or their financial interest with said bidder in his business. h. Did not provide, directly or indirectly to any officer or employee of the City of Placentia any gratuity, entertainment, meals, or anything of value, whatsoever, which could be objectively construed as intending to invoke any form of reciprocation or favorable treatment.

That no officer or principal of the undersigned firm is related to any officer or employee of the city by blood or marriage within the third degree or is employed, either full or part time, by the City of Placentia either currently or within the last two (2) years, That no officer or principal of the undersigned firm nor any subcontractor to be engaged by the principal has been convicted by a court of competent jurisdiction of 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 work contract, with any public entity, within the fast three years.

I certify, under penalty of perjury under the laws of the State of California, that the foregoing is true and correct and that this certification was executed:
on November 6, 2025 at Diamond Bar California.

Firm CTBT Concrete Paving Inc.

Street324 S. Diamond Bar Blvd PMB 275
City Diamond Bar State
g.

CA zip 91765
(Signature)
Jose Carvajal, President
(Print Name & Title)

EXHIBIT C

INSURANCE REQUIREMENTS
A. Minimum Scope and Limits of Insurance
City reserves the right to review any and all of the required insurance policies and/or endorsements, but has no obligation to do so. Failure to demand evidence of full compliance with the insurance requirements set forth in this Agreement or failure to identify any insurance deficiency shall not relieve Contractor from, nor be construed or deemed a waiver of, its obligation to maintain the required insurance at all times during the performance, including any extension thereof, of this Agreement.

Consultant shall obtain, maintain, and keep in full force and effect during the life of this Agreement, including any extension thereof, all of the following minimum scope of insurance coverages:

1. Commercial General Liability Insurance
• Commercial general liability insurance no less broad than Insurance Services Office (ISO) form CG 00 01,
• Minimum Limits_ $2,000,000.00 per occurrence; $4,000,000.00 general aggregate; $4,000,000.00 products/completed operations aggregate. The aggregate limit, encompassing the above coverage, shall apply separately to this project/location. The required limits may be provided by a combination of general liability insurance and commercial excess or umbrella liability insurance. If Contractor maintains higher limits than the specified minimum limits, City requires and shall be entitled to coverage for the higher limits maintained by the Contractor.
• Any deductible or self-insured retention shall be shown on the certificate of insurance, If the deductible or self-insured retention exceeds $25,000.00, it must be approved in advance by City Contractor is responsible for any deductible or self-insured retention and shall fund it upon City's written request, regardless of whether Contractor has a claim against the insurance or is named as a party in any action involving City. • Coverage shall be continued for three (3) years after completion of the work. • City shall be endorsed as an additional insured for liability arising out of ongoing and completed operations by or an behalf of the Contractor. City shall continue to be an additional insured for completed operations for three (3) years after completion of the work. General liability coverage can be provided in the form of an endorsement to the Contractor's insurance at least as broad as one of the following ISO ongoing operations forms: CG 20 10 or CG 20 26 or CG 20 33 (not allowed from subcontractors), or CG 20 38; and one of the following ISO completed operations forms: CG 20 37, 2039 (not allowed from subcontractors), or CG 20 40. • The policy definition of "insured contract" shall include assumptions of liability arising out of both ongoing operations and the products/completed operations hazard ("f' definition of insured contract in ISO form CG 00 01, or equivalent). • The insurance provided to the additional insureds shall be primary to, and non- contributory with, any insurance or self-insurance program maintained by there

• The policy shall cover inter -insured suits and include a "separation of insureds" or "severability" clause which treats each insured separately. • The policy shall be endorsed to include a written waiver of the insurer's right to subrogate against all persons or entities that are, or are required to be, additional insureds.
• The policy shall not contain a contractors' warranty or other similar language which eliminates or restricts insurance because of a subcontractor's failure to carry specific insurance or to supply evidence of such insurance.
• Reauired evidence of coverage:

1. Copy of the endorsements naming the City of Placentia, its officers, officials, employees, agents, and volunteers as additional insureds;

2. Copy of the endorsement or policy language indicating that coverage applicable to the additional insureds is primary and non-contributory;

3. Properly completed certificate of insurance; and

4. Completed and signed Agent/Broker Questionnaire with supporting documentation as required.

2. Business Automobile Liability Insurance
• Minimum Limit $2,000,000.00 combined single limit per accident. • Coverage shall apply to all owned, hired, leased, and non -owned vehicles. • City shall be endorsed as additional insured.
• Reauired evidence of coverage:

1. Copy of the endorsement naming the City of Placentia, its officers, officials, employees, agents, and volunteers as additional insureds; and

2. Properly completed certificate of insurance.

3. Workers' Compensation & Employer's Liability Insurance • Workers' compensation insurance with statutory limits as required by the Labor Code of the State of California.
• Employer's liability with limits of $1,000,000.00 per accident; $1,000,000.00 disease per employee; $1,000,000.00 disease per policy.
• The policy shall include a written waiver of the insurer's right to subrogate against City. • Reauired evidence of coverage:

1. Subrogation waiver endorsement; and

2. Properly completed certificate of insurance.

4. Contractor's Pollution Liability insurance
• Minimum Limits: $2,000,000.00 per pollution incident; $2,000,000.00 policy aggregate. • Coverage shall apply to pollution incidents at or from any location at which Contractor

is performing work under this Agreement.
• Any deductible or self-insured retention shall be shown on the certificate of insurance If the deductible or self-insured retention exceeds $25,000.00, it shall be approved in advance by City. Contractor is responsible for any deductible or self-insured retention and shall fund it upon City written request, regardless of whether Contractor has a claim against the insurance or is named as a party in any action involving City. • City shall be endorsed as an additional insured for liability arising out of ongoing and completed operations by or on behalf of the Contractor. Additional insured status shall continue for three (3) years after completion of the work. • The insurance provided to the additional insureds shall apply on a primary and non- contributory basis with respect to any insurance or self-insurance program maintained by them.
• The insurance shall be continued for three (3) years after completion of the work • Required evidence of coverace:

1. Copy of the endorsement naming the City of Placentia, its officers, officials, employees, agents, and volunteers as additional insureds; 2, Copy of the endorsement or policy language indicating that coverage for the additional insureds is primary and non-contributory; and

3. Properly completed certificate of insurance.

5. Surety Bonds
• Bid bond.
• Performance and payment bonds for the entire contract price. • The surety must be authorized to issue these bonds in the State of California.

6. Standards for Insurance Companies
• AN insurance policies shall be issued by an insurance company currently authorized by the Insurance Commission to transact business of insurance or is on the List of Approved Surplus Line Insurers in the State of California, with an assigned policyholders' rating of A- (or higher) and Financial Size Category Class VII (or larger) in accordance with the latest edition of Best's Key Rating Guide.

B. Documentation and Other Provisions

1. The certificate of insurance shall include the following reference'. [Golden Avenue Bridge Replacement Project]

2. The name and address for additional insured endorsements and certificates of insurance is: City of Placentia, 401 E. Chapman Ave., Placentia, CA 92870

3. Defense fees and costs shall not deplete the limits of any insurance provided under this Agreement.

4. Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure the City is an additional

insured on insurance required from subcontractors.

5. Contractor agrees to waive and to obtain endorsements from insurers waiving subrogation rights against the City of Placentia, its officers, officials, employees, agents, and volunteers for losses arising from work performed by Contractor for the City and to require each of its subcontractors, if any, to do likewise under their insurance policies,

6. The Contractor's insurance coverage shall be primary insurance coverage at least as broad as ISO CG 20 01 04 13 as respects the City of Placentia, its officers, officials, agents, employees, and volunteers. Any other insurance maintained by the City of Placentia shall be excess and not contributing with the insurance provided by this policy,

7. Coverage shall be on a standard occurrence form. Claims-made forms are not acceptable. Modified, limited, or restricted occurrence forms are not acceptable.

8. Said policies shall not terminate, nor shall they be cancelled or coverage reduced, without at least thirty (30) days' written notice to the City. In the event of any cancellation or reduction in coverage or limits of any insurance, Contractor shall forthwith obtain and submit proof of substitute insurance. Should Contractor fail to immediately procure other insurance, as specified, to substitute for any cancelled policy or reduction in the required insurance limits, the City may procure such insurance at Contractor's sole cost and expense.

9. Current evidence of coverage shall be provided for the entire required period of insurance.

10. Upon written request, certified copies of required insurance policies shall be provided within thirty (30) days.

Project No. 1601

EXHIBIT D

CERTIFICATES OF INSURANCE AND ENDORSEMENTS

AC EP CERTIFICATE OF LIABILITY INSURANCE
I4
DATE (MMIDG7YYYYI
01/21/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate hoider Is an ADDITIONAL INSURED, the policy{les) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the torrns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder in lieu of such efdars$ment(S),

PRODUCER ICONTACT
NAME:

McRae Associates Insurance Services Pham
VUC Na. Erle
1265 N. Manassero St Suite 303 EMAIL
ADDRESS:

Anaheim, CA 92807

INSURED

CT & T CONCRETE PAVING, INC,
324 5 DIAMOND BAR BLVD. PMB 275
DIAMOND BAR, CA 91765
Hiarlcela Aguirre
(714)779-6999 I Fac, Not ((71417794303
marlceiamcraeinsurance.insure

INSURER'S) AFFORDING COVERAGE

TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

INSURER A

INSURER B
INSURER C: BENCHMARK SPECIALTY INSURANCE COMANK 17180
INSURER D :

NAIL IM
25674
GREAT AMERICAN INSURANCE 22136

INSURER E'

INSURER F
COVERAGES CERTIFICATE NUMBER: 00041005-0 REVISION NUMBER: 174

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. (NSR ADDL SUER POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE (tap yy\1r1 POLICY NUMBER (MM117DFYYYYI IMMIDPIYYYYI UMVTS A X COMPAERCIAI. GENERAL UABILJTY y Y DTE-CO-2X94621A-TIL-25 1010112026 10/01/2026 EACH OCCURRENCE >< IUNeVIrU
CLAIMS -MADE _X OCCUR

OEN'L AGGREGATE LIMIT APPLIES PER'
POLICY LxjO LOC
JECPRT
OTHER;___

A AUTOMOBILE IJABILJTY

X ANY AUTO
01A'NED
_ AUTOS ONLY
X nu o6 ONLY
A
A
x

SCHEDULED
AUTOS

AVMS ONLY
X UM6IRELLA.1JA1I X I OCCUR
EXCESS LIAR 1 CLAIMs.MADE
DED l RETENTIONS 0
WORKERS OMP NSAT1OR

AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPA(ITNEa7EAECUTIVE
OFFICERIMEMEER EXCLUDED?
{Mandatory In N$41
I/yes, ca merlge umder
DESCRIPTION OF OPERATIONS below

B PROPERTY/INLAND MAR

C POLLUTION LIABILITY
YIN
Y Y BA -2x930002 -25-26-G
PREMISES (Ea occumancp)
MEC EXP;Any one personli

PERSONAL & ADV INJURY

GE NERAL AGGREGATE
PRODUCTS • COMPIOP AGO
s
S
5 5
5 5
10161/x025 1af11/2026 seacdae°I `Ns3LtELIMIT
BODILY INJURY (Per person) 5
BODILY INJURY {Par accident) S

PROPERTY OAMA GE
1,17,1*90
10/01/2026 EACH OCCURRENCE 5 6,000,000
nGORECIAnrle 5 6,000,000
1610112o20 X 1 STATUTE 1 1
E,L.EAcHAtcoorr $ 1,000,000
E L DISEASE - EA EMPLOYEE 5 1,000, 000
E L. DISEASE - POLICY Li IT 5 1 A000,000
04(271202S 04/27/2026 SCHEDULED EEQUIPME NT $129,692
09/13/2026 08718/2026 EACH OCC/ GEN $2 mill / $2 mill
Y Y CUP-2X94920A-25-26 10/01'2026
NIA
In Excess of GL , Auto, and WC
Y UB -2X937955-25-26 10!0112025
MACE2289310201
52430192
1,000.000
300,000
5,000
11,000,000

2.000 000
2,000,000

1.000.000
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remiche Schedule, may he attached Ir mere apace is required) Project Name; Golden Avenue Bridge Replacement Project, FEDERAL PROJECT NO. BRLS-5269 (025) CITY PROJECT NO. 1801 City of Placentla, its officers, officials, employees. agents, and volunteers are named as additional insured with respects to the above mentioned policies per attached endorsement(s). Coverage is primary & noncontributory as required by written contract, per attached endorsement Forms. Waiver of subrogation applies to general liability and excess liability, if required by written contract.
(continued on ACORD 101 Additional Remarks Schedule)

CERTIFICATE HOLDER
City of Placentia
401 E Chapman Ave.

Placentia, CA 92870
ACORD 25 (2016/03)

CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE
-7
(MAG)
O 1988-2015 ACORD CORPORATION, All tights reserved.

The ACORD name and logo are registered marks of ACORD Printed by MAG on 11/0412025 at 01.00PM

AGENCY CUSTOMER ID:

LOC #:

Amo LP ADDITIONAL REMARKS SCHEDULE

AOENCY NAMED INSURED
McRae Associates Insurance Services CT & T CONCRETE PAVING, INC.

POLICY NUMBER
NIA

CARRIER
Multiple Carriers

NAIC CODE
EFFECTIVE DATE:

Page 2 ends

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE! Certificate of Liability Insurance {continued from Description of Operations)
"Should any of the above-described policies be canceled before the expiration date thereof, a 30 days written notice will be mailed to the certificate holder(s).

ACORD 101 (2008/01)
2008 ACORD CORPORATION. All rights reserved.

The ACORD name and [Ogo are registered marks of ACORD
Printed by MAG on November 04, 2025 at 01;O0PM

Policy Number: DTE-C0-2X94621A-TI l--25

COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.

BLANKET ADDITIONAL INSURED
(Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PROVISIONS
The following is added to SECTION II — WHO IS AN
INSURED:

Any person or organization that you agree in a
written contract or agreement to Include as an
additional insured on this Coverage Part is an
insured, but only.
a. With respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
injury" caused by an offense that is committed,
subsequent to the signing of That contract or
agreement and while that part of the contract or
agreement is in effect; and
b. if, and only to the extent that, such injury or
damage is caused by acts or omissions of you or
your subcontractor in the performance of your
work" to which the written contract or agreement
applies. Such person or organization does not
qualify as an additional insured with respect to
the independent acts or omissions of such
person or organization.

The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or
agreement. the insurance provided to the
additional insured will be limited to such
minimum required limits. For the purposes of
determining whether this limitation applies, the
minimum limits required by the written contract or
agreement will be considered to include the
minimum limits of any Umbrella or Excess
liability coverage required for the additional
insured by that written contract or agreement.

This provision will not increase the limits of
insurance described in Section III — Limits Of
insurance.
b. The insurance provided to such additional
insured does not apply toy
CG D2 46 04 19
(1)
Any "bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional
architectural, engineering or surveying
services, including:
(a)
The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders or change orders, or the
preparing, approving, or failing to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering activities.
(2) Any "bodily injury" or "properly damage"
caused by "your work" and included in the
"products -completed operations hazard"
unless the written contract or agreement
specifically requires you to provide such
coverage for that additional insured during
the policy period.
c. The additional insured must comply with the
following duties:
(1)
Give us written notice as soon as practicable
of an "occurrence" or art offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence"
or offense.
(2) If a claim is made or "suit" is brought against
the additional insured:
2018 The Travelers Indemnity Company. All rights reserved, Page 1 of 2

COMMERCIAL GENERAL LIABILITY
(a) Immediately record the specifics of the
claim or "suit" and the date received: and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit" as soon as practicable,
(3) Immediately send us copies of all legal
papers received in connection with the claim
or "suit", cooperate with us in the
investigation or settlement of the claim or
defense against the "suit", and otherwise
comply with all policy conditions.

Page2of2
(4) Tender the defense and indemnity of any
claim or "suit" to any provider of other
insurance which would cover such additional
insured for a loss we cover. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other insurance
available to such additional insured which
covers that person or organization as a
named insured as described in Paragraph 4.,
Other Insurance, of Section IV — Commercial
General Liability Conditions.

Policy Number: DTE-C0.2X94621A-TIL-25

COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

XTEND ENDORSEMENT FOR CONTRACTORS
This endorsement modifies insurance provided under the following

COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage far any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. Who Is An Insured — Unnamed Subsidiaries
B. Blanket Additional Insured — Governmental
Entities — Permits Or Authorizations Relating To
Operations

PROVISIONS
A, WHO IS AN INSURED — UNNAMED

SUBSIDIARIES
The following is added to SECTION II — WHO IS
AN INSURED:

Any of your subsidiaries, other than a partnership,
joint venture or limited liability company, that is
not shown as a Named Insured in the
Declarations is a Named Insured if:
a. You are the sole owner of, or maintain an
ownership interest of more than 50% in, such
subsidiary on the first day of the policy period;
and
b. Such subsidiary is not an insured under
similar other insurance.

No such subsidiary is an insured for "bodily injury"
or "property damage" that occurred, or "personal
and advertising injury" caused by an offense
committed:
a. Before you maintained an ownership interest
of more than 50% in such subsidiary; or
b. After the date, it any, during the policy period
that you no longer maintain an ownership
interest of more than 50% in such subsidiary_
For purposes of Paragraph 1. of Section II — Who
Is An Insured, each such subsidiary will be
deemed to be designated in the Declarations as;
CG Di 16 02 19
C. Incidental Medical Malpractice
D. Blanket Waiver Of Subrogation
E. Contractual Liability — Railroads
F. Damage To Premises Rented To You
a. An organization other than a partnership, joint
venture or limited liability company; or
b. A trust;
as indicated in its name or the documents that
govern its structure_
B. BLANKET ADDITIONAL INSURED —
GOVERNMENTAL ENTITIES — PERMITS OR

AUTHORIZATIONS RELATING TO OPERATIONS
The following is added to SECTION II -- WI-tO IS
AN INSURED;
Any governmental entity that has issued a permit
or authorization with respect to operations
performed by you or on your behalf and that you
are required by any ordinance, law, building code
or written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only with respect to liability for "bodily injury", "property damage" or "personal and
advertising injury" arising out of such operations.

The insurance provided to such governmental
entity does not apply to:
a. Any "bodily injury", "property damage" or
"personal and advertising injury" arising out of
operations performed for the governmental
entity; or
b. Any "bodily injury" or "property damage"
included in the "products -completed
operations hazard
© 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 includes copyrighted material or Insurance Services Office, inc., with its permission

COMMERCIAL GENERAL LIABILITY
C. INCIDENTAL MEDICAL MALPRACTICE

1. The following replaces Paragraph b. of the
definition of "occurrence" in the
DEFINITIONS Section;
b. An act or omission comrnitled in providing
or failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to a person, unless you are in
the business or occupation of providing
professional health care services.

2. The following replaces the last paragraph of
Paragraph 2.a,(1) of SECTION II - WHO IS
AN INSURED:

Unless you are in the business or occupation
of providing professional health care services.

Paragraphs (1)(a), (b), (c) and (d) above do
not apply to "bodily injury" arising out of
providing or failing to provide;
(a) "Incidental medical services" by any of
your "employees" who is a nurse, nurse
assistant, emergency medical technician
or paramedic; or
(b) First aid or "Good Samaritan services" by
any of your "employees" or "volunteer
workers", other than an employed or
volunteer doctor, Any such "employees"
or "volunteer workers" providing or failing
to provide first aid or "Good Samaritan
services" during their work hours for you
will be deemed to be acting within the
scope of their employment by you or
performing duties related to the conduct
of your business.

3. The following replaces the last sentence of
Paragraph 5. of SECTION III - LIMITS OF
INSURANCE.

For the purposes of determining the
applicable Each Occurrence Limit, all related
acts or omissions committed in providing or
failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to any one person will be deemed to
be one "occurrence".

4. The following exclusion is added to
Paragraph 2., Exclusions, of SECTION I -

COVERAGES - COVERAGE A - BODILY

INJURY AND PROPERTY DAMAGE
LIABILITY;
Sale Of Pharmaceuticals
"Bodily injury" or "property damage" arising
out of the violation of a penal statute or
ordinance relating to the sale of

Page 2 of 3 ends

pharmaceuticals committed by, or with the
knowledge or consent of, the insured.

5. The following is added to the DEFINITIONS
Section:
"Incidental medical services" means'
a. Medical, surgical, denial, Laboratory, x-ray
or nursing service or treatment, advice or
instruction, or the related furnishing of
food or beverages; or
b. The furnishing or dispensing of drugs or
medical, dentat, or surgical supplies or
appliances.

6. The following is added to Paragraph 4.b.,
Excess Insurance, of SECTION IV -

COMMERCIAL GENERAL LIABILITY
CONDITIONS:

This insurance is excess over any valid and
collectible other insurance, whether primary,
excess, contingent or on any other basis, that
is available to any of your "employees" for
"bodily injury" that arises out of providing or
failing to provide "incidental medical services"
to any person to the extent not subject to
Paragraph 2.a.(1) of Section 11 - Who Is An
Insured,
D. BLANKET WAIVER OF SUBROGATION
The following is added to Paragraph 13., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV -- COMMERCIAL GENERAL
LIABILITY CONDITIONS:

If the insured has agreed in a contract or
agreement to waive that insured's right of
recovery against any person or organization, we
waive our right of recovery against such person or
organization, but only for payments we make
because of;
a. "Bodily injury" or "property damage" that
occurs; or
b. "Personal and advertising injury" caused by
an offense that is committed;
subsequent to the execution of the contract or
agreement.

E. CONTRACTUAL LIABILITY - RAILROADS

1. The following replaces Paragraph c. of the
definition of "insured contract" in the
DEFINITIONS Section:
c. Any easement or license agreement;
(0 2017 The Travelers Indemnity Company. All rights reserved. CG 03 16 02 19 Includes copyrighted material of Insurance Services Office, Inc , with its permission.

2. Paragraph f.(1) of the definition of "insured
contract" in the DEFINITIONS Section is
deleted.

F. DAMAGE TO PREMISES RENTED TO YOU
The following replaces the definition of "premises
damage" in the DEFINITIONS Section:
"Premises damage" means "property damage" to:

CG 03 16 0219

COMMERCIAL GENERAL LIABILITY
a. Any premises while rented to you or
temporarily occupied by you with permission
of the owner; or
b. The contents of any premises while such
premises is rented to you, if you rent such
premises for a period of seven or fewer
consecutive days.
1+2017 The Travelers Indemnity Company, All rights reserved Page 3 of 3 Includes Cppyrighted material of Insurance Services Office, Inc., with its permission.

Policy Number: DTE-Cts-2X94621A-11L-25

COMMERCIAL GENERAL LIABILITY

COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights. duties and what is and is not covered.

Throughout this policy the wards "you" and "your" refer to the Named Insured shown in the Declarations, and
any other person or organization qualifying as a Named
Insured under this policy. The words "we", "us" and
"our" refer to the company providing this insurance.

The word "insured" means any person or organization
qualifying as such under Section 11 — Who Is An
Insured_
Other words and phrases that appear in quotation
marks have special meaning. Refer to Section V --
Definitions.

SECTION I — COVERAGES
COVERAGE A — BODILY INJURY AND PROPERTY

DAMAGE LIABILITY

1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "bodily injury' or "property damage"
to which this insurance applies. We will have
the right and duty to defend the insured against
any "suit" seeking those damages, However,
we will have no duty to defend the insured
against any "suit" seeking damages for "bodily
injury" or 'property damage" to which this
insurance does not apply. We may, at our
discretion, investigate any "occurrence" and
settle any claim or "suit" that may result, But:
(1) The amount we will pay for damages is
limited as described in Section 111 — Limits
Of Insurance: and
(2) Our right and duty to defend end when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.

No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments,
b. This insurance applies to "bodily injury" and
"property damage" only if:

CG T1 00 02 1g
(1) The "bodily injury" or "property damage" i5
caused by an 'occurrence" that takes place
in the 'coverage territory";
(2) The "bodily injury" or "property damage"
occurs during the policy period: and
(3) Prior to the policy period, no insured listed
under Paragraph 1. of Section 11 — Who Is
An Insured and no "employee" authorized
by you to give or receive notice of an
"occurrence" or claim knew that the "bodily
injury" or "property damage" had occurred,
in whole or in part If such a listed insured
or authorized "employee" knew, prior to the
policy period, that the "bodily injury" or
"property damage" occurred, then any
continuation, change or resumption of such
"bodily injury" or "property damage" during
or after the policy period will be deemed to
have been known prior to the policy period.
c. "Bodily injury" or "property damage" which
occurs during the policy period and was not,
prior to the policy period, known to have
occurred by any insured listed under Paragraph

1. of Section 11 — Who Is An Insured or any
"employee" authorized by you to give or receive
notice of an "occurrence" or claim, includes any
continuation, change or resumption of that
"bodily injury" or "property damage" after the
end of the policy period.
d. "Bodily injury" or "property damage" will be
deemed to have been known to have occurred
at the earliest time when any insured listed
under Paragraph 1. of Section 11 — Who Is An
Insured or any "employee" authorized by you to
give or receive notice of an "occurrence" or
claim:
(1) Reports all, or any part, of the "bodily
injury" or "property damage" to us or any
other insurer;
(2) Receives a written or verbal demand or
claim for damages because of the "bodily
injury' or "property damage"; or
(3) Becomes aware by any other means that
"bodily injury" or "property damage" has
occurred or has begun to occur.
'0 201 ? The Travelers Indemnity Company . All rights reserved, Page 1 of 21 Includes copyrighted material or Insurance Services Office, Inc, With Its perrnisst❑n.

COMMERCIAL GENERAL LIABILITY
c. Method Of Sharing
If all of the other insurance permits contribution
by equal shares, we will follow this method also.

Under this approach each insurer contributes
equal amounts until it has paid its applicable
limit of insurance or none of the loss remains,
whichever comes first.

If any of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurers
share is based on the ratio of its applicable limit
of insurance to the total applicable limits of
insurance of all insurers,
d. Primary And Non -Contributory Insurance If
Required By Written Contract
if you specifically agree in a written contract or
agreement that the insurance afforded to an
insured under this Coverage Part must apply on
a primary basis, or a primary and non-
contributory basis. this insurance is primary to
other insurance that is available to such insured
which covers such insured as a named insured.
and we will not share with that other insurance,
provided that:
(1) The "bodily injury" or "property damage" for
which coverage is sought occurs; and
(2) The "personal and advertising injury" for
which coverage is sought is caused by an
offense that is committed:
subsequent to the signing of that contract or
agreement by you.

S. Premium Audit
a. We will compute all premiums for this Coverage
Part in accordance with our rules and rates,
b. Premium shown in this Coverage Part as
advance premium is a deposit premium only. At
the close of each audit period we will compute
the earned premium for that period and send
notice to the first Named Insured. The due date
for audit and retrospective premiums is the date
shown as the due date on the bill. If the sum of
the advance and audit premiums paid for the
policy period is greater than the earned
premium. we will return the excess to the first
Named Insured,
c, The first Named Insured must keep records of
the information we need for premium
computation, and send us copies at such times
as we may request.

6. Representations
By accepting this policy, you agree:

Page 16 of 21 ends

a. The statements in the Declarations are
accurate and complete:
b. Those statements are based upon
representations you made to us; and
c. We have issued this policy in reliance upon
your representations.

The unintentional omission of, or unintentional error
in, any information provided by you which we relied
upon in issuing this policy will not prejudice your
rights under this insurance. However, this provision
does not affect our right to collect additional
premium or to exercise aur rights of cancellation or
nonrenewal in accordance with applicable insurance
laws or regulations.

7. Separation Of Insureds
Except with respect to the Limits of Insurance. and
any rights or duties specifically assigned in this
Coverage Part to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom claim
is made or "suit" is brought.

8. Transfer Of Rights Of Recovery Against Others
To Us
If the insured has rights to recover all or part of any payment we have made under this Coverage Part.
those rights are transferred to us. The insured must
do nothing after loss to impair them. At our request,
the insured will bring "suit" or transfer those rights
to us and help us enforce them.

9. When We Do Not Renew
If we decide not to renew this Coverage Part, we will
mail or deliver to the first Named Insured shown in
the Declarations written notice of the nonrenewal
riot less than 30 days before the expiration date.

If notice is mailed, proof of mailing wilt be sufficient proof of notice.

SECTION V — DEFINITIONS

1. "Advertisement" means a notice that is broadcast or
published to the general public or specific market
segments about your goods, products or services
for the purpose of attracting customers or
supporters. For the purposes of this definition:
a. Notices that are published include material
placed on the Internet or on similar electronic
means of communication; and
b. Regarding websites, only that part of a website
that is about your goods, products or services
for the purposes of attracting customers or
supporters is considered an advertisement.
2011 The Travelers Indemnity Company . AI{ rights reserved. CG Ti 00 02 19 Includes copyrighted material of insurance Services 011ice, Inc. with its permission.

Policy Number: BA -2X930002 -25-26-G

COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.

A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSURED
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E, SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
F. HIRED AUTO — LIMITED WORLDWIDE COV-
ERAGE — INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE — CLASS

PROVISIONS

A, BROAD FORM NAMED INSURED
The following is added to Paragraph A.1.. Who Is
An Insured, of SECTION 11 — COVERED AUTOS
LIABILITY COVERAGE:

Any organization you newly acquire or form dur-
ing the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage,
Coverage under this provision is afforded only un-
til the 180th day after you acquire or form the or-
ganization or the end of the policy period, which-
ever is earlier.

B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1..

Who Is An Insured, of SECTION II — COVERED
AUTOS LIABILITY COVERAGE:

Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi-
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which
CA T3 53 02 15
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
I. PHYSICAL DAMAGE — TRANSPORTATION

EXPENSES -- INCREASED LIMIT
J. PERSONAL PROPERTY
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
this insurance applies and only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section II.

C. EMPLOYEE HIRED AUTO

1. The following is added to Paragraph A.1.,
Who Is An Insured, of SECTION II — COV-
ERED AUTOS LIABILITY COVERAGE:

An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in an "employee's"
name, with your permission, while performing
duties related to the conduct of your busi-
ness.

2. The following replaces Paragraph b. in B.5.,
Other Insurance. of SECTION IV — BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered 'autos" you own:
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
an "employee's" name, with your
2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission

COMMERCIAL AUTO
permission, while performing duties
related to the conduct of your busi-
ness.

However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
covered "auto".

D. EMPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II -- COVERED AUTOS
LIABILITY COVERAGE:

Any "employee" of yours is an "insured" while us-
ing a covered "auto" you don't own, hire or borrow
in your business or your personal affairs.

E. SUPPLEMENTARY PAYMENTS —INCREASED
LIMITS

1. The following replaces Paragraph A.2.a.(2),
of SECTION II — COVERED AUTOS LIABIL-
ITY COVERAGE:
(2) Up to $3,000 for cost of bail bonds (in-
cluding bonds for related traffic law viola-
tions) required because of an "accident"
we cover. We do not have to furnish
these bonds.

2. The following replaces Paragraph A.2.a.(4),
of SECTION II — COVERED AUTOS LIABIL-
ITY COVERAGE:
(4) All reasonable expenses incurred by the
"insured" at our request, including actual
Toss of earnings up to $500 a day be-
cause of time off from work.

F. HIRED AUTO — LIMITED WORLDWIDE COV-
ERAGE — INDEMNITY BASIS
The following replaces Subparagraph (5) in Para-
graph B.7., Policy Period, Coverage Territory,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS:
(5)
Anywhere in the world, except any country or
jurisdiction while any trade sanction, em-
bargo, or similar regulation imposed by the
United States of America applies to and pro-
hibits the transaction of business with or
within such country or jurisdiction, for Cov-
ered Autos Liability Coverage for any covered
"auto" that you lease, hire, rent or borrow
without a driver for a period of 30 days Or less
and that is not an "auto" you lease, hire, rent
or borrow from any of your "employees",
partners (if you are a partnership), members
(if you are a limited liability company) or
members of their households.
(a) With respect to any claim made or "suit"
brought outside the United States of
America, the territories and possessions
of the United States of America, Puerto
Rico and Canada:
(i) You must arrange to defend the "in-
sured" against, and investigate or set-
tle any such claim or "suit" and keep
us advised of all proceedings and ac-
tions.
(11) Neither you nor any other involved
"insured" will make any settlement
without our consent.
(iii) We may, at our discretion, participate
in defending the "insured" against, or
in the settlement of, any claim or
"suit".
(iv) We will reimburse the "insured" for
sums that the "insured" legally must
pay as damages because of "bodily
injury" or "property damage" to which
this insurance applies, that the "in-
sured" pays with our consent, but
only up to the limit described in Para-
graph C., Limits Of Insurance, of
SECTION Il -- COVERED AUTOS
LIABILITY COVERAGE.
(v) We will reimburse the "insured" for
the reasonable expenses incurred
with our consent for your investiga-
tion of such claims and your defense
of the "insured" against any such
"suit", but only up to and included
within the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II — COVERED AUTOS
LIABILITY COVERAGE, and not in
addition to such limit. Our duty to
make such payments ends when we
have used up the applicable limit of
insurance in payments for damages,
settlements or defense expenses.

This insurance is excess aver any valid
and collectible other insurance available
to the "insured" whether primary, excess,
contingent or on any other basis.
(c) This insurance is not a substitute for re-
quired or compulsory insurance in any
country outside the United States, its ter-
ritories and possessions, Puerto Rico and
Canada.
(b)

Page 2 of 4 ends

Includes copyrighted material of Insurance Services office, Inc. with its permission.

(d)
You agree to maintain all required or
compulsory insurance in any such coun-
try up to the minimum limits required by
local law. Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory in-
surance requirements.

It is understood that we are not an admit-
ted or authorized insurer outside the
United States of America, its territories
and possessions, Puerto Rico and Can-
ada. We assume no responsibility for the
furnishing of certificates of insurance, or
for compliance in any way with the laws
of other countries relating to insurance.

G. WAIVER OF DEDUCTIBLE — GLASS
The following is added to Paragraph D.. Deducti-
ble, of SECTION III — PHYSICAL DAMAGE
COVERAGE:

No deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.

H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
The following replaces the last sentence of Para-
graph A.4.b., Loss Of Use Expenses, of SEC-
TION III — PHYSICAL DAMAGE COVERAGE:

However, the most we will pay for any expenses
for loss of use is $65 per day, to a maximum of
$750 for any one "accident".

PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
The following replaces the first Sentence in Para-
graph A.4.a., Transportation Expenses, of
SECTION III — PHYSICAL DAMAGE COVER-
AGE:

We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.

J. PERSONAL PROPERTY
The following is added to Paragraph A.4., Cover-
age Extensions, of SECTION III — PHYSICAL
DAMAGE COVERAGE:

Personal Property
We will pay up to $400 for "loss" to wearing ap-
parel and other personal property which is:
(1) Owned by an "insured"; and
CAT3530215

COMMERCIAL AUTO
(2) In or on your covered "auto".

This coverage applies only in the event of a total
theft of your covered "auto".

No deductibles apply to this Personal Property
coverage.

K. AIRBAGS
The following is added to Paragraph B.3., Exclu-
sions, of SECTION III •- PHYSICAL DAMAGE
COVERAGE:

Exclusion 3.a, does not apply to "loss" to one or
more airbags in a covered "auto" you own that in-
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1,b. and A,1.c,, but
only:
a. If that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; and
c. The airbags were not intentionally inflated,
We will pay up to a maximum of $1,000 for any
one "loss".

L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV — BUSINESS AUTO CONDITIONS:

Your duty to give us or our authorized representa-
tive prompt notice of the "accident" or "loss" ap-
plies only when the "accident" or "loss" i5 known
to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c)
(d)
A member (if you are a limited liability com-
pany);
An executive officer, director or insurance
manager (if you are a corporation or other or-
ganization); or
(e) Any "employee" authorized by you to give no-
tice of the "accident" or "loss
M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.5., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS:

5. Transfer Of Rights Of Recovery Against
Others To Us
We waive any right of recovery we may have
against any person or organization to the ex-
tent required of you by a written contract
signed and executed prior to any "accident"
or "loss", provided that the "accident" or "loss"
arises out of operations contemplated by
02015 The Travelers Indemnity Company. All rights reserved, Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission.

COMMERCIAL AUTO
such contract. The waiver applies only to the
person or organization designated in such
contract.

N. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph B.2., Con-
cealment, Misrepresentation, Or Fraud, of
SECTION IV — BUSINESS AUTO CONDITIONS:

The unintentional omission of, or unintentional
error in, any information given by you shall not
prejudice your rights under this insurance. How-
ever
owever this provision does not affect our right to col- lect additional premium or exercise our right of
cancellation or non -renewal.

Page 4 of 4 ends

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

POLICY NUMBER. BA -2X930002 -25-26-G

COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BLANKET ADDITIONAL INSURED - PRIMARY AND

NON-CONTRIBUTORY WITH OTHER INSURANCE -

CONTRACTORS
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

PROVISIONS

1. The following is added to Paragraph c, in A.1.,
Who Is An Insured, of SECTION fl — COVERED
AUTOS LIABILITY COVERAGE:

This includes any person or organization who you
are required under a written contract or
agreement, that is signed by you before the
"bodily injury" or "property damage" occurs and
that is in effect during the policy period, to name
as an additional insured for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the extent of
that person's or organization's liability for the
conduct of another "insured".

CA T4 99 02 16

2. The following is added to Paragraph 8.5., Other
Insurance of SECTION IV — BUSINESS AUTO
CONDITIONS!
Regardless of the provisions of paragraph a. and
paragraph d. of this part 5. Other Insurance, this
insurance is primary to and non-contributory with
applicable other insurance under which an
additional insured person or organization is a
named insured when a written contract or
agreement with you, that is signed by you before
the "bodily injury' or "property damage" occurs
and that is hi effect during the policy period,
requires this insurance to be primary and non-
contributory.
2016 The Travelers Indemnity Company. M rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with Its permission.

TRAVELERS)

WORKERS COMPENSATION
AND

EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 99 03 76 ( A)—
POLICY
)—POLICY NUMBER: UB -2X937955 -25-26-G

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS

ENDORSEMENT - CALIFORNIA
(BLANKET WAIVER)
We have the nght to recover our payments from anyone Liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule.

The additional premium for this endorsement shall be °/u of the California workers' compensation pre- mium_
Schedule
Person or Organization Job Description
As required by written contract
This endorsement changes the policy to which it is attached and is effective on the date Issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy)
Endorsement Effective Insured Policy No. UB -2X937955 -25-26-G Endorsement No to101l2o25 Premium
Insurance Company
Trevelers Property Casualty Company
Countersigned by

Page 1 of 1 ends

09/30/2025
McRAE ASSOCIATES INSURANCE SERVICES
Te whom this may concern,
Please be advised that if we get notified by any of the insurance companies listed on the certificate that the insured, CT & T Concrete Paving, Inc. will be receiving a notice of cancellation for any of the below reasons a written notice will be mailed or delivered to you. 1) 10 days before the effective date of cancellation if they cancel for non-payment of premium or 2) 30 days' notice of cancellation will state the effective date of cancellation. The policy will end an that date.

If you have any questions or concerns please feel free to contact our office.

Thank you,
. r
Patrick McRae
R Cense No 0637431
%laid {. IA, o1sseio yu fC 303 Arretheillr Nati I:A 9280 {7K+ 779.6999 r=qx f J j41 779-6903 E mad n,mcm s 8i:t14lobal r

3;kc,25,Eggolk
Agenda Item No: 1.e

PLACENTIA CITY COUNCIL AGENDA REPORT
Meeting Date: October 6, 2026
Submitted by: Gabriel Guerrero-Gabany
From: Public Works
Subject:

APPROVAL OF PLANS AND AWARD OF CONSTRUCTION CONTRACT TO KALBAN, INC. FOR THE CDBG SIDEWALK AND CURB RAMP ADA IMPROVEMENT PROJECT, CITY PROJECT NO. 27-101
Financial Impact:

Expense:

Available Budget:
$214.125.56
$155,000.00
$ 15,500.00
$ 43,625.56
$214.125.56
$176,679.00
$ 37,446.56
Total Construction Cost
Construction Contract Amount
Construction Contingency Amount
Construction Inspection and Management Costs
Total Proiect Budaet City Proiect No. 27-101
Fiscal Year 2026-27 CIP Budget - CDBG
(204-80100-9600)
Measure U (102-80100-9600)
Summary:

The scope of work for the Community Development Block Grant (CDBG) Sidewalk and Curb Ramp Americans with Disabilities Act (ADA) Improvement Project includes removal of existing sidewalk, curb, and gutter and other existing improvements for the construction of new concrete curb ramps, sidewalks, retaining curb, cross gutters, full depth asphalt concrete pavement along Livingston Ave from Tuffree Blvd to Kraemer Blvd, and replacing two driveways located along Yorba Linda Blvd and Seville St (Attachment 1).

The City solicited competitive bids for this project. A total of nineteen (19) bids were received for this project on September 9, 2026. These bids consisted of one base bid schedule. The grand total of the bid schedule was used as the basis in determining the low bid for this project. The low bid received from Kalban, Inc. in the amount of $155,000 was found to be the lowest responsive and most responsible bid received.

A component of this project requires the allocation of funding for inspection and construction management services. The City requested five (5) quotes from its on-call list of construction management and inspection consultants. After reviewing the quotes, it was determined that Berg & Associates submitted the most qualified proposal in the amount of $43,625.56 for inspection and construction management services.

Staff recommends that City Council award a construction contract to Kalban, Inc. in the 168

amount of $155,000.00 including a ten percent (10%) construction contingency amount of $15,500.00 to cover any unforeseen conditions found during construction. The total construction contract cost, including contingency, construction management and inspection services amounts to $214,125.56.

Recommended Action:

It is recommended that the City Council:

1. Approve the Engineered Plans and Specifications prepared by the Engineering Department for the CDBG Sidewalk and Curb Ramp ADA Improvement Project, City Project No. 27-101; and

2. Approve a Public Works Agreement with Kalban, Inc., for the CDBG Sidewalk and Curb Ramp ADA Improvement Project in the amount of $155,000.00; and

3. Reject all other bids received and authorize return of the bid bonds; and

4. Authorize the Acting City Administrator to approve contract change orders up to ten percent (10%) of the contract amount, or $15,500.00, for a total construction contract not -to -exceed amount of $170,500; and

5. Approve a purchase order with Berg and Associates to provide construction management and inspection services for a not -to -exceed amount of $43,625.56; and

6. Authorize the Acting City Administrator and/or her designee to execute all necessary documents, in a form approved by the City Attorney.

Strategic Plan Statement:

The item conforms to Strategic Goal No. 3, Maintain and enhance streets, parks, and public facilities to ensure they are well-appointed, clean, attractive, and reflective of the city's commitment to quality.

Discussion:

The scope of work for the CDBG Sidewalk and Curb Ramp ADA Improvement Project includes removal of existing sidewalk, curb and gutter and other existing improvements for the construction of new concrete curb ramps, sidewalks, retaining curb, cross gutters, full depth asphalt concrete pavement along Livingston Ave from Tuffree Blvd to Kraemer Blvd, and replacing two driveways located along Yorba Linda Blvd and Seville St.

On September 9, 2026, the City received nineteen (19) bids from contractors. The following table provides the total bid amounts received from each contractor and these amounts reflect the bid schedule which was used as the basis of award:

Contractor Bid Amount
Kalban, Inc. $155,000.00
CJ Concrete Construction, Inc. $158,975.00
LCR Earthwork & Engineering, Corp. $160,500.00
Pavement Rehab Company $169,000.00
S&H Civil Works $174,400.00
Van Engineering $181,400.00
Aza Construction $185,950.00
TVR Construction Engineering, LLC. $194,880.00
Leonida Builders, Inc. $207,300.00
CT&T Concrete Paving, Inc. $221,400.00
169

Alfaro Communications Construction, Inc.

Diamond Construction & Design
All American Building Services
Oppenheimer National
AEC Moreno Corporation
Gentry General Engineering, Inc.

Roadway Engineering & Construction Corp.

HZS Engineering, Inc.

Aquaphoenix Builders
$222,586.60
$222,664.00
$235,200.00
$238,810.00
$271,900.00
$305,200.00
$338,740.00
$364,500.00
$370,623.00
After reviewing the bids, it was determined that Kalban, Inc. submitted the lowest responsible bid. Upon review and analysis, Staff determined the bid proposal to be responsive and valid.

Based upon Kalban, Inc.'s reference check, and submitted bid, Staff recommends awarding a construction contract to Kalban, Inc. for the CDBG Sidewalk and Curb Ramp ADA Improvement Project.

A component of this project requires the allocation of funding for inspection and construction management services. The City requested five (5) quotes from its on-call list of construction management and inspection consultants. The following table provides the total amounts received from each consultant.

Consultant CDBG Project
Ardurra N/A
Bowman (Infrastructure Engineers) $14,040.00
Berg & Associates $43,625.56
NV5 $42,662.00
Z&K Consultants $74,660.00
After reviewing the quotes, it was determined that Berg & Associates submitted the most qualified proposal, and staff recommends approving a purchase order in the total amount of $43,625.56 for Berg & Associates for inspection and construction management services.

In summary, Staff recommends that City Council award a construction contract to Kalban, Inc. in the amount of $155,000.00 with a ten percent (10%) construction contingency amount of $15,500.00 and approving a purchase order with Berg & Associates for $43,625.56. The total construction cost amounts to $214,125.56.

Financial Summary:

The total construction cost for the Fiscal Year CDBG Sidewalk and Curb Ramp ADA Improvement Project amounts to $214,125.56. This cost consists of the bid amount submitted by Kalban, Inc. in the amount of $155,000.00, a construction contingency in the amount of $15,500.00 and construction inspection and management services with Berg & Associates in the amount of $43,625.56. A total of $176,679 was budgeted in the FY 2026-27 CIP Budget for this project.

To cover the costs of the construction inspection and management for this project, a budget transfer was performed. There were Measure U savings from the Fiscal Year 2026-27 170

Residential Roadway Rehabilitation Project. A total of $37,446.56 was transferred from the residential street rehabilitation project to the CDBG Sidewalk and Curb Ramp ADA Improvement Project.

Funding for this project is supported by the sources outlined below:

Funding Source Amount Account
FY 2026-27 CDBG $176,679 204-80100-9600 - Project: 27-101 Measure U $37,446.56 102-80100-9600 - Project: 27-101
Total $214,125.56
Attachments
Attachment 1 - Plans.pdf
Attachment 2 - Kalban PWA_signed.pdf
171

GENERAL NOTES:

1. WORK SHALL CONFORM TO THE CITY OF PLACENTIA STANDARD PLANS AND THE APWA STANDARD SPECIFICATIONS FOR PUBLIC WORKS CONSTRUCTION (GREEN BOOK, CURRENT EDITION). THE STANDARD PLANS AND SPECIFICATIONS SHALL BE CONSIDERED A PART OF THE IMPROVEMENT PLANS AND CONTRACTORS SHALL HAVE THEM ON THE JOB SITE AT THE TIME OF CONSTRUCTION.

2. CONTRACTORS AND SUBCONTRACTORS SHALL OBTAIN APPROPRIATE PERMITS AND LICENSES FROM THE CITY OF PLACENTIA AND OTHER GOVERNING JURISDICTIONS PRIOR TO ANY CONSTRUCTION OR EXCAVATION IN EXISTING RIGHT-OF-WAYS OR EASEMENTS.

3. THE CONTRACTOR SHALL NOTIFY THE CITY ENGINEER'S OFFICE AT LEAST ONE FULL WORKDAY PRIOR TO START OF ANY CONSTRUCTION.

4. PRIOR TO ANY EXCAVATION, THE DEVELOPER IS RESPONSIBLE FOR CONTACTING ALL UTILITY AND OIL COMPANIES IN ADDITION TO THE UNDERGROUND SERVICES ALERT (1-800-422-4133) AT LEAST 48 HOURS IN ADVANCE OF ANY WORK TO BE PERFORMED.

5. THE EXISTENCE AND LOCATION OF UNDERGROUND UTILITY PIPES OR STRUCTURES SHOWN ON THESE PLANS WERE OBTAINED BY A

SEARCH OF THE AVAILABLE RECORDS, BUT NO GUARANTEE IS MADE THAT ALL SUBSTRUCTURES ARE SHOWN OR THAT THE LOCATIONS SHOWN ARE EXACT. THE CONTRACTOR SHALL TAKE DUE PRECAUTIONARY MEASURES TO PROTECT ALL UTILITY LINES INCLUDING THOSE NOT OF RECORD OR NOT SHOWN.

6. ALL UTILITIES SHALL BE INSTALLED PER PERMITS ISSUED FOR SUCH WORK. AS -BUILT PLANS SHALL BE SUBMITTED TO THE CITY ENGINEER'S OFFICE UPON COMPLETION OF WORK.

7. COMPACTION TESTS ARE REQUIRED ON ALL STREETS AND TRENCH CONSTRUCTION (SUBGRADE 909 AND SUB -BASE 959 RELATIVE COMPACTION).

8. UTILITY TRENCH BACKFILL COMPACTION SHALL BE VERIFIED PRIOR TO STREET PAVING.

9. ELEVATIONS SHALL BE BASED ON ORANGE COUNTY SURVEYOR'S BENCHMARKS.

10. MONUMENTS SHALL BE SET AND TIES SUBMITTED TO THE CITY ENGINEER'S OFFICE PRIOR TO ACCEPTANCE OF IMPROVEMENTS. TIES AND NOTES SHALL BE LINKED ON ORANGE COUNTY SURVEY PAPER.

11. TRAFFIC CONTROL AND SAFETY SHALL BE MAINTAINED PER "STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION, MANUAL OF WARNING SIGNS, LIGHTS, AND DEVICES FOR USE IN WORK ON HIGHWAYS." BARRICADES, WARNING SIGNS, TRAFFIC SIGNS, OR OTHER

TRAFFIC CONTROL DEVICES WILL NOT BE REMOVED OR RELOCATED WITHOUT THE APPROVAL OF THE CITY ENGINEER OR HIS REPRESENTATIVE. THE CONTRACTOR WILL NOTIFY THE CITY INSPECTOR IN ADVANCE OF WHEN SUCH REMOVAL OR RELOCATION WILL TAKE PLACE. APPROPRIATE TEMPORARY, BARRICADES, SIGNS, ETC WILL BE INSTALLED TO THE SATISFACTION OF THE CITY ENGINEER.

12. ALL SURVEY MONUMENTS SHALL BE PROTECTED AND PERPETUATED IN PLACE. ANY DISTURBED OR COVERED MONUMENTS SHALL BE RESET BY THE REGISTERED LICENSED CIVIL ENGINEER AT THE DIRECTION OF THE CITY ENGINEER.

13. CONCRETE SHALL BE A MINIMUM 5-1/2 SACK MIX UNLESS OTHERWISE NOTED IN APPROVED PLANS OR SPECIFICATIONS.

14. EXISTING STRIPING AND PAVEMENT MARKINGS DAMAGED DURING CONSTRUCTION SHALL BE RESTORED IN THEIR ENTIRETY PER CITY APPROVAL.

15. EXISTING IRRIGATION LINES, VALVES, AND HEAD SHALL BE RELOCATED AS REQUIRED.

16. EXISTING IRRIGATION AND VEGETATION DAMAGED DURING CONSTRUCTION SHALL BE RESTORED PER CITY APPROVAL.

17. CONTRACTOR SHALL MAINTAIN POSITIVE DRAINAGE AROUND CURB RETURNS AND MAINTAIN EXISTING DRAINAGE PATTERNS WHEN CONSTRUCTING PROPOSED PCC IMPROVEMENTS.

18. CONTRACTOR SHALL PROTECT IN PLACE EXISTING SIFI CONDUIT NEXT TO EXISTING CURB AND GUTTER, CROSS GUTTER AND EXISTING IMPROVEMENTS.

19. PROPOSED IMPROVEMENTS FOR PATH OF TRAVEL SHALL NOT EXCEED 1.59 MAX CROSS -SLOPE AND 4.59 MAX RUNNING SLOPE.

20. CURB RAMP AND DRIVEWAY DETAILS SHOWN ARE TYPICAL AND NOT SITE-SPECIFIC UNLESS OTHERWISE NOTED. CONTRACTOR SHALL

FIELD VERIFY EXISTING CONDITIONS, GRADES, DIMENSIONS, AND ELEVATIONS PRIOR TO CONSTRUCTION AND SHALL NOTIFY THE ENGINEER OF ANY CONDITIONS REQUIRING MODIFICATION OF THE TYPICAL CURB RAMP AND DRIVEWAY DETAILS. SITE-SPECIFIC MODIFICATIONS SHALL BE REVIEWED AND APPROVED BY THE ENGINEER PRIOR TO CONSTRUCTION.

21. PRIOR TO FINAL PROJECT ACCEPTANCE, CONTRACTOR SHALL SUBMIT CASP CERTIFICATION FOR EACH CURB RAMP.

22. SHOULD CONFLICTING INFORMATION BE FOUND ON THE PLANS, THE CONTRACTOR SHALL NOTIFY THE ENGINEER BEFORE PROCEEDING WITH THE WORK IN QUESTION.

UTILITY CONTACTS:

CITY CITY OF PLACENTIA
CONTACT: GABRIEL GUERRERO-GABANY

WATER GOLDEN STATE WATER
CONTACT: ENGINEERING

WATER METROPOLITAN WATER DISTRICT
CONTACT: OC SYSTEM PROTECTION OFFICE

ELECTRICAL SOUTHERN CALIFORNIA EDISON DISTRIBUTION
CONTACT: GILBERT ACEVES

GAS SOUTHERN CALIFORNIA GAS
CONTACT: RYAN LOPEZ

TELEPHONE AT&T DISTRIBUTION
CONTACT: SUBSTRUCTURE RECORDS REQUEST

CABLE CHARTER COMMUNICATIONS
CONTACT: COZETTE MILES
LEGEND:

SAWCUT AND REMOVE EXISTING PCC
° IMPROVEMENT AND CONSTRUCT PCC
IMPROVEMENT AS SHOWN ON PLAN.

O
1' WIDE A.C. SLOT PAVING PER DETAIL
B ON SHEET 5.

SEWER MANHOLE
® WATER VALVE
® STORM DRAIN MANHOLE
NUMBER

DATE BY
- - - TC

REVISIONS

DESCRIPTION
W
(714) 993-8250
(800) 999-4033
(714) 547-5084
(909) 329-9445
(714) 634-5067
(510) 645-2929
(909) 721-8502
---TC
-S -
G

TELECOM LINE

EASEMENT LINE

WATER LINE

SEWER LINE

GAS LINE
APP'D DATE BENCHMARK:

CDBG SIDEWALK AND CURB RAMP

ADA IMPROVEMENT PROJECT
PROJECT NO. 27-101

CITY OF PLACENTIA

TUFFREE BLVD

SIERRA BONITA DR
c
1 SHT NO. 2

VALENCIA AVE

YORBA LINDA BLVD
ABBREVIATIONS:

A.B. -AGGREGATE BASE
A.C. -ASPHALT CONCRETE
ARCH. -ARCHITECTURAL
B.. R. -BEGIN OF CURB RETURN
B.C. -BACK OF CURB
B. 0. R.

B.O.W.

BLDG
C. L. F.

C.I.P.

C. B.

C/L
C.F.

ARCH.

E. C.

E.C.R.
(0.00)
E. P.

EXIST.

F. H.

F. G.

F. 0.

F.S.

F. L.

G. B.

G.V.

H.C.

H=
H.P.

INV.

L.S.

REFERENCES
- BOTTOM OF PIPE
- BOTTOM OF WALL
- BUILDING
- CHAIN LINK FENCE
- CAST IRON PIPE
- CATCH BASIN
- CENTERLINE
- CURB FACE
- CONCRETE
- END OF CURB
- END OF CURB RETURN
- EXISTING ELEVATION
- EDGE OF PAVEMENT
- EXISTING
- FIRE HYDRANT
- FINISH GRADE
- FLUSH OUT
- FINISH SURFACE
- FLOW LINE
- GRADE BREAK
- GAS VALVE
- HANDICAP
- HEIGHT OF RETAINING
- HIGH POINT
- INVERT
- LANDSCAPING

HERITAGE AVE

LMNGSTON AVE
SHT NO. 3
SHT NO.5

INDEX MAP
N.T.S

LARKSPUR DR
1 SHT NO.5
L.P.

M.H.

N.G.

N.T.S

0.C. P. W.

P.V.C.

P.G.

PKWY DRAIN
R/W
R
R. D.

R.C. P.

ST. LT.

S.D.

S.F.

S.W.

T. C.

T. S.

T. 0. P.

T. F.

T.W.

T. R.

T. G.

TOP
TOE
T. B.

VAR.

W.V.

N KRAEMER BLVD
SHT NO. 4
- LOW POINT
- MANHOLE
- NATURAL GAS
- NOT TO SCALE
- ORANGE COUNTY PUBLIC WORKS
- POLYVINYLCHLORIDE
- POWER POLE
- PROPERTY LINE
- PARKWAY DRAIN
- RIGHT OF WAY
- RATE OF GRADE
- ROOF DRAIN
- REINFORCED CONCRETE PIPE
- STREET LIGHT
- SLOPE
- STORM DRAIN
- SQUARE FEET
- STEM WALL
- TOP OF CURB
- TOP OF CONCRETE SLAB
- TOP OF PIPE
- TOP OF FOOTING
- TOP OF WALL
- TOP OF RAIL
- TOP OF GRATE
- TOP OF SLOPE
- TOE OF SLOPE
- TOP OF BERM
- VARIES
- WATER VALVE
Prepared under the supervision of
'&44.

R.C.E. No.

Drawn by: BB/SK
Checked by: GGG
Recommended by: GGG
8/25/26
Date
SEAL

CONSTRUCTION NOTES

REMOVE EXISTING IMPROVEMENTS AND CONSTRUCT PCC CURB RAMP PER OCPW O STD. PLAN 1115 AND AS SHOWN ON PLAN. COLOR OF DETECTABLE WARNING SURFACE SHALL BE YELLOW. CASE PER PLAN.

OREMOVE EXISTING IMPROVEMENTS AND CONSTRUCT 4" THICK PCC SIDEWALK PER 2 OCPW STD. PLAN 1205 AND AS SHOWN ON PLAN.

O3 SAWCUT AND REMOVE EXISTING AND CONSTRUCT PCC CURB (A2-8) AND GUTTER PER 0.C.P.W. STD. PLAN 120-2, INCLUDE 1' WIDE A.C. SLOT PAVING.

REMOVE EXISTING IMPROVEMENTS AND CONSTRUCT CONSTRUCT PCC CROSS OGUTTER INCLUDING MONOLITHIC CURB PER SPPWC STD. PLAN 122-2 AND AS SHOWN ON PLAN, INCLUDE 1' WIDE A.C. SLOT PAVING.

SAWCUT AND REMOVE EXISTING PCC DRIVEWAY AND CONSTRUCT 6" PCC O DRIVEWAY PER 0.C.P.W. STD. PLAN 1210, INCLUDE 1' WIDE A.C. SLOT PAVING PER DETAIL B ON SHEET 5.

O INSTALL DOWELS AT CONTACT JOINT PER DETAIL "A" ON SHEET 2. 0 PROTECT IN PLACE PAVEMENT IN MORATORIUM. FORM AGAINST THE EXISTING A.C. SECTION SHEET INDEX:

SHT NO. DESCRIPTION
1 TITLE SHEET, GENERAL NOTES AND ABBREVIATIONS
2 CURB RAMPS AT SIERRA BONITA
3 CURB RAMPS AT HERITAGE AVE AND LARKSPUR DR
4 CURB RAMPS AT KINGSTON RD
5 DRIVEWAYS
Underground Service Alert
of Southern California
Know what'beIOW.

Calbefore you dig.

TWO WORKING DAYS

BEFORE YOU DIG

NOTICE TO CONTRACTOR
www.DigAlert.org
PURSUAN T TO ASSEMBL Y B/LL 4216 NO EXCA VA TION PERM/ T

IS VALID UNLESS THE CONTRACTOR CONTACTS AND OBTAINS
A DIG ALERT TICKET NUMBER. CALL 811 A T LEAST TWO
WORKING DA YS PRIOR TO COMMENCING' EXCA VA TION.

APPROVAL
CHRISTOPHER TANIO, R.C.E. 82756 Date

CITY ENGINEER / DIRECTOR OF PUBLIC WORKS

IMPROVEMENT PLANS

CDBG SIDEWALK AND CURB RAMP

ADA IMPROVEMENT PROJECT

TITLE SHEET AND GENERAL NOTES

CITY OF PLACENTIA
DWG. ID.

PW -SI -19
SHT1_ OF 5
172

EXIST.

R/W
JOIN
EXIST.

EXIST.

R/W
1 TOP SIGN
JOIN
STA 10+42.16 BCR w
RET. WALL
•
JOIN
EXIST.

STRIPIN
L
G I� G
I G)
0 - G- -
M -
M M
12+00

LIVINGSTON AVE

STREET LIGHT

LIVINGSTON AVE
•
IN
IST. �`—
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J01
EXIST.

JOIN
EXIST.

CROSS GUTTER

AND SPANDRELS
1 /v
EXIST.

SIERRA BONITA DR
0 Z
0 co
L.L
w
VJ
WV
JOIN
EXIST.
1 0
EXIST.

R/W
JOIN
EXIST.

STA 10+40.80 ECR
1 STRIPING
MOW
JOIN
EXIST.

STA 10+00.00 SIERRA BONITA =
STA 12+79.77 LIVINGSTON (E OF TUFFREE BLVD)
■■ MH
STA 12+79.77 LIVINGSTON AVE (5 OF SIERRA BONITA DR) =
STA 9+90.00 SIERRA BONITA
13+0
+50.35 ECR
JOIN
EXIST.

JOIN
EXIST.
411F
STA 9+51.70 BCR
J IN
EXI T.

STOP SIGN 1
S— S
JOI
EXIST.

LIVINGSTON AVE
JOIN
EXIST.

EXIST._
8/W
Ift

REVISIONS
NUMBER DATE BY DESCRIPTION APP'D DATE BENCHMARK:

REFERENCES
Prepared under the supervision of
yaSzi_41,462.244.4.0
R.C.E. No.

Drawn by: SK
Checked by: GGG
Recommended by: GGG
8/25/26 8/25/26
Date
SEAL
FESS/
klERR
J
rri
ca C 92943 a
Z
Exp.12/31/27.` *
CIVI�-
OF C M -\F

PROPOSED CONCRETE CURB
SAWCUT AND JOIN EXIST.

EXISTING CONCRETE SPANDREL
#4 EPDXY COATED DOWELS.
12" LONG AT 2' 0.C. ALONG

PROPOSED CURB RAMP
I
0 10 20
Feet
CONSTRUCTION NOTES:

O REMOVE EXISTING IMPROVEMENTS AND CONSTRUCT PCC CURB RAMP PER OCPW 1 STD. PLAN 1115 AND AS SHOWN ON PLAN. COLOR OF DETECTABLE WARNING SURFACE SHALL BE YELLOW. CASE PER PLAN.

OREMOVE EXISTING IMPROVEMENTS AND CONSTRUCT 4" THICK PCC SIDEWALK PER OCPW STD. PLAN 1205 AND AS SHOWN ON PLAN.

SAWCUT AND REMOVE EXISTING AND CONSTRUCT PCC CURB (42-8) AND GUTTER PER 0.C.P.W. STD. PLAN 120-2, INCLUDE 1' WIDE A.C. SLOT PAVING.

O REMOVE EXISTING IMPROVEMENTS AND CONSTRUCT CONSTRUCT PCC CROSS 4 GUTTER INCLUDING MONOLITHIC CURB PER SPPWC STD. PLAN 122-2 AND AS SHOWN ON PLAN, INCLUDE 1' WIDE A.C. SLOT PAVING.
06 INSTALL DOWELS AT CONTACT JOINT PER DETAIL 'A" ON SHEET 2.

O PROTECT IN PLACE PAVEMENT IN MORATORIUM. FORM AGAINST THE EXISTING A.C.

SECTION
LEGEND:

SAWCUT AND REMOVE EXISTING IMPROVEMENT AND CONSTRUCT
PCC IMPROVEMENT AS SHOWN ON PLAN.
1' WIDE A.C. SLOT PAVING PER DETAIL B ON SHEET 5.

DISPOSITION NOTES:
1 PROTECT IN PLACE. (TYPE PER PLAN.)
9„
1 2"
3"
VARIES

PARKWAY
4' MIN. 6"

CONCRETE RETAINING CURB
PER STD. RAMP PLAN

PROPOSED CONCRETE

SIDEWALK PER PLAN

PROPOSED CURB RAMP PER PLAN
MAX 8.33%
DETAIL "A"

CURB RAMP JOINT DETAIL AT EXISTING SPANDREL
N.T.S.

PROPOSED CURB

RAMP LANDING PER
PLAN MAX 2%
Underground Service Alert
of Southern California

TWO WORKING DAYS

BEFORE YOU DIG
Know what'beIOW.

Callbefore you dig.

NOTICE TO CONTRACTOR
www.DigAlert.org
PURSUANT TO ASSEMBLY BILL 4216 NO EXCA VA TION PERMIT

IS VALID UNLESS THE CONTRACTOR CONTACTS AND OBTAINS'
A DIG ALERT TICKET NUMBER. CALL 811 AT LEAST TWO
WORKING DAYS PRIOR TO COMMENCING EXCA VA TION.

IMPROVEMENT PLANS

CDBG SIDEWALK AND CURB RAMP

ADA IMPROVEMENT PROJECT

PLAN SHEET

CITY OF PLACENTIA
DWG. NO.

SWSI19
SHT 2 OF 5

HERITAGE AVE
w
w
L.L
w
M I

4.0 JOIN
EXIST.

EXIST.

R/W
JOIN
EXIST.

ST SIGN
WV
STA 10+51.32 BCR
STA 10+52.67 ECR
TYPE 2
EXIST. JOIN TYPE 2
R/W EXIST.

JOIN
EXIST.
-yaw -mow .^
G G G

STREET LIGHT
M M M

LIVINGSTON AVE
15+00

CROSS GUTTER

AND SPANDRELS

LIVINGSTON AVE
00 16+00
STA 10+00.55 LARKSPUR DR =
STA 15+58.29 LIVINGSTON AVE (E OF SIERRA BONITA DR)
l'

ST SIGN
STA 10+52.68 BCR
M
M

M STREET LIGHT

LIVINGSTON AVE
1 7+95.56
U)
G
M
0 CROSS GUTTER
A 1 SPANDRELS
G
1 LIVINGSTON AVE

LARKSPUR DR
(1)
STA 10+52.15 ECR
M
G G
STA 10+00.00 LARKSPUR DR =
STA 18+39.94 LIVINGSTON AVE (E OF SIERRA BONITA DR)
S
19+00
M

REVISIONS
NUMBER DATE BY DESCRIPTION APP'D DATE BENCHMARK:

REFERENCES
Prepared under the supervision of
yaszi_41,462.244,Loia.a.,17_
R.C.E. No.

Drawn by: SK
Checked by: GGG
Recommended by: GGG
8/25/26
Date
SEAL
I
rri
ca
C 92943 a
z
Exp.12/31/27-". *
CIVIC
OF C M -\F
0 10 20
Feet
CONSTRUCTION NOTES:

REMOVE EXISTING IMPROVEMENTS AND CONSTRUCT PCC CURB RAMP PER OCPW STD. PLAN 1115 AND AS SHOWN ON PLAN. COLOR OF DETECTABLE WARNING SURFACE SHALL BE YELLOW. CASE PER PLAN.

OREMOVE EXISTING IMPROVEMENTS AND CONSTRUCT 4" THICK PCC SIDEWALK PER OCPW STD. PLAN 1205 AND AS SHOWN ON PLAN.

REMOVE EXISTING IMPROVEMENTS AND CONSTRUCT CONSTRUCT PCC CROSS 0 GUTTER INCLUDING MONOLITHIC CURB PER SPPWC STD. PLAN 122-2 AND AS SHOWN ON PLAN.

O6 INSTALL DOWELS AT CONTACT JOINT PER DETAIL "A" ON SHEET 2.

LEGEND:

SAWCUT AND REMOVE EXISTING PCC IMPROVEMENT AND
CONSTRUCT PCC IMPROVEMENT AS SHOWN ON PLAN.

DISPOSITION NOTES:
1 PROTECT IN PLACE. (TYPE PER PLAN.)
Underground Service Alert
of Southern California

TWO WORKING DAYS

BEFORE YOU DIG
Know what'beIOW.

Callbefore you dig.

NOTICE TO CONTRACTOR
www.DigAlert.org
PURSUANT TO ASSEMBLY BILL 4216 NO EXCA VA TION PERMIT

IS VALID UNLESS THE CONTRACTOR CONTACTS AND OBTAINS'
A DIG ALERT TICKET NUMBER. CALL 811 AT LEAST TWO
WORKING DAYS PRIOR TO COMMENCING EXCA VA TION.

IMPROVEMENT PLANS

CDBG SIDEWALK AND CURB RAMP

ADA IMPROVEMENT PROJECT

PLAN SHEET
DWG. NO.

PW—SI-19
CITY OF PLACENTIA SHT 3 OF 5

STA 20+86.05 BCR
•
JOIN
EXIST. 4.5'
—\;...
0 Z
0 vJ
Z
EXIST.

R/W
JOIN
EXIST.

STA 10+51.78 BCR
L
7 G
M
G_
12'

LIVINGSTON AVE
GJ`— 01
JOIN
EXIST_
EXIST.

R/W
601
EXI
W
0 G / G
1 STREET LIGHT
21+00
0 LIVINGSTON AVE
1 n.
\\
,\►
.ao
.oao
00 ��\
o.

10.0' *SS
�k
TYPE 2
ai
O

REVISIONS
NUMBER DATE BY DESCRIPTION APP'D DATE BENCHMARK:
\1
. \*
%1I
1 11
v 1
M
/
EXIST. 4.5'
R/W
JOIN
EXIST.

U
• ■
D
O
on STRIPING
D
M
BROOKHAVEN AVE.

WV
N
STA 10+00.00 KINGSTON RD =
STA 21+30.17 LIVINGSTON AVE (0 OF SIERRA BONITA DR)
+
N
N JOIN
EXIST.
—S
TYPE 2
STA 9+62.44 ECR
JOIN
EXIST.
r
JOIN
EXIST.

STA 9+61.68 BCR

STREET LIGHT
1 JOIN
EXIST.

REFERENCES
Prepared under the supervision of
yaszi_41,462.244,Loia.a.,17_
R.C.E. No.

Drawn by: SK
Checked by: GGG
Recommended by: GGG
8/25/26
Date
SEAL
FESS/
ERR
J
rvtca
C 92943 a
Z
Exp.12/31/27.` *
CIVIC
OF C M -\F
0 10 20
Feet
CONSTRUCTION NOTES:

REMOVE EXISTING IMPROVEMENTS AND CONSTRUCT PCC CURB RAMP PER OCPW STD. PLAN 1115 AND AS SHOWN ON PLAN. COLOR OF DETECTABLE WARNING SURFACE SHALL BE YELLOW. CASE PER PLAN.

OREMOVE EXISTING IMPROVEMENTS AND CONSTRUCT 4" THICK PCC SIDEWALK PER OCPW STD. PLAN 1205 AND AS SHOWN ON PLAN.

OSAWCUT AND REMOVE EXISTING AND CONSTRUCT PCC CURB (A2-8) AND GUTTER PER 0. C. P. W. STD. PLAN 120-2.

REMOVE EXISTING IMPROVEMENTS AND CONSTRUCT CONSTRUCT PCC CROSS O GUTTER INCLUDING MONOLITHIC CURB PER SPPWC STD. PLAN 122-2 AND AS SHOWN ON PLAN.
06 INSTALL DOWELS AT CONTACT JOINT PER DETAIL 'A" ON SHEET 2.

O PROTECT IN PLACE PAVEMENT IN MORATORIUM. FORM AGAINST THE EXISTING A.C.

SECTION.

LEGEND:

SAWCUT AND REMOVE EXISTING PCC IMPROVEMENT AND
CONSTRUCT PCC IMPROVEMENT AS SHOWN ON PLAN.
1' WIDE A.C. SLOT PAVING PER DETAIL B ON SHEET 5.

DISPOSITION NOTES:
1 PROTECT IN PLACE. (TYPE PER PLAN.)
Underground Service Alert
of Southern California

TWO WORKING DAYS

BEFORE YOU DIG
Know what'beIOW.

Callbefore you dig.

NOTICE TO CONTRACTOR
www.DigAlert.org
PURSUANT TO ASSEMBLY BILL 4216 NO EXCA VA TION PERMIT

IS VALID UNLESS THE CONTRACTOR CONTACTS AND OBTAINS
A DIG ALERT TICKET NUMBER. CALL 811 AT LEAST TWO
WORKING DAYS PRIOR TO COMMENCING EXCA VA TION.

IMPROVEMENT PLANS

CDBG SIDEWALK AND CURB RAMP

ADA IMPROVEMENT PROJECT

PLAN SHEET

CITY OF PLACENTIA
DWG. NO.

SWSI19
SHT 4 OF 5

RIBBON GUTTER

CURB & GUTTER

35.6'

CURB & GUTTER

E YO R BA LINDA BLVD

RIBBON GUTTER
1 Pfr
1 FurAli

CURB & GUTTER

SEVILLE ST

CURB & GUTTER

REVISIONS
NUMBER DATE BY DESCRIPTION APP'D DATE BENCHMARK:

REFERENCES
0 N
10 20
Feet
0 10
Prepared under the supervision of
yaszi_41,462.244,Loia.a.,17_
R.C.E. No.

Drawn by: SK
Checked by: GGG
Recommended by: GGG
8/25/26
Date
20 Feet
SEAL
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CONSTRUCTION NOTES:

OREMOVE EXISTING IMPROVEMENTS AND CONSTRUCT 4" THICK PCC SIDEWALK PER OCPW STD. PLAN 1205 AND AS SHOWN ON PLAN.

OSAWCUT AND REMOVE EXISTING AND CONSTRUCT PCC CURB (A28) AND GUTTER PER 0.C.P.W. STD. PLAN 120-2.

SAWCUT AND REMOVE EXISTING PCC DRIVEWAY AND CONSTRUCT 6" PCC ODRIVEWAY PER 0.C.P.W. STD. PLAN 1210, INCLUDE 1' WIDE A.C. SLOT PAVING PER DETAIL 8 ON SHEET 5.

LEGEND:

SAWCUT AND REMOVE EXISTING PCC IMPROVEMENT AND
CONSTRUCT PCC IMPROVEMENT AS SHOWN ON PLAN.

DISPOSITION NOTES:
1 PROTECT IN PLACE. (TYPE PER PLAN.)
EXIST./PROP.

SIDEWALK
(VAR. PER PLAN)

ADJUST/REPLACE IMPACTED

LANDSCAPE AND IRRIGATION
N
—SA WCU T A.C.
\ � r
\ CONSTRUCT 6" DEPTH,
72 MINIMUM WIDTH AC SLOT PAI/ING.

CURB AND GUTTER REPAIR DETAIL
N.T.S.
6''
—EXIST. FINISHED SURFACE
Underground Service Alert
of Southern California

TWO WORKING DAYS

BEFORE YOU DIG
Know what'beIOW.

Callbefore you dig.

NOTICE TO CONTRACTOR
www.DigAlert.org
PURSUANT TO ASSEMBLY BILL 4216 NO EXCA VA TION PERMIT

IS VALID UNLESS THE CONTRACTOR CONTACTS AND OBTAINS
A DIG ALERT TICKET NUMBER. CALL 811 AT LEAST TWO
WORKING DAYS PRIOR TO COMMENCING EXCA VA TION.

IMPROVEMENT PLANS

CDBG SIDEWALK AND CURB RAMP

ADA IMPROVEMENT PROJECT

PLAN SHEET

CITY OF PLACENTIA
DWG. NO.

WSI— 19
SHT 5 OF 5

Project No. 27-101

CITY OF PLACENTIA

PUBLIC WORKS AGREEMENT FOR
CDBG SIDEWALK AND CURB RAMP ADA IMPROVEMENT PROJECT NO. 27-101 THIS AGREEMENT (herein "Agreement") is made and entered into this 6th day of October, 2026 by and between the CITY OF PLACENTIA, a municipal corporation and charter city, (herein "City") and Kalban, Inc. (herein "Contractor"). The parties hereto agree as follows:

WITNESSETH:

A. WHEREAS, City requires the construction of CDBG Sidewalk and Curb Ramp ADA Improvement Project including construction of improvements that comply with all accessibility requirements as set forth more fully in this Agreement.

B. WHEREAS, Contractor represents to City that Contractor is qualified to perform said work and has submitted a proposal to City for the same.

C. WHEREAS, City desires to have Contractor perform said services on the terms and conditions set forth herein.

D. WHEREAS, no official or employee of City has a financial interest, within the provisions of Sections 1090-1092 of the California Government Code, in the subject matter of this Agreement.

NOW, THEREFORE, for and in consideration of the mutual covenants and conditions contained herein and for good and valuable consideration, the receipt and sufficiency of which is acknowledged by both parties, City and Contractor hereby agree as follows:

1.0 DEFINITIONS

1.1 Definitions. As used in this Agreement, the following definitions shall be applicable:
(a) Contractor. Contractor shall mean Kalban, Inc a (California corporation, partnership, individual) located at 26450 Ruether Ave #201, Santa Clarita, CA, 91350.
(b) City. City shall mean the City of Placentia, a Municipal Corporation and Charter City, located at 401 E. Chapman Ave., Placentia, California 92870. (c) City Council. City Council shall mean the City Council of the City of Placentia.
(d) Contract Officer. Contract Officer shall mean the person designated by the City Administrator or City Engineer of City and shall have the duties set forth in Section 5.2.
(e) Services. Services shall mean the services to be performed by the Contractor pursuant to this Agreement.

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Project No. 27-101
(f) Satisfactory. Satisfactory shall mean satisfactory to the City Administrator or his/her designee.

2.0 SERVICES OF CONTRACTOR

2.1 Scope of Services. In compliance with all terms and conditions of this Agreement, the Contractor shall provide those services specified in the "Scope of Services" attached hereto as Exhibit "A" and incorporated herein by this reference, which services may be referred to herein as the "services" or "work" hereunder. As a material inducement to the City entering into this Agreement, Contractor represents and warrants that Contractor is a provider of first class work and services and Contractor is experienced in performing the work and services contemplated herein and, in light of such status and experience, Contractor covenants that it shall follow the highest professional standards in performing the work and services required hereunder and that all materials will be of good quality, fit for the purpose intended. Further, Contractor represents that it is knowledgeable and experienced in constructing improvements that are compliant with all applicable accessibility requirements and warrants that all work performed under this agreement will comply with all applicable accessibility requirements.

2.2 Documents Included in Contract. This contract consists of this Agreement and any Exhibits, which are incorporated herein by this reference. In the event of an inconsistency, the terms of this Agreement shall govern.

2.3 Compliance with Law. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, and regulations of the City and any Federal, State, or local governmental agency having jurisdiction in effect at the time service is rendered, including but not limited to, all applicable accessibility requirements and the claims procedure set forth in Public Contract Code Section 9204, a summary of which is attached to this agreement as Exhibit "E".

2.4 Licenses, Permits. Fees, and Assessments. Contractor shall obtain at its sole cost and expense such licenses, permits, and approvals as may be required by law for the performance of the services required by this Agreement, including registration with the Department of Industrial Relations of the State of California as required by Labor Code Section 1725.5 before commencing performance under this Agreement. Contractor shall have the sole obligation to pay for any fees, assessments, and taxes, plus applicable penalties and interest, which may be imposed by law and arise from or are necessary for the Contractor's performance of the services required by this Agreement, and shall indemnify, defend, and hold harmless City against any such fees, assessments, taxes penalties, or interest levied, assessed, or imposed against City hereunder.

Contractor shall be responsible for all subcontractors' compliance with this Section 2.4.

2.5 Familiarity with Work. By executing this Contract, Contractor warrants that Contractor (a) has thoroughly investigated and considered the scope of services to be performed, including the requirement that the facilities being constructed must comply with all applicable accessibility requirements, (b) has carefully considered how the services should be performed, and (c) fully understands the facilities, difficulties, and restrictions attending performance of the services under this Agreement. If the services involve work upon any site, Contractor warrants that Contractor has or will investigate the site and is or will be fully acquainted with the conditions there existing, prior to commencement of services hereunder. Should Contractor discover any latent or unknown conditions, which will materially affect the performance of the services hereunder, Contractor shall immediately inform the City of such fact and shall not proceed except at Contractor's risk until written instructions are received from the Contract Officer.

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Project No. 27-101

2.6 Standard of Performance. Contractor, its subcontractors, and their employees, in the performance of Contractor's work under this Agreement, shall be responsible for exercising the degree of skill and care required by customarily accepted good professional practices and procedures used in the Contractor's field.

Any costs for failure to meet the foregoing standard or to correct otherwise defective work that requires re -performance of the work, shall be borne in total by the Contractor and not by the City. The failure of a project to achieve the performance goals and objectives stated in this Agreement is not a basis for requesting re -performance unless the work conducted by Contractor and/or its subcontractors is deemed by the City to have failed the foregoing standard of performance.

In the event Contractor fails to perform in accordance with the above standard:

1. Contractor will re -perform, at its own expense, any task which was not performed to the reasonable satisfaction of City. Any work re -performed pursuant to this paragraph shall be completed within the time limitations originally set forth for the specific task involved.

Contractor shall work any overtime required to meet the deadline for the task at no additional cost to the City;

2. The City shall provide a new schedule for the re -performance of any task pursuant to this paragraph in the event that re -performance of a task within the original time limitations is not feasible; and

3. The City shall have the option to direct Contractor not to re -perform any task which was not performed to the reasonable satisfaction of the City Project Manager pursuant to application of (1) and (2) above. In the event the City directs Contractor not to re -perform a task, the City shall negotiate a reasonable settlement for satisfactory work performed.

No previous payment shall be considered a waiver of the City's right to reimbursement.

Nothing contained in this section is intended to limit any of the rights or remedies which the City may have under law.

2.7 Care of Work. The Contractor shall adopt reasonable methods during the life of the Agreement to furnish continuous protection to the work, and the equipment, materials, papers, documents, plans, studies, and/or other components thereof to prevent losses or damages, and shall be responsible for all such damages, to persons or property, until acceptance of the work by City, except such losses or damages as may be caused by City's own negligence.

2.8 Further Responsibilities of Parties. Both parties agree to use reasonable care and diligence to perform their respective obligations under this Agreement. Both parties agree to act in good faith to execute all instruments, prepare all documents and take all actions as may be reasonably necessary to carry out the purposes of this Agreement. Unless hereafter specified, neither party shall be responsible for the service of the other. Contractor shall require all subcontractors to comply with the provisions of this agreement.

2.9 Additional Services. City shall have the right at any time during the performance of the services, without invalidating this Agreement, to order extra work beyond that specified in the Scope of Services or make changes by altering, adding to, or deducting from said work. No such extra work may be undertaken unless a written change order is first given by the Contract Officer to the Contractor, incorporating therein any adjustment in (i) the Contract Sum as set forth in Section D-4

Project No. 27-101

3.1, and/or (ii) the time to perform this Agreement, which said adjustments are subject to the written approval of the Contractor. Any increase in compensation of ten percent (10%) or less of the Contract Sum, or in the time to perform of one hundred eighty (180) days or less, may be approved by the Contract Officer. It is expressly understood by Contractor that the provisions of this Section shall not apply to services specifically set forth in the Scope of Services or reasonably contemplated therein. Contractor hereby acknowledges that it accepts the risk that the services to be provided pursuant to the Scope of Services may be more costly or time consuming than Contractor anticipates and that Contractor shall not be entitled to additional compensation therefore.

2.10 Prevailing Wage Laws. Contractor represents and warrants that it is registered with the Department of Industrial Relations as required by SB 854 and Labor Code 1725.5 and understands that this project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor shall ensure that its subcontractors comply with said requirements. Contractor shall comply with Labor Code Section 1771.4 and shall post all legally required job site notices. In accordance with Labor Code Section 1770 et seq., the Director of the Department of Industrial Relations of the State of California has ascertained a general prevailing rate of wages, which is the minimum amount, which shall be paid to all workers employed to perform the work pursuant to this Agreement. A copy of the general prevailing wage rate determination is on file in the Office of the City Clerk and is hereby incorporated by reference into this Agreement. In accordance with the provisions of Labor Code Section 1810 et seq., eight (8) hours is the legal working day. Contractor must forfeit to the City Twenty Five Dollars ($25.00) a day for each worker who works in excess of the minimum working hours when Contractor does not pay overtime.

Contractor is required to post a copy of such wage rates at all times at the contract site. The statutory penalties for failure to pay prevailing wage or to comply with State wage and hour laws will be enforced. Contractor also shall comply with State law requirements to maintain payroll records and shall provide for certified records and inspection of records as required by California Labor Code Section 1770 et. seq., including Section 1776. Contractor shall comply with all statutory requirements relating to the employment of apprentices.

3.0 COMPENSATION

3.1 Contract Sum. For the services rendered pursuant to this Agreement, the Contractor shall be compensated as specified herein, but not exceeding the maximum contract amount of One Hundred Fifty -Five Thousand Dollars ($155,000.00) (herein "Contract Sum"), except as provided in Section 2.9. The Contract Sum shall include the attendance of Contractor at all project meetings reasonably deemed necessary by the City; Contractor shall not be entitled to any additional compensation for attending said meetings.

3.2 Progress Payments. Prior to the first day of the month, during the progress of the work, commencing on the day and month specified in the Agreement, Contractor shall submit to the Contract Officer a complete itemized statement of all labor and materials incorporated into the work during the preceding month and the portion of the contract sum applicable thereto. Upon approval in writing by the Contract Officer, payment shall be made in thirty (30) days. City shall pay Contractor a sum based upon ninety-five percent (95%) of the contract price apportionment of the labor and materials incorporated into the work under the contract during the month covered by said statement. The remaining five percent (5%) thereof shall be retained as performance security. Refer to Section 8.4 of this Agreement for retention of funds.

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Project No. 27-101

4.0 PERFORMANCE SCHEDULE

4.1 Time of Essence. Time is of the essence in the performance of this Agreement.

4.2 Schedule of Performance. Contractor shall commence the services pursuant to this Agreement upon receipt of a written notice to proceed and shall perform all services within the time period(s) established in the "Schedule of Performance" attached hereto as Exhibit "B", and incorporated herein by this reference. When requested by the Contractor, extensions to the time period(s) specified in the Scope of Services may be approved in writing by the Contract Officer.

4.3 Force Maieure. The time period(s) specified in the Scope of Services for performance of the services rendered pursuant to this Agreement shall be extended because of any delays due to unforeseeable causes beyond the control and without the fault or negligence of the Contractor, including, but not restricted to, acts of God or of the public enemy, unusually severe weather, fires, earthquakes, floods, epidemics, quarantine restrictions, riots, strikes, freight embargoes, wars, litigation, and/or acts of any governmental agency, including the City, if the Contractor shall within ten (10) days of the commencement of such delay notify the Contract Officer in writing of the causes for the delay. The Contract Officer shall ascertain the facts and the extent of delay, and extend the time for performing the services for the period of the enforced delay when and if in the judgment of the Contract Officer such delay is justified. The Contract Officer's determination shall be final and conclusive upon the parties to this Agreement.

4.4 Term. Unless earlier terminated in accordance with Section 8.9 of this Agreement, this Agreement shall continue in full force and effect until final approval and acceptance of the project by the Contract Officer. Notwithstanding the foregoing, this Agreement shall terminate no later than October 6, 2027, unless the parties mutually agree in writing to extend the term.

5.0 COORDINATION OF WORK

5.1 Representative of Contractor. The following principals of Contractor are hereby designated as being the principals and representatives of Contractor authorized to act in its behalf with respect to the work specified herein and make all decisions in connection therewith:

ATTN: Matthew Lawrence
Kalban, Inc.
26450 Ruether Ave #201
Santa Clarita, CA, 91350
It is expressly understood that the experience, knowledge, capability and reputation of the foregoing principals were a substantial inducement for City to enter into this Agreement. Therefore, the foregoing principals shall be responsible during the term of this Agreement for directing all activities of Contractor and devoting sufficient time to personally supervise the services hereunder.

For purposes of this Agreement, the foregoing principals may not be replaced nor may their responsibilities be substantially reduced by Contractor without the express written approval of City.

5.2 Contract Officer. The Contract Officer shall be such person as may be designated by the City Administrator or City Engineer of City. It shall be the Contractor's responsibility to assure that the Contract Officer is kept informed of the progress of the performance of the services and the Contractor shall refer any decisions that must be made by City to the Contract Officer. Unless otherwise specified herein, any approval of City required hereunder shall mean the approval of the D-6

Project No. 27-101
Contract Officer. The Contract Officer shall have authority to sign all documents on behalf of the City required hereunder to carry out the terms of this Agreement.

5.3 Prohibition Against Assignment. The experience, knowledge, capability, and reputation of Contractor, its principals and employees were a substantial inducement for the City to enter into this Agreement. Neither this Agreement nor any interest herein may be transferred, assigned, conveyed, hypothecated, or encumbered voluntarily or by operation of law, whether for the benefit of creditors or otherwise, without the prior written approval of City. Transfers restricted hereunder shall include the transfer to any person or group of persons acting in concert of more than twenty five percent (25%) of the present ownership and/or control of Contractor, taking all transfers into account on a cumulative basis. In the event of any such unapproved transfer, including any bankruptcy proceeding, this Agreement shall be void. No approved transfer shall release the Contractor or any surety of Contractor of any liability hereunder without the express consent of City.

5.4 Independent Contractor. Neither the City nor any of its employees shall have any control over the manner, mode, or means by which Contractor, its subcontractors, agents, or employees, performs the services required herein, except as otherwise set forth herein. City shall have no voice in the selection, discharge, supervision, or control of Contractor's employees, subcontractors, servants, representatives or agents, or in fixing their number, compensation, or hours of service. Contractor shall perform all services required herein as an independent contractor of City and shall remain at all times as to City a wholly independent contractor with only such obligations as are consistent with that role. Contractor shall not at any time or in any manner represent that it or any of its subcontractors, agents, or employees are agents or employees of City.

City shall not in any way or for any purpose become or be deemed to be a partner of Contractor in its business or otherwise or a joint venture or a member of any joint enterprise with Contractor.

5.5 Identity of Persons Performing Work. Contractor represents that it employs or will employ at its own expense all personnel required for the satisfactory performance of any and all tasks and services set forth herein. Contractor represents that the tasks and services required herein will be performed by Contractor or under its direct supervision, and that all personnel engaged in such work shall be fully qualified and shall be authorized and permitted under applicable State and local law to perform such tasks and services.

5.6 Utility Relocation. City is responsible for removal, relocation, or protection of existing main or trunk line utilities to the extent such utilities were not identified in the invitation for bids or specifications. City shall reimburse contractor for any costs incurred in locating, repairing damage not caused by contractor, and removing or relocating such unidentified utility facilities, including equipment idled during such work. Contractor shall not be assessed liquidated damages for delay arising from the removal or relocation of such unidentified utility facilities.

5.7 Trenches or Excavations. Pursuant to California Public Contract Code Section 7104, in the event the work included in this Agreement requires excavations more than four (4) feet in depth, the following shall apply.
(a) Contractor shall promptly, and before the following conditions are disturbed, notify City, in writing, of any: (1) material that Contractor believes may be material that is hazardous waste, as defined in Section 25117 of the Health and Safety Code, that is required to be removed to a Class I, Class II, or Class III disposal site in accordance with provisions of existing law; (2) Subsurface or latent physical conditions at the site different from those indicated; or (3) Unknown physical conditions at the site of any D-7

Project No. 27-101
unusual nature, different materially from those ordinarily encountered and generally recognized as inherent in work of the character provided for in the contract.
(b) City shall promptly investigate the conditions, and if it finds that the conditions do materially so differ, or do involve hazardous waste, and cause a decrease or increase in Contractor's cost of, or the time required for, performance of any part of the work shall issue a change order per Section 2.9 of this Agreement.
(c) That, in the event that a dispute arises between City and Contractor whether the conditions materially differ, or involve hazardous waste, or cause a decrease or increase in Contractor's cost of, or time required for, performance of any part of the work, Contractor shall not be excused from any scheduled completion date provided for by the contract, but shall proceed with all work to be performed under the contract. Contractor shall retain any and all rights provided either by contract or by law, which pertain to the resolution of disputes and protests between the contracting parties.

6.0 INSURANCE, INDEMNIFICATION, AND BONDS

6.1 Insurance. The Contractor and all subcontractors, if any, shall procure and maintain, at its sole cost and expense, in a form and content satisfactory to City, during the entire term of this Agreement, including any extension thereof, insurance as set forth in Exhibit "C" attached hereto and incorporated herein by this reference.

Conditions:

In accordance with Public Contract Code Section 20170, the insurance of surety companies who provide or issue the policy shall have been admitted to do business in the State of California with a credit rating of A- or better.

The City of Placentia, its officers, officials, employees, agents, and volunteers shall be named as additional insureds.

Prior to commencement of any work under this contract, Contractor shall deliver to the City insurance endorsements confirming the existence of the insurance required by this contract, and including the applicable clauses applicable clauses as set forth in Exhibit "C" attached hereto and incorporated herein by this reference.

Such endorsements shall be signed by an authorized representative of the insurance company and shall include the signatory's company affiliation and title. Should it be deemed necessary by the City, it shall be Contractor's responsibility to see that the City receives documentation, acceptable to the City, which sustains that the individual signing said endorsements is indeed authorized to do so by the insurance company.

If the Contractor fails to maintain the aforementioned insurance, or secure and maintain the aforementioned endorsement, the City may obtain such insurance, and deduct and retain the amount of the premiums for such insurance from any sums due under the agreement. However, procuring of said insurance by the City is an alternative to other remedies the City may have, and is not the exclusive remedy for failure of Contractor to maintain said insurance or secure said endorsement. In addition to any other remedies D-8

Project No. 27-101
the City may have upon Contractor's failure to provide and maintain any insurance or policy endorsements to the extent and within the time herein required, the City shall have the right to order Contractor to stop work hereunder, and/or withhold any payment(s) which became due to Contractor hereunder until Contractor demonstrates compliance with the requirements hereof.

Nothing herein contained shall be construed as limiting in any way the extent to which Contractor may be held responsible for payments of damages to persons or property resulting from Contractor's or its subcontractor's performance of the work covered under this agreement.

Each contract between the Contractor and any subcontractor shall require the subcontractor to maintain the same policies of insurance that the Contractor is required to maintain pursuant to this Section 6.1.

6.2 Certificates of Insurance. Contractor shall provide to City certificates of insurance showing the insurance coverages, as well as providing the City with the required endorsements described above, in a form and content approved by City, prior to performing any services under this Agreement. The certificates of insurance and endorsements shall be attached to this Agreement as Exhibit "D" and are incorporated herein by this reference.

6.3 Indemnification. Contractor shall protect, defend, indemnify, hold free and harmless the City of Placentia, its officers, officials, employees, agents, and volunteers, at Contractor's sole expense, from and against any and all actions, suits, claims, damages to persons or property, losses, costs, penalties, obligations, errors, omissions, or liabilities (herein "claims or liabilities") that may be asserted or claimed by any person, firm, or entity arising or alleged to arise out of or in any way connected with the performance of the work, operations, or activities of Contractor, its agents, employees, subcontractors, or invitees, provided for herein, or arising or alleged to arise from the acts or omissions of Contractor hereunder, or arising or alleged to arise from Contractor's performance of or failure to perform any term, provision, covenant, or condition of this Agreement including all acts or omissions, willful misconduct or negligent conduct, whether active or passive, on the part of the Contractor, its employees, and/or subcontractors. (a) Contractor will defend any action or actions filed in connection with any of said claims or liabilities and will pay all costs and expenses, including legal costs and attorneys' fees incurred in connection therewith. (b) Contractor will promptly pay any judgment rendered against the City, its officers, officials, employees, agents, or volunteers for any such claims or liabilities arising or alleged to arise out of or in connection with Contractor's (or its agents', employees', subcontractors', or invitees') negligent performance of or failure to perform such work, operations, or activities hereunder; and Contractor agrees to save and hold the City, its officers, officials, employees, agents, and volunteers harmless therefrom. (c) In the event the City, its officers, officials, employees, agents, or volunteers are made a party to any action or proceeding filed or prosecuted against Contractor for such damages or other claims arising or alleged to arise out of or in connection with the performance of or failure to perform the work, operation or activities of Contractor hereunder, Contractor shall pay to the City, its officers, officials, employees, agents, or volunteers, any and all costs D-9

Project No. 27-101
and expenses incurred by the City, its officers, officials, employees, agents, or volunteers in such action or proceeding, including but not limited to, legal costs and attorneys' fees for counsel selected by City. (d) Contractor's duty to defend and indemnify as set out in this Section 6.3 shall include any claims, liabilities, obligations, losses, demands, actions, penalties, suits, costs, expenses or damages or injury to persons or property arising or alleged to arise from, in connection with, as a consequence of or pursuant to any State or Federal law or regulation regarding hazardous substances, including but not limited to the Federal Insecticide, Fungicide and Rodenticide Act ("FIFRA"), Comprehensive Environmental Response, Compensation and Liability Act of 1980 ("CERCLA"), Resource Conservation and Recovery Act of 1976 ("RCRA"), the Hazardous and Solid Waste Amendments of 1984, the Hazardous Material Transportation Act, the Toxic Substances control Act, the Clean Air Act, the Clean Water Act, the California Hazardous Substance Account Act, the California Hazardous Waste Control Law or the Porter -Cologne Water Quality Control Act, as any of those statutes may be amended from time to time.

Notwithstanding the foregoing, Contractor shall not be liable for the defense or indemnification of the City for claims, actions, complaints, or suits arising out of the sole active negligence or willful misconduct of the City.

The Contractor's indemnification obligations pursuant to this Section 6.3 shall survive the termination of this Agreement. Contractor shall require the same indemnification from all subcontractors.

6.4 Labor and Materials and Performance Bonds. Concurrently with execution of this Agreement, Contractor shall deliver to City a labor and materials bond and a performance bond each in the sum of the amount of this Agreement, in the forms provided by the City Clerk, which secures the faithful performance of this Agreement. The bonds shall contain the original notarized signature of an authorized officer of the surety and affixed thereto shall be a certified and current copy of his power of attorney. The bonds shall be unconditional and remain in force during the entire term of the Agreement and shall be null and void only if the Contractor promptly and faithfully performs all terms and conditions of this Agreement.

6.5 Sufficiency of Insurer or Surety. Insurance required by this Agreement shall be satisfactory only if issued by companies qualified to do business in California, rated "A-" or higher in the most recent edition of Best's Key Rating Guide or in the Federal Register, and only if they are of a Financial Size Category Class VII or larger, unless such requirements are waived by the Risk Manager of the City due to unique circumstances. In the event the Project Manager and Risk Manager determine that the work or services to be performed under this Agreement creates an increased risk of loss to the City, the Contractor agrees that the minimum limits of the insurance policies required by this Section 6 may be changed accordingly upon receipt of written notice from the Project Manager provided that the Contractor shall have the right to appeal a determination of increased coverage by the Project Manager to the City Council of City within ten (10) days of receipt of notice from the Project Manager.

6.6 Substitution of Securities. Pursuant to California Public Contract Code Section 22300, substitution of eligible equivalent securities for any monies withheld to ensure performance D-10

Project No. 27-101
under the contract for the work to be performed will be permitted at the request and expense of the successful bidder.

7.0 RECORDS AND REPORTS

7.1 Reports. Contractor shall periodically prepare and submit to the Contract Officer such reports concerning the performance of the services required by this Agreement as the Contract Officer shall require. Contractor hereby acknowledges that the City is greatly concerned about the cost of work and services to be performed pursuant to this Agreement. For this reason, Contractor agrees that if Contractor becomes aware of any facts, circumstances, techniques, or events that may or will materially increase or decrease the cost of the work or services contemplated herein or, if Contractor is providing design services, the cost of the project being designed, Contractor shall promptly notify the Contract Officer of said fact, circumstance, technique or event and the estimated increased or decreased cost related thereto and, if Contractor is providing design services, the estimated increased or decreased cost estimate for the project being designed.

7.2 Records. Contractor shall keep, and require subcontractors to keep, such books and records (including but not limited to payroll records as required herein) as shall be necessary to perform the services required by this Agreement and enable the Contract Officer to evaluate the performance of such services. The Contract Officer shall have full and free access to such books and records at all times during normal business hours of City, including the right to inspect, copy, audit and make records and transcripts from such records. Such records shall be maintained for a period of three (3) years following completion of the services hereunder, and the City shall have access to such records in the event any audit is required.

7.3 Ownership of Documents. All drawings, specifications, reports, records, documents, and other materials prepared by Contractor, its employees, subcontractors, and agents in the performance of this Agreement shall be the property of City and shall be delivered to City upon request of the Contract Officer or upon the termination of this Agreement, and Contractor shall have no claim for further employment or additional compensation as a result of the exercise by City of its full rights of ownership of the documents and materials hereunder. Contractor may retain copies of such documents for its own use. Contractor shall have an unrestricted right to use the concepts embodied therein. All subcontractors shall provide for assignment to City of any documents or materials prepared by them, and in the event Contractor fails to secure such assignment, Contractor shall indemnify City for all damages resulting therefrom.

7.4 Public Records Act Disclosure. Contractor has been advised and is aware that this Agreement and all reports, documents, information, and data, including, but not limited to, computer tapes, discs or files furnished or prepared by Contractor, or any of its subcontractors, pursuant to this Agreement and provided to City may be subject to public disclosure as required by the California Public Records Act (California Government Code Section 7920.000 et seq.). Exceptions to public disclosure may be those documents or information that qualify as trade secrets, as that term is defined in the California Government Code Section 7924.510, and of which Contractor informs City of such trade secret. The City will endeavor to maintain as confidential all information obtained by it that is designated as a trade secret. The City shall not, in any way, be liable or responsible for the disclosure of any trade secret including, without limitation, those records so marked if disclosure is deemed to be required by law or by order of the Court.

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8.0 GENERAL PROVISIONS

8.1 Governing Law. This Agreement shall be construed and interpreted both as to validity and to performance of the parties in accordance with the laws of the State of California. Legal actions concerning any dispute, claim, or matter arising out of or in relation to this Agreement shall be instituted in the Superior Court of the County of Orange, State of California, or any other appropriate court in such county, and Contractor covenants and agrees to submit to the personal jurisdiction of such court in the event of such action.

8.2 Representatives. The City Administrator or his or her designee shall be the representative of City for purposes of this Agreement and may issue all consents, approvals, directives, and agreements on behalf of the City, called for by this Agreement, except as otherwise expressly provided in this Agreement.

The Principal set forth in Section 5.1 above shall be the representative for Contractor for purposes of this Agreement, and shall be authorized to issue all consents, approvals, directives, and agreements on behalf of Contractor called for by this Agreement, except as otherwise expressly provided in this Agreement.

8.3 Disputes. In the event either party fails to perform its obligations hereunder, the nondefaulting party shall provide the defaulting party written notice of such default. The defaulting party shall have ten (10) days to cure the default; provided that, if the default is not reasonably susceptible to being cured within said ten (10) day period, the defaulting party shall have a reasonable time to cure the default, not to exceed a maximum of thirty (30) days, so long as the defaulting party commences to cure such default within ten (10) days of service of such notice and diligently prosecutes the cure to completion; provided further that if the default is an immediate danger to the health, safety and general welfare, the defaulting party shall take such immediate action as may be necessary. Notwithstanding the foregoing, the nondefaulting party may, in its sole and absolute discretion, grant a longer cure period. Should the defaulting party fail to cure the default within the time period provided in this Section, the nondefaulting party shall have the right, in addition to any other rights the nondefaulting party may have at law or in equity, to terminate this Agreement.

Compliance with the provisions of this Section 8.3 shall be a condition precedent to bringing any legal action, and such compliance shall not be a waiver of any party's right to take legal action in the event that the dispute is not cured.

8.4 Retention of Funds. Progress payments shall be made in accordance with the provisions of Section 3.2 of this Agreement. In accordance with said section, City shall pay Contractor a sum based upon ninety-five percent (95%) of the contract price apportionment of the labor and materials incorporated into the work under the contract during the month covered by said statement. The remaining five percent (5%) thereof shall be retained as performance security to be paid to the Contractor within sixty (60) days after final acceptance of the work by the City Council, after Contractor shall have furnished City with a release of all undisputed contract amounts if required by City. In the event there are any claims specifically excluded by Contractor from the operation of the release, the City may retain proceeds (per Public Contract Code 7107) of up to 150% of the amount in dispute. City's failure to deduct or withhold shall not affect Contractor's obligations hereunder.

8.5 Waiver. No delay or omission in the exercise of any right or remedy by a nondefaulting party on any default shall impair such right or remedy or be construed as a waiver. A party's consent to or approval of any act by the other party requiring the party's consent or approval shall not be deemed to waive or render unnecessary the other party's consent to or approval of any D-12

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subsequent act. Any waiver by either party of any default must be in writing and shall not be a waiver of any other default concerning the same or any other provision of this Agreement.

8.6 Rights and Remedies. Rights and Remedies are cumulative except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the parties are cumulative and the exercise by either party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or different times, of any other rights or remedies for the same default or any other default by the other party.

8.7 Legal Action. In addition to any other rights or remedies, either party may take legal action, in law or in equity, to cure, correct or remedy any default, to recover damages for any default, to compel specific performance of this Agreement, to obtain declaratory or injunctive relief, or to obtain any other remedy consistent with the purposes of this Agreement.

8.8 Liquidated Damages. Since the determination of actual damages for any delay in performance of this Agreement would be extremely difficult or impractical to determine in the event of a breach of this Agreement, the Contractor and its sureties shall be liable for and shall pay to the City Two Thousand Eight Hundred Dollars ($2,800.00) as liquidated damages for each working day of delay in the performance of any service required hereunder, as specified in the Scope of Services (Exhibit "A") or Schedule of Performance (Exhibit "B"). The City may withhold from any monies payable on account of services performed by the Contractor any accrued liquidated damages.

8.9 Termination for Default of Contractor. If termination is due to the failure of the Contractor to fulfill its obligations under this Agreement, Contractor shall vacate any City owned property which Contractor is permitted to occupy hereunder and City may, after compliance with the provisions of Section 8.3, take over the work and prosecute the same to completion by contract or otherwise, and the Contractor shall be liable to the extent that the total cost for completion of the services required hereunder exceeds the compensation herein stipulated (provided that the City shall use reasonable efforts to mitigate such damages), and City may withhold any payments to the Contractor for the purpose of setoff or partial payment of the amounts owed the City as previously stated.

8.10 Notice. Any notice, demand, request, document, consent, approval, or communication either party desires or is required to give to the other party or any other person shall be in writing and shall be deemed to be given when served personally or deposited in the U.S. Mail, prepaid, first-class mail, return receipt requested, addressed as follows:

To City: City of Placentia
401 E. Chapman Ave.

Placentia, California 92870
Attn: Shelley Kennel
To Contractor: Kalban, Inc.
26450 Ruether Ave #201
Santa Clarita, CA, 91350
Attn: Matthew Lawrence

8.11 Non -liability of City Officers and Employees. No officer or employee of the City shall be personally liable to the Contractor, or any successor in interest, in the event of any default or D-13

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breach by the City or for any amount which may become due to the Contractor or to its successor, or for breach of any obligation of the terms of this Agreement.

8.12 Conflict of Interest. The Contractor warrants that it has not paid or given and will not pay or give any third party any money or other consideration for obtaining this Agreement.

Contractor and its officers, employees, associates, and subcontractors, if any, will comply with all conflict of interest statutes of the State of California applicable to Contractor's services under this agreement, including, but not limited to, the Political Reform Act (Government Code Sections 81000, et seq.) and Government Code Section 1090. During the term of this Agreement, Contractor and its officers, employees, associates, and subcontractor shall not, without the prior written approval of the City Representative, perform work for another person or entity for whom Contractor is not currently performing work that would require Contractor or one of its officers, employees, associates, or subcontractors to abstain from a decision under this Agreement pursuant to a conflict of interest statute. Contractor's duties and services under this Agreement shall not include preparing or assisting the City with any portion of the City's preparation of a request for proposals, request for qualifications, or any other solicitation regarding a subsequent or additional contract with the City. The City shall at all times retain responsibility for public contracting, including with respect to any subsequent phase of this project. Contractor's participation in the planning, discussions, or drawing of project plans or specifications shall be limited to conceptual, preliminary, or initial plans or specifications. Contractor shall cooperate with the public entity to ensure that all bidders for a subsequent contract on any subsequent phase of this project, if any, have access to the same information, including all conceptual, preliminary, or initial plans or specifications prepared by Contractor pursuant to this Agreement.

8.13 Covenant Against Discrimination. Contractor covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, or ancestry in the performance of this Agreement.

To the extent required by law, contractor shall take affirmative action to ensure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, or ancestry.

8.14 Interpretation. The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of this Agreement or any other rule of construction which might otherwise apply.

8.15 Severabilitv. In the event that any one or more of the phrases, sentences, clauses, paragraphs, or sections contained in this Agreement shall be declared invalid or unenforceable by a valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs, or sections of this Agreement which are hereby declared as severable and shall be interpreted to carry out the intent of the parties hereunder unless the invalid provision is so material that its invalidity deprives either party of the basic benefit of their bargain or renders this Agreement meaningless.

8.16 Hiring of Illegal Aliens Prohibited. Contractor shall not hire or employ any person to perform work within the City of Placentia or allow any person to perform work required under this Agreement unless such person is properly documented and legally entitled to be employed within the United States. Further, Contractor shall comply with the following:

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(a) Unauthorized Aliens. Contractor hereby represents and warrants that it will comply with all the provisions of the Federal Immigration and Nationality Act, 8 U.S.C.A. §§ 1101, et seq., as amended, and in connection therewith, shall not employ unauthorized aliens as defined therein. Should Contractor so employ such unauthorized aliens for the performance of any work and/or services under this Agreement, and should any liability or sanctions be imposed against City for such use of unauthorized aliens, Contractor hereby agrees to reimburse City for any and all liabilities, actions, suits, claims, demands, losses, costs, judgments, arbitration awards, settlements, damages, demands, orders, or penalties which arise out of or are related to such employment, together with any and all costs, including attorneys' fees, incurred by City.
(b) E -Verify. If Contractor is not already enrolled in the U.S. Department of Homeland Security's E -Verify program, Contractor shall enroll in the E -Verify program within fifteen (15) days of the effective date of this Agreement to verify the employment authorization of employees assigned to perform work hereunder. Contractor shall verify employment authorization within three (3) days of hiring a new employee to perform work under this Agreement. Information pertaining to the E -Verify program can be found at http://www.uscis.gov , or access the registration page at https://e- verify.uscis.gov/enroll. Contractor shall certify its registration with E -Verify and provide City its registration number within sixteen days of the effective date of this Agreement. Failure to provide certification will result in withholding payment until full compliance is demonstrated.

8.17 Unfair Business Practices Claims. In entering into a public works contract or a subcontract to supply goods, services, or materials pursuant to a public works contract, the contractor or subcontractor offers and agrees to assign to the awarding body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C.

Sec. 15) or under the Cartwright Act (Chapter 2, (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, services, or materials pursuant to the public works contract or the subcontract. This assignment shall be made and become effective at the time the awarding body renders final payment to the contractor without further acknowledgment by the parties. (Sec. 7103.5, California Public Contract Code).

8.18 Corporate Authority. The persons executing this Agreement on behalf of the parties hereto warrant that (i) such party is duly organized and existing, (ii) they are duly authorized to execute and deliver this Agreement on behalf of said party, (iii) by so executing this Agreement, such party is formally bound to the provisions of this Agreement, and (iv) the entering into this Agreement does not violate any provision of any other Agreement to which said party is bound.

8.19 PERS Eligibility Indemnification. In the event that Contractor or any employee, agent, or subcontractor of Contractor providing services under this Agreement claims or is determined by a court of competent jurisdiction or the California Public Employees Retirement System (PERS) to be eligible for enrollment in PERS as an employee of the City, Contractor shall indemnify, defend, and hold harmless City for the payment of any employee and/or employer contributions for PERS benefits on behalf of Contractor or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions, which would otherwise be the responsibility of City.

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Notwithstanding any other agency, State, or Federal policy, rule, regulation, law, or ordinance to the contrary, Contractor and any of its employees, agents, and subcontractors providing service under this Agreement shall not qualify for or become entitled to, and hereby agree to waive any claims to, any compensation, benefit, or any incident of employment by City, including but not limited to eligibility to enroll in PERS as an employee of City and entitlement to any contribution to be paid by City for employer contribution and/or employee contributions for PERS benefits.

8.20 Cooperation. In the event any claim or action is brought against City relating to Contractor's performance or services rendered under this Agreement, Contractor shall render any reasonable assistance and cooperation which City might require.

8.21 Legal Responsibilities. The Contractor shall keep itself informed of City, State, and Federal laws, ordinances, and regulations, which may in any manner affect the performance of its services pursuant to this Agreement. The Contractor shall at all times observe and comply with all such laws, ordinances, and regulations. Neither the City, nor its officers, agents, or employees shall be liable at law or in equity as a result of the Contractor's failure to comply with this section.

8.22 Termination for Convenience. The City may terminate this Agreement without cause for convenience of the City upon giving contractor 30 days prior written notice of termination of the Agreement. Upon receipt of the notice of termination the Contractor shall cease all further work pursuant to the Agreement. Upon such termination by the City the Contractor shall not be entitled to any other remedies, claims, actions, profits, or damages except as provided in this paragraph. Upon the receipt of such notice of termination Contractor shall be entitled to the following compensation:

1. The contract value of the work completed to and including the date of receipt of the notice of termination, less the amount of progress payments received by contractor.

2. Actual move -off costs including labor, rental fees, equipment transportation costs, the costs of maintaining on-site construction office for supervising the mover -off.

3. The cost of materials custom made for this Agreement which cannot be used by the Contractor in the normal course of his business, and which have not been paid for by City in progress payments.

4. All costs shall not include any markups as might otherwise be allowed by any plans or specifications which were a part of the Agreement.

The provisions of this paragraph shall supersede any other provision of the Agreement or any provision of any plans, specification, addendums, or other documents which are or may become a part of this Agreement. City and Contractor agree that the provisions of this paragraph are a substantive part of the consideration for this Agreement.

8.23 Responsibility for Errors. Contractor shall be responsible for its work and results under this Agreement. Contractor, when requested, shall furnish clarification and/or explanation as may be required by the City's representative, regarding any services rendered under this Agreement at no additional cost to City. In the event that an error or omission attributable to Contractor occurs, then Contractor shall, at no cost to City, provide all necessary design drawings, estimates, and other Contractor professional services necessary to rectify and correct the matter D-16

Project No. 27-101
to the sole satisfaction of City and to participate in any meeting required with regard to the correction.

8.24 Order of Precedence. In the event of an inconsistency in this Agreement and any of the attached Exhibits, the terms set forth in this Agreement shall prevail. If, and to the extent this Agreement incorporates by reference any provision of any document, such provision shall be deemed a part of this Agreement. Nevertheless, if there is any conflict among the terms and conditions of this Agreement and those of any such provision or provisions so incorporated by reference, this Agreement shall govern over the document referenced.

8.25 Costs. Each party shall bear its own costs and fees incurred in the preparation and negotiation of this Agreement and in the performance of its obligations hereunder except as expressly provided herein.

8.26 No Third -Party Beneficiary Rights. This Agreement is entered into for the sole benefit of City and Contractor and no other parties are intended to be direct or incidental beneficiaries of this Agreement and no third party shall have any right in, under or to this Agreement.

8.27 Headings. Paragraphs and subparagraph headings contained in this Agreement are included solely for convenience and are not intended to modify, explain or to be a full or accurate description of the content thereof and shall not in any way affect the meaning or interpretation of this Agreement.

8.28 Construction. The parties have participated jointly in the negotiation and drafting of this Agreement. In the event an ambiguity or question of intent or interpretation arises with respect to this Agreement, this Agreement shall be construed as if drafted jointly by the parties and in accordance with its fair meaning. There shall be no presumption or burden of proof favoring or disfavoring any party by virtue of the authorship of any of the provisions of this Agreement.

8.29 Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original. All counterparts shall be construed together and shall constitute one agreement.

8.30 Fundina Source Conditions — Contractor's Obliaation. Contractor acknowledges that the City may be paying for the Project by using funds it receives or will receive from various funding sources in the form of grants and/or subsidies, and the like under certain terms and conditions. Contractor warrants that it is not suspended or debarred from doing business with the United States government and can legally be paid from federal funds. Contractor acknowledges and agrees that any failure of the Contractor and/or its subcontractors to perform its obligations under the Contract, including, but not limited to, timely submitting accurate reports and records, that in any way results in the City not meeting the terms and conditions placed on the funds by the funding source, or forfeiting its entitlement to or, otherwise, not receiving, the funds, then the Contractor shall be liable to pay the City for the funds not granted to the City on the Project.

8.31 Entire Agreement. This Agreement constitutes the entire agreement between the parties with respect to any matter referenced herein and supersedes any and all other prior writings and oral negotiations. This Agreement may be modified only in writing and signed by the parties in interest at the time of such modification. The terms of this Agreement shall prevail over any inconsistent provision in any other contract document appurtenant hereto, including exhibits to this Agreement.

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Project No. 27-101
IN WITNESS WHEREOF, the parties have executed and entered into this Agreement as of the date first written above.

ATTEST:

CITY OF PLACENTIA,
A municipal corporation and Charter City
Date:

Rosanna Ramirez, Acting City Administrator
ATTEST:

Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:

CONTRACTOR:

Date:

Signature
/r'►c i1 -w (whey► V,Ze. P t< drA—
Name and Title
vac/
Social Security or Taxpayer ID Number
Christian L. Bettenhausen, City Attorney
APPROVED AS TO INSURANCE:

Cyndi Alvarenga, Risk Management
D-18
Date:

Date:
q -la 10146

Project No. 27-101
APPROVED AS TO CONTENT:

Shelley Kennell, Project Manager
DEPARTMENTAL APPROVAL:

Date:

Chris Tanio, Director of Public Works/City Engineer
D-19

Project No. 27-101
Bond No.: ES00026658
Premium is included in the performance bona
Executed in: 3 Counterparts
Pagel of 2
(Use of City Bond Form is Required)

LABOR AND MATERIAL PAYMENT BOND

PUBLIC WORK (CALIFORNIA)
KNOW ALL MEN BY THESE PRESENT:

WHEREAS, Kalban, Inc. as Principal, has
entered into a contract dated October 6, 2026 , with the City of Placentia (Obligee) referred to and made a part hereof to perform the following work, to wit: CDBG SIDEWALK AND CURB RAMP ADA * and all appurtenant work in accordance with PROJECT NO. 27-101 , which requires Principal to file this bond to secure claims made in relation to the project. * IMPROVEMENT PROJECT
NOW THEREFORE, we, Kalban, Inc. , as Principal,
and Everest National Insurance Company , a corporation organized under the laws of Delaware and duly authorized to transact business in the State of California, as Surety, are held firmly bound unto the City of Placentia, as Obligee, and all sub- contractors, laborers, material persons and other persons employed in the performance of the referenced agreement, in the sum of One Hundred Fifty Five Thousand & 00/100 Dollars ($** lawful money of the United States of America, for the payment whereof well and truly to be made the Principal and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. ** $155,000.00 If the above bounden PRINCIPAL, his or its heirs, executors, administrators, successors, assigns, or any of his or its sub -contractors, fails to pay for any materials, provisions, provender, or other supplies, or teams, implements or machinery, used in, upon, for or about the performance of the work contracted to be done, or for any work or labor to persons named in Section 9100 or the Civil Code, thereon of any kind, or for amounts due under the Unemployment Insurance Code with respect to such work or labor deducted, withheld and paid over to the Employment Development Department from the wages of employees of the contractor and sub -contractors pursuant to Section 13020 of the Unemployment Insurance Code, that the SURETY on this bond will pay the same, in an amount not exceeding the sum specified in this bond, AND ALSO, in case suit is brought upon this bond, a reasonable attorney's fee, which shall be awarded by the court to the prevailing party in said suit, said attorney's fee to be taxed as costs in said suit and to be included in the judgment herein rendered.

Project No. 27-101

Page 2 of 2 ends

any such contract or agreement, or under the bond, nor, where the bond is given for the benefit of claimants, by any fraud practiced by any person other than the claimant seeking to recover on the bond.

This bond shall inure to the benefit of any and all persons, companies and corporations entitled to file claims under the Civil Code so as to give them a right of action in a suit on this bond.

This bond is executed for the purpose of complying with the laws of the State of California and shall inure to the benefit of any of the persons named in Section 9100 of the Civil Code of the State of California.

IN WITNESS THEREOF, we have hereunto set our hands and seals this 6th day of October , 2026.
(Corporate Seal)
(Corporate Seal)
APPROVED AS TO FORM:

Is1 Christian L. Bettenhausen
City Attorney
Kalban, Inc.

Principal
By
C_. E. o .

Title
Everest National Insurance Company
Principal Surety
By
Rebecca Haas -Bates, Attorney -in -Fact
Title

CALDi;"c v3it9DA ACKNOWLEDGMENT NT CIVIL CODE 5 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

State of California
County of 1 ®„Q , f. Zil °
.11
On "%30—ZOZ6 before me, AMetLeitivoe 441 -Ani
Date Mere Insert Name and Title of the Or icer
10 personally appeared �� o' re car ie - eek.,
Name(s) of Signer(s)
?milk
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 sarne 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 persons) acted, executed the instrument.

ANDREW LEMASTER
Notary Public - California
Los Angeles County
/ Commission # 2522471
My Comm. Expires Jun 16, 2029
Place Notary Seal and/or Stamp Above
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.

Signaturej,GrJ" ,$
Signature of Notary Public
--- OPTIONAL
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.

Desc.ripiiori 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:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual
❑ Trustee
❑ Other:

Signer is Representing:
❑ Attorney in Fact
❑ Guardian or Conservator
©2019 National Notary Association
. Number of Pages:

Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 ��icsN ° My Comm, Expires Mar 13. 2029
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
nature of Notaty 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 Labor and Material
Title or Type of Document: Payment Bond No. ES00026658 Document Date:

Number of Pages: Two (2) Signer(s) Other Than Named Above:

Capacity(ies) Claimed by Signer(s)
Signer's Name: Rebecca Haas -Bates
El Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual G71 Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:

Signer Is Representing:

Everest National Insurance Company
•
10/06/2026
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
0 Individual 0 Attorney in Fact
0 Trustee 0 Guardian or Conservator
0 Other:

Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907

everest

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 offices 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 its true and lawful Attorney(s)-in-fact to 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 full power 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 if such 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 April 21, 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 attomey 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 attomey, and to attach thereto the corporate seal of the Company.

RESOLVED, FURTHER, that the signature of such officers named in the preceding resolutions and the corporate seal of the Company may be affixed to such powers of attorney or to any certificate 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.

IN WITNESS WHEREOF, Everest Reinsurance Company and Everest National Insurance Company have caused their corporate seals to be affixed hereto, and these presents to be signed by their duly authorized officers this 10th day 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 affixed to the aforesaid instrument is such corporate seal and was affixed thereto; and that he executed said instrument by like order.

LINDA ROBINS
Notary Public, State of New York
No 01R06239736
Qualified in Queens County
Tenn Expires April 25, 2027
/J
Linda Robins, Notary Public
I, Sylvia Semerdjian, Assistant Secretary of Everest Reinsurance Company and Everest National Insurance Company do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Section of the bylaws and resolutions of said Corporation as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN THE 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 full force and effect.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Company, this 6th day of October 202 6 . dt� 'yam •!:4-
f SEAL
r+�t 1965
d_ . TxL,iWA.^-,
By: Sylvia Semerdjian, Assistant Secretary
ES 00 01 04 16

Project No. 27-101

Page 1 of 1 ends

(Use of City Form is Required)

Deep 1961 --Pre;
' e,et u -A Se6re-f ur
Business Address:
uctro 40 -ter n-ue`° 14
1`'v' Keit i4j 144 -grvo
Telephone Number: OP ---re'i1 1 19 ,$
Date: 1 '31) --Ze).

Print Name: Allttt 4/4 10,wr`Pi%4
6 4111M—riff
Principal
Signature:
1J1�e, Pres?oleo
Title

Project No. 27-101

TAX IDENTIFICATION NUMBER

Page 1 of 1 ends

(Use of City Form is Required)
The Tax Equity and Fiscal Responsibility Act of 1982 requires the payer (City of Placentia) to report to the Internal Revenue Service taxable payments to payees.

CITY OF PLACENTIA FINANCE DEPARTMENT
401 E. Chapman Ave.

Placentia, CA 92870 ,�
Exempt: Yes No % Telephone ('1 £� ) ro !"J -10‘C
CORPORATION: 1 / ! QP' -v
U.S.A. OR ANY AGENCIES THEREOF: N /A
IRS CODE #501 TAX-EXEMPT ORGANIZATION:../1.f ),%�
!f/j

ANON-COMMISSIONED
�CITY OF PLACENTIA EMPLOYEE:

SOLE PROPRIETOR•/ V h4
A PARTNERSHIP: /V//
OTHER: Al (Explain)
'%� [ r'O^ tet✓ ,
Signature/Title: �i� ` Date:

Project No. 27-101

CITY OF PLACENTIA

PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENT: That,
N
Bond No. ES00026658 N
Premium: $1,085.00
Premium is for contract term and is subject
to adjustment based on final contract price
Executed in: 3 Counterparts
WHEREAS, the CITY OF PLACENTIA (hereinafter called the "City") has awarded to Kalban, Inc. , a California corporation (hereinafter "Principal"), an Agreement, dated October 6 , 20 26 ("Agreement"), whereby Principal agreed to provide construction services including CDBG SIDEWALK AND CURB RAMP ADA IMPROVEMENT PROJECT NO. 27-101 WHEREAS, the Public Work to be performed by the Principal is more particularly set forth in the Agreement which is incorporated herein by reference and made a part hereof; and WHEREAS, said Principal is required under the terms of the Agreement to furnish a bond for the faithful performance of the Agreement;
NOW, THEREFORE, we, Kalban, Inc. , as Principal, and Everest National * as Surety, are held and firmly bound unto the City in the sum of One Hundred Fifty Five Thousand & 00/100 Dollars ($** ), this amount being not Tess than one hundred percent (100%) of the total contract price under Agreement, lawful money of the United States of America for payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors jointly and severally, firmly by these presents.
* Insurance Company ** $155,000.00
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, the obligation shall become null and void if the above -bounded Principal, his or its heirs, executors, administrators, successors, or assigns, shall in all things stand to and abide by well and truly keep and perform all the undertakings, terms, covenants, conditions, and agreements in the said Agreement and any alteration thereof, made as therein provided, all within the time and in the manner therein designated and in all respects according to their true intent and meaning, and shall indemnify and save harmless the City, its officer, agents and employees, as therein stipulated; otherwise it shall be and remain in full force and virtue.

Project No. 27-101
obtaining payment in full from Surety. If.for any reason payment received by the City in respect of the obligations of the Principal under the Agreement guaranteed pursuant to this bond is rescinded or must be returned or restored by the City, this bond shall be automatically reinstated and shall continue to be in effect as if such payment had not been made.

IN WITNESS WHEREOF three (3) identical counterparts of this instrument, each of which shall for all purposes be deemed an original thereof, have been duly executed by the Principal and Surety named herein, on the 6th day of October , 20 26 , the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative pursuant to authority of its governing body. (Seal)
SURETY Everest National Insurance Company
By
Rebecca Haas -Bates, Attorney -in -Fact
(Seal)
PRINCIPAL Kalban,� Inc.
(
By X ^—c�.

X MROV.ji
100 Everest Way, Warren Corporate Center 26450 Ruether Avenue, Unit 201 Warren, NJ 07059
APPROVED:

Santa Clarita, CA 91350

ADDRESS ADDRESS

CITY ATTORNEY

INSTRUCTIONS
Two (2) Notarized Signatures required
from all Corporations.
1 The above bond must be executed by both the Principal and the Surety.

2. If the Principal is a corporation, the bond must be executed in the corporate name and signed by the President or a Vice -President and the Secretary or Assistant Secretary, and the corporate seal affixed. If the Principal is a partnership, all partners must sign it. If the Principal is an individual doing business under a fictitious name, it must be signed by all persons having an interest in the business, and the fictitious name must be signed also.

The bond must be notarized by both the Principal and the Surety.

3. The City Attorney of the City of Placentia must approve the bond.

4. The bond, after approval, must be filed with the City Clerk of the City of Placentia.

CALOIPONNOA ACKNOWLEDGMENT G(>b'dfEl T CIVIL CODE 3 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not" the' truthfulness, accuracy, or validity of that document.

State of California
P
County of IL
On 3 O- 202 G before me,
Date
personally appeared
J
Le Ado? PSP //@t a+ Iia, hi Ill,
Jere Insert Nome and Title of the Officer
I( ogre Q 'It cam.449 a�fY/V
Nome(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.

ANDREW LEMASTER
Notary Public - California
Los Angeles County
LCommission # 2522471
My Comm. Expires Jun 16, 2029
Place Notary Seal and/or Stamp Above
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
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:
❑ Corporate Officer - Title(s):
❑ Partner - 0 Limited 0 General
❑ Attorney in Fact
❑ Guardian or Conservator
❑ Individual
❑ Trustee
❑ Other:

Signer's Name:
❑ Corporate Officer - Title(s):
❑ Partner - 0 Limited 0 General
❑ Individual
❑ Trustee
❑ Other:

Signer is Representing:
❑ Attorney in Fact
❑ Guardian or Conservator

CALGIFORN ZA ACCK OCIL DO Z NT CIVIL CODE § 1139
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 105 Ain perk-
}
On (1-30-20Z6 before me, hiof eiry Le/Qct peri No°farr Poi I , Date Here insert Name and Title of thL Officer
personally appeared ReAfe. ne�rra4
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.

ANDREW LEMASTER
Notary Public - California
Los Angers County
17 Commission # 2522471
My Comm, Expires Jun 16, 2029
.iSy,u'LLatlY-wyghJ., l':iw,at Y4,.,raiaY ailis
Place Notary Seal and/or Stamp Above
OPTI
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 -,47,4esiour
Signature of Notary Public
NAL
Cornpleting this inforrnation 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:
❑ Corporate Officer — Titles):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:

State of California
County of Orange
On 09/17/2026
before me, A. Lamontagne, Notary Public
Date
personally appeared Rebecca Haas -Bates
Here Insert Name and Title of the Officer
Name(&),of Signer
who proved to me on the basis of satisfactory evidence to be the persons} whose name* is/tee subscribed to the within instrument and acknowledged to me that twishe/theft executed the same in his/her/their authorized capacity ids), and that by his/her/ heir signatureN.on the instrument the person(, 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.

A. LAMONTAGNE
Notary Public • California
Orange County
Commission # 2514271
My Comm. Expires Mar 13. 2029
WITNESS my hand and official seal.

Sirs :`tune of Notary Public
Place Notaty 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: Performance Bond No. ES00026658 Document Date:

Number of Pages: Two (2) Signer(s) Other Than Named Above:

Capacity(ies) Claimed by Signer(s)
Signer's Name: Rebecca Haas -Bates
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ individual Ga Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:

Signer Is Representing:

Everest National Insurance Company
10/06/2026
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
0 Individual 0 Attorney in Fact
0 Trustee 0 Guardian or Conservator
❑ Other:

Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907

everest

William Syrkin, Rebecca Haas -Bates, Megan Hake, Richard Adair its true and lawful Attorney(s)-in-fact to 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 full power of substitution and revocation.

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 April 21, 2016:

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 attomey, and to attach thereto the corporate seal of the Company.

RESOLVED, FURTHER, that the signature of such officers named in the preceding resolutions and the corporate seal of the Company may be affixed to such powers of attorney or to any certificate relating thereto by facsimile, and any such power of attomey 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 itis attached.

LINDA ROBINS
Notary Public, State of New York
No 01R06239736
Qualified in Queens County
Term Expires April 25, 2027
Linda Robins, Notary Public
1, Sylvia Semerdjian, Assistant Secretary of Everest Reinsurance Company and Everest National Insurance Company do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Section of the bylaws and resolutions of said Corporation as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN THE 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 full force and effect.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Company, this 6th day of October 202 6 .

ES 00 01 04 16
By: Sylvia Semerdjian, Assistant Secretary

Project No. 27-101

STATEMENT OF NON -COLLUSION BY CONTRACTOR
The undersigned who submits herewith to the City of Placentia a bid or proposal does hereby certify:
a. That all statements of fact in such bid or proposal are true. b. That such bid or proposal was not made in the interest of or on behalf of any undisclosed person, partnership, company, association, organization or corporation. c. That such bid or proposal is genuine and not collusive or sham. d. That said bidder has not, directly or indirectly by agreement, communication or conference with anyone, attempted to induce action prejudicial to the interest of the City of Placentia or of any other bidder or anyone else interested in the proposed procurement. e. Did not, directly or indirectly, collude, conspire, connive or agree with anyone else that said bidder or anyone else would submit a false or sham bid or proposal, or that anyone should refrain from bidding or withdraw his bid or proposal.
f. Did not in any manner, directly or indirectly seek by agreement, communication or conference with anyone to raise or fix the bid or proposal price of said bidder or of anyone else, or to raise or fix any overhead, profit or cost element of his bid or proposal price, or that of anyone else.

That no officer or principal of the undersigned firm nor any subcontractor to be engaged by the principal has been convicted by a court of competent jurisdiction of 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 work contract, with any public entity, within the last three years.

9. j•
I certify, under penalty of perjury under the laws of the State of California, that the foregoing is true and correct and that this certification was executed:,
On (410-1C at Gt/t�i'i t"`
Firm gdi /hO c 6 -
Street ZS Z init`e'Ave .l ZD I
Citv5.( to CA ZigL33
California.
�tlintrWsalee V, e
(Print Name & Title)

Project No. 27-101

EXHIBIT A

SCOPE OF SERVICES
The project includes providing all labor, materials, equipment, tools and incidentals as required to install new concrete curb ramps to meet ADA compliance and in accordance with project bid documents, plans, technical specifications, and all other references as depicted in strict adherence to the latest Greenbook, City's Standards and all other State specifications. The general items of work consist of removal of existing sidewalk, curb and gutter, and other existing improvements and construction of new concrete curb ramps, truncated domes, sidewalks, retaining curb, curb & gutter, cross gutters, full depth AC pavement, restoration of landscaping and irrigation systems, and such other items or details not mentioned above that are required to complete the project. The contractor shall coordinate with the contractor performing the work for City Project No. 27-104 FY 2026-2027 Residential Roadway Rehabilitation Project as work for this curb ramp project will be performed simultaneously.

CITY OF PLACENTIA

CDBG SIDEWALK AND CURB RAMP

ADA IMPROVEMENT PROJECT,
CITY PROJECT NO. 27-101
DATE: September 2, 2026
SUBJECT: Addendum # 1
This letter comprises Addendum No. 1 for the above project, request for construction bid, issued by the City of Placentia on August 25, 2026. Please take note of the items listed below which will have to be used in the preparation of your bid for this project. The following clarifications/changes are hereby issued:

REVISIONS:

1. The last sentence of the third paragraph under item 2 on sheet A-1 was updated to include the code reference for the Build America, Buy America Act.

2. The Buy America Certification Form, Materials Certification, and covered product details were added to Appendix V — CDBG Provisions.

The revised specifications are included as an attachment to this Addendum.

Please sign the following page acknowledging Addendum No. 1 and include with your bid prior to submission. All other aspects of the plans and specifications not specifically mentioned in this addendum remain unchanged.

Sincerely,
Shelley Kennel!, Associate Engineer

Page 1 of 2 ends

CITY OF PLACENTIA

CDBG SIDEWALK AND CURB RAMP

ADA IMPROVEMENT PROJECT,
CITY PROJECT NO. 27-101
DATE: September 2, 2026
SUBJECT: Addendum # 1
ADDENDUM ACKNOWLEDGMENT:

Firm Name: ea it cry, 1 r
Authorized Signature:

Date: 13-1-2o2C
Acknowledgment of Receipt of Addendum # 1 is required by signing.

Page 2 of 2 ends

SECTION A

NOTICE INVITING ELECTRONIC BIDS

1. NOTICE IS HEREBY GIVEN that the City of Placentia, as AGENCY invites electronic bids for the below stated project and will receive electronic bids for the materials, supplies, equipment and/or services set forth herein, subject to all conditions outlined in the Bid Package.

CDBG SIDEWALK AND CURB RAMP ADA IMPROVEMENT PROJECT NO. 27-101

2. Obtaining Bid Documents: The Bid and Contract Specifications for this project are available to download at no cost from PlanetBids at:
httns://obsystem.planetbids.com/oortal/54600/portal-home . All bidders shall register with PlacentBids to retrieve plans, specifications, addendums, bidders' list, etc. It is the responsibility of each prospective bidder to check PlanetBids daily through the close of bids for any applicable addendums or updates.

SECTION 3 STATEMENT: This is a HUD Section 3 covered construction contract and requires compliance with the hiring goals outlined in Section 3 of the Housing and Urban Development Act. Bidders must complete and sign the Declaration of Intent to Comply with Section 3 Requirements form and submit with bid. Failure to do so may disqualify the bid. The awarded prime contractor must work with the Labor Compliance Officer to create a Section 3 Commitment and Outreach Efforts plans. The Contractor must, to the greatest extent possible, provide training, employment, contracting, and other economic opportunities to low and very low- income persons and local businesses. The benchmark for Section 3 workers is set at 25% or more of the total number of labor hours to be worked on the Project. The benchmark for Targeted Section 3 workers is set at 5% or more of the total number of labor hours worked on the Project Contractor is allowed to count the Targeted Section 3 worker hours from the Section 3 worker hours.

The Build America, Buy America Act (BABA) requires that all iron, steel, manufactured products, and construction materials used for federally funded infrastructure projects are produced in the United States, unless otherwise exempt or subject to an approved waiver. This requirement is known as the "Buy America Preference (BAP)" and the specific requirements are codified in 2 CFR § 184.

3. Bid Opening September 9, 2026, at 2:00 P.M. No bid will be considered for award unless properly and successfully submitted through the electronic bid management system at:
httos://obsystem.olanetbids.com/portal/54600/aortal-home by the date and time specified on the cover page of this Notice Inviting Bids . All bids must be signed by an authorized representative.

Alt required sections, including pricing, shall be submitted via the website. Bidder is solely. responsible for "on time" submission of their electronic bid. The bid management system will not accept late bids and no exceptions shall be made. Bidders will receive an e -bid confirmation number with a time stamp from PlanetBids, the bid management system indicating their bid was submitted successfully. The City will only receive those bids that were transmitted successfully.

Mailed, faxed, hand delivered, or e-mailed submissions will not be accepted.

NOTE: E -Bids are sealed and cannot be viewed by the City or any other person or entity until the closing date and time. If you need to withdraw your bid, you may do so at any time before the bid deadline, by going back into the system and selecting "withdraw".

A-1

Buy America Certification Form
PURPOSE: The "Buy America Certification Form" is used to certify that, as required by federal law, all of the iron, steel (for FY23 funded projects and forward) , specific construction materials — non-ferrous metals, lumber, composite building materials, plastic and polymer based pipe and tube, (for FY24 funded projects and forward), all construction materials, including manufactured products (for FY25 funded projects and forward) utilized in federally funded projects with an aggregate of $250,000 or more funds, Including HUD CDBG funds, are produced in the United States in a manner that complies with the Build America, Buy America Act, unless an applicable waiver applies or is granted by the Made in America Office of Management and Budget (MIAO).

GENERAL INFORMATION: BABA guidance requires the following Buy America preference: 1) All iron and steel used in the project are produced in the United States. This means all manufacturing processes, from the initial melting stage through the application of coatings, occurred In the United States; 2) All listed manufactured products used In the protect are produced in the United States. This means the manufactured product was manufactured In the United States, and the cost of the components of the manufactured product that are mined, produced, or manufactured in the United States is greater than 55 percent of the total cost of all components of the manufactured product, unless another standard for determining the minimum amount of domestic content of the manufactured product has been established under applicable law or regulation; and, for FY 2025 funded projects forward; 3) All (listed and non -listed) construction materials are manufactured in the United States. This means that all manufacturing processes for the construction material occurred in the United States. The Build America, Buy America preference only applies to articles, materials, and supplies that are consumed in, incorporated into, or affixed to an infrastructure project. As such, it does not apply to tools, equipment, and supplies, such as temporary scaffolding, brought to the construction site and removed at or before the completion of the infrastructure project. Nor does a Buy America preference apply to equipment and furnishings, such as movable chairs, desks, and portable computer equipment, that are used at or within the finished infrastructure project but are not an integral part of the structure or permanently affixed to the infrastructure project.

CERTIFICATION: I hereby certify the materials to be installed pursuant to the attached Bid Submittal conform to the Build America, Buy America Act (BABAA) requirements under 2 CFR § 184. Signing this document does not relieve the signee of providing evidence of compliance upon request by OCHCD or HUD.

Prime Contractor: ea (bail, 2 ti c
Phone Number: ( -106 5
Email: Ia/bavn:t1c tte an/. Cool
The Prime Contractor is responsible for all subcontractors and for ensuring that all manufacturers and suppliers certify materials with the understanding that those certifying the material assume full legal responsibility of the material and are subject to providing documentation verifying the material meets all requirements upon demand. Any additional materials needed for the protect should be itemized, specify 1f BABA applies, and then certified by the engineer and submittal to DOH with an official Change Order. * Attach the itemized cost estimate that identifies all materials subject to BABA. 1 of 3

Build America Buy America
Materials Certification
Grantee: k,. 6)0 , titer c- Contractor:

Material Type (Steel,
Iron, Manufactured
Goods, Construction
Materials)
Description
1© Re 1(0.,,,i-e,,t,-0(
r
Location of Product
Name of Manufacturer Manufacture
By signing, I certify that the statements made above are true to the best of my ability and knowledge and that the listed materials for use in this project funded by federal/ollars were educed in the United States of America, Contractor Signature: 1 4k/TAP-0/4/1/ V
1 M of i-th Irv,. (,-4 vwk-61 G€ -- V P.
kSIL'th, 214.c
Print Contractor Name:

Contractor Company:
2 of 3

Covered Product'.

Iron and Steel
Specifically Listed Construction Materials
(non-ferrous metals; lumber; and plastic -and
polymer -based composite building materials,
pipe, and tube)
Not Listed Construction Materials (all other
plastic — and polymer -based products, glass,
fiber optic cable, optical fiber, engineered
wood, and drywall)
Manufactured Products
3of3
ObiigationDate:' .

The BAP applies to the purchase of iron and
steel for infrastructure projects beginning with
funding obligations from FY2023 CDBG funds.

The BAP will apply to the purchase of
specifically listed construction materials
beginning with funding obligations from FY2024
CDBG funds, as well as iron and steel.

The BAP will apply to the purchase of not listed
construction materials and manufactured
products beginning with funding obligations
from FY2025 CDBG funds, as well as
specifically listed construction materials, iron,
and steel.

SECTION C

PROPOSAL
for the

CDBG SIDEWALK AND CURB RAMP ADA IMPROVEMENT PROJECT
From
CITY PROJECT NO. 27-101
in the

CITY OF PLACENTIA
TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF PLACENTIA:

In compliance with the Notice Inviting Electronic Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of PLACENTIA. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of PLACENTIA, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed.

BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to'Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal.

BIDDER understands that a bid is required for the entire work and that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will re -advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures.

G-1

If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and uloid.

Accompanying this proposal of bid, find 6i-2) 8P4 the amount of $ 01/4hh said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Electronic Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be).

Bidder shall signify receipt of all Addenda here, if any:

Addenda Date Received
No.
! —2 --1.01-6
Bidder's Signature
C-2
f

ITEM
NO.

1. 2.

3. 4.

5. 6.

7. 8.

9. 10.

11. BID SCHEDULE FOR

CDBG SIDEWALK AND CURB RAMP ADA IMPROVEMENT PROJECT

ITEMS DESCRIPTION
Mobilization
Traffic Control & Public Safety
Erosion Control & BMPs
Sawcut, Remove Existing Improvements
and Construct New 4" PCC Sidewalk per
OCPW Std. Plan No. 1205
Sawcut, Remove Existing and Construct
PCC Driveway Approach (Commercial = 8")
Sawcut, Remove Existing Improvements
and Construct New Curb Ramp (Including
Dowels) per OCPW Std. Plan No. 1115
Sawcut, Remove Existing and Construct
PCC Curb and Gutter (Type A2-8)
Sawcut, Remove Existing Improvements
and Construct New PCC Cross Gutter Per
SPPWC Std. Plan No. 122-2
Root Shave
Protect In Place All SiFi Network Conduits
and Service Drops for the entire project
within the City of Placentia
Survey Markers and Monument
Preservation and Restoration

BID SCHEDULE

QUANTITY UNIT
1 LS
1 LS
1 LS
1,200 SF
300 SF
12 EA
120 LF
1,100 SF
3 EA
1 LS
1 LS
TOTAL
$ 11, 0
GRAND TOTAL BID SCI DULE PRICE WRITTEN IN FIGURES: $
cri nhil
GRAND TOTAL BID SCHEDULE PRICE WRITTEN IN WORDS:
0/7('
C-3

NOTE: The GRAND TOTAL BID PRICE shall be used as the basis of bid in determining the low bid for this project. The City reserves the right to include or remove additive work that makes up the additive bid schedule.

NOTE: The City reserves the right to award a contract to the lowest responsible bidder in parts or in its entirety and reserves the right to reject all bids and re -advertises, as it appears to be in the best interests of the City. A bid is required for this entire work, the estimated quantities set forth in this Bid Sheet being solely for the purpose of comparing bids, and final compensation under the Contract will be based upon the actual quantities of work satisfactorily completed. The unit and/or lump sum prices bid shall include all appurtenant expenses, taxes, royalties, and fees. In the case of discrepancies in the amount bid, unit prices shall govern over extended amounts, and words shall govern over figures.

The City reserves the right to increase or decrease the amount of any quantity shown and to delete any item from the Contract.

Through submission on PlanetBids, the bidder certifies that he/she has followed the bidder instructions, acknowledges the requirements set forth in this proposal form for bid submission, and has thoroughly checked the figures set forth in the proposal and inputted into PlanetBids, that they are correct to the best of his/her knowledge and constitute his/her proposal to perform all the work called out and implied throughout these contract documents. ***BID ITEMS TO BE INPUTED ON-LINE VIA PLANETBIDS***
C-4

LIST OF SUBCONTRACTORS
In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor.

PortionName and Address of Subcontractor State License Class of Work I Number
/v/
By submission of this proposal, the Bidder certifies:

1. That he is able to and will perform the balance of all work, which is not covered in the above subcontractors listing.

2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project.

C-5

NONCOLLUSION AFFIDAVIT

TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID
State of California
ss.

County of Orange
0t41 -4 -et,,,. %At ,'ket4 c -c , being first duly sworn, deposes and says that he or she is t ?- ' P eta-e'i of fCnilan.i, rfr7 c the party making
the foregoing bid that the bid is not made in the interest of, or on the 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, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid.

K o► (bay), C
Name of Bidder
Signature of Bidder
2C'f5o e f11 -4r # 2P( Sgh C(,11,-1
Address of Bidder C/f- 9/3 SO
Subscribed and sworn to before me this Te -h day of na n., d..,.-, 20 2C .

NOTARY PUBLIC ,44.7.-A;-44/- G %'G
c ti -fat

NOTARY SEAL

CALIF©iRNoA ACKNOWLEDGMENT CML CODE § 11E9
__ _ :ox::._ •�;s�.^.;:.s,r: -c:or-rc x�-.=-gym_-�o:U�o� !, ., • �.. .:.��:�..r..o.�.c.,c-,.� _ . .._�_..-.,x>-..-,.:'.?�::n��so-r.,-,��.-.�*c.c.*c_o.,<..r:..,.:,k,,:� � ., n:c=ataw-3,�=�.`o..::r-ax,=u.3..cac=ca: '.::;x-ca��rs�v`;7«..t..�5 ��v`ziaavisis�'c4�.,=W.i:.v:.��i��, <:��'= i�cXti:'✓`4- C.iic<.:

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 Las Age del
J
On Ci— 9 202.4' before me, Andrew Le /tiSs-e r NofeirY Poth1rc Date Here Insert Name and Title of the Of/icer
personally appeared AOtH'N'!'e he LAwrer)ce
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.

ANDREW LEMASTER
Notary Public - California
Los Angeles County
Commission 1 2522471 —((
My Comm, Expires Jun 16, 2029
Place Notary Seal and/or Stamp Above
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 %%'Gld-ra —
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) Claimer! by Signer(s)
Signer's Name:
❑ Corporate Officer - Title(s):
❑ Partner - ❑ Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:

Number of Pages:

Signer's Name:
❑ Corporate Officer - Title(s):
❑ Partner - 0 Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:
.- . <.�:_K,?x::= .�z -=n:�-"='i ;-:'E,-" .._ ma.c _ _ � _ _ = S_-=.. �;�.,,cr,=a-{,_O.:e,Sr�-r.� r`s,-.+sig• "--SPK-.,er::'�a:no- ^'.�.co�:� -ac. ©20'19 National Notary Association

UTILITY AGREEMENT

HONORABLE MAYOR AND CITY COUNCIL

CITY OF PLACENTIA, CALIFORNIA
The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as CDBG SIDEWALK AND CURB RAMP ADA IMPROVEMENT PROJECT, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows:
"Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved."
The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements.

The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein.

Date: q— 9-29ZC
C-7
x.,164.1, Ine
Contractor
By
Vire. . Jar r 111,1-1,1
Title

DISQUALIFICATION QUESTIONNAIRE
In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire.

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?
CI Yes a -No
If the answer is yes, explain the circumstances in the space provided.

A/ A
Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire.

C-8

COMPENSATION INSURANCE CERTIFICATE
Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate.

I am aware of the provisions of Section 3700 of the Labor Code which require 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.

Date: —.202 4"
C-9
Contractor
By
Vire Prfr,'olyre
Title

UNDERGROUND SERVICE ALERT

IDENTIFICATION NUMBER
(To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY.

Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid.

To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation.

Dig Alert Identification Number. C_ie f L --a
16164)1, LI(
Contractor
By
IA`r{ PK11 Ve get I -
Title
Date: q-7-292 C
Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request.

C-10

BIDDER'S INFORMATION
BIDDER certifies that the following information is true and correct:
kfboti. .Zi c
Bidder Name
2 6 fso Roe 1-11,fk- ,4 . # 201
Business Address
S�e►1L rlav,_
City,
(g/ ) 5 4 t/-- to“'
Telephone Number
rd
Contractor Name
A 6113S0
State Zip
100000.272
Contractor's DIR Public Works Registration Number
07SS0 deist A
State Contractor's License No. and Class
3-17- /q87
Original Date Issued

3.31- 2027
Expiration Date
The work site was inspected by ,%h,r,,,,- of our office on q — , 202a
The following are persons, firms, and corporations having a principal interest in this proposal:

Dccp„ k. 'ale/ - C5O
Ir (icy* sorok 9`h - CFO
D,'ne.ih - o-
C-11

The undersigned is prepared to satisfy the Council of the City of PLACENTIA of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. r
Comp. ny Name
Signature of Bidder
Printed or Typed Signature
Subscribed and sworn to before me this day of S't/, 7(�0.,4-+r, 20Z C NOTARY PUBLIC 716GLtV r � ,%-

NOTARY SEAL
Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years:

1. P'f /l(�jc►r.1 Flv. i /11 Firs,'- S¢. !7/hdt+,diva CA leo / Name and Address of Public Agency
Name and Telephone No. of Project Manager: /2obierfi
400o. 000 °v
Contract Amount
R ifk Pcc S.G({u../�. C t; . Ales'
Type of Work r

2. CrY DT' 44 -woo d( — 1. W., /'�AnC�I rliar &L/ 2
Nam6and Address of Public Agency
Name and Telephone No. of Project Manager: !r- / k yrn
l09 opo gb 12 fee sari. -,4
Contract Amount Type of W`ork
C624) $7D--5067
07-2 S
Date Completed
9o39/
C 7/y) Yes -MI
03-202-5-
Date
3-20Z5Date Completed

3. �, S 64,04061 le° - 6/3 F Rrrxrotwbr 61-6-1,44/e_ C.4- °7120t Namb and Address of Public Agency /�
Name and Telephone No. of Project Manager: 14 ),..bp $/1nGy m 1,�ar+, (o/$) 5tif-?9Y5" 'L$3,10 D.

(CAL[IFOIRMrA ACKNOWLEDGMENT CML CODE §1189
-c_o�,-.:.. `-.�:., .�_ ..�..-..-,:.,: •-.- -.�_1 ��`�:5:�.�'+'�-,`--"o�u�^.�i`.�i�::::`w�.``��av:_5_u:'�a�`y`w�-�xr'.� c.?n''=",.�,.-ua `wro'ukcw=r:,:a'F�``-'_�'�'�`�4'�'��in�� ;_v=car::• 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 -1 9"2920 before me, Andrew / e/fei5i-¢r %(%miry blac Date Here Insert Name and Title of the Officer
personally appeared 1 ftke V�av
Lsxi errence
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.

ANDREW LEMASTER
Notary Public - California
Los Angeles County _
Commission q 2522471
oMyComm. Expires Jun 16, 2029 i
Place Notary Seal and/or Stamp Above
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 As 44/
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:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:

Number of Pages:

Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — 0 Limited 0 General
❑ Individual 0 Attorney in Fact
❑ Trustee 0 Guardian or Conservator
❑ Other:

Signer is Representing:
s�iv>:4' -y-.eM.+=-:cr1C-f ac,..tg _ .'r!.:;sys. y:: � .i: rG=..` Via"!: .,s C. r��i :s;-.;r._-eAre,v,:sv:
+LS2.-`. v �• ..+.-�.v.J+:�a�=Sw'uJc� '3:5-..s..."W....a.:�.:.u_L1=SSz..aCNJ-Gs.S=i�u��G�+'.ha'1=v-..�-... ©2019 National Notary Association

RESPONSIBLE BIDDER — SUPPLEMENTAL QUESTIONNAIRE

1. How many years has your organization been in business in California as a contractor under your present business name and license number?
35fi Years

2. What is your firm's Average Gross Revenue for the last three years? $ ^'ll, 400, P00-9

3. Is your firm currently the debtor in a bankruptcy case? ❑ Yes a- No
If " yes," indicate the case number, bankruptcy court, and the date on which the petition was filed.

Case Number
/VA
Bankruptcy Court Date Filed

4. Was your firm in bankruptcy any time during the last five years? (This question refers only to a bankruptcy action that was not described in answer to question 2, above.) O Yesia: No
If " yes," indicate the case number, bankruptcy court, and the date on which the petition was filed.

A/7,4
Case Number
Bankruptcy Court Date Filed

5. Has any CSLB license held by your firm or its Responsible Managing Employee (RME) or Responsible Managing Officer (RMO) been suspended within the last five years? ❑ Yes la' No

6. At any time in the last five years, has your firm been assessed and paid liquidated damages after completion of a project, under a construction contract with either a public or private owner?
❑ Yes `ice No

7. Has your firm ever defaulted on a construction contract? ❑ Yes.a No
If "yes," explain on a separate page.

8. In the last five years has your firm, or any firm with which any of your company's owners, officers or partners was associated, been debarred, disqualified, removed or otherwise prevented from bidding on, or completing, any government agency or public works project for any reason?
C-13

❑ Yes' No
If "yes," explain on a separate page. State the name of the organization debarred, the year of the event, the owner of the project, and the basis for the action.

9. In the last five years, has your firm been denied an award of a public works contract based on a finding by a public agency that your company was not a responsible bidder? ❑ Yesa No
If "yes," on a separate page identify the year of the event, the entity denied the award, the owner, the project, and the basis for the finding by the public agency.

10. In the past five years, has any claim against your firm concerning your firm's work on a construction project, been filed in court or arbitration? 0 Yes > No
If "yes," on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, the name of the entity the claim was filed against, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution).

11. In the past five years, has your firm made any claim against a project owner concerning work on a project or payment for a contract, and filed that claim in court or arbitration? 0 Yes erNo
If "yes," on a separate page identify the claim be providing the name of claimant, the project name, date of the claim, name of the entity (or entities) against whom the claim was filed, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending, or if resolved, a brief description of the resolution.

12. At any time during the past five years, has any surety company made any payments on your firm's behalf as a result of a default, to satisfy any claims made against a performance or payment bond issued on your firm's behalf in connection with a construction project, either public or private?
O Yes gr No

13. In the last five years, has any insurance carrier, for any form of insurance, refused to renew the insurance policy for your firm?
❑ Yes No

14. Has your firm or any of its owners, officers, or partners ever been liable in a civil suit, or found guilty in a criminal action, for making any false claim or material misrepresentation to any public agency or entity?
❑ Yes YesDik No
C-14

15. Has your firm or any of its owners, officers or partners ever been convicted of a crime involving any federal, state, or local law related to construction? ❑ Yes0 No
If "yes," explain on a separate page, including identifying who was convicted, the name of the victim, the date of the conviction, the court and case number, the crimes, and the grounds for the conviction.

16. Has your firm or any of its owners, officers or partners ever been convicted of a federal or state crime of fraud, theft, or any other act of dishonesty? ❑ Yes No
If "yes," identify on a separate page, the person or persons convicted, the court and case number, the crimes, and the year convicted.

17. If your firm was required to pay a premium of more than one per cent for a performance and payment bond on any project(s) on which your firm worked at any time during the last three years, state the percentage that your firm was required to pay. You may provide an explanation for a percentage rate higher than one per cent, if you wish to do so.

18. During the last five years, has yourfirm ever been denied bond credit by a surety company, or has there ever been a period of time when yourfirm has no surety bond in place during a public construction project when on was required?
• Yes , No

19. Has CAL OSHA cited and assessed penalties against the General Contractor or its associates for any "serious," "willful" or "repeat" violations of its safety or health regulations in the past five years?
(Note: If you have filed an appeal of a citation, and the Occupational Safety and Health Appeals Board has not yet ruled on your appeal, you need not include information about it.)
O Yes No
If "yes," on separate page describe the citations, the party against whom the citation was made, date of citation, nature of the violation, project on which the citation was issued, owner of project, and the amount of penalty paid, if any. State the case number and date of any OSHAB decision.

20. Has the Federal Occupational Safety and Health Administration cited and assessed penalties against the General Contractor or its associates in the past five years? (Note: if an appeal of the citation has been filed and the Appeals Board has not yet ruled, or there is a court appeal pending, you need not include information about the citation.) ❑ YesZNo
C-15

If "yes," on separate page describe the citation, the party against whom the citation was made, date of citation, nature of the violation, project on which the citation was issued, owner of project, and the amount of penalty paid, if any. State the case number and date of any decision.

21. Has there been more than one occasion during the last five years in which the General Contractor or its associates was required to pay either back wages or penalties for failure to comply with the state's prevailing wage laws?
❑ Yes' No
If "yes," on separate page, describe the violator, nature of each violation, name of the project, date of its completion, the public agency for which it was constructed, the number of employees who were initially underpaid an the amount of back wages and penalties that were assessed.

22. During the last five years, has there been more than one occasion in which the General Contractor or its associates have been penalized or required to pay back wages for failure to comply with the Federal Davis -Bacon prevailing wage requirements? D Yes% No
If "yes," on separate page, describe the violator, nature of each violation, name of the project, date of its completion, the public agency for which it was constructed, the number of employees who were initially underpaid an the amount of back wages and penalties that were assessed.

C-16

DESIGN ENGINEER MAY NOT BID ON

CONSTRUCTION CONTRACT
No engineering or architectural firm which has provided design services for a projectohaU be eligible to bid on the contract to construct the project. The firms ineIigibe to bid include the prime contractor for design, subcontractors of portions of the design, and affiliates of either. An affiliate is a firm which is subject to the control of the same persons(s), through joint ownership or otherwise.

D this crfli day of Yreka', b...
54 C
Authorized Signature
H. � �_
�,r� ��/=°*,~+
Position
Company
C-17

NOTICE OF AFFIRMATIVE ACTION
"NOTICE"
By submitting a proposal on any job or entering into any contractual agreement with the City of Placentia, the undersigned agrees not to discriminate in employment decisions against any person on account of race, creed, national origin, ethnic background, color, sex, age, or handicap in performing the work required under this proposal.

ACKNOWLEDGED this 9 -f -GI day of S-< 7LEbra filer , 20 2 , at .SQ.-, 1--,t C/ar, Vex
cA1L1,
Authorized Signat e
(%r'c1 %ire.r,'ol rH /-
Position
(G /L 4r,� l �, c
Company
C-18

APPENDIX V

CDBG PROVISIONS
E-60

CDBG PROVISIONS
Required forms to be submitted with Bid are found in CDBG-1 Section.

COMPLIANCE WITH CLEAN AIR AND WATER ACTS
(Applicable to federally assisted construction contracts and related subcontracts exceeding $100,000) During the performance of this contract, the contractor and all subcontractors shall comply with the requirements of the Clean Air Act. as amended, 42 USC 1857, et seq., the Federal Water Pollution Control Act, as amended, 33 USC 1251, et seq., and the regulations of the Environmental Protection Agency with respect thereto, at 40 CFR Part 15, as amended.

In addition to the foregoing requirements, all nonexempt contractors and subcontractors shall furnish to the owner the following:

1. A stipulation by the contractor or subcontractors that any facility to be utilized in the performance of any nonexempt contract or subcontract is not listed on the List of Violating Facilities issued by the Environmental Protection Agency (EPA) pursuant to 40 CFR 1520.

2. Agreement by the contractor to comply with all the requirements of Section 114 of the Clean Air Act, as amended (42 USC 1857c-8) and Section 308 of the Federal Water Pollution Control Act, as amended (33 USC 1318) relating to inspection, monitoring, entry, reports, and information, as well as all other requirements specified in said Section 114 and Section 308, and all regulations and guidelines issued thereunder.

3. A stipulation that as a condition for the award of the contract, prompt notice will be given of any notification received from the Director, Office of Federal Activities, EPA, indicating that a facility utilized or to be utilized for the contract is under consideration to be listed on the EPA List of Violating Facilities

4. Agreement by the contractor that he will include, or cause to be included. the criteria and requirements in paragraph (1) through (4) of this section in every nonexempt subcontract and requiring that the contractor will take such action as the Government may direct as a means of enforcing such provisions.

K4 (bq�_
Name of Contractor
26 4'S O f?tti et -i f L.- Ave 201 Sa.t L, Char, r— C,t- 105'9 Address f
Signature and Title VI'r,e
9-1-292c
Date
Ptrc f i.�� N 1-

T 13, CQslip le L e 4 I -A. 41fr

CONTRACTOR FRINGE BENEFIT STATEMENT
Contract Number / Name: (Contract Location:

Contractor / Subcontractor Name:
'Business Address:
(Today's Date:

In order that the proper Fringe Benefit rates can be verified when checking payrolls on the above contract, the hourly rates for fringe benefits, subsistence and/or travel allowance payment made for employees on the various classes of work are tabulated below.

Classification:

FRINGE BENEFITS
Effective Date: Subsistence or Travel Pay:

Health & $ PAID TO: Name:

Welfare Address:

Pension $ PAID TO: Name:

Address:

Vacation/ $ PAID TO: Name:

Holiday Address:

Training $ PAID TO: Name:
and/or Other Address:

Classification:

FRINGE BENEFITS
Effective Date: Subsistence or Travel Pay:

Health & $ PAID TO: Name:

Welfare Address:

Pension $ PAID TO: Name:

Address:

Vacation/ $ PAID TO: Name:

Holiday Address:

Training $ PAID TO: Name:

And/or Other Address:

Classification:

FRINGE BENEFITS
Effective Date: Subsistence or Travel Pay:

Health & $ PAID TO: Name:

Welfare Address:

Pension $ I PAID TO: Name:

Address:

Vacation/ I PAID TO: Name:

Holiday Address:

Training $ I PAID TO: Name:

And/or Other Address:

Supplemental statements must be submitted during the progress of work should a change in rate of any of the classifications be made.

Submitted: Contractor / Subcontractor
IBy: Name / Title

U.S. Department of Labor
Wage and Hour Division
lo C oar1 p (e f-eot L 1 e v -

PAYROLL
(For Contractor's Optional Use; See Instructions at www.doigov/whd/forms/wh347instr,htm) Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.

NAME OF CONTRACTOR El OR SUBCONTRACTOR 0 ADDRESS
PAYROLL NO.
(i)

NAME AND INDIVIDUAL IDENTIFYING NUMBER
(e.g., LAST FOUR DIGITS OF SOCIAL SECURITY

NUMBER) OF WORKER

FOR WEEK ENDING
(2) (3)
zz
Po
Z; Z�w WORK
3 w CLASSIFICATION
N
0 3
0 0
0 s
0 0
s
0 s
(4) DAY AND DATE
itOUR 5 W011kED EAC

PROJECT AND LOCATION
(5) (6)
MHO
U.S. Wage and Hour Division
Rev. Dec. 2008
OMB No.:1235-0008
Expires: 04/30/2021
PROJECT OR CONTRACT NO.
(7) (9)
(8)

DEDUCTIONS
NET

GROSS WITH- WAGES

TOTAL RATE AMOUNT HOLDING TOTAL PAID
i DA' HOURS OF PAY _EARNED FICA TAX OTHER DEDUCTIONS FOR WEEK While completion of Form WH -347 is optional, it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R. §§ 3.3, 5,5(a). The Copeland Act (40 U.S.C. § 3145) contractors and subcontractors performing work on Federally financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee during the preceding week.' U.S. Department of Labor (DOL) regulations at 29 C.F.R. § 5.5(a)(3)(ii) require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project, accompanied by a signed 'Statement of Compliance' indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis -Bacon prevailing wage ram for the work performed. DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits.

Public Burden Statement
We estimate that is will lake an average of 55 minutes to complete this collection, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you have any comments regarding these estimates or any other aspect of this collection, including suggestions for reducing this burden, send them to the Administrator. Wage and Hour Division, U.S. Department of Labor, Room S3502, 200 Constitution Avenue, N.W.

Washington, O.C. 20210
(over)
240

t o e C907 p 1e t-eoo 1_ .1-ev. -
Date
(Name of Signatory Party) (Title)
do hereby state:
(1) That I pay or supervise the payment of the persons employed by on the
(Contractor or Subcontractor)
; that during the payroll period commencing on the
(Building or Work)
day of and ending the day of , _
all persons employed on said project have been paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said from the full
(Contractor or Subcontractor)
weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages eamed by any person, other than permissible deductions as defined in Regulations, Part 3 (29 C.F.R. Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948, 63 Stat. 108, 72 Stat. 967: 76 Stat. 357; 40 U.S.C. § 3145), and described below:
(2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor. (4) That:
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS — in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted in section 4(c) below.
(b) WHERE FRINGE BENEFITS ARE PAID IN CASH
❑ -
(c) EXCEPTIONS
REMARKS:

Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in section 4(c) below.

EXCEPTION (CRAFT) EXPLANATION

NAME AND TITLE

SIGNATURE

THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE.
241

CONTRACTOR INFORMATION
Company Name krn 6,1 ,11 Jt C
Address ZC 'fO /eAe tkey f v-.!. 2P1 C/pr,9-•.,, <4 9!3 S'f2 Telephone 03./0 9'f—(005 Fax MR(OSO1f—/OC7 E-mail /"q/`nn,;,, /CJ a epi. ro#-i Type of Firm: Individual Partnership ( ) Corporation
Corporation organized under the laws of the State of (m %, iorri, a_ Contractor's License Number 5"O7Sf 0 StateC AClassification /4 Expiration Date 3 - 31 "2P2 7 DIR Registration Number ( 00000272/
Names and titles of all officers of the firm
fcr,oe.k Eo
/ -
�t,'r,'f- .Soro,,%.a - CFO
Expiration Date - 3 0-202 7

CONTRACTOR LIST OF PROPOSED SUBCONTRACTORS
Bidder must list all subcontracts. regardless of dollar amount or oercentaoe of bid.

CDBG 5,',,A," /k 4.7/ Cnrit (t../ AM IAmproM,.a'.t1 "Hi e ,--

PROJECT NAME
C;'=1y of PI ce#i, k

AWAR ING AGENCY
r
Location: c,,47 O PIA tt✓t f + eA 27 Project Number: " 101 SUBCONTRACTORS:

Name, Address, and Telephone Number
Signature
�j-- 9-2QZ6
Date
Employer Contractor
Identification License
Number Number
Estimated Estimated
Contract Start Completion
Amount Date Date

DECLARATION OF INTENT TO COMPLY WITH
SECTION 3 REQUIREMENTS
As a minimum requirement for consideration of a contract award, the Bidder/Proposer shall declare his/her intent to comply with Section 3 (24 CFR 75) of the Housing and Urban Development Act of 1968, as amended (Section 3). The Bidder/Proposer is obliged, to the greatest extent feasible, to give opportunities for training and employment to low-income and very low-income persons residing in the service area or neighborhood in which the covered Section 3 project/service is located, and/or to award subcontracts to other Section 3 business concerns that provide economic opportunities for Section 3 workers and Targeted Section 3 workers.

Bidder/Proposer agrees that, as a condition of responsiveness to the solicitation and prior to recommendation for contract award by the Local Contracting Agency (LCA), he/she will agree to comply with the Section 3 requirements by including the Section 3 contract language in the contract, to the greatest extent feasible, to meet the Section 3 benchmarks and report all accomplishments with required documentation on a quarterly basis for the duration of the contract.

The Section 3 benchmarks apply to all Section 3 covered contracts as follows:
• Public housing financial assistance benchmarks:
o Section 3 workers: 25% or more for the total number of labor hours worked by all workers employed, and
o Targeted Section 3 workers: 5% or more of the total number of labor hours worked by all workers employed of which is included as part of the 25% threshold in the previous bullet.
• Community development financial assistance benchmarks:
o Section 3 workers: 25% or more for the total number of labor hours worked by all workers employed on a Section 3 project, and
o Targeted Section 3 workers: 5% or more of the total number of labor hours worked by all workers employed on a Section 3 project of which is included as part of the 25% threshold in the previous bullet.

Failure of the Bidder/Proposer to agree to comply with the Section 3 requirements and reporting obligations shall be grounds for determining the Bidder/Proposer non- responsive, and no further consideration for contract award shall be granted. 1 declare under penalty of perjury under the laws of the State of California that we agree to comply with the Section 3 requirements as stated above. iba
Name of Contractor/Subcontractor
Z P'so lZ�e - ,vr' # 2.0! Sa„ cr,�,,,�
Address CA 1/35'49
/I'% -A Laweeh t -.e Vi `e -e Piet, 1.40 -74 -
Print Name
«r4-
PrintName Title
Signature
7-2oz '
Date
Declaration of Intent to Comply with Section 3 Requirements Rev. 9.1.21

FEDERAL LOBBYIST CERTIFICATION
Name of Firm: eoi tbwek_ c
Address: 2 O /3k -et -Akre- /tivr # 70 / 546,7 ILA C/01, 4f -a State: C A Zip Code: 113 S O Telephone Number: ($f') S P t/ ---/P6 5 Acting on behalf of the above named firm, as its Authorized Official, I make the following Certification to the U. S. Department of Housing and Urban Development and the body awarding this federally assisted construction contract:

1. No Federal appropriated funds have been paid by or on behalf of the above named firm to any person 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 the awarding of any Federal contract, the making of and Federal grantl loan or cooperative agreement, and any extension, continuation, renewal, amendment, or modification thereof, and;

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 or any 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 above named firm shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying". in accordance with Its instructions, and;

3. The above name firm shall require that the language of this certification be Included in the award documents for all sub -awards at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreement) and that all sub -recipients shall certify and disclose accordingly.

NOTE: 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 the 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.

Authorized Official:
it 4- 'AeL^r•., ..e,., ce By:
(Print Name) (Signature)
61- T —2OZ +o
(Date)
Ver.< r ktore ii rn,L
(Title)

U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT

REPORT OF ADDITIONAL CLASSIFICATION AND RATE

1. FROM (name and address of requesting agency) 2. PROJECT NAME AND NUMBER HUD FORM 4230A
OMB Approval Number 2501-0011
(Exp. 8/31/2022)

3. LOCATION OF PROJECT (City, County and State)

4. BRIEF DESCRIPTION OF PROJECT 5. CHARACTER OF CONSTRUCTION

6. WAGE DECISION NO. (include modification number, if any) ❑ COPY ATTACHED

8. ❑ Building
O Heavy
O Highway
❑ Residential
O Other (specify)
DATE of WAGE DECISION: 7. WAGE DECISION EFFECTIVE
DATE (LOCK -IN):

WORK CLASSIFICATION(S) HOURLY WAGE RATES
BASIC WAGE FRINGE BENEFIT(S) (if any)

9. PRIME CONTRACTOR (name, address) 9a. 10. SUBCONTRACTOR/EMPLOYER, IF APPLICABLE (name, address)
0 Agree
9b. SIGNATURE DATE 0 Disagree
Check All That Apply:1
❑ The work to be performed by the additional classification(s) is not performed by a classification in the applicable wage decision. ❑ The proposed classification is utilized in the area by the construction industry. ❑ The proposed wage rate(s), including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage decision.
❑ The interested parties, including the employees or their authorized representatives, agree on the classification(s) and wage rate(s). ❑ Supporting documentation attached, including applicable wage decision.

Check One:1
❑ Approved, meets all criteria. DOL confirmation requested. ❑ One or more classifications fail to meet all criteria. DOL decision requested.

Agency Representative Date
(Typed name and signature)
Phone Number

FOR HUD USE ONLY
LR2000:

Log out:

HUD-4i30A (8-19) PREVIOUS EDITION IS OBSOLETE

HUD -4010 U.S. Department of Housing and Urban Development Federal Labor Standards Provisions Office of Davis -Bacon and Labor Standards A. APPLICABILITY
The Project or Program to which the construction work covered by this Contract pertains is being assisted by the United States of America, and the following Federal Labor Standards Provisions are included in this Contract pursuant to the provisions applicable to such Federal assistance.
(1) MINIMUM WAGES
(1) All laborers and mechanics employed or working upon the site of the work will be paid unconditionally and not less often than once a week, and without subsequent deduction or rebate on any account (except such payroll deductions as are permitted by regulations issued by the Secretary of Labor under the Copeland Act (29 CFR Part 3)), the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment, computed at rates not less than those contained in the wage determination of the Secretary of Labor (which is attached hereto and made a part hereof), regardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics. Contributions made or costs reasonably anticipated for bona fide fringe benefits under Section 1(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of 29 CFR 5.5(a)(1)(iv); also, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs, which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period.

Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to skill, except as provided in 29 CFR 5.5(a)(4).

Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: Provided, that the employer's payroll records accurately set forth the time spent in each classification in which work is performed. The wage determination (including any additional classification and wage rates conformed under 29 CFR 5.5(a)(1)(ii) and the Davis -Bacon poster (WH1321)) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place, where it can be easily seen by the workers. (ii) Additional Classifications.
(A) Any class of laborers or mechanics which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. HUD shall approve an additional classification and wage rate and fringe benefits therefor only when the following criteria have been met:
(1) The work to be performed by the classification requested is not performed by a classification in the wage determination;
(2) The classification is utilized in the area by the construction industry; and (3) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination.
(B) If the contractor, the laborers and mechanics to be employed in the classification (if known), or their representatives, and HUD or its designee agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), a report of the action taken shall be sent by HUD or its designee to the Administrator of the Wage and Hour Division ("Administrator"), Employment Standards Administration, U.S. Department of Labor, Washington, D.C. 20210. The Administrator, or an authorized representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise HUD or its designee or will notify HUD or its designee within the 30 -day period that additional time is necessary. (Approved by the Office of Management and Budget ("OMB") under OMB control number 1235-0023.) (C) In the event the contractor, the laborers or mechanics to be employed in the classification or their representatives, or HUD or its designee do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), HUD or its designee shall refer the questions, including the views of all interested parties and the recommendation of HUD or its designee, to the Administrator for determination. The Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise HUD or its designee or will notify HUD or its designee within the 30 -day period that additional time is necessary. (Approved by the Office of Management and Budget under OMB Control Number 1235-0023.)
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(D) The wage rate (including fringe benefits, where appropriate) determined pursuant to subparagraphs (1)(ii)(B) or (C) of this paragraph, shall be paid to all workers performing work in the classification under this Contract from the first day on which work is performed in the classification. (iii) Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. (iv) If the contractor does not make payments to a trustee or other third person, the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, Provided, that the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. (Approved by the Office of Management and Budget under OMB Control Number 1235-0023.) (2) Withholding. HUD or its designee shall, upon its own action or upon written request of an authorized representative of the U.S. Department of Labor, withhold or cause to be withheld from the contractor under this contract or any other Federal contract with the same prime contractor, or any other Federally -assisted contract subject to Davis -Bacon prevailing wage requirements which is held by the same prime contractor, so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee or helper, employed or working on the site of the work, all or part of the wages required by the contract, HUD or its designee may, after written notice to the contractor, sponsor, applicant, or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. HUD or its designee may, after written notice to the contractor, disburse such amounts withheld for and on account of the contractor or subcontractor to the respective employees to whom they are due. The U.S. Department of Labor shall make such disbursements in the case of direct Davis -Bacon Act contracts. (3)
Payrolls and basic records.
(1)
Maintaining Payroll Records. Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work. Such records shall contain the name, address, and social security number of each such worker, his or her correct classification(s), hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in Section 1(b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made, and actual wages paid.

Whenever the Secretary of Labor has found, under 29 CFR 5.5(a)(1)(iv), that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in Section 1(b)(2)(B) of the Davis -Bacon Act, the contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost incurred in providing such benefits.

Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. (Approved by the Office of Management and Budget under OMB Control Numbers 1235-0023 and 1215-0018) (ii) Certified Payroll Reports.
(A) The contractor shall submit weekly, for each week in which any contract work is performed, a copy of all payrolls to HUD or its designee if the agency is a party to the contract, but if the agency is not such a party, the contractor will submit the payrolls to the applicant sponsor, or owner, as the case may be, for transmission to HUD or its designee. The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 CFR 5.5(a)(3)(i), except that full social security numbers and home addresses shall not be included on weekly transmittals. Instead, the payrolls only need to include an individually identifying number for each employee (e.g., the last four digits of the employee's social security number). The required weekly payroll information may be submitted in any form desired. Optional Form WH -347 is available for this purpose from the Wage and Hour Division Web site at https://www.dol.gov/agencies/whd/forms or its successor site. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors.

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Contractors and subcontractors shall maintain the full social security number and current address of each covered worker, and shall provide them upon request to HUD or its designee if the agency is a party to the contract, but if the agency is not such a party, the contractor will submit the payrolls to the applicant sponsor, or owner, as the case may be, for transmission to HUD or its designee, the contractor, or the Wage and Hour Division of the U.S.

Department of Labor for purposes of an investigation or audit of compliance with prevailing wage requirements. It is not a violation of this subparagraph for a prime contractor to require a subcontractor to provide addresses and social security numbers to the prime contractor for its own records, without weekly submission to HUD or its designee. (Approved by the Office of Management and Budget under OMB Control Number 1235-0008.) (8) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following:
(1) That the payroll for the payroll period contains the information required to be provided under 29 CFR

5.5(a)(3)(ii), the appropriate information is being maintained under 29 CFR 5.5(a)(3)(i), and that such information is correct and complete;
(2) That each laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in 29 CFR Part 3; (3) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as specified in the applicable wage determination incorporated into the contract; and
(C) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH -347 shall satisfy the requirement for submission of the "Statement of Compliance" required by subparagraph (a)(3)(ii)(b).
(D) The falsification of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecution under Section 1001 of Title 18 and Section 3729 of Title 31 of the United States Code. (iii) The contractor or subcontractor shall make the records required under subparagraph (a)(3)(i) available for inspection, copying, or transcription by authorized representatives of HUD or its designee or the U.S. Department of Labor, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the required records or to make them available, HUD or its designee may, after written notice to the contractor, sponsor, applicant, or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds. Furthermore, failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. (4) Apprentices and Trainees.
(i)
Apprentices. Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S. Department of Labor, Employment and Training Administration, Office of Apprenticeship Training, Employer and Labor Services, or with a State Apprenticeship Agency recognized by the Office, or if a person is employed in his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is riot individually registered in the program, but who has been certified by the Office of Apprenticeship Training, Employer and Labor Services, or a State Apprenticeship Agency (where appropriate), to be eligible for probationary employment as an apprentice.

The allowable ratio of apprentices to journeymen on the job site in any craft classification shall not be greater than the ratio permitted to the contractor as to the entire work force under the registered program. Any worker listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. Where a contractor is performing construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman's hourly rate) specified in the contractor's or subcontractor's registered program shall be observed.

Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination.

Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program.

HUD -4010 (06/2022)
Previous editions are obsolete. Page 3 of 5 ref. Handbook 1344.1

If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification. If the Administrator determines that a different practice prevails for the applicable apprentice classification, fringe benefits shall be paid in accordance with that determination. In the event the Office of Apprenticeship Training, Employer and Labor Services, or a State Apprenticeship Agency recognized by the Office, withdraws approval of an apprenticeship program, the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is approved.
(ii) Trainees. Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed, unless they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration. The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the work actually performed.

In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Administration withdraws approval of a training program, the contractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved.
(iii) Equal employment opportunity. The utilization of apprentices, trainees, and journeymen under 29 CFR Part 5 shall be in conformity with the equal employment opportunity requirements of Executive Order 11246, as amended, and 29 CFR Part 30.
(5) Compliance with Copeland Act requirements. The contractor shall comply with the requirements of 29 CFR Part 3, which are incorporated by reference in this Contract.
(6) Subcontracts. The contractor or subcontractor will insert in any subcontracts the clauses contained in subparagraphs (1) through (11) in this paragraph (a) and such other clauses as HUD or its designee may, by appropriate instructions, require, and a copy of the applicable prevailing wage decision, and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in this paragraph. (7) Contract termination; debarment. A breach of the contract clauses in 29 CFR 5.5 may be grounds for termination of the contract and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. (8) Compliance with Davis -Bacon and Related Act Requirements. All rulings and interpretations of the Davis -Bacon and Related Acts contained in 29 CFR Parts 1, 3, and 5 are herein incorporated by reference in this Contract. (9) Disputes concerning labor standards. Disputes arising out of the labor standards provisions of this Contract shall not be subject to the general disputes clause of this Contract. Such disputes shall be resolved in accordance with the procedures of the U.S. Department of Labor set forth in 29 CFR Parts 5, 6, and 7. Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors) and HUD or its designee, the U.S. Department of Labor, or the employees or their representatives.
(10) Certification of Eligibility.
(i) By entering into this Contract, the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1) or to be awarded HUD contracts or participate in HUD programs pursuant to 24 CFR Part 24.

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(ii) No part of this Contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1) or to be awarded HUD contracts or participate in HUD programs pursuant to 24 CFR Part 24.
(iii) Anyone who knowingly makes, presents, or submits a false, fictitious, or fraudulent statement, representation or certification is subject to criminal, civil and/or administrative sanctions, including fines, penalties, and imprisonment (e.g., 18 U.S.C. §§ 287, 1001, 1010, 1012; 31 U.S.C. §§ 3729, 3802. (11) Complaints, Proceedings, or Testimony by Employees. No laborer or mechanic, to whom the wage, salary, or other labor standards provisions of this Contract are applicable, shall be discharged or in any other manner discriminated against by the contractor or any subcontractor because such employee has filed any complaint or instituted or caused to be instituted any proceeding or has testified or is about to testify in any proceeding under or relating to the labor standards applicable under this Contract to his employer.

B. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT
The provisions of this paragraph (b) are applicable where the amount of the prime contract exceeds $100,000. As used in this paragraph, the terms "laborers" and "mechanics" include watchmen and guards. (1) Overtime requirements. No contractor or subcontractor contracting for any part of the contract work, which may require or involve the employment of laborers or mechanics, shall require or permit any such laborer or mechanic in any workweek in which the individual is employed on such work to work in excess of 40 hours in such workweek, unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of 40 hours in such workweek.
(2) Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in subparagraph B(1) of this paragraph, the contractor, and any subcontractor responsible therefor, shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory) for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in subparagraph 8(1) of this paragraph, in the sum set by the U.S.

Department of Labor at 29 CFR 5.5(b)(2) for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of 40 hours without payment of the overtime wages required by the clause set forth in subparagraph 13(1) of this paragraph. In accordance with the Federal Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. § 2461 Note), the DOL adjusts this civil monetary penalty for inflation no later than January 15 each year.

Withholding for unpaid wages and liquidated damages. HUD or its designee shall, upon its own action or upon written request of an authorized representative of the U.S. Department of Labor, withhold or cause to be withheld from any moneys payable on account of work performed by the contractor or subcontractor under any such contract, or any other Federal contract with the same prime contract, or any other Federally -assisted contract subject to the Contract Work Hours and Safety Standards Act which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages, as provided in the clause set forth in subparagraph B(2) of this paragraph. (4) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in subparagraph B(1) through (4) of this paragraph and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in subparagraphs B(1) through (4) of this paragraph. (3)
C. HEALTH AND SAFETY
The provisions of this paragraph (c) are applicable where the amount of the prime contract exceeds $100,000. (1)
No laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his or her health and safety, as determined under construction safety and health standards promulgated by the Secretary of Labor by regulation.
(2) The contractor shall comply with all regulations issued by the Secretary of Labor pursuant to 29 CFR Part 1926 and failure to comply may result in imposition of sanctions pursuant to the Contract Work Hours and Safety Standards Act, (Public Law 91-54, 83 Stat 96), 40 U.S.C. § 3701 et seq.

The contractor shall include the provisions of this paragraph in every subcontract, so that such provisions will be binding on each subcontractor. The contractor shall take such action with respect to any subcontractor as the Secretary of Housing and Urban Development or the Secretary of Labor shall direct as a means of enforcing such provisions. (3)
Previous editions are obsolete.

HUD -4010 (06/2022)

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Placentia City CouncilOctober 6, 2026

Placentia City Council
October 6, 2026