City of Sacramento
City Council - 5PM Report
915 I Street Sacramento, CA 95814
www.cityofsacramento.org
File ID: 2023-01404 11/14/2023 Consent Item 24.
Contract: Pannell Community Center Roof Replacement Sections 6, 7 & 17 (C13900000) File ID: 2023-01404
Location: 2450 Meadowview Road, District 8, Represented by Mayor Pro Tem Vang Recommendation: Pass a Motion:1) awarding a construction contract to Pacific Polymers, Inc, DBA American Foam Experts in an amount not to exceed $265,000 for the Pannell Community Center Roof Replacement Sections 6, 7 & 17 Project; and 2) authorizing the City Manager or the City Manager’s designee to execute the contract specified above.
Contact: Norm Colby, Facilities & Real Property Superintendent, (916) 808-8335, [email protected]; James Christensen, Facilities Manager, (916) 808-5863, [email protected], Department of Public Works Presenter: None
Attachments:
1-Description/Analysis
2-Contract- Pacific Polymers, Inc. DBA American Foam Experts Description/Analysis
Issue Detail: The Pannell Community Center’s roof is nearing the end of its useful life and requires replacement. The recommended contract with Pacific Polymers, Inc. DBA American Foam Experts (Pacific Polymers, Inc.) will include the removal of the existing roof system and related components, any deck replacement, and the application of a Tremco TPA (Tri-polymer Alloy) Membrane Roof that will be mechanically attached to roof sections 6, 7 & 17 of the building.
Policy Considerations: The recommendations in this report are in accordance with the provisions of the City Code Chapter 3.60, which requires City Council approval for contracts over $250,000 or more.
Economic Impacts: The recommended contract is expected to create 1.96 jobs (1.25 direct jobs
File ID: 2023-01404 11/14/2023 Consent Item 24.
and .71 job through indirect and induced activities) and create $258,778 in total economic output ($165,883 of direct output and another $92,895 of output in indirect and induced activities).
The indicated economic impacts are estimates calculated using a calculation tool developed by the Center for Strategic Economic Research (CSER). CSER utilized the IMPLAN input-output model (2009 coefficients) to quantify the economic impacts of a hypothetical $1 million of spending in various construction categories within the City of Sacramento in an average one-year period. Actual impacts could differ significantly from the estimates and neither the City of Sacramento nor CSER shall be held responsible for consequences resulting from such differences.
Environmental Considerations:
California Environmental Quality Act: No environmental review is necessary because the recommendations in this report involve the repair of an existing structure with no expansion beyond the previously existing level of use and are therefore considered to be an exempt project or activity in accordance with Section 15301 of the CEQA Guidelines.
Sustainability: None.
Commission/Committee Action: Not applicable.
Rationale for Recommendation: The Pannell Community Center’s roof is nearing the end of its useful life and requires replacement and roof sections 6, 7 & 17 were identified as a priority to be replaced as part of the deferred maintenance program. On August 4, 2023, the Department of Public Works issued Invitation for Bid (IFB) No. B23014541003. Six bids were received, three of which were determined to be responsive in meeting the minimum local business enterprise (LBE) participation requirement. Three of the contractors failed to list any subcontractors or suppliers to meet the LBE participation requirement. Pacific Polymers, Inc. was determined to be the lowest responsive and responsible bidder. Work is anticipated to begin on site in November of 2023 if the weather conditions are optimal.
The results of IFB No. B23014541003 are listed in the table below.
CONTRACTOR Bid Amount
Pacific Polymers, Inc. $265,000
Madsen Roofing & Waterproofing, Inc. $283,394
Pac Shield Roofing Services, Inc. $297,957
California Single Ply, Inc.* $329,950
Reve Murphy Associates, Inc.* $461,991
Best Contracting Services Incorporated* $463,915
*Did not meet the minimum LBE participation requirement.
File ID: 2023-01404 11/14/2023 Consent Item 24.
Financial Considerations: Sufficient funding exists within the City Facility Reinvestment Program (C13900000) to award a construction contract to Pacific Polymers Inc. in an amount not to exceed $265,000 (Measure U, Fund 2401) for the completion of the Pannell Community Center Roofing Replacement Project.
Local Business Enterprise (LBE): Pacific Polymers, Inc. is an LBE.
Form approved by City Attorney 1-11-17 1
AGREEMENT
(Construction Contract Over $25,000)
THIS AGREEMENT, dated for identification , 20 23, is made and entered into between the CITY OF SACR AMENTO, a municipal corporation ( “City”), and PACIFIC POLYMERS, INC. DBA AMERICAN FOAM EXPERTS , 11500 Twin Cities Rd., Galt, CA 95632 (“Contractor ”) in the amount of TWO HUNDRED AND SIXTY- FIVE THOUSAND DOLLARS AND ZERO CENTS ($265,000).
Th
e City and Contractor hereby mutually agree as follows:
1. CON
TRACT DOCUMENTS
Th
e Contract Documents, sometimes also referred to as the “Contract,” consist of the following items, which are hereby incorporated by reference as if set forth in full in this Agreement:
N
otice to Contractors
Proposal Form submitted by the Contractor
Instructions to Bidders
Subcontractor and Local Business Enterprise Participation Form Drug-Free Workplace Policy and Affidavit
Construction and Demolition (C&D) Debris Recycling Requirements Workers’ Compensation Insurance Certification
Federal or State funding requirements (if applicable)
Local Business Enterprise (LBE) Requirements
Requirements of the Non-Discrimination in Employee Benefits Code Ban-The-Box Requirements
Addenda, if any
This Agreement
Standard Specifications
Special Provisions
Plans and Technical Specifications
The drawings and other data and all developments thereof prepared by City pursuant to the Contract
Any modifications of any of the foregoing made or approved by City, including but not limited to duly authorized change orders
Unl
ess specifically noted otherwise, references to the “Standard Specifications ” shall mean and refer to the Standard Specifications for Public Construction of the City of Sacramento approved by the Sacramento City Council on June 4, 2007 (Resolution No. 2007-350), and any subsequent amendments thereto approved by the Sacramento City Council or the Sacramento City Manager. Work called for in any one Contract Document and not mentioned in another is to be performed and executed as if mentioned in all Contract Documents. The table of contents, titles and headings contained in the Contract Documents are provided solely to facilitate reference to various provisions of the Contract Documents and in no way affect or limit the interpretation of the provisions to which they refer.
Form approved by City Attorney 1-11-17 2
2. D
EFINITIONS
Unl
ess otherwise specifically provided herein, all words and phrases defined in the Standard Specifications shall have the same meaning and intent in this Agreement.
3. AG
REEMENT CONTROLS
I
n the event of a conflict between any of the terms and conditions set forth in this Agreement and the terms and conditions set forth in other Contract Documents, the terms and conditions set forth in this Agreement shall prevail, except that the provisions of any duly authorized change order shall prevail over any conflicting provisions of this Agreement.
4. S
COPE OF CONTRACT
Co
ntractor agrees to furnish all tools, equipment, apparatus, facilities, labor , material and transportation necessary to perform and complete in a good and workmanlike manner to the satisfaction of City, all the Work called for in the Contract Documents entitled:
P
ANNELL COMMUNITY CENTER ROOF REPALCEMENT SECTIONS 6, 7 & 17 I
ncluding the Work called for in the f ollowing alternative bid items described in the Proposal Form:
Co
ntractor agrees to perform such Work in the manner designated in and in strict conformity with the Contract Documents.
5. CON
TRACT AMOUNT AND PAYMENTS
City
agrees to pay and Contractor agrees to accept, as complete payment for the above Work, in accordance with the schedule and procedures set forth in the Contract Documents and subject to deductions, withholdings and additions as specified in the Contract Documents, a total sum that shall not exceed the total bid amount set forth in Contractor’s Proposal Form . In addition, subject to deductions, withholdings and additions as specified in the Contract Documents , payment for individual items of the Work shall be computed as follows:
A. F
or items of the Work for which a lump sum price is specified in Contractor’s Proposal Form , Contractor shall be paid the lump sum p rice(s) specified in Contractor’s Proposal Form; and
B. F
or items of the Work for which a unit price is specified in Contractor’s Proposal Form, Contractor shall be paid the sum computed at such unit price, or computed at a different price if such differ ent price is determined by City in accordance with the Standard Specifications, based on the actual amount of each such item performed and/or furnished and incorporated in the Work ; provided Form approved by City Attorney 1-11-17 3
that in no event shall the total sum for a unit price item exceed the total bid amount set forth for such item in the Contractor’s Proposal Form, unless authorized by Change Order.
6. P
ROGRESS PAYMENTS
S
ubject to the terms and conditions of the Contract, City shall cause payments to be made upon demand of Contractor as follows:
A. On or
about the first of the month, the Engineer shall present to the Contractor a statement showing the amount of labor and materials incorporated in the Work through the twentieth (20) calendar day of the preceding month . After both Contractor and Engineer approve the statement in writing, and the City’s labor compliance officer provides written approval, the City shall issue a certificate for ninety-five (95) percent of the amount it shall find to be due, subject to any deductions or withholdings authorized or required under the Contract or any applicable Laws or Regulations.
B. N
o inaccuracy or error in said monthly estimates shall operate to release Contractor from damages arising from such Work or from enforcement of each and every provision of the Contract Documents, and City shall have the right subsequently to correct any error made in any estimate for payment.
C. Co
ntractor shall not be paid for any defective or improper Work.
D. Th
e remaining five (5) percent of the value of the Work performed under the Contract, if unencumbered and subject to any deductions or withholdings authorized or required under the Contract or any applicable Laws or Regulations, shall be released not later than sixty (60) days after completion and final acceptance of the Work by City. Acceptance by Contractor of the final payment shall constitute a waiver of all claims against the City arising under the Contract Documents, except for disputed claims in stated amounts that the Contractor specifically reserves in writing, but only to the extent that the Contractor has complied with all procedures and requirements applicable to the presentation and processing of such claim(s) under the Contract Documents. Contractor shall be entitled to substitute securities for retention or to direct that payments of retention be made into escrow, as provided in Public Contract Code Section 22300, upon execution of the City’s Escrow Agreement for Security Deposits in Lieu of Retention.
E
. The parties agree that, for purposes of the timely progress payment requirements specified in Public Contract Code Section 20104.50, the date that the City receives a statement jointly approved by the Contractor and the Engineer as provided above shall be deemed to constitute the date that City receives an undisputed and properly submitted payment request from the Contractor. Progress payments not made within 30 days after this date may be subject to payment of interest as provided in Public Contract Co de Section 20104.50.
Form approved by City Attorney 1-11-17 4
F. This Contract is subject to compliance monitoring and enforcement by the California Department of Industrial Relations, as specified in California Labor Code section 1771.4.
7. RETENTION OF SUMS CHARGED AGAINST CONTRACTOR
When, under the provisions of this Contract or any applicable Laws or Regulations, City is authorized or required to withhold, deduct or charge any sum of money against Contractor, City may deduct and retain the amount of such charge from the amount of the next s ucceeding progress estimate(s), or from any other moneys due or that may become due Contractor from City. If, on completion or termination of the Contract, sums due Contractor are insufficient to pay City's charges, City shall have the right to recover the balance from Contractor or its Sureties.
8. COMMENCEMENT AND PROSECUTION OF WORK
Contractor shall commence the Work not later than fifteen (15) working days after the date of the written Notice to Proceed from City to Contractor and shall diligently prosecute the W ork t o final completion. The phase “ commence the W ork” means to engage in a continuous program on- site including, but not limited to, site clearance, grading, dredging, land filling and the fabrications, erection, or installation of the Work.
The Notice to Proceed shall be issued within fifteen (15) calendar days following execution of the Agreement by the City and the filing by Contractor of the required Bonds and proof of insurance, provided that the Engineer may delay issuance of the Notice to Proceed if the Engineer determines in the Engineer’s sole discretion that conditions on the site of the Work are unsuitable for commencement of the Work . After the Notice to Proceed is issued, the continuous prosecution of Work by Contractor shall be subject only to Excusable Delays as defined in this Agreement.
9. TIME OF COMPLETION
The entire Work shall be brought to completion in the manner provided for in the Contract Documents on or before THIRTY (30) CALENDAR days from the date of the Notice to P roceed (hereinafter called the “ Completion Date”) unless extensions of time are granted in accordance with the Contract Documents.
Failure to complete the entire Work by the Completion Date and in the manner provided for in the Contract Documents shall subject Contractor to liquidated damages as provided in this Agreement. Time is and shall be of the essence in the performance of the Contract and the Work.
10. PAYMENTS DO NOT IMPLY ACCEPTANCE OF WORK
The payment of any progress payment, or the acceptance thereof by Contractor, shall not constitute acceptance of the Work or any portion thereof and shall in no way reduce the liability of Contractor to replace unsatisfactory work or material, whether or not the unsatisfactory character of such work or material was apparent or detected at the time such payment was made.
Form approved by City Attorney 1-11-17 5
11. ACCEPTANCE NOT RELEASE
Contractor shall correct immediately any defective or imperfect work or materials that may be discovered before final acceptance of the entire Work , whether or not such defect or imperfection was previously noticed or identified by the City . The inspection of the Work, or any part thereof, shall not relieve Contractor of any of its obligations to perform satisfactory work as herein specified.
Failure or neglect on the part of City or any of its offic ers, employees or authorized agents to discover, identify, condemn or reject defective or imperfect work or materials shall not be construed to imply an acceptance of such work or materials , if such defect or imperfection becomes evident at any time prior to final acceptance of the entire Work, nor shall such failure or neglect be construed as barring City from enforcing Contractor’s warranty(ies) or otherwise recovering damages or such a sum of money as may be required to repair or rebuild the defective or imperfect work or materials whenever City may discover the same, subject only to any statu tes of limitation that may apply to any such claim.
12. CITY'S RIGHT TO TAKE POSSESSION OF THE WORK IN WHOLE OR IN PART
The City shall have the right at any time to enter upon the Work and perform work not covered by this Contract, or to occupy and use a portion of the Work, prior to the date of the final acceptance of the Work as a whole, without in any way relieving Contractor of any obligations under this Contract.
13. NO WAIVER OF REMEDIES
Neither the inspection by City , its officers, employees or agents, nor any certificate or other approval for the payment of money, nor any payment for, nor acceptance of the whole or any part of the Work by City, nor any extensions of time, nor any position taken by City , its officers, employees or its agents shall operate as a waiver of any provision of the Contract Documents n or of any power herein reserved to City or any right to damages herein provided, nor shall any waiver of any breach of this Agreement be held to be a waiver of any other or subsequent breach. All remedies provided in the Contract Documents shall be taken and construed as cumulative; in addition to each and every other remedy herein provided, the City shall have any and all equitable and legal remedies that it would in any case have.
14. WARRANTY
Except as otherwise expressly provided in the Contract Documents, and excepting only items of routine maintenance, ordinary wear and tear and unusual abuse or neglect by City, Contractor warrants and guarantees all Work executed and all supplies, materials and devices of whatsoever nature incorporated in or attached to the Work, or otherwise provided as a part of the Work pursuant to the Contract, to be absolutely free of all defects of workmanship and materials for a period of one year after final acceptance of the entire Work by the City. Contractor shall repair or replace all work or material, together with any other work or material that may be displaced or damaged in so doing, Form approved by City Attorney 1-11-17 6
that may prove defective in workmanship or material within this one year warranty period without expense or charge of any nature whatsoever to City.
In the event that Contractor shall fail to comply with the conditions of the foregoing warranty wi thin ten (10) days after being notified of the defect in writing, City shall have the right, but shall not be obligated, to repair, or obtain the repair of, the defect and Contractor shall pay to City on demand all costs and expense of such repair.
Notwithstanding anything herein to the contrary, in the event that any defect in workmanship or material covered by the foregoing warranty results in a condition that constitutes an immediate hazard to public health or safety, or any property interest, or any person, City shall have the right to immediately repair, or cause to be repaired, such defect, and Contractor shall pay to City on demand all costs and expense of such repair.
The foregoing statement relating to hazards to health, safety or property shall b e deemed to include both temporary and permanent repairs that may be required as determined in the sole discretion and judgment of City.
In addition to the above, the Contractor shall make a written assignment of all manufacturer’s and other product warranties to the City, prior to completion and final acceptance of the Work by City.
The Contractor’s Performance Bond shall secure the performance of the Contractor’s obligations under this Section 14 , and the Contractor and its Surety shall be jointly and severally liable for these obligations.
15. LIQUIDATED DAMAGES IF WORK NOT COMPLETED ON TIME
A. The actual fact of the occurrence of damages and the actual amount of the damages that City would suffer if the entire Work, and/or any specified portion thereof, were not completed within the time(s) specified herein are dependent upon many circumstances and conditions that could prevail in various combinations, and for this reason, it is impracticable and extremely difficult to fix the actual damages. Damages that City would suffer in the event of such delay include: loss of the use of the project; expenses of prolonged assignment to the project of an architectural and /or engineering staff; prolonged costs of administration, inspection, and supervision; increased operational expenses and/or impaired operation of other facilities dependent upon completion of the project; and the loss and inconvenience suffered by the public within the City of Sacramento by reason of the delay in the completion of the project or portion thereof. Accordingly, the parties agree, and by execution of this Agreement, Contractor acknowledges that it understands and agrees, that the amount(s) set forth herein as liquidated damages reflect the parties’ best efforts at the time of entering into the Contr act to estimate the damages that may be incurred by City and the public due to the Contractor’s delay in completion of the Work and/or any specified portion thereof, and shall be presumed to be the amount of damages sustained by the failure of Contractor to complete the entire Work and/or any specified portion thereof within the time(s) specified herein.
Form approved by City Attorney 1-11-17 7
B. Contractor shall pay liquidated damages to City for failure to complete the entire Work by the Completion Date (as extended in accordance with the Contract Documents, if applicable) in the amount of $1000.00 for each calendar day after the Completion Date (as extended in accordance with the Contract Documents, if applicable), continuing to the time at which the entire Work is completed. Such amount is the actual cash value agreed upon by the City and Contractor as the loss to City and the public resulting from Contractor's default.
The parties agree, and by execution of this Agreement, Contractor acknowledges that it understands and agrees, that the foregoing provisions provide for the imposition of liquidated damages from the Completion Date (as extended in accordance with the Contract Documents, if applicable) until the date of completion of the entire Work as determined by the Engineer in accordance with Section 8 -4 of the Standard Specifications, whether or not the Work or any portion thereof is claimed or determined to be substantially complete prior to such date of completion.
C. In the event Contractor shall become liable for liquidated damages, City, in addition to all other remedies provided by law, shall have the right to withhold any and all payments that otherwise would be or become due Contractor until the liability of Contractor under this section is finally determined. City shall have the right to use and apply such payments, in whole or in part, to reimburse City for all liquidated damages due or to become due to City. Any remaining balance of such payments shall be paid to Contractor only after discharge in full of all liability incurred by Contractor under this section or otherwise under any provision of the Contract Documents or any applicable Law or Regulation. If the sum so retained by City is not sufficient to discharge all such liabilities of Contractor, Contractor shall continue to remain liable to City until all such liabilities are satisfied in full. No failure by City to withhold any payment as specified above shall in any manner be construed to constitute a release of any such liabilities nor a waiver of the Ci ty’s right to withhold payment for such liabilities.
16. INDEMNITY AND HOLD HARMLESS
A. Contractor shall defend, hold harmless and indemnify the City, its officers, employees, and agents, and each and every one of them, from and against any and all actions, damages, costs, liabilities, claims, demands, losses, judgments, penalties, costs and expenses of every type and description, whether arising on or off the site of the Work, including, but not limited to, any fees and/or costs reasonably incurred by City’ s staff attorneys or outside attorneys and any fees and expenses incurred in enforcing this provision (hereafter collectively referred to as “Liabilities”), including but not limited to Liabilities arising from personal injury or death, damage to personal, real or intellectual property or the environment, contractual or other economic damages, or regulatory penalties, arising out of or in any way connected w ith performance of or failure to perform the Work by the Contractor, any Form approved by City Attorney 1-11-17 8
subcontractor or agent , anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, whether or not (i) such Liabilities are caused in part by a party indemnified hereunder , or (ii) such Liabilities are litigated, settled or reduced to judgment; provided that the foregoing indemnity does not apply to liability for damages for death or bodily injury to persons, injury to property, or other loss, damage or expense to the extent arising from (i) the sole negligence or willful misconduct of, or defects in design furnished by, City, its agents, servants, or independent contractors who are directly responsible to City, or (ii) the active negligence of City.
B. Th
e existence or acceptance by City of any of the insurance policies or coverages described in this Agreement shall not affect or limit any of City’s rights under this Section 16, nor shall the limits of such insurance limit the liability of Contractor hereunder. The provisions of this Section 16 shall survive any expiration or termination of the Contract.
17 . CONTRACTOR SHALL ASSUME RISKS
Unt
il the completion and final acceptance by City of all Work under this Contract, the Work shall be under Contractor's responsible care and charge, and Contractor, at no cost to City, shall rebuild, repair, restore and make good all injuries, damages, re- erections, and repairs occasioned or rendered necessary by accidental causes of any nature, to all or any portions of the Work.
18 . GENERAL LIABILITY OF CONTRACTOR
E
xcept as otherwise herein expressly stipulated, Contractor shall perform all the Work and furnish all the labor, materials, tools, equipment, apparatus, facilities, transportation, power and light, and appliances, necessary or proper for performing and completing the Work herein required in the manner and within the time herein specified. The mention of any specific duty or liability of Contractor shall not be construed as a limitation or restriction of any general liability or duty of Contractor, and any reference to any specific duty or liability shall be construed to be solely for the purpose of explanation.
19 . INSURANCE
D
uring the entire term of the Contract, Contractor shall maintain the insurance coverage described in this Section 19.
F
ull compensation for all premiums that Contractor is required to pay for the insurance coverage described herein shall be included in the compensation specified for the Work performed by Contractor under this Contract. No additional compensation will be provided for Contractor’s insurance premiums. Any available insurance proceeds in excess of the specified minimum limits and coverages shall be available to the City.
Form approved by City Attorney 1-11-17 9
It is understood and agreed by the Contractor that its liability to the City shall not in any way be limited to or affected by the amount of insurance coverage required or carried by the Contractor in connection with this Contract.
A. Minimum Scope & Limits of Insurance Coverage
(1) Commercial General Liability Insurance providing coverage at least as broad as ISO CGL Form 00 01 on an occurrence basis for bodily injury, including death, of one or more persons, property damage, and personal injury, arising out of activities performed by or on behalf of Contractor and its subcontractors, products and completed operations of Contractor and its subcontractors, and premises owned, leased, or used by Contractor and its subcontractors, with limits of not less than one million dollars ($1,000,000) per occurrence. The policy shall provide contractual liability and products and completed operations coverage for the term of the policy.
(2) Au
tomobile Liability Insurance providing coverage at least as broad as ISO Form CA 00 01 for bodily injury, including death, of one or more persons, property damage, and personal injury, with limits of not less than one million dollars ($1,000,000) per accident. The policy shall provide coverage for owned, non- owned, and/or hired autos as appropriate to the operations of the Contractor.
No automobile liability insurance shall be required if Contractor completes the following certification:
“I certify that a motor vehicle will not be used in the performance of any work or services under this agreement.” ________ (Contractor initials)
(3) Excess Insurance: The minimum limits of insurance required above may be satisfied by a combination of primary and umbrella or excess insurance coverage; provided that any umbrella or excess insurance shall contain, or be endorsed to contain, a provision that it shall apply on a primary basis for the benefit of the CITY, and any insurance or self-insurance maintained by CITY, its officials, employees, or volunteers shall be in excess of such umbrella or excess coverage and shall not contribute with it.
(4) Workers’ Compensation Insurance with statutory limits, and Employers’ Liability Insurance with limits of not less than one million dollars ($1,000,000). The Workers’ Compensation policy shall include a waiver of subrogation in favor of the City.
Form approved by City Attorney 1-11-17 10
No Workers’ Compensation insurance shall be required if Contractor completes the following certification:
“I certify that my business has no employees, and that I do not employ anyone. I am exempt from the legal requirements to provide Workers' Compensation insurance.” _________
(Contractor initials)
B. Additional Insured Coverage
(1) Commercial General Liability Insurance: The City, its officials, employees, and volunteers shall be covered by policy terms or endorsement as additional insureds as respects general liability arising out of: activities performed by or on behalf of Contractor and its subcontractors; products and completed operations of Contractor and its subcontractors; and premises owned, leased, or used by Contractor and its subcontractors.
(2) Automobile Liability Insurance: The City, its officials, employees, and volunteers shall be covered by policy terms or endorsement as additional insureds as respects auto liability.
C. Other Insurance Provisions
The policies are to contain, or be endorsed to contain, the following provisions:
(1) Contractor’s insurance coverage, including excess insurance, shall be primary insurance as respects City, its officials, employees, and volunteers. Any insurance or self- insurance maintained by City, its officials, employees, or volunteers shall be in excess of Contractor’s insurance and shall not contribute with it.
(2) Any failure to comply with reporting provisions of the policies shall not affect coverage provided to City, its officials, employees, or volunteers.
(3) Coverage shall state that Contractor’s insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer’s liability.
(4) City will be provided with thirty (30) days written notice of cancellation or material change in the policy language or terms.
D. Acceptability of Insurance
Insurance shall be placed with insurers with a Bests’ rating of not less than Form approved by City Attorney 1-11-17 11
A:VI. Self- insured retentions, policy terms or other variations that do not comply with the requirements of this Section 3 must be declared to and approved by the City in writing prior to execution of this Contract.
E. Verification of Coverage
(1) Contractor shall furnish City with certificates and required endorsements evidencing the insurance required. Copies of policies shall be delivered to the City on demand. Certificates of insurance shall be signed by an authorized representative of the insurance carrier.
(2) For all insurance policy renewals during the term of this Contract, Contractor shall send insurance certificates reflecting the policy renewals directly to:
City of Sacramento
c/o EXIGIS LLC
P.O. Box 947
Murrieta, CA 92564
Insurance certificates also may be faxed to (888) 355- 3599, or e - mailed to:
[email protected]
(3) The City may withdraw its offer of contract or cancel this Contract if the certificates of insurance and endorsements required have not been provided prior to execution of this Contract. The City may withhold paym ents to Contractor or cancel the Contract if the insurance is canceled or Contractor otherwise ceases to be insured as required herein.
F. Subcontractors
Contractor shall require and verify that all subcontractors maintain insurance coverage that meets the minimum scope and limits of insurance coverage specified in subsection A, above.
20. FAILURE TO MAINTAIN BONDS OR INSURANCE
If, at any time during the performance of this Contract, Contractor fails to maintain any item of the bonds and/or insurance required under the Contract in full force and effect, Contractor shall immediately suspend all work under the Contract and notify City in writing of such failure. After such notice is provided, or if City discovers such failure and notifies Contractor, t he City thereafter may withhold all Contract payments due or that become due until notice is received by City that such bonds and/or insurance have been restored in full force and effect and that the premiums therefor have been paid for Form approved by City Attorney 1-11-17 12
a period satisfactory to the Division of Risk Management. Contractor shall not resume work until notified by City to do so, and the City shall have no responsibility or liability for any costs incurred by Contractor as a result of such suspension of Work.
In addition to the foregoing, any failure to maintain any item of the required bonds and/or insurance at any time during the performance of this Contract will be sufficient cause for termination of the Contract by City.
The Contractor shall be solely re sponsible for, and shall defend, indemnify and hold harmless the City, its officers, employees and agents against and from, any and all damages, claims, losses, actions, costs or other expenses of any kind incurred by any party as a direct or indirect resu lt of any suspension of Work or termination of the Contract under the provisions of this Section.
21. EXCUSABLE DELAYS
For the purpose of these Contract Documents, the term "Excusable Delay" shall mean, and is limited to, delay caused directly by : acts o f God; acts of a public enemy; fires; inclement weather as determined by the Engineer; riots; insurrections; epidemics; quarantine restrictions; strikes; lockouts; sitdowns; acts of a governmental agency; priorities or privileges established for the manufacture, assemble, or allotment of materials necessary in the Work by order, decree or otherwise of the United States or by any department, bureau, commission, committee, agent, or administrator of any legally constituted public authority; changes in the Work ordered by City insofar as they necessarily require additional time in which to complete the Work; the prevention of Contractor from commencing or prosecuting the Work because of the acts of others, excepting Contractor's subcontractors or suppliers; or the prevention of Contractor from commencing or prosecuting the Work because of a Citywide failure of public utility service.
The term "Excusable Delay" shall specifically not include: (i) any delay that could have been avoided by the exercise of care, prudence, foresight and diligence on the part of Contractor; (ii) any delay in the prosecution of any part of the Work that does not constitute a Controlling Operation, whether or not such delay is unavoidable; (iii) any reasonable delay resulting from time required by City for review of any Contractor submittals and for the making of surveys, measurements and inspection; and, (iv) any delay arising from an interruption in the prosecution of the Work on account of reasonable interference by other Contractors employed by City that does not necessarily prevent the completion of the entire Work within the time specified.
Excusable Delays, if any, shall operate only to extend the Completion Date (not in excess of the period of such delay as determined by City ) and shall not under any circumstances increase the amount City is required to pay Contractor except as otherwise provided in these Contract Documents.
22. CONTRACTOR TO SERVE NOTICE OF DELAYS
Whenever Contractor foresees any delay in the prosecution of the Work, and in any event as soon as possible (not to exceed a period of ten (10) calendar days) after the initial occurrence of any delay that Contractor regards as or may later claim to be an Form approved by City Attorney 1-11-17 13
Excusable Delay, the Contractor shall notify the Engineer in writing of such delay and its cause, in order that the Engineer : (i) may take immediate steps to prevent if possible the occurrence or continuance of the delay; or (ii) if this cannot be done, may determine whether the delay is to be considered excusable, how long it continues, and to what extent the prosecution and completion of the Work are delayed thereby. Said written notice shall constitute an application for an extension of time only if the notice requests such an extension and sets forth the Contractor's estimate of the additional time required together with a full description of the cause of the delay relied upon.
Aft
er the completion of any part or whole of the Work, the Engineer, in estimating the amount due Contractor, will assume that any and all delays that may have occurred in its prosecution and completion were not Excusable D elays, except for such delays for which the Contractor has provided timely written notice as required herein, and that the Engineer has found to be excusable. Contractor shall not be entitled to claim Excusable Delay for any delay for which the Contractor failed to provide such timely written notice.
23. E
XTENSION OF TIME
I
f the Contractor complies with Section 2 2, above, and the Engineer finds a delay claimed by the Contractor to be an Excusable Delay, the Contractor shall be allowed an extension of time to complete the Work that is proportional to the period of Excusable Delay determined by the Engineer, subject to the approval by City of a change order granting such time extension. During a duly authorized extension for an Excusable Delay, City shall not charge liquidated damages against the Contractor for such delay.
If th
e City extends the time to complete the Work as provided herein, such extension shall in no way release any warranty or guarantee given by Contractor pursuant to the provisions of the Contract Documents, nor shall such extension of time relieve or release the sureties of the Bonds provided pursuant to the Contract Documents. By executing such Bonds, the S ureties shall be deemed to have expressly agreed to any such extension of time. The granting of any extension of time as provided herein shall in no way operate as a waiver on the part of City of its rights under this Contract , excepting only extension of the Completion Date for such period of Excusable Delay as may be determined by the Engineer and approved by a duly authorized change order.
24. N
O PAYMENT FOR DELAYS
N
o damages or compensation of any kind shall be paid to Contractor or any subcontractor because of delays in the progress of the Work whether or not such delays qualify for extension of time under this Agreement; except that this provision shall not preclude the recovery of damages for a delay caused by the City that is unreasonable under the circumstances and that is not within the contemplation of the parties, provided that the Contractor timely submits all such written notice(s) and fully complies with such other procedures as may be specified in the Contract Documents or any Laws or Regulations for Contractor to claim damages for such delay.
25. C
HANGES IN THE WORK
Form approved by City Attorney 1-11-17 14
Changes in the Work authorized or directed in accordance with the Contract Documents and extensions of time of completion made necessary by reason thereof shall not in any way release any warranty or guarantee given by Contractor pursuant to the provisions of the Contract Documents, nor shall such changes in the Work relieve or release the Sureties on Bonds provided pursuant to the Contract Documents. By executing such Bonds, the Sureties shall be deemed to have expressly agreed to any such change in Work and to any extension of time made by reason thereof.
26. TERMINATION AFTER COMPLETION DATE
In addition to any other rights City may have, if any services or work required under the Contract (including but not limited to punch list items) are not completed as of the Completion Date (as adjusted by any extensions of time for Excusable Delays granted pursuant to the Contract Documents), City may terminate the Contract at any time after the Completion Date ( as adjusted by any extensions of time for E xcusable Delays granted pursuant to the Contract Documents ), by providing a written notice to Contractor specifying the date of termination. Such notice also may specify conditions or requirements that Contractor must meet to avoid termination of the Contr act on such date. If Contractor fails to fulfill all such conditions and requirements by such termination date, or, if no such conditions or requirements are specified, Contractor shall cease rendering services and performing work on such termination date, and shall not be entitled to receive any compensation for services rendered or work performed after such termination date. In the event of such termination, Contractor shall remain liable to City for liquidated damages incurred for any period of time prior to the termination date.
In addition to any other charges, withholdings or deductions authorized under the Contract or any Laws or Regulations, if City terminates the Contract pursuant to this section, City may withhold and deduct from any payment and/or retention funds otherwise due Contractor any sum necessary to pay the City's cost of completing or correcting, or contracting for the completion or correction of , any services or work under the Contract that are not completed to the satisfaction of th e City or that otherwise are deficient or require correction as of such termination date, including but not limited to incomplete punch list items. Such costs shall include all of the City’s direct and indirect costs incurred to complete or correct such s ervices or work, including the City’s administrative and overhead costs. If the amount of payment(s) and/or retention funds otherwise due the Contractor are insufficient to pay such costs, City shall have the right to recover the balance of such costs from the Contractor and/or its Surety(ies).
27. TERMINATION FOR CONVENIENCE
Upon written notice to the Contractor, the City may at any time, without cause and without prejudice to any other right or remedy of the City, elect to terminate the Contract for the convenience of City. In such case, the Contractor shall be paid (without duplication of any items, and after deduction and/or withholding of any amounts authorized to be deducted or withheld by the Contract Documents or any Law s or Regulations):
Form approved by City Attorney 1-11-17 15
A. For Work executed in accordance with the Contract Documents prior to the effective date of termination and determined to be acceptable by the Engineer , including fair and reasonable sums for overhead and profit on such Work;
B. For reasonable claims, costs, losses, and damages incurred in settlement of terminated contracts with subcontractors, suppliers, and others; and
C. For reasonable expenses directly attributable to termination.
Contractor shall not be paid for any loss of anticipated profits or revenue for any Work not performed prior to termination, nor for any economic loss arising out of or resulting from such termination, except for the payments listed in this section. Contra ctor’s warranty under Section 14 of this Ag reement shall apply, and Contractor shall remain responsible for all obligations related to such warranty, with respect to all portions of the Work performed prior to the effective date of the termination for convenience pursuant to this section. The City shall be entitled to have any or all remaining Work performed by other contractors or by any other means at any time after the effective date of a termination for convenience pursuant to this section.
28. TERMINATION FOR BREACH OF CONTRACT
If Contractor abandons the Work under this Contract, or if the Contract or any portion of the Contract is sublet or assigned without the consent of the City, or if the Engineer determines in the Engineer’s sole discretion that the conditions of the Contract in respect to the rate of progress of the Work are not being fulfilled or any part thereof is unnecessarily delayed, or if Contractor violates or breaches, or fails to execute in good faith, any of the terms or conditions of the Contract, or if Contractor refuses or fails to supply enough properly skilled labor or materials or refuses or fails to make prompt payment to subcontractors for material or labor, or if Contractor disregards any Laws or Regulations or proper instruction or orders of the Engineer, then, notwithstanding any provision to the contrary herein, the City may give Contractor and its Sureties written notification to immediately correct the situation or the Contract shall be terminated.
In the event that such notice is given, and, in the event such situation is not corrected, or arrangements for correction satisfactory to the City are not made, within ten (10) calendar days from the date of such notice or within such other period of time as may be specified by the City in the notice, the Contract shall upon the expiration of said period cease and terminate. In the event of any such termination, City may take over the Work and prosecute the Work to completion, or otherwise, and the Contractor and its Sureties shall be liable to City for any cost occasio ned City thereby, as hereinafter set forth.
In the event City completes the Work, or causes the Work to be completed, no payment of any kind shall be made to Contractor until the Work is complete. The cost of completing the Work, including but not limite d to, extra costs of project administration and management incurred by City, both direct or indirect, shall be deducted from any sum then due, or that becomes due, to Contractor from City. If sums due to Contractor from City are less than the cost of completing the Work, Contractor and its Sureties shall Form approved by City Attorney 1-11-17 16
pay City a sum equal to this difference on demand. In the event City completes the Work, and there is a sum remaining due to Contractor after City deducts the costs of completing the Work, then City shall pay such sum to Contractor. The Contractor and Contractor’s Sureties shall be jointly and severally liable for all obligations imposed on Contractor hereunder.
No act by City before the Work is finally accepted, including, but not limited to, exercise of other rights under the Contract, actions at law or in equity, extensions of time, payments, assessments of liquidated damages, occupation or acceptance of any part of the Work, waiver of any prior breach of the Contract or failure to take action pursuant to this section upon the happening of any prior default or breach of Contractor, shall be construed to be a waiver or esto ppel of the City’s right to act pursuant to this Section upon any subsequent event, occurrence or failure by Contractor to fulfill the terms and conditions of the Contract. The rights of City to terminate the Contract pursuant to this Section and pursuant to Sections 26 and 27 are cumulative and are in addition to all other rights of City pursuant to the Contract and at law or in equity.
29. CONTRACTOR BANKRUPT
If Contractor should commence any bankruptcy proceeding, or if Contractor is adjudged a bankrupt, or if Contractor m akes any assignment for the benefit of creditors, or if a receiver is appointed on account of Contractor's insolvency, then the City may, without prejudice to any other right or remedy, terminate the Contract and complete the work by giving notice as provided in Section 28 above.
30. SURETIES’ OBLIGATIONS UPON TERMINATION
If the City terminates the Contract pursuant to Section 28 or Section 29 above:
A. The Surety under Contractor’s performance bond shall be fully responsible for all of the Contractor’s remaining obligations of performance under the Contract as if the Surety were a party to the Contract, including without limitation Contractor’s obligations, as provided in the Contract Documents, to complete and provide a one-year warranty of the entire Work, pay liquidated damages and indemnify, defend and hold harmless City, up to the full amount of the performance bond.
B. The Surety under Contractor’s payment bond shall be fully responsible for the performance of all of the Contractor’s remaining payment obligations for work, services, equipment or materials performed or provided in connection with the Work or any portion thereof, up to the full amount of the payment bond.
31. ACCOUNTING RECORDS OF CONTRACTOR
During performance of the Contract and for a period of three (3) years after completing the entire Work, Contractor shall maintain all accounting and financial records related to the Contract and performance of the Work in accordance with generally accepted accounting practices, and shall keep and make such records available for inspection and audit by representatives of the City upon rea sonable Form approved by City Attorney 1-11-17 17
written notice.
32. USE TAX REQUIREMENTS
During the performance of this Agreement, CONTRACTOR, for itself, its assignees and successors in interest, agrees as follows:
A. Use Tax Direct Payment Permit : For all leases and purchases of material s, equipment, supplies, or other tangible personal property used to perform the Agreement and shipped from outside California, the Contractor and any subcontractors leasing or purchasing such materials, equipment, supplies or other tangible personal proper ty shall obtain a Use Tax Direct Payment Permit from the California State Board of Equalization (“SBE”) in accordance with the applicable SBE criteria and requirements.
B. Sellers Permit: For any construction contract and any construction subcontract in the amount of $5,000,000 or more, Contractor and the subcontractor(s) shall obtain sellers permits from the SBE and shall register the jobsite as the place of business for the purpose of allocating local sales and use tax to the City. Contractor and its subcontractors shall remit the self- accrued use tax to the SBE, and shall provide a copy of each remittance to the City.
C. The above provisions shall apply in all instances unless prohi bited by the funding source for the Agreement.
33. NON-DISCRIMINATION IN EMPLOYEE BENEFITS
This Agreement may be subject to the requirements of Sacramento City Code Chapter 3.54, Non -Discrimination in Employee Benefits by City Contractors. The Contract Documents include a summary of the requirements of Sacramento City Code Chapter 3.54, entitled “Requirements of the Non- Discrimination in Employee Benefits Code.” By signing this Agreement, Contractor acknowledges and represents that Contractor has read and understands these requirements and agrees to fully comply with all applicable requirements of Sacramento City Code Chapter 3.54. If requested by City, Contractor agrees to promptly provide such documents and information as may be required by City to verify Contractor’s compliance. Any violation by Contractor of Sacramento City Code Chapter 3.54 constitutes a material breach of this Agreement, for which the City may terminate the Agreement and pursue all available legal and equitable remedies.
34. CONSIDERING CRIMINAL CONVICTION INFORMATION IN THE EMPLOYMENT
APPLICATION PROCESS
This Agreement may be subject to the requirements of Sacramento City Code Chapter 3.62, Procedures for Considering Criminal Conviction Information in the Employment A pplication Process. The Contract Documents include a summary of Form approved by City Attorney 1-11-17 18
the requirements of Sacramento City Code Chapter 3.62, entitled “Ban- The-Box Requirements.” By signing this Agreement, Contractor acknowledges and represents that Contractor has read and understands these requirements and agrees to fully comply with all applicable requirements of Sacramento City Code Chapter 3.62. If requested by City, Contractor agrees to promptly provide such documents and information as may be required by City to verify Co ntractor’s compliance. Any violation by Contractor of Sacramento City Code Chapter 3.62 constitutes a material breach of this Agreement, for which the City may terminate the Agreement and pursue all available legal and equitable remedies. Contractor agr ees to require its subcontractors to fully comply with all applicable requirements of Sacramento City Code Chapter 3.62, and include these requirements in all subcontracts covered by Sacramento City Code Chapter 3.62.
Form approved by City Attorney 1-11-1719
IN WITNESS WHEREOF, the parties hereto have signed this Agreement on the date set for opposite their names.CONTRACTORUnder penalty of perjury, I certify that the taxpayer identification number and all other information provided here are correct.DATE BY_________________________________ ____________________________________Print Name____________________________________TitleBY_________________________________ ___________________________________Print Name____________________________________TitleDIR Registration #____________________________________Federal ID# ____________________________________ State ID#____________________________________ City of Sacramento Business Operation Tax Certificate No. (City will not award contract until Certificate Number is obtained)Type of Business Entity (check one):_____ Individual/Sole Proprietor_____ Partnership_____ Corporation_____ Limited Liability Company_____Other (please specify:________________)CITY OF SACRAMENTOa municipal corporationDATE BY _________________________________ For: Howard Chan, City ManagerOriginal Approved As To Form: Attest: City Attorney City Clerk 10/02/2023PresidentBobby Stepps
100002641245-2978153 X3427419104665
SACRAMENTO Bid Proposal
TO THE HONORABLE CITY COUNCIL, SACRAMENTO, CALIFORNIA: In compliance with the Contract Documents, the undersigned hereby proposes to furnish all required labor, materials, supervision, transportation, equipment, services, taxes and incidentals required for:
PANNELL COMMUNITY CENTER ROOF REPALCEMENT SECTIONS 6, 7 & 17 Bid # B23014541003
in the City and County of Sacramento, California. The Work is to be done in strict conformity with the Contract Documents now on file in the Office of the City Clerk, for the following sum:
QTY Unit Unit Price
1 LS LUMP SUM
BASE BID TOTAL
Tota
$ ,r (os -to o 0 00
$ (205 coo • 00
Itm
No. Item
1 PANNELL COMMUNITY CENTER ROOF REPALCEMENT S
ECTIONS 6, 7 & 17
CONTRACTOR NAME: fact -h(-, po ljniNecf GRAND TOTAL $ 0-5 (0", 000 ( 30 ()cap\ f-vom e)Tar-i-r- The undersigned agrees to execute the Ægreement and proviae City We executed Agreement, the required insurance certificates, endorsements, and waivers of subrogation, and the required surety bonds within ten (10) calendar days after the undersigned's receipt of the City's notice that the undersigned will be recommended for Contract award and prior to award of the Contract by the City Council. It is understood that this Bid Proposal is based upon completion of the Work within a period of 30 (THIRTY) Calendar days from the Notice to Proceed for substantial completion and, commencing on the date set forth in the written Notice to Proceed issued by the City to the Contractor. The Contractor is hereby notified and reminded that per City Contract requirements, the City will issue a Notice to Proceed within 15 calendar days of execution of contract by City. Contract workdays will start immediately on the date of the Notice to Proceed. Attached is a sample of a Notice to Proceed. The amount of liquidated damages to be paid by the Contractor for failure to complete the work by the completion date (as extended, if applicable) shall be One Thousand Dollars ($1,000) for each calendar day, continuing to the time at which the work is completed. Such amount is the actual cash value agreed upon as the loss to the City resulting from the default of the Contractor. By signing, it is also understood that all labor compliance requirements must be met by all contractors, sub-contractors, and sub-tier contractors before any payment can be made. Failure to meet the labor compliance requirements will result in your pay request or invoice being rejected.
No payment shall be made by the City until full compliance has been met. Partial payments/partial withholdings will not be authorized. Work under these Special Provisions shall be performed by qualified personnel experienced in work described herein. The Contractor and/or its subcontractor shall possess current and active licenses issued by the California Contractors State License Board at the time of the bid submittal and throughout the construction period. Any cited violations or pending violation investigations by the California Contractors State Licensing Board within three years prior to the date of the bid submittal shall be fully disclosed in the bid.
LICENSE # 9(9 q qg
Name: pacific polin&ets 013.11 Ptry\tri (on rpayo N2-er-vr Address: RYA) Iwo CI-htS Pood 6 604 /CA qra932
hol7 Issue Date: 01 /1-• f Expiration Date:
Rev 9-8-21
Ciiyof
SAC RAM ENTQ Bid Proposal
DETERMINATION OF LOW BIDDER
The determination of the low bidder will be based on the base bid and all additives, if any. However, the contract award may not include any of the additives. The City reserves the right to select which additives, if any, to include in the contract award in addition to the base bid work. If an additive is an alternative to a bid item and the additive is to be awarded, the contract amount will be based on the additive price instead of the base bid item price. In determining the amount bid by each bidder, the City may disregard mathematical errors in addition, subtraction, multiplication, and division that appear obvious on the face of the Proposal. When such a mathematical error appears on the face of the Proposal, the City shall have the right to correct such error and to compute the total amount bid by said bidder on the basis of the corrected figure or figures. The City Council may reject any and all bids and waive any informalities or minor irregularities in the bids. When an item price is required to be set forth in the Proposal, and the total for the item set forth separately does not agree with a figure which is derived by multiplying the item price times the Engineer's estimate of the quantity of work to be performed for said item, the item price shall prevail over the sum set forth as the total for the item unless, in the sole discretion of the City, such a procedure would be inconsistent with the policy of the bidding procedure. The total paid for each such item of work shall be based upon the item price and not the total price. Should the Proposal contain only total price for the item and the item price is omitted, the City shall determine the item price by dividing the total price for the item by the Engineer's estimate of the estimated quantities of work to be performed as items of work. If the Proposal contains neither the item price nor the total price for the item, then it shall be deemed incomplete, and the Proposal shall be deemed non-responsive. The undersigned has examined the location of the proposed Work, the local conditions at the place where the Work is to be done, is familiar with the Contract Documents and is familiar and expressly agrees to the liquidated damages provision of the Contract Documents. The undersigned has carefully checked all of the foregoing figures and understands that the City of Sacramento will not be responsible for any errors or omissions on the part of the undersigned in making up this Bid Proposal.
Rev 9-8-21
PRIME CONTRACTOR INFORMATION
Business Name: facific4c)olb ItlNer I r1G Piell-
liireil -001/1 Gt. Vb.% Ezcper-hz Business Address. I I VD 6 ttivi C I DO P 6 a 14- c chnp 2-
Phone:
Email: faciehe fOhnipts ð, Q wto I • to Yin Print or type dearly.- results will be emaded
ADDENDUM ACKNOWLEDGEMENT
The undersigned agrees that all addenda received and acknowledged herein shall become a part of and be included in this Bid Proposal. This Bid Proposal includes the following addenda:
Addendum I Addendum 2- Addendum 3
Addendum Addendum Addendum
Contractor Signature:
PRIME CONTRACTOR - TYPE OF BUSINESS
If the Bidder is a corporation, the Bid Proposal must be executed in the name of the corporation and must be signed by a duly authorized officer of the corporation. If the Bidder is a partnership, the Bid Proposal musthe executed in the name of the partnership and one of the partners must subscribe their signature thereto as the authorized representative of the partnership. Check one:
111 Individual Partnership
Corporation Limited Liability Company
p Other
Oìyof
SAC Mil E NTO Bid Proposal
toNnAcTOR TO• _cOMPTE AND SIGN:
BID BOND
NOT REQUIRED FOR THIS SOLICITATION
Altkired
PRIME CONTRACTOR LICENSES & TAX INFORMATION
THIS BOX FOR CITY USE ONLY
Contractors State License ft 9 9 Lig (o Expiration: O I 131)7A2F-cl
CITY CLERK TO FILL OUT
(must be valid at time of bid) Bid Bond Security Received:
DIR Registration #: l 000 2..(p4 1 2.- Expiration: 0CD /30/2r2A0 NOT REQUIRED FOR THIS SOLICITATION (must be valid at time of bid)
City of Sacramento Business Operation Tax #: t OC1G Co (must be valid prior to award of contract) BOTC Expiration: 06i 30/W21
State Tax ID# 3 9 Federal Tax ID # qg I 512
BY. far SIG '141T RE
Sq-enaS
Print or TYpe Signets Name
-t-- 09 tot /aozs Signers Title Date
Rev9-8-21
LOCAL BUSINESS ENTERPRISE (LBE)
PARTICIPATION PROGRAM
NOTE: Proposers must provide responses to the following items. Failure to provide a response to each of the items in this section may be grounds for rejection of the proposal.
1. LBE FIVE PERCENT (5%) PARTICIPATION
On April 3, 2012, the Sacramento City Council adopted a Local Business Enterprise (LBE) Preference Program to provide enhanced opportunities for the participation of local business enterprises (LBEs) in the City's contracting and procurement activities. On November 19, 2013, City Council increased the LBE preference and authorized City departments to require minimum LBE participation levels in individual contracts. Under City Code section 3.60.270 , when the bid specifications for a City contract establish a minimum participation level for LBEs, no bidder on the contract shall be considered responsive unless its bid meets the minimum LBE participation level required by the bid specifications.
The City has established a minimum 5% participation level for LBEs on this contract. Pursuant to City Code Section
3.60.270, no bidder on this contract shall be considered responsive unless its bid meets or exceeds this minimum participation level. To qualify for this requirement, bidders must either (a) be an LBE, or (b) subcontract with a qualified LBE.
Detailed information about this program can be found at http://www.cityofsacramento.org/Finance/Procurement/ Contract-Ordinances
Local Business Enterprise means a business enterprise, including but not limited to, a sole proprietorship, partnership, limited liability company, corporation, or other business entity that has a legitimate business presence in the city or unincorporated county of Sacrarnento. Evidence of legitimate business presence in the city or unincorporated county of Sacramento shall include:
1. Having a current City of Sacramento Business Operation Tax or County of Sacramento Business License for at least twelve (12) consecutive months prior to submission of bid; and
2. Having either of the following types of offices or workspace operating legally within the city or unincorporated county of Sacramento for at least twelve (12) consecutive months prior to submission of bid:
a. The LBE's principle business office or workspace; or b. The LBE's regional, branch or satellite office with at least one full time employee located in the city or unincorporated county of Sacramento.
A. L AL BUSINESS ENTERPRISE (LBE1
Is th firm submitting the bid qualified as a local business enterprise? Check the appropriate box below:
YES - the firm submitting the bid is qualified as a local business enterprise.
SUBCONTRACTING/SUPPLIERS - The firm submitting the bid is qualified by utilizing subcontractors and/or suppliers who qualify as local business enterprises.
NO - the firm submitting the bid is not qualified as a local business enterprise.
If the response to the above is YES, provide the City of Sacramento Business Operations Tax Certificate Number and/or County of Sacramento Business License Number:
co(A7C—
If the response to the above is YES, provide a current copy of the City of Sacramento Business Operations Tax Certificate and/or County of Sacramento Business License.
If the response to the above is YES, provide business office or workspace address*:
I ÇbO 'no Clfraff (Oa
G a 1+- I C4- 951032-
Address must be a physical address for the basis of location, this excludes P.O. Box addresses.
Form Updated 6/11/2020
SAC RAM E N TO
SUBCONTRACTOR AND LOCAL BUSINESS ENTERPRISE PARTICIPATION FORM FOR PUBLIC PROJECTS OVER 250,000
THIS FORM MUST BE SUBMITTED WITH THE SEALED BID PROPOSAL To be eligible for award of this contract, the bidder shall list the business entities used to attain the 5% LBE requirement. Additionally, the bidder shall list all other subcontractors who perform work, render service, or provide materials in an amount in excess of one-half of 1 percent of the total bid amount. In the case of bids for the construction of streets and highways, including bridges, subcontractors whose subcontract value exceeds one-half of 1 percent of the total bid or ten thousand dollars ($10,000), whichever is greater, shall be listed. Estimated dollar values shall be provided for 211 work, services or materials listed. No contractor or subcontractor may be listed on a bid proposal for a public works project unless registered with the Department of Industrial Relations pursuant to Labor Code section 1725.5 [with limited exceptions from this requirement for bid purposes only under Labor Code section 1771.1(a)]. The failure to attain the 5% LBE participation or the inclusion of false information or the omission of required information will render the bid non-responsive.
COPY AND A1TACH ADDITIONAL SHEETS AS NECESSARY
Prime Contractor Name vv' rig G • if-T1Vri CO (64 C pile(r / P3A _ i --vg ii,--k 142erk i (REQUIRED) Prime Contractor DIR Registration # l0000-toot Name
iBusiness
\i //I — KO c JO if
Subcontractor or Supplier? (Concrete delivery companies, temp fence companies that perform labor of installing or removing fencing and surveyors require DIR Registration) Ei Subcontractor
III Supplier
CSLB/Professional License # DIR Registration # (10 digits) Address Does this subcontractor or supplier qualify as an LBE? City, State, Zip Estimated dollar value of work, services or materials to be performed of provided $ Contact Person Type of Work, Services, or Materials to be provided to complete contract.
Email Address
Phone
Business Name Subcontractor or Supplier? (Concrete delivety cornpanies, teinp fence coinpanies that perform labor of installing or removing fencing and surveyors require DIR Registration) • Subcontractor
• Supplier
CSLB/Professional License # DIR Registration # (10 digits) Address Does this subcontractor or supplier qualify as an LBE? City, State, Zip Estimated dollar value of work, services or materials to be performed of provided $ Contact Person Type of Work, Services, or Materials to be provided to complete contract.
Email Address
Phone
l hereby certify that each subcontractor listed on this LBE Participation Form has been notified that it has been listed and has consented in writing to its name being submitted for t ts contract. The Prime Contractor also certifies that it will notify each subcontractor listed on this Form in writing if the contract award is made to the Prirne Contractor, and will make all documentation relevant to the subcontractor and LBE participation available to City of Sacramento upon request. The Prime Contractor further certifies that all of the information contained in this Form is true and correct and acknowledges that the City will rely on the accurac of this in r ation in awardin the contract.
rpartal4/14- . o [di /z3 $ aces 1000 ‘ DO
Signature (Principal of Firm) Title Date Total Bid Amount (including additive alternates if applicable) JON\
CON
Notary
SA
my App. E
City Of Sacramento Bid Proposal Guarantee
B23014541003 Page 1 of 1
KNOW ALL MEN BY THESE PRESENTS,
That we,
as Principal, and
Pacific Polymers Inc. dba American Foam Experts
Western National Mutual insurance Company
a corporation duly organized under the laws of the State of Minnesota and duly licensed to become sole surety on bonds required or authorized by the State of California, as Surety, are held and firmly bound unto the City of Sacramento, hereinafter called the City, in the penal sum of ten percent ( 10%) of the (BASE OR LUMP SUM) Proposal of the Principal above named, or other amount as set forth in the Invitation to Bidders, submitted by said Principal to the City for the Work described below, for the payment of which sum in lawful money of the United States, 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 whereas the Principal has submitted the above-mentioned Proposal to the City, for which Proposals are to be opened at the Department of City Clerk, City or Sacramento, located at 9E5 1 Street, Sacramento, CA 95814,
PANNELL COMMUNITY CENTER ROOF REPALCEMENT SECTIONS 6, 7 & 17 NOW, THEREFORE, if the aforesaid Principal is awarded the Contract and within the time and manner required under the Contract Documents, enters into a written Contract, in the prescribed form, in accordance with the Proposal, and files two (2) bonds with the City, one to guarantee faithful performance and the other to guarantee payment for labor and materials, and files the required insurance policies with the City, all as required by the Contract Documents or by law, then the obligation shall be null anti void; otherwise it shall be and remain in full force and effect.
In the event suit is brought upon this bond by the Obligee and judgment is recovered, the Surety shall pay all costs incurred by the Obligee in such suit, including a reasonable attorney's I fee to he fixed by the court, which sums shall be additional to the principal amount of this bond.
IN WITNESS THEREOF We have hereunto set our hands and seal this day of September 2021
6th
•Pacific Polymers Inc. dba American Foam Experts
(Contra (Seal
By
- Title
ORIGINAL APPROVED As To FORM:
City Attorney
SEE ATTACHED CERT1F1CATE
Western National MutuaHnsurance_Corny_
uret (S N-
By
Title Pietro Mimiche. Attorney in-Fact
Agent Name and Address PK4orred Borldirq .Soinsurio,c Services 3455 Ocean View Blvd #200. Gletidale. CA::,1208
Agent Phone ft (323)663-7814
Surety Phone tt (800) 862.6070
California License fl 0069256
Notary Pubiic - Caiifornia
ANGEL NUNEZ
Los Angeies County
Commission # 2321675 — Signatu
My Comm. Expires Mar 14, 2024
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 , -Tr.; • I/ Vs,
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 Vret4cr (vIRA,1,6v5_ before me, Angel Nunez, Notary Public Date
personally appeared Pietro Micciche
Here Insert Name and Title of the Officer
Name(s) of Stgner(s)
who proved to me on the basis of satisfactory evidence to be the person%) whose name() isWO subschbed to the within instrument and acknowledged to me that he,500040( executed the same in histAgOts*authorized capacity(M), and that by his41000131Vsignature(N) on the instrument the personN, or the entity upon behalf of which the person(4) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoingyaragraph
is true and correct.
VVITNESS m hand [n)official seal.
8ignature of Notary Public
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
Corporate Officer — Title(s):
'1 Partner — E Limid General
1. Individual g. Attorney in Fact
Trustee 1 Guardian or Conservator
I. Other:
Signer Is Representing:
Signer's Name:
Corporate Officer — Title(s):
Partner — Limited • General
7 Individual -; Attorney in Fact
' Trustee I Guardian or Conservator
Other:
Signer Is Representing:
02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) item #5907
WESTERN NATIONAL
f r ,
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Western National Mutual Insurance Company, a Minnesota mutual insurance company, does make. constitute, and appoint: Patricia Zenizo, Pietro Micciche, Manuel Reguerra, and Elisabete Salazar Preferred Bonding Services (#9760)
Its true arid lawful Attorney(s)-in-Fact, with full power and authority for and on behalf of the Company as surety, to execute and deliver and affix the seal of the Company thereto (if a seal is required) bond, undertakings recognizances or other written obligations in the nature thereof, (other than bail bonds, bank depository bonds. mortgage deficiency bonds. mortgage guaranty i4011(.rs. guaramees or ireNtailmem paper and note guaranty bonds ; self-insurance workers compensation boncis guaranteeing payment of i_inefits, hazaidous waste rernediation bonds or black lung bonds), as follows:
All written instruments in an amount not to exceed an aggregate of Seven Million Five Hundred Thousand and 00/100 ($7,500,000 00) for any single obligation, regardless of the number of instruments issued for the obligation. and to bind Western National Mutual Insurance Company thereby, and all of the acts of said Attorneys-in-Fact. pursuant to these presents. are ratified and confirmed. This appointment is made under and by authority of the board of directors at a meeting held on September 28, 2010. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of Western National Mutual Insurance Company on September 28, 2010:
RESOLVED that the president, any vice president. or assistant vice president in conjunction with the secretary or any assistant secretary. may appoint attorneys-in-fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to execute and deliver and affix the seal of the Company to bonds. undertakings, recognizances. and suretyship obligations of all kinds, and said officers may remove any such attorney-in-fact or agent and revoke any Power of Attorney previously granted to such person.
RESOLVED FURTHER that any bond, undertaking. recognizance, or suretyship obligation shall be valid and binding upon the Company (i) when signed by the president, any vice president or assistant vice president. and attested and sealed (if a seal be required) by any secretary or assistant secretary; or
(ii) when signed by the president. any vice president or assistant vice president. secretary or assistant secretary. and countersigned and sealed (if a seal be required) by a duly authorized attorney-in-fact or agent; or (iii) when duly executed and sealed (if a seal be required) by one or more attorneys-in-fact or agents pursuant to and within the limits of the authority evidenced by the Power of Attorney issued by the Company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking. recognizance, or other suretyship obligations of the Company: and such signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, Western National Mutual Insurance Company has caused these presents to be signed by its proper officer and its corporate seal to be affixed this 16th day of December, , 2020. 4 A.1‘
r`i SFAI
Jon R. Hebeisen, Secretary
STATE OF MINNESOTA, COUNTY OF HENNEPIN
Larry A. Byers, Sr. Vice President
On this 16th day of December, 2020, personally came before rne, Jon R. Hebeisen and Larry A. Byers and to me known to be the individuals and officers of the Western National Mutual Insurance Company who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn. did severally dispose and say; that they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation. itte'rie"
Je7Cnifer-A7Young, Notary Public
My commission expires January 31, 2026
JENNIFER A YOUNG
NOTARY PUBLIC
MINNE:3,T7A
my. r ,frIrr • 't
CERTIFICATE
l. the undersigned, assistant secretary of the Western National Mutual Insurance Company, a Minnesota corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore. that the Resolutions of the board of directors set forth in the Power of Attorney, are now in force.
c2'
Signed and sealed at the City of Edina, MN this k_141 day cf.c.flfsil,ef, 2.0 23 , -1- nnifer A. Young. Assistant—Se-creta!y
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF 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 Sacramento
(1,0 2-3 On before me, Joanne Venegas, Notary Public personally appeared
who proved to me on the basis of satisfactory evidence to be the person.(sj whose name(s) is4r -e subscribed to the within instrument and acknowledged to me that he/1 -16/they executed the same in his/l)er/tpeir authorized capacity(ies), and that by his/hpr/thelr signatureks -) on the instrument the persor)(s), or the entity upon behalf of which the persop{s1 acted, executed the instrument.
( e ezert name and title of the officer)
tN)CACki
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
c -ilfY Notary Public Signa
WITNESS my hand and official seal.
(Notary Public Seal)
Notary Public - California
SACRAMENTO
my App. Expires Sept. 26, 2024
JOANNE VENEGAS
COMM. #2334429 co 0
- •
E Vf
• #9
blic
1AM
ires
7NEGAS
aiíornt
:NTO
'pot. 26, 2C
2015 Version www.NotaryClasses.com 800-873-9865
- LJ
t:
•
(Title)
Partner(s)
Attorney-in-Fact 24 -
Li Trustee(s)
Other
(Title or description of attached document continued)
Number of Pacies3 Document Date
DESCRIPTION OF THE ATTACHED
DOCUMENT
Io NiopocsaiL_ w(LoieFty--
(Title or description of attached document)
ADDITIONAL OPTIONAL INFORMATION
CAPACITY CLAIMED BY THE SIGNER
Individual (s)
0 Corporate Officer
sufficient
the
+
+
+
This form complies with current California statutes regarding notary wording and. if needed, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law.
• State and County information must be the State and County where the document signer(s) personally appeared before the notary public foracknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they; is /afe ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re-seal if a area permits, otherwise complete a different acknowledgment form.
Signature of the notary public must match the signature on file with the office of county clerk.
Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. indicate title or type of attached document, number of pages anddate.
Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer. indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this docuinent to the signed document with a staple.
INSTRUCTIONS FOR COMPLETING THIS FORM
MINIMUM QUALIFICATIONS QUESTIONNAIRE
Sacramento City Code Section 3.60.020 authorizes the Sacramento City Council to adopt standard minimum qualifications for bidders on competitively bid public works construction projects, and requires, among other provisions, that a bidder meet such minimum qualifications at the time of bid opening in order to bid. On July 31, 2007, the City Council adopted Resolution No. 2007-574 establishing these standard minimum qualifications. Pursuant to City Code section 3.60.020, a bidder failing to meet these minimum qualifications at the time of bid opening shall not be considered a responsible bidder for purposes of bidding on the subject project.
All bidders must demonstrate compliance with the minimum qualifications established by Resolution No. 2007-574 by completing all of the questions contained in this questionnaire. Bidder responses shall be limited to those operating business units, offices, branches and/or subsidiary divisions of the bidder that will be involved with the performance of any project work if awarded the contract. If a bidder answers "yes" to any single question, fails to submit a fully completed questionnaire, or submits false information, this will result in a determination that the minimum qualifications are not met, and the bidder shall not be considered a qualified bidder for purposes of bidding on this contract. lf two or more entities submit a bid on a contract as a Joint Venture, each entity within the Joint Venture must separately meet these minimum qualifications for the Joint Venture to be considered a qualified bidder.
The City of Sacramento ("City") shall make its determination on the basis of the submitted questionnaire, as well as any relevant information that is obtained from others or as a result of investigation by the City.
While it is the intent of this questionnaire to assist the City in determining whether bidders possess the minimum qualifications necessary to submit bids on the City's competitively bid public works construction contracts, the fact that a bidder submits a questionnaire demonstrating that it meets these minimum qualifications shall not in any way limit or affect the City's ability to: (1) review other information contained in the bid submitted by the bidder, and additional relevant information, and determine whether the contractor is a responsive and/or responsible bidder; or (2) establish pre-qualification requirements for a specific contract or contracts.
By submitting this questionnaire, the bidder consents to the disclosure of its questionnaire answers: (i) to third parties for purposes of verification and investigation; (ii) in connection with any protest, challenge or appeal of any action taken by the City; and (iii) as required by any law or regulation, including without limitation the California Public Records Act (Calif. Gov't Code sections 6250 et seq.). Each questionnaire must be signed under penalty of perjury in the manner designated at the end of the form, by an individual who has the legal authority to bind the bidder submitting the questionnaire. if any information provided by a bidder becomes inaccurate, the bidder shall immediately notify the City and provide updated accurate information in writing, under penalty of perjury.
FOR CITY CLERK USE ONLY
RESOLUTION NO.: 2007-574
DATE ADOPTED: July 31, 2007
Minimum Qualifications Questionnaire
QUESTIONNAIRE
NOTICE: For firms that maintain other operating business units, offices, branches and/or subsidiary divisions that win not be involved with the performance of any project work if the firm is awarded the contract, references hereafter to "your firm" shall mean only those operating business units, offices, branches and/or subsidiary divisions that will be involved with the performance of any project work.
All of the following questions regarding "your firm" refer to the firm (corporation, partnership or sole proprietor) submitting this questionnaire, as well as any firm(s) with which any of your firm's owners, officers, or partners are or have been associated as an owner, officer, partner or similar position within the last five years The firm submitting this questionnaire shall not be considered a responsible bidder if the answer to any of these questions is "yes", or if the firm submits a questionnaire that is not fully completed or contains false information.
1. Classification & Expiration Date(s) of California Contractor's License Number(s) held by firm:
poochc pors t vIC- 1)12,R Aippri rov‘ ean1
2. Has a contractor's license held by your firm and/or any owner, officer or partner of your firm been revoked at anytime in the last five years
O Yes
3. Within the last five years, has a surety firm completed a contract on your firrn's behalf, or paid for completion of a contract to which your firm was a party, because your firm was considered to be in default or was terminated for cause by the project owner? /No
4. At the time of submitting this minimum qualifications questionnaire, is your firm ineligible to bid on or be awarded a public works contract, or perform as a subcontractor on a public works contract, pursuant to either California Labor Code section 1777.1 (prevailing wage violations) or Labor Code section 1777.7 (apprenticeship vi lations)? 4
5. At any time during the last five years, has your firm, or any of its owners, officers or partners been convicted of a crime involving the awarding of a contract for a government construction project, or the bidding or performance of a government contract?
FOR CITY CLERK USE ONLY
RESOLUTION NO.: 2007-574
DATE ADOPTED: July 31, 2007
Minimum Qualifications Questionnaire
O Yes
0 Yes a
• Yes /No
6. Answer either subsection A or B, as applicable:
A. Your firm has completed three or more government construction contracts in Sacramento County_within the last five years: Within those five years, has your firm been assessed liquidated damages on three or more government construction contracts in Sacramento County for failure to complete contract work on time?
NOTE: If there is a pending administrative or court action challenging the assessment of liquidated damages on a government contract within the last five years, you need not include that contract in responding to this question. 0 Yes
OR
B. Your firm has not cornpleted at least three government construction contracts in Sacramento County within the last five years: Within the last three years, has your firm been assessed liquidated damages on three or more government construction contracts for failure to complete contract work on time?
NOTE: If there is a pending administrative or court action challenging an assessment of liquidated damages on a government contract within the last three years, you need not include that contract in responding to this question. 0 Yes 0 No 0 Not applicable
7. In the last three years has your firm been debarred from bidding on, or complefing, any government agency or public works construction contract for any reason? NOTE: If there is a pending administrative or court action challenging a debarment, you need not include that debarment in responding to this question. 0 Yes cfNo
8. Has CAL OSHA assessed a total of three or more penalties against your firm for any "serious" or "willful" violation occurring on construction projects perforrned in Sacrarnento County at any time within the last three years?
NOTE: If there is a pending administrative or court action appealing a penalty assessment, you need not include that penalty assessment in responding to this question.
D Yes di No
FOR CITY CLERK USE ONLY
RESOLUTION NO.: 2007-574
Minimum Qualifications Questionnaire
Sho 0 Not applicable
DATE ADOPTED: July 31, 2007
Minimum Qualifications Questionnaire
9. Answer either subsection A or B, as preferred:
A. In the last three years has your firm had a three year average Workers' Cornpensation experience modification rate exceeding 1.1?
O Yes
OR
B. In the last three years has your firm had a three-year average incident rate for total lost workday cases exceeding 10?
NOTE: Incident rates represent the number of lost workday cases per 100 full-time workers and is to be calculated as: (N/EH) x 200,000, where = number of lost workday cases (as defined by the U.S. Dept. of Labor, Bureau of Labor Statistics)
EH = total hours worked by all employees during the calendar year 200,000 = base for 100 equivalent full-time working (working 40 hours per week,
50 weeks per year)
O Yes 0 No
10. In the past three years, has the federal EPA, Region IX or a California Air Quality Management District or Regional Water Quality Control Board assessed penalties three or more times, either against your firm, or against the project owner for a violation resulting in whole or in part from any action or omission by your firm on a project on which your firm was a contractor in Sacramento County?
NOTE: If there is a pending administrative or court action appealing a penalty assessment, you need not include that penalty assessment in responding to this question.
O Yes
FOR CITY CLERK USE ONLY
RESOLUTION NO.: 2007-574
DATE ADOPTED: July 31, 2007
Minimurn Qualifications Questionnaire
11. In the past three years, has the federal EPA, Region IX or a California Air Quality Management District or Regional Water Quality Control Board assessed a single penalty of $100,000 or more, either against your firm, or against the project owner for a violation resulting in whole or in part from any action or omission by your firm on a project on which your firm was the contractor in Sacramento County?
NOTE: If there is a pending administrative or court action appealing a penalty assessment, you need not include that penalty assessment in responding to this question.
E Yes
'No 12. In the past three years, have civil penalties been assessed against your firm pursuant to California Labor Code 1777.7 for violation of California public works apprenticeship requirements, three or more times?
NOTE: If there is a pending administrative or court action appealing a penalty assessment, you need not include that penalty assessment in responding to this question.
0 Yes
13. In the past three years, has a public agency in California withheld contract payments or assessed penalties against your firm for violation of public works prevailing wage requirements, three or more times?
NOTE: If there is a pending administrative or court action appealing a withholding or penalty assessment, you need not include that withholding or penalty assessment in responding to this question.
0 Yes
14. Has your firm been assessed penalties for violation of public works prevailing wage requirements in California, in an aggregate amount for the past three years of $50,000 or more? NOTE: If there is a pending administrative or court action appealing a penalty assessment, you need not include that penalty assessment in responding to this question.
E Yes No
FOR CITY CLERK USE ONLY
RESOLUTION NO.: 2007-574
DATE ADOPTED: July 31, 2007
Minimum Qualifications Questionnaire
VERIFICATION AND SIGNATURE
l, the undersigned, certify and declare that l have read all the foregoing answers to this Minimum Qualifications Questionnaire, and know their contents. The matters stated in these Questionnaire answers are true of my own knowledge and belief, except as to those matters stated on information and belief, and as to those matters I believe them to be true. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signed at
Signature:
Print name: 0.6195
rIPS/ Gee fr
NOTE: lf two or more entities submit a bid on a contract as a Joint Venture, each entity within the Joint Venture must submit a separate Minimum Qualifications Questionnaire. 3 L-
a q51) /1.57)0 -Tht/4 fizad 6a/f/ on 19, joi#02 3 • (Location) (Date)
FOR CITY CLERK USE ONLY
RESOLUTION NO.: 2007-574
Minimum Qualifications Questionnaire
DATE ADOPTED: July 31, 2007
Minimum Qualifications Questionnaire
CITY OF SACRAMENTO Drug-Free Policy and Affidavit
DRUG-FREE WORKPLACE POLICY AND AFFIDAVIT
BID PROPOSAL MAY BE DECLARED NONRESPONSIVE IF THIS FORM ICOMPLETED) IS NOT ATTACHED.
Pursuant to City Council Resolution CC90-498 dated 6/26/90 the following is required.
The undersigned contractor certifies that it and all subcontractors performing under this Agreement will provide a drug-free workplace by:
1. Publishing a "Drug-Free Workplace" statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violations of such prohibition.
2. Establishing a Drug-Free Awareness Program to inform employees about:
a. The dangers of drug abuse in the workplace.
b. The contractor's policy of maintaining a drug-free workplace. c. Any available drug counseling, rehabilitation, and employee assistance program. d. The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace.
3. Notify employees that as a condition of employment under this Agreement, employees will be expected to:
a. Abide by the terms of the statement.
b. Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace.
4. Making it a requirement that each employee to be engaged in the performance of the Agreement be given a copy on the "Drug-Free Workplace" statement
5. Taking one of the following appropriate actions, within thirty (30) days of receiving notice from an employee or otherwise receiving such notice, that said employee has received a drug conviction for a violation occurring in the workplace:
a. Taking appropriate disciplinary action against such an employee, up to and including termination; or b. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a federal, state, or local health, law enforcement or other appropriate agency. * I certify that no person employed by this company, corporation, or business has been convicted of any criminal drug statute violation on any job site or project where this company, corporation or business was performing was within three years of the• date of my signature below.
EXCEPTION:
Date Violation Type Place of Occurrence
If additional space is required use back of this form.
• The above statement will also be incorporated as a Dart of each subcontract agreement for anv and all subcontractors selected for performance on this vrolect.
IN THE EVENT THIS COMPANY, CORPORATION, OR BUSINESS IS AWARDED THIS CONSTRUCTION AGREEMENT, AS A RESULT OF THIS BID; THE CONTRACTOR WITH HIS/HER SIGNATURE REPRESENTS TO THE CITY THAT THE INFORMATION DISCLOSED IN THIS DOCUMENT IS COMPLETE AND ACCURATE. IT IS UNDERSTOOD AND AGREED THAT FALSE CERTIFICATION IS SUBJECT TO IMMEDIATE TERMINATION BY THE CITY.
The Representations Made Herein On This Document Are Made Under Penalty Of Perjury.
CONTRACTOWS
BY:
NA : Jí4C 2311 paoRG ppyreo - elYSP4 Cal irravj
real Title
Date: 69 /0 laitg
Signature
Effects of violations: a. Suspension of payments under the Agreement. b. Suspension or termination of the Agreement. c. Suspension or debarment of the contractor from receiving any Agreement from the City of Sacramento for a period not to exceed five years.
City of
SACRAMENTO
Department of Public Works
ADDENDUM #2
823014541003
PANNELL COMMUNITY CENTER ROOF REPLACEMENT SECTIONS 6, 7 & 17 August 24, 2023
To all Potential Bidders:
Attached hereto are addenda items, which shall be incorporated into the Invitation for Bid for above noted project. These changes shall be considered as part of the original documents, as if they were originally provided therein, and as such shall be used as contractual documents. All other terms, conditions, and specifications of the Invitation for Bid remain unchanged. Bidders must acknowledge receipt of this addendum prior to the hour and date specified in the bid request, or as amended, by one of the following methods:
(a) By acknowledging receipt, in the proposal response submitted; or (b) By separate letter which includes a reference to the Invitation for Bid and addendum number.
Failure to acknowledge receipt of this addendum in one of the above methods and cause acknowledgment to be received by the City Clerk Office at 915 I Street, Sacramento, CA 95814, prior to the hour and date specified in the Request for Proposal, may result in reiection of your offer. If by virtue of this addendum you decide to change a proposal already submitted, such change may be made by letter, provided such letter makes reference to the Invitation for Bid number and this addendum, and is received prior to the opening hour and date specified.
For any questions related to this Addendum, contact me at [email protected] or at 916.808.4011 for contractual questions. For technical questions contact the project manager, Norm Colby, at [email protected] or at 916.808.8335.
Very truly yours,
Kirsten Wise
Contracts & Compliance Specialist
Bid Number B23014541003
ADDENDUM #2 DATE: August 24, 2023
PANNELL COMMUNITY CENTER ROOF SECTION 6, 7 & 17
Addendum #2 Includes:
Item 1.
Sign-in sheet for Mandatory Pre-bid meeting attached.
Item 2.
1. Leave existing coping caps in place. Secure top of base flashing with termination bar and install new 24-gauge, galvanized skirt metal counterflashing.
2. Include 20 sheets of 5/8" plywood deck replacement in base bid.
3. Raising condensate lines to be completed by the City as needed.
4. Install walkway roll to match layout on existing roof.
THE ORIGINAL BID DUE DATE REMAINS THE SAME.
UNCHANGED PORTIONS OF THE SPECIFICATIONS REMAIN IN EFFECT. ,3ose Cm4,) bina4-cri40;-C•cc-yeK,
Da t3i0Peraexa b)t41-04kficti)ti3 tv•N
bnix_f g atibucc "t e411/17c/M9- Caw?
avikte-e- wtedA sen roof.c,jwt
80.k-A1,41-660,\T-tuaCH
PIAETZ4ER_@_ 1dZ1C. c=r4
MCNYI0of 05 Cik\.\6.1.000 0: n3. (cm\
COMPANY
r 6
E c 5
Cf.k,c(Ack- A5/4- rPlyilit
oes+ (6 ninkchlim
Ks Aft kict
Tette «Fe
14 r_
4i75
ev\easevl cl“jk_
CD
‘Nota -S\69 Utz
39A/le-t).
new/nail
EMAIL, A; ifro,P-ift@h69-1 \EL_Wom
JYYla-We^aSthtvaLSt tvic
est', onatincp be5tavitoayl .(õn
cir-4ry e fdatnC. Cele)
BID WALK SIGN IN
•10. NAME PHONE
-)1L\riotel Lb.-prttC) CicY0Vd -71Vi
ieenu-S MaNAL Cql(a) St..745"7
se:33k ?if" - -27,679
TO01 -CAS 110 -6153-6.7(16
i4A/r(47 yrikir5
-3og± veoj A
.3:3P r1/4)yri,
al 4arrit46 (310)461 -369e
CCa's`e'"- T‘Acri qi4 34" 321
0 e)\:%-\ t\,\0 t,k-k lei 530
12 ->o4 1-4 -012415 7,.. 9 I to • s-n • il-b740
13 K340 •("\Ct-' SIA6-61VM
3 1
5 5
7 10
11 9).5-1f441626-3*
n s to
ql6 965 7110
14 1064 11 CID 417t k6./19- - rdirke-Sel vv-4
15 OR1A/Vdt) CA-crep o j •Ier0qt7 (200Fgrvi7tv.191 &,749Lin1 -ritAiice)
tt./ vivid -1
LOCATION Pe c n iri e /1 Coin fil ;Ill CC 1 .7 ltr r-
pq/C4-0enien StCP;Oki 15 9 / /7
ORGANIZATION TIME EVENT DATE
ri-fy oF sap-wry/1k) //: 30 21 2.3
NO. NAME PHONE EMAIL COMPANY
16 /grit Wtx Weibl 657-2” - 0 1'0 /1441-H-OVA letfaeem-P8J eLier iPt not 1 ere 17 18
19 20
21 22
23 24
25 26
27 28
29 30
j
Cool
SACRAMENTO Department of Public Works
ADDENDUM #3
B23014544003
PANNELL COMMUNITY CENTER ROOF REPLACEMENT SECTIONS 6, 7 & 17 August 31, 2023
To all Potential Bidders:
Attached hereto are addenda items, which shall be incorporated into the Invitation for Bid for above noted project. These changes shall be considered as part of the original documents, as if they were originally provided therein, and as such shall be used as contractual documents. All other terms, conditions, and specifications of the Invitation for Bid remain unchanged. Bidders must acknowledge receipt of this addendum prior to the hour and date specified in the bid request, or as amended, by one of the following methods:
(a) By acknowledging receipt, in the proposal response submitted; or (b) By separate letter which includes a reference to the Invitation for Bid and addendum number.
Failure to acknowledge receipt of this addendum in one of the above methods and cause acknowledgment to be received by the City Clerk Office at 915 I Street, Sacramento, CA 95814, prior to the hour and date specified in the Request for Proposal may result in reiection ofyour offer. If by virtue of this addendum you decide to change a proposal already submitted, such change may be made by letter, provided such letter makes reference to the Invitation for Bid number and this addendum, and is received prior to the opening hour and date specified.
For any questions related to this Addendum, contact me at [email protected] or at 916.808.4011 for contractual questions. For technical questions contact the project manager, Norm Colby, at [email protected] or at 916.808.8335.
Very truly yours,
Kirsten Wise
Contracts & Compliance Specialist
Bid Number 823014541003
ADDENDUM #3 DATE: August 31, 2023
PANNELL COMMUNITY CENTER ROOF SECTION 6, 7 & 17
Addendum #3 Includes:
Item 1.
Contractor is responsible for securing their own City Permits. Please contact Norm Colby if you should have any questions.
THE ORIGINAL BID DUE DATE REMAINS THE SAME.
UNCHANGED PORTIONS OF THE SPECIFICATIONS REMAIN IN EFFECT. 9/5/23, 3:20 PM Looking for a Business - City of Sacramento LOOKING FOR A BUSINESS?
SEARCH THE CITY OF SACRAMENTO BUSINESS
DATABASE
Looking for a business within the City of Sacramento? Use the search tool below to search for a business by the business name o r description.
Enter the value you want to search for then click on the Search Business button. (Only the first 25 accounts will show.) For more information, please see Open BOT Information.
Search By: Business Name
Enter value to search American Foam Experts
Search Business
FINANCE HOME
ACCOUNTING
10•BUDGET
OPROCUREMENT SERVICES
)WUBLIC IMPROVEMENT
FINANCING
VREVENUE
ACCOUNTS
RECEIVABLE
VBUSINESS OPERATION
TAX
CANNABIS BUSINESS
TAX
BUSINESS OPERATION TAX INFORMATION CONTACT US
DIFFERENT TYPES OF
BUSINESSES
Close Business Name Business Description
Date
AMERICAN FOAM Contractors - 1
EXPERTS Construction A
Action
LOOKING FOR A
BUSINESS
Business Detail
BUSINESS
IMPROVEMENT AREA
RENEWING YOUR
ACCOUNT
COLLECTIONS
REAL PROPERTY
TRANSFER TAX
SHORT-TERM
VACATION RENTALS
Account Number
Business Name
• Business Description
Business Start Date
Close Date
Current Expire Date
Current License Status
. Location Street Number
Location Direction
'• Location Street Name
1046657
AMERICAN FOAM EXPERTS
Contractors - Construction
8/11/2011
6/3 0/2024
Expired _
11500
TWIN CITIES
https://www.cityofsacramento.org/Finance/Reyenue/Business-Operation-Tax/Looking-for-a-Business 2/5
9/5/23, 3:20 PM Looking for a Business - City of Sacramento
SPECIAL BUSINESS
PERMITS
TRANSIENT
OCCUPANCY TAX
PoUTILITY USER TAX
UNCLAIMED PROPERTY
CONTACT US
Location Street Type RD
Location Unit
Location City GALT
Location State CA
Location Zip code 95632 - 8406
Mail Street Number 190
• Mail Street Direction
Mail Street name
Mail Street Direction
Mail Unit
Mail City HERALD
Mail State CA
Mail Zip code 95638 - 0238
Primary Phone number (209) 748-2662
Principal Owner First name BOBBY
Principal Owner Last Name STEPPS
Powered by Open Data
Direct link
https://www.cityofsacramento.org/Finance/Revenue/Business-Operation-Tax/Looking-for-a-Business 3/5 CITY OF SACRAMENTOCERTIFICATE OF INSURANCEThis is to certify to the CITY OF SACRAMENTO that the insurance policies listed below have been issued to the named insured andare in force at this time.NAMED INSURED:ADDRESS:DESCRIPTION OF PERMIT / CONTRACT:TYPE OF INSURANCE INSURER AND POLICY NUMBERPOLICY PERIOD LIMITS OF LIABILITY Each Occurrence AggregateGENERAL LIABILITY( ) General Liability( ) Liquor Liability( ) Contractual ( ) Products / CompletedOperations( ) Personal Injury( ) Broad Form PropertyDamageBODILY INJURY $ $PROPERTY DAMAGE $ $BODILY INJURY ANDPROPERTY DAMAGE COMBINED $ $DEDUCTIBLE $ $AUTOMOBILE LIABILITY( ) Owned, Non-Owned andHired AutomobilesBODILY INJURY $(EACH PERSON)BODILY INJURY $(EACH ACCIDENT)PROPERTY DAMAGE $BODILY INJURY AND PROPERTY DAMAGE COMBINED $UMBRELLA LIABILITY( ) Umbrella / ExcessLiabilitySINGLE LIMIT $SELF-INSURED RETENTION $COMPENSATIONand Employer LiabilityEMPLOYER LIABILITY LIMIT $FIRE( ) Fire & ExtendedCoverage PerilsAMOUNT OF INSURANCES $MISCELLANEOUS COVERAGE( ) Aircraft Liability(including passengerinjuries)( ) Garage Keepers Liability( ) Watercraft Liability( ) Professional LiabilityBODILY INJURY $PROPERTY DAMAGE $AMOUNT OF INSURANCES $BODILY INJURY $PROPERTY DAMAGE $AMOUNT OF INSURANCES $OTHER INSURANCE(Indicate)THE FOLLOWING PROVISIONS APPLY:1 None of the above described coverage will be cancelled, reduced or non-renewed until after 30 days written notice has been given to the Risk Management Manager, City of Sacramento.2 The City of Sacramento, its officials, agents and employees are named on all liability policies described above (except professional liability policies) as additional insureds with respect to all operations performed for the City of Sacramento by or on behalf of the named insured.3. The above policies include a severability of interest clause.Any liability insurance maintained by the City of Sacramento will apply only in excess of the liability insurance coverage and limits described above.DATE ISSUEDAUTHORIZED REPRESENTATIVE OF INSURANCE COMPANYSignature TitleCompany NameAddressPhone Pacific Polymers, Inc. DBA American Foam Experts11500 Twin Cities Road Galt, CA 95632Pannell Community Center Roof Replacement Section 6, 7 & 17 10/02/2023President
Pacific Polymers, Inc.11500 Twin Cities Road Galt, CA 95632916-582-1265 Ace American C55543215 09/01/2023-09/01/20242,000,000.00United FinancialCasualty Co.09/05/2023-09/05/20231,000,000.00Associated Industries AES122543600 01/27/23-01/27/241,000,0001,000,0001,000,00077380R230ALIStar Stone National01/27/23-01/27/245,000,000.005,000,000.00 The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
LOCJECT
PRO-POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
OCCURCLAIMS-MADE
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$RETENTIONDED
CLAIMS-MADE
OCCUR
$
AGGREGATE $
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
PER
STATUTE
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
$
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under
DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
HIRED AUTOS
NON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
$
$
$
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.
INSD
ADDL
WVD
SUBR
N / A
$
$
(Ea accident)
(Per accident)
OTHER:
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 holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
E-MAIL
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
10/3/2023
G.L. Anderson Ins Srvs Inc
an affiliate of Professional Ins Assoc
193 Blue Ravine Rd, Suite 210
Folsom CA 95630
916-353-5130
916-353-5135
[email protected]
Associated Industries Insuranc
23140
PACIF94
StarStone National Ins. Co.
25496
Pacific Polymers, Inc
dba American Foam Experts
11500 Twin Cities Road
Galt CA 95632
Ohio Casualty Insurance Co
24074
1673711096
A
X
1,000,000
X
300,000
Excluded
1,000,000
2,000,000
X
AES122543600
1/27/2023
1/27/2024
2,000,000
B
X
5,000,000
X
77380R230ALI
5,000,000
1/27/2023
1/27/2024
C
Inland Marine
BMO66752678
9/14/2023
9/14/2024
Jobsite Limit
Catastrophe Limit
Deductible
100,000
150,000
500
The City of Sacramento, its officials, employees, and volunteers are included as Additional Insured's as their interests may appear per written contract.
Insurance is primary and non-contributory.
*30 days notice of cancellation applies except 10 days for non-payment of premium.
City of Sacramento
915 I Street
Sacramento CA 95814
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
ACORD 25 (2016/03)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
LOCJECT
PRO-POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
OCCURCLAIMS-MADE
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$RETENTIONDED
CLAIMS-MADE
OCCUR
$
AGGREGATE $
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
PER
STATUTE
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
$
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under
DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
HIRED
AUTOS ONLY
NON-OWNED
AUTOS ONLY AUTOS
AUTOS ONLY
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
$
$
$
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.
INSD
ADDL
WVD
SUBR
N / A
$
$
(Ea accident)
(Per accident)
OTHER:
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 holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
E-MAIL
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
IN ACCORDANCE WITH THE POLICY PROVISIONS.
Acct#:
2525969
10/3/2023
USI Insurance Services, LLC
844-290-4908
2502 N Rocky Point Drive
Tampa, FL 33607
[email protected]
Ace American Insurance Company
22667
Barrett Business Services, Inc.
L/C/F PACIFIC POLYMERS, INC. DBA: AMERICAN FOAM EXPERTS 11500 TWIN CITIES RD
GALT, CA 95632
A
X
C55543215
9/1/2023
9/1/2024
X
2,000,000
2,000,000
2,000,000
Policy State = CA
Waiver of Subrogation in favor of certificate holder when required by written contract 30-Day Notice of Cancellation
City Of Sacramento
915 I Street Sacramento, CA 95814
Workers' Compensation and Employers' Liability Policy
Named Insured Endorsement Number
Policy Number
Symbol: WLR Number:
Policy Period
TO
Effective Date of Endorsement
Issued By (Name of the Insurance Company)
Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.
This endorsement changes
the policy to which it is attached and is effective on the date issued unless otherwise stated.
CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This end
orsement applies only to the insurance provided by the policy because California is shown in Item
3.A. of the Information Page.
We have the right 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us.
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
Schedule
1. ( ) Specific Waiver
Name of person or organization:
( ) Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Operations:
3. Premium:
The premium charge for this endorsement shall be percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Minimum Premium:
_______________________________________
Authorized Agent
WC 90 03 75 (05/18)
ALL CALIFORNIA OPERATIONS
1.0 $0
Barrett Business Services, Inc.
L/C/F PACIFIC POLYMERS, INC. DBA: AMERICAN FOAM EXPERTS 11500 TWIN CITIES RD
GALT, CA 95632
C55543215
9/1/2023
9/1/2024
10/3/2023
Ace American Insurance Company
X
CITY OF SACRAMENTO WORKERS COMPENSATION CERTIFICATIONPage 1 of 1WORKER'S COMPENSATION CERTIFICATIONIn accordance with Article 5 (commencing at Section 1860), Chapter 1, Part 7, Division 2 of the Labor Code, the below certificate must be signed and filed with the awarding body prior to performing any work under this contract. Labor Code Section 3700, inter alia, states the following: "Every employer shall secure the payment of compensation in one or more of the following ways:"(a) By being insured against liability to pay compensation in one or more insurers duly authorized to write compensation insurance in this State. "(b) By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing proof satisfactory to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to his employees. To be signed by authorized corporate officer or partner or individual submitting the Proposal. If Bidder is: (example)1. An individual using a firm name, sign: "John Doe, an individual doing business as Blank Company."2. An individual doing business under his own name, Sign: your name only. 3. A co-partnership, sign: "John Doe and Richard Doe, co-partners doing business as Blank Company, by, John Doe, co-partner.4. A corporation, sign: "Blank Company, by John Doe, Secretary." (or other title)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: ContractorBySignature10/02/2023Pacific Polymers, Inc. DBA American Foam Experts