REQUIRED BID SUBMITTALS CHECKLIST
The following documents must be completed, signed, and submitted with the Bid. Incomplete submittals may be deemed non-responsive.
# REQUIRED DOCUMENT INCLUDED IN
BID PACKAGE
1 Bid Acknowledgement
2 Bid Schedule
3 •
eque to an of fral dried Cashier's Check, or Bid Bond
4 Designation of Subcontractors
5 Bidder Information and Experience Form
Non-Collusion Declaration
7 Iran Contracting Act Certification •
8 Public Works Contractor DIR Registration Certification 9 Contractor's Certificate Regarding Workers' Compensation 10 Acknowledgement of Insurance Requirements
11 Fleet Compliance Certification
12 Acknowledgment of Addenda (if applicable)
Copy of valid California Contractor's License Certificate 14 Copy of active California DIR Registration Certificate Villasenor Library - Parking Lot Surfacing -14- 00 21 13 - INSTRUCTIONS TO BIDDERS 00 41 43 - BID FORMS
BID ACKNOWLEDGMENT
Bids will be received at the 201 N 'E' Street, 2nd Floor, San Bernardino, California of the City of San Bernardino, until 3:00 PM on Tuesday, October 21, 2025 Villasenor Library - Parking Lot Surfacing, CIP NO. PR26-002 CONTRACT - SPECIFICATION NO. 13663
NAME OF BIDDER: JB Bostick LLC
To the CITY OF SAN BERNARDINO, with its principal place of business at Vanir Tower, 290 North D Street, San Bernardino, California 92401.
A. In response to the Notice Inviting Bids dated September 30, 2025 and in accordance with the accompanying Instructions to Bidders, the undersigned hereby proposes to the City to furnish all labor, technical and professional services, supervision, materials and equipment, other than materials and equipment specified as furnished by the City, and to perform all operations necessary and required to construct the Project in accordance with the provisions of the Contract Documents and any addenda thereto, and at the prices stated opposite the respective items set forth in the Bid Schedule.
B. This Bid constitutes a firm offer to the City which cannot be withdrawn for 90 days after the date set for opening of Bids, or until a Contract is executed by the City and a third party, whichever is earlier.
C. The undersigned certifies that it has examined and is fully familiar with all of the provisions of the Contract Documents and any addenda thereto; that it has carefully checked all of the words and figures shown in its Bid Schedule; that it has carefully reviewed the accuracy of all statements in this Bid and attachments hereto; and that it understands and agrees that the City will not be responsible for any errors or omissions on the part of the undersigned in preparing this Bid D. If awarded a Contract, the undersigned agrees to execute and deliver to the City within ten (10) days after date of receipt of Notice of Award, a signed Contract and the necessary Performance Bond, Payment Bond, and Certificates of Insurance and Endorsements.
E. The following Bid Forms, which have been completed and executed by the undersigned Bidder, are incorporated by this reference and made a part of this Bid:
1. Bid Schedule
2. Bid Guarantee in the amount of not less than 10% of the Total Bid Price.
3. Completed Designation of Subcontractors form.
4. Fully executed Noncollusion Declaration form.
Villasenor Library - Parking Lot Surfacing -15- 00 41 43 - BID FORMS
5. Completed Iran Contracting Act Certification form.
6. Completed Public Works Contractor DIR Registration Certification form.
7. Completed Contractor's Certificate Regarding Workers' Compensation form.
8. Completed Bidder Information and Experience Form.
F. The undersigned is hereby representing that it is and will be properly licensed both at the time that it submits a Bid as well as at the time the Contract is awarded, if the Contract is awarded to the undersigned.
1. Individual Contractor. Undersigned certifies that it is now licensed in accordance with the provisions of the Contractor's License Law of the State of California.
License number 341573
Expiration date 10/31/2026
License classification C12 & A
no underse i carre the in indural more or radion
License Law of the State of California.
Member No. 1
Name
License number
Expiration date
License classification
Member No. 2
Name
License number
Expiration date
License classification
(If there are more than two members of the joint venture, attach a page for the additional members) with the above information.)
Villasenor Library - Parking Lot Surfacing -16- 00 41 43 - BID FORMS The undersigned acknowledges receipt, understanding, and full consideration of the following addenda to the Contract Documents:
Addenda No. N/A
[SIGNATURE ON FOLLOWING PAGE]
Villasenor Library - Parking Lot Surfacing -17_ 00 41 43 - BID FORMS I hereby certify under penalty of perjury under the laws of the State of California that all of the information submitted in connection with this Bid and all of the representations made herein are true and correct.
BIDDER: Bidder's Business Address:
JB Bostick LLC 2870 E. La Cresta Avenue
(Company Name) Anaheim, CA 92806-1816
Bate, Cal But
(Signature)
Joel Batule / Carl Bostick
(Type or print name)
Chief Executive Officer / President
(Title)
Anaheim, CA
(Where signed) (City, State)
(corporate seal)
Dated: October 16 _ 2025
-
State of Incorporation: California
(If the Prime Contractor is a corporation, two signatures of corporate officers are required.) Names and addresses of all partners or joint venturers:
Statement of the authority of signatory to bind Bidder:
Joel Batule - Chief Executive Officer
Carl Bostick - President
*See attached Incumbency Certificate
Villasenor Library - Parking Lot Surfacing -18- 00 41 43 - BID FORMS
BID SCHEDULE
NO. ITEM DESCRIPTION UNIT OF EST. UNIT PRICE ITEM COST
MEASURE QTY.
Mobilization LS 1 2, 500.00 2, 500.00
2. Clearing and Grubbing LS 1 2, 500.00 2, 500.00
3. Erosion Control Plan & BMPs LS 1 500.00 500.00
Construct 4' × 8' Project Sign. EA 1 500.00 500.00
4. See info in Appendix
Cold mill 2" uniform depth per
5. plans and specifications, SF 32,000 .65 20, 800.00
including remove and dispose
of all existing wheel stoppers.
6. Construct 2"AC overlay per TN 385
plans and specifications 140.00 53, 900.00
Construct variable thickness
AC overlay for the designated
7. ADA parking stalls, loading LS 1 2, 500.00
area and walking path per 2, 500.00
plans and specifications
Construct variable thickness
AC overlay for the transition LS 1
area per plans and 2, 500.00 2, 500.00
specifications
Remove and dispose the
existing two (2) ramps and the
and dispose of the existing LS 1
8, 500.00 8, 500.00
all restore pay phone and
sidewalk concrete surface clear
Construct ADA Concrete Ramp
with retaining curb and
detectable warning 2'x4' per to
10. APWA/ SPPWC 111, this plan EA 2 9, 800.00
and specifications. Use 19,600.00
concrete class 560-C-3250.
MAX Slope 8.33%
Remove and dispose the
11. existing disabled parking stall EA 2 125.00 250.00
signs. Furnish and install new
Villasenor Library - Parking Lot Surfacing -19- 00 41 43 - BID FORMS ones per Caltrans Standard
Plan R99C(CA), this plan and
specifications.
Furnish and Apply 4" wide
thermoplastic reflective blue
striping, and blue borders for
handicap parking stalls, loading
12. area and path including LS 1 3, 500.00 3, 500.00
handicap and no parking
symbols per 2024 CALTRANS
standard plan A24C, this plan
and specifications
Furnish and Apply 4" wide
thermoplastic reflective white
13. Striping (parking stalls) for the LS 1 7, 650.00 7,650.00 parking lot per plans and
specifications
Repair and fill cracks, saw
cutting the existing concrete
slab into six (6) panels. Furnish
and apply sealant to the new
14. control joints. Furnish and LS 1 2, 500.00 2, 500.00 apply concrete finish painting
to the entire concrete slab
surface. As per plans and
specifications
Repair the damaged areas in
the existing PCC cross gutter.
Furnish and apply concrete LS
15. 1 2, 500.00 2, 500.00
finish painting to the entire
gutter surface. As per plans
and specifications
Clean the gutter and all curb
16. drain holes per plans and LS 1 1, 000.00 1, 000.00
specifications
BASE BID (BID ITEMS #1-16) TOTAL
TOTAL BID PRICE BASED ON BID SCHEDULE
$. 131, 200.00
Total Base Bid in Numbers
Villasenor Library - Parking Lot Surfacing -20- 00 41 43 - BID FORMS The costs for any Work shown or required in the Contract Documents, but not specifically identified as a line item are to be included in the related line items and no additional compensation shall be due to Contractor for the performance of the Work.
All blank spaces appearing above must be filled in. Failure to fill in any blank spaces may render the bid non-responsive. In case of discrepancy between the Unit Price and Item Cost set forth for a unit basis item, the Unit Price shall prevail and be utilized as the basis for determining the lowest responsive, responsible Bidder. However, if the amount set forth as a Unit Price is ambiguous, unintelligible or uncertain for any cause, or is omitted, or is the same amount as the entry in the Item Cost column, then the amount set forth in the Item Cost column for the item shall prevail and shall be divided by the estimated quantity for the item and the price thus obtained shall be the Unit Price.
For purposes of evaluating Bids, the City will correct any apparent errors in the extension of unit prices and any apparent errors in the addition of lump sum and extended prices.
The estimated quantities for Unit Price items are for purposes of comparing Bids only and the City makes no representation that the actual quantities of work performed will not vary from the estimates. Final payment shall be determined by the Engineer from measured quantities of work performed based upon the Unit Price.
The undersigned agrees that this Bid Schedule constitutes a firm offer to the City which cannot be withdrawn for the number of calendar days indicated in the Notice Inviting Bids from and after the Bid opening, or until a Contract for the Work is fully executed by the City and a third party, whichever is earlier.
If the Contract Documents specify Alternate Bid items, the City can choose to include any, all, or none of the Alternate/ Additive Bid items in the Work. If the City selects any of the Alternate/ Additive Bid items, the corresponding Alternate/ Additive Bid prices shall be added to Base Bid Price for the Work. The City can award/select Alternatel Additive Bid items at any time(s).
Name of Bidder JB Bostick LLC
Cal Bas
Dated_October 16, 2025
Villasenor Library - Parking Lot Surfacing -21- 00 41 43 - BID FORMS
BID GUARANTEE
BID BOND
[Note: Not required when other form of Bidder's Security, e.g. cash, certified check or cashier's check, accompanies Bid.]
The makers of this bond are,
Principal, and
ind are held and firmly bound unto the CITY OF SAN BERNARDINO, with its principal place o usiness at Vanir Tower, 290 North D Street, San Bernardino, California 92401, hereinafte called the City, in the penal sum of TEN PERCENT (10%) OF THE TOTAL BID PRICE of the rincipal submitted to the City for the work described below, for the payment of which sum i awful money of the United States, well and truly to be made, we bind ourselves, our heir executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH that whereas the Principal has submitted the accompanying bid dated - for Villasenor Library Parking Lot Surfacing, PR26-002, Specifications No. 13663.
If the Principal does not withdraw its Bid within the time specified in the Contract Documents; and if the Principal is awarded the Contract and provides all documents to the City as required by the Contract Documents; then this obligation shall be null and void. Otherwise, this bond will remain in full force and effect.
Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract Documents shall affect its obligation under this bond, and Surety does hereby waive notice of any such changes.
In the event a lawsuit is brought upon this bond by the City and judgment is recovered, the Surety shall pay all litigation expenses incurred by the City in such suit, including reasonable attorneys' fees, court costs, expert witness fees and expenses.
IN WITNESS WHEREOF, the above-bound parties have executed this instrument under their several seals this day of , 20 the name and corporate seal of each corporation.
(Corporate Seal)
Contractor/ Principal
By.
Title
(Corporate Seal) Surety
By
Attorney-in-Fact
(Attach Attorney-in-Fact Certificate) Title
Villasenor Library - Parking Lot Surfacing -22- 00 41 43 - BID FORMS Notary Acknowledgment
STATE OF CALIFORNIA
COUNTY OF
On - 20. , before me, _. Notary Public, personally
appeared _ who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature of Notary Public
OPTIONAL
Though the no out prevent raut end end ay and really pront of til to to anger ding un the document.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT • Individual
• Corporate Officer
Title(s) Title or Type of Document
• Partners) Limited
General Number of Pages
• Attorney-In-Fact
• Trustee(s)
• Guardian/Conservator Date of Document
• Other:
Signer is representing:
Name Of Person(s) Or Entity(ies)
Signers) Other Than Named Above
NOTE: This acknowledgment is to be completed for Contractor/Principal.
Villasenor Library - Parking Lot Surfacing -23- 00 41 43 - BID FORMS Notary Acknowledgment
STATE OF CALIFORNIA
COUNTY OF
On - 20 _, before me, _ Notary Public, personally
appeared _, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature of Notary Public
OPTIONAL
hough the information below is not required by law, it may prove valuable to persons relying on the documen and could prevent fraudulent removal and reattachment of this form to another documen
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT • Individual
• Corporate Officer
Titles) Title or Type of Document
• Partners) Limited
General Number of Pages
• Attorney-In-Fact
• Trustee(s)
• Guardian/Conservator Date of Document
• Other:
igner is representing
ame Of Person(s) Or Entitylie
Signers) Other Than Named Above
NOTE: This acknowledgment is to be completed for the Attorney-in-Fact. The Power-of-Attorney to local representatives of the bonding company must also be attached.
END OF BID BOND
Villasenor Library - Parking Lot Surfacing -24- 00 41 43 - BID FORMS
DESIGNATION OF SUBCONTRACTORS
The subcontractor listed below will perform work or labor or render service to the contractor in or about the construction of the work or improvement, or are subcontractors licensed by the State of California who will, under subcontract to the contractor, specially fabricate and install a portion of the work or improvement according to detailed drawings contained in the Contract Documents, in an amount in excess of one-half of one percent (1/2 of 1%) of the contractor's total bid.
Notwithstanding the foregoing, if the work involves the construction of streets and highways, then the Bidder shall list each subcontractor who will perform work or labor or render service to the Bidder in or about the work in an amount in excess of one-half of one percent (0.5%) of the Bidder's Total Bid Price or $10,000, whichever is greater. No additional time shall be granted to provide the below requested information.
In compliance with the Subletting and Subcontracting Fair Practices Act Chapter 4 (commencing at Section 4100), Part 1, Division 2 of the California Public Contract Code, the Bidder shall set forth below:
(a) The portion of the work to be done by the subcontractor; (b) The name and the location of the place of business; (c) The California contractor license number; and
(d) The DIR public works contractor registration number.
If a Bidder fails to specify a subcontractor or if a Bidder specifies more than one subcontractor for the same portion of work, then the Bidder shall be deemed to have agreed that it is fully qualified to perform that portion of work and that it shall perform that portion itself.
Portion of CSLB DIR
Work to be Name of Location of Contractor Registration
done by Subcontractor Business License No. Number
Subcontractor
260 Glider Circle
Striping Falcon Striping, Inc Corona, CA 92880 1066389 1000711671 Villasenor Library - Parking Lot Surfacing -25- 00 41 43 - BID FORMS Portion of CSLB DIR
Work to be Name of Location of Contractor Registration
done by Subcontractor Business License No. Number
Subcontractor
Villasenor Library - Parking Lot Surfacing -26- 00 41 43 - BID FORMS Portion of CSLB DIR
Work to be Name of Location of Contractor Registration
done by Subcontractor Business License No. Number
Subcontractor
(Attach additional sheets if necessary)
Name of Bidder JB Bostick LLC
Batull 1 Aul Bars.
Signature_
Name and Title Joel Batule - Chief Executive Officer / Carl Bostick - President Dated October 16, 2025
Villasenor Library - Parking Lot Surfacing -27- 00 41 43 - BID FORMS
BIDDER INFORMATION AND EXPERIENCE FORM
A. INFORMATION ABOUT BIDDER
(Indicate not applicable ("N/A") where appropriate.)
NOTE: Where Bidder is a joint venture, pages shall be duplicated and information provided for all parties to the joint venture.
1.0 Name of Bidder: JB Bostick LLC
2.0 Type, if Entity: Limited Liability Company
3.0 Bidder Address: 2870 E. La Cresta Avenue
Anaheim, CA 92806-1816
(714) 238-2142 (714) 238-2121
Facsimile Number Telephone Number
[email protected]
Email Address
4.0 How many years has Bidder's organization been in business as a Contractor? 56 years
5.0 How many years has Bidder's organization been in business under its present name? <2 years
5.1 Under what other or former names has Bidder's organization operated? JB Bostick Company
6.0 If Bidder's organization is a corporation, answer the following:
6.1 Date of Incorporation: December 8, 1986
6.2 State of Incorporation: California
6.3 President's Name: Carl Bostick
6.4 diso Precidento Namefe): Joel Batule
Chief Executive Officer
6.5 Secretary's Name:
6.6 Treasurer's Name:
Villasenor Library - Parking Lot Surfacing -28- 00 41 43 - BID FORMS
7.0 If an individual or a partnership, answer the following:
7.1 Date of Organization:
7.2 Name and address of all partners (state whether general or limited partnership):
8.0 If other than a corporation or partnership, describe organization and name principals:
N/A
9.0 List other states in which Bidder's organization is legally qualified to do business.
10.0 What type of work does the Bidder normally perform with its own forces?
11.0 Has Bidder ever failed to complete any work awarded to it? If so, note when, where, and why:
No
12.0 Within the last five years, has any officer or partner of Bidder's organization ever been an officer or partner of another organization when it failed to complete a contract? If so, attach a separate sheet of explanation:
No
13.0 List Trade References:
All American Asphalt, Inc. - 400 E 6th Street - Corona, CA 92879 - Phone: (951) 736-7650 Diversified Asphalt Products, Inc. - 1227 N. Olive Street - Anaheim, CA 92801 - Phone: (714) 449-8666 Villasenor Library - Parking Lot Surfacing -29- 00 41 43 - BID FORMS GuardTop - 719 W. Collins Avenue - Orange, CA 92867 - Phone: (949) 573-0445 The R.J. Noble Company, Inc. - 15505 E. Lincoln Avenue - Orange, CA 92865 - Phone: (714) 637-1550
14.0 List Bank References (Bank and Branch Address):
Farmers and Merchants Bank - 315 N Harbor Blvd. - Fullerton, CA 92832 - Phone: (714) 578-1945
15.0 Name of Bonding Company and Name and Address of Agent:
Trisura Insurance Company - Alicia Grumbles - 159 Northington Woods Dr., Mooresille, NG 28117 [REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK]
Villasenor Library - Parking Lot Surfacing -30- 00 41 43 - BID FORMS B. LIST OF CURRENT PROJECTS (BACKLOG)
[**Duplicate Page if needed for listing additional current projects.**] Project Client Reference Description of Completion Date Cost of Bidder's (agency Bidder's Work Work
name/contact
info)
Tak Colony at Califomia Hot Crackseal, Concrete 8/28/2025 $422,679.42 Temecula Valley Unified 8/6/2025 $415,921.81
School District Tenter Pao 51 60-5007 Hot Crackseal, Sealcoating Tony Tobin ES
Bear Creek Master Association aci Russe of Crackseal, Concrete Gutte 8/15/2025 $217,008.39 51) 244-00• &R Gutter & Spandr
Mariners Church Koman Garcia (14) 2% 347 °r Hot Crackseal, Sealcoating 8/4/2025 $164,235.97 Temecula Valley Unified Eric Johnston (951) 326-7450 o 8/4/2025 $206,759.49 Sai Elementary School Jennifer Pablos (951) 506-7043 Sealcoating Villasenor Library - Parking Lot Surfacing -31- 00 41 43 - BID FORMS C. LIST OF COMPLETED PROJECTS - LAST THREE YEARS
(**Duplicate Page if needed for listing additional completed projects.**] Please include only those projects which are similar enough to demonstrate Bidder's ability to perform the required Work.
Project Client Reference Description of Completion Date Cost of Bidder's (agency Bidder's Work Work
name/contact
info)
mecula Valley Unifi (s51) 328-7450 spent Treatment of Su Grand. 07/29/2024 $1,160,000.00 hool Dist/ -Pave, Sealcoat, Re-Strip
38190/018 07/30/2024 $1,339,349.00
ncrete: Remove & Repla $1,237,830.00
City of Riverside Ali Borujerdi 01/14/2025
951) 826-2001 pat Re-Strip epis
The Crosby Estates ohn Pete Overlay, Concrete 6/26/2025 $2,269,083.94 08) 250-49 raffic Loop
Villasenor Library - Parking Lot Surfacing -32- 00 41 43 - BID FORMS D. EXPERIENCE AND TECHNICAL QUALIFICATIONS QUESTIONNAIRE Personnel:
The Bidder shall identify the key personnel to be assigned to this project in a management, construction supervision or engineering capacity.
. List each person's job title, name and percent of time to be allocated to this projec ngell Alvarado - Production Manager - 10°
Gregory Beckner - Project Manager/Estimator - 90%
Michael Araiza - General Manager - 10%
2. Summarize each person's specialized education:
Angell Alvarado - Education N/A
Gregory Beckner - BA Construction Management
Michael Araiza - BA Business
3. List each persoges varado - 16 teaction experience relevant to the project:
Gregory Beckner - 23 years
Michael Araiza - 38 years
4. Summarize such experience:
Angel Alvarado- 12 Years Operator/Field Experience - 4 Years Office Management Gregory Beckner - 5 Years Operator/Field Experience - 18 Years Estimator/PM Michael Araiza - 38 Years Upper Management Production and Sales Bidder agrees that personnel named in this Bid will remain on this Project until completion of all relevant Work, unless substituted by personnel of equivalent experience and qualifications approved in advance by the City.
Villasenor Library - Parking Lot Surfacing -33- 00 41 43 - BID FORMS E. ADDITIONAL BIDDER'S STATEMENTS:
If the Bidder feels that there is additional information which has not been included in the questionnaire above, and which would contribute to the qualification review, it may add that information in a statement here or on an attached sheet, appropriately marked:
N/A
Name of Bidder JB Bostick LLC
Signature Batull - Cal Bert
Name and Title Joel Batule - Chief Executive Officer / Carl Bostick - President Dated October 16, 2025
Villasenor Library - Parking Lot Surfacing -34- 00 41 43 - BID FORMS
NON-COLLUSION DECLARATION
The undersigned declares:
I am the Chief Executive Officer / President of JB Bostick LLC _ the party making the foregoing Bid.
The Bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The Bid is genuine and not collusive or sham. The Bidder has not directly or indirectly induced or solicited any other Bidder to put in a false or sham bid. The Bidder has not directly or indirectly colluded, conspired, connived, or agreed with any Bidder or anyone else to put in a sham bid, or to refrain from bidding. The Bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the Bid Price of the Bidder or any other Bidder, or to fix any overhead, profit, or cost element of the Bid Price, or of that of any other Bidder. All statements contained in the Bid are true. The Bidder has not, directly or indirectly, submitted his or her Bid Price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.
Any person executing this declaration on behalf of a Bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the Bidder.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on October 16, 2025 [date], at Anaheim [city], California [state].
Name of Bidder JB Bostick LLC
Cael But
Signature atul /
Name and Titte Joel Batule - Chief Executive Officer / Carl Bostick - President Dated October 16, 2025
Villasenor Library - Parking Lot Surfacing -35- 00 41 43 - BID FORMS IRAN CONTRACTING ACT CERTIFICATION.
(Public Contract Code section 2200 et seq.)
As required by California Public Contract Code Section 2204, the Contractor certifies subject to penalty for perjury that the option checked below relating to the Contractor's status in regard to the Iran Contracting Act of 2010 (Public Contract Code Section 2200 et seq.) is true and correct:
M The Contractor is not:
(1) identified on the current list of person and entities engaged in investment activities in Iran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code Section 2203; or (2) a financial instruction that extends, for 45 days or more, credit in the amount of 20,000,000 or more to any other person or entity identified on the current list o ersons and entities engaging in investment activities in Iran prepared by th California Department of General Services in accordance with subdivision (b) of Public Contract Code Section 2203, if that person or entity uses or will use the credit to provide goods or services in the energy sector in Iran. - The City has exempted the Contractor from the requirements of the Iran Contracting Act of 2010 after making a public finding that, absent the exemption, the City will be unable to obtain the goods and/or services to be provided pursuant to the Contract. • The amount of the Contract payable to the Contractor for the Project does not exceed $1,000,000.
signature Batul, Cal But
Printed Name: Joel Batule / Carl Bostick -
Title: Chief Executive Officer / President
Firm Name: JB Bostick LLC
Date: October 16, 2025
Note: In accordance with Public Contract Code Section 2205, false certification of this form shall be reported to the California Attorney General and may result in civil penalties equal to the greater of $250,000 or twice the Contract amount, termination of the Contract and/or ineligibility to bid on contracts for three years.
Villasenor Library - Parking Lot Surfacing -36- 00 41 43 - BID FORMS
PUBLIC WORKS CONTRACTOR REGISTRATION CERTIFICATION
Pursuant to Labor Code sections 1725.5 and 1771.1, all contractors and subcontractors that wish to bid on, be listed in a bid proposal, or enter into a contract to perform public work must be registered with the Department of Industrial Relations. See http://www.dir.ca.gov/Public- Works/PublicWorks.html for additional information.
No bid will be accepted nor any contract entered into without proof of the contractor's and subcontractors' current registration with the Department of Industrial Relations to perform public Bidder hereby certifies that it is aware of the registration requirements set forth in Labor Code sections 1725.5 and 1771.1 and is currently registered as a contractor with the Department of Industrial Relations. '
Name of Bidder: JB Bostick LLC
DIR Registration Number: 1000000734
DIR Registration Expiration: 06/30/2028
Small Project Exemption: _ Yes or V No
Unless Bidder is exempt pursuant to the small project exemption, Bidder further acknowledges:
1. Bidder shall maintain a current DIR registration for the duration of the project.
2. Bidder shall include the requirements of Labor Code sections 1725.5 and 1771.' in its contract with subcontractors and ensure that all subcontractors are registerec at the time of bid opening and maintain registration status for the duration of the project.
3. Failure to submit this form or comply with any of the above requirements may result in a finding that the bid is non-responsive.
Name of Bidder JB Bostick LLC
signature Batull - Cal Bet
Name and Title Joel Batule - Chief Executive Officer / Carl Bostick - President Dated October 16, 2025
CONTRACTOR'S CERTIFICATE REGARDING WORKERS' COMPENSATION.
I am aware of the provisions of section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in If the Project is exempt from the contractor registration requirements pursuant to the small project exemption under Labor Cod actions 1725 5 and 1771 1. glease mark "Yes" in response to "Small Proiect Exemption.
Villasenor Library - Parking Lot Surfacing -37- 00 41 43 - BID FORMS accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this Contract.
Name of Bidder JB Bostick LLC
signature Batule Cal Bus
Name and Title Joel Batule - Chief Executive Officer / Carl Bostick - President Dated October 16, 2025
Villasenor Library - Parking Lot Surfacing -38- 00 41 43 - BID FORMS
FLEET COMPLIANCE CERTIFICATION
Bidder hereby acknowledges that they have reviewed the California Air Resources Board's policies, rules and regulations and are familiar with the requirements of Title 13, California Code of Regulations, Division 3, Chapter 9, effective on January 1, 2024 (the "Regulation"). Bidder hereby certifies, subject to penalty for perjury, that the option checked below relating to the Bidder's fleet, and/or that of their subcontractor(s) ("Fleet") is true and correct:
V The Fleet is subject to the requirements of the Regulation, and the appropriate Certificate(s) of Reported Compliance have been attached hereto. • The Fleet is exempt from the Regulation under section 2449.1(f(2), and a signed description of the subject vehicles, and reasoning for exemption has been attached hereto. • Bidder and/or their subcontractor is unable to procure R99 or R100 renewable diesel fuel as defined in the Regulation pursuant to section 2449. 1(D(3). Bidder shall keep detailed records describing the normal refueling methods, their attempts to procure renewable diesel fuel and proof that shows they were not able to procure renewable diesel (i.e. third party correspondence or vendor bids).
The Fleet is exempt from the requirements of the Regulation pursuant to section 2449(i)(4) because this Project has been deemed an Emergency, as defined under section 2449(c)(18). Bidder shall only operate the exempted vehicles in the emergency situation and records of the exempted vehicles must be maintained, pursuant to section 2449(i)(4). • The Fleet does not fall under the Regulation or are otherwise exempted and a detailed reasoning is attached hereto.
Name of Bidder: JB Bostick LLC
1 Caal Sees
Signature:
Name: Joel Batule / Carl Bostick
Title: Chief Executive Officer / President
Date: October 16, 2025
Villasenor Library - Parking Lot Surfacing -39- 00 41 43 - BID FORMS
BID GUARANTEE
BID BOND
[Note: Not required when other form of Bidder's Security, e.g. cash, certified check or cashier's check, accompanies Bid.]
The makers of this bond are, JB Bostick LLC _ as
Principal, and Indemnity National Insurance Company , as Surety and are held and firmly bound unto the CITY OF SAN BERNARDINO, with its principal place of business at Vanir Tower, 290 North D Street, San Bernardino, California 92401, hereinafter called the City, in the penal sum of TEN PERCENT (10%) OF THE TOTAL BID PRICE of the THE CONDITION OF THIS OBLIGATION IS SUCH that whereas the Principal has submitted the accompanying bid dated October 21 20 25, for Villasenor Library Parking Lot Surfacing, PR26-002, Specifications No. 13663.
If the Principal does not withdraw its Bid within the time specified in the Contract Documents; and if the Principal is awarded the Contract and provides all documents to the City as required by the Contract Documents; then this obligation shall be null and void. Otherwise, this bond will remain in full force and effect.
Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract Documents shall affect its obligation under this bond, and Surety does hereby waive notice of any such changes.
In the event a lawsuit is brought upon this bond by the City and judgment is recovered, the Surety shall pay all litigation expenses incurred by the City in such suit, including reasonable attorneys' fees, court costs, expert witness fees and expenses.
IN WITNESS WHEREOF, the above-bound parties have executed this instrument under their several seals this 15th day of October , 2025 _ the name and corporate seal of each corporation.
(Corporate Seal) JB Bostick LLC
Contractor/ Principal
By Datull
Title Toes Batule, Chief Executiveofficer
Indemnity National Insurance Company
(Corporate Seal) Surety
sy MeyenBey e
Attorney-in-Fact
(Attach Attorney-in-Fact Certificate) Title Megan Bayer, Attorney-in-Fact Villasenor Library - Parking Lot Surfacing -22- 00 41 43 - BID FORMS
STATE OF PENNSYLVANIA
COUNTY OF MONTGOMERY
on October 15,2025 → before me, Patricia Shields, a Notary Public in and for said County and State, duly commissioned and sworn, personally appeared, Megan Bayer, known to me to be the Attorney-In-Fact of Indemnity National Insurance Company, the corporation described in and that executed the within and foregoing instrument, and known to me to be the person who executed the said instrument on behalf of the said corporation, and she duly acknowledged to me that such corporation executed the same.
IN WITNESS WHEREOF, I have herunto set my hand and affixed my official seal, the day and year stated in this certificate above.
My Commission Expires December 12, 2027
Patricia Shields, Notary Public
Commission No. 1360993
COMMOMWEALTH OF PENNSYLVANIA - NOTARY SEAL
Patricia
ly Commission Expires 12/12/202
ommission # 136098
Indemnity National Insurance Company
INDEMNITY NATIONAL 238 Bedford Way
INSURANGE COMPANY
Franklin, TN 37064
Power of Attorney
KNOW ALL PERSONS BY THESE PRESENTS: that Indemnity National Insurance Company, a Mississippi corporation, (hereinafter the "Company"), does hereby constitute and appoint: George James, Stephanie Venuti, Jenna Leuck, Kyle Bambule, Matt Arensdorf, Ryan Witta, Dave Donato, Megan Bayer, Cori Keeler, Patty Shields, Jimmy Walsh, Kyle Garrett, Sarah Mainella, Charlotte Melendy of *******Trisura Insurance Company********** _to be its true and lawful Attorney-in-Fact, with full power and authority hereby conferred to sign, seal, and execute on its behalf surety ponds or undertakings and other documents of a similar nature issued in the course of its business up to a penal sum not to excee *************************Twenty Million Dollars ($20,000.000.00)************************************ This appointment is made under and executed pursuant to and by authority of the following Minutes of Special Actions Taken by Written Consent of the Board of Directors, which is now in full force and effect:
Authorization to Appoint Attorneys-in-Fact and the Use of Facsimile Signatures and Facsimile Seals for the Purpose of Issuing Bonds:
RESOLVED: That the president or any vice president may appoint attorneys-in-fact or agents with authority as defined or limited in the instrument evidencing the appointment in cach case, for and on behalf of the Company to execute and deliver and affix the seal of the Company to bonds and related obligatory certificates and documents; and any one of said officers may remove any such attorney-in-fact or agent and revoke any power previously granted to such person, whether or not such officer appointed the attorney-in-fact or agent.
RESOLVED: That any bonds and related obligatory certificates and documents shall be valid and binding upon the Company, (i) when signed by the president, or any vice president, and sealed with the Company seal; or (ii) when duly executed and sealed with the Company seal by one or more attorneys-in-fact or agents pursuant to and within the limits of authority evidenced by the power of attorney issued by the Company to such person or persons a certified copy of which power of attorney must be attached thereto in order for such obligation to be binding upon the Company.
RESOLVED: That the signature of any authorized officer and the seal of the Company may be affixed to any power of attorney or certification thereof authorizing the execution and delivery of any bonds and related obligatory certificates and documents of the Company and such signature and seal then so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of Indemnity National Insurance Company has been affixed thereto in Lexington, Kentucky this 22nd day of August, 2025.
Indemnity National Insurance Company
CORPORATE
SEAL CE.
7993
Mississippi By
Thomas F. Elkins, President
State of Kentucky
County of Fayette
NOTARY By horah A. Murphy
Notary Public
PUBLIC
My Commission Expires 09/26/2029
CERTIFICATE Notary ID Number: KYNP34336
I, James E. Hart, Secretary of Indemnity National Insurance Company, do hereby certity that the foregoing Power of Attorney is still in full force and effect, and further certify that the Minutes of Special Actions Taken by Written Consent of the Board of Directors are now in full force and effect.
IN TESTIMONY WHEREOF Thave subscribed my name and affixed the seal of said Company. Deted this IS th _day of Octuber 2025
CORPORAT
1993
Mississipe
Indemnity National Insurance Company
STATEMENT OF FINANCIAL CONDITION
December 31, 2024
Assets
Cash and short-term investments $ 46,476,464
Invested assets 306,816,923
Premium receivable 18,138,083
Other assets 13,747,581
Total assets $ 385,179,051
Liabilities
Loss and loss adjustment expense
reserves $ 44,463,960
Unearned and advance premiums 56,587,563
Amounts withheld or retained by
company for others 136,530,895
Other liabilities 11,013,011
Total liabilities 248,595,429
Surplus as regards policyholders $ 136,583,622
Total Surplus and Liabilities $ 385,179,051
1745
By: Attest:
Chief Financial Officer, Treasurer and Secretary President State of Tennessee
County of Williamson
James Ewell Hart, Chief Financial Officer, Treasurer and Secretary, and Thomas Franklin Elkins, President of Indemnity National Insurance Company, a Mississippi domiciled insurance company, being duly sworn do certify that the foregoing is a true and correct statement of financial condition of said company as of December 31, 2024.
E. hl:
Notary Public
¡TENNESSEE
NOTARY
PUBLIC
• LANSON COUN
No. 6467-5
STATE OF CALIFORNIA
DEPARTMENT OF INSURANCE
OAKLAND
Amended
Certificate of Authority
THIS IS TO CERTIFY that, pursuant to the Insurance Code of the State of California, Indemnity National Insurance Company
of Mississippi, organized under the laws of Mississippi, subject to its Articles of Incorporation or other fundamental organizational documents, is hereby authorized to transact within this State, subject to all provisions of this Certificate, the following classes of insurance:
Surety, Liability, Common Carrier Liability,
Team and Vehicle, and Automobile
as such classes are now or may hereafter be defined in the Insurance Laws of the State of California.
THIS CERTIFICATE is expressly conditioned upon the holder hereof now and hereafter being in full compliance with all, and not in violation of any, of the applicable laws and lawful requirements made under authority of the laws of the State of California as long as such laws or requirements are in effect and applicable, and as such laws and requirements now are, or may hereafter be changed or amended.
IN WITNESS WHEREOF, I have set my hand and
affix my official seal this 19'h day of March, 2025.
Ricardo Lara
Insurance Commissioner
Monica Macalust
By
Monica Macaluso
for Michael Martinez
Chief Deputy Commissioner
NOTICE:
Qualification with the Secretary of State must be accomplished as required by the California Corporations Code promptly after issuance of this Certificate of Authority. Failure to do so will be a violation of Insurance Code section 701 and will be grounds for revoking this Certificate of Authority pursuant to the covenants made in the application therefor and the conditions contained herein.
#1387001./
ACKNOWLEDGMENT
A notary public or other officer completing this
ertificate verifies only the identity of the individua
vho signed the document to which this certificate
attached, and not the truthfulness, accuracy, or
State of California
County of Orange
On October 16, 2025 before me, Andrea Carter, Notary Public (insert name and title of the officer)
personally appeared Joel Batule
who proved to me on the basis of satisfactory evidence to be the person(6) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(6) on the instrument the person(f), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
ANDREA CARTER
Notary Public - California
WITNESS my hand and official seal. Orange County
Commission #2458650
My Comm. Expires Aug 23, 2027
some lall
(Seal)
ACKNOWLEDGMENT
A notary public or other officer completing this
State of California
County of Orange
On October 16, 2025 before me, Andrea Carter, Notary Public (insert name and title of the officer)
personally appeared Carl Bostick
who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(f) on the instrument the person(f), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
ANDREA CARTER
WITNESS my hand and official seal. Notary Public - California Orange County
Commission # 2458650
My Comm. Expires Aug 23, 2027
Signatur (Seal)
BOSTICK LLC
ASPHALT PAVING CONTRACTORS (714) 238-2121
2870 EAST LA CRESTA AVE. 1 (800) 246-PAVE
ANAHEIM, CALIFORNIA 92806 Fax (714) 238-2142
INCUMBENCY CERTIFICATE
Joel Batule, the duly-elected Chief Executive Officer of JB Bostick LLC, a California limited liability company (the Company"), hereby attests to the following as a January 1, 2025:
1. I am the duly-elected Chief Executive Officer of the Company
2. The following persons have been duly elected to or appointed and do now hold the offices or positions as set forth below for the Company and the signatures opposite their names are respectively their true and genuine signatures:
Name: Office or Title: Signature:
Joel Batule Chief Executive Officer
Figs des
Carl Bostick President ..
3. The Company is a limited liability company duly organized, validly existing and in standing under the laws of the State of California.
Joel Batule, CEO
def
ANDREA CARTER
Notary Public - California
Orange County
Commission # 2458650 НИА 1 hoy
My Comm. Expires Aug 23, 2027
California Environmental Protection Agency
Air Resources Board
CERTIFICATE OF REPORTED COMPLIANCE
OFF-ROAD DIESEL VEHICLE REGULATION
is issued to
This certificate indicates that the fleet listed above has reported off-road diesel vehicles to the California Air Resources Board and has certified they are in compliance with title 13 CCR, section 2449. All applicable vehicles owned by the individual, company, or agency must be reported and labeled, as specified in Section 2449, with all possible completeness, else this certificate is null and void. Certificate expires
Off-road Diesel Fleet Identification
Jack Kitowski
Chief, Mobile Source Controi Division
To verify the authenticity of this certificate, enter this number at california Air Resources Board
CALIFORNIA
AIR RESOURCES BOARD
Certificate of Reported Compliance With:
Truck and Bus Regulation
Issued to: JB Bostick LLC
This certificate confirms that the fleet owner has attested under penalty of perjury that the statements and information they provided to the California Air Resources Board (CARB) are true, accurate, and complete regarding all relevant vehicles in the fleet required to show compliance. CARB hereby finds that the fleet listed has reported compliance with:
Title 18 COR 2025 (Truck and Bus Regulation)
IF CARB subsequently finds that the statements and information that have been provided are not true, accurate, and complete, this certificate shall be effectively revoked and the fleet subject to noncompliance penaities.
This certificate is valid until December 31, 2025
TRUCRS Fleet Identification
Printed on 2025-09-10
Jack Kitowaki 40567
Jack Kilowski 43 Vehicles
Division Chief, Mobile Source Control To verify the authenticity of this crtificate, visit Division California Air Resources Board www.arb.ca.gov/meprog/onrdiesel/tblookup.php
ACKNOWLEDGMENT
A notary public or other officer completing this
State of California
County of Orange
On October 16, 2025 before me, Andrea Carter, Notary Public (insert name and title of the officer)
personally appeared Joel Batule
who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(6) on the instrument the person(6), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
ANDREA CARTER
Notary Public - California
WITNESS my hand and official seal. Orange County
Commission # 2458650
My Comm. Expires Aug 23, 2027
Signatute (Seal)
ACKNOWLEDGMENT
A notary public or other officer completing this
State of California
County of Orange
On October 16, 2025 before me, Andrea Carter, Notary Public (insert name and title of the officer)
personally appeared Carl Bostick
who proved to me on the basis of satisfactory evidence to be the person(6) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(f), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
ANDREA CARTER
WITNESS my hand and official seal. Notary Public - Callfornia Orange County
Commission # 2458650
My Comm. Expires Aug 23, 2027
Signature (Seal)