SECTION 00400
BID FORM
NAME OF BIDDER: A\\ \O\V\t o, 0 ·,1,1e..<s\ �\d 6'111}c.q2r"t ">eS If\C.
The undersigned, hereby declare that we have carefully examined the location of the proposed Work, and have read and examined the Contract Documents, including all plans, specifications, and all addenda, if any, for the following Project:
CALLE FRONTERA LIFT STATION
SOIL STABILIZATION PROJECT
PROJECT NO. 32201
We hereby propose to furnish all labor, materials, equipment, tools, transportation, and services, and to discharge all duties and obligations necessary and required to perform and complete the Project for the following TOTAL BID PRICE:
BASE BID SCHEDULE
Bid Bid Item Description Unit of Est.
Item Measure Qty
No.
1. Initial Mobilization LS 1
2. Waste Management Plan LS 1
3. Sheeting, Shoring, and Bradng LS 1
4. Furnish and Maintain Traffic LS 1
Control (at Calle Frontera)
5. Clearing & Grubbing LS 1
6. Remove PCC Pavement Section SF 440
7. Remove Asphalt Concrete SF 410
Pavement Section
8. Remove Irrigation LS 1
9. Remove Trees EA 5
10. Remove Sealed Vent Pipe LS 1
11. Remove and Salvage Antenna LS 1
Pole
13 Unit
Price
bO, oe>O�
"), 15e,O '6'
IL/ b, Z'5'0/t. .
Total Item Cost
bCJ, Or:>D ,;.rc;;, '515"() ¢'
I q l, I 'Z-t:;O �
c;z, b'iod. • 152,b'JO d<f
7,7C/.O,q!
3<?. hb
l�.<1 b
'5'; 3'!5°!. 1 i
\1071."1)4
'l.1 ba.tf <6
"2-, b q <f e,tl
711°1(),qf;'
11.oro,l(o
b 11'33.bD
�3iq, 1'21
5', 3'o°I . 2.0
'Z.,60,'-I 6
z., I:,°( 'I cP
SECTION 00400
B10 FORM
Attachment 5
12. Remove Antenna Pole
Foundation
13. Removal and Repair Stucco and
Expansion Joints at Perimeter
Wall
14. Construct 30" Dia. Cast-InDrilled-Hole Pile
15. Construct 5'Wx3.5'H Reinforced
Concrete Pile Cap per Plans
16. Construct Reinforced Concrete
Pile Cap Closure Pour between
New and Existing Foundations
per Details 1 A and 1 B on Plans
17. Furnish and Install Polyurethane
Foam Injection at Existing Wet
Well per Plans and Specifications
18. Construct Reinforced Concrete
Pedestal, Furnish and Install
Anchor Bolts as required, and
Reinstall and Recommission
Salvaged Antenna Pole
19. Construct PCC V-Gutter over 6"
Scarified and Recornpacted
Subgrade to 95%
20. Construct 6" PCC Paving with
#4@18" EW Centered in Slab
over 2" Crushed Miscellaneous
Base over 6" Scarified and
Recompacted Subgrade to 95%
21. Construct 4" AC Pavement over
6" Crushed Miscellaneous Base
over 6" Scarified and
Recompacted Subgrade to 95%
22. Provide Temporary Supports,
Remove, Salvage for Storage at
City Yard, and Furnish and Install
New Permanent Pipe Supports
SECTION 00400
BID FORM
LS 1
SF 36
LF 560
CY 67
CY 8
LS 1
LS 1
LF 55
SF 440
SF 430
EA 4
14 5,�1fi. Zo
lOD,01
)42.. 60
\ I ,z__ '\0 .,ef"
5)7 ¢'
60,000 �
b
I I zo <ff
147.73
ts°I.{ }:, 7
o 2..10
1,too ief
5, �'30,, 'Z-0
"S,boo.16
l 9 I. '7>S-i>°6
i5t>,4�0 $)
4 /Z-9b/
bo, oco ,:d
6,12.0 ,:,:J"
13, bZ'i". I 'l
[.,'� I
'\ 'Z. 1,. • 't)'Q
t$J :iS: '){j \
-✓- '15 l�oo .v
SECTION 00400
BID FORM
23. Furnish and Install Mechanical
Modifications at Aboveground
Manifold to Recenter ss
Discharge Pipes in Existing Wet
Well Top Slab Sleeves
24 Furnish and Install 24" Box Tree
(Type By LA) w/ Deep Root UB
18-2 Root Barrier per Planting,
Root Barrier, & Staking Details 1,
2, &3
25. Furnish and Install Irrigation
Maintenance and Repairs per
Plans and Specifications
SECTION 00400
BID FORM
LS 1
EA 3
LS 1
'1',oc;Z-
,;J 5', oc,z. rffi
7./lCO«r"
1, iro !P
6(5 h ,bD0 ,,6 b boo I
In case of discrepancy between the unit price and the item cost set forth for a unit basis item, the unit price shall prevail and shall 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.
If any of the above discrepancies exist, the City may recalculate the bid price on the basis of the unit price and the bidder agrees to be bound by such recalculation.
It is understood that the quantities shown for the unit price items are approximate only and subject to increase or decrease, being stated only for the purpose of comparing bids and fixing the amount of surety bonds, and that should the quantity of work on the unit price basis be increased, the undersigned Bidder will perform the additional work at the unit price set out herein, and that should the quantity be decreased, payment is to be made on the actual quantity installed at such unit price, and the undersigned Bidder will make no claims for anticipated profits or additional compensation for any increase or decrease in the quantity. It is further understood that actual quantities on the unit price items will be determined upon completion of the work covered by the Contract.
Final payment shall be determined by the Engineer from measured quantities of work performed based upon the unit price.
TOTAL BID PRICE (BASED ON BASE BID SCHEDULE):
$ 7 6°1 C/ 0 3 . <,? 1-f
Total Base Bid Price in Numbers
5tVf.v'I ht,\ll\.dr11-&. s',t-.+-y t'line.. +i._m,.SO\tl)� ,. o",l'\e,. 1A .... N;1..,4-1-1..,u, d ollv-v:S CilM Total Base Bid Price in Written Form Q..\<j"-ty t<>1.A.r C.e.11\.t<;:,, 15 SECTION 00400
B10FORM
SECTION 00400
BID FORM
In case of discrepancy between the written price and the numerical price, the written price shall prevail. In case of a discrepancy between the electronic bid form in the City's Planet Bids system (if used) and this completed bid form, the signed hardcopy bid form (or scanned signed form uploaded to the City's Planet Bids system, shall prevail.
The undersigned agrees that this Bid Form constitutes a firm offer to City which cannot be withdrawn for the number of calendar days indicated in the Notice Inviting Bids from the bid opening, or until a Contract for the Work is fully executed by City and a third party, whichever is earlier.
The Contract duration shall commence on the date stated in City's Notice to Proceed, and shall be completed by the Contractor in the time specified in the Contract Documents. In no case shall the Contractor commence construction prior to the date stated in City's Notice to Proceed.
Bidder certifies that it is licensed in accordance with the law providing for the registration of Contractors, License No. 979981 , Expiration Date 1/31/27, class of license __A__. If the bidder is a joint venture, each member of the joint venture must include the above information.
The undersigned acknowledges receipt, understanding and full consideration of the following addenda to the Contract Documents.
Addenda No. ---------- NI A
Addend a No. �=�------- NI A
Addend a No. ---------- NIA
Bidder has attached the following:
1. The completed Contractor's Certificate Regarding Workers' Compensation form.
2. The required bid security in the amount of not less than 10% of the Total Bid Price.
3. The fully executed Non-Collusion Declaration form.
4. The completed Contractor Information and Experience form.
5. The completed List of Subcontractors form.
6. The completed Iran Contracting Act Certification form (for bids of $1,000,000 or more).
7. The completed Public Works Contractor Registration Certification form.
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, including Contractor's license number and expiration date, are true and correct. I further certify that the signatory below is authorized to submit this Bid and bind the Bidder to the terms of these Contract Documents.
16 SECTION 00400
B1OFORM
SECTION 00400
BID FORM
Name of Bidder Alliance Diversified Enterprises Inc.
Signature �<".'.':
Name Bran �ckway
Title Project Manager
Dated 11/12/25
END OF BID FORM
17 SECTION 00400
BID FORM
Section 00405
WORKER'S COMPENSATION INSURANCE CERTIFICATION
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
(ONE OF THE BOXES BELOW MUST BE CHECKED)
r
n
I have and will maintain a certificate of consent from the California Labor Commission to self-insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work to be performed under this contract.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work to be performed under this contract. My workers' compensation insurance carrier and policy number are:
Carrier Ace American Insurance Company
Policy Number C73860416
I certify that, in the performance of the work under this Agreement, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and I hereby agree to indemnify, defend, and hold harmless the City of San Clemente and all of ics officials, employees, and agents from ar,d against any and all claims, liabilities, and losses relating to personal injury or death, economic losses, and property damage arising out of my failure to provide such worker's compensation insurance. I further agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION
COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO
CRIMINAL PENAL TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
18 SECTION 00400
BID FORM
Dated: November 12th , 2025
By:
BBSI
Consultant
Brandon Brockway
Project Manager
Title
209 Avenida Del Mar, Ste. 201B
Address
San Cle1nente, California 92672
19 SECTION 00410
BID BOND
Bond# N/A
Premium: Nil
The makers of this bond are Alliance Diversified Enterprises, Inc. , as Principal, and_ Great American Insurance Company , as Surety and are held and firmly bound unto the City of San Clemente, hereinafter called City, in the penal sum of TEN PERCENT (10%) OF THE TOTAL BID PRICE of the Principal submitted to 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, 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 November 12, 20 25 for the CALLE FRONTERA LIFT STATION SOIL STABILIZATION PROJECT.
If the Principal does not withdraw its bid within the time specified in the 9ontract Documents; and if the Principal is awarded the Contract and provides all documents to 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 in 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 City and judgment is recovered, the Surety shall pay all litigation expenses incurred by 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 5th day of November , 20_l§_, the name and corporate seal of ea·ch corporation.
(Corporate seal) Alliance Diversified Enterprises, Inc.
Contr8,:to�?a�
By ______________ __,,---
Title f?,- c. S .
(Corporate Seal) Great American Insurance Company
Surety��
By _______________ _
Attorney-in-Fact_. K_a_re_n_Le_t_z ______ _
(Attach Attorney-in-Fact Certificate) Title Attorney-in-Fact 20 SECTION 00410
BID BOND
SECTION 004 10
BID BOND
Notary 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
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(les), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENAL TY OF PERJURY under the laws of the Slate of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature or Notary Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons retying on tho document and could prevent fraudulent removal and reattachment of this form to another document.
CAPACITY CLAIMED BY SIGNER
::; Individual
J Corporate Officer
Tille(s)
c: Partner( s) -
C, Limited
-- General
:: Attorney-In-Fact
:: Trustee(s)
::; Guardian/Conservator
C Other:
Signer is representing:
Name Of Person(s) Or Enlity(ies)
21 DESCRIPTION OF ATTACHED DOCUMENT
Title or Type of Document
Number of Pages
Date of Document
Signer(s) Other Than Named Above
SECTION 00410
8ID BOND
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of _Or_a_n_g�e _________ _
On November 5, 2025
Date
before me, Hannah Ogren, No tary Public
Here Insert Name and Title of the Officer
personally appeared _l<_are_n__L_ e tz __________________________ _ Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acl<nowledged 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. , ,� • e e • e e e, • 1 ltAHHAH OGREtl
Notary Public • California i5 Los Angeles County ►
Commission ii 2408621
. f
y Comm. Expires Jun 21, 2026,1
Place Notary Sea/ Above
I certify under PENAL TY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signatur
---------------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(les) Claimed by Signer(s)
Signer's Name: ___________ _
□ Corporate Officer - Title(s): _______ _
□ Partner - □ Limited □ General
□ Individual D Attorney in Fact
□ Trustee D Guardian or Conservator
D Other: ____________ _
Signer Is Representing: ________ _
Signer's Name: ____________ _
D Corporate Officer - Title(s): _____ _
D Partner - D Limited □ General
D Individual D Attorney in Fact
D Trustee □ Guardian or Conservator
D Other: ____________ _
Signer Is Representing: ________ _
©2014 National Notary Association• www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
GREAT AMERICAN INSURANCE COMPANY
Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 • 513-369-5000 • FAX 613-723-2740 The number of persons authorized by SIX this power of attorney is not more than No. O 20942
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: Thal the GREAT AMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each Individually If more than one Is named, Its true and lawful attorney-In-fact, for It and In Its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyshlp, or other written obligations In the nature thereof; provided that the liablllty of the said Company on any such bond, undertaking or contract of suretyshlp executed under this authority shall not exceed the limit stated below.
DAVID L. CULBERTSON
CHARLES L. FLAKE
SPENCER FLAl<E
HEATHER WILLIS
Name
LEXIE SHERWOOD
KAREN LETZ
Address
ALL OF
ANAHEIM, CALIFORNIA
Limit of Power
ALL
$100,000,000.00
It is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such Intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
This Power of Attorney revokes all previous powers issued on behalf of the attorney(s)-ln-fact named above.
IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by Its appropriate officers and Its corporate seal hereunto affixed this 29TH day of APRIL 2025 Attest GREAT AMERICAN INSURANCE COMPANY
JOHN K. WEBSTER (877-377-2405)
STATE OF OHIO, COUNTY OF HAMILTON - ss:
On this 29TH day of APRIL , 2025 , before me personally appeared JOHN K. WEBSTER, to me known, being duly sworn,-deposos a:id says that he r6sldfls In Cincinnati, Ohio, that he Is a Divisional Senior \'ice President of the Bond Division of Great American insurance Company, the Company described In and which executed the abqve instrument; that he knows the seal of the said Company; that the seal affixed to the said instrument Is such corporate seal; that it was so attfxed by authority of his office under the By-Laws of said Company, and that he signed his name thereto by like authority.
SUSAN h KOHORST
Nutary Public
State of Ohio
My Comm. Expires
May 18, 2030
This Power of Attorney Is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9, 2008.
RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisional Assistant Vice Presidents, or any one of them, be and hereby is authorized, from time to time, to appoint one or more Attorneys-in-Fact to execute on behalf of the Company, as surety. any and all bonds, undertakings and contracts of suretyship, or other written obllgations In the nature thereof; to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment at any time. . RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyshlp, or other written obi/gallon in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature of suc/J officer and the o�iginal seal of the Company. to be valid and binding upon Ille Company with the same force and effect as though manually affixed.
CERTIFICATION
I, STEPHEN c. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. igned and sealed this 5th day of November �c
2 c.�---_ 1\ss1stnnl Sccrdnry
S1190I(10/24)
The undersigned declares:
SECTION 00420
NON-COLLUSION DECLARATION
I am the --=P�.M�·�-of __ �A=D�E=I�--· 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 a_nd t�at this declar<;1\ion is executed on 11/li/25 ___ [date], flt Escondido [city], CA [state].
Name of Bidder Alliance Diversified Enterprises Inc.
S¼,oaWre a� Name Bra�rockway
Title Project Manager
Dated 11/12/25
END OF NON-COLLUSION DECLARATION
22 SECTION 00420
NON-COLLUSION DECLARATION
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
A. INFORMATION ABOUT BIDDER
**Failure to complete all information may render your bid nonresponsive - 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 2.0
3.0 Name of Bidder: Alliance Diversified Enterprises Inc.
Type, if Entity: Corporation
Bidder Address: 209 Avenida Del Mar, Ste. 201B
San Clemente, California 92672
Facsimile Number 760-539-9777 Telephone Number760-744-100S Email Address [email protected]
Website Address https://adeidrilling.com/
4.0 How many years has Bidder's organization been in business as a Contractor? 13 5.0 How many years has Bidder's organization been in business under its present name? �==----------- 13
6.0 5. 1 Under what other or former names has Bidder's organization operated?_N�/A�-----------------
If Bidder's organization is a corporation, answer the following:
6.1 Date of Incorporation: 8/31/2012
6.2 State of Incorporation: CA
6.3 President's/CEO Name: Rian Grenke
6.4 Vice President's Name(s): Chase Grenke
6.5 Secretary's Name: Evan Grenke
6.6 Treasurer's Name: Evan Grenke
7.0 If an individual or a partnership, answer the following:
23 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
7.1 7.2
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
Date of Organization: ________________ _
Name and address of all partners (state whether general or limited partnership):
Rian Grenke - 2235 Orange Ave, Escondido, CA 92029
Evan Grenke - 32225 Shirey Rd, Escondido, CA 92026
Chase Grenke - 30308 Rolling Hills Dr, Valley Center, CA 92082
8.0 If other than a corporation or partnership, describe organization and name principals:
NIA
9.0 List other states in which Bidder's organization is legally qualified to do business.
AZ, NV OR UT, ID and MT
10.0 What type of work does the Bidder normally perform with its own forces? Drilling/Shoring, Excavation, Underground, Trucking/Hauling
11.0 Has Bidder ever failed to complete any work awarded to it? If so, note when, where, and why:
No
12.0 Has the Bidder ever been in default, debarred or suspended in any way? If so, note when and why:
No
13.0 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
14.0 List Trade References (Materials Suppliers, Vendors, Union Representatives, etc.:
Crest Steel
Robertson's
Zs •stems
24 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
15.0 List Bank References (Bank and Branch Address):
Cal Private Bank - 9404 Genesee Ave# 100, La Jolla, CA 92037
16.0 Name of Bonding Company and Name and Address, email address and phone number of Agent:
Culbertson's Insurance Services - 5500 E. Santa Ana Canyon Road Ste. 201 Karen Letz - [email protected]
(714) 921-2096
25 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
B. LIST OF CURRENT PROJECTS (BACKLOG)
**Duplicate Page if needed for listing additional current projects** Project and Description of
Client Contact Bidder's Work
Person and
Phone Number
1452 K St Shoring
Casa Romantica Shoring & Excavation
100 W Resource Shoring
7595 Hillside Shoring
Bess Yard Geopiers
Murrieta Road
Wideninq Shoring
Marquita Pump Shoring & Excavation
Station
Completion Date Cost of Amounted
Bidder's Work Bonded
8/30/2025 $287,811.01 N/A
October 2025 $7,760,000.00 $7,760,000.00
TBD $750,000.00 N/A
TBD $1,000,000.00 N/A
TBD $3,000,000.00 N/A
TBD $2,700,000.00 N/A
2026 $2,200,000.00 $2,200,000.00
26 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
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.
Client Description of Bidder's
Work
Haig Tacorian Shoring and Excavation
Rove / Caltrans Shoring and Excavation
LB Civil / Caltrans Compaction Grouting
Landmark Shoring, Excavation,
Geoniers
National Core Shoring and Excavation
27 Period of Cost of Contact Name &
Performance Bidder's Work Phone
2021 6,000,000.00
2023 15,000,000.00
2024 3,000,000.00
2024 3,500,000.00
2023 3,500,000.00
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
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.
1. List each person's job title, name and percent of time to be allocated to this project:
Andrius Kelertas - Senior PM - 40%
Brandon Brockway - PM - 40%
Rian Grenke - President - 20%
2. Summarize each person's specialized education:
Andrius Kelertas - College Graduate and 1 O+ years in
engineering/construction
Brandon Brockway - 1 O+ years in various construction/project management projects
Rian Grenke - Owner of ADEi with 20+ years of drilling and geotechnical expertise.
3. List each person's years of construction experience relevant to the project:
Andrius Kelertas - 1 O+ years in Drilling/Shoring/Excavation Brandon Brockway - 1 O+ years in General Construction Management Rian Grenke - 20+ years in Drilling/Shoring/Excavation
4. Summarize such experience:
Andrius Kelertas - 1 O+ years in Drilling/Shoring/Excavation Brandon Brockway - 1 O+ years in General Construction Management Rian Grenke - 20+ years in Drilling/Shoring/Excavation
Bidder agrees that any 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 City.
28 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
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:
E. VERIFICATION AND EXECUTION
These Bid Forms shall be executed only by a duly authorized official of the Bidder:
I declare under penalty of perjury under the laws of the State of California that the foregoing information is true and correct:
Name of Bidder Al • ance Diversified Enterprises Inc.
Signature __ -r-.�--P-..,c_ _________
Name Brand
Title Project Manager
Dated 11/12/25
END OF CONTRACTOR INFORMATION AND EXPERIENCE FORM
29 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
SECTION 00440
LIST OF SUBCONTRACTORS FORM
In compliance with the Subletting and Subcontracting Fair Practices Act of the Public Contract Code of the State of California, each bidder shall set forth below: (a) the name and the location of the place of business, (b) the California contractor license number and DIR registration number, and (c) the portion of the work which will be done by each subcontractor who will perform work or labor or render service to the Contractor in or about the construction of the work in an amount in excess of one-half of one percent (1/2%) of the Contractor's Total Bid Price. Notwithstanding the foregoing, if the work involves streets and highways, then the Contractor shall list each subcontractor who will perform work or labor or render service to Contractor in or about the work in an amount in excess of one-half of one percent (1/2%) of the Contractor's Total Bid Price or $10,000, whichever is greater. No additional time shall be granted to provide the below requested information.
If no subcontractor is specified, for a portion of the work, or if more than one subcontractor is specified for the same portion of Work, then the Contractor shall be deemed to have agreed that it is fully qualified to perform that Work, and that it shall perform that portion itself. The Prime Contractor is required to complete at least 50% of the contract value with its own forces.
Work to be done
by
Subcontractor Subcontractor
3-,ck�
# 17 D q / ; V1 <;) hO\. lA s
Location of
Business
I{'{� g, rd,, <;,-,
1,..,-,u_. G { s l vtr,;e... c.A- "i ?_ ... � ,,,
30 CSLB Contractor
License No.
L•'- 1+-
0,15 3"6 t, I
DIR Registration
Number
/ Ob0e7 3 f b -z.:�
% of the
Work
'-I %
SECTION 00440
LIST OF SUBCONTRACTORS FORM
Work to be done
by
Subcontractor Subcontractor
31 SECTION 0044C
LIST OF SUBCONTRACTORS FORM
CSLB Contractor
Location of License No.
Business
'
SECTION 00440
LIST OF SUBCONTRACTORS FORM
DIR Registration % of the
Number Work
SECTION 00440
LIST OF SUBCONTRACTORS FORM
Work to be done CSLB Contractor DIR Registration % of the by Location of License No. Number Work
Subcontractor Subcontractor Business
In addition to submitting this Designation of Subcontractor form with its bid submission, each bidder shall, within 24 hours of the bid submission deadline, provide the City with a list of bid items that correspond to the portion of work listed for each designated subcontractor. Failure to provide this information within the time prescribed may be cause for the City to deem the Bid non-responsive and the City may reject the Bid.
Name of Bidder Alliance Diversified Enterprises Inc.
Signature
Name lJl c:1.11ur11
• }�
.u..,,.rv'-n. n-a,r _:.,
Title Pro.i
ect Manager
Dated 11/12/25
END OF LIST OF SUBCONTRACTORS FORM
32 SECTION 00440
LIST OF SUBCONTRACTORS FORM
SECTION 00450
IRAN CONTRACTING ACT CERTIFICATION
MUST BE SUBMITTED WITH BID PROPOSAL IF BID AMOUNT IS $1,000,000 OR MORE (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:
oo The Contractor is not:
(i) identified on the current list of persons and entities engaging 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
(ii) a financial institution 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 of persons and entities engaging in investment activities in Iran prepared by the 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. o 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. Documentation demonstrating the City's exemption approval is attached.
Titled:
Signed:
Project �Manager
Firm: ADEi
Date: 11/12/25
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.
END OF IRAN CONTRACTING ACT CERTIFICATION
33 SECTION 00450
I RAN CONTRACTING ACT CERTIFICATION
SECTION 00460
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/PublicWorks/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 work.
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: Alliance Diversified Enterprises Inc.
1000010481 DIR Registration Number: ___________ _
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 1771.1 in its contract with subcontractors and ensure that all subcontractors are registered 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 Bid
•
ce Diversified Enter rises Inc.
Title Project Manager
Dated 11/12/25
END OF PUBLIC WORKS CONTRACTOR REGISTRATION CERTIFICATION OFFICIAL 810 SE�URITY - DO NOT OPEN
Project :-iame: CALLE FRONTERA LIFT STATION
SOIL STABILIZATION PROJECT
Bid Oper,n,c Date: 11/12/2025