14 SECTION 00400
BID FORM
SECTION 00400
BID FORM
NAME OF BIDDER:
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:
REEVES BOOSTER PUMP STATION
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
Item
No.
Bid Item Description * Est.
Qty
Unit of
Measure Unit Price Total Item Cost
1 Mobilization/Demobilization 1 LS
2 Clear and Grub 1 LS
3 Excavation and Grading 1 LS
4 Construct Pump Station Below
Grade Structural Items 1 LS
5 Construct Pump Station Above
Grade Structural Items 1 LS
6 Construct Pump Station 16-Inch
Suction Piping 1 LS
7 Construct Pump Station 16-Inch
No-Pump Bypass Piping 1 LS
8 Construct Pump Station 16-Inch
Discharge Piping 1 LS
9 Construct Pump Station 10-Inch
Discharge Piping 1 LS
10 Construct Pump Station Vertical
Turbine Pump and Motor
Assemblies
2 EA
11 Construct Pump Station 12-Inch
Discharge Piping 2 EA
12 Construct Pump Station 6-Inch
Surge Piping and Sump Pump
System
1 LS
Elegant Construction Inc
$110,000.00
$20,000.00
$200,000.00
$300,000.00
$400,000.00
$110,000.00
$20,000.00
$200,000.00
$300,000.00
$400,000.00
$400,000.00
$250,000.00
$250,000.00
$150,000.00
$350,000.00
$180,000.00
$100,000.00
$400,000.00
$250,000.00
$250,000.00
$150,000.00
$175,000.00
$ 90,000.00
$100,000.00
Attachment 6
SECTION 00400
BID FORM
15 SECTION 00400
BID FORM
Bid
Item
No.
Bid Item Description * Est.
Qty
Unit of
Measure Unit Price Total Item Cost
13 Construct Pump Station Suction
Meter Vault 1 LS
14 Construct SDG&E Electrical
Service 1 LS
15 Construct Switchboard/Meter
Section 1 LS
16 Construct Motor Control Center 1 LS
17 Construct Pump Station Electrical
Items 1 LS
18 Testing and Commissioning 1 LS
19 Demolish/Abandon Existing
Turnout Facilities 1 LS
20 Construct Civil Restorations 1 LS
21 Field Order Allowance 1 LS $70,000 $70,000
22 Overexcavation Allowance 1 LS $30,000 $30,000
23 Construct Water Quality Analyzer 1 LS
* See Spec Section 01030 Measurement and Payment for description of above bid items.
Each individual bidder shall review the Plans and Specifications, and all other portions of the Contract Documents, and shall include all items necessary to complete the Work, including the assumption of all obligations, duties, and responsibilities necessary to the successful completion of the Contract, and the furnishing of all materials and equipment required to be incorporated in and form a permanent part of the Work: tools, equipment, supplies, transportation, facilities, labor, superintendence, and services required to perform and complete the Work; and bonds, insurance and submittals; all as per the requirements of the Contract Documents, whether or not explicitly listed or designated.
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. $ 45,000.00 $ 45,000.00
$50,000.00
$75,000.00
$38,000.00
$50,000.00
$75,000.00
$38,000.00
$30,000.00
$80,000.00
$500,000.00
$400,000.00
$65,000.00
$30,000.00
$80,000.00
$500,000.00
$400,000.00
$65,000.00
SECTION 00400
BID FORM
16 SECTION 00400
BID FORM
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.
If the Contract Documents specify alternate bid items, the following Alternate Bid amounts shall be added to or deducted from the Total Bid Price (please check the appropriate box), at the City’s sole option. The City can choose to include one or more of the Alternate Bids in the Work. If any of the Alternate Bids are selected by the City, the resulting amount shall be added to or deducted from Total Bid Price for the Work. City may select one or more of the Alternate Bids at the below stated Bid Price up to sixty (60) days following award of the Contract. City can award/select Alternate Bid items at any time(s).
Alternate
Bid Item
No.
Bid Item Description * Est.
Qty
Unit of
Measure Unit Price Total Item Cost
A1
□ Add
□ Deduct
Additional 16-Inch Gate Valves 3 EA
A2
□ Add
□ Deduct
A3
□ Add
□ Deduct
* See Spec Section 01030 Measurement and Payment for description of above bid items.
TOTAL BID PRICE (BASED ON BASE BID SCHEDULE):
$ ________________________________________
Total Base Bid Price in Numbers
__________________________________________________________________________ Total Base Bid Price in Written 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 $28,000.00 $84,000.00
$4,093,000.00
Four million, ninety-three thousand dollars
SECTION 00400
BID FORM
17 SECTION 00400
BID FORM
(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. _________, Expiration Date _______, class of license _____. 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. _______________________
Addenda No. _______________________
Addenda No. _______________________
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.
Name of Bidder
1053447 05-31-27
A, B, C8, C12, C13,
C15, C36, C54
Elegant Construction Inc
None
SECTION 00400
BID FORM
18 SECTION 00400
BID FORM
Signature
Name
Title
Dated
END OF BID FORM
Vice President
Hazem Almassry
02-25-2026
19 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)
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____________________________________________________ Policy Number______________________________________________
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 its officials, employees, and agents from and 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 PENALTIES 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.
Wesco Insurance Company
WEP3775439
55452.01510\32905704.2
20 Dated: _______________________
________________________________
Consultant
By: ________________________________
________________________________
Title
________________________________
Address
________________________________
Vice President
15375 Barranca Parkway suite J-103
Irvine CA92618
02-25-26
23 SECTION 00420
NON-COLLUSION DECLARATION
SECTION 00420
NON-COLLUSION DECLARATION
The undersigned declares:
I am the ______________ of _________________, 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 ____________________[date], at ___________________[city], ___________________[state].
Name of Bidder
Signature
Name
Title
Dated
END OF NON-COLLUSION DECLARATION
Vice President Elegant Construction Inc
02-25-2026
Irvine California
Elegant Construction Inc
Hazem Almassry
Vice President
02-25-2026
24 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
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 Name of Bidder: ___________________________________________
2.0 Type, if Entity: ___________________________________________
3.0 Bidder Address: ___________________________________________ _____________________________________________________________ _____________________________________________________________ ____________________________________________________________ Facsimile Number Telephone Number
Email Address_______________________________________
Website Address
4.0 How many years has Bidder’s organization been in business as a Contractor? _______
5.0 How many years has Bidder’s organization been in business under its present name? ________________________
5.1 Under what other or former names has Bidder’s organization operated?_______________________________________________
6.0 If Bidder’s organization is a corporation, answer the following:
6.1 Date of Incorporation: ________________________________
6.2 State of Incorporation: ________________________________
6.3 President’s/CEO Name: ________________________________
6.4 Vice President’s Name(s): ________________________________
6.5 Secretary’s Name: ________________________________
6.6 Treasurer’s Name: ________________________________
7.0 If an individual or a partnership, answer the following:
Elegant Construction Inc
S Corporation
15375 Barranca Parkway suite J-103
Irvine CA92618
949 444-5161
[email protected]
www.ElegantCon.com
6 6
N/A
California
Jan-07-2019
Sam Alhakim
Hazem Almassry
Hazem Almassry
Hazem Almassry
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
25 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
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:
___________________________________________________________ ___________________________________________________________
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:
___________________________________________________________ ___________________________________________________________ __________________________________________________________
12.0 Has the Bidder ever been in default, debarred or suspended in any way? If so, note when and why:
___________________________________________________________ ___________________________________________________________ __________________________________________________________
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:
___________________________________________________________ ___________________________________________________________ __________________________________________________________
14.0 List Trade References (Materials Suppliers, Vendors, Union Representatives, etc.:
___________________________________________________________ ___________________________________________________________ __________________________________________________________ ___________________________________________________________ ___________________________________________________________ __________________________________________________________ N/A
N/A
GENERAL BUILDING, CONCRETE, GENERAL ENGINEERING, PLUMBING, FENCING
TILE (CERAMIC AND MOSAIC), EARTHWORK AND PAVING, FLOORING No
No
No
Homedebot
LW Supply
Ganahl Lumber
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
26 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
15.0 List Bank References (Bank and Branch Address):
___________________________________________________________ ___________________________________________________________ __________________________________________________________
16.0 Name of Bonding Company and Name and Address, email address and phone number of Agent:
___________________________________________________________ ___________________________________________________________ __________________________________________________________ Chase Bank
Irvine, California
Performance Bonding Surety & Insurance Brokerage
15901 Red Hill Avenue, Suite 100 Tustin, CA 92780
Jennifer Anaya
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
27 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
B. LIST OF CURRENT PROJECTS (BACKLOG)
**Duplicate Page if needed for listing additional current projects** Project and
Client Contact
Person and
Phone Number
Description of
Bidder’s Work
Completion Date Cost of
Bidder’s Work
Amounted
Bonded
KETCHUM-LIBOLT PARK
IMPROVEMENT PARK IMPROVEMENT April/2026 $2,640,337.00
Colton Middle School Interim
Housing
Marlene Lozano 909-580-5000
Anna Baca 714-754-4983
Classroom Addition Feb 2026 $256,500.00
$597,000.00
$2,105,000.00
$1,268,375.00
$2,227,000.00
$4,250,000.00
$433,975.25
$3,097,000.00
$363,000.00
$3,235,525.00
$1,307,800.00
May -26
April/2026
April/2026
March 26
Feb - 2026
Sep 2026
April 2026
Dec 2026
May 2026
Feb 2026
HVAC AT RIVERA PARK
AND PICO PARK GYMNASIUMS
CIP PROJECT NO. 50069
COSTA MESA SKATE PARK
EXPANSION
900 ARLINGTON DR 25-01
Fullerton College Building
1246 AHU Replacement
Crystal Nguyen 714-808-4775
Goutam Dobey 909-435-7431
Building Renovation
& Expansion
Skate park expansion
Replace Building 1246
office suites
Turf Renovation Field
Joint Utilities Laboratory
Project Invitation # 521028
Marilyn Buescher 714-573-3334
Tustin Sports Park
Turf Renovation Field #3
Amy Drummond 909.748.6716 Pool Replacement
Redlands East Valley High School
Pool Replacement
OCC Breezeway Renovations
Buildings 12-14 2207
Brett McNevin [email protected]
OCC Renovations Buildings
PARK IMPROVEMENT Trai Nguyen (951) 955-6780
Mecca Neighborhood Park
Edgar Vallejo 949-724-6937
Public Safety Locker
Room Expansion
The renovation, expansion and
equipping of locker room
Monument Sign installation
Euclid Ave. Monument
Sign Project
Philip Marino 909-395-2610
2 Gyms Remodeling
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
28 SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
C. LIST OF COMPLETED PROJECTS LAST FIVE 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. The Bidder must specify a minimum of five (5) similar completed projects within the past five (5) years. Failure to meet or exceed this requirement may cause the bid to be rejected as nonresponsive.
Client Description of
Bidder’s Work
Period of
Performance
Cost of
Bidder’s Work
Contact Name
& Phone
City of Irvine
Northwood Aquatics Center Deck
Replacement (CIP 362004)
$2,380,000 Bobby Ghaemi
714-345-5002
City of Lake Forest
Neighborhood Park Renovations
Start: May 2023
Completed: May 2023 $936,893.50
Naz Mokarram
949-282-5233
El Toro High School – Restrooms
Shower Alterations
Saddleback Valley Unified
School District $849,000 Max Van de Mortel
949-580-3250
Renovation including demolition, mechanical
systems, plumbing tie-ins, and electrical upgrades. Start: Mar 2023 Completed: Oct 2023
Start: Jun 2023
Completed: Dec 2023
Pool and deck improvements with plumbing
fixtures, shower fixtures, underground
electrical conduit, power and data conduits.
Construction power, wiring, potable water facilities,
and fire protection system utilities
North Orange County Community
College District
$148,000 July 2024
Completed: Sep 2024
General construction including remodeling of
classroom space,interior improvements, and
building system adjustments.
Corazon C. Baldovino
714.808.4894
Police Department Communication
Center Renovation Project CC-1677
Room 907 Tenant Improvement at
Anaheim CampusInvitation
City of Huntington Beach Patrick Pannon $1,680,000.00 714-536-5430 Demolition of existing walls and ceiling tiles, replacement of flooring, walls, ceilings, and finishes,upgrades to electrical, data, and HVAC systems installation of furniture, and integration of audio/visual equipment such as wall-mounted monitors and video processor hardware.
September 2023
Completed: April 2025
City of Tustin
Centennial park
Park renovation July 2024 to May 2025 $5,068,238.55 Churchill, Jason : 714-573-3355
City of Irvine
Public Safety Locker Room
Expansion
$2,105,000.00 Edgar Vallejo
949-724-6937
Sep-2025
April 2026
City of Newport Beach
Police Department Parking
Lot Maintenance
$585,000.00 Ellis Petersen
949-644-3014 December 2024
Locker Room Expansion
Parking Lot Maintenance
SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
29 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:
2. Summarize each person’s specialized education:
3. List each person’s years of construction experience relevant to the project:
4. Summarize such experience:
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.
Samer Al Hakim / CEO
Majed Alnabhan Project Manager
Project Manager Full time
Superintedent Full time
Aya Sahloul Project Engineer full time
Sam Alhakim bachelor degree in Civil Engineering
bachelor degree in Civil Engineering
Majed Alnabhan High school
Aya Sahloul
Sam Alhakim
Majed Alnabhan
Aya Sahloul
15 Years
5 Years
20 Years
Supervising and perform general Carpentry works including Framing, forming of concrete forms , calculating Material quantity, also he was performing Siding works and other finishing activity SECTION 00430
CONTRACTOR INFORMATION AND EXPERIENCE FORM
30 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
Signature
Name
Title
Dated
END OF CONTRACTOR INFORMATION AND EXPERIENCE FORM
Elegant Construction Inc
Hazem Almassry
Vice President
02-25-26
55452.01510\32905704.2
31 SECTION 00440
LIST OF SUBCONTRACTORS 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 Location of
Business
CSLB Contractor
License No.
DIR Registration
Number
% of the
Work
Roll up door Overhead Door Company 12401 S La Cadena Dr Colton, CA 92324 492369 1000017098
HALCYON ELECTRIC
INCORPORATED
1055-A ORTEGA WAY
PLACENTIA, CA 92870 717223 1000001849
HATHAWAY ENGINEERING
8392 GRAND AVE
YUCCA VALLEY
CA 92284
Pump Installation 1052643 2000014023
Electrical Works 29.5%
0.5%
2%
SECTION 00440
LIST OF SUBCONTRACTORS FORM
32 SECTION 00440
LIST OF SUBCONTRACTORS FORM
Work to be
done by
Subcontractor
Subcontractor Location of
Business
CSLB Contractor
License No.
DIR Registration
Number
% of the
Work
N/A
SECTION 00440
LIST OF SUBCONTRACTORS FORM
33 SECTION 00440
LIST OF SUBCONTRACTORS FORM
Work to be
done by
Subcontractor
Subcontractor Location of
Business
CSLB Contractor
License No.
DIR Registration
Number
% of the
Work
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
Signature
Name
Title
Dated
END OF LIST OF SUBCONTRACTORS FORM
Elegant Construction Inc
Hazem Almassry
Vice President
02-25-26
N/A
34 SECTION 00450
IRAN CONTRACTING ACT CERTIFICATION
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:
□ 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. □ 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.
Signed:
Titled:
Firm:
Date:
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
Vice President
Elegant Construction Inc
02-25-26
35 SECTION 00460
PUBLIC WORKS CONTRACTOR REGISTRATION
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:
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 Bidder
Signature
Name
Title
Dated
END OF PUBLIC WORKS CONTRACTOR REGISTRATION CERTIFICATION Elegant Construction Inc
1000406720
Elegant Construction Inc
Hazem Almassry
Vice President
02-25-26