Street Rehabilitation Project, CIP No.22/23-9271
CITY OF SAN MARINO CONTRACTOR AGREEMENT
CIP NO. Street Rehabilitation Project, CIP No.22/23-9271 This City of San Marino Contractor Agreement (“Agreement”) is made and entered into for the above referenced Project by and between the City of San Marino (“Agency”), and Onyx Paving Company, Inc. (“Contractor”) on the 26th day of July 2024.
In consideration of the mutual covenants and agreements set forth herein, Agency and Contractor have mutually agreed as follows:
CONSTRUCTION
The Contractor agrees to do all the Work in connection with the [Street Rehabilitation Project, CIP No.22/23-9271, to be constructed at various locations in the City of San Marino, California, including to furnish any and all labor, services, materials and equipment to construct and complete the Project, and appurtenant work in connection therewith, said work to be done and materials to be furnished in strict conformity with the Contract Documents, including but not limited to this Agreement, approved Change Orders, Notice Inviting Bids, Instructions to Bidders, Bidder’s Proposal and Information Required for Bid Submittal, Bid Schedules, Addenda and/or Bulletins, plans, Special Provisions (Specifications), General Conditions, General Provisions, Greenbook 2021 as amended and supplemented, technical references, all other referenced documents, all codes, permit conditions and regulations, for the total amount(s) and any unit prices and additive/deductive items, including all work, labor, services, materials and equipment described and reasonably inferable from documents enumerated in Exhibit “A” attached hereto and incorporated herein by reference (such construction and furnishing of labor, service, materials and equipment hereinafter referred to as the “Work”) in a good workmanlike manner according to any and all applicable best practices to the satisfaction of the Agency. The term Contract Documents shall mean this Agreement, and all of the items enumerated in Exhibit “A” and all change orders or addenda issued by the Agency with respect thereto. Agency must consent in writing to any changes in the scope of Work. Exhibit “A” shall be deemed revised in accordance with any revisions for which Agency’s consent has been issued. Any revisions to the scope of Work for which Agency’s written consent has not provided shall be null and void and done at the risk and sole expense of the Contractor.
CONTRACT PRICE
Agency hereby agrees to pay and the Contractor agrees to accept as full compensation for all Work performed in accordance with these Contract Documents the Contract Price as set forth in Exhibit “B”, Contract Price, attached hereto and incorporated herein by reference. Payments to the Contractor shall be made in the manner described in the Special Provisions.
TIME FOR PERFORMANCE
Time is of the essence in Contractor’s performance of the Work for this Agreement. Contractor agrees to diligently pursue the performance and completion of the Work in every detail to the satisfaction of the Agency, exclusive of maintenance periods, within the specified duration set forth in the Notice to Proceed.
All timing requirements shall be strictly adhered to unless otherwise modified by the Agency in accordance with the Bid and Contract Documents.
C-1
Street Rehabilitation Project, CIP No.22/23-9271
Rev. 0
August 2023
C-2
Project No. 22/23-9271
Prior to execution of the Agreement, the State of California declared a state of emergency and issued a stay at home order in connection with the COVID-19 pandemic, and the County of Los Angeles (“County”) issued numerous orders relating to COVID-19, including without limitation an Order to Shelter in Place, originally dated March 17, 2020 (as subsequently extended and amended, including after the date of the Agreement, the “County Order”). In no event shall Contractor be entitled to any additional compensation in connection with any delay or costs associated with the COVID 19 pandemic, the County Order, or any other governmental requirements or regulations in connection therewith, whether currently existing or hereinafter enacted. In the event of any conflict between the terms of this Section and any other provision of the Agreement, in all events, the terms of this Section shall control.
DELAYS AND EXTENSIONS OF TIME
Delays and extensions of time will be handled by Agency and Contractor pursuant to the provisions of Section 6-4 of the Special Provisions. However, Contractor must comply with the written notice requirement, as well as timely report back-up information, in strict compliance with the requirements of the provisions of Section 6-4 of the Special Provisions; Contractor’s failure to submit these items within the times specified will constitute a waiver of the extension of time and payment for delay and will be ground for refusal by the Agency to consider such request.
LABOR CODE REQUIREMENTS
Pursuant to Labor Code Section 1771.1, the Contractor and all subcontractors shall be registered with the Department of Industrial Relations. Pursuant to Labor Code Section 1771.4, the Contractor is hereby notified that this Project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor, and any subcontractor engaged by Contractor, must pay not less than the specified prevailing rate of per diem wages to all workers employed in the execution of the contract. (Labor Code § 1774.) Contractor is responsible for compliance with Labor Code section 1776 relative to the retention and inspection of payroll records.
Contractor must comply with all provisions of Labor Code section 1775. Under Section 1775, Contractor may forfeit as a penalty to City up to $50.00 for each worker employed in the execution of the Contract by Contractor or any subcontractor for each calendar day, or portion thereof, in which the worker is paid less than the prevailing rates. Contractor may also be liable to pay the difference between the prevailing wage rates and the amount paid to each worker for each calendar day, or portion thereof, for which each worker was paid less than the prevailing wage rate.
Contractor acknowledges and agrees to abide by the provisions of California Labor Code §§ 1720, et seq., as well as 1771, 1773, 1773.1, 1773.2, 1773.6, 1773.7, 1774, 1775 1776 and 1777, pertaining to the obligation to pay prevailing wages with respect to the performance of work (“Prevailing Wage Laws”).
Contractor shall defend, indemnify, and hold the City, its elected officials, officers, employees, and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws.
Contractor acknowledges that under California Labor Code sections 1810 et seq., eight hours of labor constitutes a legal day’s work. Contractor will forfeit as a penalty to City the sum of $25.00 for each worker employed in the execution of this Contract by Contractor or any subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in any one calendar Rev. 0
August 2023
C-3
Project No. 22/23-9271
day and 40 hours in any one calendar week in violation of the provisions of Labor Code section 1810. (Labor Code § 1813.)
NON-DISCRIMINATION
Contractor, its officers, agents, employees, and subcontractors may not discriminate in the employment of persons to perform the Work because of the race, religion, creed, color, national origin, ancestry, physical handicap, medical condition, marital status, sex or age of such person, except as may be permitted by California Government Code section 12940. Contractor is responsible for compliance with this section.
AUTHORIZED AGENCY REPRESENTATIVES
On behalf of the Agency, the City Engineer of the City of San Marino shall be the Agency’s authorized representative in the interpretation and enforcement of all Work performed in connection with this Agreement. The City Engineer may delegate authority in connection with this Agreement to his/her assigned designees.
INDEMNIFICATION
Contractor agrees to indemnify, defend and hold harmless City, its elected officials, officers, employees and agents from and against, any and all liabilities, claims, actions, causes of action, proceedings, suits, damages, judgments, liens, levies, costs and expenses of whatever nature, including reasonable attorneys’ fees and disbursements (collectively, “Claims”), which City may suffer or incur or to which City may become subject by reason of or arising out of any injury to or death of any person(s), damage to property, loss of use of property, economic loss or otherwise occurring as a result of any negligent or willfully wrongful acts or omissions of Contractor, its officers, employees, agents, or subcontractors committed in performing any Work under this Contract, excluding Claims occurring as a result of the City’s sole negligence or willful acts or omissions.
If any action or proceeding is brought against City by reason of any of the matters against which Contractor has agreed to indemnify City as provided above, City need not have first paid for any of the matters to which City is entitled to indemnification in order to be so indemnified. In the event of any Claim made against City, City may, in its sole discretion, reserve, retain or apply any funds due to Contractor under this Contract for the purpose of resolving such Claim. The provisions of this section will survive the expiration or earlier termination of this Agreement.
CLAYTON AND CARTWRIGHT ACT ASSIGNMENTS. In entering into this Contract or a contract with a subcontractor to supply goods, services, or materials pursuant to this Contract for the Project, Contractor and any or subcontractor is deemed to have offered and agreed to assign to City all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C.
Sec. 15) or under the Cartwright Act (Chapter 2, commencing with Section 16700 of Part 2 of Division 7 of the California Business and Professions Code), arising from purchases of goods, services, or materials for the Project. This assignment will be deemed made and will become effective at the time City tenders final payment to Contractor, without further acknowledgement by the Parties.
INSURANCE
Rev. 0
August 2023
C-4
Project No. 22/23-9271
Contractor agrees to have and maintain in full force and effect during the term of this Agreement the insurance coverages listed in Exhibit “C” (“Insurance”), which is made a part of this Agreement.
Further, by signing below Contractor certifies that he/she/it is aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for Workers’ Compensation or to undertake self-insurance in accordance with the provisions of that Code, and agrees to comply with such provisions before commencing the performance of the Work of this Agreement. Additionally, Contractor shall require each subcontractor to comply with the requirements of Section 3700 of the Labor Code, including requiring each subcontractor to execute the following certification:
“I am aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for worker’s compensation or to undertake self-insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the Work of this Agreement.”
ENTIRE AGREEMENT; CONFLICT
The Contract Documents comprise the entire agreement between the Agency and the Contractor with respect to the Work. In the event of conflict between the terms of this Agreement and the bid of the Contractor, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid conflicting herewith.
PROJECT DOCUMENTATION
All data, drawings, maps, models, notes, books, documents, papers, daily reports, schedules, time and materials tickets, employee time sheets, accounting records and other evidence pertaining to costs incurred, photographs, reports, studies and other documents (collectively, “Project Documents”) prepared, developed or discovered by Contractor in the course of performing any of the Work under this Contract will become the sole property of City. Upon the expiration or termination of this Contract, Contractor must turn over all original Project Documents to City in its possession, but may retain copies of any of the Project Documents it may desire.
Contractor shall maintain the Project Documents and shall make such materials available at its office at all reasonable times during the term of this Agreement and for three (3) years from the date of final payment under this Agreement any documents not turned over to Agency for inspection by Agency.
FALSE CLAIMS
Contractor acknowledges that if a false claim is submitted to the Agency, it may be considered fraud and Contractor may be subject to criminal prosecution. Contractor acknowledges that the False Claims Act, California Government Code sections 12650, et seq., provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include within their scope false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. In the event the Agency seeks to recover penalties pursuant to the False Claims Act, it is entitled to recover its litigation costs, including attorneys’ fees. Contractor hereby acknowledges that the filing of a false claim may the Contractor to an administrative debarment proceeding wherein Contractor may be prevented from further bidding on public contracts for a period of up to five (5) years.
Rev. 0
August 2023
C-5
Project No. 22/23-9271
I have read and understood all of the provisions of this Section 13, above:
(Initial) (Initial)
INDEPENDENT CONTRACTOR
Contractor is and will at all times remain as to City a wholly independent contractor and shall not be an employee, agent, partner or joint venturer of the Agency. Agency shall have the right to control Contractor insofar as the results of Contractor’s services rendered pursuant to this Agreement; however, Agency shall not have the right to control the means by which Contractor accomplishes such services.
Neither the City nor any of its officers, employees, or agents will have control over the conduct of Contractor or any of Contractor’s officers, employees, agents or subcontractors, except as expressly set forth in the Contract Documents. Contractor may not at any time or in any manner represent that it or any of its officers, employees, agents, or subcontractors are in any manner officers, employees, agents or subcontractors of City.
LICENSES AND PERMITS
Contractor must, at Contractor’s sole expense, obtain all necessary permits and licenses required for the Work, and give all necessary notices and pay all fees and taxes required by law, including, without limitation, any business license tax imposed by City. Contractor represents and declares to Agency that it has all licenses, permits, qualifications and approvals of whatever nature which are legally required to practice its profession. In performing the Work, Contractor must comply with all applicable statutes, laws and regulations, including, but not limited to, OSHA requirements and the City of San Marino Municipal Code.
GENERAL PROVISIONS
Authority to Execute. Each Party represents and warrants that all necessary action has been taken by such Party to authorize the undersigned to execute this Contract and to bind it to the performance of its obligations.
Assignment. Contractor may not assign this Contract without the prior written consent of City, which consent may be withheld in the City’s sole discretion since the experience and qualifications of Contractor were material considerations for this Contract.
Binding Effect. This Agreement is binding upon the heirs, executors, administrators, successors and permitted assigns of the Parties.
Integrated Contract. This Contract, including the Contract Documents, is the entire, complete, final and exclusive expression of the Parties with respect to the Work to be performed under this Contract and supersedes all other agreements or understandings, whether oral or written, between Contractor and City prior to the execution of this Contract.
Modification of Contract. No amendment to or modification of this Contract will be valid unless made in writing and approved by Contractor and by the City Council or City Manager, as applicable. The Parties agree that this requirement for written modifications cannot be waived and that any attempted waiver will be void.
Rev. 0
August 2023
C-6
Project No. 22/23-9271
Counterparts and Facsimile Signatures. This Contract may be executed in several counterparts, each of which will be deemed an original, and all of which, when taken together, constitute one and the same instrument. Amendments to this Contract will be considered executed when the signature of a party is delivered by facsimile transmission. Such facsimile signature will have the same effect as an original signature.
Waiver. Waiver by any Party of any term, condition, or covenant of this Contract will not constitute a waiver of any other term, condition, or covenant. Waiver by any Party of any breach of the provisions of this Contract will not constitute a waiver of any other provision, or a waiver of any subsequent breach or violation of any provision of this Contract. Acceptance by City of any Work performed by Contractor will not constitute a waiver of any of the provisions of this Contract.
Interpretation. This Contract will be interpreted, construed and governed according to the laws of the State of California. Each party has had the opportunity to review this Contract with legal counsel.
The Contract will be construed simply, as a whole, and in accordance with its fair meaning. It will not be interpreted strictly for or against either party.
Severability. If any term, condition or covenant of this Contract is declared or determined by any court of competent jurisdiction to be invalid, void or unenforceable, the remaining provisions of this Contract will not be affected and the Contract will be read and construed without the invalid, void or unenforceable provision.
Venue. In the event of litigation between the Parties, venue in state trial courts will be in the County of Los Angeles. In the event of litigation in a U.S. District Court, venue will be in the Central District of California, in Los Angeles.
IN WITNESS WHEREOF this Agreement is executed as of the date first written above.
AGENCY:
City of San Marino
By:
Phillippe Eskandar, City Manager
CONTRACTOR:
By:
Name:
Its:
By:
Name:
Its:
ATTEST:
By:
Alison Walker, City Clerk Contractor’s City Business License No.
APPROVED AS TO FORM: State Contractor License No. & Class Onyx Paving Company, Inc.
Rev. 0
August 2023
C-7
Project No. 22/23-9271
By:
Joseph Montes, City Attorney
DIR Registration No. & Exp
Street Address
City, State, Zip Code
[NOTE: In the event the Contractor is a Corporation, the signatures of two separate persons holding different offices must be provided.]
Rev. 0
August 2023
C-8
Project No. 22/23-9271
EXHIBIT A
CONTRACT DOCUMENTS
City of San Marino Contractor Agreement
Change Orders issued by Agency, signed by Contractor and (if necessary) approved by City Council Notice Inviting Bids, Instructions to Bidders, and Bidder’s Proposal and Information Required for Bid Submittal
Bid Schedule(s)
Addenda and/or Bulletins
Plans
Special Provisions (Specifications)
General Conditions
General Provisions Standard Specifications for Public Works Construction (“Greenbook”) 2021 edition as amended and supplemented
State Standard Specifications
State Standard Plans
Permits issued by jurisdictional regulatory agencies
Electric, gas, telephone, and cable television company specifications and standards Notice of Award
Notice to Proceed
Certificate(s) of Required Insurance and Worker’s Compensation Insurance Security for Payment (Labor & Materials) and Performance Escrow Agreement for Security Deposits in Lieu of Retention If there is a conflict between any of the Contract Documents, the documents highest in precedence shall control. The order of precedence of the Contract Documents shall be as provided in Section 3-7.2 of the Special Provisions. Detail drawings shall take precedence over general drawings.
Rev. 0
August 2023
C-9
Project No. 22/23-9271
EXHIBIT B
CONTRACT PRICE
The Contract Price for performing all Work described in the Contract Documents, including labor, materials, services and equipment is the total amount of all lump sum items and of all unit price sums, determined by multiplying the unit price for each item times the actual quantity of each such item, as determined by the Agency.
Rev. 0
August 2023
C-10
Project No. 22/23-9271
EXHIBIT C
INSURANCE
1. General Requirements. Contractor must procure and maintain in full force and effect during the term of this Contract the following types of insurance with coverage limits complying, at a minimum, with the limits set forth below:
Type of Insurance Limits (combined single)
Commercial General Liability $5,000,000
Business Automobile Liability $5,000,000
Workers’ Compensation $1,000,000
Builder’s Risk Completed value of the project
Surety Bonds As described below
Professional Liability $1,000,000
Contractors’ Pollution Legal Liability $1,000,000
If the contractor maintains higher limits than the minimums shown above, the City requires and shall be entitled to coverage for the higher limits maintained by the contractor. Any available insurance proceeds in excess of the specific minimum limits of insurance and coverage shall be available to the City.
2. Commercial General Liability Insurance. Insurance Services Office Form CG 00 01 covering CGL on an “occurrence” basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $5,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit.
3. Business Auto Coverage. Insurance Services Office Form Number CA 0001 covering Code 1 (any auto), with limits no less than $5,000,000 per accident for bodily injury and property damage. If Contractor or Contractor’s employees will use personal autos in any way on this Project, Contractor must provide evidence of personal auto liability coverage for each such person.
4. Workers Compensation. Insurance as required by the State of California, with Statutory Limits, and Employers’ Liability insurance with a limit of no less than $1,000,000 per accident for bodily injury or disease.
5. Builder’s Risk (Course of Construction). Insurance utilizing an “All Risk” (Special Perils) coverage form, with limits equal to the completed value of the project and no coinsurance penalty provisions. Contractor may submit evidence of Builder’s Risk insurance in the form of Course of Construction coverage. Such coverage shall name the City as a loss payee as their interest may appear.
Rev. 0
August 2023
C-11
Project No. 22/23-9271
6. Surety Bonds. Contractor shall provide the following Surety Bonds: (1) Bid bond, (2) performance bond, (3) payment bond, and (4) maintenance bond. The Payment Bond and the Performance Bond shall be in a sum equal to the contract price. If the Performance Bond provides for a oneyear warranty a separate Maintenance Bond is not necessary. If the warranty period specified in the contract is for longer than one year a Maintenance Bond equal to 10% of the contract price is required. Bonds shall be duly executed by a responsible corporate surety, authorized to issue such bonds in the State of California and secured through an authorized agent with an office in California.
7. Professional Liability. If design/build, with limits no less than $1,000,000 per occurrence or claim, and $2,000,000 policy aggregate.
8. Contractors’ Pollution Legal Liability and/or Asbestos Legal Liability and/or Errors and Omissions (if project involves environmental hazards) with limits no less than $1,000,000 per occurrence or claim, and $2,000,000 policy aggregate.
9. Other Insurance. Contractor may be required to obtain such other insurance coverage as may be required by applicable law or by the City.
10. Excess or Umbrella Liability Insurance (Over Primary). If an excess or umbrella liability policy is used to meet limit requirements, the insurance must provide coverage at least as broad as specified for the underlying coverages. Any such coverage provided under an excess or umbrella liability policy must include a “drop down provision” providing primary coverage above a maximum $25,000 self-insured retention for liability not covered by primary but covered by the umbrella. Coverage must be provided on a “pay on behalf” basis, with defense costs payable in addition to policy limits. There must be no cross-liability exclusion precluding coverage for claims or suits by one insured against another. Coverage must be applicable to City for injury to employees of Contractor, its subcontractors or others performing work to satisfy Contractor’s obligations under this Contract. The scope of coverage provided is subject to approval of City following receipt of proof of insurance as required herein. Limits are subject to review, but in no event may be less than $2,000,000 per occurrence and aggregate.
11. Certificates of Insurance and Endorsements. Prior to commencing any Work under this Contract, Contractor must file with the Director Certificates of Insurance and Endorsements evidencing the existence of all insurance required by this Contract, along with such other evidence of insurance or copies of policies as may reasonably be required by City. Such Certificates of Insurance and Endorsements must be in a form approved by the City Attorney of City. Contractor must maintain current certificates and endorsements on file with City during the term of this Contract reflecting the existence of all required insurance. Each of the certificates must expressly provide that no material change in the policy, or termination thereof, will be effective except upon 30 days prior written notice to City. The City reserves the right to require complete, certified copies of the insurance certificates and endorsements.
12. Accessibility of Insurers. Insurance is to be placed with insurances with a current A.M. Best rating of no less than A: VII, unless otherwise acceptable to the City.
13. Waiver of Subrogation. Contractor hereby agrees to waive rights of subrogation which any insurer of Contractor may acquire from Contractor by virtue of the payment of any loss.
Contractor agrees to obtain any endorsement that may be necessary to affect this waiver of Rev. 0
August 2023
C-12
Project No. 22/23-9271
subrogation. The Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of the Entity for all work performed by the Contractor, its employees, agents and subcontractors.
14. Failure to Maintain Required Insurance. If Contractor, for any reason, fails to have in place at all times during the term of this Contract all of the required insurance coverage, the Director may obtain such coverage at Contractor’s expense and deduct the cost from the sums due Contractor.
15. Subcontractors. Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure that Entity is an additional insured on insurance required from subcontractors. For CGL coverage subcontractors shall provide coverage with a format least as broad as CG 20 38 04 13.
16. Effect of Coverage. The existence of the required insurance coverage under this Contract will not be deemed to satisfy or limit Contractor’s indemnity obligations under this Contract.
Contractor acknowledges that the insurance coverage and policy limits set forth in this Contract constitute the minimum coverage and policy limits required. Any insurance proceeds available to City in excess of the limits and coverage required by this Contract, and which is applicable to a given loss, must be made available to City to compensate it for such losses.
17. Special Risks or Circumstances. Entity reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other circumstances.
Rev. 0
August 2023
C-13
Project No. 22/23-9271
PAYMENT BOND
(Bond for Labor and Material)
KNOW ALL PERSONS BY THESE PRESENTS:
1.01 THAT WHEREAS, CITY OF SAN MARINO (Owner) has awarded to (Name of Contractor) as Principal, Contract Number dated
the day of , 20___ (the Contract), titled the City of
[______________]_______________________________________Project in the amount of $ , which Contract is by this reference made a part hereof, for the work of the following Contract:
[PROJECT NAME AND LOCATION]
1.02 AND WHEREAS, Principal is required to furnish a bond in connection with the Contract to secure the payment of claims of laborers, mechanics, material suppliers, and other persons as provided by law;
1.03 NOW, THEREFORE, we, the undersigned Principal and (Name of Surety) , as Surety, are held and firmly bound unto Owner in the sum of 100% OF THE CONTRACT PRICE ($ ), for which payment well and truly to be made we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents.
1.04 THE CONDITION OF THIS OBLIGATION IS SUCH, that if Principal, or its executors, administrators, successors, or assigns approved by Owner, or its subcontractors shall fail to pay any of the persons named in California Civil Code Section 9100, or amounts due under the State of California Unemployment Insurance Code with respect to work or labor performed under the Contract, or for any amounts required to be deducted, withheld, and paid over to the State of California Employment Development Department from the wages of employees of Principal and subcontractors pursuant to Section 13020 of the State of California Unemployment Insurance Code with respect to such work and labor, that Surety will pay for the same in an amount not exceeding the sum specified in this bond, plus reasonable attorneys’ fees, otherwise the above obligation shall become and be null and void.
1.05 This bond shall inure to the benefit of any of the persons named in California Civil Code Section 9100, as to give a right of action to such persons or their assigns in any suit brought upon this bond. The intent of this bond is to comply with the California Mechanic’s Lien Law.
1.06 Surety, for value received, hereby expressly agrees that no extension of time, change, modification, alteration, or addition to the undertakings, covenants, terms, conditions, and agreements of the Contract, or to the work to be performed thereunder, shall in any way affect the obligation of this bond; and it does hereby waive notice of any such extension of time, change, modification, alteration, or addition to the undertakings, covenants, terms, conditions, and agreements of the Contract, or to the work to be performed thereunder.
Rev. 0
August 2023
C-14
Project No. 22/23-9271
1.07 Surety’s obligations hereunder are independent of the obligations of any other surety for the payment of claims of laborers, mechanics, material suppliers, and other persons in connection with Contract; and suit may be brought against Surety and such other sureties, jointly and severally, or against any one or more of them, or against less than all of them without impairing Owner’s rights against the other.
1.08 Correspondence or claims relating to this bond shall be sent to Surety at the address set forth below.
IN WITNESS WHEREOF, we have hereunto set our hands this day of , 20___.
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corp. Seal) Company: (Corp. Seal)
Signature Signature
Name Name
Title Title
Street Address Street Address
City, State, Zip Code City, State, Zip Code
END OF DOCUMENT
Rev. 0
August 2023
C-15
Project No. 22/23-9271
CONSTRUCTION PERFORMANCE BOND
THIS CONSTRUCTION PERFORMANCE BOND (Bond) is dated [Month, Day], 201_ is in the amount of [ Insert Amount ] (Penal Sum), which is 100% of the Contract Sum and is entered into by and between the parties listed below to ensure the faithful performance of the Contract identified below. This Bond consists of this page and the Bond Terms and Conditions, Paragraphs 1 through 14 attached to this page. Any singular reference to [Insert name of Contractor] (Contractor), [Insert name of Surety] (Surety), CITY OF SAN MARINO (Owner), or other party shall be considered plural where applicable.
CONTRACTOR: SURETY:
[Insert name of Contractor] [Insert name of Surety]
Address Principal Place of Business
City/State/Zip City/State/Zip
CONSTRUCTION CONTRACT: [PROJECT NAME AND ADDRESS], dated [Month, Day], 20_, in the amount of [ Insert Amount].
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corp. Seal) Company: (Corp. Seal)
Signature: Signature:
Name: Name:
Title: Title:
Rev. 0
August 2023
C-16
Project No. 22/23-9271
BOND TERMS AND CONDITIONS
Contractor and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to Owner for the complete and proper performance of the Construction Contract, which is incorporated herein by reference.
If Contractor completely and properly performs all of its obligations under the Construction Contract, Surety and Contractor shall have no obligation under this Bond.
If there is no Owner Default, Surety’s obligation under this Bond shall arise after:
Owner provides Surety with written notice that Owner has declared a Contractor Default under the Construction Contract pursuant to the terms of the Construction Contract; and Owner has agreed to pay the Balance of Contract Sum:
To Surety in accordance with the terms of this Bond and the Construction Contract; or
3.2.2 To a Contractor selected to perform the Construction Contract in accordance with the terms of this Bond and the Construction Contract.
When Owner has satisfied the conditions of Paragraph 3 above, Surety shall promptly (within 40 Days) and at Surety’s expense elect to take one of the following actions:
Arrange for Contractor, with consent of Owner, to perform and complete the Construction Contract (but Owner may withhold consent, in which case the Surety must elect an option described in Paragraphs 4.2, 4.3 or 4.4 below); or
Undertake to perform and complete the Construction Contract itself, through its agents or through independent contractors or Construction entities; provided, that Surety may not select Contractor as its agent or independent contractor or Contractor without Owner’s consent; or
Undertake to perform and complete the Construction Contract by obtaining bids from qualified contractors or Construction entities acceptable to Owner for a contract for performance and completion of the Construction Contract and, upon determination by Owner of the lowest responsive and responsible Bidder, arrange for a contract to be prepared for execution by Owner and the contractor or Contractor selected with Owner’s concurrence, to be secured with performance and payment bonds executed by a qualified surety equivalent to the bonds issued on the Construction Contract; and, if Surety’s obligations defined in Paragraph 6 below, exceed the Balance of Contract Sum, then Surety shall pay to Owner the amount of such excess; or Waive its right to perform and complete, arrange for completion, or obtain a new contractor or Contractor, and with reasonable promptness under the circumstances and, after investigation and consultation with Owner, determine in good faith its monetary obligation to Owner under Paragraph 6 below, for the performance and completion of Rev. 0
August 2023
C-17
Project No. 22/23-9271
the Construction Contract and, as soon as practicable after the amount is determined, tender payment therefor to Owner with full explanation of the payment’s calculation. If Owner accepts Surety’s tender under this Paragraph 4.4, Owner may still hold Surety liable for future damages then unknown or unliquidated resulting from the Contractor Default, as agreed by Owner and Surety at the time of tender. If Owner disputes the amount of Surety’s tender under this Paragraph 4.4, Owner may exercise all remedies available to it at law to enforce Surety’s liability under Paragraphs 6 and 6.3 below.
At all times Owner shall be entitled to enforce any remedy available to Owner at law or under the Construction Contract including, without limitation, and by way of example only, rights to perform work, protect Work, mitigate damages, advance critical Work to mitigate schedule delay, and coordinate Work with other consultants or contractors.
If Surety elects to act under Paragraphs 4.1, 4.2 or 4.3 above, within the time period provided in Paragraph 4, above, and complies with its obligations under this Bond, Surety’s obligations under this Bond are commensurate with Contractor’s Construction Contract obligations. Surety’s obligations include, but are not limited to:
Contractor’s obligations to complete the Construction Contract and correct Defective Work; Contractor’s obligations to pay liquidated damages; and To the extent otherwise required of Contractor under the Construction Contract, Contractor’s obligations to pay additional legal, design professional, and other costs not included within liquidated damages resulting from Contractor Default (but excluding attorney’s fees incurred to enforce this Bond).
If Surety does not elect to act under Paragraphs 4.1, 4.2, 4.3, or 4.4, above, within the time period provided in Paragraph 4, above, or comply with its obligations under this Bond, then Surety shall be deemed to be in default on this Bond ten Days after receipt of an additional written notice from Owner to Surety demanding that Surety perform its obligations under this Bond. Such Surety default shall be independent of the Contractor Default. To the extent Surety’s independent default causes Owner to suffer damages including, but not limited to, delay damages, which are different from, or in addition to (but not duplicative of) damages which Owner is entitled to receive under the Construction Contract, Surety shall also be liable for such damages. In the event any Surety obligation following its independent default is inconsistent or conflicts with California Civil Code Section 2809, or any other law which either prohibits, restricts, limits or modifies in any way any obligation of a surety which is larger in amount or in any other respect more burdensome than that of the principal, Surety hereby waives the provisions of such laws to that extent.
If Surety elects to act under Paragraphs 4.1, 4.3 or 4.4 above, within the time period provided in Paragraph 4, above, and complies with all obligations under this Bond, Surety’s monetary obligation under this Bond is limited to the Penal Sum.
No right of action shall accrue on this Bond to any person or entity other than Owner or its successors or assigns.
Rev. 0
August 2023
C-18
Project No. 22/23-9271
Surety hereby waives notice of any change, alteration or addition to the Construction Contract or to related subcontracts, design agreements, purchase orders and other obligations, including changes of time, and of any Owner action in accordance with Paragraph 5 above. Surety consents to all terms of the Construction Contract, including provisions on changes to the Contract. No extension of time, change, alteration, Modification, deletion, or addition to the Contract Documents, or of the Work (including services) required thereunder, or any Owner action in accordance with Paragraph 5 above shall release or exonerate Surety on this Bond or in any way affect the obligations of Surety on this Bond, unless such action is an Owner Default.
Any proceeding, legal or equitable, under this Bond shall be instituted in any court of competent jurisdiction where a proceeding is pending between Owner and Contractor regarding the Construction Contract, or in the Superior Court of the County of Los Angeles, California, or in a court of competent jurisdiction in the location in which the Work is located. Communications from Owner to Surety under Paragraph 3.1 above shall be deemed to include the necessary agreements under Paragraph 3.2 above unless expressly stated otherwise.
All notices to Surety or Contractor shall be mailed or delivered (at the address set forth on the signature page of this Bond), and all notices to Owner shall be mailed or delivered as provided in Section 1-
7.1.10 of the Special Provisions. Actual receipt of notice by Surety, Owner or Contractor, however accomplished, shall be sufficient compliance as of the date received at the foregoing addresses.
Any provision in this Bond conflicting with any statutory or regulatory requirement shall be deemed deleted herefrom and provisions conforming to such statutory requirement shall be deemed incorporated herein.
Definitions
Balance of Contract Sum: The total amount payable by Owner to Contractor pursuant to the terms of the Construction Contract after all proper adjustments have been made under the Construction Contract, for example, deductions for progress payments made, and increases/decreases for approved Modifications to the Construction Contract.
Construction Contract: The agreement between Owner and Contractor identified on the signature page of this Bond, including all Contract Documents and changes thereto.
Contractor Default: Material failure of Contractor, which has neither been remedied nor waived, to perform or otherwise to comply with the terms of the Construction Contract, limited to “default” or any other condition allowing a termination for cause as provided in Section 6-7.3 of the Special Provisions).
Owner Default: Material failure of Owner, which has neither been remedied nor waived, to pay Contractor progress payments due under the Construction Contract or to perform other material terms of the Construction Contract, if such failure is the cause of the asserted Contractor Default and is sufficient to justify Contractor termination of the Construction Contract.
END OF DOCUMENT
Rev. 0
August 2023
C-19
Project No. 22/23-9271
ESCROW AGREEMENT FOR SECURITY DEPOSIT IN LIEU OF RETENTION Public Contract Code Section 22300
THIS ESCROW AGREEMENT (“Escrow Agreement”) is made and entered into this day of ________________, 20__, by and between City of San Marino (“Owner”), whose address is 2200 Huntington Drive, San Marino, CA 91108, [Name of Contractor] (“Contractor”), whose principal place of business is located at [Contractor’s Address], and Owner, as escrow agent [OR] [Name of Bank], a state or federally chartered bank in the State of California, whose place of business is located at [Address] (“Escrow Agent”).
For the consideration hereinafter set forth, Owner, Contractor and Escrow Agent agree as follows:
1. Pursuant to Public Contract Code Section 22300, Contractor has the option to deposit securities with Escrow Agent as a substitute for retention earnings required to be withheld by Owner pursuant to Contract Number entered into between Owner and Contractor for the City of [______________] __________________ Project in the amount of $ dated , 20__ (the “Contract”). Alternatively, on written request of Contractor, Owner shall make payments of the retention earnings directly to Escrow Agent. When Contractor deposits the securities as a substitute for Contract earnings, Escrow Agent shall notify Owner within ten Days of the deposit. The market value of the securities at the time of substitution shall be at least equal to the cash amount then required to be withheld as retention under terms of Contract between Owner and Contractor. Securities shall be held in name of , and shall designate Contractor as the beneficial owner.
2. Owner shall make progress payments to Contractor for those funds which otherwise would be withheld from progress payments pursuant to Contract provisions, provided that Escrow Agent holds securities in form and amount specified in Paragraph 1 of this Document 006290.
3. When Owner makes payment(s) of retention earned directly to Escrow Agent, Escrow Agent shall hold said payment(s) for the benefit of Contractor until the time that the escrow created under this Escrow Agreement is terminated. Contractor may direct the investment of the payments into securities. All terms and conditions of this Escrow Agreement and the rights and responsibilities of the parties shall be equally applicable and binding when Owner pays Escrow Agent directly.
4. Contractor shall be responsible for paying all fees for the expenses incurred by Escrow Agent in administering the Escrow Account, and all expenses of Owner. Such expenses and payment terms shall be determined by Owner, Contractor, and Escrow Agent.
5. Interest earned on securities or money market accounts held in escrow and all interest earned on that interest shall be for sole account of Contractor and shall be subject to withdrawal by Contractor at any time and from time to time without notice to Owner.
6. Contractor shall have the right to withdraw all or any part of the principal in the Escrow Account only by written notice to Escrow Agent accompanied by written authorization from Owner to Escrow Agent that Owner consents to withdrawal of amount sought to be withdrawn by Contractor.
7. Owner shall have the right to draw upon the securities in event of default by Contractor. Upon seven Days written notice to Escrow Agent from Owner of the default, Escrow Agent shall immediately convert the securities to cash and shall distribute the cash as instructed by Owner.
Rev. 0
August 2023
C-20
Project No. 22/23-9271
8. Upon receipt of written notification from Owner certifying that the Contract is final and complete, and that Contractor has complied with all requirements and procedures applicable to the Contract, Escrow Agent shall release to Contractor all securities and interest on deposit less escrow fees and charges of the Escrow Account. The escrow shall be closed immediately upon disbursement of all moneys and securities on deposit and payments of fees and charges.
9. Escrow Agent shall rely on written notifications from Owner and Contractor pursuant to Paragraphs 5 through 8, inclusive, of this Document 00 6290 and Owner and Contractor shall hold Escrow Agent harmless from Escrow Agent’s release and disbursement of securities and interest as set forth.
10. Names of persons who are authorized to give written notice or to receive written notice on behalf of Owner and on behalf of Contractor in connection with the foregoing, and exemplars of their respective signatures are as follows:
ON BEHALF OF OWNER: ON BEHALF OF CONTRACTOR:
____________________________________ ___________________________________ Title Title
____________________________________ ___________________________________ Name Name
____________________________________ ___________________________________ Signature Signature
____________________________________ ___________________________________ Address Address
____________________________________ ___________________________________ City/State/Zip Code City/State/Zip Code
ON BEHALF OF ESCROW AGENT:
____________________________________
Title
____________________________________
Name
____________________________________
Signature
____________________________________
Address
____________________________________
City/State/Zip Code
IN WITNESS WHEREOF, the parties have executed this Escrow Agreement by their proper officers on the date first set forth above.
OWNER: CONTRACTOR
CITY OF SAN MARINO _____________________________________ Rev. 0
August 2023
C-21
Project No. 22/23-9271
______________________________ _____________________________________ Title Title
________________________________ _____________________________________ Name Name
________________________________ _____________________________________ Signature Signature
ATTEST
_____________________________________
Signature
_____________________________________
Print Name
Secretary
ESCROW AGENT
_____________________________________
_____________________________________
Title
_____________________________________
Print Name
_____________________________________
Signature
[IF REQUIRED] REVIEWED AS TO FORM:
_____________________________________
Counsel for Owner
_____________________________________
Print Name
_____________________________________
Date
Rev. 0
August 2023
C-22
Project No. 22/23-9271
At the time the Escrow Account is opened, Owner and Contractor shall deliver to Escrow Agent a fully executed counterpart of this Document.
Project No. 22/23-9271
Rev. 0
August 2023
COC-1
Street Rehabilitation Project, CIP No.22/23-9271
CONTRACTOR'S CERTIFICATION OF COMPLETION
DATE: ________________________
TO: City of San Marino
Office of the City Engineer
Parks and Public Works Department
2200 Huntington Drive
San Marino, California 91108
FROM: __________________________________________________________ (Firm or Corporation)
PROJECT: Street Rehabilitation Project, CIP No. 22/23-9271 This is to certify that I, acting as an authorized official of the above stated firm or corporation, have been properly authorized by said firm or corporation to sign the following statements pertaining to the subject Project and Contract Documents:
1. I know, of my own personal knowledge, and do hereby certify, that the work of the contract described above has been performed, and materials used and installed in every particular, in accordance with, and in conformity to, the Bid, Contract Documents and Contract.
2. The contract work is now complete in all parts and requirements, and ready for your final inspection.
3. I understand and agree that neither the determination by the Owner that the work is complete, nor the acceptance thereof by the Owner, shall operate as a bar to claim against the Contractor under the terms of the guarantee provisions of the Contract Documents or as a bar or waiver of tort and contract claims that might be alleged with respect to performance of the work.
Signature of Prime Contractor Signature of Prime Contractor Print name and title Print name and title
(If the Prime Contractor is a corporation two signatures of corporate officers are required.) Rev. 0
August 2023
COC-2
Street Rehabilitation Project, CIP No.22/23-9271
CONTRACTOR’S AFFIDAVIT OF DISPOSAL
WHEREAS, on the ______ day of ____________________, 20______, the undersigned entered into and executed a contract with City of San Marino for the Street Rehabilitation Project as particularly described in said contract and identified as CIP No. 22/23-9271, and WHEREAS, the specifications of said contract requires the Contractor to affirm that "all brush, trash, debris, and surplus materials resulting from this project have been disposed of in a legal manner" and that all designated recyclable materials are properly recycled in compliance with the City of San Marino Ordinances.
WHEREAS, said contract has been completed, all surplus materials disposed of, and proof of compliance with the City of San Marino Municipal Code has been furnished.
NOW, THEREFORE, in consideration of the final payment by the City of San Marino to said Contractor under the terms of said contract, the undersigned Contractor, hereby certifies and affirms under penalty of perjury that all surplus materials as described in said contract have been disposed of at the following location(s):
Type of material disposed of Type of material disposed of Name of disposal site Name of disposal site
Address of disposal site Address of disposal site
Type of material disposed of Type of material disposed of Name of disposal site Name of disposal site
Address of disposal site Address of disposal site
By signing and submitting this form to the City of [_____________] on this ____ day of ___________, 20___, I (we) hereby certified and swear under penalty of perjury under the laws of the State of California that the aforementioned information is true and correct without omission, error or misrepresentation.
Signature of Prime Contractor Date Signature of Prime Contractor Date Print name and title Print name and title
Rev. 0
August 2023
COC-3
Street Rehabilitation Project, CIP No.22/23-9271
(If the Prime Contractor is a corporation two signatures of corporate officers are required.) Rev. 0
August 2023
COC-4
Street Rehabilitation Project, CIP No.22/23-9271
CONSENT OF SURETY FOR FINAL PAYMENT
In accordance with the provisions of the contract between the Owner and the Contractor, and the following named Surety:
on the Payment Bond in the amount of Dollars,
of the following named Contractor:
hereby approves of final payment to the Contractor, and further agrees that said final payment to the Contractor shall not relieve the Surety named herein of any of its obligations to the Owner, as set forth in said Surety company's bond.
IN WITNESS WHEREOF, the Surety Company has hereunto set its hand and seal this _______ day of _________________, 20_____.
Signature of Authorized Surety Representative
Title
(CORPORATE SEAL)
Rev. 0
August 2023
COC-5
Street Rehabilitation Project, CIP No.22/23-9271
CONTRACTOR’S AFFIDAVIT OF PAYMENT
To All Whom It May Concern:
WHEREAS, the undersigned has been contracted by the City of San Marino to furnish labor and materials for the Street Rehabilitation Project, CIP No. 22/23-9271, under a contract dated the ______day of __________________, 20___, in the City of [_____________], County of [_____________], State of California, of which City of [_____________] is the Owner.
NOW, THEREFORE, this _________ day of ___________________, 20___ the undersigned, as the Contractor for the above-named Contract pursuant to the Conditions of the Contract hereby certifies that, except as listed below, he has paid in full or has otherwise satisfied all obligations for all materials and equipment furnished, for all work, labor, and services performed, and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or his property might in anyway be held responsible.
EXCEPTIONS: (If none, write "None". If required by the Owner, the Contractor shall furnish bond satisfactory to the Owner for each exception.)
Signature of Prime Contractor Date Signature of Prime Contractor Date Print name and title Print name and title
(If the Prime Contractor is a corporation two signatures of corporate officers are required.) Rev. 0
August 2023
COC-6
Street Rehabilitation Project, CIP No.22/23-9271
GUARANTEE AGREEMENT
TO:The CITY OF San Marino (Owner), for construction of the [PROJECT NAME AND ADDRESS].
The undersigned guarantees all construction performed on this Project and also guarantees all material and equipment incorporated therein.
1.01 Contractor hereby grants to Owner for a period of [one year] following the date of Final Acceptance of the Work completed, or such longer period specified in the Contract Documents, its unconditional warranty of the quality and adequacy of all of the Work including, without limitation, all labor, materials and equipment provided by Contractor and its Subcontractors of all tiers in connection with the Work.
1.02 Neither final payment nor use nor occupancy of the Work performed by the Contractor shall constitute an acceptance of Work not done in accordance with this Guaranty or relieve Contractor of liability in respect to any express warranties or responsibilities for faulty materials or workmanship.
Contractor shall remedy any defects in the Work and pay for any damage resulting therefrom, which shall appear within [one year], or longer if specified, from the date of Final Acceptance of the Work completed.
1.03 If within [one year] after the date of Final Acceptance, or such other period of time as may be prescribed by laws or regulations, or by the terms of Contract Documents or any extended warranty or guaranty, any Work is found to be Defective, Contractor shall promptly, without cost to Owner and in accordance with Owner’s written instructions, correct such Defective Work. Contractor shall remove any Defective Work rejected by Owner and replace it with Work that is not Defective, and satisfactorily correct or remove and replace any damage to other Work or the work of others resulting therefrom. If Contractor fails to comply promptly with the terms of such instructions, or in an emergency where delay would cause serious risk of loss or damage, Owner may have the Defective Work corrected or the rejected Work removed and replaced. Contractor shall pay for all claims, costs, losses and damages caused by or resulting from such removal and replacement. Where Contractor fails to correct Defective Work, or defects are discovered outside the correction period, Owner shall have all rights and remedies granted by law.
1.04 Contractor shall respond within 72 hours to any claim made by Owner pursuant to this guaranty.
1.05 Observation and inspection of the Work shall not relieve Contractor of any of its obligations under the Contract Documents. Even though equipment, materials, or Work required to be provided under the Contract Documents have been inspected, accepted, and estimated for payment, Contractor shall, at its own expense, replace or repair any such equipment, material, or Work found to be Defective or otherwise not to comply with the requirements of the Contract Documents up to the end of the guaranty period.
1.06 This Guaranty is in addition to any other Contractor warranties contained in the Contract Documents, and not in lieu of, any and all other Contractor liability imposed under the Contract Documents or at law. In the event of any conflict or inconsistency between the terms of this Guaranty Rev. 0
August 2023
COC-7
Street Rehabilitation Project, CIP No.22/23-9271
and any Contractor warranty or obligation Contractor under the Contract Documents or at law, such inconsistency or conflict shall be resolved in favor of the greater protection to Owner. (Signature line on next page)
Date: _______________________________, 20___
Contractor's Name
By:
Signature
Print Name
Title
Street Address
City, State, Zip code
Project No. 22/23-9271
CERTIFIED PAYROLL GUIDELINES
AT THE START OF THE JOB PLEASE PROVIDE THE FOLLOWING FOR EACH CONTRACTOR / SUBCONTRACTOR:
1.) A list of all trades & crafts anticipated on the job (see separate example sheet).
For example, if the project is calling for state prevailing wages, the relevant information can be found on www.dir.ca.gov/OPRL/PWD/index.htm. Make sure you check if the project is state or federal.
2.) If fringes are paid directly to a plan (partly or in full), please provide fringe benefit statements for all crafts anticipated
3.) Proof of payment of training dues (if applicable)
4.) A list of all subcontractors anticipated on the job (applies to main contractor only) PLEASE NOTE:
• The start date of the job is payroll week #1 for the main contractor and every subcontractor on the job, regardless of being on the job at the beginning or not. • For each week please provide either a payroll report with statement of compliance OR where no work is performed a statement of non-performance for all contractors/subs. The only exception: The weeks before the initial work start can be grouped into 1 statement of non-performance as long as the entire time frame is specified. Otherwise a statement of non-performance is required weekly. • When a contractor/subcontractor has completed their work on the job, a FINAL statement of non-performance is required. This can be identical to a regular statement of non-performance except it needs to specify that it is the final statement. • It is imperative payroll documents are received complete and promptly in order to authorize the contractor’s invoices. Therefore, please send 1 set of originals with wet signatures of everything as promptly as possible
Issued 3-28-2022 CGP - 1 Prj. No. 21-9271
U.S. Department of Labor PAYROLL
(For Contractor's Optional Use; See Instructions at www.dol.gov/whd/forms/wh347instr.htm) Wage and Hour Division
Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.
NAME OF CONTRACTOR OR SUBCONTRACTOR ADDRESS OMB No.: 1235-0008 Expires: 01/31/2015
PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO. (1) (2) (3) (4) DAY AND DATE (5) (6) (7) (9)
(8)
DEDUCTIONS
O O O O O O O O
NAME AND INDIVIDUAL IDENTIFYING NUMBER
(e.g., LAST FOUR DIGITS OF SOCIAL SECURITY
NUMBER) OF WORKER O. OF N
NG i LDO HHTIW
S N IOT EMPXE
WORK
CLASSIFICATION
T. S OT. OR
HOURS WORKED EACH DAY
TOTAL
HOURS
RATE
OF PAY
GROSS
AMOUNT
EARNED FICA
WITHHOLDING
TAX OTHER
TOTAL
DEDUCTIONS
NET
WAGES
PAID
FOR WEEK
S
SS S S S S S
Rev. Dec. 2008
While completion of Form WH-347 is optional, it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R. §§ 3.3, 5.5(a). The Copeland Act (40 U.S.C. § 3145) contractors and subcontractors performing work on Federally financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee during the preceding week." U.S. Department of Labor (DOL) regulations at 29 C.F.R. § 5.5(a)(3)(ii) require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project, accompanied by a signed "Statement of Compliance" indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed. DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits.
Public Burden Statement
We estimate that is will take an average of 55 minutes to complete this collection, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you have any comments regarding these estimates or any other aspect of this collection, including suggestions for reducing this burden, send them to the Administrator, Wage and Hour Division, U.S. Department of Labor, Room S3502, 200 Constitution Avenue, N.W.
Washington, D.C. 20210
(over)
Appendix 3 -
2 Date
I,
(Name of Signatory Party) (Title)
do hereby state:
(1) That I pay or supervise the payment of the persons employed by on the
(Contractor or Subcontractor)
; that during the payroll period commencing on the
(Building or Work)
day of , , and ending the day of , ,
all persons employed on said project have been paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said from the full
(Contractor or Subcontractor)
weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages earned by any person, other than permissible deductions as defined in Regulations, Part 3 (29 C.F.R. Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948, 63 Start. 108, 72 Stat. 967; 76 Stat. 357; 40 U.S.C. § 3145), and described below:
(2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3) That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor. (4) That:
(a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS − in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe bene fits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,except as noted in section 4(c) below. (b) WHERE FRINGE BENEFITS ARE PAID IN CASH
− Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in section 4(c) below. (c) EXCEPTIONS
REMARKS:
EXCEPTION (CRAFT) EXPLANATION
NAME AND TITLE SIGNATURE
THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE.
Issued 3-28-2022 CGP - 3 Prj. No. 21-9271
STATEMENT
OF
NON-‐PERFORMANCE
Name
of
Contractor
/
Subcontractor:
______________________________________
Payroll
Number(s):
#________________
Final
Statement
of
Non
Performance
(Please
circle): Yes
No
Payroll
Week
Ending
Date:
________________________
I
do
hereby
state
that
no
mechanics,
laborers,
apprentices
or
trainees
were
employed
on
the
construction
site
of
the
Project
______________________________
_____________________________________________
during
the
payroll
period
commencing
on
the
___
day
of
___________
2013 and
ending
the
___
day
of
____________,
2013.
Signature
of
Authorized
Person:
________________________________
Title:
_________________________________
Date: _________________________________
2019 2019
Issued 3-28-2022 CGP - 4 Prj. No. 21-9271
LIST OF TRADES & CRAFTS
PROJECT NAME:
CONTRACTORS NAME:
PAYROLL CONTACT PERSON:
PHONE:
EMAIL:
DATE:
TRADE OR CRAFT PREVAILING WAGE
CLASSIFICATION & GROUP
DETERMINATION
NUMBER
PAGE
NUMBER
FEDERAL/
STATE
EXPIRATION
Note:
* Denotes rate is good for
the life of the project
** Denotes predetermined
increase
Issued 3-28-2022 CGP - 5 Prj. No. 21-9271
LIST OF TRADES & CRAFTS
EXAMPLE ONLY – TO SHOW HOW TO FILL THIS IN CORRECTLY
PROJECT NAME: National City Street Resurfacing
CONTRACTORS NAME: XYZ Construction Inc.
PAYROLL CONTACT PERSON: Pete Smith
PHONE: 619 111 2222
EMAIL: [email protected]
DATE: 2nd April 2013
TRADE OR CRAFT PREVAILING WAGE
CLASSIFICATION & GROUP
DETERMINATION
NUMBER
PAGE
NUMBER
FEDERAL/
STATE
EXPIRATION
LABORER
(CONSTRUCTION-FENCE ERECTORHOUSEMOVER)
LABORER: ENGINEERING
CONSTRUCTION, GROUPS 1 & 5
SD-23-102-3-2012-1 30 STATE June 30, 2013**
LABORER AND RELATED
CLASSIFICATIONS
LABORER: BUILDING
CONSTRUCTION, GROUPS 1, 2, 4
SD-23-102-4-2012-1 29 STATE June 30, 2013**
OPERATING ENGINEER GROUPS 2, 4, & 8 SD-23-63-3-2011-2 25 STATE June 30, 2012*
PARKING AND HIGHWAY
IMPROVEMENT (STRIPING, SLURRY
AND SEAL COAT OPERATIONSLABORER)
GROUPS 2 & 4 SC-23-102-6-2011-1 18E STATE June 30, 2012* Note:
Issued 3-28-2022 CGP - 6 Prj. No. 21-9271
CONTRACTOR FRINGE BENEFIT STATEMENT
Contract Number: Project Name: Today's Date:
Contractor / Subcontractor Name: Business Address:
Classification: Effective Date: Subsistence or Travel Pay:
$
Health & $ PAID TO: Name:
Welfare Address:
Pension $ PAID TO: Name:
Address:
Vacation/ $ PAID TO: Name:
Holiday Address:
Training $ PAID TO: Name:
and/or Other Address:
Classification: Effective Date: Subsistence or Travel Pay:
$
Health & $ PAID TO: Name:
Welfare Address:
Pension $ PAID TO: Name:
Address:
Vacation/ $ PAID TO: Name:
Holiday Address:
Training $ PAID TO: Name:
And/or Other Address:
Classification: Effective Date: Subsistence or Travel Pay:
$
Health & $ PAID TO: Name:
Welfare Address:
Pension $ PAID TO: Name:
Address:
Vacation/ $ PAID TO: Name:
Holiday Address:
Training $ PAID TO: Name:
And/or Other Address:
Submitted: Contractor / Subcontractor By: Name / Title
Supplemental statements must be submitted during the progress of work should a change in rate of any of the classifications be made. FRINGE BENEFITS FRINGE BENEFITS FRINGE BENEFITS In order that the proper Fringe Benefit rates can be verified when checking payrolls on the above contract, the hourly rates for fringe benefits, subsistence and/or travel allowance payment made for employees on the various classes of work are tabulated below.
Issued 3-28-2022 CGP - 7 Prj. No. 21-9271
Issued 3-28-2022 CGP - 8 Prj. No. 21-9271
Project No. 22/23-9271