COUNTY LOBBYIST CODE CHAPTER 2.160
COUNTY ORDINANCE NO. 93-0031
CERTIFICATION
Name of Firm: CT&T Concrete Paving Inc
Address: 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, State: CA Zip Code: 91765 Telephone Number: ( ) (909) 629-8000 ext 102 Acting on behalf of the above named firm, as its Authorized Official, I make the following Certification to the Los Angeles County Development Authority (LACDA).
It is understood that each person/entity/firm who applies for a Los Angeles County Development Authority contract, and as part of that process, shall certify that they are familiar with the requirements of the Los Angeles County Code, Chapter 2.160 (Los Angeles County Ordinance 93-0031) and;
2) That all persons/entities/firms acting on behalf of the above named firm have and will comply with the County Code, and;
That any person/entity/firm who seeks a contract with the Los Angeles County Development Authority shall be disqualified therefrom and denied the contract and, shall be liable in civil action, if any lobbyist, lobbying firm, lobbyist employer or any other person or entity acting on behalf of the named firm fails to comply with the provisions of the County Code.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into contract with Los Angeles County and the Los Angeles County Development Authority.
Authorized Official:
CT&T Concrete Paving inc By:
(Contractor/Subcontractor) (Signature)
6/12/2025 Jose Carvajal - President
(Date) (Title)
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT HUD FORM 4230A REPORT OF ADDITIONAL CLASSIFICATION AND RATE ОМВ Аргона NIk. 281202)
1. FROM (name and address of requesting agency) 2. PROJECT NAME AND NUMBER
3. LOCATION OF PROJECT (City, County and State)
4. BRIEF DESCRIPTION OF PROJECT 5. CHARACTER OF CONSTRUCTION Building • Residential
Heavy Other (specify)
- Highway
6. WAGE DECISION NO. (include modification number, if any) DATE of WAGE DECISION: 7. WAGE DECISION EFFECTIVE DATE (LOCK-IN):
• COPY ATTACHED
8. WORK CLASSIFICATION(S) HOURLY WAGE RATES
BASIC WAGE FRINGE BENEFIT(S) (if any)
Not Applicable
9. PRIME CONTRACTOR (name, address) 9a. 10. SUBCONTRACTOR/EMPLOYER, IF APPLICABLE (name, address)
• Agree
9b. SIGNATURE DATE • Disagree
[Check All That Apply:
• The work to be performed by the additional classification(s) is not performed by a classification in the applicable wage decision.
The proposed classification is utilized in the area by the construction industry.
The proposed wage rate(s), including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage decision.
The interested parties, including the employees or their authorized representatives, agree on the classification(s) and wage rate(s).
Supporting documentation attached, including applicable wage decision.
Check One:
Approved, meets all criteria. DOL confirmation requested.
One or more classifications fail to meet all criteria. DOL decision requested.
FOR HUD USE ONLY
LR2000:
Agency Representative Date
Log in:
(Typed name and signature)
Log out:
Phone Number
HUD-4230A (8-19) PREVIOUS EDITION IS OBSOLETE
CONTRACTOR LIST OF PROPOSED SUBCONTRACTORS
Bidder must list all subcontracts, regardless of dollar amount or percentage of bid.
FY 2024-25 GDBG Ramp Project City of san Marino
PROJECT NAME
AWARDING AGENCY
Location: San Marino, CA Project Number: 24/25 - 9272A
Employer Contractor Estimated Estimated
SUBCONTRACTORS:
Identification License Contract Start Completion
Name, Address, and Telephone Number Amount Date TRADES TO BE USED Number Number Date
C C 350 27-321810 25 8133 8,800 TBD TBD sorveying
online Striping or Corne 800258901 862350 6,400 TBD Signing + Striping 20,a2cayC74) 28607250 TBD
Signature Jose Carvajal, President
Name and Title
06/13/25 CTRT Concrete Paring Inc.
Date Company Name
WORKER'S COMPENSATION CERTIFICATION
I certify, by my signature below, that I am aware of the provisions of Section 3700 of the California Labor Code. $3700 requires every employer be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code. I further certify that I will comply with such provisions before commencing the performance of the work of this contract.
Date: 6/12/2025 Project Number: 2024-GEN-013
Project Name: CDBG ADA Sidewalk/Curb Ramp Project
Company Name: CT&T Concrete Paving Inc
Address: 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar,CA, 91765 Print Name: Jose Carvajal
Title: President
Signature:
Certification of Understanding and Authorization
This certification is required when a Payroll Officer is not listed on the business license (03/30/17)
Contractor Name: CT&T Concrete Paving Inc
Project Name: CDBG ADA Sidewalk/Curb Ramp Project CDBG Project Number: 2024-GEN-013 Project Location: San Marino
Local Contracting Agency (LCA): San Marino
Labor Standards Officer (LSO): Telephone:
The contractor certifies, by signature below, that the designated payroll officer has received a copy of the federal wage decision assigned to this project as identified below;
• CA 20240022 Modification Number S Dated 3/28/25
The payroll officer acknowledges, by signature below, that she/he have also received, read, and understands the following provision and publication;
• Federal Labor Standards Provisions (HUD-4010 form), and • Contractor's Guide to Prevailing Wage Requirements for Federally-Assisted Construction Projects.
Further, the person designated as the Payroll Officer understands the labor standards reporting requirements applicable to the above listed project, and she/he is hereby authorized to sign the Statement of Compliance form that will accompany each weekly payroll report for this project on behalf of the contractor.
CT&T Concrete Paving Inc 875627
Contractor's Business Name License Number
Jose Carvajal
Print Name of Owner or Principal listed on the business license Signatafe of Owner or Principal listed on the business license President 6/12/2025
Title Date
Jackie Carvajal DackilCara
Print Name of Payroll Officer Signature of Payroll Officer
NON-SEGREGATED FACILITIES CERTIFICATION
Federally Assisted Construction Projects
The federally assisted construction contractor certifies that he/she DOES NOT and WILL NOT:
Maintain or provide, for his/her employees, any segregated facilities at any of his/her establishments.
Permit his/her employees to perform their services at any location, under his/her control, where segregated facilities are maintained.
The federally assisted contractor agrees that a breach of this certification is a violation of the Equal Opportunity Clause in this contract. As used in this certification, the term segregated facilities means any waiting room, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national origin, because of habit, local custom, or otherwise.
The federally-assisted contractor agrees that (except where he/she has obtained identical certifications from proposed subcontractors for specific time periods) he/she will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause, and that he/she will retain such certifications in his/her files.
NOTE: The penalty for making false statements in offers are prescribed in 18 U.S.C. 1001.
Date: 6/12/2025 Project Number: 2024-GEN-013
Company: CT&T Concrete Paving Inc
Address: 324 S. Diamond Bar Bivd, PMB.275, Diamond Bar, CA, 91765 By: Jose Carvajal
Title: President
PAST PERFORMANCE CERTIFICATION
With regard to performance of previous contracts or subcontracts subject to the Equal Opportunity Clause and filing of required reports The bidder, •proposed sub-contractor, hereby certifies that he/she Zhas, has not, participated in a previous contract or subcontract subject to the Equal Opportunity Clause, as required by Executive Orders 10925, 11114, or 11246, and that he/she has, Khas not, filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance (OFCC), a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filing requirements.
Date: 06/12/25 Project Number: 24/25-9272A ContractAward: $ Awarding Agency: City of San Marino
Contractor Name: CTR Concrete Paring Inc. Total Number of Employees 35 Affiliate Company: NIA
By: _
Title: President
NOTE: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b)(1), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5 (Generally only contracts or subcontracts of $10,000 or under are exempt).
Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the U.S. Department of the Interior or by the Director, Office of Federal Contract Compliance, U.S.
Department of Labor.
SF-100 (EEO-1) must be filed by;
(A) All private employers who are:
(1) Subject to Title VIl of the Civil Rights Act of 1964 (as amended) with 100 or more employees. (2) Subject to Title VIl who has fewer than 100 employees, if the company is owned or affiliated with another company, or there is centralized ownership, control or management so that the group legally constitutes a single enterprise, and the entire enterprise employs a total of 100 or more employees. (B) All federal contractors (private employers), who:
(1) Are not exempt as provided for by 41 CFR 60-1.5
(2) Have 50 or more employees, and
a. Are prime contractors or first-tier subcontractors, and have a contract, subcontract, or purchase order amounting to $50,000 or more; or
b. Serve as a depository of Government funds in any amount, or c. Is a financial institution, which is an issuing, and paying agent for U.S. Savings Bonds and Notes.
California Public Contract Code requires every bid on every public works contract of a public to include a declaration under penalty of perjury under the laws of the State of California, in the following form:
NONCOLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID The undersigned declares:
President of CTRT Concrete Paring Inc.
1am 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]." 6/12/25 Pomona, CA
Jose carrajal, president
CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189
8888088888888888888888888888888888888883838383888388818881888889888888848380838883 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On June 13*n 12025 _ before me, Eduardo Flores-Najera, Notary Public Here Insert Name and Title of the Officer
personaly appeared Jose Guadalup mergers
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
EDUARDO FLORES-NAJERA paragraph is true and correct.
Notary Public • California
Los Angeles County
Commission # 2519450 WITNESS my hand and official seal.
My Comm. Expires May 4, 2029
Signature
Place Notary Seal and/or Stamp Above Signature of Notary Public - OPTIONAL
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages: _
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signers)
Signer's Name: Signer's Name:
• Corporate Officer - Title(s): • Corporate Officer - Title(s):
• Partner - • Limited • General • Partner - • Limited • General • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer is Representing: Signer is Representing:
388488808888888089888888880848:8480848888838883
©2019 National Notary Association
FEDERAL LOBBYIST CERTIFICATION
Name of Firm: CT&T Concrete Paving Inc
Address: 324 S. Diamond Bar Bivd, PMB 275, Diamond Bar,CA State: CA Zip Code: 91765 Telephone Number: (
) (909) 629-8000 ext 102
Acting on behalf of the above named firm as its Authorized Official, I make the following Certification to the U.S.
Department of Housing and Urban Development and the Los Angeles County Development Authority (LACDA).
No Federal appropriated funds have been paid by or on behalf of the above named firm to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of and Federal grant, loan or cooperative agreement, and any extension, continuation, renewal, amendment, or modification thereof, and;
2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee or any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with this Federal contract, grant loan, or cooperative agreement, the above named firm shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying", in accordance with its instructions, and;
3) The above name firm shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreement) and that all sub-recipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into the transaction imposed by Section 1352 Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Authorized Official:
CT&T Concrete Paving Inc By:
(Contractor/Subcontractor) (Signature)
6/12/2025 Jose Carvajal - President
(Date) (Title)
DECLARATION OF INTENT TO COMPLY WITH
SECTION 3 REQUIREMENTS
As a minimum requirement for consideration of a contract award, the Bidder/Proposer shall declare his/her intent to comply with Section 3 (24 CFR 75) of the Housing and Urban Development Act of 1968, as amended (Section 3). The Bidder/Proposer is obliged, to the greatest extent feasible, to give opportunities for training and employment to low-income and very low-income persons residing in the service area or neighborhood in which the covered Section 3 project/service is located, and/or to award subcontracts to other Section 3 business concerns that provide economic opportunities for Section 3 workers and Targeted Section 3 workers.
Bidder/Proposer agrees that, as a condition of responsiveness to the solicitation and prior to recommendation for contract award by the Local Contracting Agency (LCA), he/she will agree to comply with the Section 3 requirements by including the Section 3 contract language in the contract, to the greatest extent feasible, to meet the Section 3 benchmarks and report all accomplishments with required documentation on a quarterly basis for the duration of the contract.
The Section 3 benchmarks apply to all Section 3 covered contracts as follows:
• Public housing financial assistance benchmarks:
• Section 3 workers: 25% or more for the total number of labor hours worked by all workers employed, and
• Targeted Section 3 workers: 5% or more of the total number of labor hours worked by all workers employed of which is included as part of the 25% threshold in the previous bullet.
• Community development financial assistance benchmarks:
• Section 3 workers: 25% or more for the total number of labor hours worked by all workers employed on a Section 3 project, and
Targeted Section 3 workers: 5% or more of the total number of labor hours worked by all workers employed on a Section 3 project of which is included as part of the 25% threshold in the previous bullet.
Failure of the Bidder/Proposer to agree to comply with the Section 3 requirements and reporting obligations shall be grounds for determining the Bidder/Proposer non- responsive, and no further consideration for contract award shall be granted.
I declare under penalty of perjury under the laws of the State of California that we agree to comply with the Section 3 requirements as stated above.
CT&T Concrete Paving Inc 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, St Name of Contractor/Subcontractor Address
Jose Carvajal President
Print Name Title
4/12/25
Signature Date
Declaration of Intent to Comply with Section 3 Requirements Rev. 9.1.21 City of San Marino
PROJECT NO. 24/25-9272A ADDENDUM | Proposal Due Date: June 13, 2025 12:00 PM 2024-25 CDBG SIDEWALK RAMP PROJECT
ADDENDUM NUMBER I TO NOTICE INVITING BIDS
Date: June 2, 2025
2024-25 CDBG SIDEWALK RAMP PROJECT
PROJECT NO. 24/25-9272A
A. This Addendum shall be considered part of the proposal documents for the above-mentioned project as though it had been issued at the same time and shall be incorporated integrally therewith. Where provisions of the following supplementary data differ from those of the original proposal documents, this Addendum shall govern and take precedence. BIDDERS MUST SIGN THE ADDENDUM AND SUBMIT IT WITH THEIR B. Prospective proposers are hereby notified that they shall make any necessary adjustments in their estimates as a result of this Addendum. It will be construed that each proposal is submitted with full knowledge of all modifications and supplemental data specified herein.
Except as described below, the original bid documents remains unchanged:
I. The Notice Inviting Bids is hereby revised to incorporate the attached form for a Bid Bond. Bidders shall include the completed version of this form in their final submittal package (to be uploaded as a response to Question 1-
"Respondent Submittals (without cost)".
Acknowledgement Required Below
PROPOSER MUST ACKNOWLEDGE THIS AMENDMENT BY SIGNING BELOW AND ATTACHING THE SIGNED ADDENDUM TO THE PROPOSAL:
Company Name CT&T Concrete Paving Inc
Contact Person Jose Carvajal
Signature
Date 6/12/2025
Amber Shah, PE
Director of Park and Public Works / City Engineer
City of San Marino
[email protected]
(626) 300-0765
ADDENDUM I
City of San Marino Proposal Due Date: June 13, 2025 12:00 PM PROJECT NO. 24/25-9272A ADDENDUM 2 2024-25 CDBG SIDEWALK RAMP PROJECT ADDENDUM NUMBER 2 TO NOTICE INVITING BIDS
Date: June 10, 2025
2024-25 CDBG SIDEWALK RAMP PROJECT
PROJECT NO. 24/25-9272A
A. This Addendum shall be considered part of the proposal documents for the above-mentioned project as B. Prospective proposers are hereby notified that they shall make any necessary adjustments in their estimates as a result of this Addendum. It will be construed that each proposal is submitted with full knowledge of all modifications and supplemental data specified herein.
Except as described below, the original bid documents remains unchanged:
1. The Notice Inviting Bids is hereby revised to incorporate the attached form for Listing of Subcontractors. Bidders shall include the completed version of this form in their final submittal package (to be uploaded as a response to Acknowledgement Required Below
PROPOSER MUST ACKNOWLEDGE THIS AMENDMENT BY SIGNING BELOW AND ATTACHING THE SIGNED ADDENDUM TO THE PROPOSAL:
Company Name CT*T Concrete Paring Inc.
Contac Person, Jose Carvajal
Signature
Date 06/12/25
One u
Amber Shah, PE
Director of Park and Public Works / City Engineer
City of San Marino
[email protected]
(626) 300-0765
ADDENDUM 2
BIDDER'S PROPOSAL
CDBG SIDEWALK RAMP PROJECT
PROJECT NO. 24/25-9272A
DESIGNATION OF
SUBCONTRACTORS
Name of
Subcontractor and Description of Work Subcontractor's DIR Registration Location of Place of License No. Number
Business
on point and surveying LS 8133 1000003100
someying
tot orange Tree lane
Suite 240 redland:
Car, 92374
Onlime Striping Signing it 1000012226
servre 862350
it day anyon striping
(Bidder to attach additional sheets if necessary)
(PUBLIC CONTRACT CODE $4100 ET SEQ.)
CDBG Sidewalk Ramp Projects CIP No.24/25-9272A
BID SECURITY FORM FOR BOND
KNOW ALL MEN BY THESE PRESENTS
That we cT&T Concrete Paving, Inc.
_as Principal,
and Contractors Bonding and Insurance Company
are held and firmly bound unto CITY OF SAN MARINO hereinafter called the "Agency" in the penal sum of TEN PERCENT (10%) OF THE TOTAL AMOUNT OF THE BID or the principal above named, submitted by said Principal to the Agency for the work described below, for the payment of which sum in lawful money of the United States, well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents.
In no case shall the liability of the surety hereunder exceed the sum of $ Ten Percent of the Total Bid Amount
THE CONDITION OF THIS OBLIGATION IS SUCH,
That whereas the Principal has submitted the above mentioned bid to the Agency for certain construction specifically described as follows, for which bids are to be opened on the , 2025, for
CDBG Sidewalk Ramp Projects CIP No.24/25-9272A
NOW, THEREFORE, IF the aforesaid principal shall not withdraw said bid within the period specified therein after the opening of the same, or, if no period be specified, with sixty (60) days after said opening, and shall within the period specified therefore, or, if no period be specified, within ten (10) days after the prescribed forms are presented to him for signature, enter into a written contract with the Agency in the prescribed form, in accordance with the bid as accepted, and file the two bonds with the Agency, one to guarantee faithful performance and the other to guarantee payment for labor and materials, as required by law, then this obligation shall be null and void; otherwise it shall be and remain in full force and virtue.
In the event suit is brought upon this bond by the Agency and judgment is recovered, the surety shall pay all costs incurred by the Agency in such suit, including a reasonable attorney's fee to be fixed by the Court.
IN WITNESS WHEREOF, we have hereunto set our hands and seals on this 10th _day of_ June 2025
Contractors Bonding and
CT&T Concrete Paving, In (SEAL) surance Company _ (SEAL) . (SEAL)
Jose Carvajal, President Emilie Young. Afforney-in-fact CDBG Sidewalk Ramp Projects CIP No.24/25-9272A
CDBG Sidewalk Ramp Projects CIP No.24/25-9272A
BID SECURITY FORM FOR BOND
ATTORNEY-IN-FACT ACKNOWLEDGEMENT OF SURETY
STATE OF
/ ss
COUNTY OF
On this day of — 2025, before me, the undersigned, a Notary Public in and for said County and State, personally appeared
known to me to be the person whose name
is subscribed to the within instrument as the attorney-in-fact of the , the corporation named as Surety in
said instrument, and acknowledged to me that he subscribed the name of said corporation thereto as Surety, and his own name as attorney-in-fact.
NOTE: Signature of those executing for Surety NOTE: The Attorney-in-fact must attach a must be properly acknowledged. certified copy of the Power of Attorney.
Signature:
Name (Type or Print):
Notary Public in and for said County and State
My Commission expires:
CDBG Sidewalk Ramp Projects CIP No.24/25-9272A
CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On June Bot Date 2025 before me, Eduardo Flores -Nagera Notary Public Here Insert Name and Title of the Officel
ersonally appeared dose Guadalupe Carvaja
Vame(s) of Signer(s
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
EDUARDO FLORES-NAJERA
Notary Public - California WITNESS my hand and official seal.
Los Angeles County
Commission # 2519450
My Comm. Expires May 4, 2029
Signatu
Place Notary Seal and/or Stamp Above Signature of Notary Public - OPTIONAL
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:_
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signers)
Signer's Name: Signer's Name:
• Corporate Officer - Title(s): • Corporate Officer - Title(s):
• Partner - • Limited • General • Partner - • Limited • General • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer is Representing: Signer is Representing:
88888888888888888888888888:8888838883818883838 18880818880848888888 188888888818 ©2019 National Notary Association
ARIZONA NOTARY ACKNOWLEDGMENT
State of Arizona
County of Maricopa
On this JUN 1 O 2025 , before me Danielle Hanson
[Name of Notary Public]
personally appeared Emilie Young _ whose identity was proven [Name of Signer]
to me on the basis of satisfactory evidence to be the person who he or she claims to be, and acknowledged that he or she signed the above/attached document.
Witness my hand and official seal.
DANIELLE IRIS HANSON
Notary Public - Arizona
Maricopa County
Commission # 653538
My Commission Expires
August 11, 2027
(Seal)
[Affix Seal Here] An
Signature of Notary Public
POWER OF ATTORNEY
RL Insurance Company
Contractors Bonding and Insurance Company
9025 N. line: 30D-645-240.IL. 61615
Know All Men by These Presents:
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired.
That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together, the "Company") do hereby make, constitute and appoint:
Yung T. Mullick. P. Austin Neff, Irene Luong. Emilie Young, Danielle Hanson, Christine Woolford, Alexander R. Holsheimer, Thao Luu, Joseph P. McGrady, jointy or severely
_ its true and lawful Agents) and Attorneys) in Fact, with foll posed and ratanty her bly confered oxeen, execute, acknowledge and deliver for and on is behalf as Surey, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five Million ($25,000,000.00 _ for any single obligation.
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company.
RLd Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation, and is now in force, to-wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective. Sr. Vice President - with its corporate seal affixed this 27th September 2024
RLI Insurance Company
URANCE CO Contractors Bonding and Insurance Company
CORPORATE Ei Hair
. SEAL SEAL By:
Eric Raudins Sr. Vice President
State of Illinois ILLINOIS
• SS
County of Peoria
CERTIFICATE
On this 27th day of September 2024
Public, personally appeared 202o being borme duly Sorr I, the undersigned officer of RLI Insurance Company and/or eric Raudins Contractors Bonding and Insurance Company, do hereby certify acknowledged that he signed the above Power of Attorney as the aforesaid that the attached Power of Attorney is in full force and effect and is ficer of the RLd Insurance Company and/or Contractors Bonding an irrevocable; and furthermore, that the Resolution of the Company as nsurance Company and acknowledged said instrument to be the voluntar set forth in the Power of Attorney, is now in force. In testimony act and deed of said corporation. whereof, I have hereunto set my hand and the seal of the RLI Company Compot any or Contracters Bonding 225 Insurance ud scat
By: Kul Insurance Company
Notary Public Contractors Bonding and Insurance Company
JILL A SCOTT
Notary Public
State of Ohio
My Comm. Expires
September 22. 2025 Corporate Secretary
0456659020212
A0058D19