CITY OF SANTA ANA Addendum No. Four
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
BID PROPOSAL
TO: CITY COUNCIL OF THE CITY OF SANTA ANA
FROM: GEMS Environmental Management Services, Inc.
REQUIREMENT:
The undersigned bidder declares that they have carefully examined the location of the proposed work, that they have examined the Contract Documents in its entirety and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said plans (if any) and the specifications for the unit price(s) or lump sum(s) set forth in the following Item Description Qty Unit Unit Price Amount
Remove Underground Storage Tanks 1 LS $ $
33,084.00 33,084.00
2 Remove Above Ground Fuel Storage 1 LS $
Tank/Dispenser System 3,444.00 3,444.00
3 Remove Existing Metal Enclosure 1 LS $ $
3,318.00 3,318.00
4 Concrete caissons/structural footing 1 | LS $
foundation 37,049.22 37,049.22
5 Install Above Ground Fuel Storage 1 LS $ $
Tank/Dispenser System 123,287.22 123,287.22
6 Install Portable DEF Storage Tank I LS $ 25,147.76
25,147.76
7 Install Metal Bollards 1 LS $ S 10,907.22
10,907.22
Install Metal Structure/Canopy with I LS $ $
metal decking and metal roofing 132,263.22 132,263.22
Fire extinguishers 1 LS $ $
420.00 420.00
10 | Product pipes, vapor pipes and fittings 1 LS $ $
and accessories, pipe support 11,763.22 11,763.22
11 Transition sumps & vapor pot 1 LS $ $
12,600.00 12,600.00
12| Veeder-Root TLS 450 1 LS $
40,841.22 40,841.22
13 Unleaded + Diesel fuel dispenser, 2-hose ]LS $ $
42,696.22 42,696.22
14 Dispensing Pump Control Panel 1 TLS $ $
5,943.00 5,943.00
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CITY OF SANTA ANA Addendum No. Four
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
Item Description Qty Unit Unit Price Amount
15 Fuel Turbines 1 IS $ 16,896.22
16,896.22
16 1 LS $ $
29,273.22 29,273.22
17 Power, control and communication ]LS $
conduits, cables, seals and support 17,141.22 17,141.22 18 Concrete Pavement Removal/Installation 1,100 SF $ $
50.80 55,880.00
Fencing and Barricades 1 LS $
17,367.22 17,367.22
20 Disposal of Construction Materials 1 LS $ $
21,557.22 21,557.22
Sheeting, Shoring, Bracing and 1 TLS $ $
Excavation Protection 13,224.00 13,224.00
22 As-Built Plans 1 LS $5000
5,000.00
23 Construction Permit 1 IS $10,000 $
10,000.00
24 TOCHCA Fees I LS $5000 $
5,000.00
TOTAL BASE BID $ 674,103.40
The lowest responsible bidder shall be selected based on the total base bid. The City reserves the right to award the Base Bid, and any, all, or none of the add-alternate bid items (if any). * The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the "25%" limit as stated in Section 7-3.5 of the Standard Specifications. The actual amount for this item will be dictated by the actual quantity used, and the Agency reserves the right to increase or decrease the quantity of this item accordingly. + This bid item is considered a Specialty Item per Section 3-2 of the Standard Specifications.
TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within eighty (80) working days after the commencement date stated in the Notice to Proceed. Upon issuance of the Notice to Proceed, Contractor shall immediately place order for long-lead time items: Above ground fuel storage tank/dispenser system, Transition sumps & vapor pot, unleaded + diesel fuel dispenser, 2-hose, Veeder-root TLS 450, Dispensing pump, fuel turbines, etc.
The liquidated damages amount, in lieu of the amount specified in Subsection 6-9 of the Standard Specifications, shall be $1,725 per calendar day.
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CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
Name of Firm GEMS Environmental Management Services, Inc.
Signature of BIDDER
Title President
(If an individual, so state. If a firm or co-partnership, state the firm name and give the names of all individual co-partners composing the firm. If a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof.) GEMS Environmental Management Services, Inc
Richard Camacho - President
Jennifer Camacho - Secretary
P-3 of P-19
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
BIDDER'S STATEMENT
BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent Construction Contract Agreement shall constitute the entire agreement between BIDDER and the AGENCY only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Public Works Agency Executive Director or his/her duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to BIDDER or deposited with the United States Postal Service properly addressed to the BIDDER with the correct postage affixed thereto.
BIDDER further agrees that upon delivery (as defined above) of the accepted agreement he/she will furnish AGENCY all required bonds and certificate of liability insurance within ten (10) business days or the funds, check, draft, or BIDDERS bond substituted in lieu thereof accompanying this proposal shall become the property of the AGENCY and shall be considered as payment of damages due to the delay and other causes suffered by AGENCY because of the failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered is difficult to ascertain; otherwise said funds, check, drafts, or BIDDER'S bond substituted in lieu thereof shall be returned to the undersigned.
BIDDER understands that a bid is required for the entire work, the estimated quantities set forth in the bid schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. The BIDDER also certifies that the bid is a balanced bid.
In accordance with Section 7028.15 of the California Business and Professions Code, the undersigned certifies under penalty of perjury that the foregoing is true and correct.
Name of Firm GEMS Environmental Management Services, Anc.
Signature of BIDDER fund al
Title President
(If an individual, so state. If a firm or co-partnership, state the firm name and give the names of all names of president, coriay, Treasure a f angratie, salt legal name of corporation, GEMS Environmental Management, Inc.
Richard Camacho - President
Jennifer Camacho - Secretary
P-4 of P-19
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT
The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and all his/her subcontractors are registered with the State of California Department of Industrial Relations (DIR), and that the following is true and correct.
Contractor's Name: GEMS Environmental Management Services, Inc.
Business Address: 1120 Willow Pass Court, Concord, CA 94520 Business E-Mail Address: [email protected]
Telephone: (925) 671-6822
State Contractor's License No. and Class: 864458 A - Haz License Expiration Date: 9/30/2027
State Dept. of Industrial Relations (DIR)
Registration No.: 1000001924
State Dept. of Industrial Relations (DIR)
Registration Expiration Date: 6/30/2027
Signed:
Title: President
P-5 of P-19
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT
Contractor is aware of the requirements of California Labor Code Section 1720, et seq., as well as California Code of Regulations, Title 8, Section 16,000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencesten of thira griefine or per shal ma needed so thereines a per to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site.
Contractor shall detend, indemnity 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.
The undersigned certifies that the foregoing is true and correct.
Name of Firm GEMS Environmental Management Services, Inc Signature of BIDDER Man E inte
Title President
(if an individual, so state)
P-6 of P-19
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
OWNERSHIP AFFIDAVIT
STATE OF CALIFORNIA
COUNTY OF ORANGE
CITY OF SANTA ANA
Richard Camacho _, being duly sworn, deposes and says:
•INDIVIDUAL That he/she is the party making the foregoing proposal:
[PARTNERSHIP That he/she is a member of the co-partnership firm designated as:
and who has been and is duly vested with the authority to make and execute instruments for the co-partnership by:
who constitute the other members of the co-partnership. [X CORPORATION Tarsident of GEMS Environmental Management Services, Inc. a corporation which is making the foregoing proposal:
•JOINT VENTURE That he is of:
one of the parties making the foregoing proposal as a joint venture, and the he/she has been and is duly vested with the authority to execute instruments for an on behalf of the parties making said bid who are:
that such a bid is genuine and not collusive or sham, and has not in any manner sought by collusion to secure any advantage against the City of Santa Ana or any person interested in the proposed Signature of Bidder
Subscribed and sworn to before me this _ _ day of _ 20_ Signature of officer Administering Oath (Notary Public)
SEE ATTACHED NOTARIAL CERTIFICATE
Typeter:here
P-7 of P-19
CALIFORNIA JURAT GOVERNMENT CODE § 8202
I888205788803373138883 3030318038818083009T@98:30808306888495833430ES 38883:38808180882888889913831831898883180840878038803381319 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 Contra Costa
Subscribed and sworn to (or affirmed) before me on
this 4 day of November. 20_25 by
Date Month Year
(1) Richard E. Camacho
PAULA TLEIMAT
Notary Public - California
Contra Costa County (and (2)
Commission # 2424919
My Comm. Expires Nov 2, 2026 Name(s) of Signers)
proved to me on the basis of satisfactory evidence to
be the person(s) who appeared before me.
signature Pana t
Place Notary Seal and/or Stamp Above Signature of Notary Public - OPTIONAL
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Description of Attached Document
Title or Type of Document: Ownership Affidavit
Document Date: _ Number of Pages:
Signer(s) Other Than Named Above:
34849488808:30805:80548334S88:848898S8808#80888150 BABESAS BARRIE 89NE 88S888888S8888S8888883988858888188 ©2019 National Notary Association
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
BID BOND
KNOW ALL PRESENT that,
GEMS Environmental Management Services, Inc. ., as BIDDER, and Developers Surety and Indemnity Company , as SURETY,
are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal sum of Ten percent of the total amount bid Dollars ($ 10% ), which is ten percent (10% f the total amount bid by BIDDER to AGENCY for the above-stated project, for the payment o which sum, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of AGENCY.
IN-WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seal this 2nd_ day of October , 2025. Richard Camacho-President
BIDDER* (925) 671-6820
GEMS Environmental Management Services, Inc.
_1120 Willow Pass Court, Concord, CA 94520
By:
SURETY* Developers Surety and Indemnity Company
800 Superior Avenue E, 21st floor, Cleveland, OH 44114
Cia N. Luca
By:
Lisa M. Lucas, Attorney-in-fact
Subscribed and sworn to before me See attached notary acknowledgement this day of , 20
Signature:
Notary Public in and for the County of _, State of
* Provide BIDDER/SURETY name, address, and telephone number and the name, title, address, and telephone number of authorized representative.
P-8 of P-19
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California )
County of Contra Costa )
on October 2, 2025 Tanya Chinchilla, Notary Public
before me, _
Date Here Insert Name and Title of the Officer
Lisa M. Lucas
personally appeared
Name(s) of Signers)
who proved to me on the basis of satisfactory evidence to be the person(* whose names) is/are subscribed to the within instrument and acknowledged to me that Ke/she/eX executed the same in Diz/her/he authorized capacity(6x), and that by Kis/her/tiXsignature(8) on the instrument the person (s), or the entity upon behalf of which the persong) 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.
TANYA CHINCHILLA
Notary Public - California
WITNESS my hand and official seal.
Contra Costa County
Commission # 2472174
My Comm. Expires Nov 16, 2027
Signature
Place Notary Seal Above
- OPTIONAL
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Description of Attached Document
Title or Type of Document: Document Date: _
Number of Pages: _ Signers) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
] Corporate Officer - Title(s): • Corporate Officer - Title(s):
• Partner - • Limited • General • Partner - • Limited • General I Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: Signer Is Representing:
wwwwwwwwwwwww.
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
POWER OF ATTORNEY FOR
COREPOINTE INSURANCE COMPANY
DEVELOPERS SURETY AND INDEMNITY COMPANY
59 Maiden Lane, 43rd Floor, New York, NY 10038
(212) 220-7120
KNOW ALL BY THESE PRESENTS that, except as expressly limited herein, COREPOINTE INSURANCE COMPANY and DEVELOPERS SURETY AND INDEMNITY COMPANY, do hereby make, constitute and appoint:
Lisa M. Lucas and Tanya Chinchilla San Ramon, CA
, of
as its true and lawful Attorney-in-Fact, to make, execute, deliver and acknowledge, for and on behalf of said companies, as sureties, bonds, undertakings and contracts of suretyship giving and granting unto said Attomey-in-Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each of said company could do. but reserving to each of said company full power of substitution and revocation, and all of the acts of said Altomey-in-Fact, pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is effective July 20, 2023 and shall expire on December 31, 2025.
This Power of Attorney is granted and is signed under and by authority of the following resolutions adopted by the Board of Directors of COREPOINTE INSURANCE COMPANY and DEVELOPERS SURETY AND INDEMNITY COMPANY (collectively, "Company") on February 10, 2023.
RESOLVED, that Sam Zaza, President, Surety Underwriting, James Bell, Vice President, Surety Underwriting, and Craig Dawson, Executive Underwriter, Surety, each an employee of Am Trust North America, Inc., an affiliate of the Company (the "Authorized Signors"), are hereby authorized to execute a Power of Attorney, qualifying attorney(s)-in-fact named in the Power of Attorney to execute, on behalf of the Company, bonds, undertakings and contracts of suretyship, or other suretyship obligations; and that the Secretary or any Assistant Secretary of the Company be, and each of them hereby is, authorized to attest the execution of any such Power of Attorney.
RESOLVED, that the signature of any one of the Authorized Signors and the Secretary or any Assistant Secretary of the Company, and the seal of the Company must be affixed to any such Power of Attorney, and any such signature or seal may be affixed by facsimile, and such Power of Attorney shall be valid and binding upon the Company when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached.
IN WITNESS WHEREOF, COREPOINTE INSURANCE COMPANY and DEVELOPERS SURETY AND INDEMNITY COMPANY have caused these presents to be signed by the Authorized Signor and attested by their Secretary or Assistant Secretary this March 27.2023
INSURA YAND IN
By:
CORPORA; ORPORAT
Printed Nan Sam Zaz
Title: President, Surety Underwriting (SEAL 1936
CALIFORN
ACKNOWLEDGEMENT:
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 Orange
March. 2023. before me. Hoang-Quven Phu Pham • personally appeared Sam Zaza who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to within the instrument and acknowledged to me that they executed the same in their authorized capacity, and that by the signature on the instrument the entities upon behalf which the person acted. executed this instrument I certify. under penalty of perjury, under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
HOANG-QUYEN P. PHAM
Notary Public - California
Orange County
Signature
Commission # 2432970
My Comm. Expires Dec 31, 2026
CORPORATE CERTIFICATION
The undersigned, the Secretary or Assistant Secretary of COREPOINTE INSURANCE COMPANY and DEVELOPERS SURETY AND INDEMNITY COMPANY, does hereby certify that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in this Power of Attorney are in force as of the date of this Certification.
This Certification is executed in the City of Cleveland. Ohio, this March 19.2023 -DocuSigned by:
By: Barry W. Moses Barry W. Moses, Assistant Sécretary POA No. N/A 6B641SE7ADE548C
DocuSignEnvelopeID:3352BFD6-5E9D-4796-837E-C1E455E6530F Ed. 0323 Signed and sealed this 2nd day of October, 2025
...
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
LIST OF SUB-CONTRACTORS
Section 4100 et. seq. of the Public Contract Code requires listing of all subcontractors with the bid for all subcontract work exceeding the following amount:
• Streets, highways including bridge projects: ½% of the bid or $10,000, whichever is greater • Buildings, parks, or other projects: 2% of the bid
Section 1725.5 of the Public Contract Code requires all Subcontractors be registered with the State Department of Industrial Relations (DIR).
BIDDER proposes to subcontract certain portions of the work to the firms listed below:
Name Arias Concrete Contractor Inc Name Nieto and Sons Trucking, Inc.
License #/Exp. 1075559/ Exp. 5/31/27 License #/Exp. 673912/Exp. 7/31/27 DIR Reg. #/Exp. 1000828207/ Exp. 6/30/26 DIR Reg. #/Exp. 1000015003/Exp. 6/30/27 Location Pittsburg, CA 94565 Location Brea, CA 92821
Phone (925) 446-2492 Phone (714) 990-6855
Type Of Work Concrete work Type Of Work Clean and dispose tanks Amount $ $35,910.00 Amount $ $10,955.00
Name Name
License #/Exp. License #/Exp.
DIR Reg. #Exp. DIR Reg. #/Exp.
License # License #
Location Location
Phone Phone
Type Of Work Type Of Work
Amount $ Amount $
Name Name
License #/Exp. License #/Exp.
DIR Reg. #/Exp. DIR Reg. #/Exp.
License # License #
Location Location
Phone Phone
Type Of Work Type Of Work
Amount $ Amount S
ham's Cind
Signature of Biddel
p-9 of P-19
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
REFERENCES
The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER has performed similar work within the past three years.
1. _East Bay Municipal Utility District, 375 11th Street, Oakland, CA 94607 Name and Address of Owner.
Christian Narvaez (510) 287-1015
Name and Telephone Number of person familiar with project. $432,188.08 Diesel Tank Install 6/20/2025
Contract Amount Type of Work Date Completed
2. _Ciy of Pittsburg, 65 Civic Avenue, Pittsburg, CA 94565 Name and Address of owner.
Mariana Mena (925) 252-4115
Name and Telephone Number of person familiar with project. $995,096.00 AST Replacement 9/26/2024
Contract Amount Type of Work Date Completed
3. AC Transit, 1600 Franklin Street, Oakland, CA 94612
Name and Address of owner.
Stephen Stanley, 1600 Franklin Street, Oakland, CA 94612 Name and Telephone Number of person familiar with project. $525.803.00 UST Removal/AST Install 1/11/2024
Contract Amount Type of Work Date Completed
The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance and bonds.
Edgewood Insurance Brokers & Consultants, 3000 Executive Pkwy, Suite 325, San Ramon, CA 94583 (925) 244-7700 Developers Surety and Indemnity, P.O. Box 19725, Irvine, CA 92623-9725 (925) 244-7700 Edgewood Insurance Brokers & Consultants, 1390 Willow Pass Rd., Concord, CA 94520 (415) 356-3991 P-10 of P-19
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
ADDITIONAL REFERENCES
The following are the names, addresses, and telephone numbers for THREE public agencies for which the BIDDER or Subcontractor has performed similar work in the past five years.
1. SEE ATTACHED LIST
Name and Address of Owner.
Name and Telephone Number of person familiar with project.
Contract Amount Type of Work Date Completed
2. -
Name and Address of owner.
Name and Telephone Number of person familiar with project.
Contract Amount Type of Work Date Completed
Name and Address of owner.
Name and Telephone Number of person familiar with project.
Contract Amount Type of Work Date Completed
P-11 of P-19
PROJECT REFERENCES
GEMS ENVIRONMENTAL MANAGEMENT SERVICES, INC.
Project Description Contract Number Project Date Total Cost Agency Contact Name and Phone Number Corporation Yard Fueling System Replacement - Project. No. 3118 2/19/24-9/26/24 $995,096.00 City of Pittsburg Mariana Mena AST 65 Civic Avenue (925) 252-4115 [email protected] Pittsburg, CA 94565
Repair Existing Underground Fuel Storage Tank FA468623P0047 9/12/23-4/3/24 $198,395.70 U.S. Department of the Air Force Katherine Moe Sumps, Spill Buckets, Shut Off Valves, 6500 B Street, Room 101 (530) 634-2399 Caps, Adaptors, and Multiport Manways at Beale AFB, CA 95903-1709 [email protected] Beale Air Force Base, CA
Install New Underground Fuel System and CP21-02 11/29/22-9/28/23 $3,456,336.00 County of Ventura Jonathan Jacobson Canopy, and Remove Existing Underground 800 South Victoria Ave (805) 654-2022 Fuel System and Canopies for the County Ventura, CA 93009 [email protected] General Services Agency, Ventura, CA
Remove and Replace Fuel Pumps and 04A6055 9/21/20-12/31/20 $42,896.23 CA Department of Transportation (Caltrans) Carlos Gutierrez Dispensers, Caltrans District 04 Maintenance 611 Payran Street (707) 753-1152 Station, Dixon, CA Petaluma, CA 94952 [email protected] Refurbish, Relocate and Reinstall Aboveground 24717 9/16/19-2/24/20 $411,885.16 Johnson Petroleum Construction, Inc. Scott Johnson Fuel Storage Tank at Recology, Santa Rosa, CA P.O. Box 7169 (916) 265-8080 Auburn, CA 95604 [email protected]
Fuel Dispenser, Pumps, and Cardlock Fuel Site 013455 1/9/19-1/28/19 $218,742.07 Contra Costa County Stan Burton Upgrade Fleet Services / Public Works Department (925) 313-7077 2467 Waterbird Way [email protected]
Martinez, CA 94553
Underground Fuel Tank Removal and Above 4700 10/17/17-12/21/18 $1,102,775.34| CA Department of General Services Randall Mummert Ground Fuel Tank Installation at the Ronald M. 707 3rd Street- 3rd Floor (916) 443-9814 George Buildng, San Francisco West Sacramento, CA 95605 [email protected] Fuel Farm Facility Improvements - Big Bear 2017-10-26-A 2/12/18-11/14/18 1,518,296.58 Big Bear Airport Distric Ryan Goss Ariport District, Big Bear City, CA 01 Valley Blvc (909) 585-3219 Big Bear City, CA 92314 [email protected]
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
NON-COLLUSION AFFIDAVIT
(Title 23 United States Code Section 112 and Public Contract Code Section 7106) In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by since BiDDER, ou to fi any vented, poith an yost teet of the bid price, or or at of any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further. that 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, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid.
Note: The above Non-collusion Affidavit is part of the Proposal. BIDDERS are cautioned that making a false certification may subject the certifier to criminal prosecution.
Signed
State of California
County of Contra Costa
Subscribed and sworn to (or affirmed) before me on this 4 _ day of November, 2025, by Richard Camacho — proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me
SEE ATTACHED NOTARIAL CERTIFICATE
Notary Public Signature Notary Public Seal
P-12 of P-19
CALIFORNIA JURAT GOVERNMENT CODE § 8202
83830383:308031808:38803130808:80808180888:94808:94805280888194808*S 3883 3 8838888183818888833988888083S181819 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 Contra Costa
Subscribed and sworn to (or affirmed) before me on
this 4 _ day of — No entere _, 20.25, by
Date Year
(1) Richard E. Camacho
PAULA TLEIMAT
Notary Public • California
Contra Costa County (and (2) -),
Commission #2424919 Name(s) of Signers)
My Comm. Expires Nov 2, 2026
proved to me on the basis of satisfactory evidence to
be the person(s) who appeared before me.
Gas
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: Non-Collusion Affidavit
Document Date: . Number of Pages:
Signers) Other Than Named Above: _
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TAMIR STATUAR
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
NON-DISCRIMINATION CERTIFICATE
The undersigned contractor or corporate officer, during the performance of this contract, certifies as follows:
rms of compensation; and selection for training, including apprenticeship. The Contracto rees to post in conspicuous places, available to employees and applicants for employment
2. The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.
3. The Contractor shall send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment.
4. The Contractor shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor.
5. The Contractor shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders.
6. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law.
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CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
7. The Contractor shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the Contractor may request that the United States enter into such litigation to protect the interests of the United States.
8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as contractor of public works violating this Section is subject to all the penalties imposed for a violation of the Chapter.
Raunfailan
Title: President
Firm: GEMS Environmental Management Services, Inc.
Date: 11/04/2025
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CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
STATEMENT REGARDING APPRENTICESHIP REQUIREMENTS
The undersigned BIDDER is familiar with the requirements of Section 1777.5 of the State Labor Code regarding employment of apprentices, and understands that contractors on contracts exceeding $30,000 or 20 working days shall:
1. Apply to the joint apprenticeship committee administering the apprenticeship standards of the crad or trade in tic are othere fre pailoyment andering aprentice contractor or industry affected.
2. Employ the number of apprentices or the ratio of apprentices to journeymen stipulated in the apprenticeship standards.
3. Contribute to the fund or funds in each craft or trade in which he/she employs journeymen or apprentices on the public work, in the same amount or upon the same basis and in the same manner as the other contractors, except contractors not signatory to the trust agreement shall pay a like amount to the California Apprenticeship Gouncil.
Signed: Paul, Canst
Title: President
Firm: GEMS Environmental Management Services, Inc.
Date: 11/04/2025
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CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
STATEMENT REGARDING "ANTI-KICKBACK" REQUIREMENTS
The undersigned is submitting this proposal for performing by contract the work required by these bid documents, agrees to comply with the Copeland "Anti-Kickback" Act (18 USC 74) as supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that each contractor or subcontractor shall be prohibited from inducing, by any means, any person employed in the construction or repair of public work, to give up any part of the compensation to which he/she is otherwise entitle
Signed:
Title: President
Firm: GEMS Environmental Management Services, Inc.
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CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
FLEET COMPLIANCE CERTIFICATION
Bidder hereby acknowledges that they have reviewed the California Air Resources Board's policies, rules and regulations and are familiar with the requirements of Title 13, California Code of Regulations, Division 3, Chapter 9, effective on January 1, 2024 (the "Regulation"). Bidder hereby certifies, subject to penalty for perjury, that the option checked below relating to the Bidder's fleet, and/or that of their subcontractors) ("Fleet") is true and correct:
The Fleet is subject to the requirements of the Regulation, and the appropriate Certificate(s) of Reported Compliance have been attached hereto.
The Fleet is exempt from the Regulation under section 2449.1(f)(2), and a signed description of the subject vehicles, and reasoning for exemption has been attached hereto.
Bidder and/or their subcontractor is unable to procure R99 or R100 renewable diesel fuel as defined in the Regulation pursuant to section 2449.1(f)(3). Bidder shall keep detailed records describing the normal refueling methods, their attempts to procure renewable diesel fuel and proof that shows they were not able to procure renewable diesel (i.e. third party correspondence or vendor bids).
The Fleet is exempt from the requirements of the Regulation pursuant to section 2449(i)(4) because this Project has been deemed an Emergency, as defined under section 2449(c)(18). Bidder shall only operate the exempted vehicles in the emergency situation and records of the exempted vehicles must be maintained, pursuant to section 2449(i)(4).
The Fleet does not fall under the Regulation or are otherwise exempted and a detailed reasoning is attached hereto.
Name of Bidder: GEMS Environgenta flanagement Seryices, Inc.
Signature: Aunt li
Name: Richard Camacho
Title: President
Date: 11/04/2025
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California Environmental Protection Agency
Air Resources Board
January 1, 2025
CERTIFICATE OF REPORTED COMPLIANCE
OFF-ROAD DIESEL VEHICLE REGULATION
is issued to
GEMS ENVIRONMENTAL MANAGEMENT SVCS,
INC
This certificate indicates that the fleet listed above has reported off-road diesel vehicles to the California Air Resources Board and has certified they are in compliance with title 13 CCR, section 2449. All applicable vehicles owned by the individual, company, or agency must be reported and labeled, as specified in Section 2449, with all possible completeness, else this certificate is null and void. Certificate expires 2/28/2026 Off-road Diesel Fleet Identification
7635
Jack Kitowski
Chief, Mobile Source Control Division To verify the authenticity of this certificate, enter this number at California Air Resources Board
http://www.arb.ca.gov/doors/compliance_cert1.html
CALIFORNIA
AIR RESOURCES BOARD
Certificate of Reported Compliance With:
Truck and Bus Regulation
Issued to: Nieto and Sons Truck, Inc.
This certificate confirms that the fleet owner has attested under penalty of perjury that the statementsand information they provided to the California Air Resources Board (CARB) are true, accurate, and complete regarding all relevant vehicles in the fleet required to show compliance. CARB hereby finds that the fleet listed has reported compliance with California Code of Regulations (CCR):
Title 13 CCR 2025 (Truck and Bus Regulation)
If CARB subsequently finds that the statements and information that have been provided are not true, accurate, and complete, this certificate shall be effectively revoked and the fleet subject to noncompliance penalties.
This certificate is valid until December 31, 2024
Printed on 2024-02-20 TRUCRS Fleet Identification
Jack Kitowaki 9938
Jack Kitowski 12 Vehicles
To verify the authenticity of this certificate, visit
Division Chief, Mobile Source Control
Division California Air Resources Board www.arb.ca.gov/msprog/onrdiesel/tblbokup.php
CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE
In conformance with Public Contract Code Section 10162, the BIDDER shall complete, under penalty of perjury, the following questionnaire:
Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of Yes. No x
If the answer is yes, explain the circumstances in the following space.
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CITY OF SANTA ANA
PROPOSAL
PROJECT NO.: 24-6053
SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT
STATEMENT REGARDING COMMUNITY WORKFORCE AGREEMENT (CWA)
REQUIREMENTS
This is to certify that the undersigned BIDDER, and subcontractors, have read and understood the 'WA entered into by and between the City of Santa Ana, the Los Angeles/Orange Counties building and Construction Trades Council, and the signatory Craft Councils and Local Unions, The undersigned BIDDER hereby agrees to comply with all terms and conditions of the CWA, andys. If liar coraleing constred by the pri, contine wil and beeuinero sign tor etter of Assent that appears as Attachment A to the CWA The undersigned BIDDER has reviewed the Public Works Construction Permit and required deposit described in Section 2- 2a and the Notice of Inviting Bids.
Signed:
Title: President
Firm: GEMS Environmental Management Services, Inc.
Date: 11/04/2025
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