DocuSign Envelope lD: 5746M84-550F-4DDB-9D35-7C3BEC00E6B3
PROPOSAL FORM
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City ol Santa Clarita, California
TO THE CtW OF SANTA CIAR|TA, AS C|TY:
ln accordance with CITY's NOTICE INVITING BIDS, the undersigned BIDDER hereby proposes to furnish all materials, equipment, tools, labor, and incidentals required for the above-stated project as set forth in the plans, specifications, and contract documents therefore, and to perform all work in the manner and time prescribed therein.
BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, INSTRUCTIONSTOBIDDERS,andaII othercontractdocuments. lfthisproposal isacceptedforaward,B|DDERagrees to enter into a contract with CITY at the unit and/or lump sum prices set forth in the following BID SCHEDULE. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to ClTy of the proposal guarantee accompanying this proposal.
BIDDER understands that a bid is required for the entire work that the estimated quantities set forth in 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 ctry RESERVES THE RTGHT To tNCREASE oR DECREASE THE AMOUNTOFANYQUANTITYSHOWNANDTODELETEANYITEMFROMTHECONTRACT. ltisagreedthattheunitand/or lump sum price(s) bid include all appurtenant expenses, taxes, royalties, and fees for the project's duration. ln case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. lf awarded the contract, the undersigned further agrees that in the event of the Bidder's default in executing the required contract and filing the necessary bonds and insurance certificates within ten working days after the date of the CITY's notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the CITY and this bid and the acceptance hereof may, at the CITY's option, be considered null and void.
Company Name: California Commercial Pools, lnc.
Company Address 2255 E Auto Centre Drive,
rllllllrr,
Glendora CA91740
,o
Phone: 909-394-1280
Email: 1980
Brett Smifh
Print Nome *
lttttt
Title:
Signature:
Date:
bids@calcom mpools.com iSEAL -a:
By:
5t16t2022
DocuSign Envelope lD: 57464484-550F-4DDB-9D35-7C38EC0OE6B3
NOTICE TO BIDDERS REGARDING CONTRACTUAL REQUIREMENTS
Bid #ENG-21-22-M303s
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, project M3035 City Project No. M3035
City of Santa Clarita, California
SUMMARY OF INDEMNITY AND INSURANCE REqUIREMENTS
1-. These are the- lndemnity and lnsurance Requirements for Contractors providing services or supplies to City of Santa Clarita (City). By agreeing to perform the work or submitting a proposal, you verify that you comply with and agree to be bound by these requirements. lf any additional Contract documents are executed, the actual lndemnity language and lnsurance Requirements may include additional provisions as deemed appropriate by City's Risk Manager.
Questions and requests for modification of these terms must be negotiated and approved prior to bid submission and are at the full discretion of the City.
2. You should check with your lnsurance advisors to verify compliance and determine if additional covera8e or limits may be needed to adequately insure your obligations under this agreement. These are the minimum required and do not in any way represent or imply that such coverage is sufficient to adequately cover the Contractor's liability under this agreement. The full coverage and limits afforded under Contractot's policies of lnsurance shall be available to Buyer and these lnsurance Requirements shall not in any way act to reduce coverage that is broader or includes higher limits than those required.
The lnsurance obligations under this agreement shall be: 1-all the lnsurance coverage and limits carried by or available to the Contractor; or 2-the minimum lnsurance requirements shown in this agreement, whichever is greater. Any insurance proceeds in excess of the specified minimum limits and coverage required, which are applicable to a given loss, shall be available to City.
3. Contractor shall furnish the City with original Certificates of lnsurance including all required amendatory endorsements and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. City reserves the right to require full-certified copies of all I nsurance coverage and endorsements.
I. INDEMNIFICATION:
City and its respective elected and appointed boards, officials, officers, agents, employees, and volunteers (individually and collectively, "lndemnitees") shall have no liability to CONTRACTOR or any other person for, and CONTRACTOR shall indemnify, defend, protect, and hold harmless lndemnitees 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 attorney's fees and disbursements (collectively, "Claims"), which lndemnitees may suffer or incur or to which lndemnitees 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 or allegedly caused by the CONTRACTOR'S performance of or failure to perform any services under this Agreement, or by the negligent or willful acts or omissions of CONTRACTOR, its agents, officers, directors, or employees, committed in performing any of the services under this Agreement. lf any action or proceeding is brought againSt lndemnitees by reason of any of the matters against which CONTRACTOR has agreed to indemnify lndemnitees as provided above, CONTRACTOR, upon notice from DocuSign Envelope lD: 5746AA84-550F-4DDB-9D35-7C38EC00EOB3 City, shall defend lndemnitees at its expense by counsel acceptable to City, such acceptance not to be unreasonably wlthheld. lndemnitees need not have first paid for any of the matters to which lndemnitees are entitled to indemnification in orderto be so indemnified. The limits of the insurance required to be maintained by CONTRACTOR in this Agreement shall not limit the liability of CONTRACTOR hereunder, The provisions of this section shall survive the expiration or earlier termination of this agreement.
The provisions of this section do not apply to Claims occurring as a result of the City's active negligence or acts of omission.
II.INSURANCE
CONTRACTOR shall maintain and submit certificates of all applicable insurance including, but not limited to, the following and as otherwise required by law. The terms of the insurance policy or policies issued to provide the above insurance coverage shall provide that said insurance may not be amended or canceled by the carrier, for non-payment of premiums or otherwise, without thirty (30) days prior written notice of amendment or cancellation to the CITY. ln the event the said insurance is canceled, the CONTRACTOR shall, priorto the cancellation date, submit to the City Clerk new evidence of insurance in the amounts established.
Liabilitv lnsurance
During the entire term of this Agreement, the CONTRACTOR agrees to procure and maintain General Liability insurance at its sole expense to protect against loss from liability imposed by law for damages on account of bodily injury, including death therefrom, suffered or alleged to be suffered by any person or persons whomsoever, resulting directly or indirectly from any act or activities, errors or omissions, of the ClW, or CONTRACTOR or any person acting for the CITY, or under its control or direction, and also to protect against loss from liability imposed by law for damages to any property of any person caused directly or indirectly by or from acts or activities of the CITY, or CONTRACTOR or any person acting for the ClW, or under its control or direction. Such public liability and property damage insurance shall also provide for and protect the CITY against incurring any legal cost in defending claims for alleged loss. Such General, Public and Professional liability and property damage insurance shall be maintained in full force and effect throughout the term of the Agreement and any extension thereof in the amount indicated above or the following minimum limits:
Commercial General Liability lnsurance, including coverage for Premises and Operations, Contractual Liability, Personal lnjury Liability, Products/Completed Operations Liability, and lndependent Contractors' Liability (if applicable), in an amount of not less than two million dollars (52,000,000.00) per occurrence, four million dollars (54,000,000.00) annual aggregate, written on an occurrence form.
Products/Completed Operations coverage shall extend a minimum of three (3) years after project completion. Coverage shall be included on behalf of the CONTRACTOR for covered claims arising out of the actions of independent contractors. lf the CONTRACTOR is using subcontractors, the policy must include work performed "by or on behalf" of the CONTRACTOR, Policy shall contain no language that would invalidate or remove the CONTRACTOR'S duty to defend or indemnify for claims or suits expressly excluded from coverage. Policy shall specifically provide for a duty to defend on the part of the CONTRACTOR.
DocuSign Envelope lD: 5746M84-550F-4DDB-9D35-7C38EC00E6B3 Worker's Compensation I nsurance
The CONTRACTOR shall procure and maintain, at its sole expense, Worker's Compensation lnsurance in the amount of S1,000,000 per occurrence or in such amount as willfully comply with the laws of the State of California and which shall indemnify, insure and provide legal defense for both the CONTRACTOR and the CIW against any loss, claim or damage arising from any injuries or occupational diseases happening to any worker employed by the CONTRACTOR in the course of carrying out the work within the Agreement, Such insurance shall also contain a waiver of subrogation naming the City of Santa Clarita.
Automotive lnsurance
The CONTRACTOR shall procure and maintain, at its sole expense, throughout the term of this Agreement, and any extension thereof, public liability and property damage insurance coverage for automotive equipment with coverage limits of not less than 51,000,000 combined single limit for each accident. All such insurance shall be primary insurance and shall name the City of Santa Clarita as an additional insured.
Build s Risk
Upon commencement of construction and with approval of CITY, CONTRACTOR shall obtain and maintain Builder's Risk lnsuranceforthe entire duration of the Project untilonlythe CITY has an insurable interest.
The Builder's Risk coverage shall include the coverages as specified below:
The named insureds shall be CONTRACTOR and CITY, including its officers, officials, employees, and agents. All subcontractors (excluding those solely responsible for design work) of any tier and suppliers shall be included as additional insureds as their interests may appear. CONTRACTOR shall not be required to maintain property insurance for any portion of the Project following transfer of controlthereof to ClTy.
The policy shall contain a provision that all proceeds from the Builder's Risk Policy shall be made payable to the clw. The clrY will act as a fiduciary for all other interests in the project.
Policy shall be provided for replacement value on an "all risk" basis for the completed value of the project.
There shall be no coinsurance penalty or provisional limit provision in any such policy. policy must include:
(L) coverage for any ensuing loss from faulty workmanship, nonconforming work, omission or deficiency in design or specifications; (2) coverage against machinery accidents and operationaltesting; (3) coverage for removal of debris, and insuring the buildings, structures, machinery, equipment, materials, facilities, fixtures and all other properties constituting a part of the Project; (4) Ordinance or law coverage for contingent rebuilding, demolition, and increased costs of construction; (5) transit coverage (unless insured by the supplier or receiving contractor), with sub-limits sufficient to insure the full replacement value of any key equipment item; (6) ocean marine cargo coverage insuring any project materials or supplies, if applicable; (7) coverage with sub-limits sufficient to insure the full replacement value of any property or equipment stored either on or off the site or any staging area. Such insurance shall be on a form acceptable to CITY to ensure adequacy of terms and sub-limits and shall be submitted to the CIW prior to commencement of construction.
Fire and Extended Coverage lnsurance (Services involving real propertv onlv) CONTRACTOR agrees to procure and maintain, at its sole expense, during the term of this Agreement, and any extension thereof, a policy of fire, extended coverage and vandalism insurance.
Docusign Envelope lD: 5746M84-550F-4DDB-9D35-7C3BEC0OE6B3 Pollution Liabilitv and/or Asbestos Pollution Liabilitv and/or Errors & Omissions Contractors Pollution Liability and/or Asbestos Pollution Liability and/or Errors & Omissions with limit no less than 52,000,000 per claim or occurrence and 52,000,000 aggregate per policy period of one year.
Coverage must be included for bodily injury and property damage, including coverage for loss of use and/or diminution in property value, and for clean-up costs arising out of, pertaining to, or in any way related to the actual or alleged discharge, dispersal, seepage, migration, release or escape of contaminants or pollutants, arising out of or pertaining to the services provided by CONTRACTOR under this Agreement, including the transportation of hazardous materials or contaminants.
Professional Liabilitv (if Desisn-Build)
Professional Liability lnsurance, insuring against professional errors and omissions arising from CONTRACTOR'S work on the Project, in an amount not less than [$2,000,000] combined single limit for each occurrence. lf CONTRACTOR cannot provide an occurrence policy, CONTRACTOR shall provide insurance covering claims made as a result of performance of work on this Project and shall maintain such insurance in effect for not less than three years following final completion of the Project.
Waiver of Subrogation
All insurance coverage maintained or procured pursuant to this Agreement shall be endorsed to waive subrogation against the ClW, its elected or appointed officers, agents, officials, employees and volunteers or shall specifically allow CONTRACTOR or others providing insurance evidence in compliance with these specifications to waive their right of recovery prior to a loss. CONTRACTOR hereby waives its own right of recovery against the CITY, and shall require similar written express waivers and insurance clauses from each of its subconsultants.
Separation of lnsureds
A severability of interests provision must apply for all additional insureds ensuring that CONTRACTOR'S insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the insurer's limits of liability. The policy(ies) shall not contain any cross-liability exclusions.
Pass Through Clause
CONTRACTOR agrees to ensure that its subconsultants, subcontractors, and any other party involved with the project who is brought onto or involved in the project by CONTRACTOR, provide the same minimum insurance coverage and endorsements required of CONTRACTOR. CONTRACTOR agrees to monitor and review all such coverage and assumes all responsibility for ensuring that such coverage is provided in conformity with the requirements of this section. CONTRACTOR agrees that upon request, all Agreements with consultants, subcontractors, and others engaged in the project will be submitted to the ClTy for review.
Self-lnsu red Retentions
Any self-insured retentions must be declared to and approved by the CITY. The CITY reserves the right to require that self-insured retentions be eliminated, lowered, or replaced by a deductible. Self-insurance will not be considered to comply with these specifications unless approved by the ClW.
DocuSign Envelope lD: 5746M84-550F-4DDB-9D35-7C38EC00EOB3 Primarv and Additional lnsured
All of such insurance shall be primary and shall name the City of Santa Clarita as additional insured. A Certificate of lnsurance and an additional insured endorsement (for general and automobile liability), evidencing the above insurance coverage with a company acceptable to the City's Risk Manager shall be submitted to the clrY prior to execution of this Agreement on behalf of the clry.
Requirements
Should CONTRACTOR, for any reason, fail to obtain and maintain the insurance required by this Agreement, CITY may obtain coverage at CONTRACTOR'S expense and deduct the cost of such insurance from payments due to CONTRACTOR under this Agreement or terminate. ln the alternative, should CONTRACTOR fail to meet any of the insurance requirements under this Agreement, CITY may cancel the Agreement immediately with no penalty.
Should CONTRACTOR'S insurance required by this Agreement be canceled at any point prior to expiration of the policy, CONTRACTOR must notify CITY within 24 hours of receipt of notice of cancelation.
Furthermore, CONTRACTOR must obtain replacement coverage that meets all contractual requirements within 10 days of the prior insurer's issuance of notice of cancelation. CONTRACTOR must ensure that there is no lapse in coverage,
lf the operation underthis Agreement results in an increased or decreased risk in the opinion of the City's Risk Manager, then the CONTRACTOR agrees that the minimum limits herein above designated shall be changed accordingly upon request by the City's Risk Manager.
The CONTRACTOR agrees that provisions of this paragraph as to maintenance of insurance shall not be construed as limiting in any way the extent to which the CONTRACTOR may be held responsible for the payment of damages to persons or property resulting from the CONTRACTOR'S activities or the activities of any person or persons for which the CONTRACTOR is otherwise responsible.
I have read and understand the above requirements and agree to be bound by them for any work performed for the City.
Authorized Signature: Date: 511612022
Printed Name: Brett Smith, Vice President
*
tat
DocuSign Envelope lD: 5746M84-550F-4DDB-9D35-7C38EC00E683
BIDDER'S INFORMATION AND CERTIFICATION
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City of Sonto Clorito, CA
Bidder certifies that the representations of the bid are true and correct and made under penalty of perjury.
EqUAL EMPLOYMENT OPPORTUNIW COMPLIANCE
Bidder certifies that in all previous contracts or subcontracts, all reports which may have been due under the requirements of any ClW, State, or Federal equal employment opportunity orders have been satisfactorily filed, and that no such reports are currently outstanding.
AFFIRMATIVE ACTION CERTIFICATION
Bidder certifies that affirmative action has been taken to seek out and consider minority business enterprises for those portions of the work to be subcontracted, and that such affirmative actions have been fully documented, that said documentation is open to inspection, and that said affirmative action will remain in effect for the life of any contract awarded hereunder. Furthermore, Bidder certifies that affirmative action will be taken to meet all equal employment opportunity requirements of the contract documents.
CERTI FICATION REGARDI NG DI R CONTRACTOR/SU BCONTRACTOR REG ISTRATION By my signature hereunder, as the Contractor, I certify that Contractor, and all Subcontractors listed on the Subcontractor Designations form are the subject of current and active contractor registrations pursuant to Division 2,Part 7, Chapter 1(commencing with section L72Ol of the California Labor Code. Contractor/s registration number is indicated below. Subcontractors' registration numbers are indicated on the Su bcontractor Designations form.
Bidder'S Name: California Commercial Pools, lnc.
Business Address: 2255 E Auto Centre Drive, Glendora CA 91740 Telephone No.: 909-394-1280
State CONTRACTOR's License No. & Class:
DtR No.: 1000001406
415172-B&C53
OriginalDate 01t29t1980 Expiration Date 061301202s
The following are the names, titles, addresses, and phone numbers of all individuals, firm members, partners, joint ventures, and/or corporate officers having a principal interest in this proposal:
California Commercial Pools, lnc.
E. Lee Jackson, President & Treasurer I David E. Jackson, Vice president & Secretary DocuSign Envelope lD: 5746AA84-550F-4DDB-9D35-7C38EC00EOB3 Brett Smith, Vice President
Jason Jackson, Vice President
Rvan Jackson. Vice President
The dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in this proposal, or any firm, corporation, partnership or joint venture of which any principal having an interest in this proposal was an owner, corporate officer, partner or joint venture are as follows:
N/A
All current and prior DBAs, alias, and/or fictitious business names for any principal having an interest in this proposal are as follows:
N/A
lN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, title, hands, and seals of allaforementioned principals this 16th day of May 204_.
BIDDER: Itr,
Signatu
Brett Smith, Vice President
Name and Title of Signatory
California Commercial Pools, lnc.
Legal Name of Bidder
2255 E Auto Centre Drive, Glendora CA 917 40
*
llr
Address
909-394-1 280 95-3452683
Telephone Number Federal Tax l.D. No.
This document must be notarized prior to submittal.
State of California
County of
On Mav 16.
Date
personally appeared
Signer ls Representing:
@2014 National Notary Association . www.NationalNotary.org . 1-800-US NOTARY (1-800-S76-6827) ttem #5907 cALtFORfltA ALL.PURPOSE ACKI|OWLEDGUEI{T ctvtL coDE s 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.
Los Angeles
before me, H Palrrmhn NotarV Public
Here lnsert Name and Title of the Officer
Brett Smith
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(q) whose name($ @"<"subscribed to the within instrument and acknowledged to me that@yslre/thai executed the's'aile in @her/their authorized capacity(leq), and that.by<fiB/he/their signature-fr) on the instrument the persong], or the entity upon behalf of which the person(q) acted, executed the insirument.
I certify under PENALTY OF PERJURY under the taws
of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and seal
Signature
of Notary Public
Place Notary Seal Above
Though thrb section is optional, compteting this information can deter atteration of the document or fraudulent reaftachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Bidders lnfo & Cert Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Signer(s)
Signer's Name:
E Corporate Officer - Title(s): Vice Presidont n Corporate Officer - Title(s):
)
)
n Partner - n Limited ! General
n lndividual ! Attorney in Fact
flTrustee tr Guardian or Conservator
U Other:
fl Partner - n Limited ! General
tl lndividual I Attorney in Fact
E Trustee n Guardian or Conservator
D Other:
Signer ls Representing
DocuSign Envelope lD: 5746AA84-550F-4DDB-9D35-7C38EC00EOB3
BIDDER'S QUESTIONNAIRE
Bid #ENG-21-22-M303s
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City ol Santa Clarita, California
1. Submitted by: Catifornie CommerciFt poots, tnc Telephone: ono-?or-,l ran Principal Office Address:
2. Type of Firm:
tr C Corporation
0t S Corporation
tr lndividual/Sole Proprietor or Single -Member LLC
tr Partnership
tr Limited Liability Company "C" C-Corp
tr Limited Liability Company "S" S-Corp
tr Limited Liability Company "p" partnership
tr Other
3a. lf a corporation, answer these questions:
Date of lncorporation i 0112911980 State of lncorporation: California President's Name: E. Lee Jackson
Vice-President's Name David F .lackson Brett Smith I Jason Jackson I Rvan .lackson Secretary or Clerk's Name: David F .lackson
Treasurer's Name: E. Lee Jackson
2255 E Auto Centre Drive. Glendora CA 917
3b. lf a partnership, answer these questions:
Date of organization: N/A State Organized in
Name of all partners holding more than a 10% interest:
Designate which are General or Managing Partners.
DocuSign Envelope lD: 5746M84-550F-4DDB-9D35-7C38EC00E683 BIDDER'S QUESTIONNAIRE (cont'd)
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Conffete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City of Sonta Clarita, California
4. Name of person holding CONTRACTOR's license: California Commercial Pools. lnc.
License number: 415172 Class: B & C53 Fvni ration Date: 1113012023 D.l,R. Registration # 1000001406
5 CONTRACTOR's Representative
Title: Vice President
Brett Smith
Alternate: JasonJackson
Title: Vice President
6. List the major construction projects your organization has in progress as of this date:
A.
Owner: Perris Union High School District (Paloma Valley High School) Project Location
Type of Project:
31375 Bradley Road, Menifee CA 92584
33M outdoor oool , plaster, tile. equipment. mechanical room B.
Owner; Perris Union High School District (Heritage High School) Project Location
Type of Project:
2600 Briggs Road, Menifee CA 92585
33M outdoor pool, plaster, tile, equipment, mechanical room c.
Owner: Santa Rosa JR College
Project Location: 1501 Menidocino Ave, Santa Rosa CA 95401 Type of Project: 50M Pool, Bulkhead , Plaster, Tile, equipment, mechanical room, timing system.
DocuSign Envelope ID: 5746M84-550F-4DDB-9D35-7C38EC00E683 CERTI FICATION OF NON.SEG REGATED FACI LITIES
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City of Santa Clarita, California
The BIDDER certifies that it does not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. The BIDDER certifies further that it will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it will not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. The BIDDER 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 rooms, work areas, rest rooms, and wash rooms, 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 othenruise. The BIDDER agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding S1O,OO0 which are not exempt from the provisions of the EqualOpportunity clause, and that it will retain such certifications in its files, California Commercial Pools, lnc.
BIDDER
Required by the May 19, 1"957 order on Elimination of Segregated Facilities, by the Secretary of Labor - 32 F.R. 7439, May L9,1967 (F.R. Vol. 33, No. 33 - Friday, February i_6, 19G8 - p. 3065).
DESIGNATION OF SUBCONTRACTORS
Bid # ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster – Phase II and III, Project M3035 City Project No. M3035
City of Santa Clarita, California
Listed below are the names and locations of the places of busin ess of each subcontractor, supplier, and vendor who will perfor m work or labor or render service in excess of ½ of 1 percent, or $10,000 (whichever is g reater) of the prime contractor's total bid. If no Subcontractors will be used fill out the form with NA. Add addt. sheets if needed.
Subcontractor
DIR Registration No.* Dollar Value of Work
Location and Place of Business
Bid Schedule Item No’s: Description of Work
License No.
Exp. Date: / / Phone ( )
Subcontractor
DIR Registration No.* Dollar Value of Work
Location and Place of Business
Bid Schedule Item No’s:
Description of Work
License No.
Exp. Date: / / Phone ( )
Subcontractor
DIR Registration No.* Dollar Value of Work
Location and Place of Business
Bid Schedule Item No’s: Description of Work
License No.
Exp. Date: / / Phone ( )
NOTE: A BIDDER or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5 of the Labor Code. It is not a violation of this section for an unregistered BIDDER to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the BIDDER is registered to perform public work pursuant to Section 1725.5 of the Labor Code at the time the contract is awarded. *Pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code.
Rebel Industries, Inc. 1000001809
17053 Campo Drive, Parker CO 80134
Pool Tile
807357 04/30/2024 626-825-0811
Aqua Construction, Inc. 1000002113
449 W Foothill Blvd, Ste 272, Glendora CA 91741
Pool Plaster
992227 04/30/2024 626-335-9407
Freedom Concrete Cutting, Inc. 1000364975
P.O. Box 869, Riverside, CA 92502
Demo
1052097 04/30/2023 951-455-3809
$222,000.00
16 $433,400.00
15 $128,700.00
3 DocuSign Envelope lD: 5746M84-550F-4DDB-9D35-7C3BEC00E6B3
REFERENCES
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City of Santa Clarito, California
The following are the names, addresses, and telephone numbers of three public agencies for which bidder has performed and completed work of a similar scope and size within the past 3 years. lf the scope of work/specifications requests references different than instructions above, the scope of work/specifications shall govern:
1. Anaheim Union High School District, Arturo Lavenant Jr. - 501 Crescent way , Anaheim Ca.(Cypress & Loara H igh Schools) Name and Address of Owner / Agency
Arturo Lavenant Jr. | 714-999-5678 | [email protected] Name and Telephone Number of Person Familiar with project $2,284,000.00 Renovation of Pool, equip, tile, plaster and pool deck 05t2020 Contract Amount Type of Work Date Completed
2. San Jose Unified School District, John Perrine - Multiple Schools, San Jose Ca. (San Jose Pool Modernizations) Name and Address of Owner / Agency
John Perrine | 408-717-6200 or 408-717-2959 [email protected] Name and Telephone Number of Person Familiar with project $s,736,810.00 Replaster, new tile, equip, timing system, new main drains i2t2O2O Contract Amount Type of Work Date Completed
3. Desert Sands Unified School District, Jose Quintana - 47-950 Dune Palms Road, La Quinta, CA 92253 (La Quinta HS Deck / Plaster) Name and Address of Owner / Agency
.lnsc flr rintana I 77 7 -42OO I iose nr rinlenad)dcserlsan.lq US Name and Telephone Number of Person Familiar with project $1 ,048,000.00 Retile, Replaster pool and replaced pool deck 08t2019 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
Kenneth Coate 951-788-8581
inSufanCebOndS: ArchlnsuranceCompany,33g0UniversityAve,Ste300,RiversideCAg250l DocuSign Envelope lD: 5746M84-550F-4DDB-9D3S-7C3BECOOE6B3
DEBARMENT AND SUSPENSION CERTIFICATION
TITLE 49. CODE OF FEDERAT REGULATIONS. PART 29
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, project M3O3S City Project No. M3035
City of Santa Clarita, California
The bidder under penalty of perjury, certified that except as noted below, he/she or any person associated therewith in the capacity of owner, partner, director, office manager:
is not currently under suspension, debarment, voluntary exclusion or determination of ineligibility by any federal AGENCY;
has not been suspended, debarred, voluntarily excluded, or determined ineligible by any federal AGENCY within past three years;
does not have a proposed debarment pending; and
has not been indicted, convicted, or had a civil judgment rendered against it by a court of competentjurisdiction in any matter involving fraud or official misconduct within the past L0 years. lf there are any exceptions to this certification, insert the exceptions in the following space.
N/A
Exceptions will not necessarily result in denial of award but will be considered in determining bidders, responsibility. For any exception noted above, indicate below to whom it applies, initialing AGf ruCy, and dates of action.
N/A
The Contractorfurther certifies that it shall not knowingly enter into any transaction with any subcontractor, material supplier, or vendor who is debarred, suspended, declared ineligible, or voluntarily excluded from covered transactions by any federal or state department/agency.
NOTE: Providing false information may result in criminal prosecution or administrative sanctions.
The above certification is
also constitute signature
Bidder:
Signatu
part of the Proposal. signing this Proposal on the signature portion thereof shall of this
tlll,r,
M
Title Brett Smith Vice President ,o
DocuSign Envelope lD: 5746M84-550F-4DDB-9D3S-7C3BEC0OE6B3
EQUAL EMPLOYMENT OPPORTUN IW CERTI FICATION
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City of Santa Clarito, Calilornia
This bidder California Commercial Pools. proposed subcontractor N/A , hereby certifies that it has X , has not participated in a previous contract or subcontract subject to the equal opportunity clause, as required by Executive Orders LO9ZS.tI II4, or 71246, and that it has x , has not filed with the Joint Reporting Committee, and Director of Office of Federal Contract Compliance, a Federal Government contracting or administering AGE NCY, or the former President's Committee on Equal Employment Opportunity, all reports that are under the applicable filing requirements. rlllll, Company: California
By:
Title: Brett Smith, Vice President
Date 511612022
*frtlrrttl
Note: The above certification is required by the Equal Employment Opportunity of the Secretary of Labor (41 CFR 60-1.7(b)(L)) and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause as set forth in 41 CFR 60-l-.5, (Generally only contracts or subcontracts of 510,000 or under are exempt.) Currently, the Standard Form 100 (EEO-l) is the only report required by the Executive Orders or their implementing regulations.
Proposed prime CONTRACI-ORS/BIDDER 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 BIDDER submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor.
DocuSign Envelope lD: 5746M84-550F-4DDB-9D3S-7C38EC00E683
EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City of Santa Clarito, Calilornia
This bidder california commercial Pools, lnc. , proposed subcontractor Rebel Industries, lnc. , hereby certifies that it has has not x** , participated in a previous contract or subcontract zublect to the equal opportunity clause, as required by Executive Orders L0925.1,L1,t4, or IL246, and that it has , has not x . filed with the Joint Reporting Committee, and Director of Office of Federal Contract Compliance, a Federal Government contracting or administering AGENCY, or the former President's Committee on Equal Employment Opportunity, all reports that are under the applicable filing requirements.
Company:
By:
Title:
Date: 05116t2022
Rebel lndustries, lnc.
Mark Frandsen, President
Note: The above certification is required by the Equal Employment Opportunity 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 as set forth in 41 CFR 60-1.5, (Generally only contracts or subcontracts of S10,000 or under are exempt.) Currently, the Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their im plementing regulations.
Proposed prime CONTRACIORS/BIDDER 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 4j.
CFR 60-1.7(b)(1) prevents the award of contracts and subcontracts unless such BIDDER submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. **Rebel lndustries has less than 100 employees and is not required to complete/submit this form
Docusign Envelope lD: 5746AA84-SS0F-4DDB-9D35-7C38EC0OE6B3
EQUAL EMPLOYMENT OPPORTUNIW CERTI FICATION
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - phase ll and lll, project M3035 City Project No. M3035
City ol Santa Clarita, California
ThiS biddef California Commerciat poots, tnc. proposed subcontractor Aqua Construction, lnc. , hereby certifiesthat it has has not participated in a previous contract or subcontract subject to the equalopportunity clause, as required by Executive Orders IO925.IILI4, or LL246, and that it has has notX , filed with the Joint Reporting Committee, and Director of Office of Federal Contract Compliance, a Federal Government contracting or administering AGENCy, or the former President's Committee on Equal Employment Opportunity, all reports that are under the applicable filing requirements.
Company:
By:
Title:
Date: 05117t2022
Note: The above certification is required by the Equal Employment opportunity of the Secretary ofLabor (41 cFR 60-1.7(b)(1)) and must be submitted by bidders and proposed subcontractors onty inconnection with contracts and subcontracts which are subject to the equal opportunity clause as set forthin 41 CFR 60-1.5, (Generally only contracts or subcontracts of $10,000 oi underare exempt.) Currently, the Standard Form 100 (EEO-1) is the only report required by the Executive Orders or theirimplementing regu lations.
Proposed prime CoNTRAcToRS/BIDDER 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 BIDDER submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, office of Federal Contract Compliance, U.S. Department of Labor.
DocuSign Envelope lD: 5746AA84-550F-4DDB-9D35-7C38EC00EOB3
I RAN CONTRACTI NG ACT CERTIFICATION
(Pubf ic Contract Code Sections22OO et seq.l
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City ol Santa Clarita, Calilornia
As required by California Public Contract Code section 2204, Proposer certifies that the option checked below relating to Propose/s status in regard to the lran Contracting Act of 2010 (Public Contract Code sections 22OO et seq.) is true and correct:
Proposer is not:
(i) identified on the current list of persons and entities engaging in investment activities in lran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code section 2203; or (ii) a financial institution that extends, for 45 days or more, credit in the amount of 520,000,000 or more to any other person or entity identified on the current list of persons and entities engaging in investment activities in lran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code section 2203, if that person or entity uses or will use the credit to provide goods or services in the energy sector in lran.
Los Angeles County has exempted Proposer from the requirements of the lran Contracting Act of 2010 after making a public finding that, absent the exemption, Los Angeles County will be unable to obtain the goods and/or services to be provided pursuant to the Contract.
The amount of the Contract payable to Proposer for the Project is less than 51,000,000.
CERTIFICATION
l, the official named below, CERTIFY UNDER PENALTY OF PERJURY, that I am duly authorized to legally bind the Proposer to the above selected option. This certification is made under the laws of the State of California.
Contractor
California Commercial Pools, lnc.
Firm
tr
Sign
5t16t2022 Brett Smith Vice President
Date Name/Title
Note: ln accordance with Public Contract Code section 2205, false certification of this form shall be reported to the California Attorney General and may result in civil penalties equal to the greater of 5250,000 or twice the Contract amount, termination of the Contract and/or ineligibility to bid on contracts for three years.
END OF DOCUMENT
IItar, l1
DocuSign Envelope lD: 3AC1 1 8AF-06D4-45F0-8284-E2E1BED4F3FJ Addendum No.1
April L4,2O22
Addendum No.1
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, Project M3035 City Project No. M3035
City of Sonta Cldrito, Colifornio
This oddendum must be acknowledged via BidNet and should be included with the bid response.
The purpose of this addendum is to address the following for this Bid:
I. BID SCHEDULE
Please see the attached Bid Schedule. The Bid Schedule must be filled out and submitted with the bid response.
[)anow ]!,,
arnon
City Engineer
END OF ADDENDUM
This addendum must be acknowledged via BidNet and should be included with the response llalII,,
511612022
Date
Brett Smith, Vice President
,o
Galifornia Commercial Pools, lnc.
Company Name
BtD # ENG-21-22-M3035
DocuSign Envelope lD: 584571 E6-3082-4FD1-BFB1-7C388AA91 84S Addendum No.2
May 6,2022
Addendum No.2
BrD # ENG-21-22-M3035
City Project No. M3035
Aquatic center Pool Deck concrete Repairs and Replaster - phase ll and lll City of Sdnto Clorita, California
This addendum must be ocknowledged via BidNet and should be included with the bid response.
I. PRE-BID MEETING
There was a non-mandatory, pre-bid meeting on May 3,2022 beginning at 10:00 AM. The meeting was located at Santa Clarita Aquatic Center, 20850 Centre Pointe Parkway, Santa Clarita, CA 91350.
Attendine Staff:
r Peter Henne - Administrotor, Public Works
o Danielle Marquez - Buyer, Administrotive Services
r Taryn Flatt - Supervisor, Recreotion and Community Services r Stewart Williams - General Maintenonce Speciolist, Neighborhood Services o Pete McJunkin - Recreotion and Community Services Coordinator, Recreotion and Community Services
o Vincent Tsai - Aquotics Specialist, Recreation Community Services r Juan Martinez - Supervisor, Neighborhood Services
. Cassidy Skelton - Parks Administrotor, Neighborhood Services Attending Vendors:
o Leanne Harvey, Californio Woters
The following questions were asked and answered:
Q1) Willthe permitting be completed?
A1) Yes. Currently the design consultant, Aquatic Design Group [ADG] submitted the plans to County of Los Angeles Public Health, Environmental Health, Recreational Waters Program Plan Check Counter for their review and approval, ahead of the bidding, award, and contract processes of hiring a construction company, so the plans are ready for the contractor to pick-up in person prior to the Pre-construction meeting.
Q2) ls everything on the deck protect in place?
A2) Many items currently on the 25-meter and SO-meter pool decks are portable, and will be relocated prior to August 8 (SO-meter pool) and August 22 (25-meter pool). There are items directly adjacent to, or adjacent to the 'haul route / path of construction travel' requiring protection and care as 'existing facility improvements'.
BID # ENG-2L-22-M303s
DocuSign Envelope lD: 5BA571 E6-3082-4FD1-BFB1-7C388M91845 Addendum No.2
May 6,2022
Q3) Are the diving boards protect in place as well?
43) Yes, protect-in-place.
Q4) Where's the access to the 50-meter pool (competition pool)? 44) The access to the SO-meter pool deck, as well as the 25-meter pool deck will be through a large swinging gate, accessible from the EAST parking lot, adjacent to the Pump Building.
The followins was reviewed:
o Project scope of work
o Bidding Guidelines
II. UPDATED BID SCHEDULE
Please see the attached updated Bid Schedule. This form must be filled out and submitted with the bid response. The General Provisions, Section 7-1, page 88 has also been updated to reflect the removal of line item #L1. Please see the attached updated section of the General Provisions.
Attachments:
o Pre-bid Sign-ln Sheet
o Pre-bid Meeting Notes
. Updated Bid Schedule
. Updated General Provisions, Section 7-1, page 88
DS
by:
[)anow l],, lht\
Damon Letz
City Engineer
END OF ADDENDUM
@
,rrtttll
This addendu
Brett S , Vice President
California Commercial Pools, lnc.
via BidNet and should be included with the response
511612022
Company Nome
BtD # ENG-21-22-M3035
Dote
DocuSign Envelope lD: 5746AA84-550F-4DDB-9D3S-7C38EC00E683
PROPOSAL GUARANTEE BID BOND
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - Phase ll and lll, project M3035 City Project No. M3035
City of Santa Clarita, California
KNOW ALL PERSONS BY
Endurance Assurance
THESE pRESENTS that California Commercial Pools, lnc. as BIDDER, and ration SURETY, are held and firmly bound unto the
City of Santa Clarita, as CITY, in the pen al sum of (1) dollars (S --------'----- ), which is ten percent (10%) of the total amount bid by BIDDER to C|TYforthe above-stated project, forthe payment of which sum, BIDDER and ,S,URETY agree to be bound, i-ojpJly-a.1d severally, firmly by these presents. (1) not to exceed ten percent (10Yo) of the total bid amoirni THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to submit a bid to ClTy for the above-stated project, if said bid is rejected, or if said bid is accepted and the contract is awarded and entered into by BIDDER in the manner and time specified, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of ClTy.
lN WITNESS WHEREAS, the parties hereto have set their names, titles, hands, and seals, this 13th Day of May 2022
CONTRACTOR: By:
Name and Title of Signatory Signa tll
N\M
California Commercial Pools, lnc.
Legal Name of Bidder
2255 E. Auto Centre Drive Glendora c491740 S
Bidder Address
909-394-1 280 q5-g q6zlehg
Telephone Number Federal Tax l.D. No.
sURETy*: Endurance Assurance Corporation By:
Name
61 5-553-9412 [email protected]
Sign Renae N. Balderas,
Attorney ln Fact
Phone Number and Email
725 South Figueroa Street, Suite 2100, Los Angeles, CA 90017 Address
*Provide BIDDER and SURETY name, phone number, email, and the name, title, address, and phone number for authorized representative' IMPoRTANT - Surety Companies executing Bonds must appear on the Treasury Department's most current list (Circular 570, as amended) and be authorized to transact business in the State where the project is located.
This document must be notarized prior to submittal.
INSUBANCE
SOMPO INTERNATIONAL
POWER OF ATTORNEY
4252
KNOW ALL BY THESE PRESENTS, that Endurance Assurance Corporation, a Delaware corporation, Endurance American Insurance Company, a Delawarecorporation, Lexon lnsurangg CgqqanV, a Texas corporation, and/or Bond Safeguard lnsurance Gompany, a South Dakota corporation, each, a ,,bompany" andcolleciively, "S9mpo lnternational," do hereby constitute and appoint: Julia B. Bales, Kenneth A. Coate, ifenae tt. Balderas, Stephanie D. Fisher as true and lawful and deliver on iis behalf as aforesaid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that nosingle bond or undertaking so made, executed and delivered shall obligate the Company for any portion of the penal sum thereof in excess oi the sum of ONE HUNDRED MILLION Dollars ($100,000,000.00).
Such bonds and undertakings forsaid purposes, when duly executed by said attorney(s)-in-fact, shall be binding upon the Company as fully and to the same extent as ifsigned byihe President of the Company underits corporate seal attested by its Corporate Secretary.
This appointment is made under and by authority of certain resolutions adopted by the sole shareholder of each Company by unanimous wriiten consent effective the 1Srh day of June,2019, a copy of which appears below underthe heading entiiled,,Certificate,,.
This Power of Attorney is signed and sealed by facsimile under and by authority of the following resolution adopted by the sole shareholder of each Company byunanimous written consent effective the 1Sth day ofJune, 2019 and said resolution has not since been revoked, ame;ded or repealed:
RESOLVED' that the signature of an individual named above and the seal of the Company may be affixed to any such power of attorney or any certificate relating theretoby facsimile, and any such power of attorney or certificate bearing such facsimile signature or seal shall be valid and binding upon tne iompany in the future wittirespectto any bond or undertaking to which it is attached. lN WTNESS WHEREOF, each Company has caused this instrument to be signed by the following officers, and its corporate seal to be affixed this 15th day ofJune,2019. {s
ce Assurance Endurance American Lexon lnsurance Company Bond Safeguard *?t
By:By r|xBy
nsel Ric rd unsel Ap
SEAL i SEAI.
18962OO2 j
ACKNOWLEDGEMENT
On this 1Sth day of June, 2019, before me, personally came the above signatories known to me, who being duly sworn, did and say that of eachof the Companies; and that he executed said instrument on behalf of each Company by authority of his of each By
lraE
rqE!&
Amy aylor, My
CERTIFICATE
l, the undersigned Officer of each Company, DO HEREBY CERTIFy that:
1 . That the orig inal power of attorney of which the foregoing .is a copy was duly executed on behalf of each Company and has not since been revoked, amended or modifled;that the undersigned has compared the foregoing copy thereof with the original power of attorney, and that ihe lame is a true and correct copy of the original po*"1. oiattorney and of the whole thereof;
2. The following are resolutions which were adopted by the sole shareholder of each Company by unanimous written consent effective June 1S, 201 9 and said resolutionshave not since been revoked, amended or modified:
'RESOLVED, that each of the individuals named below is authorized to make, execute, seal and deliver for and on behalf of the Company any and all bonds, UNdCTtAKiNgS OT ObIigAtiONS h SUTCTY OT CO.SUTCtY With OthCTS: RICHARD M. APPEL, BRIAN J, BEGGS, CHRISTOPHER DONELAN,.SHARON L. SIMS,CHRISTOPHER L. SPARRO, MARIANNE L, WILBERT ; and be it further
RESOLVED' that each of the individuals named above is authorized to appoint attorneys-in-fact for the purpose of making, executing, sealing and delivering bonds,undertakings or obligations in surety or co-surety for and on behalf of the Company.',
3. The undersigned further certifies that the above resolutions are true and correct copies ofthe resolutions lN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seat this 13th day of as so of the whole thereof.
20 22
By:
NOTICE: U, S, TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL (OFAC) possible impact on your surety coverage due to directives issued by OFAC. Please read this Notice carefully. on the United States Treasury's website - https://www.treasury.oov/resource-center/sanctions/,SDN-List. subject to OFAC. When a surety bond or other.form of surety coverage is considered to be such a blocked or frozen contract, no payments nor premium relunds may be made withojtauthorization from OFAC. Other limitations on the premiums and payments may also apply.
Any reproductions are void.
Surety Claims Submission: [email protected] Telephone:615-553-9500 Mailing Address: Sompo lnternational; 12890 Lebanon Road; MountJuliet, TN 37122-2820 SOUTH
DAKOTA
INSURANCE
COMPANY
EAL
opt
rI
CALIFORNIA ACKNOWLEDGMENT ctvtL coDE s 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 Riverside
o" FiAV tr3 2022
Dote
before me, Karina J.Cot.ton, Notary Public
personally appeared
Here Insert Nqme and Title of the Officer
Renae N. Balderas
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person$) whose name(s) islarssubscribed to the within instrument and acknowledged to me that#e/she/theyexecuted the same inhis/herAlreir authorized capacity(ies), and that bytris/herftheir signature(s) on the instrument the persong|, or the entity upon behalf of which the person(s) acted, executed the instrument.
I cenify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and officialseal.
Signature
Ploce Notary Seol ond/or Stomp Above Signature of Notory Public
OPTIONAL
Completing this information con deter alteration of the document or fraudulent reottachment of this form to on unintended document.
Description of Attached Document
Title or Type of Document:
DocumentDate: NumberofPages:_
Signe(s) Other Than Named Above:
Capacity(ies| Claimed by Signer(s)
Signer's Name:
El Corporate Officer - Title(s):
tr Partner- tr Limited tr General
tr lndividual E Attorney in Fact
tr Trustee n Guardian or Conservator
tr Other:
Signer is Representing:
Signer's Name:
E corporate officer - Title(s):
tr Paftner- tr Limited tr General
tr lndividual B Attorney in Fact
El Trustee o Guardian or Conservator
tr Other:
J. COTTON
. #225774X,
NOTARY PUBLIC - CATIFORNIA
RI\/ERSIDE COUNTY
My Comm. Expiros Sept. 10, Z02Z
KA
c
02019 National Notary Association
Signer is Representing:
No.5082-3
STATE OF'CALIFORNIA
DEPARTMENT OF II{SURANCE
SANF'RANCISCO
Amended
Certificate of Authorlty
THIS IS TO CERTIFY that, pursuant to the Insurance Code of the State of Califtrnia, Endurarice Assurance Corporation
ef Delaware. organized under the law; of DeloWare, subject to its Articles of Incorporation ar other fundamental organizational documents, is hereby quthorized to transact within this State, subject to all provisions of this Cerffficate, thefollowing classes of i4surance:
Fire, Marine, Suretlr, Disability, Plate Glass, Liability, .Workers' Compensation, Common Carrier Liability, Boiler and Machinery; Burglary, Credit, Sprinkler, Team and Vehicle, Automobile, Aircrafit, and lViisceUaneous gs such classgs are uow er may hereafter be deJined in the Insurance Laws of t|1e State of Californta.
THIS CERTIFICATE is expressly conditioned upon the holder hereof nlw andhereafter being in full compliance with all, and nat invtolation of any, of the applicable laws andlawful requirements rnade under authorlty of the luws of the State of California as long as such lafis or requirements are in ffict and applicable, and as such iaws and reqairements now are, or nqy hereafter be changed or qmended.
IN WITNESS WHEREOF, efective as of ihe 23'd day of August, 2416, Ihave ltereunto set my hand and causedmy fficial seal to be afixedthis 23'd day ofAugust, 2016.
Dave Jones
trnsur aice Cofl miss io\er
&"4?*^-
By Carol Frair
for Joel Laucher
Chief beptity
NOTICET
Qualifioation with the Secretary of$tate mqst be bqcomplished as reqgired by ttre Califomia Cqr4oJalion$ gode pfomptly ater issuanceofthjsCertificateofAuthority. Failuretodosowilibeavioiationofl:rsuranceCodesectionT0landwillbegroundsfor revoking this Certificate ofAnthority pursuanl ta the coveiauts m4de in the gpplication therefpr and the oonditinn$ contained herein.
State of California
County of Los Angeles
personally appeared
Gapacity(ies) Claimed by Signer(s)
Signer's Name:
E Corporate Officer - Tifle(s):
n Partner - tr Limited n General
Signer ls Representing
CALIFORI{I,A ALT.PURPOSE ACKIIOWLEDGTEIIT CML CODE S 1189 A notary public or other officer completing this certificate verifles only the identity of the individual who signed thedocument to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. )
)
On Mav 16.2022 before me,
Date
H Nota Public
Here lnsert Name and Title of the Officer
Brett Smith
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(q) whose name(\) @"<"subscribed to the within instrument and acknowledged to me that @i56;e7ihe] e*e"uteo the same in @.her/tlrcir authorized gap-acilv0€, and that.by<fiFtftaitrt€ir signature-(s) on tne instrumlnt the persong),or the entity upon behalf of which the person(e acted, executel the iniirument.
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 officiatseat.
Signature
of Notary Public
Place Notary SealAbove
OPTIONAL
Though this section is optional, completing
f rau d u lent reattac h m e nt of
n lndividual n Attorney in Fact
! Trustee n Guardian or Conservator
! Other:
this information can deter alteration of the document or this form to an unintended document.
Description of Attached Document
Title or Type of Document: Bid Bond Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Brett Smith Signer's Name:
\/inn Dra idanl tr Corporate Officer - Titte(s):
DPartner - nLimited IGeneral
tl lndividual ! Attorney in Fact
n Trustee ! Guardian or Conservator
D Other:
Signer ls Representing:
o201 4 National Notary Association 'www.NationalNotary.org . 1-8oo-us NoTARy (1-go0-s76-6g27) ltem #5g07 DocuSign Envelope lD: 5746AA84-550F-4DDB-9D35_7C3BEC00E6B3 NON-COttUSION AFFIDAVIT
(Title 23 United states code section l"i 2 and public contract code section 710G) Bid #ENG-21-22-M3035
Aquatic center Pool Deck concrete Repairs and Replaster - phase ll and lll, project M3035 City Project No. M3035
City ol Santo Clorito, Calilornio
THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THE'BIDDER'S CERTIFICATION'SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH FORM APART OF THE PROPOSAL, BIDDERS ARE CAUTIONED THAT MAKING A FALSE CERTIFICATION MAYSUBJECT THE CERTIFIER TO CRIMINAL PROSECIJTION.
To the CITY OF SANTA CLARTTA:
ln conformance with Title 23 United states code section i.12 and public contract code 7106, theBidder declares that the bid is not made in the interest of, or on behalf olany undisclosed person,partnership, company, association, organization, or corporation; that 6e\ fiO is genuine and notcollusive or sham; that the Bidder has not directly or indirectly induced or solicited iny other bidderto put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreedwith any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; thatthe Bidder has not in any manner, directly or indirectly, sought by agreement, communication, orconference with anyone to fix the bid price of the Bidder or. rny other bidder, or to fix any overhead,profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantageagainst the public body awarding the contract of anyone interested in the proposed contracu that allstatements contained in the bid are true; and, further, that the Bidder has noi, directly or indirectly,submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulgedinformation 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 effectuatea collusive or sham bid.
DocuSign Envelope lD: 5746M84-5S0F-4DDB-gD3S-7C38EC00E683 NON.COLLUSION AFFI DAVIT
Bid #ENG-21-22-M3035
Aquatic Center Pool Deck Concrete Repairs and Replaster - phase ll and lll, project M3035 City Project No. M3035
City of Santo Clarita, Colifornia
TO BE EXECUTED BY EACH BIDDER OF A PRINCIPAL CONTRACT
STATE OF CALIFORNIA
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COUNTY OF LOS ANGELES
Bidder:
Signatu
Title Brett Smith, Vice President
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Brett Smith
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the party making the foregoing bid; that such
bid is not made in the interest of or behalf of any undisclosed person, partnership, .oipuny, association, organization or corporation, that such bid is genuine and not collusive or sham, ihat said BIDDER has notdirectlyor indirectly induced or solicited any other BIDDER to put in a false or sham bid, or that anyone shallrefrain from bidding, that said BIDDER has not in any mannei, directly or indirectly sought by agreements, communication or conference with anyone to fix the bid price of said BIDDER or. of any other BIDDER, or tofix the overhead, profit, or cost element of such bid price, or of that of any other BlD6ER, or to secure anyadvantage against the public body awarding the contract or anyone inteiested in the pioposed contractlthat allstatements contained in such bid are true, and further, thai said BIDDER has not, iirectly or indirectly,submitted its bid price, or any breakdown thereof, or the contents thereof, or divulged information or daterelative thereto, or paid and will not pay any fee in connection, therewith to rny .6rporation, partnership, company, association, organization, bid depository, or to any member or CIW thereof, or to any other individual information or date relative thereto, or paid and will not pay any fee in conneciion, therewith to any corporation, partnership, company association, organization, bid depository, or to any member or ClTy thereof, or to any other individual, except to such person or persons as have a partnershipor other financial interest with said BIDDER in his general business.
This document must be notarized prior to submittal.
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State of California
County of Los Angeles
On Mav 16.2022
Date
personally appeared
Title or Type
Signer's Name: Brett Smith
E Corporate Officer - Tifle(s):
Signer ls Representing:
CALIFOR]IIA ALL-PURPOSE ACKIIOWLEDGTET{T ctvrl coDE s 1189 A notary public or other officer completing this certiflcate verifles only the identity of the individual who signed thedocument to which this certificate is attached, and not the truthfulnes., "."ur..y,
or validity of that document.
)
)
before me, Public
Here lnsert Name and Title of the Officer
Brett Smith
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the p?rsg.n6) whose name(\) @arcsubscribed to the within instrument and acknowledged to me in"t ei"rtelihe] "i""ri"o the same in @her/ttrcirauthorized 9aO-acity{eq), and that.byWtitmt*signature-(s) on the ii.,sirurlnltf,e person(s),or the entity upon behalf of which the person(q)- acted, executeE the insirument.
I certify under PENALry OF PERJURY under the taws
of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and seal
H. PALUMBO
Couu.# 2299043
I{OTARY PUBIIC. CATIFORI{IA Signature
los ANoErEs CouNrY
l/lY CorrM. ExP. iurY 27, 2023
! Panner - n Limited n General
! lndividual D Attorney in Fact
! Trustee n Guardian or Conservator
! Other:
of Notary Public
n Partner - n Limited I General
Ll lndividual ! Attorney in Fact
I Trustee f] Guardian or Conservator
tr Other:
Signer ls Representing:
Place Notary SealAbove
OPTIONAL
Though thr's section is optional, completing this information can deter alteration of the document orfraudulent reattachment of this form to an unintended document.
Description of Attached Document
Of DOCUmenl; Non-CollusionAffidavit Document Date
Number of Pages: Signer(s) Other Than Named Above:
Gapacity(ies) Gtaimed by Signer(s)
Signer's Name
\/ina anf n Corporate Officer - Title(s)
@2014 National Notary Association . www.NationalNotary.org . 1-BoO-US NOTARY (1 -800-826-6g20 Item #5907