SECTION B
Bid Instructions and Bid Clauses
DOCUMENT CHECKLIST
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
The following documents must be completed and submitted by the bidder as per the outlined timeframes.
The following documents must be provided by ALL bidders:
Uploaded via BidNet (see Section C)
• Proposal Form
/ Notice to Bidders Regarding Contractual Requirements
Bid Schedule
Bidder's Information and Certification
Bidder's Questionnaire
Certification of Non-Segregated Facilities
Designation of Subcontractors
References
Iran Contracting Act Certification
Non-Collusion Affidavit
All signed addendums (if any) - Digitally acknowledged by uploading via BidNet NONE Delivered to City Hall, Attn: Purchasing, Suite 120 prior to bid closing:
Proposal Guarantee Bond/Bidder's Bond (Notarized)
The following documents must be provided by the AWARDEE ONLY (With Agreement) Delivered to City Hall, Attn: Ramiro Fuentes
• Capital Improvement Project Agreement
• Faithful Performance Bond (Notarized)
Labor & Material Bond (Notarized)
Insurance Required by Contract
W9
Fringe Benefit Statement
PROPOSAL FORM
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
TO THE CITY OF SANTA CLARITA, AS CITY:
In 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, INSTRUCTIONS TO BIDDERS, and all other contract documents. If this proposal is accepted for award, BIDDER agrees 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 CITY 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 CITY RESERVES THE RIGHT TO INCREASE OR DECREASE THE AMOUNT OF ANY QUANTITY SHOWN AND TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum price(s) bid include all appurtenant expenses, taxes, royalties, and fees for the project's duration. In case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures.
If 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: Sully-Miller Contracting Co.
135 S. State College Blvd. Suite 400
Company Address:
Brea, CA. 92821
714.578.9600
Phone:
Email: SULLY 1) [email protected]
฿V: 'Anthony Lino
Print Name
Title:™ Director of Preconstruction / Assistant Secretary Signature:
Date:
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_ Orange )
On 03.31.2025 before me, _ Monica Baldacci, Notary Public Date Here Insert Name and Title of the Officer
personally appeared Anthony Lino
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
MONICA MARIE BALDACCI S WITNESS my hand and official seal.
COMMISSION #2447801
Votary Public - California HMD1
ORANGE COUNTY
My Commission Expires Signature
MAY 25, 2027 Signature of Notary Public
Monica Baldacci, Notary Public
Place Notary Seal Above
- OPTIONAL -
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
• Corporate Officer - Title(s): • Corporate Officer - Title(s):
• Partner - • Limited • General • Partner - • Limited • General • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: Signer Is Representing: _
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
NOTICE TO BIDDERS REGARDING CONTRACTUAL REQUIREMENTS
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
SUMMARY OF INDEMNITY AND INSURANCE REQUIREMENTS
1. These are the Indemnity and Insurance 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. If any additional Contract documents are executed, the actual Indemnity language and Insurance Requirements may include additional provisions as deemed appropriate by City's Purchasing Agent.
2. You should check with your Insurance advisors to verify compliance and determine if additional coverage 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 Contractor's policies of Insurance shall be available to Buyer and these Insurance Requirements shall not in any way act to reduce coverage that is broader or includes higher limits than those required.
The Insurance obligations under this agreement shall be: 1—all the Insurance coverage and limits carried by or available to the Contractor; or 2-the minimum Insurance 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 Insurance including all required amendatory endorsements and a copy of the Declarations and Endorsement Page of the CL policy listing all policy endorsements to City before work begins. City reserves the right to require full-certified copies of all Insurance coverage and endorsements.
I. INDEMNIFICATION:
City and its respective elected and appointed boards, officials, officers, agents, employees, and volunteers (individually and collectively, "Indemnitees") shall have no liability to CONTRACTOR or any other person for, and CONTRACTOR shall indemnify, defend, protect, and hold harmless Indemnitees 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 Indemnitees may suffer or incur or to which Indemnitees 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.
If any action or proceeding is brought against Indemnitees by reason of any of the matters against which CONTRACTOR has agreed to indemnify Indemnitees as provided above, CONTRACTOR, upon notice from City, shall defend Indemnitees at its expense by counsel acceptable to City, such acceptance not to be unreasonably withheld. Indemnitees need not have first paid for any of the matters to which Indemnitees are entitled to indemnification in order to 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. In the event the said insurance is canceled, the CONTRACTOR shall, prior to the cancellation date, submit to the City Clerk new evidence of insurance in the amounts established.
Liability Insurance
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 CITY, 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 CITY, 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 Insurance, including coverage for Premises and Operations, Contractual Liability, Personal Injury Liability, Products/Completed Operations Liability, and Independent Contractors' Liability (if applicable), in an amount of not less than two million dollars ($2,000,000.00) per occurrence, four million dollars ($4,000,000.00) 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. If 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.
Worker's Compensation Insurance
The CONTRACTOR shall procure and maintain, at its sole expense, Worker's Compensation Insurance in the amount of $1,000,000 per occurrence or in such amount as will fully comply with the laws of the State of California and which shall indemnify, insure and provide legal defense for both the CONTRACTOR and the CITY 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 Insurance
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 $1,000,000 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.
Waiver of Subrogation
All insurance coverage maintained or procured pursuant to this Agreement shall be endorsed to waive subrogation against the CITY, 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 Insureds
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 CITY for review.
Self-Insured 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 CITY.
Primary and Additional Insured
All of such insurance shall be primary and shall name the City of Santa Clarita as additional insured. A Certificate of Insurance and an additional insured endorsement (for general and automobile liability), evidencing the above insurance coverage with a company acceptable to the City's Purchasing Agent shall be submitted to the CITY prior to execution of this Agreement on behalf of the CITY.
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. In 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.
If the operation under this Agreement results in an increased or decreased risk in the opinion of the City's Purchasing Agent, then the CONTRACTOR agrees that the minimum limits herein above designated shall be changed accordingly upon request by the City's Purchasing Agent.
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: 3.28.2025
Printed Name: Anthony Lino
BID SCHEDULE (COPPERHILL NORTH AND SOUTH)
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
Fill out this form completely and submit with the bid response. Line item pricing must be entered on BidNet. In the event any mathematical discrepancies are found, please refer to Section B, Bid Instructions.
The award of contract, if made, will be to the lowest responsive BIDDER determined solely by the AGENCY.
The AGENCY also reserves the right to add/delete the quantities to the existing bid items, or delete the entire bid item if they are found not required by the Agency during the course of the construction, or add new bid items or scope of work by Contract Change Order at any time during the project up to the last contract working day.
BIDDER must hold pricing for one hundred twenty (120) days following the bid due date. In the event a final contract has not been awarded within this period; the City reserves the right to negotiate extensions to this period. The BIDDER agrees to hold all unit prices in this Bid Schedule constant throughout the duration of the project up to the last contract working day.
ITEM UNIT
BID ITEMS UNIT QTY TOTAL COST
NO. PRICE
1 Mobilization, Bonds & Insurance LS 1 40,250.00. 40,250.00 2 Traffic Control LS 1 150,000.00|150,000.00
3 Storm Water Pollution Prevention - BMP Plan LS 1 10,000.00 10, 000.00 4 AC D2 PG 64-10 TN 729 186.00 135,594.00
5 AC C2 PG 64-10 TN 618 184.00.113,712.00
6 ARHM GG-C PG 64-16 TN 2,739 173.00 473,847.00
7 Remove & Replace 5" AC SF 75,214 6.50 /488,891.00
Cold Plane & Remove 8" SF 14,970 3.50 52, 395.00
9 Stabilization Allowance SF 9,020 3.00 27,060.00
10 Keycut A1 LF 4,644 6.60 30,650.40
11 Keycut B1 LF 382 40.50 15,471.00
12 Lower Manhole Covers to Finish Grade EA 24 2,500.00 60, 000.00 13 Lower Water Valve Covers to Finish Grade EA 29 200.00 5, 800.00 14 Lower Utility Cover / Vault / Well to Finish Grade EA 1 2,500.00 2,500.00 15 Adjust Manhole Covers to Finish Grade EA 24 1,200.00 28,800.00 16 Adjust Water Valve Covers to Finish Grade EA 29 245.00 7,105.00 17 Adjust Utility Cover / Vault / Well to Finish Grade EA 1 3, 320.00 3,320.00 18 Install Blue RPM's @ Fire Hydrant EA 12 8.00 96.00
19 6" White Line (Thermo) LF 160 5.00 800.00
20 12" White Crosswalk/Limit Line (Thermo) LF 3,038 3.00 9,114.00 21 Striping Detail #12(Thermo & Markers) LF 7,294 0.75 5,470.50 22 Striping Detail #29 (Thermo & Markers) LF 2,447 3.00 7, 341.00 23 Striping Detail #37B (Thermo) LF 415 2.00 830.00
24 Striping Detail #38 (Thermo & Markers) LF 2,906 2.00 5, 812.00 25 Striping Detail #38A (Thermo) LF 1,710 1.50 2,565.00 26 Striping Detail #40 (Thermo & Markers) LF 2,086 0.85 1,773.10 27 Arrow Type IV (L/R) (Thermo) EA 24 95.00 2,280.00
28 Chevron Striping EA 950 6.25 5,937.50
29 Install Temporary Video Detection System EA 16 5,100.00 81,600.00 30 Remove and Install Permanent Traffic Loops EA 51 490.00 24,990.00 31 Remove and Replace Sensys EA 12 1,900. 09 22,800.00
TOTAL BASE BID AMOUNT FOR COPPERHILL NORTH AND SOUTH: $ 1, 816, 804.50 TOTAL BASE BID AMOUNT IN WORDS: One Million Eight Hundred Sixteen Thousand Eight Hundred Four Dollars
and Fifty Cents.
BIDDER'S INFORMATION AND CERTIFICATION
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, CA
Bidder certifies that the representations of the bid are true and correct and made under penalty of perjury.
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE
Bidder certifies that in all previous contracts or subcontracts, all reports which may have been due under the requirements of any CITY, 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.
CERTIFICATION REGARDING DIR CONTRACTOR/SUBCONTRACTOR REGISTRATION 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 1720) of the California Labor Code. Contractor's registration number is indicated below. Subcontractors' registration numbers are indicated on the Subcontractor Designations form.
Bidder's Name: Sully-Miller Contracting Co.
Business Address: 135. S State College Blvd. Suite 400. Brea. CA, 92821 714.578.9600
Telephone No.:
State CONTRACTOR's License No. & Class: 747612-A
DIR No.: 1000003664
Original Date: 12/2014 Expiration Date: 6/30/2026
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:
See attached Certificate of Incumbency
CERTIFICATE OF INCUMBENCY
I, Anthony L. Martino, Il, do hereby certify that I am the Secretary of Sully-Miller Contracting Company, a Delaware corporation, and that as such I have access to and custody of the corporate records and minute books of said corporation.
And I do hereby further certify that the following persons are duly elected officers of said corporation.
NAME TITLE
Marcus Leavitt Chairman of the Board
William Joseph Thomas Boyd President
Jae Won Vice President, CFO, Treasurer & Assistant Secretary Scott Bottomley Vice President & Assistant Secretary
James Wilson Vice President & Assistant Secretary
Jeff Galterio Vice President & Assistant Secretary
Anthony L. Martino, Il Secretary
Mark Pachura Assistant Secretary
Anthony Lino Assistant Secretary
I further certify that the following persons are duly elected directors of said corporation.
Marcus Leavitt
Leslie Edwards
I further certify that the following is a true and correct copy of a resolution duly adopted by the Board of Directors of said Company at a meeting held on December 5, 2024, and that this resolution has not been in any way rescinded, annulled, or revoked but the same is still in full force and effect:
BID TENDERS: GENERAL
RESOLVED, that any officer of the Corporation be and they hereby are authorized in the name and on behalf of the Corporation, under its corporate seal or otherwise (i) to prepare proposals and bids for the supplying of construction materials and the performance by itself or in joint venture, of work of whatsoever nature in connection with the construction or paving of highways, roads and airports and in connection with earthworks and civil engineering projects of all kinds, together with all work incidental thereto, (ii) to execute and submit any and all such proposals and bids to any governmental authority, instrumentality, or agency of the United States, its several states, territories and possessions, including without limitation, any municipality or other political or corporate subdivision thereof, and to any corporation, partnership, sole proprietorship, or other business entity, (iii) in connection with any such submission, to deliver bid deposits or bonds as may be required and (iv) to execute and deliver definitive agreements binding the Corporation to perform work in accordance with any proposals and bids authorized hereby.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seal this 6th day of March 2025.
(SEALS, Anthony L. Martino, II, Secretary
Sully-Miller Contracting Company
DIR State of California
Department of
EST. 1927 Industrial Relations
Contractor Information
Legal Entity Name
SULLY-MILLER CONTRACTING COMPANY
Legal Entity Type
Corporation
Status
Active
Registration Number
1000003664
Registration effective date
07/01/24
Registration expiration date
06/30/26
Mailing Address
135 S STATE COLLEGE BLVD, SUITE 400 BREA 92821 CA United States of America Physical Address
135 5 STATE COLLEGE BLVD, SUITE 400 BREA 92821 CA United States of America Email Address
[email protected]
Trade Name/DBA
License Number (s)
CSLB:747612
SULLY-MILLER CONTRACTING CO.
License 747612A
135 S. State College Bivd., STE. 400 * Brea, CA 92821 • PHONE 714-578-9600 License Certificate
I certify under penalty of perjury under the laws of the State of California that the following is true and correcti
CSLB: Waltene
747612-A Jeff Galterio, Assistant Secretary
I2 CONTRACTORS Consumers Licensees Applicants
Or
TATE LICENSE BOARI
SULLY • MILLER CONTRACTING COMPANY
135 SOUTH STATE COLLEGE BLD
SUITE 400
BREA, CA 92821
Business Phone Number:(714) 578-9600
Entity Corporation
Issue Date 03/30/1998
Expire Date 03/31/2026
License Status
This license is current and active.
All information below should be reviewed.
Classifications
A - GENERAL ENGINEERING
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:
NO
All current and prior DBAs, alias, and/or fictitious business names for any principal having an interest in this proposal are as follows:
NO
IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, title, hands, and seals of all aforementioned principals this day of_03 _ 2025
D
BIDDER:
Signature
' Anthony Lino, Director of Preconstruction / Assistant Secretary Name and Title of Signatory
Sully-Miller Contracting Co.
Legal Name of Bidder
135. S. State College, Suite 400 Brea Ca. 92821
Address
714.578.9600 33-0787630
Telephone Number Federal Tax I.D. No.
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 Orange )
On 03.31.2025 before me,_ Monica Baldacci, Notary Public Date Here Insert Name and Title of the Officer
personally appeared Anthony Lino
Name(s) of Signers)
who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
MONICA MARIE BALDACCI S WITNESS my hand and official seal.
COMMISSION #2447801
Notary Public - California HMD1
ORANGE COUNTY
My Commission Expires Signature
MAY 25, 2027 Signature of Notary Public
Monica Baldacci, Notary Public
Place Notary Seal Above
- OPTIONAL -
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: _ Document Date:
Number of Pages: _ Signers) Other Than Named Above:
Capacity(ies) Claimed by Signers)
Signer's Name: Signer's Name:
• Corporate Officer - Title(s): • Corporate Officer - Title(s):
• Partner - • Limited • General • Partner - • Limited • General • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: Signer Is Representing: _
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
BIDDER'S QUESTIONNAIRE
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
1. Submitted by: Sully-Miller Contracting Co. Telephone: 714.578-9600 Principal Office Address: 135. S State College Blvd. Suite 400. Brea CA. 92821
2. Type of Firm:
• C Corporation
* S Corporation
Individual/Sole Proprietor or Single -Member LLC
Partnership
Limited Liability Company "C" C-Corp
• Limited Liability Company "S" S-Corp
Limited Liability Company "P" Partnership
Other
3a. If a corporation, answer these questions:
Date of Incorporation: 06.16.97 State of Incorporation: Delaware President's Name: William Joseph Thomas Boyd, RMO
Vice-President's Name: Scott Bottomley
Secretary or Clerk's Name: Anthony L. Martino, II
Treasurer's Name: Jae Won
3b. If a partnership, answer these questions:
Date of organization: State Organized in:
Name of all partners holding more than a 10% interest:
Designate which are General or Managing Partners.
BIDDER'S QUESTIONNAIRE (cont'd)
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
4. Name of person holding CONTRACTOR's license: William J.T. Boyd, President/RMO License number: 747612 _Class: A Expiration Date: 03.31.2026 D.I.R. Registration #_1000003664
5. CONTRACTOR's Representative: Anthony Lino
Title:_ Director of Preconstruction / Assistant Secretary Alternate: Jeff Galterio
Title: Vice President
List the major construction projects your organization has in progress as of this date:
A.
Owner: Please see attached List of Active Projects
Project Location:
Type of Project:
B.
Owner: _
Project Location:
Type of Project:
C.
Owner:
Project Location:
Type of Project:
SULLY-MILLER CONTRACTING PI = PATTI IBARRA
1/8/2025 PROJECT LIST - ACTIVE JOBS MK = MAVIS KNOX
P.E. CONTRACT EST.
DIR NO. JDE JOB# AGENCY JOB NAME / LOCATION EST. PM SUPT. FOREMAN START Federal Funds UDBE AB-219 Concrete SWPPP PLAN WDID # PLA Public Works Submit CPR to SM LCP Tracker Others Program Assigned to COMMENTS
PM AMOUNT
of Subs
10225892 Santa Monica Annual Contract Pessa Conover N/A Oison Snidecor 5,000,000 2/10/20 2/28/25 4 zz 28. • • 10226838 Long Beach Annual Local Streets Pessa NA Olson Stewart 3,000,000 3220 1231244 08-0K1224 Rie. Oak Hill In Victorville in San
>> 391861 10257589 Caltrans Bemardino County Bahramzi N/A Thorpe Gutierrez 121,672,000 11/8/21| 12/31/24 4 396744 10259382 Hesperia lanchero Road Corndor Widening Project Sanchez Royster NIA Willamson Mauldin 37,492,0001 173/221 6730723 07-326804 Rte. 210 ADA Curb Ramp Upgrade
N/A 10261756 Caltrans Project Kirk Conover N/A Love Machado 23,680,000 1/3/22 12/31/25 4 Los Angeles
440837 10286538 World Airports Taxiway D Extension (Child Job) Flores Romero N/A Gomez Leclerca 84,560,000 2/23/23 1/11/26 4 z < JOC Terminal Apron Concrete Repairs FY 23-24
at John Wayne Airport - MA-080-23010700 - IFB-
TBD 10295103 County of Orange 080-2353102 (Parent Job) Quintal Conover N/A Love Dodge 5,000,000 2/8/24 11/25/24 4 z TBDI TBD мк) Castaic - Hasley Hills South, Project ID No.
497096 10306489 LACDPW RDC0015875 Castro Graham N/A Love Bautista 832,65- 4/15/24 9/27/24 4 493829 10306682 Santa Monica FY 23-24 Annual Paving Project Castro Graham Love Bautisn 1720/24 10/15/24 08-1P700, Rie. 127 Repair Roadways Damages,
497372 10309065 Caltrans Em ency Ce. 15935 Separaton in San Uddin Bahramzi NA Patel 9,000.000 9/11/23 9/27/24 4 TBD Baker, CA TBD 10309927 Caltrans Bemardino Sanchez N/A Mauldin 35,935,000 5/6/24 12/31/244 TBD LACDPW, Hazard Avenue, Et A, RDC0016052,
517177 10310800 LACDPW East Los Angeles Castro Jones N/A Camarillo 4,710,000 5/6/24| 11/30/24 4YN N Y Y TBD TED TED TED MK Jeffrey/Alton Intersection Improvements CIP
> 525384 10312919 Irvine 311406 ST-24-0002 King N/A Camarillo 2.816.577 5/27/24 5/31/25 4N NNY Altadena Or & Washington Blvd Roadway
> 514013 10314596 LACOPW Improvements, Project ID No. RMD2504001 Acosta N/A Arqueta 5,543,839 3/11/24 12/31/24 4NN N Y Anaheim Real
Estate Partners OC Vibe Public Infrastructure Improvements Re- > 505513 10314672 LLC Bid Almanza Patel Clayton 29,965,000 3/1/24 3/31/25 4 N NN Y N TBO TED TED TBO MK Pavement Preservation (Resurfacing) North Los
Angeles County Project ID No. RMDJOC6770
506073 10315281 |LACDPW "Parent Job) Quintal Cobum N/A Perez 5,250,000 1/1/24 12/31/24 4N NN Y 180 10 180180 2024 Pavement Overlay and Resurfacing
478750 10315332 Thousand Oaks Program Cl 5594 and Cl 5595 Castro Royster N/A Royster 13.129,797 5/6/24 10/31/24 4N NN Y Y TBD TED| TOD T8D MK Pavement Reconstruction (Sustainable) North Los
508380 10315393 LACDPW Angeles County RMDJOC6773 (Parent Job) Quintal Coburn N/A TBD 5,250,000 1/1/24 12/31/24 4N NN Y Y TED TED TED TEO PI Commercial Terminal Apron Concrete Repairs,
Task Order No. 0700-2, Fund/Job Code 280-280-
280-0320-1400-JX3PW603 (Child Job No.
509312 10318823 County of Orange 1020610311 Quintal Quintal N/A Love Luu 1,749,333 2/8/24 11/25/244 N NN Y N Arterial Road Rehabilitation Project, City Project
521485 10319316 Palmdale No. PN 869 Sanchez Garcia Cisneros 19,449,515 7/10/24 2/14/25 4 530676 10320687 Irvine liver/Alton Intersection Imnrovementa Flores Jones Clayton TBD" 9/16/24 On-Call Emergency Facilties Repair Services for
10321704 [LACOPW Road Maintenance Division, RFP No. Espinoza TBD TBD 10322379 Santa Clarita 2023-24 Annual Overlay D Proj Sanchez Graham Love Bautista 8/12/241 10/31/244 N Upper Roadway Methacrylate Rehabilitation (Child
509312 10325874 County of Orange Job to 10295103) Quintal N/A Love 2.210,873 5/10/24 11/25/241 516268 10322098 LACOPW LACOPW, Pumnt Pres N. LA 6771 Conover Coburn N/A Lare у под то под подт 20240536746 -Ullerton Orangethorpe Ave Infrastructure Improvement Silva Acosta N/A IBD Argueta 3.976,752 9/9/24 1/15/25 4 zl Walnut Grove Avenue & Roadway Intersection
А 20240553607 10330991 San Gabriel mprovements Dodge Graham N/A Love 2.172,641 4 N N Y Y TED T8D T8D TRD MK 2023-24 Resurfacing Project, Residential
> 20240550167 10331665 Irvindale Resurfacing Phase Ill- Peck Road Silva Jones N/A Clayton Camarillo 1982.,0981 12/19/244 N NY 10333060 Santa Monica Viramontes Graham Love TBD
Sera Paway Phase 4- Conser 2710 Agua Duice
506073 10333519 LACDPW Cyn Rd, JOC6770-200.00 (Child Job to Conover Cobum N/A Love Tule 1,793,265 9/16/24| 10/11/244 N NNY Y TED TED TBO TBO PI Ardndge Electric, STaRT Rai Modemization 15-Minute Service to 10334672 Inc. Folsom Clausen Gomez 92,000 9/12/24 9126/24 4 10340039 S-M Internal Capex, Dredge Anchor Blocks Cheeseman Cheeseman N/A Woolston NINN Commercial Terminal Apron Concrete Repairs,
Task Order No. 1241-1, Fund/Job Code 280-280-
280-0320-1400-JX3PW603 (Child Job No.
509312 10340370 County of Orange 10295103) Quintal Quintal N/A Love Lara 1.738,833 3/3/25| 6/30/254 IN NNY Source: 2-Anaholm
THAN Const
8•Victorvite C2 - COLAS GROUP INTERNAL: Employees and partners who need to know. ACTIVE JOBS - PAGE 1 OF 2 SULLY-MILLER CONTRACTING PI = PATTI IBARRA
1/8/2025 PROJECT LIST - ACTIVE JOBS MK = MAVIS KNOX
I OUR NO. JDE JOB# AGENCY JOB NAME / LOCATION SUPT. P.E. FOREMAN STARTE 380n # COM Vld PUDIC WOrKS Submit CPR to SH 5a30 we bota sisule D1 pauD ssy COMMENTS
PM AMOUNT
No. of Subs
Upper Roadway Maintenance Rehabilitation, Task
Order No. 1241-1, Fund/Job Code 281-280-281-
509312 10310371 County of Orange Prove Avenue at Foi gi Set an 1075103). Quintal Quintal N/A Love Lara 703,599 1/13/25 2/28/254 A 20240547503 10336148 Ontario Sewer Improvements Mcdermot N/A Aquirre Gutierrez 20,323,888 1/13/25 9/30/2026 NA 10336627 S-M Intemal Blue Diamond, Irvindale Plant Upgrade Johnson N/A 10337766 S-M Internal Pit 2 Site Grade/Pave NA Clayton
ACTIVE JOBS - TOTAL 451.579,011
3=Oxnard
C2 - COLAS GROUP INTERNAL: Employees and partners who need to know. ACTIVE JOBS - PAGE 2 OF 2
CERTIFICATION OF NON-SEGREGATED FACILITIES
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
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 otherwise. 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 $10,000 which are not exempt from the provisions of the Equal Opportunity clause, and that it will retain such certifications in its files.
Sully-Miller Contracting Co.
BIDDER
Required by the May 19, 1967 order on Elimination of Segregated Facilities, by the Secretary of Labor - 32 F.R. 7439, May 19, 1967 (F.R. Vol. 33, No. 33 - Friday, February 16, 1968 - p. 3065).
DESIGNATION OF SUBCONTRACTORS
Bid # CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
Subcontractor DIR Registration No.* Dollar Value of Work Chrisp Company 1000000306 $ 45,427.10
Location and Place of Business
2280 S. Lilac Ave., Bloomington, CA 92316
Bid Schedule Item No's: Description of Work
Base
2,18-28 Striping & Marking
License No. Exp. Date: Phone (T
374600 05/31/25 909/746-0356
ubcontracto DIR Registration No.* Dollar Value of Work
rosstown Electrical
& Data, Inc 1000000155 $ 104,520-ll
Location and Place of Business
5454 Diaz Street, Irwindale, CA 91706
Bid Schedule Item No's: Description of Work
Base Bid:
1 (P) , 29, 31 ELectrica-
License No. Exo. Date: Phone ( )
756309 11/30/26 626/813-6693
Subcontractor DIR Registration No.* Dollar Value of Work Cindy Trump, Inc. dba
$ 176,628.00
Lindy's Cold Planing 1000008423
Location and Place of Business
625 W. Mountain Ave., La Habra, CA 90631
Bid Schedule Item No's: Description of Work
Base Bid:
7, 8(P), 10, 11 Cold Planing
License No. Exp. Date: / / Phone (7
754500 09/30/26 562/697-2286
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 'ublic Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered anc ualified 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 t
DESIGNATION OF SUBCONTRACTORS
Bid # CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
Service in exes the a panel, or 200 place er res race price contracter la and no renter reuse i renom with NA. Add addt. sheets if needed.
Substatilities DIR Registration No.* Dollar Value of Work austing Inc 1000004286 $ 45,700.00
cation and Place of Busine
1345 Quarry street, #101, Corona, CA 92878
Ba see Be tem No's: Description of Work
12,14,15,17 Adjust Utilities
License No. Exp. Date: / / Phone (T
932798 05/31/25 951/279-6869
Subcontractor DIR Registration No.* Dollar Value of Work california Professional
Focation and price of Business Inc.. 1000377609 $ 24,174.00 19062 San Jose Avenue, La Puente, CA 91748
Bid Schedule Item No's: Description of Work
Base Bid:
30 Loops
License No. Exp. Date: 77 Phone | T
793907 04/30/27 626/810-1338
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 Contrac 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.
DESIGNATION OF SUBCONTRACTORS
Bid # CIP-24-25-MO1570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
sarice in exes a%, a pren, or 20,0 wilcer rese the prime onto or or and no sure rates a se use i tre reme 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 ubmit 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 Contrac code, provided the BIDDER is registered to perform public work pursuant to Section 1725.5 of the Labor Code at the time the contract i awarded. *Pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code.
DESIGNATION OF SUBCONTRACTORS
Bid # CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
seed in eve the or penelor 200 mile reso each palcontrade or tea and no court perse euse fier re arm 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.
REFERENCES
Bid #CIP-24-25-M01570A
2024-25 Overlay A Project
City Project No. MO157
City of Santa Clarita, California
The following are the names, addresses, and telephone numbers of three public agencies for which bidder as performed and completed work of a similar scope and size within the past 3 years. If the scope of work/specifications requests references different than instructions above, the scope of work/specifications shall govern:
1. City of Santa Clarita, 2021-2022 Federal Resurfacing Project Name and Address of Owner / Agency
Jodee Roth 661/ 259-2489
Name and Telephone Number of Person Familiar with Project Mobilization, Earthwork, Adjust Manholes,
AC Paving, Traffic Control, SWPPP, 9/27/2023
$4,358,532.00 Electrical, Striping & Marking.
Contract Amount Type of Work Date Completed
2. Caltrans, 09-392004 Rte. 395 in Lone Pine, Inyo.
Name and Address of Owner / Agency
Damien L. Cherenzia 916-227-6299
Name and Telephone Number of Person Familiar with Project Traffic Control, Shoulder Backing, HMA,
WPCP, TRO, Construction Area Signs, Striping
5,285,000.00 & Marking, Guard Rail, Rumble Strip. 9/19/2023 Contract Amount Type of Work Date Completed
City of Garden Grove- Various Residential Streets Reconstruction 2023 Name and Address of Owner / Agency
Mark Uphus 714-741-5000
6,988,665.00 12/15/23
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 bonds: See see attached list of Surety /m
SULLY-MILLER CONTRACTING CO.
License 747612A
135 S. State College Blvd., STE. 400 • Brea, CA 92821 • PHONE 714-578-9600 The Following are the names, addresses, and telephone numbers for all brokers and sureties from whom Bidder intends to procure insurance and bonds:
Agent for Surety:
Willis Risk & Insurance Services
2010 Main Street, Suite 1050
Irvine, CA 92614
Phone 949/885-1206
FAX 949/885-1225
Contact: Victoria Campbell
Surety :
Liberty Mutual Insurance Co.
8044 Montgomery Road Suite #137
Cincinnati, OH 45236
Phone 513/984-2222 X 321
FAX 513/984-3165
Contact: Kelley Brown
Surety:
Berkshire Hathaway Specialty Insurance
1314 Douglas Street
Omaha, NE 68102
Phone 770/625-2509
Contact: D.J. Conroy
Insurance:
Liberty Mutual Group
1133 Avenue of America
New York, NY 10036
Phone 800/227-9887 Ext 443
FAX 212/391-1954
Insurance:
Marsh USA
445 South Street Suite 210
Morristown, NJ 07962
Phone 973/401-5151
FAX 973/401-5045
Contact: Anton Schmitt
IRAN CONTRACTING ACT CERTIFICATION
(Public Contract Code Sections 2200 et seq.)
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
As required by California Public Contract Code section 2204, Proposer certifies that the option checked below relating to Proposer's status in regard to the Iran Contracting Act of 2010 (Public Contract Code sections 2200 et seq.) is true and correct:
Proposer is not:
(i) identified on the current list of persons and entities engaging in investment activities in Iran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code section 2203; or
a financial institution that extends, for 45 days or more, credit in the amount of $20,000,000 or more to any other person or entity identified on the current list of persons and entities engaging in investment activities in Iran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code section 2203, if that person or entity uses or will use the credit to provide goods or services in the energy sector in Iran.
Los Angeles County has exempted Proposer from the requirements of the Iran 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 $1,000,000.
CERTIFICATION
1, 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
Sully-Miller Contracting Co.
Firm
03.28.25 Anthony Lino, Director of reconstruction/ Assistant Secretary Date Name/Titler:
Note: In accordance with Public Contract Code seclión 2205, false certification of this form shall be reported to the California Attorney General and may result in civil penalties equal to the greater of $250,000 or twice the Contract amount, termination of the Contract and/or ineligibility to bid on contracts for three years.
END OF DOCUMENT
NON-COLLUSION AFFIDAVIT
(Title 23 United States Code Section 112 and Public Contract Code Section 7106) Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
To the CITY OF SANTA CLARITA:
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 agreement, communication, or conference with anyone to fix the bid price of the Bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, 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.
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 A PART OF THE PROPOSAL. BIDDERS ARE CAUTIONED THAT MAKING A FALSE CERTIFICATION MAY SUBJECT THE CERTIFIER TO CRIMINAL PROSECUTION.
NON-COLLUSION AFFIDAVIT
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
TO BE EXECUTED BY EACH BIDDER OF A PRINCIPAL CONTRACT
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
Anthony Lino _ being first duly sworn deposes and says that he/she is Director of Preconstruction/Assistant Secretary (sole owner, a partner, president, etc.) of Sully-Miller Contracting Co. the party making the foregoing bid; that such bid is not made in the interest of or behalf of any undisclosed person, partnership, company, association, organization or corporation, that such bid is genuine and not collusive or sham, that said BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, or that anyone shall refrain from bidding, that said BIDDER has not in any manner, 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 to fix the overhead, profit, or cost element of such bid price, or of that of any other BIDDER, or to secure any advantage against the public body awarding the Contract or anyone interested in the proposed Contract; that all statements contained in such bid are true, and further, that said BIDDER has not, directly or indirectly, submitted its bid price, or any breakdown thereof, or the contents thereof, or divulged information or date relative thereto, or paid and will not pay any fee in connection, therewith to any corporation, partnership, company, association, organization, bid depository, or to any member or CITY thereof, or to any other individual information or date relative thereto, or paid and will not pay any fee in connection, therewith to any corporation, partnership, company association, organization, bid depository, or to any member or CITY thereof, or to any other individual, except to such person or persons as have a partnership or other financial interest, with Said BIDDER in his general business.
Bidder
Signature Anthony Lino
Title Director of Preconstruction/Assistant Secretary
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 Orange )
On 03.31.2025 before me, - Monica Baldacci, Notary Public Date Here Insert Name and Title of the Officer
personally appeared Anthony Lino
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
MONICA MARIE BALDACCI B
COMMISSION #2447801 WITNESS my hand and official se
HMD1 otary Public - Calite:. HMI
RANGE COUNT
My Commission Expires 1 h1
MAY 25, 2027 Signature
Signature of Notary Public
Monica Baldacci, Notary Public
Place Notary Seal Above
- OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: _ Document Date:
Number of Pages: . Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
] Corporate Officer - Title(s): • Corporate Officer - Title(s):
] Partner - O Limited • General • Partner - O Limited • General Indiviul • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: _ Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
SECTION B
Bid Instructions and Bid Clauses
DOCUMENT CHECKLIST
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
The following documents must be completed and submitted by the bidder as per the outlined timeframes.
The following documents must be provided by ALL bidders:
Uploaded via BidNet (see Section C)
• Proposal Form
Notice to Bidders Regarding Contractual Requirements
Bid Schedule
• Bidder's Information and Certification
N Bidder's Questionnaire
• Certification of Non-Segregated Facilities
• Designation of Subcontractors
References
Iran Contracting Act Certification
Non-Collusion Affidavit
All signed addendums (if any) - Digitally acknowledged by uploading via BidNet NONE Delivered to City Hall, Attn: Purchasing, Suite 120 prior to bid closing:
• Proposal Guarantee Bond/Bidder's Bond (Notarized)
The following documents must be provided by the AWARDEE ONLY (With Agreement) Delivered to City Hall, Attn: Ramiro Fuentes
• Capital Improvement Project Agreement
Faithful Performance Bond (Notarized)
0 Labor & Material Bond (Notarized)
Insurance Required by Contract
0 W9
Fringe Benefit Statement
PROPOSAL FORM
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
TO THE CITY OF SANTA CLARITA, AS CITY:
In 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, INSTRUCTIONS TO BIDDERS, and all other contract documents. If this proposal is accepted for award, BIDDER agrees 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 CITY 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 CITY RESERVES THE RIGHT TO INCREASE OR DECREASE THE AMOUNT OF ANY QUANTITY SHOWN AND TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum price(s) bid include all appurtenant expenses, taxes, royalties, and fees for the project's duration. In case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures.
If 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: Sully-Miller Contracting Co.
135 S. State College Blvd. Suite 400
Company Address:
Brea, CA. 92821
714.578.9600
Phone:
Email, SULLY 4/7 [email protected]
BV: Anthony Lino
=: = Print Name
Title:™ Direciprof Preconstruction / Assistant Secretary Signature:
328.2025
Date:
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 _ Orange
On _ 03.31.2025 before me,. Monica Baldacci, Notary Public Date Here Insert Name and Title of the Officer
personally appeared Anthony Lino
Name(s) of Signers)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
MONICA MARIE BALDACCI S WITNESS my hand and official seal.
COMMISSION 2447801
otary Public - Californi HMD
RANGE COUNT
My Commission Expires Signature.
MAY 25, 2027 Signature of Notary Public
Monica Baldacci, Notary Public
Place Notary Seal Above
- OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: _ Document Date:
Number of Pages: . Signers) Other Than Named Above:
Capacity(ies) Claimed by Signers)
Signer's Name: Signer's Name:
] Corporate Officer - Title(s): • Corporate Officer - Title(s):
• Partner - D Limited • General • Partner - • Limited • General • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: _ Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
NOTICE TO BIDDERS REGARDING CONTRACTUAL REQUIREMENTS
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
SUMMARY OF INDEMNITY AND INSURANCE REQUIREMENTS
1. These are the Indemnity and Insurance 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. If any additional Contract documents are executed, the actual Indemnity language and Insurance Requirements may include additional provisions as deemed appropriate by City's Purchasing Agent.
2. You should check with your Insurance advisors to verify compliance and determine if additional coverage 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 Contractor's policies of Insurance shall be available to Buyer and these Insurance Requirements shall not in any way act to reduce coverage that is broader or includes higher limits than those required.
The Insurance obligations under this agreement shall be: 1-all the Insurance coverage and limits carried by or available to the Contractor; or 2-the minimum Insurance 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 Insurance 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 Insurance coverage and endorsements.
I. INDEMNIFICATION:
City and its respective elected and appointed boards, officials, officers, agents, employees, and volunteers (individually and collectively, "Indemnitees") shall have no liability to CONTRACTOR or any other person for, and CONTRACTOR shall indemnify, defend, protect, and hold harmless Indemnitees 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 Indemnitees may suffer or incur or to which Indemnitees 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.
If any action or proceeding is brought against Indemnitees by reason of any of the matters against which CONTRACTOR has agreed to indemnify Indemnitees as provided above, CONTRACTOR, upon notice from City, shall defend Indemnitees at its expense by counsel acceptable to City, such acceptance not to be unreasonably withheld. Indemnitees need not have first paid for any of the matters to which Indemnitees are entitled to indemnification in order to 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. In the event the said insurance is canceled, the CONTRACTOR shall, prior to the cancellation date, submit to the City Clerk new evidence of insurance in the amounts established.
Liability Insurance
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 CITY, 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 CITY, 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 Insurance, including coverage for Premises and Operations, Contractual Liability, Personal Injury Liability, Products/Completed Operations Liability, and Independent Contractors' Liability (if applicable), in an amount of not less than two million dollars ($2,000,000.00) per occurrence, four million dollars ($4,000,000.00) 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. If 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.
Worker's Compensation Insurance
The CONTRACTOR shall procure and maintain, at its sole expense, Worker's Compensation Insurance in the amount of $1,000,000 per occurrence or in such amount as will fully comply with the laws of the State of California and which shall indemnify, insure and provide legal defense for both the CONTRACTOR and the CITY 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 Insurance
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 $1,000,000 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.
Waiver of Subrogation
All insurance coverage maintained or procured pursuant to this Agreement shall be endorsed to waive subrogation against the CITY, 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 Insureds
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 CITY for review.
Self-Insured 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 CITY.
Primary and Additional Insured
All of such insurance shall be primary and shall name the City of Santa Clarita as additional insured. A Certificate of Insurance and an additional insured endorsement (for general and automobile liability), evidencing the above insurance coverage with a company acceptable to the City's Purchasing Agent shall be submitted to the CITY prior to execution of this Agreement on behalf of the CITY.
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. In 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.
If the operation under this Agreement results in an increased or decreased risk in the opinion of the City's Purchasing Agent, then the CONTRACTOR agrees that the minimum limits herein above designated shall be changed accordingly upon request by the City's Purchasing Agent.
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: 3.28.2025
Director of Preconstruction / Assistant Secretary
Printed Name: Anthony Lino
BID SCHEDULE (COPPERHILL NORTH AND SOUTH)
Bid #CIP-24-25-MO1570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
Fill out this form completely and submit with the bid response. Line item pricing must be entered on BidNet. In the event any mathematical discrepancies are found, please refer to Section B, Bid Instructions.
The award of contract, if made, will be to the lowest responsive BIDDER determined solely by the AGENCY.
The AGENCY also reserves the right to add/delete the quantities to the existing bid items, or delete the entire bid item if they are found not required by the Agency during the course of the construction, or add new bid items or scope of work by Contract Change Order at any time during the project up to the last contract working day.
BIDDER must hold pricing for one hundred twenty (120) days following the bid due date. In the event a final contract has not been awarded within this period; the City reserves the right to negotiate extensions to this period. The BIDDER agrees to hold all unit prices in this Bid Schedule constant throughout the duration of the project up to the last contract working day.
ITEM UNIT
BID ITEMS UNIT QTY TOTAL COST
NO. PRICE
1 Mobilization, Bonds & Insurance LS 1 40,250.00 40,250.00 2 Traffic Control LS 1 150,000.00 150,000.00
Storm Water Pollution Prevention - BMP Plan LS 1 10,000.0010,000.00 4 AC D2 PG 64-10 729 186.00 135,594.00
5 AC C2 PG 64-10 TN 618 184.00 113, 712.00
6 ARHM GG-C PG 64-16 TN 2,739 173.00 473, 847.00
7 Remove & Replace 5" AC SF 75,214 6.50 488,891.00
8 Cold Plane & Remove 8" SF 14,970 3.50 52, 395.00
9 Stabilization Allowance SF 9,020 3.00 27,060.00
10 Keycut A1 LF 4,644 6.60 30,650.40
11 Keycut B1 LF 382 40.50 15,471.00
Lower Manhole Covers to Finish Grade EA 24 2,500.00 60,000.00 13 Lower Water Valve Covers to Finish Grade EA 29 200.00 5,800.00 14 Lower Utility Cover / Vault / Well to Finish Grade EA 1 2,500.00 2,500.00 15 Adjust Manhole Covers to Finish Grade EA 24 1,200.00 28,800.00 16 Adjust Water Valve Covers to Finish Grade EA 29 245.00 7,105.00 17 Adjust Utility Cover / Vault / Well to Finish Grade EA 1 3,320.00 3,320.00 18 Install Blue RPM's @ Fire Hydrant EA 12 8.00 96.00
19 6" White Line (Thermo) LF 160 5.00 800.00
20 12" White Crosswalk/Limit Line (Thermo) LF 3,038 3.00 9,114.00 21 Striping Detail #12(Thermo & Markers) LF 7,294
0.75 5,470.50
22 Striping Detail #29 (Thermo & Markers) LF 2,447 3.00 7,341.00 23 Striping Detail #37B (Thermo) LF 415 2.00 830.00
24 Striping Detail #38 (Thermo & Markers) LF 2,906 2.00 5,812.00 25 Striping Detail #38A (Thermo) LF 1,710 1.50 2,565.00 26 Striping Detail #40 (Thermo & Markers) LF 2,086 0.85 1,773.10 27 Arrow Type IV (L/R) (Thermo) EA 24 95.00 2,280.00
28 Chevron Striping EA 950 6.25 5,937.50
29 Install Temporary Video Detection System EA 16 5,100.00 81,600.00 30 Remove and install Permanent Traffic Loops EA 51 490.00 24,990. 00 31 Remove and Replace Sensys EA 12 1,900.00 22,800.00
TOTAL BASE BID AMOUNT FOR COPPERHILL NORTH AND SOUTH: $ 1, 816, 804.50 TOTAL BASE BID AMOUNT IN WORDS: One Million Eight Hundred Sixteer Thousand Eight Hundred Four • Dollars
and Fifty Cents.
BIDDER'S INFORMATION AND CERTIFICATION
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, CA
Bidder certifies that the representations of the bid are true and correct and made under penalty of perjury.
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE
Bidder certifies that in all previous contracts or subcontracts, all reports which may have been due under the requirements of any CITY, 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.
CERTIFICATION REGARDING DIR CONTRACTOR/SUBCONTRACTOR REGISTRATION 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 1720) of the California Labor Code. Contractor's registration number is indicated below. Subcontractors' registration numbers are indicated on the Subcontractor Designations form.
Bidder's Name: Sully-Miller Contracting Co.
Business Address: 135. S State College Blvd. Suite 400. Brea. CA, 92821 Telephone No.: 714.578.9600
State CONTRACTOR's License No. & Class: 747612-A
DIR No.: 1000003664
Original Date: 12/2014 Expiration Date: 6/30/2026
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:
See attached Certificate of Incumbency
CERTIFICATE OF INCUMBENCY
I, Anthony L. Martino, II, do hereby certify that I am the Secretary of Sully-Miller Contracting Company, a Delaware corporation, and that as such I have access to and custody of the corporate records and minute books of said corporation.
And I do hereby further certify that the following persons are duly elected officers of said corporation.
NAME TITLE
Marcus Leavitt Chairman of the Board
William Joseph Thomas Boyd President
Jae Won Vice President, CFO, Treasurer & Assistant Secretary Scott Bottomley Vice President & Assistant Secretary
James Wilson Vice President & Assistant Secretary
Jeff Galterio Vice President & Assistant Secretary
Anthony L. Martino, I| Secretary
Mark Pachura Assistant Secretary
Anthony Lino Assistant Secretary
I further certify that the following persons are duly elected directors of said corporation.
Marcus Leavitt
Leslie Edwards
I further certify that the following is a true and correct copy of a resolution duly adopted by the Board of Directors of said Company at a meeting held on December 5, 2024, and that this resolution has not been in any way rescinded, annulled, or revoked but the same is still in full force and effect:
BID TENDERS: GENERAL
RESOLVED, that any officer of the Corporation be and they hereby are authorized in the name and on behalf of the Corporation, under its corporate seal or otherwise (i) to prepare proposals and bids for the supplying of construction materials and the performance by itself or in joint venture, of work of whatsoever nature in connection with the construction or paving of highways, roads and airports and in connection with earthworks and civil engineering projects of all kinds, together with all work incidental thereto, (ii) to execute and submit any and all such proposals and bids to any governmental authority, instrumentality, or agency of the United States, its several states, territories and possessions, including without limitation, any municipality or other political or corporate subdivision thereof, and to any corporation, partnership, sole proprietorship, or other business entity, (iii) in connection with any such submission, to deliver bid deposits or bonds as may be required and (iv) to execute and deliver definitive agreements binding the Corporation to perform work in accordance with any proposals and bids authorized hereby.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the corporate seal this 6th day of March 2025.
LILLER 4226
(SEALS, Anthony L. Martino, II, Secretary
Sully-Miller Contracting Company
15: 440°
State of California
DIR
Department of
EST. 1927 Industrial Relations
Contractor Information
Legal Entity Name
SULLY-MILLER CONTRACTING COMPANY
Legal Entity Type
Corporation
Status
Active
Registration Number
1000003664
Registration effective date
07/01/24
Registration expiration date
06/30/26
Mailing Address
135S STATE COLLEGE BLVD, SUITE 400 BREA 92821 CA United States of America Physical Address
135 5 STATE COLLEGE BLVD, SUITE 400 BREA 92821 CA United States of America Email Address
[email protected]
Trade Name/DBA
License Number (s)
CSLB:747612
m
SULLY-MILLER CONTRACTING CO.
License 747612A
135 S. State College Bivd., STE. 400 • Brea, CA 92821 + PHONE 714-578-9600 License Certificate
I certify under penalty of perjury under the laws of the State of California that the following is true and cored.
CSLB: WYatting
747612-A Jeff Galterio, Assistant Secretary
TE SOETRAGTONS Consumers Licensees Applicants
Or
SULLY MILLER CONTRACTING COMPANY
135 SOUTH STATE COLLEGE BLD
SUITE 400
BREA, CA 92S21
Business Phone Number:(714) 578-9600
Entity Corporation
Issue Date 03/30/1998
Expire Date 03/31/2026
License Status
This license is current and active.
All information below should be reviewed.
Classifications
A - GENERAL ENGINEERING
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:
NO
All current and prior DBAs, alias, and/or fictitious business names for any principal having an interest in this proposal are as follows:
NO
IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, title, hands, and seals of all aforementioned principals this 28th _ day of 03 _ 2025. " Ly
tel fo
BIDDER:
Signature
'Anthony Lino, Director of Preconstruction / Assistant Secretary Name and Title of Signatory
Sully-Miller Contracting Co.
Legal Name of Bidder
135. S. State College, Suite 400 Brea Ca. 92821
Address
714.578.9600 33-0787630
Telephone Number Federal Tax I.D. No.
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 XÔC HẤNỨ NẤXỨ XNHNỨNNNNNHNNHĨXĨĨNĨXẤẤXXXXā
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
On 03.31.2025 before me,. Monica Baldacci, Notary Public Date Here Insert Name and Title of the Officer
personally appeared Anthony Lino
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
MONICA MARIE BALDACCI § WITNESS my hand and officiat seal.
COMMISSION #2447801
Notary Public - California
HMD ORANGE COUNTY
My Commission Expires Signature
MAY 25, 2027 Notary Public
Signature of
Monica Baldacci, Notary Public
Place Notary Seal Above
— OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an nintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
• Corporate Officer - Title(s): • Corporate Officer - Title(s):
• Partner - • Limited • General • Partner - • Limited • General • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: _ Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
BIDDER'S QUESTIONNAIRE
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
1. Submitted by: Sully-Miller Contracting Co. Telephone: 714.578-9600 Principal Office Address: 135. S State College Blvd. Suite 400. Brea CA. 92821
2. Type of Firm:
C Corporation
* S Corporation
Individual/Sole Proprietor or Single -Member LLC
Partnership
Limited Liability Company "C" C-Corp
Limited Liability Company "S" S-Corp
Limited Liability Company "P" Partnership
Other
3a. If a corporation, answer these questions:
Date of Incorporation: 06.16.97 State of Incorporation: Delaware President's Name: William Joseph Thomas Boyd, RMO
Vice-President's Name: Scott Bottomley
Secretary or Clerk's Name: Anthony L. Martino, II
Treasurer's Name: Jae Won
3b. If a partnership, answer these questions:
Date of organization: _State Organized in: _
Name of all partners holding more than a 10% interest:
Designate which are General or Managing Partners.
BIDDER'S QUESTIONNAIRE (cont'd)
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
4. Name of person holding CONTRACTOR's license: William J.T. Boyd, President/RMO License number: 747612 _ Class: A Expiration Date: _ 03.31.2026 D.I.R. Registration # 1000003664
5. CONTRACTOR's Representative: Anthony Lino
Title:_Director of Preconstruction / Assistant Secretary Alternate: Jeff Galterio
Title: Vice President
6. List the major construction projects your organization has in progress as of this date:
A.
Owner: Please see attached list of Active Projects
Project Location:
Type of Project:
B.
Owner: _
Project Location:
Type of Project:
C.
Owner:
Project Location:
Type of Project:
SULLY-MILLER CONTRACTING PI = PATTI IBARRA
1/8/2025 PROJECT LIST - ACTIVE JOBS MK = MAVIS KNOX
Asst. P.E. CONTRACT EST. Federal Funds 2000067 # GIGM
DIR NO. JDE JOB# AGENCY JOB NAME / LOCATION EST. SUPT. FOREMAN AMOUNT START NV7d Submit CPR to SM Sa30 COMMENTS No. of Subs
TBD 10225892 Santa Monica Annual Contract Conover N/A Snidecor 5,000,000| 2/10/20 2/28/25 4 102268381 Annual Local Streets Possa Roehi Olson Stewart 3.000.0001 727317241 zz Long Beach
08-0KT224 Rte. Oak Hill In Victorville in San
391861 10257589 Caltrans Ranchero Road Comfor Widening Proper Bahramzi N/A Tharpe Gutierrez 12/31/24| 4 TOD 396744 10259382 Hesperia Sanchez Royster N/A Willamson Mauldin 1218320001- 11/8/21 6730723 4 07-326804 Rte. 210 ADA Curb Ramp Upgrade
N/A 10261756 Caltrans Project Kirk Conover N/A Love Machado 23,680,000| 1/3/22 12/31/25 4 Los Angeles
440837 10286538 World Airports Taxiway D Extension (Child Job) Flores Romero Gomez Leclerca 84.560,000 2/23/23 z JOC Terminal Apron Concrete Repairs FY 23-25
at John Wayne Airport - MA-080-23010700 - IFB-
TBD 10295103 County of Orange 080-2353102 (Parent Job) Quintal Conover N/A Dodge 5,000,000 2/8/24 11/25/24 4 TRO TRE TRO Castaic - Hasley Hills South, Project ID No.
497096 10306489 LACDPW RDC0015875 Graham N/A Love Bautista 4/15/24 9/27/244 493829 10306682 Santa Monica FY 23-24 Annual Paving Project Castro Graham NIA Love Bautisn 3572,35 1720/24 10/15/24 4 08-1P700, Rte. 127 Repair Roadways Damages,
497372 10309065 Caltrans Emergency Contract - San Bernardino Uddin Bahramzi N/A Thorpe Patel 9,000,000 9/11/23 9/27/24 4 z Baker, CA 08-1G6404 Rie. 157395 Separation in San
TBD 10309927 Caltrans Sanchez Garcia NIA TBD Mauldin 35,935,000 12/31/24 4 LACDPW, Hazard Avenue, Et Al, RDC0016052,
517177 10310800 LACDPW | East Los Angeles Castro Jones. NIA Camarillo 4,710,000 5/6/24 11/30/24 4 YNNY Y TED TED TBO T8D MK effrey/Alton Intersection Improvements CIP
525384 10312919 Irvine 311406 ST-24-0002 King Jones N/A TBD Camarillo 2,816.577 5/27/24 5/31/254 N N N Y Y TBO TRO TED TED PI Altadena Dr & Washington Bivd Roadway
514013 10314596 LACDPW | Improvements, Project ID No. RMD2504001 Almanza Acosta N/A Arqueta 5,543,839 3/11/24| 12/31/244 N NN Y Y TBD TaD TBD TBO MK Anaheim Real
Estate Partners OC Vibe Public Infrastructure Improvements Re- 505513 10314672 LLC Almanza Patel N/A Clayton Rosas 29,965,000 3/1/24 3/31/254 N NN Y N TBO TBD| TED TBD| MK Pavement Preservation (Resurfacing) North Los
Angeles County Project ID No. RMDJOC6770
506073 10315281 LACDPW (Parent Job) Quintal Cobum N/A Perez 5,250,000 1/1/24 12/31/244 N NN Y Y TBO TED T8O T8O Pi 2024 Pavement Overlay and Resurfacing
478750 10315332 Thousand Oaks Program Cl 5594 and Cl 5595 Castro Royster N/A TBD Royster 13,129,797 5/6/24 10/31/24 4 N NN Y Pavement Reconstruction (Sustainable) North Los
508380 10315393 LACDPW Angeles County RMDJOC6773 (Parent Job) Quintal Cobum N/A 5,250,000 1/1/24 12/31/24 4N NNY Y т8D T8O T80 Tво P Commercial Terminal Apron Concrete Repairs.
Task Order No. 0700-2, Fund/Job Code 280-280-
280-0320-1400-JX3PW603 (Child Job No.
509312 10318823 County of Orange 10295103) Quintal Quintal N/A Love 1,749,333 2/8/24 11/25/24 4 N NN Y Arterial Road Rehabilitation Project, City Project
521485 10319316 Palmdale No. PN 869 Sanchez Garcia N/A TBD Cisneros 19,449,515 7/10/24| 7 TED TO TO TO K 530676 10320687 Irvine Culver/Alton Intersection improvements Jones N/A Clayton z On-Call Emergency Facilities Repair Services for
TBD 10321704 LACDPW | Road Maintenance Division, RFP No. Sanioza TBD N/A 1,228,872 TANT 10322379 Santa Clarita 2023-24 Annual Overlay D Project Graham N/A Love Bautista 6.527,408 10/31/24 4 z Upper Roadway Methacrylate Rehabilitation (Child
509312 10325874 County of Orange Job to 10295103) Quintal Quintal N/A Love 2.210,873 5/10/24 11/25/24 4 z 516268 10322098 LACOPW LACDPW, Pymnt Pres N. LA 6771* Conover Cobum NA Lara zzz Perez
A 20240536746 10330221 Fullerton Orangethorpe Ave Infrastructure Improvement Silva N/A Arqueta 3,976,752 9/9/241 1/15/25 4 z TBO| T60 BO TBO PI:
Walnut Grove Avenue & Roadway Intersection
20240553607 10330991 San Gabriel Improvements Dodge Graham N/A Bautista 2,172,641 ININ Y У тво тао тво тво мк 2023-24 Resurlacing Project, Residential
20240550167 10331665 Irwindale Resurfacing Phase IlI- Peck Road Jones Clayton Camarillo 10/24/24 12/19/244 > > 10333060 Santa Monica Airport Paving Improvements SP 2716 Viramontes T Graham Love 1984,096- zz Sierra Highway Phase 4 - Center St to Agua Dulce
506073 10333519 LACDPW Cyn Rd, JOC6770-200.00 (Child Job to Conover Cobum N/A Tule 1.793,265 9/16/24| 10/11/24 4 Alanage Electic, SacRT Rail Modernization 15-Minute Service to TBD 10334672 Inc. Folsom Clausen Romero N/A Gomez 92,000 9/12/24 9/2624 4 Y TED TED TRO TED PI TBD 10340039 S-M Internal" capex, Dredge Anchor Blocks Cheeseman Cheeseman NA Woolston Commercial Terminal Apron Concrete Repairs,
Task Order No. 1241-1, Fund/Job Code 280-280-
280-0320-1400-JX3PW603 (Child Job No.
509312 10340370 County of Orange 10295103) Quintal Quintal N/A Love 1.738,833 | 3/3/25 6/30/254 IN NNY Source: 2%Anaheim
ENC Const
8eVictorvlle partners who need to know ACTIVE JOBS - PAGE 1 OF 2 SULLY-MILLER CONTRACTING PI = PATTI IBARRA
1/8/2025 PROJECT LIST - ACTIVE JOBS MK = MAVIS KNOX
I DIR NO. JDE JOB# AGENCY JOB NAME / LOCATION EST. PM SUPT. P.E. FOREMAN CONTRACT EST. Subsistence AB-219 Concrete SWPPP PLAN WDID # PLA Pubiic Works Submit CPR to SM LCP Tracker OCPS Others Program Assigned to COMMENTS
AMOUNT START
No. of Subs
Upper Roadway Maintenance Rehabilitation, Task
Order No. 1241-1, Fund/Job Code 281-280-281-
509312 10340371 County of Orange P453-4200-W1299453 (Child Job to 10295103) Quintal Quintal N/A Love 703,599 1/13/25 2/28/254 z z Grove Avenue at Hort Bivd Street and Trunk
A 20240547503 10336148 Ontario Sewer Improvements Silva Mcdermot N/A Gutierrez 20,323.888 1/13/25 9/30/2026 4 10336627 S-M Internal Blue Diamond, Irvindale Plant Upgrade 10/1/24 z:
Al N/A 10337766 S-M Internal Pit 2 Site Grade/Pave N/A Clayton ACTIVE JOBS - TOTAL 151.579.011
Source: 2= Anaheim
8a Victorvite ~ . COLAS GROUP INTERNAL: Emolovees and partners who need to know ACTIVE JOBS - PAGE 2 OF 2
CERTIFICATION OF NON-SEGREGATED FACILITIES
Bid #CIP-24-25-MO1570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
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 otherwise. 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 $10,000 which are not exempt from the provisions of the Equal Opportunity clause, and that it will retain such certifications in its files.
Sully-Miller Contracting Co.
BIDDER
Required by the May 19, 1967 order on Elimination of Segregated Facilities, by the Secretary of Labor - 32 F.R. 7439, May 19, 1967 (F.R. Vol. 33, No. 33 - Friday, February 16, 1968 - p. 3065).
DESIGNATION OF SUBCONTRACTORS
Bid # CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
with NA. Add addt, sheets if needed.
Subcontractor DIR Registration No.* Dollar Value of Work Chrisp Company 1000000306 $ 15,427.10
Location and Place of Business
2280 S. Lilac Ave., Bloomington, CA 92316
id Schedule Item No's Description of Work
Base 27 C
2,18-28 Striping & Marking
License No. Exp. Date: Phone (T
374600 05/31/25 909/746-0356
Subcontractor DiR Registration No.* Dollar Value of Work crosstown Electrical
& Data, 1000000155 $ 104.520.00
Location and Place of Business
5454 Diaz Street, Irwindale, CA 91706
Bid Schedule Item No's: Description of Work
Base Bid:
1 (P), 29, 31 Electrical
License No. Exp. Date: Phone | i
756309 11/30/26 626/813-6693
Subcontractor DIR Registration No.* Dollar Value of Work Cindy Trump, Inc. dba
$ 176,628.00
Lindy's Cold Planing 1000008423
Location and Place of Business
625 W. Mountain Ave., La Habra, 90631
Bid Schedule Item No's: Description of Work
Base Bid:
7, 8(P), 10, 11 Cold Planing
License No. Exp. Date: / / Phone ( )
754500 09/30/26 562/697-2286
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.
DESIGNATION OF SUBCONTRACTORS
Bid # CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
steles the one and it, 00 the places er lu re free pico tear or ta bid and contractors or euse i are re o with NA. Add addt. sheets if needed
Substatt it ies DIR Registration No.* Dollar Value of Work Adjusting, InC 1000004286 $ 45,700.00
ocation and Place of Busines
1345 Quarry Street, #101, Corona, CA 92878
Ba seeds tem No's: Description of Work
12,14,15,17 Adjust Utilities
License No. Exp. Date: / / Phone (
932798 05/31/25 951/279-6869
Sali tornia Professiona iR Registration No.* Dollar Value of Work Location and Place of Business Inc. 1000377609 $ 24,174.00 19062 San Jose Avenue, La Puente, CA 91748
Bid Schedule Item No's: Description of Work
Base Bid:
30 Loops
License No. Exp. Date: / / Phone |]
793907 04/30/27 626/810-1338
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 o 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.
REFERENCES
Bid #CIP-24-25-MO1570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
The following are the names, addresses, and telephone numbers of three public agencies for which bidder as performed and completed work of a similar scope and size within the past 3 years. If the scope o ork/specifications requests references different than instructions above, the scope of work/specification shall govern:
1. City of Santa Clarita, 2021-2022 Federal Resurfacing Project Name and Address of Owner / Agency
Jodee Roth 661/ 259-2489
Name and Telephone Number of Person Familiar with Project Mobilization, Earthwork, Adjust Manholes,
AC Paving, Traffic Control, SWPPP
$4,358,532.00 Electrical, Striping & Marking. 9/27/2023 Contract Amount Type of Work Date Completed
2. Caltrans, 09-392004 Rte. 395 in Lone Pine, Inyo
Name and Address of Owner / Agency
Damien L. Cherenzia 916-227-6299
Name and Telephone Number of Person Familiar with Project Traffic Control, Shoulder Backing, HMA
NPCP, TRO, Construction Area Signs, Stripin
5,285,000.00 & Marking, Guard Rail, Rumble Strip. 9/19/2023 Contract Amount Type of Work Date Completed
3. City of Garden Grove- Various Residential Streets Reconstruction 2023 Name and Address of Owner / Agency
Mark Uphus 714-741-5000
Name and Telephone Number of Person Familiar with Project AC Paving, Earthwork, Mobilization, Concrete Improvements, Striping & Marking Survey, SWPPP, Traffic Control, Adjust Utilities, Full Depth reclamation, Fencing 12/15/23 6,988,665.00 Tree Removal, Cold Milling, Profilographing, Survey, AC Dike 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 bonds: _See attached list of Surety /m
SULLY-MILLER CONTRACTING CO.
License 747612A
135 S. State College Bivd., STE. 400 • Brea, CA 92821 • PHONE 714-578-9600 The Following are the names, addresses, and telephone numbers for all brokers and sureties from whom Bidder intends to procure insurance and bonds:
Agent for Surety:
Willis Risk & Insurance Services
2010 Main Street, Suite 1050
Irvine, CA 92614
Phone 949/885-1206
FAX 949/885-1225
Contact: Victoria Campbell
Surety :
Liberty Mutual Insurance Co.
8044 Montgomery Road Suite #137
Cincinnati, OH 45236
Phone 513/984-2222 X 321
FAX 513/984-3165
Contact: Kelley Brown
Surety:
Berkshire Hathaway Specialty Insurance
1314 Douglas Street
Omaha, NE 68102
Phone 770/625-2509
Contact: D.J. Conroy
Insurance:
Liberty Mutual Group
1133 Avenue of America
New York, NY 10036
Phone 800/227-9887 Ext 443
FAX 212/391-1954
Insurance:
Marsh USA
445 South Street Suite 210
Morristown, NJ 07962
Phone 973/401-5151
FAX 973/401-5045
Contact: Anton Schmitt
IRAN CONTRACTING ACT CERTIFICATION
(Public Contract Code Sections 2200 et seq.)
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
As required by California Public Contract Code section 2204, Proposer certifies that the option checked below relating to Proposer's status in regard to the Iran Contracting Act of 2010 (Public Contract Code sections 2200 et seg.) is true and correct:
Proposer is not:
(i) identified on the current list of persons and entities engaging in investment activities in Iran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code section 2203; or
(ii) a financial institution that extends, for 45 days or more, credit in the amount of $20,000,000 or more to any other person or entity identified on the current list of persons and entities engaging in investment activities in Iran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code section 2203, if that person or entity uses or will use the credit to provide goods or services in the energy sector Los Angeles County has exempted Proposer from the requirements of the Iran 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 $1,000,000.
CERTIFICATION
1, 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
Sully-Miller Contracting Co. All fo
Firm
03.28.25 . Anthony Lino, Director of reconstruction / Assistant Secretary Date Name/Title:.
Note: In accordance with Public Contract Code section 2205, false rertification of this form shall be reported to the California Attorney General and may result in civil penalties equal to the greater of $250,000 or twice the Contract amount, termination of the Contract and/or ineligibility to bid on contracts for three years.
END OF DOCUMENT
BIDDER'S BOND
Bid #CIP-24-25-MO1570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
Proposals must be accompanied by a proposal guarantee consisting of a certified check, cashier's check or BIDDER's bid bond payable to the CITY or cash deposit in the amount not less than ten (10) percent of the total amount bid. Certified check, cashier's check or Bidder's bid bond must be received at City Hall, 23920 Valencia Bivd., Santa Clarita, CA 91355, Attn: Purchasing, Suite 120, and marked with the words "BID BOND FOR" and the bid #, no later than the bid closing date and time, for the BIDDER to be considered responsive.
NOTE: The following form shall be used in case check accompanies bid.
Accompanying this Proposal is a *certified/cashier's check payable to the order of the City of Santa Clarita for: 10% of Bid Amount dollars ($10% _, this amount being not less than ten percent (10%) of the total amount of the bid. The proceeds of this check shall become the property of said CITY provided this Proposal shall be accepted by said CITY through action of its legally constituted contracting authorities, and the undersigned shall fail to execute a contract and furnish the required bonds within the stipulated time; otherwise, the check shall be returned to the undersigned.
Project Name: 2024-25 Overlay A Project REBID
Bid No.! Y-! CIP-24-25-M01570A REBID
project No M0157
nthony Lino, Assistant Secretary
Suly Miller Contracting Co.
CONTRACTOR/BIDDER
153. S State College Blvd Suite 400
Address
Brea, CA 92821
City, State, Zip Code
* Delete the inapplicable work.
NOTE: If the bidder desires to use a bond instead of a check, the following form shall be executed.
The sum of this bond shall be not less than ten percent (10%) of the total amount of the bid.
PROPOSAL GUARANTEE BID BOND
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
Sully-Miller Contracting Company → as BIDDER, and
KNOW ALL PERSONS BY THESE PRESENTS that
Liberty Mutual Insurance Company as SURETY, are held and firmly bound unto the City of Santa Clarita, as CITY, in the penal sum ofAmount Bid _), which is ten percent (10%) of the total amount bid by BIDDER to CITY for the above-stated project, for the payment of 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 submit a bid to CITY 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 CITY.
IN WITNESS WHEREAS, the parties hereto have set their names, titles, hands, and seals, this 27th Day of March → 2025.
CONTRACTOR: Anthony Lino - Assistant Secretary
Name and Title of Signatory Signatur
Sully-Miller Contracting Company
Legal Name of Bidder
135 S. State College Blvd., Suite 400, Brea, CA 92821
Bidder Address
714-578-9600 33-0787630
Telephone Number Federal Tax I.D. No.
Liberty Mutual Insurance Company
SURETY*:
Name
513-792-1862 [email protected]
Phone Number and Email
175 Berkeley Street, Boston MA 02116
Address
*Provide BIDDER and SURETY name, phone number, email, and the name, title, address, and phone number for Surety signatures must be notarized prior to submittal.
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_Orange
On 03.31.2025 before me, Monica Baldacci, Notary Public Date Here Insert Name and Title of the Officer
personally appeared Anthony Lino
Name(s) of Signers)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
MONICA MARIE BALDACCI WITNESS my hand and official seal.
COMMISSION #2447801
Notary Public - California
ORANGE COUNTY pie
My Commission Expires Signature
MAY 25, 2027 Signature of Notary Public
Monica Baldacci, Notary Public
Place Notary Seal Above
- OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: 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 • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 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 Orange )
MAR 2 7 2025 before me,_L. Clark, Notary Public
On
Date Here Insert Name and Title of the Officer
personally appeared Victoria M. Campbell
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
• of the State of California that the foregoing paragraph is true and correct.
L. CLARK
Notary Public - California WITNESS my hand and official seal.
Los Angeles County
Commission # 2503609
My Comm. Expires Nov 28, 2028 x. Chk
Signature
Signature of Notary Public
Place Notary Seal Above
- OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document MAR 2 7 2025
Title or Type of Document: _ Document Date:
Number of Pages: Signer(s) 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 - O Limited • General O Indiidual X Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: Signer Is Representing: _
XXXXXXXK08N//X////K/X:T///K/WHOKGHWKEGGKENOKECORYK
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated.
Liberty Liberty Mutual Insurance Company
Mutuál. The Ohio Casualty Insurance Company Certificate No: 8205201-971932 West American Insurance Company
SURETY
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Khoi Tran; Victoria M. Campbell
all of the city of Los Angeles state of CA each individually if there be more than one named, its true and lawful attomey-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and alf undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 5th day of April 2021
Liberty Mutual Insurance Company
The Ohio Casually Insurance Company
SAL CASUALTY INSURANCE INSURANCE West American Insurance Company (CORPORATE (CORPORATE (CORPORATE
1912 8 1919 1991
OHIO ANTINOD vid? lane,
ANTON INDIANA INVANS
LSEM By:
guarantees. David M. Carey, Assistant Secretary
State of PENNSYLVANIA
SS
County of MONTGOMERY
On this_ day of April 2021 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. note, loan, interest rate or residual value ERESA PASTELLA Commonwealth of Pennsylvania - Notary Seal Teresa Pastella, Nolary Public
Montgomery County Pastella
My commission expires March 28, 2025 By:
LOSY NAN Commission number 1126044 Teresa Pasteila, Notary Public For bond and/or Power of Attomey (POA) verification inquiries please call 610-832-8240 or email [email protected].
Member, Pennsy/vania Association of Notaries
This Power of Attomey is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casually Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
Not valid for mortgage, ARTICLE IV - OFFICERS: Section 12. Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in wrting by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all currency rate undertakings, bonds, recognizances and other surety obligations. Such altomeys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind th Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary.
Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations.
Authorization -By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of th company, wherever appearing upon a certified copy of any power of altomey issued by the Company in connection with surety bonds, shall be valid and binding upon the Company witl the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby cerlift that the original power of attormey of which the foregoing is a full, true and correct copy of the Power of Attorey executed by said Companies, is in full force and effect and has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 27th day of March _ 2025:
INSURANCE CASUALT CORPORATE
CORPORATE
1912 1919 1991 Rani cler
HOW HAMPER ANTINOD By:
ANTON INDIANA Renee C. Llewellyn, Assistant Secretary
INVO LSEM
LMS-12873 LMIC OCIC WAIC Multi Co 02/21
SULLY-MILLER
LETTER OF TRANSMITTAL
CONTRACTING CO.
FROM: SULLY-MILLER CONTRACTING COMPANY DATE: 03/31/25
135 S. STATE COLLEGE BLVD., STE. 400
BREA, CA 92821
TO: City of Santa Clarita RE: 2024-25 Overlay A Project - REBID ATTN: Purchasing-Michele Arima Bid # CIP-24-25-M01570A REBID 233920 Valencia Blvd. City Project No. M01570A
Santa Clarita, CA 91355 BID DATE: April 2, 2025 @ 11:00 a.m. 661/286-4066 BID BOND
[email protected] TRANSMITTAL NO:
GENTLEMEN:
WE ARE SENDING YOU: X ATTACHED VIA: Federal Express
THE FOLLOWING ITEMS:
SHOP DRAWINGS CHANGE ORDER SAMPLES
-
SUBMITTALS PLANS OTHER
Original SPEC. SECTION DESCRIPTION
1 BID BOND FOR THE ABOVE REFERENCED PROJECT
THESE ARE TRANSMITTED AS CHECKED BELOW:
_APPROVAL RETURN FOR CORRECTION OTHER:
SUBMIT FOR YOUR INFORMATION
RESUBMIT
REMARKS:
Please find attached the original wet signature bid bond per the plans and specifications for the above mentioned project.
Please contactor our office if you have any questions regarding this transmittal. Thank you.
COPIES:
FILE Jessica Delgado-Daniels
Estimating Coordinator
Transaction Record FedEx®
TRACKING NO.: SHIP DATE: ESTIMATED SHIPPING CHARGES:
880208845194 Mar 31, 2025 17.88 USD
From address To address
Jessica Daniels Michele Arima
Sully-Miller Contracting City of Santa Clarita
135 S. State College Bivd 23920 Valencia Bivd
Suite 400 Purchasing Department
92821 CA Brea 91355 CA SANTA CLARITA
US US
Phone: 7145789600 Phone: 6612864066
[email protected] [email protected] Package information
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Bill transportation cost to: ******473 P.O. No.: 100783.72140.80 Bill duties, taxes and fees to: Invoice No.:
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DELIVERED
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4/1/25 at 9:34 AM
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880208845194 0 0
FROM
Sully-Miller Contracting
Jessica Daniels
135 5. State College Bivd Suite 400
Brea, CA US 92821
7145789600
Label Created
3/31/25 5:39 PM
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OAKLAND, CA
4/1/25 3:15 AM
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NORTH HILLS, CA
4/1/25 8:30 AM
DELIVERED
Michele Arima
City of Santa Clarita
23920 VALENCIA BLVD
SANTA CLARITA, CA US 91355
6612864066
Delivered
4/1/25 at 9:34 AM
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SHIP DATE 0 3/31/25
STANDARD TRANSIT ® 4/1/25 before 10:30 AM
DELIVERED 4/1/25 at 9:34 AM
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NON-COLLUSION AFFIDAVIT
(Title 23 United States Code Section 112 and Public Contract Code Section 7106) Bid #CIP-24-25-MO1570A REBID
2024-25 Overlay A Project REBID
City Project No. M01570A REBID
City of Santa Clarita, California
To the CITY OF SANTA CLARITA:
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 agreement, communication, or conference with anyone to fix the bid price of the Bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, 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.
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 A PART OF THE PROPOSAL. BIDDERS ARE CAUTIONED THAT MAKING A FALSE CERTIFICATION MAY SUBJECT THE CERTIFIER TO CRIMINAL PROSECUTION.
NON-COLLUSION AFFIDAVIT
Bid #CIP-24-25-M01570A REBID
2024-25 Overlay A Project REBID
City Project No. MO1570A REBID
City of Santa Clarita, California
TO BE EXECUTED BY EACH BIDDER OF A PRINCIPAL CONTRACT
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
the hone taint _ being first duly sworn deposes and says that he/she is Director of Preconstruction/Assistant Secretary owner, a partner, president, etc.) Sully-Miller Contracting Co. the party making the foregoing bid; that such bid is not made in the interest of or behalf of any undisclosed person, partnership, company, association, organization or corporation, that such bid is genuine and not collusive or sham, that said BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, or that anyone shall refrain from bidding, that said BIDDER has not in any manner, 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 to fix the overhead, profit, or cost element of such bid price, or of that of any other BIDDER, or to secure any advantage against the public body awarding the Contract or anyone interested in the proposed Contract; that all statements contained in such bid are true, and further, that said BIDDER has not, directly or indirectly, submitted its bid price, or any breakdown thereof, or the contents thereof, or divulged information or date relative thereto, or paid and will not pay any fee in connection, therewith to any corporation, partnership, company, association, organization, bid depository, or to any member or CITY thereof, or to any other individual information or date relative thereto, or paid and will not pay any fee in connection, therewith to any corporation, partnership, company association, organization, bid depository, or to any member or CITY thereof, or to any other individual, except to such person or persons as have a partnership or other financial interest with Said BIDDER in his general business.
Bidder:
Signature Anthony Lino
Director of Preconstruction/Assistant Secretary
Title
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_ Orange )
On - 03.31.2025 before me, Monica Baldacci, Notary Public Date Here Insert Name and Title of the Officer
personally appeared Anthony Lino
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
MONICA MARIE BALDACCI B
COMMISSION #2447801 WITNESS my hand and official sea
otary Public - Calito:. HMI
RANGE COUNT
My Commission Expires 1h1
MAY 25.2027 Signature
Signature of Notary Public
Monica Baldacci, Notary Public
Place Notary Seal Above
- OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: _ _ Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
• Corporate Officer - Title(s): • Corporate Officer - Title(s):
• Partner - • Limited • General • Partner - • Limited • General • Individual • Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer Is Representing: _ Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907