CONSTRUCTION CONTRACT
This co
ntract is made and entered into on _____________, by and between PAVEMENT COATINGS, C O., a STATE OF CALIFORNIA CORPORATION, with a business address at 2150 BELL AVE., SUITE 125, SACRAMENTO, 95838 , hereinafter called "CONTRACTOR," and CITY OF STOCKTON, a municipal corporation, hereinafter called "CITY."
W I T N E S S E T H:
WHER
EAS, plans and specifications for the construction of LOCAL STREET RESURFACING PROGRAM FY 2021 -22 SB1 – MICRO-SURFACING (PROJECT NO.
WT22003), hereinafter called “PROJECT,” were regularly adopt ed by Council Resolution No. __________________, on _________________; and WHEREAS, the contract for said work was regularly awarded to CONTRACTOR, by Council Resolution No. __________________, on ________________.
NOW, THEREFORE, in consideration of the promises and of the mutual covenants herein contained, the parties hereto expressly agree as follows:
CONTRACTOR agrees:
1. SCOPE OF SERVICES. To do the work and furnish all the labor, materials, tools, equipment, and insurance required for the construction of PROJECT in accordance with the plans and specifications adopted on _____________, by Council Resolution No. __________________ . The "contract documents ," which include the bid documents, project plans, specifications, all letters of clarification, and the City of Stockton Standard Specifications and Plans, are incorporated into and made a part of this contract by this reference to the same extent as if fully set forth.
2. COMPE NSATION. To do and perform the work contemplated hereby in a good and workmanlike manner and to furnish all labor, materials, tools , and equipment necessary therefore at the prices specified in Exhibit A, attached hereto and by reference made a part hereof, under the direction of and to the complete satisfaction of the Director of Public Works of the City of Stockton. Total compensation for services and reimbursement for costs shall not exceed $ 709,288, or as otherwise mutually agreed to in a Contract Change Order.
3. INSURANCE. CONTRACTOR shall not commence any work before obtaining, and shall maintain in force at all times during the duration and performance of this contract, the policies of insurance specified in Exhibit B, which is attached to this contract and incorporated by this reference, and as provided in the “contract documents” including Section 7- 1.06 of the City of Stockton Standard Specifications and Plans as adopted on September 27, 2016 , by Council Resolution No. 2016- 09-27, effective September 27, 2016.
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Local Construction Contract - PAVEMENT COATINGS, CO. - PROJECT NO. WT22003 (Updated 12/31/20)
It shall be a requirement under this agreement that any available insurance proceeds broader than or in excess of the specified minimum i nsurance coverage requirements and/or limits shall be available to the Additional Insured.
Further
more, the requirements for coverage and limits shall be (1) the minimum coverage and limits specified in this Agreement; or (2) the broader coverage and maximum limits of coverage of any i nsurance policy or proceeds available to the named Insured; whichever is greater.
The Addi
tional Insured coverage under the CONTRACTOR’s policy shall be “primary and non-contributory” and will not seek contribution from the City of Stockton’s insurance or self-insurance and shall be at least as broad as ISO CG 20 01 04 13.
The li
mits of insurance required in this agreement may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess i nsurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of the City of Stockton (if agreed to in a written contract or agreement) before the City of Stockton’s own insurance or self - insurance shall be called upon to protect it as a named insured.
All self-i
nsured retentions ( SIR) must be disclosed to the CITY’s Risk Management for approval and shall not reduce the limits of liability. Payment Bond in the amount of the self-insured retention (SIR) may be required.
Polic
ies containing any self-insured retention (SIR) provision shall provide or be endorsed to provide that the SIR may be satisfied by either the named insured or the CITY.
The CITY r
eserves the right to obtain a full certified copy of any i nsurance policy and endorsements.
Failur
e to exercise this right shall not constitute a waiver of right to exercise later.
CONTRACT
OR shall maintain insurance as required by this contract to the fullest amount allowed by law and shall maintain insurance for a minimum of five years following the completion of this project. In the event contractor fails to obtain or maintain completed operations coverage as required by this agreement, the City at its sole discretion may purchase the coverage required and the cost will be paid by contractor.
CONTRACT
OR agrees to include with all Subcontractors in their subcontract the same requirements and provisions of this agreement including the indemnity and insurance requirements to the extent they apply to the scope of the Subcontractor’s work.
Subcontractors hired by CONTRACTOR agree to be bound to CONTRACTOR and the CITY in the same manner and to the same extent as CONTRACTOR is bound to the CITY under the Contract Documents. Subcontractor further agrees to include these same provisions with any Sub-subcontractor. A copy of the CITY Contract Document Indemnity and Insurance provisions will be furnished to the Subcontractor upon request. The 2 of 48
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Local Construction Contract - PAVEMENT COATINGS, CO. - PROJECT NO. WT22003 (Updated 12/31/20)
General CONTRACTOR shall require all sub-contractors to provide a valid certificate of insurance and the required endorsements included in the agreement prior to commencement of any work and contractor will provide proof of compliance to the City.
4. INDEMNITY AND HOLD HARMLESS. With the exception that this section shall in no event be construed to require indemnification by Contractor to a greater extent than permitted under the public policy of the State of California, Contractor shall indemnify, protect, defend with counsel approved by City and at Contractor’s sole cost and expense, and hold harmless City, its Mayor, Council, officials, representatives, agents, employees, and volunteers from and against any and all claims, causes of action, liabilities, judgments, awards, losses, liens, claims, stop notices, damages, expenses, and costs (including without limitation attorney s’ fees, expert and consultant fees, and other expenses of litigation) of every nature, including, but not limited to, death or injury to persons, or damage to property, which arise out of or are in any way connected with the work performed, materials furnished, or services provided under this Agreement, or from any violation of any federal, S tate, or municipal law or ordinance, or City Policy, by Contractor or Contractor’s officers, agents, employees, volunteers or subcontractors.
Contractor shall not be obligated to indemnify or defend City for claims finally determined by a court of law or arbitrator to arise from the active negligence or willful misconduct of the City. It is the intent of the Parties that this indemnity obligation is at least as broad as is permitted under California law. To the extent California Civil Code sections 2782, et seq., limit the defense or indemnity obligations of Contractor to City, the intent hereunder is to provide the maximum defense and indemnity obligations allowed by Contractor under the law. The indemnity set forth in this section shall not be limited by insurance requirements or by any other provision of this Agreement.
With e
xception that this section shall in no event be construed to require indemnification, including the duty to defend, by Contractor to a greater extent than permitted under the public policy of the State of California, the parties agree that Contractor’s duty to defend City is immediate and arises upon the filing of any claim against the City for damages which arise out of or are in any way connected with the work performed, materials furnished, or services provided under this Agreement by Contractor or Contractor’s officers, agents, employees, volunteers or subcontractors. Contractor’s duties and obligations to defend the City shall apply regardless of whether or not the issue of the City’s liability, breach of this Agreement, or other obligation or fault has been determined.
Contractor shall be immediately obligated to pay for City’s defense costs of the claim, including, but not limited to, court costs, attorney’s fees and costs, expert consultant and witness fees and costs, other witness fees, document reproduction costs, arbitration fees, and, if after final judgment an appeal is pursued, all of such costs for the appeal.
At the conclusion of the claim, if there is any determination or finding of sole active negligence or willful misconduct on the part of the City, City will then reimburse Contractor for amounts paid in excess of Contractor’s proportionate share of responsibility for the damages within 30 days after Contractor provides City with copies of all bills and expenses incurred in the defense of the claim(s). It is agreed between the parties that this reimbursement provision assures Contractor is not obligated to defend 3 of 48
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or indemnify City in an amount greater than provided for under California law, including, without limitation, California Civil Code sections 2782, 2782.6, and 2782.8.
With t
he exception that this section shall in no event be construed to require indemnification by Contractor to a greater extent than permitted under the public policy of the State of California, and in addition to the other indemnity obligations in this Agreement, Contractor shall indemnify, defend, and hold harmless City, its Mayor, Council, officials, representatives, agents , employees, and volunteers from and against all claims, losses, expenses, and costs including, but not limited to, attorneys’ fees, arising out of any claim brought against the City by an employee, office, agent, or volunteer of Contractor, regardless of whether such claim may be covered by any applicable workers compensation insurance. Contractor’s indemnification obligation is not limited in any way by any limitation on the amount or type of damages, compensation, or benefits payable by or for the Contractor under workers’ compensation acts, disability acts, or other employee benefit acts.
The Cit
y’s acceptance of the insurance certificates required under this Agreement does not relieve the CONTRACTOR from its obligation under this paragraph. The indemnification obligations of this section shall survive the termination of this agreement.
Any exceptions to this language may result in a proposal being deemed non-responsive.
CONTRACTOR/Subcontractor's responsibility for such defense and indemnity obligations shall survive the termination or completion of this agreement for the full period of time allowed by law.
The defense
and indemnification obligations of this agreement are undertaken in addition to, and shall not in any way be limited by, the insurance obligations contained in this agreement. If any section, subsection, sentence, clause or phrase of this indemnification is for any reason held to be invalid or unconstitutional, such decision shall not affect the validity of the remaining portions of this indemnification.
5. STANDARD PLANS AND SPECIFICATIONS. The performance of said work and the furnishing of said materials shall be executed in accordance with Section 8-1.04B of the City of Stockton Standard Specifications and Plans as adopted on September 27, 2016, b y Council Resolution No. 2016- 09-27-1213, effective September 27, 2016, and the provisions of the issued project specifications.
The Dir
ector of Public Works will furnish CONTRACTOR a weekly statement showing the number of days charged to the contract for the preceding week, the number of days specified for completion of the contract, and the number of days remaining to complete the contract. CONTRACTOR will be allowed one (1) week in which to file a written protest setting forth in what respects said weekly statement is incorrect, otherwise the statement shall be deemed to have been accepted by CONTRACTOR as correct.
6. WORKI NG DAYS. This work shall be diligently prosecuted to completion before the expiration of 25 WORKING DAYS beginning on the tenth calendar day after the date shown on the Notice to Proceed. It is agreed by the parties to the contract that 4 of 48
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in case all the work called for under the contract in all parts and requirements, is not finished or completed within the number of days as set forth, damage will be sustained by the CITY, and that it is and will be impracticable and extremely difficult to ascertain the actual damage which CITY will sustain in the event of and by reason of such delay; and it is therefore agreed that CONTRACTOR will pay to CITY the sum of FOUR THOUSAND AND NO/100 DOLLARS ($4,000.00) per day for each and every calendar days delay in finishing the work in excess of the number of days prescribed; and CONTRACTOR agrees to pay said liquidated damages as herein provided, and in case the same are not paid, agrees that CITY, may deduct the amount thereof from any monies due or that may become due CONTRACTOR under the contract.
It is
further agreed that in case the work called for under the contract is not finished and completed in all parts and requirements within the number of days as specified, the CITY shall have the right to increase the number of days or not, as may seem best to serve the interest of CITY, and if the CITY decides to increase the said number of days, the CITY shall further h ave the right to charge to CONTRACTOR, CONTRACTOR's heirs, assigns or sureties, and to deduct from the final payment for the work, all or any part, as may be deemed proper, the liquidated damages as specified or the actual cost of engineering, inspection, superintendence, and other overhead expenses which are directly chargeable to the contract, and which accrue during the period of such extension, whichever is greater, except the cost of final surveys and preparation of final estimate shall not be included in such charges.
A work
ing day shall not include, nor shall CONTRACTOR be assessed with liquidated damages nor the additional cost of engineering and inspection during any delay beyond the time named for the completion of the work caused by acts of God or of the public enemy, acts of CITY, fire, floods, epidemics, quarantine restrictions, strikes, and freight embargoes and subject to approval by the Director of Public Works , inability to get materials ordered by CONTRACTOR or subcontractor due to such causes provided that CONTRACTOR shall notify the Director of Public Works in writing of the causes of delay within five (5) working days from the beginning of any such delay, and the Director shall ascertain the facts and the extent of the delay, and Director's findings of the facts thereon shall be final and conclusive.
If CO
NTRACTOR is delayed by reason of alterations made in these specifications, or by any act of the Director of Public Works or of the CITY, not contemplated by the contract, the time of completion shall be extended proportionately and CONTRACTOR shall b e relieved during the period of such extension of any claim for liquidated damages, engineering or inspection charges or other penalties. CONTRACTOR shall have no claim for any other compensation for any such delay.
7. CONFORMANCE TO APPLICABLE LAWS. Contractor shall comply with all applicable Federal, State, and Municipal laws, rules, and ordinances. Contractor shall not discriminate in the employment of persons or in the provision of services under this Contract on the basis of any legally protected classification, including race, color, national origin, ancestry, sex or religion of such person.
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TITLE VI
Titl
e VI of the Civil Rights Act of 1964 requires that “no person in the United States shall, on the grounds of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.” (42 USC Section 2000d)
http://www.dol.gov/oasam/regs/statutes/titlevi.htm.
The Cit
y of Stockton requires compliance with the requirements of Title VI in all of its programs and activities regardless of funding source. b. DISCRIMINATION AND HARASSMENT POLICY
The Cit
y of Stockton has a Discrimination and Harassment Policy ( Exhibit C). The purpose of this policy is to reaffirm the CITY’s commitment to demonstrating respect for all individuals by strictly prohibiting discrimination and harassment, including sexual harassment in the workplace, to define the types of behavior and conduct prohibited by this policy, and to set forth a procedure for reporting, investigating, and resolving complaints of discrimination and harassment in the workplace.
c. LABOR STANDARDS PROVISIONS/CALIFORNIA LABOR CODE
The bidder
shall understand that conditions set forth in Chapter 1, Part 7, Division 2 of the California Labor Code shall be considered part of the contract agreement.
https://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode= LAB&division=2.&title=&part=7.&chapter=1.&article=2.
d. PREVAILING WAGE
CONT
RACTOR and any subcontractor shall pay each employee engaged in the trade or occupation not less than the prevailing hourly wage rate. In accordance with the provisions of Section 1770 of the Labor Code, the Director of Department of Industrial Relations of the State of California has determined the general prevailing wage and employer payments for health and welfare, pension, vacation, travel time, and subsistence pay as provided for in Section 1773.1, apprenticeship or other training programs authorized by Section 3093 and similar purposes applicable to the work to be done. CONTRACTOR performing the work under this contract shall obtain a copy of the wage rate determination and shall distribute copies to each subcontractor. As the wage determination for each craft reflects an expiration date, it shall be the prime CONTRACTOR and each subcontractor's responsibility to insure that the prevailing wage rates of concern is current and paid to the employee.
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i. The C
ONTRACTOR performing the work shall be responsible for
obtaining a copy of the State wage rate determination. State wage rates may be obtained at
http://www.dir.ca.gov/OPRL/pwd/Determinations/Northern/Northern.pd f. The CONTRACTOR shall be responsible for posting said wage rates at a prominent location at the work site and shall maintain same in a good readable condition for the duration of the work.
ii. Should t
he CONTRACTOR choose to work on a Saturday, Sunday or
on a holiday recognized by the Labor Unions, the CONTRACTOR shall reimburse the CITY the actual cost of engineering, inspection, superintendence, and or other overhead expenses which are directly chargeable to the contract. Should such work be undertaken at the request of the CITY, reimbursement will not be required. To conform strictly with the provisions of Division 2, Part 7, Chapter 1, Article 2, of the Labor Code of the State of California. To forfeit as a penalty to CITY the sum of TWENTY -FIVE AND NO/100 DOLLARS ($25.00) for each laborer, worker, or mechanic employed by CONTRACTOR, or by any subcontractor under CONTRACTOR, in the execution of this contract, for each calendar day during which any laborer, worker, or mechanic is required or permitted to work more than eight (8) hours and who is not paid the general prevailing rate of per diem wages for holiday and overtime work in violation of the provisions of Sections 1770 to 1781 of the Labor Code of the State of California. That all sums forfeited under the provisions of the foregoing sections shall be deducted from the payments to be made under the terms of this contract.
iii. The CO
NTRACTOR to whom the contract is awarded shall insure that the prime and each subcontractor will in accordance with Section 1776 of the Labor Code, maintain certified payroll records. A copy of said records shall be provided with each invoice to the Public Works Department, Attention Contract Compli ance Officer. It shall be the CONTRACTOR’S responsibility to obtain copies of the current prevailing wage rate determination for all subcontractors. Additionally, certified payroll records must be uploaded to the DIR website as required by labor code.
iv. The CO
NTRACTOR shall comply with the provisions established in Section 1777.5 of the Labor Code concerning the 1) certified approval by local joint apprenticeship committees for the employment and training of apprentices, and 2) contribution of funds to administer and conduct apprenticeship programs, if applicable to the job. e. LOCAL EMPLOYMENT ORDINANCE
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Pursua
nt to Stockton Municipal Code Section 3.68.095 the CONTRACTOR and all subcontractors shall make a good faith effort to employ at least 50 percent of the workforce on this project from local residents, as measured by total labor work hours. Failure of any CONTRACTOR or subcontractor to comply with these requirements shall be deemed a material breach of the contract or subcontract. CONTRACTORS and subcontractors shall maintain records necessary for monitoring their compliance with section
3.68.095.
CITY
agrees:
8. COMP ENSATION. To pay CONTRACTOR for the work herein contemplated in the following manner: Progress payments will be made on or about the first day of each calendar month, in such sum as shall make the aggregate of payment up to such day equal to ninety-five percent (95%) of the proportional contract price, upon the basis of the progress certificate of the Director of Public Works as to the amount of work done and the proportional amount of the contract price represented therefor e; and all of the remaining part of the contract price not as aforesaid paid, shall be paid at the expiration of thirty-five (35) days from the completion of said work of construction and the certification by the Director of Public Works of such completion.
9. SECURITIES. Pursuant to Section 22300 of the Public Contract Code, CONTRACTOR will be permitted, at its request and sole expense, to substitute securities for any monies withheld by the CITY to ensure performance under the contract. Said securities will be deposited either with the CITY or with a State or federally chartered bank as escrow agent. Securities eligible for this substitution are those listed in Section 16430 of the California Government Code or bank or savings and loan certificates of deposit.
CONTRACTOR shall be the beneficial owner of any securities substituted for monies withheld and shall receive any interest thereon.
10. CHANGE ORDERS . CITY reserves the right to make such alterations, deviations, additions to or omissions from the plans and specifications, including the right to increase or decrease the quantity of any item or portion of the work, as may be deemed by the Engineer to be necessary or advisable and to require such extra work as may be determined by the Engineer to be required for the proper completion or construction of the whole work contemplated.
Any suc
h changes will be set forth in a contract change order which will specify, in addition to the work done in connection with the change made, adjustment of contract time, if any, and the basis of compensation for such work. A contract change order will not become effective until approved by the City Manager and/or the City Council.
Proces
sing of change orders shall be in accordance with Section 4- 1.05A of the City of Stockton Standard Specifications and Plans as adopted by Council on Septem ber 27, 2016, by Resolution No. 2016-09-27-1213, effective September 27, 2016, or as otherwise 8 of 48
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amended by Council. When the compensation for an item of work is subject to adjustment under the provisions of Standard Specifications and Plans, Section 4- 1.05A, CONTRACTOR shall, upon request, promptly furnish the Engineer with adequate detailed cost data for such item of work.
11. AUDITS. CITY reserves the right to periodically audit all charges made by CONTRACTOR to CITY for services under the contract. Upon request, CONTRACTOR agrees to furnish CITY, or a designated representative, with necessary information and assistance.
CONT
RACTOR agrees that CITY or its delegate will have the right to review, obtain and copy all records pertaining to performance of the contract. CONTRACTOR agrees to provide CITY or its delegate with any relevant information requested and shall permit CITY or its delegate access to its premises, upon reasonable notice, during normal business hours for the purpose of interviewing employees and inspecting and copying such books, records, accounts, and other material that may be relevant to a matter under investigation for the purpose of determining compliance with this requirement.
CONTRACTOR further agrees to maintain such records for a period of three (3) years after final payment under the contract.
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12. WAIVER. It is expressly understood and agreed by and between the parties hereto that a waiver of any of the conditions of this contract shall not be considered a waiver of any of the other conditions thereof.
It is further understood and agreed by and between the parties hereto that time is of the essence of this contract in all respects.
IN WITNESS WHEREOF, the parties hereto have hereunto affixed their hands and seals the day and year first above written.
ATTEST:
ELIZA R. GARZA, CMC
CITY CLERK
By: __________ _
APPROVED AS TO FORM & CONTENT:
LORI M. ASUNCION
ACTING CITY ATTORNEY
By: __________ _
DEPUTY CITY ATTORNEY
CITY:
By: ____________ _
HARRY BLACK
CITY MANAGER
95-2916670
Tax Identification No.
Local Construction Contract - PAVEMENT COATINGS, CO. - PROJECT NO. WT22003 10 of 48
(Updated 12/31/20)
EXHIBIT 2
_icrrYOF .... .. .. STOCKTON
PUBLIC WORKS DEPARTMENT
BID FORMS
FOR
LOCAL STREET RESURFACING PROGRAM
FY 2021-22 SB1 MICRO-SURFACING
PROJECT NO. WT22003D
DO NOT DETACH ANY OF THIS MATERIAL
THIS CONSTITUTES YOUR BID PROPOSAL
SUBMIT ONE ORIGINAL OF THIS BID PROPOSAL
Job Walk: N/A
BID OPENING: Thursday, May 26th at 2:00 pm, City Hall, Clerk's Office Bid Fonns
BIDDER'S NAME: Pavement Coatings co.
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EXHIBIT 2
EXHIBIT A
LOCAL STREET RESURFACING PROGRAM
FY 2021-22 SB1 MICRO-SURFACING
BIDDER'S CHECKLIST/AGREEMENT
CITY OF STOCKTON PUBLIC WORKS DEPARTMENT
(Checklist Not Required to be Submitted)
Did you complete and/or properly sign:
_X_You have carefully examined the specifications and all other provisions of this form and understand the meaning, intent, and requirements of the same. _ X_Review and sign all Letters of Clarification on the City website at www.stocktonca.gov/pwbid prior to submitting your bid. Submit signed letters with bid.
X
X
List of Subcontractors (Bid Forms)
Non-Collusion Declaration form (Bid Forms)
X
X
Department of Industrial Relations Labor Compliance Self-Certification (Bid Forms) Title VI Violation Self-Certification (Bid Forms)
X
X
Registered with the Department of Industrial Relations (California Labor Code Section 1725.5) Submit proof of registration (registration number, contractor name, license type/number) from Department of Industrial Relations for all Contractors/Subcontractors (regardless of tier). Proof of registration is due with bid submittal. Subcontractor proof of registration is due no later than four business days after bid opening. Bids will not be accepted from unregistered contractors.
X Local Employment Ordinance form (Bid Forms)
X Local Business Preference Ordinance form (Bid Forms)
_ X_Advise all subcontractors of prevailing wage rate, apprenticeship, Title VI, DIR, and all other contract compliance requirements
_x_lnclude your 10% bidder's security (bidder's bond, certified or cashier's check) _ X_Review and understand all Questions/Answers/Clarifications on the City website at www.stocktonca.gov/pwbid prior to submitting your bid
X Submit company name and contact information to Katrina Cooper at (209) 937-8676 or email at [email protected].
_x_Attend Job Walk, if mandatory: N/A
X Submit one (1) Original of all bid documents
X Deliver the sealed bid proposal to City Hall, City Clerk's Office (P1 floor), 425 N. El Dorado Street, Stockton, CA 95202 not later than Thursday, May 26th, 2:00 pm. Sealed bid shall be marked "BID" and indicate project name, number, and bid opening date. Due to the novel COVID-19, there are changes to the City's bid submission process. Please note that some overnight delivery services do not deliver directly to the City Clerk's Office. This could result in the bid arriving in the City Clerk's Office after the bid opening deadline and therefore not being accepted. During these times of local health concerns, bid openings are closed to the public. Bidders and the public are invited to view the live stream of the bid opening at http://www.stocktonca.gov/government/oMeetings/councilMeetings.html Bid Fonns Page 2 of 11 Last Revised 12/31/20
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EXHIBIT 2
EXHIBIT A
BID FOR PUBLIC WORK
CITY OF STOCKTON
Stockton, CA __ M_ay_2_6 __ , 20�2=2 __
TO THE HONORABLE CITY COUNCIL OF THE CITY OF STOCKTON:
Pursuant to your Notice Inviting Sealed Bids, I, we, or either of us:
Corporation
(State whether individual, firm, corporation, association, or co-partne rship) hereby offer (and hereby promise and agree in case this bid is accepted) to furnish all labor, material, equipment and supplies necessary to complete the work mentioned in said Notice Inviting Sealed Bids in strict accordance with the plans and specifications for said work to be done and labor, materials, and equipment and supplies to be furnished, which plans and specifications are on file in the office of the City Clerk of the City of Stockton and made part hereof by reference, the same as if herein fully set out, at the following rates and prices, to-wit:
Bid Fonns Page 3 of 11 Last Revised 12/31/20
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EXHIBIT A
LOCAL STREET RESURFACING PROGRAM
FY 2021-22 SB1 - MICRO-SURFACING
PROJECT NO. WT22003D
BIDD ING SCHEDULE
Each bidder shall bid each item, including all alternate bid(s). Failure to bid an Item shall be Just cause for considering the bid as non-responsive. Une item costs should include all Contractor's overhead and profit and indirect costs. Bids not presented on City fonns shall be cause for considering the bid as non-responsive .
..
�;. .. . .. " . . .
. - . . ..
-·.• .'?t:: �_;\ ·:. -._: .
·, . ..
;.•· . . . ...
. . .
. . . .. . _._ .• .: . •,.• ' . . ·/ . ·: .. . .::.• .. . ... • -:!tein :: . pe�pt1on·. ·- ..
..
· U.nit · Quantity· · Unif price ·., · Total-Price: t
.,
1 2
3 4
5 6
7 8
9 10
11 BidFonns
.. " ' ...
Mobilization LS 1 $15,000.00 $15,000.00
Traffic Control LS 1 $28,200.00 $28,200.00
Water Pollution Control LS 1 $1,500.00 $1,500.00
Material Testing LS 1 $30,000.00 $30,000.00
Remove Existing Pavement LS 1 $21,500.00 $21,500.00 Striping, Marking, and Legends Install Detail 9 Striping LF 3,800 $1.18 $4,484.00
lnstaN Detail 22 Striping LF 2,700 $1.66 $4,482.00
lnstaU Detail 38 Striping LF 400 $1.78 $712.00
Install Speed Bump Legend EA 20 $220.00 $4,400.00
Install White Thermoplastic SF 1,500 $5.94 $8,910.00 (All Pavement Legends) Micro-surfacing (Type II) SY 281,000 $2.10 $590,100.00
TOTAL BID $709,288.QQ
BIDDER'S NAME Pavement Coatings Co.
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EXHIBIT A
BIDDER CERTIFICATION
The undersigned agrees that if this bid is accepted, he/she will contract with the City of Stockton in the form of contract attached hereto to perform all of the work in accordance with the contract and the drawings, specifications, and other documents incorporated therein; that he/she will take in full payment therefor, and for all other obligations assumed under the contract, the prices set forth in the following bid schedule except as otherwise provided in the specifications; and that he/she will execute such contract and furnish the required contract bonds in the manner and within the time provided in the bidding requirements and conditions. The undersigned further agrees that he/she has carefully examined the site of the work and the bid documents and any addenda thereto, and is fully informed of the nature and location of the work, the quantities of the work, and the conditions to be encountered in performing the work; that the only parties interested in this bid as principals are those named herein and that this bid is made without collusion with any other party; and that this bid is submitted in all respects in accordance with the bidding requirements and conditions and all other requirements of the bid documents.
A BID GUARANTY ACCOMPANIES THIS BID IN THE FORM OF: (Check one of the following) □ □ □
�
Cash, or
Cashier's check, or
Certified check payable to City of Stockton, or
Bidder's bond in favor of the City .
. For any amount not less than ten percent (10%) of the aggregate of the bid.
ALSO ACCOMPANYING THIS BID ARE THE FOLLOWING ATTA CHMENTS, PROPERLY EXECUTED AND SIGNED:
1. List of Subcontractors 4. Title VI Self-Certification
2. Non-Collusion Declaration 5. Local Employment Ordinance Acknowledgement
3. DIR Self-Certification 6. Local Business Preference Acknowledgement
THE CITY RESERVES THE RIGHT TO REJECT ANY AND ALL BIDS
Pavement Coatings Co. (916) 642-1751 95-2916670
Name of Firm Phone Tax I.D. No.
2150 Bell Ave., Suite 125 Sacramento, CA 95838
Address City State Zip
303609,A,C32 09/30/2022
Contractor Lie. No. & Classification Expiration Date
NOTE - State law requires bidders on public agency contracts to include on their bid: (1) their State contractors license number, (2) the license expiration date, and (3) a statement that the representations made therein are made under penalty of perjury. The law further states that "Any bid not containing this information, or bid containing information which Is substantially proven false shall be considered non-responsive and shall be rejected by the public agency." THE REPR .. ENTATIONS MADE HEREIN ARE MADE UNDER PENAL TY OF PERJURY . ,
·· · BIDDER SIGN ·. . _____ <= HERE Tim Schmid, Vice President Signature Title
Bid Forms Page 5 of 11 Last Revised 12/31/20
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LIST OF SUBCONTRACTORS
GENERAL CONTRACTOR: Pavement Coatings Co.
PROJECT: Local Street Resurfacing Program FY 2021-22 S81 - Microsurfacing Project, Project No. WT22003D
PLEASE LIST BELOW ALL SUBCONTRACTORS CONTRIBUTING TO THIS WORK Each bidder shall give the name, business address, license number, description of the work, and the dollar amount to be PAID the subcontractor, for each subcontractor that will be used on the project, if the Bidder is awarded the contract. Only subcontractors with work in excess of one-half of one percent (0.5%) or $10,000 (whichever is greater) of the Bidder's total bid need to be listed. All work in excess of one-half of one percent (0.5%) or $10,000 (whichever is greater) of the Bidder's total bid, for which a subcontractor is not listed on this form, shall be performed by the Bidder's own organization.
Additional numbered pages listing proposed subcontractors may be attached to this page. Each page shall be headed "Proposed Subcontractors" and shall be signed by the Bidder.
BUSINESS
NAME/ADDRESS
C. r\f \ /;\t) (l\lilr.t-.1\.V'\\,I
I \
I fl m S-w,i ":e.':l A\J e .
Stt>cltoVI, C. A, q5 7., S
Bid Fonns
PRINT LEGIBLY OR TYPE
LICENSE DEPT. OF TYPE OF WORK AMOUNT
NUMBER & INDUSTRIAL
LICENSE RELATIONS
CLASSIFICATION REGISTRATION
NUMBER
3 7� �00 A.C.--\ 3 \ 0()000()"?.()lil l<i1il TW>.IM �� 1.1-�'. $t.\t.\,S1S,QD c--11. 'l L�GA'\-\c,,\') I S-\ D.
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NON-COLLUSION DECLARATION
(Title 23 United States Code Section 112 and Public
Contract Code Section 7106)
To the CITY of STOCKTON DEPARTMENT OF PUBLIC WORKS.
The undersigned declares:
I am the Vice President , of Pavement Coatings Co. , the party making the foregoing bid.
The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding. The bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. All statements contained in the bid are true. The bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.
Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint venture, ' ,
limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on �'f{:J-3(:k:>:}-d- atsacramento(city), _CA __ (state). ��Vice President
(Signature)
Bid Forms Page 7 of 11 Last Revised 12/31/20
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Bid Fonns
DEPARTMENT OF INDUSTRIAL RELATIONS
LABOR COMPLIANCE
SELF-CERTIFICATION
We, the undersigned, self-certify that we will comply with all California Department of Industrial Relations (DIR) laws, rules and regulations that apply to Public Work as defined in Labor Code Section 1720(a)(1 ), as well as Senate Bill 854 (2014 ), and all other related statutes.
In addition, we acknowledge that to be eligible to bid on City of Stockton Public Works projects, we and all subcontractors under us are registered, and will remain registered with the DIR until project completion; otherwise, we will be disqualified from consideration as a bidder for the subject project.
CONTRACTOR: Pavement Coatings Co.
BY:�
TITLE: Tim Schmid, Vice President
DATE: §R-3/ JOrYI
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TITLE VI VIOLATION SELF-CERTIFICATION
We, the undersigned, self-certify that pursuant to Federal Code of Regulations (CFR), 23 CFR 200.9, 633 and 49 CFR 21. 7, we do not have any unresolved violations under Title VI of the Civil Rights Act of 1964 and related statutes, including Americans with Disabilities Act (ADA). In addition, we acknowledge that an unresolved Title VI violation will disqualify us for consideration as a bidder for the subject project.
CQNJRACTOR: Pavement Coatings Co.
BY: 41/
Tim Schmid, Vice President
TITLE
Bid Fonns Page 9 of 11 Last Revised 12/31 /20
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LOCAL EMPLOYMENT ORDINANCE
This contract is subject to the requirements of the City of Stockton's Local Employment Ordinance. By my signature below, I certify that I have read and understood the Local Employment Ordinance of the City of Stockton, and agree to abide by its provisions. If selected to perform this contract, I specifically agree to report data on the actual number of Stockton residents employed, and understand that data will be subject to verification by an independent auditor.
Signature of Bidder
Date Signed
�hmid, Vice President
S-/�3(��:?--
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LOCAL BUSINESS PREFERENCE ORDINANCE
The City of Stockton's Local Business Preference Ordinance applies to this project. By my signature below, I certify that I have read and understood the Local Business Preference Ordinance of the City of Stockton, and agree to abide by its provisions.
Signature of Bidder
Date Signed
�m Schmid, Vice President
s-/.?-3 I !Jo;)-;;,..
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Contractor Information
Legal Entffy Name
PAVEMENT COATINGS CO.
Legal Entity l)pe
Corporation
Status
Expired
Registration Number
1000003382
Registration effective date
5/25/2018
Registration expiration date
6/30/2019
Malling Address
10240 SAN SEVAINE WAY JURUPA VALLEY 91752 CA United States ••• Physical Address
10240 SAN SEVAINE WAY JURUPA VALLEY 91752 CA United States ••• Email Address
Trade Name/OBA
PAVEMENT COATINGS CO.
Ucense Number(s)
CSLB:303609
Registration History
Effective Date Expiration Date
5/25/2018 6/30/2019
5/9/2017 6/30/2018
5/4/2016 6/30/2017
6/8/2015 6/30/2016
12/3/2014 6/30/2015
7/1/2019 6/30/2020
7/1/2020 6/30/2023
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Legal Entity Information
Corporation Number:
con4948
Federal Employment Identffication Number:
President Name:
DOUGLAS FORD
Vice President Name:
TIMOTHY SCHMID
Treasurer Name:
NATHAN SEYLER
Secretary Name:
TOM MUCENSKI
CEO Name:
Agent of Service Name:
STEPHEN CONCANNON
Agent of Service Malllng Address:
10240 SAN SEVAINE WAY JURUPA VALLEY 91752 CA United States of America Workers Compensation
Do you lease employees through
Professional Employer
Organization (PEO)?:
Please provide your current
workers compensation insurance
information below:
PEO PEO PEO
PEO InformationName Phone Email
Insured by Carrier
Policy Holder Name:PAVEMENT COATINGS CO.Insurance Carrier:TRAVELERS INDEMNITY COMPANY (THE)Policy Number:
VTC2JUB8J79408117Inception date:10 / 1/2017Expiration Date:10 / 1/2018 23 of 48
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f.,Libertr,
� Mutual.
SURETY
Liberty Mutual Surety
Attention: LMS Claims
P.O. Box 34526
Seattle, WA 98124
Phone: 206-473-621 O
Fax: 866-548-6837
Email: [email protected]
www.LibertyMutualSuretyClaims.com
The Ohio Casualty Insurance Company
BID OR PROPOSAL BOND
KNOW ALL MEN BY THESE PRESENTS, That we, Pavement Coatings Co. ------------------- of Jurupa Valley, CA
(hereinafter called the Principal) as Principal, and The Ohio Casualty Insurance Company principal office in the City of Boston , Massachusetts
Surety), as Surety, are held and finnly bound unto City of Stockton , with its
(hereinafter called the
-----------------------
of ------------------------------------�----
(hereinafter called the Obligee) in the penal sum of Ten Percent of Bid Amount ----------------------- Doll a rs 10% of Amount Bid lawful money of ------------------------ the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns.
THE CONDITION OF THIS OBLlGA TION IS SUCH, that whereas, the Principal has submitted the accompanying bid dated May 26, 2022 for Local Street Resurfacing Program FY 2021-22 881 - Microsurfacing Project,
Project No. WT22003D
NOW, THEREFORE, if the Obligee shall make any award according to the tenns of said bid and the Principal shall enter into a contract with said Obligee in accordance with the tenns of said bid and give bond for the faithful perfonnance thereof within the time specified; or if no time is specified within thirty days after the date of said award; or if the Principal shall, in the case of failure so to do, indemnify the Obligee against any loss the Obligee may suffer directly arising by reason of such failure, not exceeding the penalty of this bond, then this obligation shall be null and void; otherwise to remain in full force and virtue,
Signed, sealed and dated: May 19, 2022 _.;-.......:...�------------- Principal
By: •
TfM
The Ohio Casualty Insurance Company
By: J:d
BrianA.McGoldrick, (Attorney-in-fact)
LMS-20e65e 11/17
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189
\��--�-�-�&&�����������-�--�-������-�--�-�-�-����-�-�-�-�� A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
San Bernardino County of ____________ _
On May 19, 2022 before me, Brigid LopF-e=z�,�N�o�t=ary'-1-"P�u=b=l=ic�--------- Oate Here Insert Name and Title of the Officer
personally appeared Brian A. McGoldrick
Name(s) of Signer(�
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/tooy executed the same in his/txer/1:bair authorized capacity(m), and that by his/jqw/J:ooir signature(St) on the instrument the person($), or the entity upon behalf of which the person(s) acted, executed the instrument. 0 BRIGID
0 LOPEZ
O O
i
COMM. #2287217 z
Notary Public • Calif.ornia �
Orange County ...
M Comm. Ex ires Ma .2, 2023
Place Notary Seal Above
I certify under PENAL TY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature
.............
----------------OPTIONAL _____ ,..... ________ _
Though this section is optional, completing this information can er alteration of the document or fraudulent reattachment of this form to an · tended document.
Description of Attached Document
Title or Type of Document: ---------"'----- Document Date: _______ _ Number of Pages: ___ Signer(s) Other Th
Capacity(ies) Claimed by Signer(s)
Signer's Name: ____________ _
·· � Corporate Officer - Title(s): ______ _
, Partner - Cl Limited :J Gener
,_J Individual � Attorney in ct
!.� Trustee □ Guardian r Conservator
7 Other: _______ ,,__ ______ _
Signer's Name: ____________ _
'J Corporate Officer - Title(s): ______ _
-, Partner - 0 Limited Cl General
:J Individual □ Attorney in Fact
7 Trustee O Guardian or Conservator
� l Other: ______________ _
Signer Is Representing: _______ _ _
�.;:;- "". _ . .:..•.:.. .:_• . -=-·- - ����������
©2014 National Notary ssociation • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 25 of 48
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f._Libe11J.
\pl Mutual.
SURETY
Thi$ Power of Attorney lilllits 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 Mutual Insurance Company
The Ohio Casualty Insurance Company
West American Insurance Company
POWER OF ATTORNEY
Certificate No: 8205623·971991
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporaliOn duly 01ganlzed under the laws of th& State of New Hampshire, that Liberty M.rtual Insurance COmpany is a corporation duty 01ganlzed under the laws of the State of Massachusetts, and West AmeriCan Insurance Company is a COIJ)Oration dUly organized under the laws of the State of lndiala (herein collectively called the "Coml)anies1, pursuant to and by arthonty herein set forth, does hereby nMltl, constitUte and appoint, Brian A.
McGoldrick; Brigid Loll$ Evett Lam; Richard L. Wells
all of the cily of Placentia . state of CA each Individually W there be more than one named, itS true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on itS behalf as surety and as Its act and deed, any and all undenakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duty signed by the president and attested by the secretary of the Companies in their own proper person$.
IN WITNESS WHEREOF, this Power of Attomey has been subsa'ibed by an authorized officer Of official of the Companie$ and the corporate seers of the Compa,ies haYe been affixed thereto this ..2Q!!!__ day of May ,..J.m._.
Liberty Wual Insurance Company
The Ohio Casualty lnsurooce �any
1 .____:_:__, er.�- l�
:t:f ; State of PENNSYLVANIA
David M. Garey, Assistant Secretary _[ i 'g ::l County of MJNTGOMERY ss §� �.._ � On this 20th diJi of � , 2021 before me personally appeared David M. Carey, who acknowledged himself to be the AssistMt Secretary of Liberty �al Insurance rJ � � lii Company �hio Casualty pany, and West American Insurance Company, and that he, as such, being authoriZed so to do, execute the foregoing instrument for the purposes ! :l5 � > therein contained by signing on behalf of the COIJ)Orations by himself as a duly authorized officer. � .!R� I IN WITNESS WH�EOF. I haYe hereunto subscri>ed my name and affixed my notaial seal at King of Prussia, Pennsylvania, on the day and yeer first above written. � �- o- l'G:) <:,I' PJ\s1- .----------, �_Q ,_. 'l�· !1-oNWf � Commonwealth of Pemsytvania • Notaty Seal >--� ... 0 lJJ 0� 4<,, < T1!re$8 Pastella, Notary Publlo Ac--.. i
Q) .!9Cl) ,.,, 0 "" " Montgomery County {I/, ; . . , II + I I c: E g.! OF MycommissionexplresMaroh28,2025 By: µ.,iu-,µ � 0 co f!! '<k I';'!' Commlsslonnomber1126044 --J----_..,,--,....,_-,..,,.... _________ ,;s;:..., cu 'ti 1,,J'4'Nsy\?Jf' -fJ -.PennsylYaniaA$9ociotionofNotaries T eresaPastella, Notar,Publk: <( o O> 4> 7:.irit p\\'<>v o !ij!
.g> .$ This Power of Attorney is made and executed pwsuant to and by authOlity of the following By-laws and Authorizations of The Ohio casualty Insurance Company, Liberty Mutual j � � .!i_ Insurance Company, and West Amerlc.»1 Insurance Company which resolutions are now in fuU force and effect reading as follows: � � ,.. ,! ARTICLE IV • OFFICERS: Section 12, Power of Attorney. '- °I> .S I! Any officer or other � of the CO!poration autholized for that purpose in writing by the Chairman or the Presiden� and subject to such limitation as the Chairman or the :g � ;g O President may prescribe, shall appoint such attomeys-in-fact, as may be nooessary to act In behaf of the Corporation to make, execute, seat, acknowledge and deliver as surety � � � c: any and llll undertakings, bonds, �llZllll(j8$ and olher Sll'ety obligaions. Suell � subject to the Imitations set forth in their respective powers of atl!)me'f, shall "P rJ a � hcwe fuR power to bind the Corporation by thei' signature and execution of any such inslrufhents and to atladl lhef'eto the seal of the Corpoialk)n. When so executed, such .8 i z ij ilstruments Shal be as bin<1n9 as if signed by the President and attested to by the Secretary. Any power or authclnty granted to any represenfative or atlDmey..Jn-fact under the 0 as
()l'OYisiOr1s ofthiS al1icle may be revoked at any time by the Board, the Chaimlcrl, the President or by the officer or officers granting such power or authority, u.
ARTICLE XIII- Execution of Contracts: Section 5. Surety Boods and Undeltakilgs.
Any officer of the Company autholized for that purpose In writing by the chainniln or the president, and subject to such Umitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act In behaf of the Company to make, execute, seal, acknowledge and deliver as surety any and atl undertakings, bonds, recognizances and other surety obligations, Such attomeys-in-ract subject to !he Umitations set forth in their l'flSl)8Clive powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and lo attach thereto the seal of the Company. When so executed such instruments shall be as bindilY,I as K signed by the president and attested by the secreta,y.
Certificate cl Designation -The President of the Company, acting pursuant to the Bylaws of the Company, aulhorlzes David M. carey, Assistant Secrela'y to appoint such attorneys.in tact as may be necessa,y to act on behalf of the Company to make, execute, seal, !ICknoWledge and deliver as Sll'ety any and al undertakings, bonds, recognizances and olher surety obligation$.
Authorization -By unamnous consent of the Company's Board of Directors, the Company consents that facsimile or mechlllk:aHy reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified c:opy of any power of attorney issued by the Company in connection with surety bonds, Shall be valid and binding upon the Company with the sane force Md effeet as th(logh manually affixed.
I, Renee C. Llewellyn, the undersigned, Assislant Secretary, The Ohio Casualty lnSll'ance Company, Lkty M.rtual Insurance Company, and West Amerlc.»1 lnSll'ance Company do hereby certify that the Ol'iginal power of attorney of which the foregoilg is a ful, true and correct copy al 1he Power of Attorney executed by said Companie$, is in fut force and etrect and has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this� day of May , �.
By: .-?-/41"1--
-=-Renee=�----.r,. LI,.,..ewellyn----..,,-----, Assistant,,......,,...,....,,.,,Secretay,---..,....... ______ _ LMS-12873 LMIC OCIC WAJC Multi Co 02/21
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189
A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
county of Sacramento
On May 23, 2022 before me, · Rick James Arias, Notary Public Date Here Insert Name and Title of the Officer
personally appeared _T_im_S_c_h_m_i_d ______________________ _ 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. 1············1RICK JAMES ARIAS
: ' Notary Public • California : 1 Solano County � z Commission # 2278601 � My Comm, Expires Mar 21, 2023
Place Notary Seal Above
I certify under PENAL TY OF PERJURY under the laws
of the State of California that the foregoing paragraph is true and correct.
Si
---------------OPTIONAL---------------
Though this section is optional, completing this information can deter alteration of the document fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: --------------------:::a,,.C....-------- Document Date: _________________ _
Signer(s) Other Than Named Above: ----------=->""'------------- Capacity(ies) Claimed by Signer(s)
Signer's Name: --------------:::a,r;
□ Corporate Officer - Title(s): -----'""---
□ Part.ner - □ Limited □ General
□ Individual □ AttorneY. · act
□ Trustee □ Gu an or Conservator
□ Other:------::.,,,-=----------
Signer Is Re
Signer's Name: ___________ _
□ Corporate Officer - Title(s): ______ _
□ Partner - □ Limited □ General
□ Individual □ Attorney in Fact
□ Trustee □ Guardian or Conservator
□ Other: _____________ _
Signer Is Representing; ________ _
©2015 National Notary Association• www.National Notary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 27 of 48
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:ontractor Information
Legal Entity Name
CHRISP COMPANY
Leplllllityl)pe
Corporation
S1alus
Active
Reglstaatlo.'t Number
1000000306
lt6glltiation ..ffKIMdllte
07�1/19
RegisbalMI expeatlon date
06/'30/22.
Malling�
43650 OSGOOD ROAD FREMONT 94539 CA United States -
Physical�
43650 OSGOOD ROAD FREMONT 94539 CA United States _
&nail�
jhansonOdvispcocom
Trade Name/Dt.\
CHRISP CDMPANY
Uc:ame ....... (s)
CSLB:374600
CSLB-374600
Legal Entity Information
Corporation Entity Number:
Federal Employment lclentiftcation Number:
Plesident Name:
Vice President Name:
y.....,..Name:
Seaetary Name:
CEOName:
�ency foe Seryjce:
Agent of Service Name:
Agent of Service Mailing Address:
Reaistration Historv
Efhdifto.te
06(11/18
05/(1:)/17
05/12/16
06/12/15
07/10/14
07/01/19
C0908398
942578099
ROBERT CHRISP
DAVID MORRIS
TAMMIE ALLISON
ROBERT CHRISP
CHRISP COMPANY
bpi! d11111>ate
06/30/19
06/30/18
06/30/17
06/30/16
06/30/15
06/'30/22.
43650 OSGOOD ROAD FREMONT 94539 CA nited States of America 28 of 48
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, Worker's Compensation
Do you lease employees tlwaugh Protasslonal Employer Organization (PEO)?: No Please provide your current worker's compe11Atio11 inslnnce Information below:
PEO PEO PEO
PEO lnformationName Phone Email
Insured by Carrier
Policy Holder Name:
Insurance carrier:
Policy Number:
Inception elate:
Expiration Date;
ARl"HURJ.
1000004442
12/01/21
12/01/22
HER & COMPANY
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