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Item 15 Page 208 of 235
QUESTIONN
AIRE REGARDING SUBCONTRACTORS
Bidder shall answer the following questions and submit with his/her Contract proposal. 1. Were bid depository or registry services used in obtaining subcontractors bid figures in order to compute your bid? Yes □ No�
2. If the answer to No. 1 is "Yes", please forward a copy of the rules of each bid depository you used with this questionnaire.
3. Did you have any source of subcontractors' bids other than bid depositories? No
4. Has any person or group threatened you with subcontractor boycotts, union boycotts, or other sanctions to
attempt to convince you to use the services or abide by the rules of one or more bid depositories? Yes D No Iii
5. If the answer to No. 4 is "Yes", please explain the following details: (a) Date: (b) Name of person or group: (c) Job involved (if applicable): (d) Nature of the threats: (e) Additional comments: (Use additional paper if necessary)
6. Was a conscious effort made to recruit or provide equal opportunity for bids by minority or project area subcontractors?
Y
es D No fl]
7. Was a conscious effort made to recruit and hire project area lower-income residents? Please submit statement.
Yes D
No(l]
8. We declare under penalty of perjury that the foregoing is true and correct.
Dated this l.f day of Au�ui/- , 20
23. All of the above statements as to experience, financial qualifications, and available plant and equipment are submitted in conjunction with the proposal, as a part thereof, and the truthfulness and accuracy of the information Is guaranteed by the bidder. l J J O r. ·
Name of Company �-f'-1 d,¼4, KaJh-�
1.vic.
By: 8:cvt)etii"'-- R-e(A.'a2
Title: ft::c>SJ�
Southland Roofing Inc.
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Item 15 Page 209 of 235
SPECIAL TY CONTRACTOR OR SUBCONTRACTOR STATEMENT OF QUALIFICATIONS
ROOFING WORK
As part of its Bid, Bidder shall submit this Statement of Qualifications for the Subcontractor that will perform the roofing work, or for the Bidder itself, if Bidder w,11 self-perform the Work. This information shall provide evidence to indicate successful experience in providing work comparable to that specified in the Project Drawings and Specifications. Referenced qualifications shall demo strate experience as a successful installer of roofing materia or an approved equal at the discretion of the City Staff.
A Bid may be rejected as non-responsive if Bidder fails to provide this completed form with the Bid or submits this form with inaccurate information.
Mandatory qualifications: Specialty Contractor (or Bidder, if self-performing) shall possess a valid C-39 Roofing Contractor California Contractors License at the time of the Bid Deadline and at all times during performance of the Work and shall establish that it satisfactorily completed at least three (3) projects as the installer of a minimum of roofng work; each comparable in scope and complexity to this Project, within three (3) years prior to the Bid Deadline.
Specially Contractor ame: �ul-l,/c<A,Jf.l.. 00 {-: "1j Iv, C.
Project Manager/ Foreman:
�g�¢�VV\.��Q�
V\.�__.._t�•-
----------------
Phone No: 323 -{;'fO- ]/O'f
COMPARABLE PROJECTS (Provide three (3))
Project Name:
Ro><9JM,0,1,.f tft,dl/e g ool
Address: 4]15 R,S<'=IN\Of.4A
A,,e. � Ce.sce'P'td
-tk.-i-h,oye cA CJ/1214
Date Completed: f3 /Jl } 20 '"l.
3 r ,
Reference/ Contact Name:
_..L,,.._,.,v'--'i""'Se__�=-
�u __________________ _
Reference/ Contact Phone No:
�8 ..... £�8_-
--'-]-=J-=S'-
�-5:.....__'1.,___)-'-(f ------------
Description of work performed: Re t:Dl?P (?)C;s
..J-c'� ,hJL·· /4��
Southland Roofing Inc.
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Item 15 Page 210 of 235
2. Project Name: s;;V\ M<.3 r z i-i,.o Cew4cr
Address: / 8CO fjuhJt"�}ovt Dr. 5¢':\ Mc}v-,-Vlo cA °IJ/08 Date Completed: 06 /zo 23 I
Reference I Contact Name:
..... A ..... ��---- rJ M . ------------
Reference/ Contact Phone No: 6/<6-9*0-05)2
Description of work performed: � -t:::90 F' e,,,.._ t"S l ,--j b u/d�
3. Project Name:
�
n-d <:::;_Jvi.Js
Address: 13 / 5 S tJ d s CM SJ• /1or:e<,,,-0 [&f1e Y c;A 12 5 55 I
Date Completed: as;/2.o 23
Reference I Contact Name: ___ {<.._d,,(...,-----'�--'-,1'-Y-----'C.=--'--.. ____ _____
___ _
Reference I Contact Phone No: .... ·fl_b�0_-_______..1f-'-t/-4-l/-�l�B ...... f__._l __________ _ Description of work performed: {(e-r-oo{ e;u�k� fv;Ja{;,,_,{f
4. Project Name:
�
rr
o
u
�h S Af
s·. Gjvn
Address: 1q2Q {LI L/4Jv k Aoe .. 8uv-.bJc.-i k c;A
'f!SOG
Date Completed: o7 I 2o .2, 3
t
Reference I Contact Name: _j)��vt-vt�,��-· �Af�------------ -
Reference I Contact P one No:
_,@"""<-''f/....,_-
_,/t__.!/-=:S"---
-'--/ 1.,_Z�I __________ _
Description of work performed: a_<::>v (' res-./orcJ.1-(ot-'J Southland Roofing Inc.
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Item 15 Page 211 of 235
CONTRACTOR'S AFFIDAVIT OF NON-COLLUSION
STA E OF CALIFORNIA
COUNTY OF .b!22-/Jh,seles
f?eir §evii-, Re�.)
) ss
)
being first duly sworn, deposes and says:
1. That he/she is the Pn::;1s
,
'efBd-
.
(Title of office if a corporation, •sole owner," "Partner," or other proper title) of x.v?l.10 t...d R,o,;,(1 �
j0
c, , (hereinafter called "Contractor'')
who has submitted to the City of Vernon a Bid fothe construction of the Public Works Department;
2. That said Bid is
genuine; that the same • not sham; that all statements of fact therein are true;
3. hat said Bid is not made in the interest or behalf of any person, partnership, company, association, organization. or corporation not named or disclosed;
4. That Contractor did not, directly or indirectly induce, solicit, agree, collude, conspire or contrive with anyone e se to submit a false or sham bid, to refrain from bid ing, or withdraw his/her bid, to raise or fix the Bid price of Contractor or of anyone e e, or to raise or fix any overhead profit, or cost element of Contractor's price or the price of anyone else; and did not attempt to induce action prejudicial to the interests of the City of Vernon, or of any ot er Bidder, or anyone else interested in the proposed Contract;
5. That the Contractor has not in any manner sought by collusion to secure for himself an advantage over any other Bidders or induce action prejudicial to the interests of the City of Vernon or of any other Bidder, or anyone else interested in the proposed Contract;
6. That the Contractor has not accepted any bid from any Subcontractor or material supplier through any bid depository, the bylaws. rules or regulations of which prohibit or prevent the Contractor from considering any bid from any Subcontractor or material supplier, which is not processed through said bid depository, or whic prevent any Subcontractor or material supplier from bidding to any Contractor who does not use the facilities of or accept bids from or through such bid depository; /II
Ill
Ill
Ill
Ill
Ill
/II
/II
Southland Roofing Inc.
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Item 15 Page 212 of 235
7. That the Contractor did not, directly or indirectly, submit the Contractor's Bid price or any breakdown thereof, or the contents thereof, or divulge information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, or to any individual or group of individuals, except to the City of Vernon, or to any person or persons who have partnership or other financia interest with said Contractor in his/her business.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Dated this _li_ day of
AvjV.5l 2,p23 at
L
o.> 11"1,�
eles I
---'""'c'-"-A,____
Month/Year i;;f City State
Title
Southland Roofing Inc.
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Item 15 Page 213 of 235
THE
BIDDER'S INSURANCE COMPANY(S) OR INSURANCE AGENT MUST COMPLETE THIS FORM AND
THE BIDDER MUST SUBMIT THIS CERTIFICATION WITH THE BID FORMS.
I, the undersigned (Please check one box) underwriter agent, certify that I and the Contractor listed below ave jointly reviewed the "I surance Requirements" in these Bidding Documents and the Contract Documents. If the City of Vernon ("City") awards the Contractor the Contract for this project, I will be able-within fourteen (14) calendar days after the Contractor is notified of the Contract's award-to furnish the City with valid insurance forms (including one or more insurance certificates and additional insured endorsements) that fully meet all of the Insurance Requirements.
Pascal Burke Insurance Brokerage Inc
Name of Insurance Company
Pascal Burke
lnsuranc�
�
�
nt's Name (Printed)
(signature) i/��
2102 Business Center Drive Ste. 280
Address
877-893-7629
Telephone Number
Contractor's Name
Irvine
City
8/24/2023
Date
Insurance Agent's Name
CA 92612
State Zip Code
[email protected]
Email Address
City Specification Number
Below State the Name of Insurance Company Providing Coverage:
DO NOT write "Will Provide," "To Be Determined," "When Required," or similar phrases.
Sutton Specialty Insurance Company
Commercial General Liability
Workers' Compensation Liability
City Will Purchase Policy, if required
Builders Risk
Automobile Liability
Pollution Liability
[NOTE TO CONTRACTOR: See "Insurance Requirements" EXHIBIT 4 of the Contract for the requirement of obtaining Pollution Liability Insurance.]
NOTE TO HE UNDERWRI ER / AGENT: If the insurance forms that the Contractor submits to the City do not fully comply with the Insurance Requirements, and/or if the Contractor fails to submit the forms within the 14-day time limit, the City may: (1) declare the Contractor's Bid on-responsive, and (2) award the Contract to the next lowest responsible Bidder.
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Item 15 Page 214 of 235
THE BIDDER'S INSURANCE COMPANY(S) OR INSURANCE AGENT MUST COMPLETE THIS FORM AND
THE BIDDER MUST SUBMIT THIS
CERTIFICATION WITH THE BID FORMS. I, the undersigned (Please check one box) O underwriter D agent, certify that I and the Contractor listed below have jointly reviewed the "Insurance Requirements" in these Bidding Documents and the Contract Documents. If the City of Vernon ("City") awards the Contractor the Contract for this project, I will be able-within fourteen (14) calendar days after the Contractor is notified of the Contract's award-to furnish the City with valid insurance forms (including one or more insurance certificates and additional insured endorsements) that fully me I all o the Insurance Requirements. :J � P:'l ..,� �ewv cot= 1lrt Wllr� J
Name of Insurance Company Date 1'4►� M, G''JUJ:'Lf� <ftk. �dMU/J.PrNqr�ct;U {/',v., Insurance Agent's N rinted} Insurance Agent's Name
(signature}_-"=-��=-----==-----
l\,tt \o\,J t �G,t\J'Oy\. �
Address
Sf g "Si l#S-• '.17J '?
Telephone Number
Contractor's Name
City State Zip Code
�,O(,t$ 'l. �(M/&"IAI"[� • 4tx._
Email Address
City Specification Number
Below State the Name of Insurance Company Providing Coverage:
DO NOT write "Will Provide," "To Be Determined," "When Required," or similar phrases.
Commercial General Liability
(JJ�ASD7d)3o�oO
Workers' Compensation Liability
City Will Purchase Policy, if required
Builders Risk
Automobile Liability
Pollution Liability
[NOTE TO CONTRACTOR: See "Insurance R
uirements" EXHIBIT 4 of the Contract for the requirement of obtaining Pollution Liability Insurance.]
NOTE TO THE U DERWRITER / AGENT: If the insurance forms that the Contractor submits to the City do not fully comply with the Insurance Requirements, and/or if the Contractor fails to submit the forms within the 14-day time limit, the City may: ( 1) declare the Contractor's Bid non-responsive, and 2) award the Contract to the next lowest responsible Bidder.
Southland Roofing Inc.
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Item 15 Page 215 of 235
THE BIDDER'S INSURANCE COMPANY(S) OR INSURANCE AGENT MUST COMPLETE IS FORM AND
THE BIDDER MUST SUBMIT THIS CERTIFICATION WITH THE BID FORMS.
I, the undersigned (Please check one box) underwriter Xagent, certify that I and the Contractor listed below have jointly reviewed the "Insurance Requirements" in these Bidding Documents and the Contract Documents. If the City of Vernon ("City") awards the Contractor the Contract for this project, I will be able-within fourteen (14) calendar days after the Contractor is notified of the Contract's award-to furnish the City with valid insurance forms (including one or more insurance certificates and additional insured endorsements) that fully meet all of the Insurance Requirements.
Auto Insurance Specialists, LLC
Name of Insurance Company
Jennifer Rhodes Insurance Agent's Name {Printed)
(signature) � �c/4.,__
PO Box 160
Santa Ana
Address City
866-570-7335 Telephone Number
Southland Roofing Inc.
Contractor's Name
8/25/2023
Date
Insurance Agent's Name
CA
State Zip Code
[email protected]
Email Address
City Specification Number
Below State the Name of Insurance Company Providing Coverage:
DO NOT write
"Will Provide," "To Be Determined," "When Required," or simi ar phrases.
Commercial General Liability
Workers' Compensation Liability
City Will Purchase Policy, if required
Builders Risk
California Automobile Insurance Company
Automobile Liability
Pollution Liability
[NOTE TO CONTRACTOR: See "Insurance Requirements" EXHIBIT of the Contract for the requirement of obtaining Pollution Liability Insurance.]
OTE TO THE UNDERWRITER/ AGENT: If the insurance forms that the Contractor submits to the City do not fully comply with the Insurance Requirements, and/or if the Contractor fails to submit the forms within the 14-day time limit, the City may: (1) declare the Contractor's Bid non-responsive, and (2) award the Contract to the next lowest responsible Bidder.
Southland Roofing Inc.
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Item 15 Page 216 of 235
CERTIFICATE OF EQUAL OPPORTUNITY PRACTICES
City of Vernon
4305 Santa Fe Avenue
Vernon, CA 90058
(323) 583-8811
Website: www.ci
tyofvernon.org
Article I. Affidavit of Equal Opportunity Employment
&
Non-segregation (Form AA-1)
Article II. Vendor List Questionnaire (Forms AA-2 & 3)
In order to be placed to the City's vendor list and be eligible to receive City business, you must provide the following information except where indicated as "optional." By submitting this form you are declaring under penalty of perjury under the laws of the State of (alifornia and the laws of the United States that the information is true and correct. Furthermore, you are certi fying that
your firm will adhere to equal opportunity employment practices to assure that applicants and employees are not discriminated against because of their race, religion, color, national origin, ancestry, disability, sex or age. And, your firm does not and will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained.
Name of Company: �b /.;\w;} Ro£d0 <ltC
,
Business Telephone: ·31
0-
cjD3 -0536
Address:
{"5 5- fu,tfu.x Aue #Zoo
City:
Los Avis des' State: cA Zip
C{C);23
6 Contact Person\ler- fl:eu:i...,
Pr-� E-mail Address
P:
�./-h/di-.d
{?;oh'.,,G)
111t�-c
f)
,.,,
Tax ID Number (or Social Security Number) '38-£<?02523
Remit Address (if different)
(optional) d
Please state clearly and concisely the type(s) of goods and services your company provides:
R.00 �iv,,� s-errvi'< ¢5
The following section is OPTIONAL and is for statistical reporting purposes only. Ownership (please check all that a
pply):
African-American__ Asian__ Armenian__ Hispanic__ Native American __ Disabled__ Female __
Southland Roofing Inc.
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Item 15 Page 217 of 235
Project Workforce Utilization (Form AA-2)
This form is to be included in all bid documents for projects involving labor or services valued at $25,000 or more.
Instructions: Please indicate the job titles/classifications to be used in the performance of this contract should it be awarded to your firm. Please indicate the number of employees in each job classification as well as the number of new hires, if any, as a result of this contract.
Name of Company: �,,/hbuJR.m�1! f 1/lC- Project:Ci-f.7/ll/'Kocf'<Re pldcetet<»tl
Job Titles/Classification Estimated number of existing staff to be employed in Estimated number of new hires to be employed in this classification if awarded the contract this classification if awarded the contract For�..-,c\-Vl I c}
R,.,..,._,:, { p ire.. L/ 0
Wei t>eArS ·)
Are any current employees or potential
new hires Vernon residents? If so, how
many?
Southland Roofing Inc.
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Item 15 Page 218 of 235
Current Permanent Workforce Utilization (Form AA-3)
OPTIONAL
Name of Co
�
pany:
yµf[1 Jc� (,,t d �C(lfj ftJCv
Project: L/1/
J!/r:l/1 Root="' f<ep
/�qcJ.n.C'-<4 4.
Completion of this form is OPTIONAL. Any information supplied by vendors is for reporting purposes only and will not be factored into the award of any contract.
Instructions: Please indicate the number of employees in each Job Classification belonging to the following groups.
White African-American Hispanic Asian/Pacific Native Armenian Male Female (not of Hispanic (not of Hispanic Islander American
origin) origin)
CLASSIFICATION
Officials/
Managers
.--1 r( )<.
Professionals 6
>
(
Technicians :J. ·-1-.
Office/Clerical I -I ·-I
i<
Skilled Craft Workers
6' )<
Operators (semi-skilled)
Laborers � X
Service Workers
TOTAL d j_ /8 K
)t-
Southland Roofing Inc.
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Item 15 Page 219 of 235
BID BOND
RECITALS:
Bond: BB2021851
1. The City of Vernon, California ('"City"), has issued a Notice Inviting Bids for the Work described as follows:
Specification No. 075216.:12 City Ha Roof Replacement tor Department of Public Works in Vernon, CA. (
"Project")
.
2. In response lo the Notice Inviting Bids. Southland Roofing, Inc. 145 South Fairfax Ave #
200, Los Angeles, CA 90036
(Name, address, and telephone of Contractor)
_3_01_9- _o_
3-_os_3_s _ _____
___________________
(
"Principal
"
).
has submitted the accompanying Bid for the Project.
3. Principal is required under the terms of the Specification and all Bidding Documents referenced in it-to furnish a bond with
the Bid.
4. The Specification, including all its amendments and supplements, and Principal's Bid are incorporated into this Bond and mdde a part of it by this reference.
OBLIGATION:
THEREFORE, for value received, We, Principal and
American Contractors Indemnity CompanY._ 801 S. Figueroa Street, -Jt.ZQQ, Los An��s, _CA QQ.01Z (Name, address, and telephone of Surety)
310-649-0990 {"Surety"),
a duly admitted surety insurer under California·s laws, agree as follows:
By this Bond, We jointly and severally obligate and bind ourselves, and our respective heirs, executors, administrators, successors, and assigns to pay City the penal sum of Thirty-Nine Thousand & 00/100 __________________ Dollars($ 39,000.00 ) ("the Bonded Sum"), this amount comprising not less than TEN PERCENT (10%) of Principal's Base Bid, in lawful money of the United States of America.
The Licensed Agent for Surety is:
Orr & Associates Insurance SeNices 28!Bq Sin\)le Oa�Drive_Suite 255, Temecula. CA 92590 (Name, address, and telephone)
909-806-0884 Registered Agent's Califomia Department of Insurance License No. _o_J1_84_3_s __ _
THE CONDITION OF THIS BOND'S OBLIGATION IS THAT, if: (1) Principal does not (a) withdraw its Bid for the period specified in the Bidding Documents, or if no period is specified for ninety (90) calendar days after City awards the Contract for the Project, or (b) attempt to withdraw its Bid when the requirements of California Public Contract Code §5101 et seq., or any successor legislation, are not met; or (2} City awards Principal the Contract in response to Principal's Bid, and within the time and manner specified by the Specification or Contract Documents or if no period is specified within fourteen (14) calendar days after the Contract's award, Principal (a) signs and delivers to City the Contract, in accordance with the Bid as accepted, (b) furnishes the required bonds for not only Principal's faithful performance and proper fulfillment of the Contract, but also Principal's payment for labor and materials used in the Project, and (c) furnishes the required insurance, then this obligation becomes null and void.
Otherwise, this Bond remams in full force and effect, and the following terms and conditions apply tu this Bond:
1. Surety's obligations under this Bond are separate, independent from, and not contingent upon any other surety's guaranteeing that upon City's awarding the Contract to Principal, the Principal will enter into the Contract with City.
2. No right of action accrues on this Bond to any entity other than City or its successors and assigns.
3. If an action at law or in equity is necessary to enforce or interpret this Bond's terms, Surety must pay in addition to the Bonded Sum City's reasonable attorneys' fees and litigation costs, in an amount the court fixes.
4. Surety shall mail City written notice at least 30 days before: (a) the effective dale on which the Surety will cancel, terminate, or withdraw from this Bond; or (b} this Bond becomes void or unenforceable for any reason.
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Item 15 Page 220 of 235
\
On the date set forth below, Principal and Surety duly executed this Bond, with the name of each party appearing below and signed by its representative(s) under the authority of its governing body.
Date: August 21, 2023
PRINCIPAL: SURETY:
American Contractors Indemnity Company
Address for Serving Notices or Other Documents:
/l/S S: &Jcfu _ #2.e;v CORPORATE SEAL
I I '
(Company Nam11f
(Signature)
B
y
: Nhung H. Saephan
(Name)
Its:
Attorney-in-Fact
(Title}
Address for Serving fllotices or Other Documents:
801 S. Figueroa Street, #700
Los Angeles, CA 90017
CORPORATE SEAL
• EVIDENCE MUST BE A TT ACHED OF THE AUTHORITY OF ANY PERSON SIGNING AS ATTORNEY-IN-FACT. • THE ATTORNEY-IN-FACTS SIGNA TIJRE MUST BE NOTARIZED. ■ A CORPORA TE SEAL MUST BE IMPR
ESSED ON THIS FORM WHEN THE PRINCIPAL, OR THE SURETY, OR BOTH ARE A CORPORATION.
Southland Roofing Inc.
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Item 15 Page 221 of 235
STATE OF CALIFORNIA )
) ss
COUNTY OF )
BOND ACKNOWLEDGMENT
FOR
SURETY'S A TTORNEY-IN-FAC'
On this ___ day of _______ 20
__ ,
before me, (name), a Notary Public for said County, personally appeared (name), who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument as the attorney in fact of ____________ , and acknowledged to me that he/she subscribed the nar1e of _______________ thereto as principal, and his/he own name as attorney in fact.
certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
Notary Public
SEAL
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Item 15 Page 222 of 235
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
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 }
J I • On 75 1 1,{}"t-- before me, KATY TAYLOR Notary Public, ofoe , -----'"�(---he'--re'--i---
ns .... e ..... rt=n--arn'"""e__) _______ _
personally appeared NHUNG H. SAEP"""'H:.:....:A:.:....oN ___________ _ who proved to me on the basis of satisfactory evidence to be the person(s-) whose name(&) is/afesubscribed to the within instrument and acknowledged to me that 19e/she/thay executed the same in his/her/t"1€if authorized capacity(fes
7, and that by rus/her/their signature(&1 on the instrument the person(s-), or the entity upon behalf of which the person(s➔ acted, executed the instrument.
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.
(Seal)
_________ OPTIONAL INFORMATION _________ _
Description of Attached Document
Title or Type of Document: ____________ Number of Pages:
Document Date: Othe
r
: ___________________ _
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Item 15 Page 223 of 235
TOKIO MARINE
HCC
KNOW ALL MEN BY THESE PRESENTS:
POWER OF ATTORNEY
That American Contractors Indemnity Company of the State of California, a California corporation, does hereby appoint, NHUNG H. SAEPHAN
its true and awful Attorney-in-Fact, with full authority to execute on its behalf bond number _____ B_B_2_0_2_1_8_5_____ 1 _
issued in the course of its business and to bind the Company thereby, in an amount not to exceed ___ ______ T_h_re_e_m_ill_io_n_a_n-'-d-'0-'0_/ 1_0_0 _______ ___ , ___ $"'-'3;.....,0_;;_;0=----=0...._,0:c.cO=----=O--=-=.O=----=O _ __,) This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the Board of Directors of AMERICAN CONTRACTORS INDEMNITY COMPANY at a meeting duly called and held on the pt day of September, 2011
'Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full poweI and authority to appoint any one or more suitable persons as Attomey(s)-in-r-act to represent and act for and on behalf of the Company subject to the following provisions.
Attorney-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the relea, e of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power ot attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or Jndertaking to which it s attached.
The Attorney in-Fact named above may be an agent or a broker of the Company. The granting of this Power of Attorney is specific to this bond and does not indicate whether the Attorney-in-Fact is or is not an appointed agent of the Company.
IN WITNESS WHEREOF. Amencan Contractors lndemn,It\.',,,,¾ompany has caused its seal to be affixed hereto and executed by • ,s Pre ident on this 181h day of April, 2022 ,"''�1
,�<;10�.�
lr°�--- • -�i
i
-••• "'" •• "
By·
, \. /.'" c, '"''
• �:1
C'>ll.u:ont.),\�
,,,,,
❖ ....
AMERICAN C'ONT
Ada
1 A Notary Public or other officer completing this certifit,ate i/'e/f1 Ies only the identity of the individual who signed the document to which ' this certifi ... ate 1s attached, and not the truthfulness, accurac , or validi of that document.
State of California
County of Los Angeles
On this 18
th day of April 2022, before me, Sonia 0. CarreJo, a notary public, personally appeared Adam S. Pessin, President of Arnenvan Contractors Indemnity Company, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted. executed the instrument.
I certify under PENAL TY OF PERJURY under the laws of the State of CALlf-ORNIA that the: foregoing paragraph is true and correct.
WITNE:SS my hand�
and official seal, � °;,;;:;;; 0 :��£�1���� 0 f
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Signature ( (seal) l ., ecm,,.,.,;,,,,, 21�s110
L J •• •• My Comm. Expirl'I � 23, 1016 [
I. Kio Lo, Assistant Secretary of American Contractors Indemnity Company. do hereby certify that the Power of Attorney and the resolution adopted by the Board of Directors of said Company as set forth above, are true and correct transcripts thereof and that neither the said Power of Attorney nor the resolution have been revokPd and they are now in full force and effect.
IN WITNESS WHEREOF,
21st day of
have hereunto set my hand and affixed the seals of said Companies at Los Angeles. California this A t 2023 """""''
Bond No.
Agency No.
882021851
7413
ugus 1 -�--· "'❖,,❖�?J',.�.10118 t1��--·· \0
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Visit trnhcc com/surety for more information ,,�\'.:'�,���,,,,,,• HCCSOZZPOAACIC07/2023 Southland Roofing Inc.
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Item 15 Page 224 of 235
TOKIO MARIN
E
HCC
Fraud Warnings
Fraud Warnings and Privacy Notice
Any person who knowingly presents a false or fraudulent claim for payment of a loss or be.1efit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.
APPLICABLE IN ALABAMA
Any person who knowingly presents a false or fraudulent claim for payment of a loss 01 benefit or who knowingly presents false information in an application for insurance is guilty of a crime and may be subject to restitution. fines or confinement in prison, or any combination thereof.
APPLICABLE IN ARKANSAS, LOUISIANA AND WEST VIRGINIA
Any person who knowingly presF>nts a false or fraudulent clann for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement ir prison.
APPLICABLE IN CALIFORNIA
For your protection California law requires the following to appear on this form. Any person who knowingly presents false or fr audulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to lines and confinement in state prison.
APPLICABLE IN COLORADO
It is unlawful to knowingly provide false, incomplete. or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines. denial of insurance. and civil damages. Any insurance company or agent of an insurance company who knowingly provides false. incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement of award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.
APPLICABLE IN THE DISTRICT OF COLUMBIA
WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits, if false information materially related to a claim was provided by the applicant.
APPLICABLE IN FLORIDA
Any person who knowingly and with intent to injure. defraud. or deceive any insurer files a statement of claim or an application containing any false, incomplete, o, misleading mformation is guilty of a felony of the third degree.
APPLICABLE IN HAWAII
For your protection. Hawa law reqt ires you to be informed that presenting a fraudulent claim for payment of a loss or benefit is a crime punishable by fines or imprisonment, or botr APPLICAl::ILE IN KANSAS Any person who. knowingly and with intent to defraud, presents. causes to be presented or prepares will> knowledge or belief that it will be presented to or by an insurer, purported insurer, broker or any agent thereof, any written statement as part of, or in su
pport of. an application for the issuance of. or the rating of an insurance policy for personal or commercial insurance, or a claim for payment or other benefit pursuant to an insurance policy for commercial or personal insurance which such person knows to contain materially false information concerning any fact material thereto; or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act.
APPLICABLE IN KENTUCKY
Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime APPt !CABLE IN MAINE
It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the p,;rpose of defrauding the company. Penalties may
include imprisonment, fines or denial of insurance benefits.
TMHCCZZP.' "RAUDPRIVACYOl/2023
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TOKIO MARINE
HCC
APPLICABLE IN MARYLAND
Fraud Warnings and Privacy Notice
Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.
APPLICABLE IN MINNESOTA
Any person who files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime.
APPLICABLE IN NEW JERSEY
Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.
APPLICABLE: IN OHIO
Any person who, with intent to defraud or knowing that he/she is facilitating a fraud against an insurer submits an application or files a claim containing a false or deception statement is guilty of insurance fraud.
APPLICABLE IN OKLAHOMA
WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.
APPLICABLE IN OREGON
Material misstatements, misrepresentations. omissions or concealments by an insured that are fraudulent or material to the insurance contract, the risk assumed. or the interests of an insurer and are relied upon by an insurer may result in policy rescission, cancellation. or denial of claim.
APPLICABLE IN TENNESSEE, VIRGINIA AND WASHINGTON
It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines or denial of insurance benefits.
APPLICABLE IN VERMONT
Any person who knowingly presents a false statement in an application for insurance may be guilty of a criminal offense and subject to penalties under state law.
NOTICE TO NEW YORK APPLICANTS:
Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, infonnation concerning any fact material thereto, commits a fraudulent insurance act. which is a crime. and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.
TMHCCZZM_FRAUOPRIVACY0l/2023
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··FAcrs�::
•• ,<; �- ..... t
.- ' • ,. . · • -• • ' ·.; �� 1't
WHAT DOES TOKIO MARINE HCC DO WITH YOUR
PERSONAL INFORMATION?
Rev. January 1, 2023
Financial companies choose how they share your personal 1nformat1on. F-ederal law g.ves c;onsumer:::, the I ght to imit ;;;ome b Jt 'lot all sr aring. Fede•al law also requires us to tell you how we coliec
1, share. and protect your personal informat1c,n. Please read tr1s notice carefully to understand what we do.
The types of personal informatior we coller:t and share rJepend on the product or sentice you havE with us. This information ,.nay 11c!ude:
■ Account and transaction information: • Contart and demographic.; information: • Financial •1formatior 111 Claims information- and
111 Credit his101y.
All financial companies need to shdre customers perso, al information IC' run their everyday business. 1•1 the section below. we list the easons financial companies can share their customers· personal information. the reasons Tokio Mar,ne HCC chooses to share- and whether you can lirrnt th s sharing
Reasons we can share your personal information
For our everyday business purposess .1ch as to process your transactions, maintain your account(s). respond to cout ord,.,rs and
legal investigations, or r-z:poii 10 credit bureaus
For our marketing purposesto offer our products and servk;es to vou For joint marketing with other financial
companies
For our affiliates' everyday business purposesnformat;on c,bout vuur transactions and expe, iences For our affiliates' everyday business purposesnforrnation about your creditworthiness For our affiliates to market to you
For nonaffiliates to market to you
Does Tokio Marine HCC share?
Yes
Yes
Yes
Yes
Yes
Yes
No
■ Cail (888) 688-0775 -- O' II n1eru Vo I prompt VO througr your vt oice(s). ,. I: mail JS onlinE' [email protected].
Please note:
No
No
No
No
Yes
Yes
N/A
When you arc no longer our customer. we continue !o share your information as describec1 in this notic'
Ho·
•Neve , yoc, can contact us at any time to limit our sha1 ng.
Call (888) 688-0775 or se id us an email at [email protected] TMHCCSZZPRIVACYNOTICE0l/2023
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F4t·i--__________________________________ _
Who is providing this notice?
How does Tokio Marine HCC protect my
personal information?
How does Tokio Marine HCC collect my
personal information?
Why can't I limit all sharing?
What happens when I limit sharing
for an account I hold jointly with
someone else?
Affiliates
Nonaffiliates
Joint marketing
Tokio Marine HCC is the trading name of HCC Insurance Holdings, Inc.
To protect your personal infor"1atlo, fr-,m unauthorized access and use. we rriaintain reasonable administrative. technical and physical safeguards designed to protect your personal information against accidental, .mlawfL or unauthorized destruction loss. alteration. access disc1osure 01 use.
We collect your personal '1format1on, for example when yoL, • Sign up for and use our services. including when yo1 choose to pmv1de us with your nformation on ine or offline·
• nteract with our website ,nd mobile applications; • Obtain an insurance product from us through a broker, where we may cotler:t personal information trom your broker in order to prepare your quote and/or your insurance policy and/or
• Submit an insura. ce claim. so we can prope· y handle your claim.
We may also collect your personal information from others, E Jch as credit bureaus. affiliates. or other cc'l1panies
t-ederal law gives you ·:he right to limit only:
,. sharing for affiliates' everyday business purposes-information about yOL, creditworthiness:
,. affiliates from using your information to market to you, ard • sranng for nonaffiliates to 1T1arket to you. :0 tat(-_ ,aws and 1ndiv1dual companies may give you additiona1 rights to limit sl1armg.
Your choices will apply to everyone on your account
Companie_, related by common ownership or control. They can be financial and nonfinanc,al co npanies. • Our affiliates mcfu,1e our family if c:ompar,ies. available at https:llwww. tokiomarinehd. comlenlcompany/aboutlqroup.html.
Companies not related by common ownership or :ont··ol. They can be financial and nonfinancial companies.
A formal agreement between ncnaffiliated financial companies that together market fmanc1al products or services to you. ■ Our joint marketing pa,tners m, ude categories uf cumparies such as ,nsuran, companies.
For more information please review our privacy policy located at httpc;://www.tmhcc.com/en-us/legal/privacy-policy.
TMHCCSZZPli VAC" 'NO" ICE0112023
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Item 15 Page 228 of 235
PUBLIC WORKS
DEPARTMENT
4305 Santa 1-c Avenue, Vernon, C'alifomia
900:58 Telephone l'.'23) 583-8811
August 17, 2023
NOTICE TO BIDDERS -ADDEND{ .M NO. 1
NIB FOR
CITY HALL ROOF REPLACEMENT
Via Planetbid�
This notice shall be considered as Addendum No. I to the Notice Inviting- Bids for the above-mentioned project and modifies the original Contract Documents, as noted below. Portions vf the Contract not specifa;ally mentioned in the Addendum remain in rorce. This informational notice is to provide clarification to questions that have arisen during advertisement. The questions and responses are the following::
Bid due date has been challged to Tuesday, August 29, 2023, at 2:00 pm. :Bi.cl S.�cification
In the bid Specification, the following items are to be amended as tallow:
1. BIDDING FORM SCHEDULE OF BID /
Remove and instaU all existing metal coping caps with new 22-gauge galvanized sheet metal.
Remove and replace any damaged insulation if needed per specifications.
2. BIDDING FORM
- BIDDER'S PROPOSAL /
'7 ot 178 has been amended to remove the following forms:
Statement of Violations of Federal, State, or Local Law Statement of Disqualification or Debarment
3. Fxhibit
Page :\6
B
or Special
SPEC'IAl
Provision
PROVISION
has been
/
amended to include Section -, . JO:
2.10 METAL COPING CAPS - Installation of new 22-gauge, galvanized steel coping:
Install new 22-gauge, galvanized steel continuous cleat fa<;tened with galvanized steel roofing nails that penetrate wood nailer a minimum of 1". Sccm·c at 6" oc.
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Hook coping to continuously cleat and fasten the interior of coping with galvanized steel hex head screws with neoprene washers. Secure at 18" oc.
Make a note that the roofing cap sht.>et and plies will be removed as part of the tear-off, but the existing insulation is to staJ in place and be re-used. Only if any insulation is damaged during removal should the insulation he replaced with like-kind /new.
Uuestion.s & Answers -·· - - --- - . --
l. The spec book calls for a full demolition and installation of the ISO foam boards. Are we plicing to demolish everything or only demolishfog the built-up roof and then installing dens deck on top of the existing ISO foam?
The roofing cap sheet and plies will be remov..;d as part of the tear~oft, bul the <'Xisting insulaLion will ,/" stay in pla e and be re-used. If any insulation is damaged dming removal, the insulation should be replaced with like-kind/ new.
2. v\1hen is the Cit) looking to start th.is project?
/
Late October nr early November.
3. Is there matc1ial available or back ordered for this project'? /
Materials arc available, but if nut, there is a kad time of twu weeks for materials.
4. What is the existing insulation thickness on all sections? ./ i'he City docs not have that information.
5. Will the existing roof be removed from the substrate, or will the insulation remain? _,,_--
Insulation will rclllain in place as is.
6. If the .insulation remains, will a line item be added to the bid form for a square foot replacement /
cost if any wet or damaged insulation is discovered?
Bid items hnve been added to include removinp.- and replacing any damaged insul, tion on the ro01.
7. Is a moisture scan required, and who is responsible for conducting it'! /
A moisture- s-.an has been completed & found to I){' in rood condition.
8. Will this curb be raised or remain and he roofed over? /
Tht: .:urb is to remain 111 place
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9. \-\ill the existing counterflashing on the walls and curbs be reused or replaced? if replaced, will /' 24 gauge galvanized be acceptable?
Bid items have been added to include removing- and installing all existing metal coping caps with new 22-gauge galvanized sheet metal.
Aerial Images of the entire project are attached for reference.
If you have any questions, please contact Carlos Velazquez 01 my sta11 at (321i 'i83-881 I extension "26 or at [email protected].
Sincerely,
Daniel Wall, P.E
Director of Public Works
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SCHEDULE OF BID PRICES
PROJECT: Cityj-fall Roof Replacement
s1OOER's NAME 5a.)� I� Roo0VI-£ f "'-c.
BASE BID
Pursuant to and in compliance with your Notice Inviting Bids and Contract Documents relating to the Project including all Addenda (attach signed copies), Bidder, having become thoroughly familiar with the terms and conditions of the Contract Documents and with local conditions affecting the performance and the costs of the Work at the place where the Work is to be done, hereby proposes and agrees to fully pertorm the Work withi the time stated in strict accordance with the Contract Documents (including the furnishing of any and all labor, materials, tools, expendable equipment, and utility and transportation services necessary to fully perform the Work and complete it in a workmanlike manner) for the total Base Bid sum of:
T},, ..-ee hv.,..c/r-ed_ Sev�-1.v c;;,·;c -+L.cus <i.H.c( _ J ,,.J (;',.:£ 1--i""i.,,..c/v-ed Dollars Item No.
1. -
2 3
_ __
Description
City Hall Roof Repairs per specifications
Remove and install all existing metal coping caps with new Units Quantity
LS
LS
22-gauge galvanized -----------sheet metal +----+---
Amount
:?Gl,a:?O�..i'
Remove
�
nd replace any damaged insulation per F 100
spec1f1cat1on
3 50
�
,< 5
BIDTOTAL - "l
$
.
3-16,5"W� --- WRITTEN AMOUNT $
v-� Uv�ed�-ve.-.7-5;)<
-fk,�bJe�e✓ %p
All other work items, labor, materials, tools and incidentals which are not specifically listed in the above bid item s. but
are necessary to complete the project per specifications, and all other applicable standards and codes are considered to be included in the above bid items.
If there is a discrepancy between ( 1) the "Grand Total" shown immediately above, (2) any of the "total costs" shown in the far right column above, or (3) the individual Unit Price, then the Unit price shali control over the total cost, and the total cost shall control over the total. If, however, the unit price is ambiguous, unintelligible, or uncertain for any cause, or is omitted, or is the same amount as the entry for the item total, then the item total shal: prevail and shall be divided by the estimated quantity for the item and the price thus obtained shall be the unit price.
Bidder shall exclude the cost of Permit Fees from Bidder's Base Bid sum; Base Bid sum shall include the cost of administration and coordination of Governmental Approvals and Utility Fees.
Bidder acknowledges that determination of the lowest Bid will be based on the combined total of the amounts entered below for the Base Bid plus all of the listed Bid Alternate items, and that once the low bid is determined on this basis, the City will be free to select Bid Alternates for inclusion in the Work in any order or combination, or to reject any or all Bid Alternates.
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BIDDER'S PROPOSAL
The unders Jned submits this Bid n response ro the Not...:e ll'lv''ing B Is issued by the City lo construct the Work of the following Project i� ac•;ordance with the Contract Documents:
PROJECT: Q!Y Hall Rogf Rep acement
A. Enclosed "lerewit" and oy this reference incorporated here:� and made a part of this Bidder's Bid are the following corp eted forms:
1. Bidder's Proposal
2. Scht.dule of Bid Prices
3. :ncurnbency Certf'icatc
4. Bid Security in the fo" JWiny 'orm (check one):
D Cashier's Check 0 Certified Check
5. Bidder's Statement of Qua
1 "icalio"S
6. Experience Forrri
7. Spec· 3lty Contractor
Statement of Qualifications
8. Contractor Safety Questionnaire
9. Des1gml" on of Subcontractors
10. Contractor's Affidavit of No•'-Collusion
11. msurance Requirements Affidavit
12. Pre-Bid Site Inspection Cert 'icat,Jn
I&] Bid Bond OCasr
B. Acknov,1edgment of Addenda. The Bidder shall acknowledge the receipt of a Addenda by attach' copy o' all Aduenda, and by ,sting all Addenda received and attached n the space oelow. /J_o il.L_
i an Aride1"Ju·n or Addenda have beer issued by the City am not attached and noteu :ibove as by the Bidoer, the Bid ,ray be rejectell.
p.P
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a. Basis of design product: Tr
emco, Solargard 6083 Base and Top Coat.
b. Solar Reflectance Index (SR
I), white, ASTM E1980: 105 initial; 100 aged.
c. Volatile Organic Compounds (VOC , maximum, ASTM D3960: 50 g/L. d. Tensile Strength at 73 deg. F (23 deg. C), minimum, ASTM D2370: 250 psi (1700 kPa).
e. Elongation at 73 deg. F
(23 deg. C), minimum, ASTM D2370: 350 percent.
f. Flexibility at
-15 deg F (-26 deg C), ASTM D522: Pass 1/2 inch mandrel bend after 1000 hrs. accelerated weathering.
g. Solids by weight, minimum ASTM D1644: 60 percent.
h. Solids by volum
e, minimum ASTM D2697: 50 percent.
i. Color, Top Coat: White.
j. Minimum Thickness over BUR and MB: 24 mils (0.60 mm} wet each coat for base and finish coats.
2.10 METAL COPING CAPS
A. Install new 22-gauge, galvanized steel coping:
1. Install a new 22-gauge, ?alvanized steel cuntinuuus cleat fastened with galvanized steel ruufing nails that penetrate w0od nailer a minimum of I". Secure at 6" nc.
2. H�>nk coping to cnntinuuusly cleat and fasten the interior porti0n nf coping with galvanized steel hex head Sl:rews with neoprene washers. Secure at 18" oc. � Make a note that the roofing cap sheet and plies will he remove<.l as part of the tear-off, but the existing insulation is Lv stay in place and be re-used. Only if any insulatinn is damaged during removal sh0uld the insulatinn be replaced with likekind /new.
EXr- B - ' 'lL A Pf. • 'N
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