LABOR AND MATERIALS CONTRACT BETWEEN THE CITY OF VERNON AND HAUL-AWAY RUBBISH SERVICE CO., INC. FOR MIXED WASTE COLLECTION, RECYCLING AND
DISPOSAL SERVICES
COVER PAGE
Contractor: Haul-Away Rubbish Service Co., Inc.
Responsible Principal of Contractor: Morris M. Beliakoff, Jr., President Notice Information - Contractor: Haul-Away Rubbish Service Co., Inc. 1205 Date Street
Montebello, CA 90640
Attention: Morris M. Beliakoff, Jr., President
Phone: (323) 721-0371
Notice Information - City: City of Vernon
4305 Santa Fe Avenue
Vernon, CA 90058
Attention: Daniel Wall,
Director of Public Works
Telephone: (323) 583-8811 ext. 305
Commencement Date: May 7, 2024
Termination Date: May 7, 2027
Consideration: Total not to exceed $360,000 (includes all applicable sales tax); and more particularly
described in Exhibit C
Records Retention Period Three (3) years, pursuant to Section 8.3
LABOR AND MATERIALS CONTRACT BETWEEN THE CITY OF VERNON AND HAULAWAY RUBBISH SERVICE CO., INC. FOR MIXED WASTE COLLECTION, RECYCLING AND
DISPOSAL SERVICES
This Contract is made between the City of Vernon, a California charter City and California municipal corporation ("City"), and Haul-Away Rubbish Service Co., Inc., a California corporation, with headquarters located at 1205 Date Street, Montebello, CA 90640 (“Contractor”).
The City and Contractor agree as follows:
1.0 Contractor shall furnish all necessary and incidental labor, material, equipment, transportation and services as described in, and strictly in accordance with, and subject to all terms and conditions set forth in Specifications for Mixed Waste Collection, Recycling and Disposal Services, as more fully set forth in the Scope of Services, attached hereto and incorporated herein by reference as Exhibit “A”.
1.1 All work performed under this Contract shall be performed in accordance with and subject to applicable local, state, and federal requirements and only with a current and valid City franchise for solid waste handling services pursuant to Vernon Municipal Code Section 8.12.060. Failure to maintain a valid City franchise for solid waste handling services shall constitute a breach of Contractor’s obligations under this Contract and may serve as grounds for default and termination with cause pursuant to Section 7.15 herein.
2.0 All work shall be done in a manner satisfactory to the City’s Director of Public Works (the “Director”), or the Director’s designee, in writing, and shall be of highest quality with respect to the contract specifications.
In the event Contractor fails to perform satisfactorily the City shall advise Contractor in writing, and Contractor shall have thirty (30) days to cure such failure to satisfactorily perform. If Contractor fails to so cure its performance within said 30 days, the City may, at its option, terminate this Contract for default without further liability, other than payment to Contractor for work performed satisfactorily prior to the date of termination.
3.0 Contractor shall commence work upon the execution of this contract and shall perform work requested in writing by Director.
4.0 In consideration of satisfactory and timely Performance of requested work pursuant to the Schedule set forth in Exhibit “B,” which is attached hereto and incorporated herein by reference, the City shall pay Contractor as follows:
The bid amounts, according to the requested and accepted price set forth in the Contractor’s bid proposal, attached hereto and incorporated herein by reference as Exhibit “C”. The total amount to be paid to Contractor during the term of this contract shall not exceed three hundred and sixty thousand dollars ($360,000.00) without the prior approval of the City Council and without a written amendment of this contract.
5.0 Concurrently with the execution of this Contract, Contractor shall furnish bonds of a surety satisfactory to the City, as provided in the specifications and Notice Inviting Bids. The cost of the bonds shall be paid by Contractor.
6.0 GENERAL TERMS AND CONDITIONS.
6.1 INDEPENDENT CONTRACTOR.
6.1.1 It is understood that in the performance of the services herein provided for, Contractor shall be, and is, an independent contractor, and is not an agent or employee of City and shall furnish such services in its own manner and method except as required by this Contract. Further, Contractor has and shall retain the right to exercise full control over the employment, direction, compensation and discharge of all persons employed by Contractor in the performance of the services hereunder. Contractor shall be solely responsible for, and shall indemnify, defend and save City harmless from all matters relating to the payment of its employees, including compliance with social security, withholding and all other wages, salaries, benefits, taxes, exactions, and regulations of any nature whatsoever.
6.1.2 Contractor acknowledges that Contractor and any subcontractors, agents or employees employed by Contractor shall not, under any circumstances, be considered employees of the City, and that they shall not be entitled to any of the benefits or rights afforded employees of City, including, but not limited to, sick leave, vacation leave, holiday pay, Public Employees Retirement System benefits, or health, life, dental, long-term disability or workers' compensation insurance benefits.
6.2 CONTRACTOR NOT AGENT. Except as the City may authorize in writing, Contractor and its subcontractors, if any, shall have no authority, express or implied, to act on behalf of or bind the City in any capacity whatsoever as agents or otherwise.
6.3 OWNERSHIP OF WORK. All reports, drawings, plans, specifications, computer tapes, floppy disks and printouts, studies, memoranda, computation sheets and other documents prepared by Contractor in furtherance of the work shall be the sole property of City and shall be delivered to City whenever requested. Contractor shall keep such documents and materials on file and available for audit by the City for at least three (3) years after completion or earlier termination of this Contract. Contractor may make duplicate copies of such materials and documents for its own files or for such other purposes as may be authorized in writing by the City.
6.4 CORRECTION OF WORK. Contractor shall promptly correct any defective, inaccurate or incomplete tasks, deliverables, goods, services and other work, without additional cost to the City. The performance or acceptance of services furnished by Contractor shall not relieve the Contractor from the obligation to correct subsequently discovered defects, inaccuracy or incompleteness.
6.5 WAIVER. The City's waiver of any term, condition, breach or default of this Contract shall not be considered to be a waiver of any other term, condition, default or breach, nor of a subsequent breach of the one waived.
6.6 SUCCESSORS. This Contract shall inure to the benefit of, and shall be binding upon, the parties hereto and their respective heirs, successors and/or assigns.
6.7 NO ASSIGNMENT. Contractor shall not assign or transfer this Contract or any rights hereunder without the prior written consent of the City and approval by the City Attorney, which may be withheld in the City's sole discretion. Any unauthorized assignment or transfer shall be null and void and shall constitute a material breach by the Contractor of its obligations under this Contract. No assignment shall release the original parties or otherwise constitute a novation.
6.8 COMPLIANCE WITH LAWS. Contractor shall comply with all Federal, State, County and City laws, ordinances, resolutions, rules and regulations, which are, as amended from time to time, incorporated herein and applicable to the performance hereof.
6.9 ATTORNEY'S FEES. If any action at law or in equity is brought to enforce or interpret the terms of this Contract, the prevailing party shall be entitled to reasonable attorney's fees, costs and necessary disbursements in addition to any other relief to which such party may be entitled.
7.0 INTERPRETATION.
7.1 APPLICABLE LAW. This Contract, and the rights and duties of the parties hereunder (both procedural and substantive), shall be governed by and construed according to the laws of the State of California, without regards to its conflict of laws rules.
7.2 ENTIRE CONTRACT. This Contract, including any Exhibits attached hereto, constitutes the entire contract and understanding between the parties regarding its subject matter and supersedes all prior or contemporaneous negotiations, representations, understandings, correspondence, documentation and agreements (written or oral).
7.3 WRITTEN AMENDMENT. This Contract may only be changed by written amendment executed by Contractor and the City Administrator or other authorized representative of the City, subject to any requisite authorization by the City Council. Any oral representations or modifications concerning this Contract shall be of no force or effect.
7.4 SEVERABILITY. If any provision in this Contract is held by any court of competent jurisdiction to be invalid, illegal, void, or unenforceable, such portion shall be deemed severed from this Contract, and the remaining provisions shall nevertheless continue in full force and effect as fully as though such invalid, illegal, or unenforceable portion had never been part of this Contract.
7.5 ORDER OF PRECEDENCE. In case of conflict between the terms of this Contract and the terms contained in any document attached as an Exhibit or otherwise incorporated by reference, the terms of this Contract shall strictly prevail. The terms of the City's Specifications shall control over the Contractor's bid.
7.6 CHOICE OF FORUM. The parties hereby agree that this Contract is to be enforced in accordance with the laws of the State of California, is entered into in the City of Vernon and that all claims or controversies arising out of or related to performance under this Contract shall be submitted to and resolved in a forum within the County of Los Angeles at a place to be determined by the rules of the forum.
7.7 TIME OF ESSENCE. Time is strictly of the essence of this Contract and each and every covenant, term and provision hereof.
7.8 AUTHORITY OF CONTRACTOR. The Contractor hereby represents and warrants to the City that the Contractor has the right, power, legal capacity and authority to enter into and perform its obligations under this Contract, and its execution of this Contract has been duly authorized.
7.9 ARBITRATION OF DISPUTES. Any dispute for under $25,000 arising out of or relating to the negotiation, construction, performance, non-performance, breach or any other aspect of this Contract, shall be settled by binding arbitration in accordance with the Commercial Rules of the American Arbitration Association at Los Angeles, California and judgment upon the award rendered by the Arbitrators may be entered in any court having jurisdiction thereof. This clause shall not preclude the Parties from seeking provisional remedies in aid of arbitration from a court of appropriate jurisdiction. The City does not waive its right to object to the timeliness or sufficiency of any claim filed or required to be filed against the City and reserves the right to conduct full discovery.
7.10 INDEMNITY.
7.10.1 Contractor agrees to indemnify, hold harmless and defend (even if the allegations are false, fraudulent or groundless), to the maximum extent permitted by law, the City, its City Council and each member thereof, and its officers, employees, commission members and representatives, from any and all liability, loss, suits, claims, damages, costs, judgments and expenses (including attorney's fees and costs of litigation) which in whole or in part result from, or arise out of, or are claimed to result from or to arise out of:
A. any activity on or use of City's premises or facilities or any performance under this Contract; or
B. any acts, errors or omissions (including, without limitation, professional negligence) of Contractor, its employees,
representatives, subcontractors, or agents in connection with the performance of this Contract.
7.10.2 This contract to indemnify includes, but is not limited to, personal injury (including death at any time) and property or other damage (including, but without limitation, contract or tort or patent, copyright, trade secret or trademark infringement) sustained by any person or persons (including, but not limited to, companies, or corporations, Contractor and its employees or agents, and members of the general public). The sole negligence or willful misconduct of City, its employees or agents other than Contractor or Contractor’s subcontractors are excluded from this indemnity contract.
7.11 RELEASE. Contractor agrees to release and covenants not to sue the City, its City Council and each member thereof, and its officers, employees, commission members and representatives for any damage or injury (including death) to itself, its officers,
employees, agents and independent contractors damaged or claiming to be damaged from any performance under this Contract.
7.12 INSURANCE. The insurance requirements as they relate to this work shall be in accordance with the terms and conditions described in the Notice Inviting Bids is included in Exhibit 4 – Insurance Requirements.
7.13 NOTICES. Any notice or demand to be given by one party to the other shall be given in writing and by personal delivery or prepaid first-class, registered or certified mail, addressed as follows. Notice simply to the City of Vernon or any other City department is not adequate notice.
If to the City: City of Vernon
Attn: Daniel Wall, Director of Public Works
4305 Santa Fe Avenue
Vernon, CA 90058
With a Copy to: Carlos R. Fandino, Jr.
City Administrator
City of Vernon
4305 Santa Fe Avenue
Vernon, CA 90058
If to the Contractor: Haul-Away Rubbish Service Co., Inc.
Morris M. Beliakoff, Jr., President
1205 Date Street
Montebello, CA 90640
Any such notice shall be deemed to have been given upon delivery, if personally delivered, or, if mailed, upon receipt or upon expiration of three (3) business days from the date of posting, whichever is earlier. Either party may change the address at which it desires to receive notice upon giving written notice of such request to the other party.
7.14 TERMINATION FOR CONVENIENCE (Without Cause). City may terminate this Contract in whole or in part at any time, for any cause or without cause, upon fifteen (15) calendar days' written notice to Contractor. If the Contract is thus terminated by City for reasons other than Contractor's failure to perform its obligations, City shall pay Contractor a prorated amount based on the services satisfactorily completed and accepted prior to the effective date of termination. Such payment shall be Contractor's exclusive remedy for termination without cause.
7.15 DEFAULT. In the event either party materially defaults in its obligations hereunder, the other party may declare a default and terminate this Contract by written notice to the defaulting party. The notice shall specify the basis for the default. The Contract shall terminate unless such default is cured before the effective date of termination stated in such notice, which date shall be no sooner than ten (10) days after the date of the notice.
Termination for cause shall relieve the terminating party of further liability or responsibility under this Contract, including the payment of money, except for payment for services satisfactorily and timely performed prior to the service of the notice of termination, and except for reimbursement of (1) any payments made by the City for service not subsequently performed in a timely and satisfactory manner, and (2) costs incurred by the City in obtaining substitute performance.
7.16 ASSIGNMENT OF ANTITRUST CAUSES OF ACTION. Contractor hereby agrees to assign to the City all rights, title and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. § 15) or under Chapter 2 of the Cartwright Act (commencing with Section 16700) or part 2 of Division 7 of the California Business and Professions Code, or any similar or successor provisions of Federal or State law, arising from purchases of goods, services or materials pursuant to this Contract or any subcontract. This assignment shall be made and become effective at the time the City tenders final payment to the Contractor, without further acknowledgment by the parties.
8.0 ADDITIONAL ASSURANCES
8.1 EQUAL EMPLOYMENT OPPORTUNITY PRACTICES. Contractor
certifies and represents that, during the performance of this Contract, the Contractor and any other parties with whom it may subcontract shall adhere to equal opportunity employment practices to assure that applicants and employees are treated equally and are not discriminated against because of their race, religion, color, national origin, ancestry, disability, sex, age, medical condition, marital status. Contractor further certifies that it will not maintain any segregated facilities. Contractor further agrees to comply with The Equal Employment Opportunity Practices provisions as set forth in Exhibit “D”.
8.2 VERNON BUSINESS LICENSE. Contractor shall obtain, and pay any and all costs associated therewith, any Vernon Business License which may be required by the Vernon Municipal Code.
8.3 MAINTENANCE AND INSPECTION OF RECORDS.
The City, or its authorized auditors or representatives, shall have access to and the right to audit and reproduce any of the Contractor's records to the extent the City deems necessary to insure it is receiving all money to which it is entitled under the Contract and/or is paying only the amounts to which Contractor is properly entitled under the Contract or for other purposes relating to the Contract.
The Contractor shall maintain and preserve all such records for a period of at least 3 years after termination of the Contract.
The Contractor shall maintain all such records in the City of Vernon. If not, the Contractor shall, upon request, promptly deliver the records to the City of Vernon or reimburse the City for all reasonable and extra costs incurred in conducting the audit at a location other than the City of Vernon, including, but not limited to, such additional (out of the City) expenses for personnel, salaries, private auditors, travel, lodging, meals and overhead.
8.4 CONFLICT. Contractor hereby represents, warrants and certifies that no member, officer or employee of the Contractor is a director, officer or employee of the City of Vernon, or a member of any of its boards, commissions or committees, except to the extent permitted by law.
EXHIBIT A
SCOPE OF SERVICES
General Scope of Work:
Under the proposed Labor and Materials Contract (Contract), the selected bidder (Contractor) shall be required to provide mixed waste collection, recycling and disposal services as specified for the following locations:
Address Type
4305 Santa Fe Avenue City Facility
3376 E. 50th Street 2-Bedroom Apartment
3378 E. 50th Street 2-Bedroom Apartment
3380 E. 50th Street 1-Bedroom Apartment
3382 E. 50th Street 1-Bedroom Apartment
3384 E. 50th Street 1-Bedroom Apartment
3386 E. 50th Street 1-Bedroom Apartment
3388 E. 50th Street 2-Bedroom Apartment
3390 E. 50th Street 2-Bedroom Apartment
2221 E. 55th Street City Facility
4990 Seville Avenue City Facility
2716 Leonis Boulevard City Facility
2323 E. Vernon Avenue City Facility
4963 E. Soto Street City Facility
1. The City has eighteen (18) single family homes and two (2) privately owned homes located over approximately 5.2 square miles that currently receive trash service from Haul-Away Rubbish Service Co., Inc.
2. The City requires the Contractor bill the following single-family residences directly for their trash service:
Address Type
3345 Fruitland Avenue 3-Bedroom Home
3349 Fruitland Avenue 2-Bedroom Home
3353 Fruitland Avenue 3-Bedroom Home
3357 Fruitland Avenue 3-Bedroom Home
3361 Fruitland Avenue 3-Bedroom Home
3365 Fruitland Avenue 2-Bedroom Home
3550 East Vernon Avenue 3-Bedroom Home
3560 East Vernon Avenue 2-Bedroom Home
4321 Furlong Place 3-Bedroom Home
4322 Furlong Place 3-Bedroom Home
4323 Furlong Place 2-Bedroom Home
4324 Furlong Place 2-Bedroom Home
4325 Furlong Place 2-Bedroom Home
4326 Furlong Place 2-Bedroom Home
4327 Furlong Place 2-Bedroom Home
4328 Furlong Place 2-Bedroom Home
4329 Furlong Place 3-Bedroom Home
4330 Furlong Place 3-Bedroom Home
2328 Vernon Avenue Duplex 2, 2-Bedroom Homes
2332 Vernon Avenue 4-Bedroom Home
3. The Contractor shall commit to recycling or diverting from disposal as much of the recyclable materials collected from City facilities as feasibly possible. A quarterly report of recycled and materials diverted from disposal shall be submitted to the City (one copy each to the Public Works Department and the Health and Environmental Control Department) by March 1st of each year for the previous year. The quarterly report shall include information on the tonnage and categories of materials (paper, cardboard, aluminum, glass, organic waste, etc.) and the recycling/diversion facilities where the materials were delivered.
4. The Contractor shall clearly summarize their customer service plans, including lines of communication with City residents and City customers.
5. Service for residential customers shall be rendered between the hours of 9:00 a.m. to 4:00 p.m. Service for all other facilities shall be rendered between the hours of 7:00 a.m. to 3:00 p.m.
6. The Contractor shall have a representative in charge at all times whenever any work is in progress by the Contractor.
7. The primary Public Works contact person will be Daniel Wall, Director of Public Works, who may be contacted at (323) 583-8811, ext. 305 or via e-mail at [email protected], Monday through Thursday, 7:00 a.m. to 5:30 p.m.
8. The City considers the Contractor’s Project Manager as a key position towards the success of this Contract. The City expects the Contractor’s Project Manager to be trained in refuse collection and have a minimum of three (3) years of experience in a related field. In addition, the Project Manager shall have excellent oral and written skills, along with a sound technical background in the principles and practices of waste management.
9. If any subcontractor or person employed by the Contractor shall appear to a designated City representative to be incompetent, intemperate, troublesome, or acts in a disorderly or otherwise objectionable manner, he/she shall be immediately discharged from the project on notice provided by the designated City representative.
10. The Contractor’s fleet shall be in compliance with all air pollution laws in accordance with all applicable sections of Title 13, California Code of Regulations.
The Contractor’s fleet shall conform to any and all methods for determining compliance, as it pertains to air pollution laws, for a municipality that contracts with
owners for solid waste collection in the State of California. In addition, all vehicles are required to meet South Coast Air Quality Management District (SCAQMD) clean air regulations.
11. The Contractor has not received a citation or failure-to-abate notice in the last three (3) years from the California Division of Occupational Safety and Health.
12. The Contractor’s terminal, where it maintains the vehicles that will be used to serve the City, has received a rating of Satisfactory (S) by the California Highway Patrol in their most recent (Biennial Inspection of Terminals) inspection.
13. The Contractor shall provide all labor, equipment, materials, tools, and supervision required to perform refuse collection, recycling, and disposal services.
14. The Contractor shall obtain all necessary City, County, State, and Federal permits and/or licenses for Contractor’s activities at no cost to the City.
15. The Contractor shall immediately notify the City of any changes in the Contractor’s insurance, permits, and licenses. Failure to do so may result in the immediate termination of the Contract for default.
16. The Contractor shall conform to all of the City’s safety requirements and operating rules at all times.
17. The Contractor will be responsible for the training, supplying, and usage of all safety equipment. All traffic safety equipment must be approved by the City. Suitable clothing, gloves, and shoes that meet CALOSHA standards are required.
18. The Contractor shall adhere to all CALOSHA standards and EPA guidelines while engaged in refuse hauling and disposal functions.
19. The Contractor shall respond to an authorized City representative’s service request within 24 hours. Regular business hours are 7:00 a.m. to 5:30 p.m., Monday through Thursday. At the sole discretion of the City, a designated City representative may alter the hours and days of services.
20. Holidays observed by the City:
1. January 1st – New Year’s Day
2. The 3rd Monday in January – Martin Luther King, Jr. Day
3. The 3rd Monday in February – Presidents Day
4. March 31st – Cesar Chavez Day
5. The last Monday in May – Memorial Day
6. July 4th – Independence Day
7. The first Monday in September – Labor Day
8. The second Monday in October – Indigenous Peoples’ Day
9. November 11th – Veterans Day
10. The 4th Thursday in November – Thanksgiving Day
11. December 24th – Christmas Eve
12. December 25th – Christmas Day
13. December 31st – New Year’s Eve
21. The City will not provide storage facilities for the Contractor. The City will not be liable or responsible for any damage, by whatever means, or for theft of materials or equipment on the jobsite.
22. All debris derived from these services shall be removed from City property and become the property of the Contractor. The Contractor shall dispose of all debris from these services in a legally established area appropriate for the type of debris being disposed. Disposal shall be at the Contractor’s expense. The Contractor shall not allow any materials or debris from its operations under the Contract to be deposited in the storm drains and/or gutters in violation of the National Pollution Discharge Elimination System or state law.
23. The Contractor shall adhere to state-mandated recycling requirements, including but not limited to AB 341 and SB 1383.
24. The Contractor shall have and maintain a current and valid City of Vernon Franchise Hauler Permit that shall be submitted with the bid package.
25. The Contractor shall maintain all bins in a first-class condition and remove any and all graffiti from trash bins.
EXHIBIT B
SCHEDULE
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r
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SCHEDULE OF BID PRICES
PROJECT: Mixed Waste Collection, Recvclinq anddsposal Services, Contract No. 20240297 BIDDER'S NAME: Haul-Away Rubbish Service Co., Inc.
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 perform the Work within 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:
*One thousand four hundred eighty two and no/100 Dollars Item No. Location Description
1. City Hall Provide two (2) three (3) cubic
4305 Sante Fe yard recycle bins, and pick up
Avenue and dispose of contents two (2)
times per week.
2. City Hall Provide three (3), three (3) cubic
4305 Santa Fe yard mixed waste bins, and pick
Avenue up and dispose of contents two
(2) times per week.
3. City Apartments Provide one (1) three (3) cubic
3376-3390 E. 50th yard recycle bin, and pick up
Street and dispose of contents one (1)
time per week.
4. City Apartments Provide one (1) three (3) cubic
3376-3390 E. 50th yard mixed waste bin, and pick
Street up and dispose of contents one
(1) time per week.
5. Recycling Center Provide four (4) forty (40) yard
2221 E. 55th Street roll-off containers for mixed
waste and pick up, haul and
dispose of contents on an as
needed basis.
6. Recycling Center Provide one (1) three (3) yard
2221 E. 55th Street bin for waste tires and pick up,
haul and dispose of contents on
an as needed basis.
7. Power Plant provide one (1) forty (40) yard
4963 Soto Street roll-off container for mixed
waste. The container should be
($1 482 00
Quantity
2 bins
3 bins
1 bin
1 bin
4 bins
1 bin
1 bin
Monthly Unit
Cost
$55 ea.
$92 ea.
$45 ea.
$79 ea.
$89 /ton
$110 / haul
$95 /ea.
:589 /ton
Total
Monthly
Cost
$110.00
$276.00
$45.00
$79.00
__ 15
tons
Monthly Cost
on hauls per
$95 per
pick up
Monthly Cost
on hauls per n
based
month.
based
onth.
$375 per ha �I
8. Public Utilities
4990 Seville
Avenue
9. Public Utilities -
Gas
2716 Leonis Blvd.
10. Petrelli Electric
2323 E. Vernon
Avenue
11. Petrelli Electric
2323 E. Vernon
Avenue
r 12. Petrelli
2800 Soto Street
13. Station A
4990 Seville
Avenue
14. Station A
4990 Seville
Avenue
,-
15. City Housing
See Pages 9-10
16. City Housing
See Pages 9-10
delivered for use, picked up,
and removed from the facility as
needed. Estimate the container
will be in use for approximately
one month, twice a year.
Provide one (1) three (3) cubic
yard mixed waste bin, and pick
up and dispose of contents one
(1) time per week.
Provide one (1) three (3) cubic
yard mixed waste bin to be
picked up on an as needed
basis.
Provide one (1) three (3) cubic
yard mixed waste bin, and pick
up and dispose of contents one
( 1) time per week.
Provide one (1) three (3) cubic
yard recycle bin, and pick up
and dispose of contents one (1)
time per week.
Provide disposal of contents of
two (2) forty (40) cubic yard
mixed waste bin one ( 1) time
per month.
Provide one (1) three (3) cubic
yard mixed waste bin, and pick
up and dispose of contents one
(1) time per week.
Provide one (1) three (3) cubic
yard recycle bin, and pick up
and dispose of contents one (1)
time per week.
1 bin
1 bin
1 bin
1 bin
2 bin
1 bin
1 bin
SUBTOTAL ITEMS 1-14:
Provide one (1) ninety-six (96)
gal. mixed waste bin, and pick 20
up at each of 20 listed homes homes
and dispose of contents once
per week.
Provide one ( 1) sixty (60) gal.
recycle bin, and pick up at each 20
of 20 listed homes and dispose homes
$79 ea. $79.00
$5
0 ea. $5
0.00 $79 ea. $79.00
$45 $45.00
ea.
Monthly Cost D $
89 /ton on hauls per r�
$110 per ha1 I
$79 $79.00
ea.
$45 ea. $45.00
$982.00
•sase Bid does not include on-call
Roll-Off work
$15/home
$10 /home
$300.00
$200.00
ased
onth.
I I of contents once per week. I I
SUBTOTAL ITEMS 15-16: $500.00
SUBTOTAL COST
PER MONTH $ 500.00
WRITTEN AMOUNT
$ FIVE HUNDRED AND 00/10�
All other work items, labor, materials, tools and incidentals which are not specifically listed in the above bid items, 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 shall 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 shall prevail and shall be divided by the estimated quantity for the item and the price thus obtained shall be the unit price.
Respectfully submitted:
1205 Date Street, Montebello, CA 90640
Signature
President
Title
Business License # OBL-010308
License Number
(SEAL - if Bid is by a corporation)
Address
April 2, 2024
Date
12/31/2024
Date of Expiration
Attest: ______________ _
Amount of Certified or Cashier's Check or Bid Bond $ 10% of Bid Name of Bonding Company: HARCO National Insurance Co.
INCUMBENCY CERTIFICATE
Print legibly the names and title of the president and all officers of the Company who are authorized to sign the Bid Forms:
PRESIDENT'S & OFFICERS' NAME:
Morris M. Beliakoff, Jr. President
David Beliakoff Secretary
EXHIBIT C
PROPOSAL
r
~ BID
f
~' City of Vernon
Mixed Waste Collection, Recycling and Disposal
for the Department of Public Works
~- CONTRACT No. 20240297
City Clerk
4305 Santa Fe Avenue
Vernon, CA 90058
r
Bid Due:
Tuesday, April 9th, 2024 @ 2:00 PM
i d7"atc~ oguTatJ, -eRta,~~i~i esEzv~eE ~o., ~ne.
1205 Date Street
Montebello, CA 90640
r Phone: (323)721-0371 Fax (323)887-0920
info @haulawayrubbish.com
BIDDER'S PROPOSAL
The undersigned submits this Bid in response to the Notice Inviting Bids issued by the City to construct the Work of the following Project in accordance with the Contract Documents:
PROJECT: Mixed Waste Collection, Recycling and Disposal Services, Contract No. 20240297 A. Enclosed herewith and by this reference incorporated herein and made a part of this Bidder's Bid are the following completed forms:
1. Bidder's Proposal
2. Schedule of Bid Prices
3. Incumbency Certificate
4. Bid Security in the following form (check one):
D Cashier's Check □ Certified Check
5. Bidder's Statement of Qualifications
6. Experience Form
� Bid Bond
7. Statement of Violations of Federal, State or Local Law, if applicable
8. Contractor Safety Questionnaire
9. Designation of Subcontractors
10. Contractor's Affidavit of Non-Collusion
11. Insurance Requirements Affidavit
12. Statement of Disqualification or Debarment
13. Pre-Bid Site Inspection Certification
D Cash
B. Acknowledgment of Addenda. The Bidder shall acknowledge the receipt of all Addenda by attaching a signed copy of all Addenda, and by listing all Addenda received and attached in the space below.
Addendum No. 1 - dated April 4, 2024
If an Addendum or Addenda have been issued by the City and not attached and noted above as being received by the Bidder, the Bid may be rejected.
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C. Inspection of the Work and Contract Documents. Bidder certifies that it has carefully examined and is fully familiar with all of the provisions of the Bidding Documents and said Bidding Documents contain sufficient detail regarding the Work to be performed; that it has notified City of any errors or omissions in the Bidding Documents and/or any unusual site conditions; and that it has carefully checked all words, prices, and statements in this Bidding Document. Bidder hereby certifies that he/she and his/her Subcontractors have inspected the site and related Drawings and Specifications of Work and fully acquainted themselves with all conditions and matters which may in any way affect the Work, time of completion or the costs thereof.
Bidder also certifies he/she has observed the designated Contractor Work areas and access routes, if disclosed or shown, as part of the Work in this Contract.
PRE-BID SITE INSPECTION - CERTIFICATION:
Person(s) who inspected site of the proposed Work for your firm:
Name: Morrie Beliakoff, Jr.
Title: President
ame: David Beliakoff
Title: Secretary
Date of Inspection 4/2/2024
Date of Inspection __ 4_!_21_2_0_24 __ _
D. Bidder agrees that all costs of Work shown in the Bidding Documents, including work reasonably inferable therefrom and necessary thereto, are included in his/her Bid. All Work shown in the Contract Documents for which a specific line item is not provided in the Bidding Form is included in the Bidder's Total Base Bid Price.
E. Forfeiture of Bid Security. Bidder further agrees that, in case of his/her default in executing the required Contract and the required bonds, or furnishing the required insurance, the money payable under the Bid Security accompanying this Bid shall be applied by the City towards payment of the damage to the City on account of such default, as provided in the Bidding Documents.
F. Period of lrrevocability. Bidder agrees that this Bid shall remain open and shall not be withdrawn for a period of not less than ninety (90) calendar days from the date of award of Contract, or until rejected by the City, whichever period is shorter.
G. Bid Dispute Indemnification. In the event of a Bid dispute based upon the Bidder's submission of this Bid and the City acceptance of same, the Bidder shall indemnify, defend (with counsel acceptable to City), and hold harmless the City, its City Council members, employees, and agents from liability, daims, demands, damages, and costs arising therefrom if such dispute or action arises solely upon the award of a Contract in compliance with federal, state, and local laws.
The Bidder declares that neither he/she nor any member of his/her firm or corporation is an officer or employee of the City of Vernon.
I hereby certify under penalty of perjury under the laws of the State of California that the representations made herein are true and correct.
Executed this 2nd day of April . 2024, at __ M_o_nt_e_b_el_lo _____ C_a_lii_o_rn_ia ___ _ City State
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Bidder's Proposal
Respectfully Submitted
COMPANY NAME:
ADDRESS:
CONTACT PERSON:
NAME OF BIDDER
Haul-Away Rubbish Service Co., Inc.
1205 Date Street
Montebello, CA 90640
Morris M. Beliakoff, Jr.
TELEPHONE NUMBER: ------------- (323) 721-0371
E-MAIL: [email protected]
CALIFORNIA STATE CONTRACTOR'S LICENSE NUMBER: _______ _ EXPIRATION DATE:
TAX IDENTIFICATION NO.: --95-2------ 905736 ---
SURETY COMPANY: C&D Bonding/Harco
All Bid forms must be signed where so indicated by the person or persons duly authorized to sign on behalf of the Bidder. By signing the Bid, the person signing is deemed to represent that he or she has authority to bind the Bidder.
Failure to sign the Bidder's Proposal may invalidate the Bid.
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BIDDER'S PROPOSAL- SIGNATURE($):
Form of Entity of Bidder:
Please check the appropriate signature block below and fill in all related information. □ Sole Proprietorship:
Name: ____________ _
Title: ____________ _
Signature: ___________ _
List all d/b/a's: -------------------------
D Partnership: D General Partner D Limited Partner
Name: ____________ _
Title: ____________ _
Signature: ___________ _
0 Corporation:
Name: Morris M. Beliakoff, Jr. Corporate Officer Title: _P_re_s_id_e_n__t ___ _ Signature:�.... � b 4-J{ �
□ Joint Venture: D Corporation
D Individual
□Partnership
D Other ----
Name: __________ _
Title: ____________ _
Signature: ___________ _
Name of all Joint Venturers:
Corporate Seal
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[If the Bidder is a corporation or a limited liability company, enter state or county of incorporation in addition to the business address and include an incumbency certificate executed by a Secretary thereof in the form set forth herein listing each officer with signing authority and his/her corresponding office. If the Bidder is a partnership or joint venturer stating that the respective partner or joint venturer agrees to be held jointly and severally liable for any and all of the duties and obligations of the Bidder under the Bid and under any contract arising therefrom. Attach evidence to the Bid Proposal Form that the individual signing has authority to do so.]
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 r—
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. r
State of Califor is
County of f ~~rii`r-o
~P~ ~ g ~d~4 Claudia Eter ' 1'~1o~s~~ry Public On before me, n~t~,~Iira~nontes ry , Date ` ~ w _ ~ ~ n Here Insert ~Q(ame and Title of the Officer personally appeared (`" L l~ ~ < <u ~ l ' 1..~G ~[k' ~-W'f Q r Names) of Signers)
I
r— who proved to me on the basis of satisfactory evidence to be the persons) whose names) is/are subscribed 1, 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 signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. r
certify under PENALTY OF PERJURY under the
'~iM~~ ~ , CLAUDIA EjERNI'i~ ~~D~S~ laws of the State of California that the foregoing COMM. #239433 n paragraph is true and correct.
U NOT pgMlpEIF,,,S ~ ~
O C~,n~~ y 17, 2026 WITNESS my hand and official seal.
Signature
Place Notary Sea! and/or Stamp Above Signature of Notary Public A 11T~/\~~ A t
yr ~ ~v~~r+~
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Documer~~ ~~~ ~~~ n
Title or Type of document: ~ c`~"~
Document Date: ~P~ a S 202 Number of Pages:
Signers) Other Than Named Above: ~ l
Capacity(ies) Claimed by Signers)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑General
D Individual ❑ Attorn in Fact
❑ Trustee ❑ Gu ian of Conservator
❑ Other:
Signer is Representing:
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02017 National Notary Association
Signer's Name:
❑ Corporate Officer — Title(s):
D Partner — ❑Limited ❑General
D Individual ❑Attorney in Fact
❑ Trustee ❑Guardian of Conservator
❑ Other:
Signer is Repre nting:
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SCHEDULE OF BID PRICES
PROJECT: Mixed Waste Collection, Recvclinq anddsposal Services, Contract No. 20240297 BIDDER'S NAME: Haul-Away Rubbish Service Co., Inc.
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 perform the Work within 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:
*One thousand four hundred eighty two and no/100 Dollars Item No. Location Description
1. City Hall Provide two (2) three (3) cubic
4305 Sante Fe yard recycle bins, and pick up
Avenue and dispose of contents two (2)
times per week.
2. City Hall Provide three (3), three (3) cubic
4305 Santa Fe yard mixed waste bins, and pick
Avenue up and dispose of contents two
(2) times per week.
3. City Apartments Provide one (1) three (3) cubic
3376-3390 E. 50th yard recycle bin, and pick up
Street and dispose of contents one (1)
time per week.
4. City Apartments Provide one (1) three (3) cubic
3376-3390 E. 50th yard mixed waste bin, and pick
Street up and dispose of contents one
(1) time per week.
5. Recycling Center Provide four (4) forty (40) yard
2221 E. 55th Street roll-off containers for mixed
waste and pick up, haul and
dispose of contents on an as
needed basis.
6. Recycling Center Provide one (1) three (3) yard
2221 E. 55th Street bin for waste tires and pick up,
haul and dispose of contents on
an as needed basis.
7. Power Plant provide one (1) forty (40) yard
4963 Soto Street roll-off container for mixed
waste. The container should be
($1 482 00
Quantity
2 bins
3 bins
1 bin
1 bin
4 bins
1 bin
1 bin
Monthly Unit
Cost
$55 ea.
$92 ea.
$45 ea.
$79 ea.
$89 /ton
$110 / haul
$95 /ea.
:589 /ton
Total
Monthly
Cost
$110.00
$276.00
$45.00
$79.00
__ 15
tons
Monthly Cost
on hauls per
$95 per
pick up
Monthly Cost
on hauls per n
based
month.
based
onth.
$375 per ha �I
8. Public Utilities
4990 Seville
Avenue
9. Public Utilities -
Gas
2716 Leonis Blvd.
10. Petrelli Electric
2323 E. Vernon
Avenue
11. Petrelli Electric
2323 E. Vernon
Avenue
r 12. Petrelli
2800 Soto Street
13. Station A
4990 Seville
Avenue
14. Station A
4990 Seville
Avenue
,-
15. City Housing
See Pages 9-10
16. City Housing
See Pages 9-10
delivered for use, picked up,
and removed from the facility as
needed. Estimate the container
will be in use for approximately
one month, twice a year.
Provide one (1) three (3) cubic
yard mixed waste bin, and pick
up and dispose of contents one
(1) time per week.
Provide one (1) three (3) cubic
yard mixed waste bin to be
picked up on an as needed
basis.
Provide one (1) three (3) cubic
yard mixed waste bin, and pick
up and dispose of contents one
( 1) time per week.
Provide one (1) three (3) cubic
yard recycle bin, and pick up
and dispose of contents one (1)
time per week.
Provide disposal of contents of
two (2) forty (40) cubic yard
mixed waste bin one ( 1) time
per month.
Provide one (1) three (3) cubic
yard mixed waste bin, and pick
up and dispose of contents one
(1) time per week.
Provide one (1) three (3) cubic
yard recycle bin, and pick up
and dispose of contents one (1)
time per week.
1 bin
1 bin
1 bin
1 bin
2 bin
1 bin
1 bin
SUBTOTAL ITEMS 1-14:
Provide one (1) ninety-six (96)
gal. mixed waste bin, and pick 20
up at each of 20 listed homes homes
and dispose of contents once
per week.
Provide one ( 1) sixty (60) gal.
recycle bin, and pick up at each 20
of 20 listed homes and dispose homes
$79 ea. $79.00
$5
0 ea. $5
0.00 $79 ea. $79.00
$45 $45.00
ea.
Monthly Cost D $
89 /ton on hauls per r�
$110 per ha1 I
$79 $79.00
ea.
$45 ea. $45.00
$982.00
•sase Bid does not include on-call
Roll-Off work
$15/home
$10 /home
$300.00
$200.00
ased
onth.
I I of contents once per week. I I
SUBTOTAL ITEMS 15-16: $500.00
SUBTOTAL COST
PER MONTH $ 500.00
WRITTEN AMOUNT
$ FIVE HUNDRED AND 00/10�
All other work items, labor, materials, tools and incidentals which are not specifically listed in the above bid items, 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 shall 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 shall prevail and shall be divided by the estimated quantity for the item and the price thus obtained shall be the unit price.
Respectfully submitted:
1205 Date Street, Montebello, CA 90640
Signature
President
Title
Business License # OBL-010308
License Number
(SEAL - if Bid is by a corporation)
Address
April 2, 2024
Date
12/31/2024
Date of Expiration
Attest: ______________ _
Amount of Certified or Cashier's Check or Bid Bond $ 10% of Bid Name of Bonding Company: HARCO National Insurance Co.
INCUMBENCY CERTIFICATE
Print legibly the names and title of the president and all officers of the Company who are authorized to sign the Bid Forms:
PRESIDENT'S & OFFICERS' NAME:
Morris M. Beliakoff, Jr. President
David Beliakoff Secretary
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N/A
The undersigned hereby certifies to the City of Vernon that he/she is the duly elected and acting Secretary of Haul-Away Rubbish Service Co .. Inc. (the "Company"), and that, as such, he/she is authorized to execute this Incumbency Certificate on behalf of the Company, and further certifies that the persons named above are the duly elected, qualified and acting officers of the Company, holding on the date hereof, the titles and positions set forth opposite their names and are authorized to sign the Bid Forms.
IN WITNESS WHEREOF, the undersigned has executed this Incumbency Certificate this ---2.mL day of April , 2024
David Beliakoff
Sec�z:ame-Printed
Se� etar{s ,,J8L4= Signature
Bond No.: __ N_/A ______ _
Premium Amount: $ __ 0 ____ _
Bond's Effective Date: _____ _
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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 Califo nia
County of
On APR 0 ~ 201~~
Date
personally appeared NI, o rY ►~s
before me, Claudia Eternz o Miram~ntes ~o~stry Public
. ~ He nse Name and Title of the Officer !~ ~ 3~~~ ~ ~r , ate- _ `a./ Names) of Signers) who proved to me on the basis of satisfiactory evidence to be the persons) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. r
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~...... CI.AUDU EtfRMN ~IA~f1~S0
v
COMM. #2394337 n
` ~ NOTARYPUBUC-IJ1t.FORNA ...,
Q LOS Atd~iB.Es ~s
Carnrn, E~lres Febn~ary 17.2026
Place Notary Seal and/or Stamp Above
certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
Signature of Notary Public
.rte ~ ~~~..~~
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Do~nent
Title or Type of Docum~r~:~~;]..
Document Date: P I~ ~ ' Number of Pages:
Signers) Other Than Named Above: 1J ~ 1~~"
Capacity(ies) Claimed by Signer(sj
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑ neral
❑ Individual Attorney in Fact
❑ Trustee ❑Guardian of Conservator
❑ Other:
Signer is Repr enting:
02017 National Notary Association
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑General
❑ Individual ❑ Att " ey in Fact
o Trustee uardian of Conservator
❑ Other:
Signer is Represe ng:
r Page 30 of 81
61U BOND
RE ITALS:
1. The Cly of Vernon, Cali(crnia ;'City'), has issued a Notice Inviting Bids for the Work described as follows:
Contract No.20240297: Mixetl 4Vasle_CollecGon Re~clinq and Disposa(Serrces in Vernon, CA. ("Project").
2. In response to the h'olice Inviting Bids, HAUL-AWAY RUBBISH SERVICE, CO., 1NC. {Name, address, and telephone of Contractor)
1205 DATE STREET, MONTEBELLO, CA 9064Q, P)323-721-0377 j•princlpaf'}, has submitted the accampanying Bid fa lfie Prcjecf.
3. Prinupal is required under the terms of the Specification and all Bidding Documents referenced in it to furnish a bind vr~lh the Bid.
4. The Specification, im~uding all its amendments and supplements, and Principal's Bid are incorporzfed info this Bond and made a part of ii by th s reference.
QBUGATION:
THEREFORE, for valuo received, We, Pancipal ark
HARCO NATIONAL WSURANCE COMPANY - 42000 SIX FORKS ROAD, SUITE 1400 tNarne, address, and telephone of Surely)
RALEIGH, NC 27609, P)919-833-1600 ('Surety'}, a duly
admitted surety Insurer undor California's latias, agree as follo~vs:
By it s Bond, ~Ve;oinlly and severally obligate and bind ourselves, and our respective heirs, executors, adminis!rators, successors, and assigns to pay Cily the pen21 sum of TEN PERCENT OF AMOUNT BID Dalars {$ toyo cr• etc ('the Bonded S~.mi"), this amount comprising not less than i EN PERCENT (10%) of Principal's Base Bld, In lawful money of the United Stales of Arr,erica.
The Licensed Agent for Surely is: KEVIN E. VEGA, 534 E. BADILLO ST. COVINA, CA 91723, P)626-859-1000 {Name, address, and telephone)
Reg~ste~ ed AgenCs California Deaartment o' Insurance License No. OF92118 _ _,e THE CONDITf ON OF THIS QOND'S OBLfGAT10~ IS THAT, IL (1) Principal does no1(a) wilhdra~v its Bid for the period speufied in the Bidding Docume.~ls, a if no period is specified for ninety (90) ca;endar days after Cily awards the Conlrac( for the Project, or (b} aifempi to withdraw its Bid when the require~nen►s of California Public Contract Code §5101 et seq., cr any successor Ieg:sialian, are not met; or (2) City awards Prindpal the Contract in response to Principal's Bid, and within the time and manner specified by the Spe;.~caGen or Ccnlracl Documen's a if no period is specified vrilhin fourteen (14) calendar days after the Contract's a~Nard, Principal (a) signs and delivers to Cily the Corr;rapt, in accordance tivilh the Bid as accepted, fib) furnishes the ~- required bonds for net oNy Prinapal's faithful performance and groper ful(illmenl o! the Contract, but also Principal's payment fa labor and materials used in the Project, and (c) furnishes the required insurance, then Ihis obligation becomes nuA and void.
Otherwise, this Bond remains in fu6 force and effect, and the following terms 2nd candiGons apply to this Bond:
1. Surelys o~ligaGons undue this Bond are separate, Indepe~denl from, and no; contingent upon any other surety's guaranteeing Iha1 upon Cil~/s awarding the Contract to Principal, the Principal will e~ier in;o the Contract with Cily.
2. No right of aclio~ accrues cn tlris Qond to any entity other iha~ City or its successors ar~d assigns.
3. if an action at law or in equ(ty is necessary io enforce or interpret this Bond's terms, Surely must pay in addition to the Bonded Sum City's reasonable allornays' fees and litigation casts, in an amount the court fixes.
4. Surety shall mail Cily ~ti~iltes~ notice at (eas130 days before: (a) the effective date on wFach the Surety will cancel, terminate, or ~vilhdravr from this Bond; or (b) this bond be~omos vad or unenforceab;e fa any reason.
On lhe dale set forth below. Principal and Surely duly executed this Bond, will\ the name of each party appearing below and signed by ils represenlalive{s) under the authority ol its governing body.
Date: APRIL 8TH, 2024
PRINCIPAL:
HAUL-AWAY RUBBISH SERVICE, CO., INC.
(Company Nam"f'""\
M- � "" �..LJ
(Signature)
"-J --:1.
B
y�orris M. Beliakoff, J
Pres1den,t
Its: ____________ _
(Tille)
Address 101 Serving No!iteS or Other Ooolnen1s:
1205 DATE STREET, MONTEBEUO, CA 90640
CO!l?ORATE SEAL
SURElY:
(Name)
Its: ATTORNEY-in-FACT
(Tille)
.i.ddress for Serving NO'':es or other Documents:
534 E. BADILLO ST. COVINA, CA 91723
CORPOR4TE SEAi.
• EV/DE� MUST BE ATTACHED OF THE AUTHORITY OF ANY PERSON SIGNING AS ATTORNEY-IN-FACT. • THE A TTORNEY./N-FAcrs SIGNATURE MUST BE NOTARIZED.
• A CORPORATE SEAL MUST BE IMPRESSED ON THIS FORM WHEN THE PRINCIPAL, OR THE SURETY, OR BOTH, AREA CORPORATION.
=
.:,
STATE OF CALIFORNIA )
) ss
COUNTY OF )
BOND ACKNOWLEDGMENT
FOR
SURETY'S ATTORNEY-IN-FACT
On this ___ day of ______ _
before me, ___________ ___.
(name), who proved lo me on the basis of satisfactOI}' evidence to be the instrument as the attorney in fact of _________ _,. _ _, and acknowledged lo m& that he/she subscribed lhe name of lhereto as principal, and his/he own name as attorney in fact.
I cer1ify under PENAL TY OF PERJURY under the la of the State ol California that the foregoing paragraph is true and correct.
Notary Public
SEAL
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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. r State of Califo nia ~ ~~
County •f 5 Ain. -~
r On ~PR o ~ 202 before me, Claudia Eternity Miramontes ~o~~Y'Y Public ` Date Here Insert N me and Title of the Officer
personally appeared ~~~ ~'t 3e - ~o
r Names) of Signers)
who proved to me on the basis of satisfactory evidence to be the persons) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their ~ authorized capacity(ies), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. certify under PENALTY OF PERJURY under the
~" ~ ...... . CLAUDIA ETERNffY MIRAMON'TES laws of the State of California that the foregoing E- COMM. #2394337 n paragraph is true and correct.
OU r~tn~r~ue~~c -cu~o~u►
~~E ~~~~~~6~ WITNESS my hand and official seal.
r
~.. Signature
Place Notary Seal and/or Stamp Above Signature of Notary Public AP'~T~/1\t A t
yr ~ ~v~~r+~.
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. r
Description of Attached Do
Title or Type of Document: _
..
Document Date: ~~{~ ~ g ZQ~~ Number of Pages:
Signers) Other Than Named Above: ~ ~ iT
Capacity(ies) Claimed by Signers)
Signer's Name:
❑ Corporate Officer - Title(s):
❑ Partner - ❑Limited D Ge al
❑ Individual ❑ torney in Fact
❑ Trustee Guardian of Conservator
D Other:
Signer is Repre nting:
02017 National Notary Association
Signer's Name:
❑ Corporate Officer - Title(s):
❑ Partner - ❑Limited ❑General
❑ Individual D Attor in Fact
o Trustee ❑ rdian of Conservator
❑ Other:
Signer is Representi
POWER OF ATTORNEY
HARCO NATIONAL INSURANCE COMPANY
Bond # BBSU
INTERNATIONAL FIDELITY INSURANCE COMPANY
Member companies of lAT Insurance Group, Headquartered: 702 Ober{in Road, Raleigh, North Carolina 27605 KNOW ALL MEN BY THESE PRESENTS: That HARCO NATIONAL INSURANCE COMPANY, a corporation organized and existing under the laws of the State of Illinois, and INTERNAT10M11AL FIDELITY INSURANCE COMPANY, a corporation organized and existing under the laws of the Slate of New Jersey, and having their principal o~ces located respectively in the cities of Rolling Meadows, Illinois and Newark, Ne~v Jersey, do hereby constitute and appoint
KEV{N E. VELA, BRITTON CHRISTIANSEN, MYRNA SMITH, PHILIP E. VEGA Covina, CA
their true and lawful attorneys)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of intlemniry and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract -' or otherwise, and the execution of such instruments) in pursuance of these presents, shall be as binding upon the said HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSUf2ANCE COMPANY, as fully and amply, to all intents and purposes, as if the same had been duty executed and acknowledged by their regularly elected officers at their principal offices.
This Power of Attorney is executed, and may be revoked, pursuant to and by authority of the By-Laws of HARCO NATIONAL INSURANCE COMPANY and INTERNATfONAL FIDELITY INSURANCE COMPANY and is granted under and by authority of the following reso(utlon adopted by the Board of - -' Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting duly held on the 13th day of December, 2018 and by the Board of Directors of HARCO NATIONAL INSURANCE COMPANY at a meeting held on the 13th day of December, 2018. 'RESOLVED, that (1) the Chief Executive Officer, President, Executive Vlce President, Senior Vice President, Vice President, or Secretary of the Corporation shall have the power to appoint, and Eo revoke the appointments of, Attorneys-in-Fact or agents with power and authority as defined or limited in their respective powers of attorney, and to execute on behalf of the Corporation and affix the Corporation's seal thereto, bonds, undertakings, -, recognizances, contracts of indemnity and other written obligations in the nature thereof or related thereto; and (2) any such Officers of the Corporation may appoint and revoke the appoinlrnents of joint-control custodians, agents for acceptance of process, and Attorneys-in-fact with authority to execute waivers and consents on behalf of the Corporation; and (3) the signature of any such O(Qcer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond, undertaEcing, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation, to be val id and binding upon the Corporation with the same force and effect as though manually affixed."
IN WITNESS WHEREOF, HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY have each executed and attested these presents on this 31st day of December, 2018
~~0 sG STATE OF NEW JERSEY STATE OF ILLINOIS ~O:•onvoa~f•;~n":
pAQ~~4,. ~9 Count of Essex - ~ ' ° ~ :~'
'~ ~ SEa~ ``~ ~ y
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".~b~ ~~t,~,o~`'.~;~aa
d,~~~,~ + ~~a Kenneth Chapman ~'•, ti~~"*"~ r`
Executive Vice President, Harco National Insurance Company ~~~•~ and International Fidelity insurance Company
On this 31st day of December, 2018 ,before me came the individual tivho executed the preceding instrument, to me personally known, and, being by me duly sworn, said he is the therein described and authorized officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY; that the seals affixed to said Enstrument are the Corporate Seals of said Companies; that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of sa(d Companies. .~`~"`~ ~ "' IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal, at the City of Newark, ``~~~ A•O'''
~ v~ % New Jersey the day and year ilrst above written. r'
(n: c, ~~pTAgY o ~ ~ ^
'~,;~ W ~~¢5~.~~ Shirelle A, Nutley a Notary Public of New Jersey ''~~~~~~'~ My Commission Expires Apri14,2023
CERTIFICATION
I, the undersigned officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATf0I3AL FIDELITY INSURANCE COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Sections of the By-Laws of said Companies as set forth in said Power of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the saEd Power of Attorney has not been revoked and is now in full force and effect.
IN TESTIMONY WHEREOF, I have hereunto set my hand on this day, APRIL 8TI-f, 2024 .l
A00958 ~~ e ~^'
Irene Martins, Assistant Secretary
~~
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT
A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. r
State of California
County of Los Angeles
On APRIL 8th, 2024
before me, Philip Vega ,Notary Public
~. personally appeared Kevin E. Vega
who proved to me on the basis of satisfactory evidence to be the person r 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 signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of State of California that the foregoing paragraph is true and correct. ~, ~ i r PHILIP VELA
M y ,~~~" y`~ Notary Public -California
~ ~ ~
^
Los Angeles County ~
'~~~ox"~~ My
Commission k 2327592
Comm. Expires May 31, 2024
PLACE NOTARY SEAL ABOVE
WITNESS my hand and official seal.
SIGNATURE
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BIDDER'S STATEMENT OF QUALIFICATIONS
1. ORGANIZATION
1.1 How many years has your organization been in business as a Contractor? _7_5 __ _
1.2 How many years has your organization been in business under its present name? 75
1.2.1 Under what other names has your organization operated? none
1.3 If your organization is a corporation, answer the following:
1.4 1.5
1.6 1.3.1 Date of incorporation/organization: __ Jun_e__30_,_1_9_73 __ _ _____ _
1.3.2 State of incorporation/organization: California Secretary of State
1.3.3 Corporate ID number: __ C_0 _7_02_0_7__3 _ __________ _
1.3.4 Name of President: Morris M. Beliakoff, Jr.
1.3.5 Agent for Service of Process: Morris M. Beliakoff, Jr.
If your organization is a partnership, answer the following:
1.4.1 Date of organization/formation: ______________ _
1.4.2 Type of partnership (if applicable): ____________ _
1.4.3 Name(s) of general partner(s): _____________ _
1.4.4 List all states in which you are registered and state ID numbers for each:
If your organization is individually owned, answer the following:
1.5.1 Date of organization: _________________ _
1.5.2 Name of owner: __________________ _
If the form of your organization is other than those listed above, describe it and name the principals: _______________________ _
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2. LICENSING
2.1 List jurisdictions in which your organization is legally qualified to do business, indicate registration or license numbers, and category of license, if applicable.
2.2 2.3
3. 3.1
4. Bell Gardens (License# 10004); Commerce (License# 8934557, 8913363, 8927757); El Segundo (Acct# 29476, 29477); Long Beach (Acct# BU01068070); Montebello (License# 10704898); Torrance (BL-LIC-015058); Vernon (OBL-010308) List jurisdictions in which your organization's partnership or trade name is filed.
List any licensing suspensions and/or violations assessed against your organization within the past five years.
NONE
EXPERIENCE
List the categories of Work that your organization normally performs with its own personnel.
3.2 3.3
Waste and Recycling Collection Services.
On the Experience Form, list the project information that establishes that Bidder meets the essential requirements for qualification set forth in the Mandatory Qualifications paragraph of the Notice I nvijing Bids for this Project.
On a separate sheet, list projects to which your firm or business has been awarded a government contract since your firm or business has been in existence (giving the name and address of the project, the government agency, contact name and phone number, the contract amount, and contract's starting date and ending date).
3.4 On a separate sheet, list the experience and present commitments of the key individuals of your organization.
CLAIMS; LAWSUITS; CRIMINAL ACTS
For the following questions, the term "owner" does not include owners of stock in your firm if your firm is a publicly traded corporation.
4.1 In the past five (5) years, have, you, your firm or any of its owners, partners, officers, or employees been a defendant in court, or participated in an arbitration or mediation, on a matter related to:
,-
4.1.1 The performance, non-performance, default, violation, or breach of a contract or agreement?
□ YES � NO
4.1.2 A vehicle collision or accident involving your firm's employees? � YES ONO
4.1.3 Damage to real property arising out of your services or operations? □ YES �NO
4.1.4 Employment-related litigation brought by an employee of your firm? □ YES �NO
4.1.5 Payment to a subcontractor or supplier?
□ YES �NO
4.1.6 Defective, deficient, or substandard work?
□ YES � NO
If the answer to any questions in 4.1.1 to 4.1.6 is YES, identify the name of the person or entity that sued (i.e., "the plaintiff'') or was involved in the mediation or arbitration; list the date, court, court address, and case number; describe the facts and circumstances giving rise to the lawsuit, mediation, or arbitration; and set forth the outcome or disposition. Attach additional sheets as necessary. ~see attached~
4.2 Have you or your firm ever filed a claim for damages or a lawsuit, or requested arbitration or mediation, against a government entity or a Client?
□ YES � NO
If YES, identify the government entity or client; list the date, court and case number; describe the facts and circumstances about the claim for damages, or the lawsuit, or both; and set forth the outcome or disposition. Attach additional sheets as necessary.
4.3 Are there any pending or outstanding judgments or liens against you, your firm, or any of its owners, partners, officers, or employees?
□ YES � NO
If YES, identify the name of the person or entity entitled to payment; list the date court and case number; describe the facts and circumstances giving rise to the judgment or lien; and set forth the amount of the judgment or lien. Attach additional sheets if necessary.
4.4 In the past five (5) years, has any government entity ever: (a) investigated, cited, disciplined,
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4.5 4.6
or assessed any penalties against you, your firm, or any of its owners, partners, officers, or employees, or (b) determined or concluded that your firm or any of its owners, partners, officers, or employees violated any laws, rules, or regulations? □ YES �NO
If YES, identify the government entity; list the date, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
In the past five (5) years, have you, your firm or any of its owners, partners, officers or employees been convicted of a crime related to the bidding of a government contract, the awarding of a government contract, or the performance of a government contract? ("Convicted" includes a verdict of guilty by a judge or jury, a plea of guilty, a plea of nolo contendere, or a forfeiture of bail.)
□ YES
If YES, identify the government entity; list the date, court and case number; describe the facts and circumstances about each instance; and set forth the penalty or punishment imposed. Attach additional sheets as necessary.
In the past five (5) years, have you, your firm, or any of its owners, partners, officers or employees been convicted of a crime involving embezzlement, theft, fraud, forgery, bribery, deceptive or unlawful business practices, perjury, falsifying or destroying records or evidence, or receiving stolen property, or making or submitting a false claim? □ YES
If YES, identify the crime or offense; list the date, court and case number; describe the facts and circumstances about each instance; and set forth the penalty or punishment imposed. Attach additional sheets as necessary.
4. 7 Have you or, if Bidder is a corporation, any principal of the corporation ever been convicted of a felony?
□ YES �NO
If YES, please explain the details of that conviction and, if so, whether you or said officer have served his or her sentence.
4.8 In the past five (5) years, has a government entity determined or concluded that you, your firm, or any of its owners, partners, officers or employees made or submitted a false claim (including a false claim for payment), or made a material misrepresentation? □ YES �NO
If YES, identify the government entity, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
Page40 of 81
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4.9 Have you or your company ever been charged by any governmental agency for failure to follow safety procedures? If YES, please explain.
□ YES �NO
4.10 Has any governmental agency ever submitted a complaint against you or your firm to the California State Labor Commission for failure to submit certified payrolls? If your answer is "Yes", please provide the details of such complaint.
5. FIRM'S OPERATIONAL STATUS
□ YES �NO
5.1. In the past seven (7) years, has your firm, or anyone else acting on behalf of your firm, filed for bankruptcy, insolvency, receivership, or reorganization? □ YES
If YES, list the filing date, identify the court and case number; describe the facts and circumstances giving rise to each instance; and set forth the disposition or current status.
Attach addrrional sheets as necessary.
5.2. In the past five (5) years, has your firm had an consolidations, mergers, acquisitions, closings, layoffs or staff reductions?
□ YES �NO
If YES, list the filing date, and describe the facts and circumstances about each instance.
Attach addrrional sheets as necessary.
5.3. Is your firm in the process of, or in negotiations toward: (a) consolidating, merging, selling, or closing its business, or (b) laying off employees or reducing staff? □ YES
If YES, describe the transaction; list the anticipated date for completing the transaction, laying off employees, or reducing staff; and describe the facts, circumstances, and reason for taking the action. Attach additional sheets as necessary.
6. BIDDING; DEBARMENT; CONTRACT PERFORMANCE
6.1. Has a government entity ever debarred, disqualified, removed, suspended, or otherwise prevented you or your firm from bidding on, contracting, or completing a construction project?
□ YES �NO
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If YES, identify the name of the government entity, list the date, and describe the facts and circumstances about each instance, and state the reason for the government enttty's action against your firm. Attach addttional sheets as necessary.
6.2. Has a government entity ever rejected your firm's Bid or Proposal on the ground that you or your firm is a "non-responsible" bidder or proposer? □ YES
If YES, identify the name of the government entity, list the date, describe the facts and circumstances about each instance, and state the reason or basis for the government entity's determining that your firm was a "non-responsible" bidder. Attach additional sheets as necessary.
6.3. Have you or your firm ever failed to fulfill or perform - etther partially or completely - a contract or an agreement with a government entity or a client? □ YES
If YES, identify the name of the government entity or client, list the date, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
6.4. In the past five (5) years, have you or any officer or principal of your firm been an officer of another firm which failed to perform a contract or agreement? □ YES
If YES, list the date, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
6.5. Has your firm ever advised a government entity or a client, while your firm was under contract with the government entity or client, that your firm could not (or would not) fulfill or perform - either partially or completely-the contract or the agreement based on the prices that your firm had originally submitted in a Bid or a Proposal? □ YES �NO
If YES, list the date, identify the name of the government entity or client, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
6.6. Has your firm ever requested a government entity or a client, while your firm was under contract with the government entity or client, to renegotiate one or more terms of the existing contract or agreement?
□ YES · � NO
If YES, identify the name of the government entity or client, list the date, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
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6.7. Has your firm ever requested a government entity or a client, while your firm was under contract with the government entity or client, to: (a) cancel the contract or agreement, or (b) release or discharge your firm form the contract or agreement? □ YES �NO
If YES, identify the name of the government entity or client, list the date, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
6.8. Has a government entity or a client ever terminated, suspended, or non-renewed your firm's contract or agreement before its completion?
6.9. 6.10.
□ YES l,gl NO
If YES, identify the name of the government entity, list the date, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
Has a government entity or a client ever notified or advised your firm that your firm's performance under a contract or agreement was poor, sub-standard, deficient, or noncompliant? □ YES �NO
If YES, identify the name of the government entity or client, list the date, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
In the past five (5) years, has your firm paid, or has your firm been assessed, liquidated damages on a contract or agreement?
□ YES �NO
If YES, identify all such contracts/projects by owner, owner's address, the date of completion of the project, amount of liquidated damages assessed, and all other information necessary to fully explain the assessment or payment of liquidated damages. Attach additional sheets as necessary.
7. INSURANCE AND BONDS
7.1. In the past ten years, has an insurance company or a surety company:
7 .1.1. Refused to insure your firm for liability coverage? □ YES �NO
7 .1.2. Canceled or non-renewed your firm's insurance coverage? □ YES
7.1.3. Refused to issue your firm a bond?
□ YES
�NO
7 .1.4. Canceled or revoked a bond obtained by your firm? □ YES �NO
If the answer to any questions in 7.1.1 to 7.1.4 is YES, identify the name of the insurance company or surety company, list the date, and describe the facts and circumstances about each instance. Attach addition sheets as necessary.
7.2 In the past ten (10) years, has an insurance company or surety company made any payments on your firm's behalf as a result of a default, to satisfy any claims against a performance bond, payment bond, or maintenance bond issued on your firm's behalf? □ YES �NO
If YES, identify each contract completed or amount of each claim, the name and telephone number of the claimant, the date, grounds and current status of the claim, and if resolved, the method, nature, and amount of the resolution. Attach addition sheets as necessary.
8. SURETY
8.1 8.2
If a performance and/or payment bond is required by this bid, identify the bonding company if arrangements for the bond have been made; if not, identify the bonding company for the Contractor's most recent project:
HARCO National Insurance Company
Name and address of agent:
Kevin Vega - C&D Bonding & Insurance Services
534 E Badillo St. Covina CA 91723
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.
I hereby certify under penalty of perjury under the laws of the state of California that the representation made herein are true and correct.
Signature of Bidder M- J,,._ I:, J.. J_ 0 S
Morris M. Beliakoff, Jr.
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVfL CODE § 1189 A notary public or other officer completing this certificate verifies onlythe identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. r
State of California `~.
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County of ~~j ,,.
~` APR 0 ~ ~0~~ f On before me, Claudia Eternity Miramontes ~Q~~l'Y Public Date Here Insert Na e an Title of the Officer
r.., personally appeared •
i Name(s) of Signers)
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~-- who proved to me on the basis of satisfactory evidence to be the persons) whose names} is/are subscribed ~ to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. r
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certify under PENALTY OF PERJURY under the
ClAUDIA~~~~}~///~~~ ~~/^ /~'/~ laws of the State of California that the foregoing ~ COMM. #2394337
paragraph is true and correct.
V NOT,~a~r~us~.~c-cAt.~or~ n
~ ~osaNc~~s ~ WITNESS my hand and official seal.
Can fires Februcuy 17. 2026
Signature
Place Notary Seal and/or Stamp Above Signature of Notary Public A P1T~/1\t A t
yr ~ ~v~~r~~.
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Doc me t I
Title or Type of Document: ~ ~ ~ c~ f~~ G~
Document Date: ~ P ~ ~ ~ ~~7~ Number of Pages:
Signers) Other Than Named Above: N L/~'
Capacity(ies) Claimed by Signers)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑General
❑ Individual ❑ Attor yin Fact
❑ Trustee ❑ rdian of Conservator
❑ Other:
Signer is Representi
02017 National Notary Association
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑ G neral
❑ Individual ttorney in Fact
o Trustee Guardian of Conservator
❑ Other:
Signer is Repr nting:
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BIDDER'S EXPERIENCE FORM
PROJECT NAME: Mixed Waste Collection, Recycling and Disposal Services COMPANY NAME: Haul-Away Fubbish Service Co., Inc.
CONTRACT NO. -------- 20240297 --------
***Please use additional sheets if necessary
List below the project information that establishes that Bidder meets the essential requirements for qualification set forth in the Mandatory Qualifications paragraph of the Notice Inviting Bids for this Project.
2 3
CONTRACT CONTRACT CONTRACT PROJECT NAME AND CONTACT PHONE START DATE END DATE $ AMOUNT AGENCY ADDRESS CONTACT NAME NUMBER 1/1/2015 5/12/2024 Citv Of Vernon 4305 Santa Fe Avenue Daniel Wall (323) 583- 8811 --&t)±
Fe.fuse
sp:,satColloctioo, Focycl rg Vernon, CA 90058 Dir-Public Works ext. 305 Servi ... �....,
Cept of R.Jblic ittks
City of Long Beach 2929 E. Willow Street Barbara Moore (562) 570-2811 R.blic Wxks/Ehvircrm=nta Long Beach, CA 908(6
8/16/2010 9/30/2024 Services fura3u
Citv of Bell Gardens 8327 Garfield Avenue (562) 806-7770 1/1/2022 12/31/202€
Bell Gardens, CA 90201 6122
All of the above statements as to experience are submitted in conjunction with the proposal, as a part thereof, and the truthfulness and accuracy of the information is guaranteed by the Bidder. I hereby certify under penalty of perjury under the laws of the state of California that the representation made herein are true and correct.
Signature of Bidder fu - A... /6 J.. J Q (_
Print Name: Morris M. Beliakoff, Jr.
State of California Contractor's License No. ________ _ Contractor's License expiration date ___________ _
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of Califor is
County of
o~~
before me, Claudia Eternity Miramontes ~a~Ai'3' Public
Here Insert Name and Title of the Officer
On
Date
~ personally appeared
Names) of Signe
~, who proved to me on the basis of satisfactory evidence to be the persons) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their j authorized capacity(ies), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. ,..:.. CLAUDIA ETERNITY MIRAMONTES ~
H COMM. #2394337 n
U Hora~rPttauc-cn~~ow~u►
O cos a~c~~s
Ekes Fetxucsy 17.2026
Place Notary Seal and/or Stamp Above
certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
Signature of Notary Public
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached D
Title or Type of Document: ,., ~ - ~~~
Document gate: APR ~ ~ ~OZ~ ~ Number of Pages: ~__
Signers) Other Than Named Above:
Capacity(ies) Claimed by Signers)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑General
❑ Individual ❑ Attorney n Fact
❑ Trustee o Guard' of Conservator
O Other:
Signer is Representing:
02017 National Notary Association
Signer's Name:
❑ Corporate Officer — Title(s):
o Partner — ❑Limited ❑ neral
❑ Individual Attorney in Fact
o Trustee Guardian of Conservator
❑ Other:
Signer is Representing:
CONTRACTOR SAFETY QUESTIONNAIRE
Company Name: Haul-Away Rubbish Service Co., Inc.
Primary Type of Work: Waste & Recycling Collection Serv ices
Person Completing Form: Morrie Beliakoff, Jr.
Title: President
Date: 4/2/2024
Phone umber: (323) 721-0371
SAFETY PERFORMANCE
1. List your company's Interstate Experience Rating Modifier {ERM) 1 for the three most recent years. _62.?6._ ________ _
67%
65%
2. List your company's number of injuries/illnesses from your OSHA 300 logs for the three most recent years.
20.ll_ 202.L_ 202.L_
a. Fatalities o o o
b. OSHA recordable incidents
c. Lost work day incidents
d. Total lost work days
e. Total hours worked
0 _o _
0 62,793
_o_ 1
_ o_
0 180
63.581 �
3. Upon request from the City, the contractor(s) shall provide copies of the following items (a-g); and Items ( dg) for each listed Subcontractor a). OSHA 300 logs for the most recent three years
and current year-to-date
b). Verification of ERM from your insurance carrier
c). Injury/Illness Report
d). Complete written Safety Program
4. Company Safety Contact:
a. Name Morrie Beliakoff, Jr.
b. Phone (323) 721-0371
e). Training Plans
�- Training Certificates for Employees
g). Emergency Response Training
1 ERM = applies to workers' compensation policies. It compares the experience of this contractor to others of similar size, type and ratio. Used against annual premium. II has a direct correlation to how much the contractor pays in workers' comp premium.
CONTRACTOR SAFETY QUESTIONNAIRE (continued)
SAFETY PROGRAM
1. SAFETY PROGRAM DOCUMENTATION
a. Do you have a written safety program manual?
1) Last revision date ----=5:..:..:/2=--=4=/2=0=22=---- b. Do you have a written safety field manual?
c. Are all workers given a booklet that contains work rules, responsibilities, and other appropriate information?
2. POLICY AND MANAGEMENT SUPPORT
a. Do you have a safety policy statement from an officer of the company?
b. Do you have a disciplinary process for enforcement
of your safety program?
c. Does management set corporate safety goals?
d. Does executive management review:
D Accident reports?
D Safety statistics?
D Inspection reports?
e. Do you safety pre-qualify subcontractors?
f. Do you have a written policy on accident reporting
and investigation?
g. Do you have a light-duty, return-to-work policy?
N/A
h. Is safety part of your supervisor's performance evaluation? i. Do you have a personal protective equipment (PPE) policy? Circle One
I Yes �o
I Yes �o
I Yes �o
I Yes �o
I Yes �o
( Yes �o
�o
0 0
¥es-Ne-
( Yes Jo
Ye◄ Flo
I ?es �o
( Yes �o
j. Do you have a written substance abuse program? I Yes �o If yes, does it include (check all applicable boxes):
� Pre-employment testing D Return-to-duty testing
[¼] Random testing [¼] Disciplinary process
D Reasonable cause testing D Alcohol testing
D Post accident testing D National Institute on Drug Abuse I¼! Panel Screen X California Employer Notice Program
� FMCSA Clearinghouse
k. Does each level of management have assigned safety ,.I ""'Ye_s.,.. �o
duties and responsibilities?
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3. TRAINING AND ORIENTATION
a. Do you conduct safety orientation training for each
employee?
b. Do you conduct site safety orientation for every
person new to the job stte?
I Yes �o
I Yes �o
c. Does your safety program require safety training meetings? I Yes �o for each supervisor (foreman and above)?
How often?
D Weekly D Monthly� Quarterly D Annually D Other ___ _
d. Do you hold tool box/tailgate safety meetings
focused on your specific work operations/exposures?
How often?
Ye◄ No I
□ Weekly □ Daily □ Other ___ _
e. Do you require equipment operation/certification training?
4. ADMINISTRATION AND PROCEDURES
a. Does your written safety program address
administrative procedures?
If yes, check which apply:
I Yes �o
I Yes �o
_ Pre project/task planning
X Record keeping
_x Emergency procedures
_ Audits/inspections
_ Safety committees
HAZCOM
X Accident investigations/reporting
_ Training documentation
_ Substance abuse prevention
Return-to-work
_ Hazardous work permits
_ Subcontractor prequalification
b. Do you have project safety committees?
c. Do you conduct job site safety inspections?
How often?
ffiil,o
I Yes �o
� Daily □ Weekly □ Monthly □ Other ___ _
Do these inspections includes a routine safety
inspection of equipment (e.g., scaffold, ladders, fire
extinguishers, etc.)?
d. Do you investigate accidents?
How are they reported?
D Total company
D By project
D By superintendent
D By project manager
I Yes l)o
I Yes lo
D By foreman � In accordance with OSHA
e. Do you discuss safety at all preconstruction and progress meetings? ¥es-1"leN/A
f. Do
D
you
For
perform
personnel
rigging
D
and
For
lifting
equipment
checks prior
D
to
Heavy
lifting?
lifts
Ye'1To"'1(moretFi'an 10,000 lbs.)
5. WORK RULES
a. Do you periodically update work rules? I Yes �o
b.
When was the last update? Review at Safety Meetings
What work practices are addressed by your work rules?
D CPR/first aid � Access-entrances/stairs
� Barricades, signs, 5a Respiratory protection
and signals
D Blasting
� Communications
� Compressed air and gases
D Concrete work
D Confined-space entry
D Cranes/rigging and hoisting
D Electrical grounding
D Environmental controls and
Occupational health
� Emergency procedures
1¼J Fire protection and prevention
D Floor and wall openings
D Fall protection
� Housekeeping
D Ladders and scaffolds
� Mechanical equipment/
maintenance/pre-op checks/
operation
D Welding and cutting (hot work)
D Material handling/storage
D Temporary heat
� Vehicle safety
� Traffic control
� Site visitor escorting
D Public protection
D Equipment guards and grounding
5a Monitoring equipment
D Flammable material handling/storage
D Site sanitation
D Trenching and excavating
D Lockout/Tagout
D Energized/pressurized equipment
� Personal protective equipment
� Tools, power and hand
� Electrical power lines
D Other _______ _
6. OSHA INSPECTIONS
a. Have you been inspected by OSHA in the last three years? O][)No b. Were these inspections in response to complaints?
c. Have you been cited as a result of these inspections? If yes, describe the citations (add additional sheets if necessary):
Inspection on a truck showed that it did not have a proper label that the manufacturer of that truck was responsible for installing. The manufacturer sent the specific label to install.
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DESIGNATION OF SUBCONTRACTORS
NAME OF BIDDER: Haul-Away Rubbish Service Co., Inc.
Each Bidder must list, on the form provided on the next page, each Subcontractor who will perform work or labor or render service to the Contractor in or about the construction of the Work or improvement, or a Subcontractor licensed in the State of California who, under subcontract to the Contractor, specially fabricates and installs a portion of the Work or improvement according to detailed drawings contained in the Drawings and Specifications, in an amount in excess of one-half of one percent of the Contractor's Base Bid Amount. Each Subcontractor must have an active and current license, and all requisite specialty certifications, when listed.
Bidder must provide the following information for EACH Subcontractor.
1. The name of the Subcontractor;
2. The trade and type of work that the Subcontractor will perform;
3. Location (address) of Subcontractor's place of business;
4. Subcontractor's license number; and any specialty licenses;
5. Subcontractor's public works contractor registration number; and
6. Dollar value of the Work that the Subcontractor will perform.
Subletting or subcontracting of any portion of the Work in excess of one-half of one percent of the Contractor's Base Bid to which no Subcontractor was designated in the original Bid shall only be permitted in cases of public emergency or necessity, and then only after a finding reduced to writing as a public record of the City setting forth the facts constituting the emergency or necessity.
If the Contractor violates any of the above provisions the Contractor may be in breach of this Contract and the City may exercise the option, in its own discretion, to (1) cancel this Contract, or (2) assess the Contractor a penalty in an amount not more than ten percent (10%) of the amount of the subcontract involved, and this penalty shall be deposited in the fund out of which the prime Contract is awarded.
If the Contractor fails to specify a Subcontractor, or if the Contractor specifies more than one Subcontractor for the same trade or type of Work to be performed under the Contract in excess of one-half of one percent of the Contractor's Base Bid Amount, then the Contractor agrees that he/she is fully qualified to perform that Work himself/herself, and that he/she shall perform that Work himself/herself. If after award of Contract, the Contractor subcontracts any such Work, the Contractor will be subject to the statutory penalties.
DESIGNATION OF SUBCONTRACTORS FORM
IS ON THE FOLLOWING PAGE
Please type or legibly print (attach additional sheets as necessary).
Public Works
Name of Subcontractor Email Contact Trade and Type Business Location Information of Work to be License Contractor Dollar ($) Value Number Registration Performed Number
N/A
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The Contractor shall not:
A. Substitute any person as Subcontractor in place of the Subcontractor listed in the original Bid, except that the City may consent to the substitution of another person as Subcontractor in any of the following situations:
1. When the Subcontractor listed in the Bid, after having had a reasonable opportunity to do so, fails or refuses to execute a written contract for the scope of Work specified in the Subcontractor's bid and at the price specified in the Subcontractor's bid, when that written contract, based upon the general terms, conditions, Drawings and Specifications for the Project or the terms of Contractor's written Bid, is presented to the Subcontractor by the Contractor;
2. When the listed Subcontractor becomes insolvent or the subject of an order for relief in bankruptcy;
3. When the listed Subcontractor fails or refuses to perform his/her subcontract;
4. When the listed Subcontractor fails or refuses to meet the bond requirements of the Contractor as set forth in Public Contract Code Section 4108;
5. When the Contractor demonstrates to the City that the name of the Subcontractor was listed as the result of an inadvertent clerical error;
6. When the listed Subcontractor is not licensed pursuant to the Contractors License Law;
7. When the City determines that the Work performed by the listed Subcontractor is substantially unsatisfactory and not in substantial accordance with the Drawings and Specifications, or that the Subcontractor is substantially delaying or disrupting the progress of the Work;
8. When the listed Subcontractor is ineligible to work on a public works project pursuant to Section 1777 .1 or 1777. 7 of the Labor Code; or
9. When the City determines that the listed Subcontractor is not a responsible contractor.
B. Permit any subcontract to be voluntarily assigned or transferred or allow it to be performed by anyone other than the original Subcontractor listed in the original Bid, without the consent of the City.
C. Other than in the performance of "change orders" causing changes or deviations from the original Contract, sublet or subcontract any portion of the Work in excess of one-half of one percent of the Contractor's Base Bid Amount as to which his/her original Bid did not designate a Subcontractor.
Prior to approval of the Contractor's request for a Subcontractor substitution, the City shall give notice in writing to the listed Subcontractor of the Contractor's request to substitute and of the reason for the request. The notice will be served by certified or registered mail to the last known address of the Subcontractor. The listed Subcontractor who has been so notified shall have five (5) Working Days within which to transmit to the City written objections to the substitution. Failure to file these written objections shall constitute the listed Subcontractor's consent to the substitution.
If written objections are filed, the City shall give notice in writing of at least five (5) Working Days to the listed Subcontractor of a hearing by the City on the Contractor's request for substitution.
The Contractor, as a condition to asserting a claim of inadvertent clerical error in the listing of a Subcontractor, shall within two (2) Working Days after the time of the Bid Deadline, give written notice to the City and copies of such notice to both the Subcontractor he/she claims to have listed in error and the intended Subcontractor who had bid to the Contractor prior to the Bid Deadline.
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QUESTIONNAIRE 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
2. 3.
4. 5.
bid? Yes □ No � N/A
If the answer to No. 1 is "Yes", please forward a copy of the rules of each bid deposttory you used with this questionnaire.
Did you have any source of subcontractors' bids other than bid depositories? NIA 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□ No� N/A
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? Yes D No� NIA
7. Was a conscious effort made to recrutt and hire project area lower-income residents? Yes□ No� NIA
Please submit statement.
8. We declare under penalty of perjury that the foregoing is true and correct.
Dated this 2nd day of April , 20�.
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.
Name of Company
By: I'!::- h f>A,LJ� C
Title: President
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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 Califo nia
County of
On APR Q B 201 before me, Claudia Eternzty Miramontes ~p~Ax'Y Public Date Here Insert Name d Title of the Officer
personally appeared Y l ~ ~ c
who proved to me on the basis of satisfactory evidence to be the persons) whose names) is/are subscribed r 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 signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. r
::.»... CLAU0IA Et'ERNIIY MIRAMOI~t1E$ ~
~ ~ COMM. #2394337
V NOTARYPUBLIC.GAf.IFpRNU1 ~
~ LOS ANGELES ,,,,
Corm. Expires Febnx~y 17.2026
r Place Notary Seal and/or Stamp Above
certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
Signature of Notary Public
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached D ument ,/
Title or Type of Document: U c3} ~- ~ 9 ~~
Document Date: A~R ~ ~ U~~ Number of Pages:
Signers) Other Than Named Above: ~~ L~—
Capacity(ies) Claimed by Signers)
Signer's Name:
o Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑General
❑ Individual ❑Attorney in t
o Trustee ❑ Guardi of Conservator
❑ Other:
Signer is Representing:
02017 National Notary Association
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑General
❑ Individual ❑ torney in Fact
❑ Trustee ❑Guardian of Conservator
❑ Other:
Signer is epresenting:
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CONTRACTOR'S AFFIDAVIT OF NON-COLLUSION
STATE OF CALIFORNIA )
COUNTY OF Los Angeles
) ss
)
_Mo__rr _isM_. _B_e_l_ia_k_off_,_J_ r_. ______ being first duly sworn, deposes and says:
1. That he/she is the President (Title of office if a corporation, "sole owner," "Partner," or other proper title) of Haul-Away Rubbish Service Co., Inc. , (hereinafter called "Contractor") who has submitted to the City of Vernon a Bid for the construction of the Mixed Waste Collection, Recycling and Disposal Services, City Contract No. 20240297
2. That said Bid is genuine; that the same is not sham; that all statements of fact therein are true;
3. That 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 else to submit a false or sham bid, to refrain from bidding, or withdraw his/her bid, to raise or fix the Bid price of Contractor or of anyone else, 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 other 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 which 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; Ill
Ill
Ill
Ill
Ill
Ill
Ill
Ill
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 financial 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� day of __ A_p_ril _, _20_2_4 ___ at __ M_on_te_b_e_llo _____ _ Month/Year City
Morris M. Beliakoff, Jr.
Contractor (Please Print)
Contractor's Signature �
President
Title
California
State
CALIFORNIA ALL-PUF2POSE 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. rState of Ca "fornia `,,
~s County of v~~w-~ .
r on APR a ~ ~~Z~ before me, Claudia Eternity Miramonte~ ~Q~AI'Y Public l Date Here nse a e and Title of the Officer
personally appeared J r ` ` ' ~ ! 7''
r Name(sJ of Sign r(s)
r. who proved to me on the basis of satisfactory evidence to be the persons) whose names) is/are subscribed f to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their i authorized capacity(ies), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument.
ClAUD1A E"fERNI~ ~~~ ~
COMM. #2394337 ~
V KOT~~ .~
p Cam~~ wary 17.2026
Place Notary Seal and/or Stamp Above
certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
Signature of Notary Public
yr ~ ~v~~r~~
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Do ent
Title or Type of Document: ~~- I~~n Lass I, ~ (S!0'-V
Document Date: Number of Pages:
Signers) Other Than Named Above:
J
Capacity(ies) Claimed by Signers)
Signer's Name:
o Corporate Officer - Title(s):
❑ Partner - ❑ Limited o Genera
❑ Individual ❑ At ey in Fact
❑ Trustee uardian of Conservator
D Other:
Signer is Repres ing:
02017 National Notary Association
Signer's Name:
❑ Corporate Officer - Title(s):
o Partner - D Limited ❑General
❑ Individual rney in Fact
❑ Trustee ❑Guardian of Conservator
❑ Other:
Signer is Repr senting:
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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) D underwriter � 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 meet all of the Insurance Requirements.
Name of Insurance Company
Arthur J. Gallagher Company
Insurance Agent's Name (Printed)
(signature) Jr=
500 N Brand Blvd #100
Telephone Number
City
Haul-Away Rubbish Service Company Inc
Contractor's Name
4.3.24 Date
Erin Viker
Insurance Agent's Name
CA 91203
State Zip Code
Erin [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.
Certain Underwriters at Lloyds
Commercial General Liability
Insurance Company of the West
Workers' Compensation Liability
City Will Purchase Policy, if required
Builders Risk
XL Speciality Insurance
Automobile Liability
Certain Underwriters at Lloyds
Pollution Liability
[NOTE TO CONTRACTOR: See "Insurance Requirements" EXHIBIT 4 of the Contract for the requirement of obtaining Pollution Liability Insurance.]
NOTE 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.
CERTIFICATE OF EQUAL OPPORTUNITY PRACTICES
City of Vernon
4305 Santa Fe Avenue
Vernon, CA 90058
(323) 583-8811
Website: www.cityofvernon.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 California and the laws of the United States that the information is true and correct. Furthermore, you are certifying 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: Haul-Away Rubbish Service Co., Inc.
Business Telephone: (32 3) 721-0371
Address: 1205 Date Street
City: Montebello State: __ CA__ Zip 90640
Contact Person Morrie Beliakoff, Jr. E-mail Address [email protected] (optional)
Tax ID Number (or Social Security Number) _9_5-_29_0_5_7_3_6 _____ Remit Address (if different)
SAME
Please state clearly and concisely the type(s) of goods and services your company provides:
Waste and Recycling Collection Services
The following section is OPTIONAL and is for statistical reporting purposes only. Ownership (please check all that apply):
African-American__ Asian Armenian
Disabled __
Hispanic__ Native American __
Female __
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.
Mixed Waste Co llecti on, Pecycling & Disposal Services Name of Company: Ha ul-Away Pubbish Service Co ., Inc. Project: _C_on__tr_a_c_t__#20__24_0_2_9_7 __________ _ 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 1 Front Load Driver No chan9e in offir.P staff 0
1 Po ll Off Dr iver
1 Pecycle Driver
Are any current employees or potential
new hires Vernon residents? If so, how
many? NO
,
Current Permanent Workforce Utilization {Form AA-3)
OPTIONAL
Name of Company: ___________________ _
Project: _______________________ _
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
Professionals
Technicians
Office/Clerical
Skilled Craft Workers
Operators
( semi-skilled)
Laborers
Service Workers
TOTAL
SUMMARY OF SOLID WASTE DISPOSAL AND DIVERSION
Project Title: Mixed Waste Collection, Recycling and Disposal Services Contract No. 20240297 Type of Material (a) Disposed in
Class 111 Landfills
Tons/CY
Asphalt
Concrete
Metal
Other Segregated
Materials (Describe):
Miscellaneous
Construction Waste
Total 0
Form to be submitted to the City
SIGNATURE: f\A- � /6 ,d.j� �
TITLE: President
DATE: 4/2/2024
(b) Diverted from
Class 111 Landfills by
Tons/CY
0 2.19 RECYCLED, REUSABLE AND RECYCLABLE PRODUCTS
(c) [Leave This
Column Blank]
Tons/CY
0 (d) Disposed in Inert
Fills
Tons/CY
0 The Contractor is encouraged to propose recycled, reusable and recyclable products for use by the City.
Those items should be clearly identified. The City may require further information or documentation to ascertain the suitability/appropriateness of a proposed product. [END OF ARTICLE]
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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 Califo nia
County of s r y ' ~-:
On ~ P R ~ ~ ~,~_ before me, Claudia Etern~~ Miramontes ~o~Ary Public Date _ r, Here Insert Name and Title of the Officer
r personally appeared
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Names) of Signers)
who proved to me on the basis of satisfactory evidence to be the persons) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. q~p~q Y MtRAMONTES O
..~...
'~ COMM. #2394337
~ nwT~rPue~.~c.ca.,~°w~"i` ~
0 ~~, EIS ~ebnaary 17.2026.
Place Notary Seal and/or Stamp Above
certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
Signature of Notary Public
OPTIONAL
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Doc ent
Title or Type of Document: J~ ~~ ~ i
Document Date:
Signers) Other Than Named Above:
U U~~
Capacity(ies) Claimed by Signers)
Signer's Name:
D Corporate Officer — Title(s):
❑ Partner — ❑ Limited D Gener
❑ Individual ❑ rney in Fact
❑ Trustee Guardian of Conservator
❑ Other:
Signer is Repr enting:
02017 National Notary Association
Number of Pages:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑ Gener
❑ Individual orney in Fact
o Trustee ❑Guardian of Conservator
❑ Other:
Signer Representing:
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April 4, 2024
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~, '•
`~ _:,~~CAL I FORNIA
NOTICE TO BIDDERS -ADDENDUM No.l
MIXED WASTE COLLECTION, RECYCLING AND DISPOSAL SERVICES CONTRACT No. 20240297
Via Planetbids
This notice shall be considered as Addendum No. 1 to the Specifications for the abovementioned project and modifies the original Specifications and Contract Documents as noted r
below. Portions of the Contract, not specifically mentioned in the Addendum, remain in force.
Contract Specifications
No Changes
Questions &Answers
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1. Table of Contents, Article 3, 3.07 Liquidated Damages (between pages 85 and 89), that there should be information on that page in the document; however, there is no section 3.07. We r' suppose that once the liquidated damages amount has been confirmed, the Table of Contents will be more accurate and reflect the information in the document. r- For this Contract, there is no liquidated damages.
2.On Page 11, Time for Completion, that Work must be completed within two (2) calendar days after a written notice to proceed. However, that does not make sense when the project is to pick up waste and recycling daily for 3 years (?).
The start and end dates will be determined once we are ready to award and execute the three-year contract. Regarding "complete the work within two (2) calendar days...", it means we expect any related work asked by the city to be completed within two calendar days.
3. On Page 12, states that Each Bid must be made on the Bid Forms obtainable at the Public Works Department. We want to confirm that all the appropriate and necessary Bid Forms are included in the email sent to us already. We do not have to seek out any other forms, do we? All the necessary Bid Forms are included in the emailed document. There is no need to seek out other forms.
Public Works Department
4305 Santa Fe Avenue, Vernon, CA, 90058
CityofVernon.org
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8VERNONCALIFORNIA
4. On Page 13 - Registration with the Department of Industrial Relations. This appears to be for construction-type Contractors. When we look up the "crafts" on the DIR site, our business doesn't match the professions. Is this something you expect all of the haulers to complete? The City of Vernon will complete and provide contractor with the DIR number.
5. On Page 16 - How do you want the Incumbency Certificate authenticated? Notarized? The Incumbency Certificate Form must be filled out and notarized. Furthermore, all signatures must be notarized.
6. On Page 29, ask for Acknowledgment of the addenda, with signed copies of all addenda. By "Addenda," do you mean the Exhibits?
"Addenda" refers to the addendum posted on 04/04/24. Once the Addendum/Addenda is posted, you must acknowledge it by submitting signed copies with your bid proposal.
7. On Page 62, For projects involving labor or services valued at $25,000 or more, is that monthly or annually?
The " Project Workforce Utilization" form is required to be filled out because the service value of the contract is more than $25,000.
8. Is there an initial start date for this contract?
The contract's start date is to be determined after the contract has been fully executed.
If you have any questions, please contact Cynthia Cano, Administrative Secretary, at [email protected].
Sincerely,
Daniel Wall, P.E.
Director of Public Works
Enclosures - NA
'f- '-f- J...02..tj
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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. r State of Calif rnia `,
l County of S ~Z~
~PR o $ 101 before me Claudia Eter fiJp~st~'y Public On natty M~ramonte~ , Date Here Inse Nam and Tale of the Officer
personally appeared
Names) of Signers)
r who proved to me on the basis of satisfactory evidence to be the persons) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their ~ authorized capacity(ies), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument.
E
certify under PENALTY OF PERJURY under the
,r ~ Ct,pUplA ETERNITY MIRAMONTES~ laws of the State of California that the foregoing ! t-- COMM. #2394337 n paragraph is true and correct.
U NOTARY PUBLIC -CAL~ORNIA ,,,,~
p ~osnr~cE~s -~ WITNESS m hand and official seal.
~" Corrxn E~lres February 17, 2026 Y
I
Signature
r Place Notary Seal and/or Stamp Above Signature of Notary Public l /1r1T1/1\t A 1
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Docum@nt , ~~~
Title or Type of Document: ISUI ~V'L ~l~
Document Date: ~ P ~ ~~~ Number of Pages:
Signers) Other Than Named Above:
r
Capacity(ies) Claimed by Signers)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited o General
❑ Individual ❑ ey in Fact
❑ Trustee Guardian of Conservator
❑ Other:
Signer is Repr enting:
02017 National Notary Association
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑Limited ❑General
❑ Individual D Attorne n Fact
o Trustee ❑Guar ' n of Conservator
❑ Other:
Signer is Representing:
~-- Page 68 of 81
A~~ ~~ CERTIFICATE OF LIABILITY INSURANCE
DATA/3/2OZ~)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS i CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ~ BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. ~ If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Arthur J. Gallagher Risk Management Services, LLC
~ 745 Francis Street
San Luis Obispo CA 93401
CONTACT
NAME: EI'Itl VI{C@C
PHONE F,ax
E ~ $~~-~30-1222 ac rvo :805-545-8224
MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE NAIC #
License#: OD69293 INSURERA: Llo ds of London S ndicate 1919 INSURED HAULRUB-01
Haul-Away Rubbish Service Company Inc
1205 Date Street
ENSURER B : XL S @CIaI Insurance Com an 37885
INSURER C :Underwriters at Llo d's, London 32727
Montebello CA 90640 iNsuReR v : Insurance Com an of the West 27847
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: 1679516515 REVISION NUMBER:
I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TypE OF INSURANCE ADDL SUBR
LTR POLICY NUMBER MM DD/YYYY MM DD/YYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY Y Y CSIEL00583-00 8/15/2023 8/15/2024 EgCH OCCURRENCE $ 1,000,000
AMA TOR N D
CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ 300,000
MED EXP (Any one person) $ 5,000
PERSONAL 8~ ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X ~
PRO- ❑ POLICY JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: Pollution Liabilit $ 1,000,000
B I AUTOMOBILELIABILITY Y Y AEC005480904 8/15/2023 ~ 8/15/2024 COMBINED SINGLE LIMIT Ea accident $ 1,000,000
~ X ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED ~ BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
C ~ UMBRELLA LIAR X OCCUR CSIXEL00278-00 8/15/2023 8/15/2024 E,o,CH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000
DED RETENTION $ $
t p ~ WORKERS COMPENSATION Y I WLV 5043145 05 10/1 /2023 10/1 /2024 X STATUTE ERH AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE ~Y ~ E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N / A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 ` DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named as additional insured with respect to general liability per attached CG20100704 and CG20370704, Auto liability per XIC4111013 and pollution liability per attached CSIEL0000034. Waiver of subrogation applies per attached CG24041093, EN0118-0211, and CA04441013. Primary and non-contributory applies per attached CSI EL0000013, EN0118-0211 'and XIC4111013. Waiver of subrogation applies with respect to workers compensation per WC990634800 attached. Excess to follow form GL, AL, Pollution Additional Insured: City of Vernon, its directors, commissioners, officers, employees, and volunteers
CERTIFICATE HOLDER CANCELLATION
CITY OF VERNON
r-~ 4305 SANTA FE AVENUE
VERNON CA 90058
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
rr— O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD t
part of the FAIRFAX group
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NON-CONTRIBUTORY ADDITIONAL
INSURED WITH WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
CONTRACTORS POLLUTION LIABILITY COVERAGE PART
ERRORS AND OMISSIONS LIABILITY COVERAGE PART
THIRD PARTY POLLUTION LIABI ITY COVERAGE PART
SCHEDULE
Name of Additional Insured Person(s) or Organization(s) Where Required by Written Contract
A. SECTION Ill - WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but solely as respects "claims" caused in whole or in part, by "your work" for that person or organization performed by you, or by those acting on your behalf.
This insurance shall be primary and non-contributory, but only in the event of a named insured's sole negligence.
B. We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for "damages" arising out of "your work" performed under a designated project or contract with that person(s) or organization(s ).
C. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies.
ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED.
EN0118-0211 Page 70 of 81
POLICY NUMBER: AEC005480904 COMMERCIAL AUTO
CA 04 44 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Courage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: HAUL-AWAY RUBBISH SERVICE COMPANY, INC.
Endorsement Effective Date: August 15, 2023
SCHEDULE
Names) Of Persons) Or Organization(s):
WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT EXECUTED PRIOR TO LOSS (EXCEPT WHERE NOT PERMITTED BY LAW).
~ Information required to complete this Schedule, if not shown above, will be shown in the Declarations. ~ The Transfer Of Rights Of Recovery Against Others
To Us condition does not apply to the persons) or
organizations) shown in the Schedule, but only to the
extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or
organization.
CA 04 44 10 13 O Insurance Services Office, Inc., 2011 Page 1
r
POLICY NUMBER: AEC005480904 XIC4111013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AUTOMATIC ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
AUTO DEALERS COVERAGE FORM
A. COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an "insured" any person or organization you are required in a written contract to name as an additional insured, but only for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of:
1. You, while using a covered "auto"; or
2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered "auto" with your permission;
Provided that:
a. The written contract is in effect during the policy period of this policy; b. The written contract was signed by you and executed prior to the "accident" causing "bodily injury" or "property damage" for which liability coverage is sought; and c. Such person or organization is an "insured" solely to the extent required by the contract, but in no event if such person or organization is solely negligent.
B. The Limits of Insurance provided for the Additional Insured shall not be greater than those required by contract and, in no event shall the Limits of Insurance set forth in this policy be increased by the contract.
C. General Conditions, Other Insurance is amended as follows:
Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether such insurance is primary, excess, contingent or on any other basis unless the contract specifically requires that this policy be primary.
All terms, conditions, exclusions and limitations of this policy shall apply to the liability coverage provided to any additional insured, and in no event shall such coverage be enlarged or expanded by reason of the contract.
All other terms and conditions of this policy remain unchanged.
XIC4111013 © 2013 X.L. America, Inc. All Rights Reserved.
May not be copied without permission.
Includes coovriahted material of Insurance Services Office. Inc .. with its oermission.
Policy number: CSIEL00179-00 COMMERCIAL
GENERAL LIABILITY
CG 20 37 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -OWNERS, LESSEES OR
CONTRACTORS -COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Persons)
Or Or anization s :
Location And Description Of Completed
O erations
Any persons) or organizations) whom the Named
Insured agrees, in a written contract, to name as
an additional insured. However, this status exists
onl for the pro~ect specified in that contract.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Section II -Who Is An Insured is amended to include as an additional insured the persons) or organizations) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard".
CG 20 37 07 04
O ISO Properties, Inc., 2004
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED- OWNERS, LESSEES ORCONTRACTORS
{BLANKET) ENDORSEMENT
This endorsement modifies insurance provided under the following:
CONTRACTORS POLLUTION LIABILITY
Name Of Additional Insured Person(s) Or Location(s) Of Covered Operations Organization(s)
Automatic status as required in written contract
or agreement with you.
(1) Section Ill - WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed by that insured.
(2) With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to bodily injury or property damage occurring after:
A. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or
B. That portion of your work out of which the bodily injury or property damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
All other terms and conditions of this policy remain unchanged.
CSI EL 000 0034 Page 74 of 81
~~
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -BLANKET WC 99 06 34
(Ed . 8-00)
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us).
The additional premium for this endorsement shall be 2 % of the total California Workers' Compensation premium otherwise due.
Schedule
Person or Organization
ANY PERSON OR
ORGANIZATION FOR
WHOM THE NAMED
INSURED IS REQUIRED
UNDER WRITTEN
CONTRACT TO FURNISH
THIS WAIVER
Job Description
CALIFORNIA
OPERATIONS ONLY
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 10/01/2023 Policy No. WLV .WLV 5043145 05 Endorsement No.
Insured HAUL AWAY RUBBISH SERVICES CO Premium $ INCL .
Insurance Company INSURANCE COMPANY OF THE WEST
Countersigned By
WC 99 06 34
~~ (Ed. &00) i i
INSURED
Page of 75 of 81
1 Policy Number: CSIEL00583-00 COMMERCIAL
GENERAL LIABILITY
CG 20 10 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -OWNERS, LESSEES OR
CONTRACTORS -SCHEDULED PERSON OR
ORGANIZATION
r This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Persons)
Or Or anization s : Location(s) Of Covered Operations
Any persons) or organizations) whom the Named
Insured agrees, in a written contract, to name as an
Additional insured. However, this status exists only
for the pro~ect specified in that contract.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II —Who Is An Insured is amended to include as an additional insured the persons) or organizations) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insureds) at the locations) designated above.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
1. Al i work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insureds) at the location of the covered operations has been completed; or
2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
CG 20 10 07 04
I
Page of 76 of 81
COMMERCIAL GENERAL LIABILITY
CG 24 04 10 93
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Any persons) or organizations) whom the Named
Insured agrees, in a written contract. However, this
status exists only for the project specified in that contract. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. )
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIALGENERAL LIABILITY CONDITIONS) is amended by the addition of the following:
We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above.
CG 24 04 10 93
O Insurance Services Office, Inc., 1992
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY & NON-CONTRIBUTORY ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY
CONTRACTORS POLLUTION LIABILITY
TRANSPORTATION POLLUTION LIABILITY
PROFESSIONAL LIABILITY
Name of Person or Organization:
SCHEDULE
If no person or organization is entered in the schedule above, then this endorsement applies to:
Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract.
In consideration of the premium charged, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non-contributory to this insurance.
All other terms and conditions of this policy remain unchanged.
CSI EL 000 0013
~ pF E'ER
~•'~. ~`'`~"~'*°~ City of Vernon BUSINESS LICENSE CERTIFICATE ~' 4305 South Santa Fe Avenue, Vernon, CA 90058
~'~' (323) 583-8811
~ ~~
`~EL7 t11V0
Business Name: HAUL-AWAY RUBBISH SERVICE CO., INC.
DBA: HAUL-AWAY RUBBISH SERVICE CO., INC.
Business Location: 1205 DATE ST Mailing Address: 1205 DATE ST
MONTEBELLO , CA MONTEBELLO , CA
90640 90640
Owner:
License Number: OBL-010308 License Type: In City Business (GBL) Issued Date: 1/1/2024 Classification: Manufacturing
Expiration Date: 12/31/2024
The person, firm or corporation named below is granted this certificate (pursuant to the provisions of the City Business License Ordinances of the City of Vernon, California} to engage in, carryon or conduct, in the City of Vernon, California, the business, trade, calling, profession, exhibition or occupation described below for the period indicated. This license is permission only and is issued without verification that the license is subject to or exempt from licensing by the State of California; nor shall such issuance be deemed a waiver of the City of Vernon of past future violations of such laws or ordinances.
TO BE POSTED !N A CONSPICUOUS PLACE
~au,~ ~~ra tc~~i~i esE~vieE ~o. ~ne.
i
VEHICLE COLLISION SUMMARY
Employee: Richard W. Broadway, Jr.
Plaintiffs: Mark S. Guido and Emily C. Guido
Date Action Filed: October 8, 2019
Court: Superior Court of the State of California for the County of Los Angeles, Spring Street Courthouse 1 Address: 312 North Spring Street
Los Angeles, CA 90012
Case Number: 19STCV35853
Richard Broadway was driving aroll-off with the flow of traffic at 20 mph on Sepulveda, when Mark Guido was riding his bicycle and hit our roll-off truck from behind. The weather was clear and dry.
Case settled on April 25, 2022
Employee: Carlos E. Hernandez Duarte
Plaintiff: Veronica Aguirre Jaimes, et al.
Date Action Filed: 5/31/2023
Court: Superior Court of the State of California for the County of Los Angeles, Spring Street Courthouse Address: 312 North Spring Street
Los Angeles, CA 90012
Case Number: 23STCV12413
Carlos Hernandez was driving a roll off on the freeway heading south. He saw a multiple vehicle pileup accident in front of him and slowed down to a stop. As Carlos was stopped for over a minute, his roll off was rear ended.
Case: Pending
1205 Date Street, Montebello, CA 90640 Phone (323)721-0371 Fax (323)887-0920 [email protected]
EXHIBIT D
EQUAL EMPLOYMENT OPPORTUNITY
PRACTICES PROVISIONS
A. Contractor certifies and represents that, during the performance of this Contract, the contractor and each subcontractor shall adhere to equal opportunity employment practices to assure that applicants and employees are treated equally and are not discriminated against because of their race, religious creed, color, national origin, ancestry, handicap, sex, or age. Contractor further certifies that it will not maintain any segregated facilities.
B. Contractor agrees that it shall, in all solicitations or advertisements for applicants for employment placed by or on behalf of Contractor, state that it is an "Equal Opportunity Employer" or that all qualified applicants will receive consideration for employment without regard to their race, religious creed, color, national origin, ancestry, handicap, sex or age.
C. Contractor agrees that it shall, if requested to do so by the City, certify that it has not, in the performance of this Contract, discriminated against applicants or employees because of their membership in a protected class.
D. Contractor agrees to provide the City with access to, and, if requested to do so by City, through its awarding authority, provide copies of all of its records pertaining or relating to its employment practices, except to the extent such records or portions of such records are confidential or privileged under state or federal law.
E. Nothing contained in this Contract shall be construed in any manner as to require or permit any act which is prohibited by law.
CONTRACT 20240297 BOND DOCUMENTS