Elka Construction, Inc.
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached and not the truthfulness, accuracy, or validity of that document.
State of California }
County of Los Angeles }
On_ 4/24/2024 betore me, _ Zipporah D. Kiger, Nantary Pridicen personally appeared Patrick T. Moughan
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) (s/are subscribed to the within instrument and acknowledged to me that Chelshe/they executed the same in this/her/their authorized capacity(ies), and that by histher/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
ZIPPORAH D. KICER X
WITNESS my hand and official seal. C1 :. #2371787 SC
NOTARY PUBLIC - CALIFORNIA
LOS ANGELES COUNTY
My Comm. Expires Aug. 21, 2025
Notary Public Signature (Notary Public Seal)
INSTRUCTIONS FOR COMPLETING THIS FORM
ADDITIONAL OPTIONAL INFORMATION This form complies with current California statues regarding notury wording and.
DESCRIPTION OF THE ATTACHED DOCUMENT if needed, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary cov.
(Title or description of attached document) • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signers) personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title (notary public). • Print the names) of document signers) who personally appear at the time of CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. • Individual (s) information may lead to rejection of document recording.
Corporate Officer • The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re-seal if a (Title) sufficient area permits, otherwise complete a different acknowledgment form Partners) • Signature of the notary public must match the signature on file with the office of the county clerk.
Attorney-in-Fact Additional information is not required but could help to ensure this Trustee(s) acknowledgment is not misused or attached to a different document.
Other * Indicate title or type of attached document, number of pages and date • Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). 2015 Version www.NotaryClasses.com 800-873-9865 • Securely attach this document to the signed document with a staple.
Elka Construction, Inc. Page 152 of 180
*****
OLD REPUBLIC SURETY COMPANY
*****
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock insurance corporation, does make, constitute and appoint:
Mark D. Kiger, Patrick T. Moughan, Tami Mason of Hemosa Beach, CA its true and lawful Attorneys)-in-Fact, with full power and authority for and on behalf of the company as surety, to execute and deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof, other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and not uaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, or black lung bonds), as follow
ALL WRITTEN INSTRUMENTS
and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attorneys-in-Fact, pursuant to these presents, are ratified and confirme his appointment is made under and by authority of the board of directors at a special meeting held on February 18, 1982 This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD REPUBLIC SURETY COMPANY on February 18,1982.
RESOLVED that, the president, any vice-president or assistant vice president, in conjunction with the secretary or any assistant secretary, may appoint attorneys-in-fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to execute and deliver and affix the seal of the company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may remove any such attorney-in-fact or agent and revoke any Power of Attorney previously granted to such person.
RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company (i) when signed by the president, any vice president or assistant vice president, and attested and sealed if a seal be required) by any secretary or assistant secretary; or
(ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be required) by a duly authorized attorney-in-fact or agent; or (iii) when duly executed and sealed (if a seal be required) by one or more attorneys-in-fact or agents pursuant to and within the limits of the authority evidenced by the Power of Attorney issued by the company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the company; and such signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be
SURETY OLD REPUBLIC SURETY COMPANY
REPUBLIC
CORPORATE
SEAL
Kaung saffres
1981
ant Secreta
President
STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS
On this 17th day of June 2022 -, personally came before me, - Alan Pavlic -.-
and ., to me known to be the individuals and officers of the OLD REPUBLIC SURETY COMPANY who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: that they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation.
NOTAR, Kathry. R. Peasson
PUBLIO Notary Public
My Commission Expires: September 28. 2022
CERTIFICATE (Expiration of notary's commission does not invalidate this instrument) 1, the undersigned, assistant secretary of the OLD REPUBLIC SURETY COMPANY, a Wisconsin corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of Attorney, are now in force.
24 April 2024
74 0072 Signed and sealed at the City of Brookfield, Wi this - _ day of Kara saffres
ORSC 22262 (3-06)
Global Capital Ins Services
Elka Construction, Inc. Page 153 of 180
BOND ACKNOWLEDGMENT
FOR
SURETY'S ATTORNEY-IN-FACT
STATE OF CALIFORNIA
ss
COUNTY OF Los Angeles
On this 29t _day of April , 20 24
before me,_ Rose Waveszes _(name), a Notary Public for said County, personally appeared (name), who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument as the attorney in fact of Bond _ and acknowledged to me that ne/she subscribed the name of Elia Kaleh thereto as principal, and his/he own name as attorney in fact.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
der
Notary Public
SEAL
ROSE MORESZES
Notary Public - California
Los Angeles County
Commission # 2397544
candleMy Comm. Expires Apr 14, 2024
n. an eran
Elka Construction, Inc. Page 154 of 180
BIDDER'S STATEMENT OF QUALIFICATIONS
1. ORGANIZATION
1.1 How many years has your organization been in business as a Contractor? 7 years
1.2 How many years has your organization been in business under its present name? 1 years
1.2.1 Under what other names has your organization operated? N/A
1.3 If your organization is a corporation, answer the following:
1.3.1 Date of incorporation/organization: 10/24/2017
1.3.2 State of incorporation/organization: California
1.3.3 Corporate ID number: 4078148
1.3.4 Name of President: Toni Kaleh
1.3.5 Agent for Service of Process: Elia Kaleh
1.4 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 partners):
1.4.4 List all states in which you are registered and state ID numbers for each:
1.5 If your organization is individually owned, answer the following:
1.5.1 Date of organization:_
1.5.2 Name of owner:
1.6 If the form of your organization is other than those listed above, describe it and name the principals:
Elka Construction, Inc. Page 155 of 180
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.
Legally bound to perform work in the state of California, CSLB 1083334 A, C21
2.2 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
3. EXPERIENCE
List the categories of Work that your organization normally performs with its own personnel.
Elia Kaleh-Grading, dirt moving, demolition, excavation Toni Kaleh-Grading, dirt moving, demolition, excavation
3.2 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 Inviting Bids for this Project.
3.3 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.
4. 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.
matter related to:
Elka Construction, Inc. Page 156 of 180
4.1.1 The performance, non-performance, default, violation, or breach of a contract or agreement?
•YES DA NO
4.1.2 A vehicle collision or accident involving your firm's employees? • YES * NO
4.1.3 Damage to real property arising out of your services or operations?
LIYES & NO
4.1.4 Employment-related litigation brought by an employee of your firm?
LI YES X NO
4.1.5 Payment to a subcontractor or supplier?
• YES [XI NO
4.1.6 Defective, deficient, or substandard work?
L YES IX 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.
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 XI 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 X 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, Elka Construction, Inc. Page 157 of 180
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? LOYE X No
If YES, identify the government entity; list the date, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
4.5 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 [XI NO
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.
4.6 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 * NO
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 Conced dier corporation, any principal the corporation ever ben • YES [X 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 XI NO
If YES, identify the government entity, and describe the facts and circumstances about each instance. Attach additional sheets as necessary.
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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 XI 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.
LI YES X NO
5. FIRM'S OPERATIONAL STATUS
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? LI YES * NO
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 additional 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 XI NO
If YES, list the filing date, and describe the facts and circumstances about each instance.
Attach additional 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 XI NO
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
Has a government entity ever debarred, disqualified, removed, suspended, or otherwise prevented you or your firm from bidding on, contracting, or completing a construction XI NO
Elka Construction, Inc. Page 159 of 180
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 entity ction against your firm. Attach additional sheets as necessar
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 ENO
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
6.3. Have you or your firm ever failed to fulfill or perform - either partially or completely - a contract or an agreement with a government entity or a client?
LI YES XI 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.
6.4. 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?
JJ YES & NO
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? XI 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.
Elka Construction, Inc. Page 160 of 180
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
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.
Has a government entity or a client ever terminated, suspended, or non-renewed your firm's contract or agreement before its completion?
• YES X 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.
6.9. 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 non- LI 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.
6.10. In the past five (5) years, has your firm paid, or has your firm been assessed, liquidated damages on a contract or agreement?
•YES XI NO
If YES, identify all such contracts/projects by owner, owner's address, the date of ompletion of the project, amount of liquidated damages assessed, and all other informatio ecessary to fully explain the assessment or payment of liquidated damages. Attac additional sheets as necessary.
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? L YES * NO
7.1.2. Canceled or non-renewed your firm's insurance coverage? • YES * NO
7.1.3. Refused to issue your firm a bond?
•YES XI NO
Elka Construction, Inc. Page 161 of 180
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 ayments on your firm's behalf as a result of a default, to satisfy any claims agains! erformance bond, payment bond, or maintenance bond issued on your firm's behal 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 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:
Global Risk
8.2 Name and address of agent:
Spencer Letz 200 Pier Ave. Suite 132 Hermosa Beach, CA 9025 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.
1 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 lia Kalch
Elka Construction, Inc. Page 162 of 180
BIDDER'S EXPERIENCE FORM
55h Street Recycle Center & Nursery - Soil & Miscellaneous PROJECT NAME: Construction Material Removal CONTRACT NO. 2024XXXX COMPANY NAME: Elka Construction inc
***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.
CONTRACT CONTRACT CONTRACT PROJECT NAME AND CONTACT PHONE START DATE END DATE $ AMOUNT AGENCY ADDRESS CONTACT NAME NUMBER 1 Bradt Reservoir Slope Repair 851 Calle Agua San Clamente, 09/14/2023 01/05/2024 Vernon Weisman (949) 523-8963
$215,000.00 Joint Regional Water Supply CA 92673
System
2 Onsite and offsite work for 655 N Highland Springs Ave 02/14/2023 06/25/2024 $2,000,000.00 Ali Harb (909) 214-3333 Splash Car Wash Beaumont, CA 92223
Harb Boys inc.
3 Grading and dirt moving 1031 Rosecrans Ave Suite 207
06/05/2023 10/18/2023 $105,000.00 Chand Ravilya (909) 562-6388 Anthem Oil inc Fullerton, CA 92833
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 Signature of Bidder Elia Kaleh
Print Name: Elia Kaleh
State of California Contractor's License No. 1083334
Contractor'sLicense expiration date 11/30/2025
Elka Construction, Inc. Page 163 of 180
CONTRACTOR SAFETY QUESTIONNAIRE
Company Name: Elka Construction inc
Primary Type of Work: Grading, Demolition, Excavatio, and Trucking Person Completing Form: Elia Kaleh
Title: CFO _Phone Number: (951) 972-0806
Date: 04/07/2024
SAFETY PERFORMANCE
List your company's Interstate Experience Rating Modifier (ERM)1 for the three most recent years. 20 21 N/A
20 22 N/A
20-23 NR
2. List your company's number of injuries/illnesses from your OSHA 300 logs for the three most recent years. 2020, го 21, 20.22
a. Fatalities
b. OSHA recordable incidents 0 0 0
C. Lost work day incidents 0 0 0
d. Total lost work days 0 0 0
e. Total hours worked 2,911 3,268 3,840
3. Upon request from the City, the contractors) shall provide copies of the following items (a-g); and Items (d- g) for each listed Subcontractor
a). OSHA 300 logs for the most recent three years e). Training Plans and current year-to-date
b). Verification of ERM from your insurance carrier f). Training Certificates for Employees c). Injury/liness Report g). Emergency Response Training d). Complete written Safety Program
Company Safety Contact:
a. Name Elia Kaleh
-
b. Phone (951) 972-0806
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. It has a direct correlation to how much the contractor pays in workers' comp premium.
Elka Construction, Inc. Page 164 of 180
CONTRACTOR SAFETY QUESTIONNAIRE (continued)
SAFETY PROGRAM
1. SAFETY PROGRAM DOCUMENTATION Circle One
a. Do you have a written safety program manual (Yes No
1) Last revision date 01/03/202
b. Do you have a written safety field manual? res) No
c. Are all workers given a booklet that contains work rules, responsibilities, and other appropriate information? (Yes No
2. POLICY AND MANAGEMENT SUPPORT
a. Do you have a safety policy statement from an officer of (Yes No the company?
b. Do you have a disciplinary process for enforcement res No of your safety program?
c. Does management set corporate safety goals? (Yes No
d. Does executive management review:
X Accident reports? Yes No
XI Safety statistics? Yes No
X] Inspection reports? Yes No
e. Do you safety pre-qualify subcontractors? Tes No
f. Do you have a written policy on accident reporting Yes No and investigation?
g. Do you have a light-duty, return-to-work policy? (Tes No h. Is safety part of your supervisor's performance evaluation? Yes No i. Do you have a personal protective equipment (PPE) policy? Yes No j. Do you have a written substance abuse program? Yes NO If yes, does it include (check all applicable boxes):
L Pre-employment testing ] Return-to-duty testing
L Random testing Disciplinary process
• Reasonable cause testing • Alcohol testing
• Post accident testing • National Institute on Drug Abuse • Panel Screen
k. Does each level of management have assigned safety Yes No duties and responsibilities?
Elka Construction, Inc. Page 165 of 180
3. TRAINING AND ORIENTATION
a. Do you conduct safety orientation training for each
employee? Yes No
b. Do you conduct site safety orientation for every Yes No person new to the job site?
c. Does your safety program require safety training meetings? (es) No for each supervisor (foreman and above)?
How often?
Ix Weekly • Monthly Quarterly Annually Other_
d. Do you hold tool box/tailgate safety meetings
focused on your specific work operations/exposures? Yes No How often?
X Weekly • Daily • Other_
e. Do you require equipment operation/certification training? Yes No
4. ADMINISTRATION AND PROCEDURES
a. Does your written safety program address
administrative procedures? Yes No
If yes, check which apply:
_Pre project/task planning X_ Emergency procedures
X Record keeping X Audits/inspections
X_ Safety committees X Accident investigations/reporting * HAZCOM X Training documentation
x Substance abuse prevention X_ Hazardous work permits
X Return-to-work X Subcontractor prequalification
b. Do you have project safety committees? Yes No
c. Do you conduct job site safety inspections? Yes No
How often?
[X Daily Weekly Monthly Other
Do these inspections includes a routine safety
inspection of equipment (e.g., scaffold, ladders, fire
extinguishers, etc.)? Yes No
d. Do you investigate accidents? Tes No
How are they reported?
X Total company • By superintendent
] By project • By project manager
By foreman • In accordance with OSHA
e. Do you discuss safety at all preconstruction and progress meetings? Yes No Elka Construction, Inc. Page 166 of 180
f. Do you perform rigging and lifting checks prior to lifting? Yes No [X) For personnel [* For equipment * Heavy lifts (more than 10,000 lbs.)
5. WORK RULES
Do you periodically update work rules? (Yes No
When was the last update? 01/03/2024
b. What work practices are addressed by your work rules? • CPR/first aid _ Access-entrances/stairs
Barricades, signs, Respiratory protection
and signals
Blasting Material handling/storage
Communications Temporary heat
Compressed air and gases ] Vehicle safety
• Concrete work X Traffic control
Confined-space entry Site visitor escorting
Cranes/rigging and hoisting Public protection
Electrical grounding Equipment guards and grounding
| Environmental controls and Monitoring equipment
Occupational health
* Emergency procedures Flammable material handling/storage X Fire protection and prevention Site sanitation
Floor and wall openings Trenching and excavating
X Fall protection ] Lockout/Tagout
Housekeeping Energized/pressurized equipment
X Ladders and scaffolds
] Mechanical equipment/ * Personal protective equipment maintenance/pre-op checks/ X Tools, power and hand
operation Electrical power lines
• Welding and cutting (hot work) Other
6. OSHA INSPECTIONS
a. Have you been inspected by OSHA in the last three years? Yes No b. Were these inspections in response to complaints? Yes No c. Have you been cited as a result of these inspections? Yes No If yes, describe the citations (add additional sheets if necessary:
Elka Construction, Inc. Page 167 of 180
DESIGNATION OF SUBCONTRACTORS
NAME OF BIDDER: Elka Construction 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
Elka Construction, Inc. Page 168 of 180
Please type or legibly print (attach additional sheets as necessary).
Public Works
Email Contact Trade and Type License Contractor
Name of Subcontractor Information of Work to be Business Location Dollar ($) Value Number Registration
Performed Number
Elka Construction, Inc. Page 169 of 180
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.
Elka Construction, Inc. Page 170 of 180
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 Yes L No XI
2. If the answer to No. 1 is "Yes", please forward a copy of the rules of each bid depository you used with this questionnaire.
3. Did you have any source of subcontractors' bids other than bid depositories? No
4. Has any person or group threatened you with subcontractor boycotts, union boycotts, or other sanctions to attempt to convince you to use the services or abide by the rules of one or more bid depositories? Yes O No XI
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 Di No XI
Was a conscious effort made to recruit and hire project area lower-income residents? Yes O No XI
Please submit statement.
8. We declare under penalty of perjury that the foregoing is true and correct.
Dated this 07 day of April _. 2024
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 Elka Construction inc
By: Elia Kaleh
Title: CFO
Elka Construction, Inc. Page 171 of 180
CONTRACTOR'S AFFIDAVIT OF NON-COLLUSION
STATE OF CALIFORNIA
COUNTY OF Riverside
Elia Kaleh being first duly sworn, deposes and says:
1. That he/she is the CFO (Title of office if a corporation, "sole owner, "Partner," or other proper title) of_Elka Construction inc (hereinafter called "Contractor") who has submitted to the City of Vernon a Bid for the construction of the Street Recycle Center & Nursery - Soil & Miscellaneous Construction Material Removal, Contract No. 2024XXXX;
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; IlI
III
IlI
IlI
IlI
Elka Construction, Inc. Page 172 of 180
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 07 day of April, 2024 at Temecula CA
Month/Year City State
Elia Kaleh
Contractor (Please Print)
Elia Kalch
Contractor's Signature
CFO
Title
Elka Construction, Inc. Page 173 of 180
THE BIDDER'S INSURANCE COMPANY(S) OR INSURANCE AGENT MUST COMPLETE THIS FORM AND
THE BIDDER MUST SUBMIT THIS CERTIFICATION WITH THE BID FORMS. 1, the undersigned (Please check one box) • 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.
Insureaze 04/072024
Name of Insurance Company Date
Johnny Bransford Johnny Bransford
Insurance Agent's Name (Printed) Insurance Agent's Name (signature)
2021 Filmore St San Francisco CA 94115
Address City State Zip Code
415-228-6911 [email protected]
Telephone Number Email Address
Elka Construction inc
Contractor's Name 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.
Insureaze Insureaze
Commercial General Liability Automobile Liability
Global Risk
Workers' Compensation Liability
City Will Purchase Policy, if required Ensured
Builders Risk 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.
Elka Construction, Inc. Page 174 of 180
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: Elka Construction inc
Business Telephone: (951) 972-0806
Address: 33259 Corte Canario
Temecula CA Zip 92592
City: _ _ State:
Contact Person Elia Kaleh E-mail Address [email protected] 82-3553055 (optional)
Tax ID Number (or Social Security Number)
Remit Address (if different)
ease state clearly and concisely the types) of goods and services your company provide Ika Construction inc provides heavy construction services such as grading, demolitio and excavation.
The following section is OPTIONAL and is for statistical reporting purposes only. Ownership (please check all that apply):
African-American Asian Armenian Hispanic Native American_ Disabled Female Arab
Elka Construction, Inc. Page 175 of 180
Project Workforce Utilization (Form AA-2)
This form is to be included in all bid documents for projects involving labor or services valued at $25,000 or more.
Instructions: Please indicate the job titles/classifications to be used in the performance of this contract should it be awarded to your firm. Please indicate the number of employees in each job classification as well as the number of new hires, if any, as a result of this contract.
Name of Company: Elka Construction inc Project: 55th Street Recycle Center - Soil & Misc. Construction Material Removal 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 Operator 2 0
Laborer 2 0
Trucker/Driver 10
Are any current employees or potential
new hires Vernon residents? If so, how
many? No
Elka Construction, Inc. Page 176 of 180
Current Permanent Workforce Utilization (Form AA-3)
Name of Company: Elia Kaleh
Project: 55th Street Recycle Center - Soil & Misc. Construction Material Removal 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 • Arab (not of Hispanic (not of Hispanic Islander American
origin) origin)
CLASSIFICATION
Officials/
Managers
Professionals
Technicians
Office/Clerical
Skilled Craft Workers
Operators 1 1 2
(semi-skilled)
Laborers 2
Service Workers
TOTAL
1 4 3
Elka Construction, Inc. Page 177 of 180
City of
OVERNON
CALIFORNIA
April 23, 2024
Via Planetbids
NOTICE TO BIDDERS - ADDENDUM No.1
to the REQUEST FOR BIDS
55th STREET RECYCLE CENTER & NURSERY - SOIL & MISCELLANEOUS CONSTRUCTION MATERIAL
REMOVAL
This notice shall be considered as Addendum No. 1 to the Request for Bids for the above- mentioned project and modifies the original Specifications and Contract Documents as noted below. Portions of the Request for Bids, not specifically mentioned in the Addendum, remain in force.
Contract Specifications
Under Other Bidding Information Section 6. Contractors License. The license requirement is amended to read as follows: "Class A, General Engineering Contractor License from the California State License Board and/or C-12 Earthwork and Paving Contractor License." Under Other Bidding Information Section 1. Contract Time. The time the work must be completed is amended from 30 calendar days to 180 calendar days.
Construction Hours updated. Work shall occur Monday-Thursday between the hours of 6:00 am to 3:00 pm.
Questions & Answers
1. Is there rebar in the concrete?
Yes.
2. Has the existing material being tested for contaminants? Yes, a copy of the soil assessment/report will be provided through PlanetBids.
3. Does the City have a franchise hauler?
The City does not have an exclusive franchise hauler.
4. Does the City have a subcontractor to keep track of quantities leaving the site? City staff will keep track of quantities and stay on the job during its duration. Contractor's job foreman will sign off daily tracking sheets, so all parties are in agreement. City staff would ensure Public Works Department
4305 Santa Fe Avenue, Vernon, CA, 90058
OVERNONCALIFORNIA
that the trucks counted, have a full load, are tarped, and are not tracking mud out.
5. Who will be responsible for the cost of water used on site? There are two (2) water hydrants onsite. Public Works will confirm with the Water Department on usage and fees.
6. What is the soil material composed of?
The majority of the soil is trench spoil mixed with pavement and other construction materials (i.e. concrete, asphalt, base, etc.)
7. Does the material need to be segregated?
That is at the discretion of the Contractor.
8. Can the duration to complete the work be updated?
Yes, per Addendum No. 1 the duration has been revised to 180 calendar days.
9. Would the City please confirm that provisions B-8 "Noise Restrictions" does not apply to this project. Also, please confirm allowable working hours for this project will be 7 days a week 24 hours a day.
No noise restrictions apply since there is no residential area within the 500 ft. radius of the site.
Allowable working hours have been revised to Monday-Thursday between the hours of 6:00 am to 3:00 pm pursuant to Addendum No. 1.
10. Would the City please clarity if the final grading elevations along the perimeter of the stockpiles will remain the same as the existing elevations after the soil exporting has been completed? Also, confirm that the site will not require any compacting testing.
This is rough grading so match perimeter elevations - remove stockpiles and provide level surface.
11. Would the City please provide a copy of the soil sampling analytical results for the stockpiled material?
Soil report will be uploaded to PlanetBids and an email will be sent when posted.
12. Would we require manifests of the material hauled after it has reached its final disposal destination?
Manifests will be required.
OVERNONCALIFORNIA
13. Would we require to remove the following materials: several hundred pounds of salvage steel, three shipping containers, seven 55-galon drums labeled "Nonhazardous Waste", Trash, and 300 spent fires of various sizes and types?
The City will remove these items prior to the start of this project.
If you have any questions, please contact Assistant Engineer, Gerard Garcia via email at [email protected].
Sincerely,
DilA Will
Daniel Wall, P.E.
Director of Public Works
Elka CBst echoaf Iâc. Page 180 of 180