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HomeMy WebLinkAboutA7125 - SUPERIOR PAVEMENT MARKING INC.2018-0456145 11/20/2018 11:32 AM Fee: $ 0.00 Recording Requested By:Page 1 of 2 Recorded in Official Records County of Riverside City Of Palm Springs Peter Aldana Assessor-County Clerk- pRe c order y, When Recorded Mail To: 1III IIIlit.'M Ir, Iliil Iln 'I II, Name: Anthony J. Mejia,City Clerk Street Address: 3200 E Tahquitz Canyon Way City&State: Palm Springs,CA 92262 SPACE ABOVE THIS LINE FOR RECORDERS USE NOTICE OF COMPLETION CA Civil Code§§ 8180-8190, 8100-81 18, 9200-9208) NOTICE IS HEREBY GIVEN THAT: 1. The undersigned is an owner of an interest of estate in the hereinafter described real property,the nature of which interest or estate is: Fee e.g. fee, leasehold,joint tenancy,ect.) 2. The full name and address of the undersigned owner or reputed owner and of all co-owners or reputed co- owners are: Name Street and No. City State City of Palm Springs 3200 E.Tahquitz Canyon Way Palm Springs CA 92262 3. The name and address of the direct contractor for the work of improvement as a whole is: Superior Pavement Markings,Inc.,P.O. Box 278,Beaumont,CA 92223 4. This notice is given for(check one): p Completion of the work of improvement as a whole. Completion of a contract for a particular portion of the work of improvement(per CA Civ. Code 8186). 5. If this notice is given only of completion of a contract for a particular portion of the work of improvement as provided in CA Civ. Code§8186),the name and address of the direct contractor under that contract is: Not Applicable 6. The name and address of the construction lender,if any, is: Not Applicable 7. On the 14" day of November,2018,there was completed upon the herein described property a work of improvement as a whole(or particular portion of the work of improvement as provided in CA Civ.Code 8186)a general description of the work provided: City Project 14-14, City of Palm Springs Bicycle Lane Project,Federal Aid Project No. CML-5282 (044) 8. The real property herein referred to is situated in the City of Palm Springs County of Riverside State of California,and is described as follows: Construction of bicycle lanes on San Rafael Drive,Farrell Drive Mesquite Avenue Camino Real La Verne Way,and Crosslev Road,in the City of Palm Springs 9. The street address of said property is: Not Applicable 10. If this Notice of Completion is signed by the owner's successor in interest, the name and address of the successor's transferor is: Not Applicable I certify(or declare)under penalty of perjury the 1 s f the State of lifo to at the foregoing is true and correct. / J n Date:qy ofg B : S nature of Own or Owner's Authorized Agent Marcus Fuller,Assistant City Manager/City Engineer City of Palm Springs Page t of 2 VERIFICATION I, Marcus Fuller , state: I am the Assistant City Manager/City Engineer("Owner","President", Authorized Agent","Partner",etc.)of the Owner identified in the foregoing Notice of Completion. I have read said Notice of Completion and know the contents thereof, the same is true of my own knowledge. I declare under penalty of perjury under the laws of the State ofCalifornia that the foregoing is true and correct. Executed on L( date),at Palm Springs (cit ),CA State). Signature of OwriX or Owner's Authorized Agent Marcus Fuller, Assistant City Manager/City Engineer City of Palm Springs 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 41`4,L9151;ede_ On f hr/e/JJ I /9 - ©/date), before me, jmnd Notary Public (name and title of officer) personally a peared &a& -k t fp llePr 'who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted,executed the instrument. I, certify under PENALTY OF PL RJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal.. KIMBERLY S. FLOYO Signature jl Commission•2127367 Notary Public-California s Z Riverside County My Comm.Expires Oct 17,2019 Page 2 of 2 AGREEMENT CONSTRUCTION CONTRACT) MAI THIS AGREEMENT made thisqAW day of Aprfl, 2018, by and between the City of Palm Springs, a charter city, organized and existing in the County of Riverside, under and by virtue of the laws of the State of California, hereinafter designated as the City, and Superior Pavement Markings, Inc., a California corporation. The City and the Contractor, in consideration of the mutual covenants hereinafter set forth, agree as follows: ARTICLE 1 -- THE WORK For and in consideration of the payments and agreements to be made and performed by City, Contractor agrees to fumish all materials and perform all work required to complete the Work as specified in the Contract Documents, and as generally indicated under the Bid Schedule(s)for the Project entitled: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEDERAL AID PROJECT NO. CML-5282 (044) The Work comprises the construction of bicycle lanes along San Rafael Drive from N. Palm Canyon Drive to Sunrise Way; Farrell Drive between Tahquitz Canyon Way and Ramon Road; Camino Real between E. Palm Canyon Drive and La Verne Way; La Verne Way between S. Palm Canyon Drive and Twin Palms Drive; and Crossley Road between Ramon Road and 34t' Avenue. The work includes removal and replacement of existing traffic striping, pavement markers, installation of thermoplastic bike lane lines, thermoplastic bike lane markings, thermoplastic crosswalks, curb painting, signs, traffic loops, vehicle detection camera adjustments, and all appurtenant work. ARTICLE 2 -- COMMENCEMENT AND COMPLETION The Work to be performed under this Contract shall commence on the date specified in the Notice to Proceed by the City, and the Work shall be fully completed within the time specified in the Notice to Proceed. The City and the Contractor recognize that time is of the essence of this Agreement, and that the City will suffer financial loss if the Work is not completed within the time specified in Article 2, herein, plus any extensions thereof allowed in accordance with applicable provisions of the Standard Specifications, as modified herein. They also recognize the delays, expense, and difficulties involved in proving in a legal proceeding the actual loss suffered by the City if the Work is not completed on time. Accordingly, instead of requiring any such proof, the City and the Contractor agree that as liquidated damages or delay (but not as a penalty), the Contractor shall pay the City the sum specified in Section 6-9 of the Special Provisions for each calendar day that expires after the time specified in Article 2, herein. In executing the Agreement, the Contractor acknowledges it has reviewed the provisions of the Standard Specifications, as modified herein, related to liquidated damages, and has made itself aware of the actual loss incurred by the City due to the inability to complete the Work within the time specified in the Notice to Proceed. CITY OF PALM SPRINGS BICYCLE LANE PROJECT ORIGINAL BIDCITYPROJECTNO. 14-14 AGREEMENT FORM FEBRUARY 8,2018 AGREEMENT AND BONDS-PAGE 1 AND/ORAGREEMENT ARTICLE 3 -- CONTRACT PRICE Bid Schedules A, B, C, D, and E The City shall pay the Contractor for the completion of the Work, in accordance with the Contract Documents, in current funds the Contract Price(s) named in the Contractor's Bid Proposal and Bid Schedule(s), and any duly authorized Construction Contract Change Orders approved by the City. The amount of the initial contract award in accordance with the Contractor's Bid Proposal is Five Hundred Ninety Six Thousand Four Hundred Eighty Two Dollars and Five Cents ($596.482.05). Contractor agrees to receive and accept the prices set forth herein, as full compensation for furnishing all materials, performing all work, and fulfilling all obligations hereunder. Said compensation shall cover all expenses, losses, damages, and consequences arising out of the nature of the Work during its progress or prior to its acceptance including those for well and faithfully completing the Work and the whole thereof in the manner and time specified in the Contract Documents; and, also including those arising from actions of the elements, unforeseen difficulties or obstructions encountered in the prosecution of the Work, suspension of discontinuance of the Work, and all other unknowns or risks of any description connected with the Work. ARTICLE 4 -- THE CONTRACT DOCUMENTS The Contract Documents consist of the Notice Inviting Bids, Instructions to Bidders, the prevailing rate of per diem wages as determined by the Director of the California Department of Industrial Relations, the accepted Bid and Bid Schedule(s), List of Subcontractors, Local Business Preference Program — Good Faith Efforts, Non- Discrimination Certification, Non-Collusion Declaration, Bidder's General Information, Bid Security or Bid Bond, this Agreement, Worker's Compensation Certificate, Performance Bond, Payment Bond, Standard Specifications, Special Provisions, the Drawings, Addenda numbers 01 to 02, inclusive, and all Construction Contract Change Orders and Work Change Directives which may be delivered or issued after the Effective Date of the Agreement and are not attached hereto. ARTICLE 5 -- MUTUAL OBLIGATIONS For and in consideration of the payments and agreements to be made and performed by the City, the Contractor agrees to furnish all materials and perform all work required for the above stated project, and to fulfill all other obligations as set forth in the aforesaid Contract Documents. City hereby agrees to employ, and does hereby employ, Contractor to provide the materials, complete the Work, and fulfill the obligations according to the terms and conditions herein contained and referred to, for the Contract Price herein identified, and hereby contracts to pay the same at the time, in the manner, and upon the conditions set forth in the Contract Documents. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO.14-14 AGREEMENT FORM FEBRUARY 8,2018 AGREEMENT AND BONDS-PAGE 2 Contractor specifically acknowledges and agrees to be bound by the Wage Rates and Labor Code requirements specified in the Contract Documents, including the requirement to furnish electronic certified payroll records directly to the Labor Commissioner (via the Division of Labor Standards Enforcement), and shall pay the general prevailing rate of per diem wages as determined by the Director of the Department of Industrial Relations of the State of California. ARTICLE 6 -- PAYMENT PROCEDURES The Contractor shall submit Applications for Payment in accordance with the Standard Specifications as amended by the Special Provisions. Applications for Payment will be processed by the City Engineer as provided in the Contract Documents. ARTICLE 7 -- NOTICES Whenever any provision of the Contract Documents requires the giving of a written Notice between the parties, it shall be deemed to have been validly given if delivered in person to the individual or to a member of the firm or to an officer of the corporation for whom it is intended, or if delivered at or sent by registered or certified mail, postage prepaid, to the last business address known to the giver of the Notice. ARTICLE 8 -- INDEMNIFICATION The Contractor agrees to indemnify and hold harmless the City, and all of its officers and agents from any claims, demands, or causes of action, including related expenses, attorney's fees, and costs, based on, arising out of, or in any way related to the Work undertaken by the Contractor hereunder. This Article 8 incorporates the provisions of Section 7-15 "Indemnification," of the Special Provisions, which are hereby referenced and made a part hereof. Prevailing Wages. Contractor agrees to fully comply with all applicable federal and state labor laws including, without limitation California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq. ("Prevailing Wage Laws"). Contractor shall bear all risks of payment or non-payment of prevailing wages under California law, and Contractor hereby agrees to defend, indemnify, and hold the City, its officials, officers, employees, agents and volunteers, free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. ARTICLE 9 -- CONFLICT OF INTEREST Conflict of Interest. Contractor acknowledges that no officer or employee of the City has or shall have any direct or indirect financial interest in this Agreement nor shall Contractor enter into any agreement of any kind with any such officer or employee during the term of this Agreement and for one year thereafter. Contractor warrants that Contractor has not paid or given, and will not pay or give, any third party any money or other consideration in exchange for obtaining this Agreement. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 AGREEMENT FORM FEBRUARY 8,2018 AGREEMENT AND BONDS-PAGE 3 ARTICLE 10 -- NON-DISCRIMINATION In connection with its performance under this Agreement, Contractor shall not discriminate against any employee or applicant for employment because of actual or perceived race, religion, color, sex, age, marital status, ancestry, national origin (i.e., place of origin, immigration status, cultural or linguistic characteristics, or ethnicity), sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition (each a "prohibited basis"). Contractor shall ensure that applicants are employed, and that employees are treated during their employment, without regard to any prohibited basis. As a condition precedent to City's lawful capacity to enter this Agreement, and in executing this Agreement, Contractor certifies that its actions and omissions hereunder shall not incorporate any discrimination arising from or related to any prohibited basis in any Contractor activity, including but not limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship; and further, that Contractor is in full compliance with the provisions of Palm Springs Municipal Code Section 7.09.040, including without limitation the provision of benefits, relating to non-discrimination in city contracting. ARTICLE 11 -- MISCELLANEOUS Terms used in this Agreement which are defined in the Standard Specifications and the Special Provisions will have the meanings indicated in said Standard Specifications and the Special Provisions. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and specifically, but without limitation, monies that may become due and monies that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment, no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. The City and the Contractor each binds itself, its partners, successors, assigns, and legal representatives, to the other party hereto, its partners, successors, assigns, and legal representatives, in respect of all covenants, agreements, and obligations contained in the Contract Documents. SIGNATURES ON NEXT PAGE CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 AGREEMENT FORM FEBRUARY 8,2018 AGREEMENT AND BONDS-PAGE 4 IN WITNESS WHEREOF, the City and the Contractor have caused this Agreement to be executed the day and year first above written. CITY OF PALM SPRINGS, APPROVED BY THE CITY COUNCIL: CALIFORNIA C B Date 5• A' David H. Re City Manager Agreement No. ATTEST: B 1Y thony J. ejia, C City APPROVED AS TO FORM: By. Edward Z. Kotki City Attorney RECOMM DELBy Thomas Garcia, Director of Engineering Services/City Engineer CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 AGREEMENT FORM FEBRUARY 8,2018 AGREEMENT AND BONDS-PAGE 5 CONTRACTOR By: Superior Pavement Markings Inc. a California corporation Firm/Company Name By: V By. Signature(notarized) Si nat a(notarized) Name: Darren Veltz Name: Roberto Garcia Title: CFO Title: Vice President 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. This Agreement must be signed in the above (This Agreement must be signed in the above space by one having authority to bind the space by one having authority to bind the Contractor to the terms of the Agreement.) Contractor to the terms of the Agreement.) State of California State of California County of range )ss County of Oranqe )ss On April 11, 2018 On April 11, 2018 before me,Lorena B. Berumen- Notary Public before me, I nrPna R eerumen- Notary Public personally appeared Darren Veltz personally appeared Roberto Garcia who proved to me on the basis of satisfactory who proved to me on the basis of satisfactory evidence to be the person(; whose nameto evidence to be the person(SA whose namew is/are subscribed to the within instrument and is/are subscribed to the within instrument and acknowledged to me that he/s1 ,e"y executed acknowledged to me that he/s$e/th* executed the same in his/I5qr/tNir authorized capacity(*, the same in hi /tt*r authorized capacity(ie)4, and that by his/hW]thW signaturesoo on the and that by his/hX/their signatures on the instrument the person(,, or the entity upon behalf instrument the person(k, or the entity upon behalf of which the person($)( acted, executed the of which the person(W acted, executed the instrument. instrument. I certify under PENALTY OF PERJURY under the I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing laws of the State of California that the foregoing paragraph is true and correct. paragraph is true and correct. WITNESS my hand an official seal. WITNESS my hand and cial sealNotarySignature: 13r122•—rotary Signature: Notary Seal: Notary Seal: LORotENA8.BERUMEN NaryPubllc-California LORENAB.BERUMENyr; zOrangeCountya NotaryPublic-California Commission#2196341 Orange County My Comm,Eaplrea Jun B,2021 Commlaeion#2196341 My Comm.hplroa Jun 6,2021 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO, 14-14 AGREEMENT FORM FEBRUARY 8,2018 AGREEMENT AND BONDS-PAGE 6 EXHIBIT "A" Federal Requirements for Federal-Aid Construction Projects Form FHWA 1273), Female and Minority Goals, Federal Trainee Program, Title IV Assurances FOLLOWS THIS PAGE CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM-EXHIBIT"A" FHWA-1273 -- Revised May 1, 2012 REQUIRED CONTRACT PROVISIONS FEDERAL-AID CONSTRUCTION CONTRACTS I. General II. Nondiscrimination It. NONDISCRIMINATION III. Nonsegregated Facilities IV. Davis-Bacon and Related Act Provisions The provisions of this section related to 23 CFR Part 230 are applicable V. Contract Work Hours and Safety Standards Act Provisions to all Federal-aid construction contracts and to all related construction VI. Subletting or Assigning the Contract subcontracts of$10,000 or more. The provisions of 23 CFR Part 230 are VI I. Safety:Accident Prevention not applicable to material supply, engineering, or architectural service Vill. False Statements Concerning Highway Projects contracts. IX. Implementation of Clean Air Act and Federal Water Pollution Control Act In addition, the contractor and all subcontractors must comply with the X. Compliance with Govemmentvdde Suspension and Debarment following policies: Executive Order 11246, 41 CFR 60, 29 CFR 1625- Requirements 1627, Title 23 USC Section 140, the Rehabilitation Act of 1973, as XI. Certification Regarding Use of Contract Funds for Lobbying amended (29 USC 794), Title VI of the Civil Rights Act of 1964, as amended,and related regulations including 49 CFR Parts 21,26 and 27; ATTACHMENTS and 23 CFR Parts 200,230,and 633. A. Employment and Materials Preference for Appalachian Development The contractor and all subcontractors must comply with: the Highway System or Appalachian Local Access Road Contracts(included requirements of the Equal Opportunity Clause in 41 CFR 60-1.4(b)and, in Appalachian contracts only) for all construction contracts exceeding $10,000, the Standard Federal Equal Employment Opportunity Construction Contract Specifications in I. GENERAL 41 CFR60-4.3. 1. Form FHWA-1273 must be physically incorporated in each Note:The U.S.Department of Labor has exclusive authority to determine construction contract funded under Title 23 (excluding emergency compliance with Executive Order 11246 and the policies of the Secretary contracts solely intended for debris removal). The contractor (or of Labor including 41 CFR 60,and 29 CFR 1625-1627. The contracting subcontractor) must insert this form in each subcontract and further agency and the FHWA have the authority and the responsibility to require its inclusion in all lower tier subcontracts (excluding purchase ensure compliance with Title 23 USC Section 140,the Rehabilitation Act orders, rental agreements and other agreements for supplies or of 1973,as amended(29 USC-794),and Title VI of the Civil Rights Act of services). 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27;and 23 CFR Parts 200,230,and 633. The applicable requirements of Form FHWA-1273 are incorporated by reference for work done under any purchase order, rental agreement or The following provision is adopted from 23 CFR 230, Appendix A, with agreement for other services. The prime contractor shall be responsible appropriate revisions to conform to the U.S. Department of Labor (US for compliance by any subcontractor, lower-tier subcontractor or service DOL)and FHWA requirements. provider. 1. Equal Employment Opportunity: Equal employment opportunity Form FHWA-1273 must be included in all Federal-aid design-build (EEO)requirements not to discriminate and to take affirmative action to contracts, in all subcontracts and in lower tier subcontracts (excluding assure equal opportunity as set forth under laws,executive orders,rules, subcontracts for design services, purchase orders, rental agreements regulations(28 CFR 35, 29 CFR 1630, 29 CFR 1625-1627,41 CFR 60 and other agreements for supplies or services). The design-builder shall and 49 CFR 27)and orders of the Secretary of Labor as modified by the be responsible for compliance by any subcontractor, lower-tier provisions prescribed herein, and imposed pursuant to 23 U.S.C. 140 subcontractor or service provider. shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract. The provisions of the Contracting agencies may reference Form FHWA-1273 in bid proposal Americans with Disabilities Act of 1990 (42 U.S.C. 12101 at seq.) set or request for proposal documents,however,the Form FHWA-1273 must forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference be physically incorporated(not referenced)in all contracts,subcontracts in this contract.In the execution of this contract,the contractor agrees to and lower-tier subcontracts (excluding purchase orders, rental comply with the following minimum speck requirement activities of agreements and other agreements for supplies or services related to a EEO: construction contract). a.The contractor will work with the contracting agency and the Federal 2. Subject to the applicability criteria noted in the following sections, Government to ensure that it has made every good faith effort to provide these contract provisions shall apply to all work performed on the equal opportunity with respect to all of its terms and conditions of contract by the contractor's own organization and with the assistance of employment and in their review of activities under the contract, workers under the contractors immediate superintendence and to all work performed on the contract by piecework, station work, or by b. The contractor will accept as its operating policy the following subcontract. statement: 3. A breach of any of the stipulations contained in these Required "It is the policy of this Company to assure that applicants are Contract Provisions may be sufficient grounds for withholding of progress employed, and that employees are treated during employment, without payments, withholding of final payment, termination of the contract, regard to their race, religion,sex,color, national origin,age or disability. suspension/debarment or any other action determined to be appropriate Such action shall include:employment,upgrading,demotion,or transfer; by the contracting agency and FHWA. recruitment or recruitment advertising;layoff or termination;rates of pay or other forms of compensation; and selection for training, including 4. Selection of Labor: During the performance of this contract, the apprenticeship,pre-apprenticeship,and/or on-the-job training." contractor shall not use convict labor for any purpose within the limits of a construction project on a Federal-aid highway unless it is labor 2. EEO Officer: The contractor will designate and make known to the performed by convicts who are an parole, supervised release, or contracting officers an EEO Officer who will have the responsibility for probation. The term Federal-aid highway does not include roadways and must be capable of effectively administering and promoting an active functionally classified as local roads or rural minor collectors.EEO program and who must be assigned adequate authority and responsibility to do so. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM—EXHIBIT"A" PAGE 2 3. Dissemination of Policy: All members of the contractor's staff b.The contractor will periodically evaluate the spread of wages paid who are authorized to hire, supervise, promote, and discharge within each classification to determine any evidence of employees,or who recommend such action,or who are substantially discriminatory wage practices. involved in such action, will be made fully cognizant of, and will implement, the contractors EEO policy and contractual c. The contractor will periodically review selected personnel actions in responsibilities to provide EEO in each grade and classification of depth to determine whether there is evidence of discrimination. employment. To ensure that the above agreement will be met, the Where evidence is found,the contractor will promptly take corrective following actions will be taken as a minimum: action. If the review indicates that the discrimination may extend beyond the actions reviewed,such corrective action shall include all a.Periodic meetings of supervisory and personnel office employees affected persons. will be conducted before the start of work and then not less often than once every six months, at which time the contractors EEO d.The contractor will promptly investigate all complaints of alleged policy and its implementation will be reviewed and explained. The discrimination made to the contractor in connection with its meetings will be conducted by the EEO Officer. obligations under this contract, will attempt to resolve such complaints, and will take appropriate corrective action within a b.All new supervisory or personnel office employees will be given a reasonable time. If the investigation indicates that the discrimination thorough indoctrination by the EEO Officer, covering all major may affect persons other than the complainant, such corrective aspects of the contractor's EEO obligations within thirty days action shall include such other persons. Upon completion of each following their reporting for duty with the contractor. investigation, the contractor will inform every complainant of all of their avenues of appeal. c.All personnel who are engaged in direct recruitment for the project will be instructed by the EEO Officer in the contractors procedures 6.Training and Promotion: for locating and hiring minorities and women. a.The contractor will assist in locating, qualifying, and increasing the d.Notices and posters setting forth the contractors EEO policy will be skills of minorities and women who are applicants for employment or placed in areas readily accessible to employees, applicants for current employees. Such efforts should be aimed at developing full employment and potential employees. journey level status employees in the type of trade or job classification involved. e.The contractors EEO policy and the procedures to implement such policy will be brought to the attention of employees by means of b.Consistent with the contractors work force requirements and as meetings,employee handbooks,or other appropriate means. permissible under Federal and State regulations,the contractor shall make full use of training programs, i.e.,apprenticeship, and on-the- 4.Recruitment:When advertising for employees,the contractor will job training programs for the geographical area of contract include in all advertisements for employees the notation: "An Equal performance. In the event a special provision for training is provided Opportunity Employer." All such advertisements will be placed in under this contract, this subparagraph will be superseded as publications having a large circulation among minorities and women indicated in the special provision. The contracting agency may in the area from which the project work force would normally be reserve training positions for persons who receive welfare derived.assistance in accordance with 23 U.S.C. 140(a). a.The contractor will, unless precluded by a valid bargaining c.The contractor will advise employees and applicants for employment agreement,conduct systematic and direct recruitment through public of available training programs and entrance requirements for each. and private employee referral sources likely to yield qualified minorities and women. To meet this requirement,the contractor will d.The contractor will periodically review the training and promotion identify sources of potential minority group employees,and establish potential of employees who are minorities and women and will with such identified sources procedures whereby minority and encourage eligible employees to apply for such training and women applicants may be referred to the contractor for employment promotion. consideration. 7.Unions: If the contractor relies in whole or in part upon unions as b.In the event the contractor has a valid bargaining agreement a source of employees, the contractor will use good faith efforts to providing for exclusive hiring hall referrals, the contractor is obtain the cooperation of such unions to increase opportunities for expected to observe the provisions of that agreement to the extent minorities and women. Actions by the contractor, either directly or that the system meets the contractors compliance with EEO through a contractors association acting as agent, will include the contract provisions. Where implementation of such an agreement procedures set forth below: has the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation a.The contractor will use good faith efforts to develop, in cooperation violates Federal nondiscrimination provisions. with the unions, joint training programs aimed toward qualifying more minorities and women for membership in the unions and c. The contractor will encourage its present employees to refer increasing the skills of minorities and women so that they may minorities and women as applicants for employment. Information qualify for higher paying employment. and procedures with regard to referring such applicants will be discussed with employees. b.The contractor will use good faith efforts to incorporate an EEO clause into each union agreement to the end that such union will be 5. Personnel Actions: Wages, working conditions, and employee contractually bound to refer applicants without regard to their race, benefits shall be established and administered, and personnel color,religion,sex, national origin,age or disability. actions of every type, including hiring, upgrading, promotion, transfer, demotion, layoff, and termination, shall be taken without c.The contractor is to obtain information as to the referral practices regard to race, color, religion, sex, national origin, age or disability. and policies of the labor union except that to the extent such The following procedures shall be followed: information is within the exclusive possession of the labor union and such labor union refuses to fumish such information to the a.The contractor will conduct periodic inspections of project sites to contractor, the contractor shall so certify to the contracting agency insure that working conditions and employee facilities do not indicate and shall set forth what efforts have been made to obtain such discriminatory treatment of project site personnel.information. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM—EXHIBIT"A" PAGE 9 d.In the event the union is unable to provide the contractor with a employees currently engaged in each work classification required by reasonable flow of referrals within the time limit set forth in the the contract work. This information is to be reported on Form collective bargaining agreement, the contractor will, through FHWA-1391. The staffing data should represent the project work independent recruitment efforts, fill the employment vacancies force on board in all or any part of the last payroll period preceding without regard to race, color, religion, sex, national origin, age or the end of July. If on-the-job training is being required by special disability; making full efforts to obtain qualified and/or qualifiable provision,the contractor will be required to collect and report training minorities and women. The failure of a union to provide sufficient data. The employment data should reflect the work force on board referrals (even though it is obligated to provide exclusive referrals during all or any part of the last payroll period preceding the end of under the terms of a collective bargaining agreement) does not July. relieve the contractor from the requirements of this paragraph. In the event the union referral practice prevents the contractor from III.NONSEGREGATED FACILITIES meeting the obligations pursuant to Executive Order 11246, as amended, and these special provisions, such contractor shall This provision is applicable to all Federal-aid construction contracts immediately notify the contracting agency. and to all related construction subcontracts of$10,000 or more. 8.Reasonable Accommodation for Applicants/Employees with The contractor must ensure that facilities provided for employees Disabilities: The contractor must be familiar with the requirements are provided in such a manner that segregation on the basis of race, for and comply with the Americans with Disabilities Act and all rules color, religion, sex, or national origin cannot result. The contractor and regulations established there under. Employers must provide may neither require such segregated use by written or oral policies reasonable accommodation in all employment activities unless to do nor tolerate such use by employee custom. The contractor's so would cause an undue hardship. obligation extends further to ensure that its employees are not assigned to perform their services at any location, under the 9. Selection of Subcontractors, Procurement of Materials and contractor's control, where the facilities are segregated. The term Leasing of Equipment:The contractor shall not discriminate on the "facilities"includes waiting rooms,work areas, restaurants and other grounds of race,color, religion, sex, national origin,age or disability eating areas,time clocks,restrooms,washrooms,locker rooms,and in the selection and retention of subcontractors, including other storage or dressing areas, parking lots, drinking fountains, procurement of materials and leases of equipment. The contractor recreation or entertainment areas, transportation, and housing shall take all necessary and reasonable steps to ensure provided for employees. The contractor shall provide separate or nondiscrimination in the administration of this contract. single-user restrooms and necessary dressing or sleeping areas to assure privacy between sexes. a.The contractor shall notify all potential subcontractors and suppliers and lessors of their EEO obligations under this contract. IV. DAVIS-BACON AND RELATED ACT PROVISIONS b.The contractor will use good faith efforts to ensure subcontractor This section is applicable to all Federal-aid construction projectscompliancewiththeirEEOobligations. exceeding $2,000 and to all related subcontracts and lower-tier 10.Assurance Required by 49 CFR 26.13(b): subcontracts (regardless of subcontract size). The requirements apply to all projects located within the right-of-way of a roadway that a.The requirements of 49 CFR Part 26 and the State DOT's U.S. is functionally classified as Federal-aid highway. This excludes DOT-approved DBE program are incorporated by reference. roadways functionally classified as local roads or rural minor collectors, which are exempt. Contracting agencies may elect to b.The contractor or subcontractor shall not discriminate on the basis of apply these requirements to other projects. race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of The following provisions are from the U.S. Department of Labor 49 CFR Part 26 in the award and administration of DOT-assisted regulations in 29 CFR 5.5"Contract provisions and related matters" contracts. Failure by the contractor to carry out these requirements with minor revisions to conform to the FHWA-1273 formal and is a material breach of this contract, which may result in the FHWA program requirements. termination of this contract or such other remedy as the contracting agency deems appropriate.1. Minimum wages 11. Records and Reports: The contractor shall keep such records as necessary to document compliance with the EEO requirements. a.All laborers and mechanics employed or working upon the site of the Such records shall be retained for a period of three years following work, will be paid unconditionally and not less often than once a the date of the final payment to the contractor for all contract work week, and without subsequent deduction or rebate on any account and shall be available at reasonable times and places for inspection (except such payroll deductions as are permitted by regulations by authorized representatives of the contracting agency and the issued by the Secretary of Labor under the Copeland Act(29 CFR FHWA. part 3)), the full amount of wages and bona fide fringe benefits(or cash equivalents thereof)due at time of payment computed at rates a.The records kept by the contractor shall document the following: not less than those contained in the wage determination of the Secretary of labor which is attached hereto and made a part hereof, 1)The number and work hours of minority and non-minority group regardless of any contractual relationship which may be alleged to members and women employed in each work classification on the exist between the contractor and such laborers and mechanics. project; 2)The progress and efforts being made in cooperation with unions, Contributions made or costs reasonably anticipated for bona fide when applicable,to increase employment opportunities for minorities fringe benefits under section 1(bX2) of the Davis-Bacon Act on and women;and behalf of laborers or mechanics are considered wages paid to such laborers or mechanics,subject to the provisions of paragraph 1 A.of 3)The progress and efforts being made in locating, hiring, training, this section; also, regular contributions made or costs incurred for qualifying,and upgrading minorities and women; more than a weekly period(but not less often than quarterly)under plans,funds, or programs which cover the particular weekly period, b.The contractors and subcontractors will submit an annual report to are deemed to be constructively made or incurred during such the contracting agency each July for the duration of the project, weekly period. Such laborers and mechanics shall be paid the indicating the number of minority, women, and non-minority group appropriate wage rate and fringe benefits on the wage determination CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM—EXHIBIT"A" PAGE 10 for the classification of work actually performed, without regard to Bacon Act have been met. The Secretary of Labor may require the skill,except as provided in 29 CFR 5.5(ax4). Laborers or mechanics contractor to set aside in a separate account assets for the meeting performing work in more than one classification may be of obligations under the plan or program. compensated at the rate specified for each classification for the time actually worked therein: Provided, that the employer's payroll y Withholdingrecordsaccuratelysetforththetimespentineachclassificationin which work is performed. The wage determination (including any additional classification and wage rates conformed under paragraph The contracting agency shall upon its own action or upon written 1.b.of this section)and the Davis-Bacon poster(WH-1321)shall be request of an authorized representative of the Department of Labor, posted at all times by the contractor and its subcontractors at the withhold or cause to be withheld from the contractor under this site of the work in a prominent and accessible place where it can be contract, or any other Federal contract with the same prime easily seen by the workers. contractor,or any other federally-assisted contract subject to Davis- Bacon prevailing wage requirements, which is held by the same b.(1)The contracting officer shall require that any Gass of laborers or prime contractor, so much of the accrued payments or advances as mechanics, including helpers, which is not listed in the wage may be considered necessary to pay laborers and mechanics, determination and which is to be employed under the contract shall including apprentices, trainees, and helpers, employed by the be classified in conformance with the wage determination. The contractor or any subcontractor the full amount of wages required by contracting officer shall approve an additional classification and the contract. In the event of failure to pay any laborer or mechanic, wage rate and fringe benefits therefore only when the following including any apprentice, trainee,or helper,employed or working on criteria have been met: the site of the work,all or part of the wages required 6y the contract, the contracting agency may, after written notice to the contractor, i) The work to be performed by the classification requested is not take such action as may be necessary to cause the suspension of performed by a classification in the wage determination;and any further payment, advance, or guarantee of funds until such violations have ceased. ii)The classification is utilized in the area by the construction industry; and 3. Payrolls and basic records iii)The proposed wage rate, including any bona fide fringe benefits, a.Payrolls and basic records relating thereto shall be maintained bybearsareasonablerelationshiptothewageratescontainedinthe wage determination. the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics 2)If the contractor and the laborers and mechanics to be employed working at the site of the work.Such records shall contain the name, in the classification (if known), or their representatives, and the address,and social security number of each such worker,his or her contracting officer agree on the classification and wage rate correct classification, hourly rates of wages paid(including rates of including the amount designated for fringe benefits where contributions or costs anticipated for bona fide fringe benefits or appropriate), a report of the action taken shall be sent by the cash equivalents thereof of the types described in section 1(bx2XB) contracting officer to the Administrator of the Wage and Hour of the Davis-Bacon Act), daily and weekly number of hours worked, Division, Employment Standards Administration, U.S. Department of deductions made and actual wages paid.Whenever the Secretary of Labor, Washington, DC 20210. The Administrator, or an authorized Labor has found under 29 CFR 5.5(ax1)(iv)that the wages of any representative, will approve, modify, or disapprove every additional laborer or mechanic include the amount of any costs reasonably classification action within 30 days of receipt and so advise the anticipated in providing benefits under a plan or program described contracting officer or will notify the contracting officer within the 30- in section 1(bx2)(B) of the Davis-Bacon Act, the contractor shall day period that additional time is necessary. maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially 3) In the event the contractor, the laborers or mechanics /o be responsible, and that the plan or program has been communicated employed in the classification or their representatives, and the in writing to the laborers or mechanics affected, and records which contracting officer do not agree on the proposed classification and show the costs anticipated or the actual cost incurred in providing wage rate (including the amount designated for fringe benefits, such benefits. Contractors employing apprentices or trainees under where appropriate), the contracting officer shall refer the questions, approved programs shall maintain written evidence of the including the views of all interested parties and the recommendation registration of apprenticeship programs and certification of trainee of the contracting officer, to the Wage and Hour Administrator for Programs, the registration of the apprentices and trainees, and the determination. The Wage and Hour Administrator, or an authorized ratios and wage rates prescribed in the applicable programs. representative, will issue a determination within 30 days of receipt b.(1) The contractor shall submit weekly for each week in which any and so advise the contracting officer or will notify the contracting contract work is performed a copy of all payrolls to the contracting officer within the 30-day period that additional time is necessary. agency. The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 4) The wage rate (including fringe benefits where appropriate) CFR 5.5(ax3xi), except that full social security numbers and home determined pursuant to paragraphs 1.b.(2)or 1.1b.(3)of this section, addresses shall not be included on weekly transmittals. Instead the shall be paid to all workers perforating work in the classification Payrolls shall only need to include an individually identifying number under this contract from the first day on which work is performed in for each employee(e.g.,the last four digits of the employee's social the classification. security number). The required weekly payroll information may be submitted in any form desired. Optional Form WH-347 is available c.Whenever the minimum wage rate prescribed in the contract for a for this purpose from the Wage and Hour Division Web site at class of laborers or mechanics includes a fringe benefit which is not http://www.dol.govlesalwhd/forms/wh347instr.htm or its successor expressed as an hourly rate, the contractor shall either pay the site. The prime contractor is responsible for the submission of benefit as stated in the wage determination or shall pay another copies of payrolls by all subcontractors. Contractors and bona fide fringe benefit or an hourly cash equivalent thereof. subcontractors shall maintain the full social security number and current address of each covered worker, and shall provide them d.If the contractor does not make payments to a trustee or other third upon request to the contracting agency for transmission to the State person, the contractor may consider as part of the wages of any DOT, the FHWA or the Wage and Hour Division of the Department laborer or mechanic the amount of any costs reasonably anticipated of Labor for purposes of an investigation or audit of compliance with in providing bona fide fringe benefits under a plan or program, prevailing wage requirements. It is not a violation of this section for a Provided, That the Secretary of Labor has found, upon the written prime contractor to require a subcontractor to provide addresses request of the contractor,that the applicable standards of the Davis- CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM—EXHIBIT"A" PAGE 11 and social security numbers to the prime contractor for its own who is not registered or otherwise employed as stated above,shall records,without weekly submission to the contracting agency. be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In 2)Each payroll submitted shall be accompanied by a"Statement of addition,any apprentice performing work on the job site in excess of Compliance,"signed by the contractor or subcontractor or his or her the ratio permitted under the registered program shall be paid not agent who pays or supervises the payment of the persons employed less than the applicable wage rate on the wage determination for the under the contract and shall certify the following: work actually performed. Where a contractor is performing construction on a project in a locality other than that in which its i) That the payroll for the payroll period contains the information program is registered, the ratios and wage rates (expressed in required to be provided under§5.5(a)(3)(ii)of Regulations,29 CFR percentages of the journeyman's hourly rate) specified in the part 5, the appropriate information is being maintained under§5.5 contractor's or subcontractors registered program shall be a)(3)(i)of Regulations,29 CFR part 5,and that such information is observed. correct and complete; ii) That each laborer or mechanic (including each helper, Every apprentice must be paid at not less than the rate specified in apprentice,and trainee)employed on the contract during the payroll the registered program for the apprentice's level of progress, period has been paid the full weekly wages earned, without rebate, expressed as a percentage of the journeyman hourly rate specified either directly or indirectly, and that no deductions have been made frinin the applicable wage determination. Apprentices shall be paid either directly or indirectly from the full wages earned, other than benefits in accordance with the provisions of the permissible deductions as set forth in Regulations,29 CFR part 3;apprenticeship program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of ii That each laborer or mechanic has been paid not less than the fringe benefits listed on the wage determination for the applicable classification. If the Administrator determines that a different practice applicable wage rates and fringe benefits or cash equivalents for the classification of work performed,as specified in the applicable wage prevails for the applicable apprentice classification, fringes shall be determination incorporated into the contract. paid in accordance with that determination. 3) The weekly submission of a properly executed certification set In the event the Office of Apprenticeship Training, Employer and forth on the reverse side of Optional Forth WH-347 shall satisfy the Labor Services,or a State Apprenticeship Agency recognized by the requirement for submission of the "Statement of Compliance" Office, withdraws approval of an apprenticeship program, the required by paragraph 3.1b.(2)of this section. contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until 4)The falsification of any of the above certifications may subject the an acceptable program is approved. contractor or subcontractor to civil or criminal prosecution under section 1001 of title 18 and section 231 of title 31 of the United b.Trainees(programs of the USDOL).States Code. c.The contractor or subcontractor shall make the records required Except as provided in 29 CFR 5.16,trainees will not be permitted to under paragraph 3.a. of this section available for inspection, work at less than the predetermined rate for the work performed copying, or transcription by authorized representatives of the unless they are employed pursuant to and individually registered in contracting agency, the State DOT, the FHWA, or the Department a program which has received prior approval, evidenced by formal of Labor, and shall permit such representatives to interview certification by the U.S. Department of Labor, Employment and employees during working hours on the job. If the contractor or Training Administration. subcontractor fails to submit the required records or to make them available, the FHWA may, after written notice to the contractor, the contracting agency or the State DOT, take such action as may be The ratio of trainees to journeyman on the job site shall not be necessary to cause the suspension of any further payment, greater than permitted under the plan approved by the Employment advance, or guarantee of funds. Furthermore, failure to submit the and Training Administration. required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress,expressed as a 4. Apprentices and trainees percentage of the journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee a.Apprentices(programs of the USOOL), program does not mention fringe benefits,trainees shall be paid the full amount of fringe benefits listed on the wage determination Apprentices will be permitted to work at less than the predetermined unless the Administrator of the Wage and Hour Division determines rate for the work they performed when they are employed pursuant that there is an apprenticeship program associated with the to and individually registered in a bona fide apprenticeship program corresponding journeyman wage rate on the wage determination registered with the U.S. Department of Labor, Employment and which provides for less than full fringe benefits for apprentices.Any Training Administration,Office of Apprenticeship Training, Employer employee listed on the payroll at a trainee rate who is not registered and Labor Services, or with a State Apprenticeship Agency and participating in a training plan approved by the Employment and recognized by the Office,or if a person is employed in his or her first Training Administration shall be paid not less than the applicable 90 days of probationary employment as an apprentice in such an wage rate on the wage determination for the classification of work apprenticeship program, who is not individually registered in the actually performed. In addition, any trainee performing work on the program, but who has been certified by the Office of Apprenticeship job site in excess of the ratio permitted under the registered program Training, Employer and Labor Services or a State Apprenticeship shall be paid not less than the applicable wage rate on the wage Agency (where appropriate) to be eligible for probationary determination for the work actually performed. employment as an apprentice. In the event the Employment and Training Administration withdraws The allowable ratio of apprentices to journeyman on the job site in approval of a training program, the contractor will no longer be any craft classification shall not be greater than the ratio permitted to permitted to utilize trainees at less than the applicable the contractor as to the entire work force under the registered predetermined rate for the work performed until an acceptable program.Any worker listed on a payroll at an apprentice wage rate, program is approved. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM—EXHIBIT"A" PAGE 12 c. Equal employment opportunity. The utilization of apprentices, by 29 CFR 5.5(a)or 29 CFR 4.6. As used in this paragraph, the trainees and journeymen under this part shall be in conformity with terms laborers and mechanics include watchmen and guards. the equal employment opportunity requirements of Executive Order 11246,as amended,and 29 CFR part 30. 1. Overtime requirements. No contractor or subcontractor d.Apprentices and Trainees(programs of the U.S.DOT)_ contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or Apprentices and trainees working under apprenticeship and skill she is employed on such work to work in excess of forty hours in training programs which have been certified by the Secretary of such workweek unless such laborer or mechanic receives Transportation as promoting EEO in connection with Federal-aid compensation at a rate not less than one and one-half times the highway construction programs are not subject to the requirements basic rate of pay for all hours worked in excess of forty hours in such of paragraph 4 of this Section IV. The straight time hourly wage workweek. rates for apprentices and trainees under such programs will be established by the particular programs.The ratio of apprentices and 2.Violation; liability for unpaid wages; liquidated damages. Intraineestojourneymenshallnotbegreaterthanpermittedbythe the event of any violation of the clause set forth in paragraph(1.)oftermsoftheparticularprogram. this section, the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such 5.Compliance with Copeland Act requirements. The contractor contractor and subcontractor shall be liable to the United States(in shall comply with the requirements of 29 CFR part 3, which are the case of work done under contract for the District of Columbia or incorporated by reference in this contract. a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect 6.Subcontracts. The contractor or subcontractor shall insert Form to each individual laborer or mechanic, including watchmen and FHWA-1273 in any subcontracts and also require the subcontractors guards, employed in violation of the clause set forth in paragraph to include Form FHWA-1273 in any lower tier subcontracts. The o this section,in the sum of p for each calendar day on which such i permittedmitted to work in excess the prime contractor shall be responsible for the compliance by any sucndividual was required or per subcontractor or lower tier subcontractor with all the contract standard workweek of forty hours without payment of the overtime clauses in 29 CFR 5.5. wages required by the clause set forth in paragraph (1.) of this section. 7. Contract termination: debarment. A breach of the contract 3.Withholding for unpaid wages and liquidated damages. The clauses in 29 CFR 5.5 may be grounds for termination of the FHWA or the contacting agency shall upon its own action or uponcontract, and for debarment as a contractor and a subcontractor as written request of an authorized representative of the Department of provided in 29 CFR 5.12. Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor 8.Compliance with Davis-Bacon and Related Act requirements. under any such contract or any other Federal contract with the same All rulings and interpretations of the Davis-Bacon and Related Acts prime contractor, or any other federally-assisted contract subject to contained in 29 CFR parts 1, 3, and 5 are herein incorporated by the Contract Work Hours and Safety Standards Act,which is held by reference in this contract. the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or 9. Disputes concerning labor standards. Disputes arising out of subcontractor for unpaid wages and liquidated damages as provided the labor standards provisions of this contract shall not be subject to in the clause set forth in paragraph(2.)of this section. the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of 4.Subcontracts. The contractor or subcontractor shall insert in any Labor set forth in 29 CFR parts 5, 6, and 7. Disputes within the subcontracts the clauses set forth in paragraph (1.)through (4.)of meaning of this clause include disputes between the contractor(or this section and also a clause requiring the subcontractors to include any of its subcontractors) and the contracting agency, the U.S. these clauses in any lower tier subcontracts. The prime contractor Department of Labor,or the employees or their representatives. shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (1.) 10.Certification of eligibility. through(4.)of this section. a.By entering into this contract, the contractor certifies that neither it VI.SUBLETTING OR ASSIGNING THE CONTRACT nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded This provision is applicable to all Federal-aid construction contractsGovernmentcontractsbyvirtueofsection3(a)of the Davis-Bacon on the National Highway System.Act or 29 CFR 5.12(ax1). b.No part of this contract shall be subcontracted to any person or firm 1.The contractor shall perform with its own organization contract workamounting is not less than 30 percent (or the a greater percentage if ineligible for award of a Government contract by virtue of section 3(a)of the Davis-Bacon Act or 29 CFR 5.12(a)(1). specified elsewhere in the contract) of the total original contract price, excluding any specialty items designated by the contracting c.The penalty for making false statements is prescribed in the U.S. agency. Specialty items may be performed by subcontract and the Criminal Code, 18 U.S.C. 1001. amount of any such specialty items performed may be deducted from the total original contract price before computing the amount of V. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT work required to be performed by the contractor's own organization 23 CFR 635.116). The following clauses apply to any Federal-aid construction contract a.The term "perform work with its own organization'refers to workers in an amount in excess of $100,000 and subject to the overtime employed or leased by the prime contractor, and equipment owned provisions of the Contract Work Hours and Safety Standards Act. or rented by the prime contractor, with or without operators. Such These clauses shall be inserted in addition to the clauses required term does not include employees or equipment of a subcontractor or lower tier subcontractor,agents of the prime contractor,or any other CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM—EXHIBIT"A" PAGE 13 assignees. The term may include payments for the costs of hiring 107 of the Contract Work Hours and Safety Standards Act (40 leased employees from an employee leasing firm meeting all U.S.C.3704). relevant Federal and Slate regulatory requirements. Leased employees may only be included in this term if the prime contractor 3.Pursuant to 29 CFR 1926.3, it is a condition of this contract that the meets all of the following conditions: Secretary of Labor or authorized representative thereof, shall have right of entry to any site of contract performance to inspect or 1) the prime contractor maintains control over the supervision of the investigate the matter of compliance with the construction safety and day-today activities of the leased employees; health standards and to carry out the duties of the Secretary under 2) the prime contractor remains responsible for the quality of the work Section 107 of the Contract Work Hours and Safety Standards Act of the leased employees; 40 U.S.C.3704). 3) the prime contractor retains all power to accept or exclude individual employees from work on the project;and Vill.FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS 4) the prime contractor remains ultimately responsible for the payment of predetermined minimum wages, the submission of payrolls, This provision is applicable to all Federal-aid construction contracts statements of compliance and all other Federal regulatory and to all related subcontracts. requirements. In order to assure high quality and durable construction in conformity b."Specialty Items" shall be construed to be limited to work that with approved plans and specifications and a high degree of requires highly specialized knowledge, abilities, or equipment not reliability on statements and representations made by engineers, ordinarily available in the type of contracting organizations qualified contractors,suppliers,and workers on Federal-aid highway projects, and expected to bid or propose on the contract as a whole and in it is essential that all persons concerned with the project perform general are to be limited to minor components of the overall their functions as carefully, thoroughly, and honestly as possible. contract. Willful falsification, distortion, or misrepresentation with respect to any facts related to the project is a violation of Federal law. To 2.The contract amount upon which the requirements set forth in prevent any misunderstanding regarding the seriousness of these paragraph(1)of Section VI is computed includes the cost of material and similar acts, Form FHWA-1022 shall be posted on each and manufactured products which are to be purchased or produced Federal-aid highway project (23 CFR 635) in one or more places by the contractor under the contract provisions. where it is readily available to all persons concerned with the project: 3.The contractor shall furnish (a) a competent superintendent or supervisor who is employed by the firm, has full authority to direct 18 U.S.C. 1020 reads as follows: performance of the work in accordance with the contract requirements, and is in charge of all construction operations "Whoever, being an officer,agent,or employee of the United States, regardless of who performs the work)and(b)such other of its own or of any State or Territory, or whoever, whether a person, organizational resources (supervision, management, and association, firm, or corporation, knowingly makes any false engineering services) as the contracting officer determines is statement, false representation, or false report as to the character, necessary to assure the performance of the contract. quality, quantity, or cost of the material used or to be used, or the quantity or quality of the work performed or to be performed,or the 4.No portion of the contract shall be sublet, assigned or otherwise cost thereof in connection with the submission of plans, maps, disposed of except with the written consent of the contracting officer, specifications,contracts, or costs of construction on any highway or or authorized representative,and such consent when given shall not related project submitted for approval to the Secretary of be construed to relieve the contractor of any responsibility for the Transportation;or fulfillment of the contract. Written consent will be given only after the contracting agency has assured that each subcontract is Whoever knowingly makes any false statement, false evidenced in writing and that it contains all pertinent provisions and representation, false report or false claim with respect to the requirements of the prime contract. character, quality, quantity, or cost of any work performed or to be performed, or materials furnished or to be furnished, in connection 5.The 30% self-performance requirement of paragraph (1) is not with the construction of any highway or related project approved by applicable to design-build contracts; however, contracting agencies the Secretary of Transportation;or may establish their own self-performance requirements. Whoever knowingly makes any false statement or false VII.SAFETY:ACCIDENT PREVENTION representation as to material fact in any statement, certificate, or report submitted pursuant to provisions of the Federal-aid Roads Act This provision is applicable to all Federal-aid construction contracts approved July 1, 1916, (39 Stat. 355), as amended and and to all related subcontracts. supplemented; 1.In the performance of this contract the contractor shall comply with Shall be fined under this title or imprisoned not more than 5 years all applicable Federal,State,and local laws governing safety,health, or both." and sanitation (23 CFR 636). The contractor shall provide all safeguards, safety devices and protective equipment and take any IX. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL other needed actions as it determines, or as the contracting officer WATER POLLUTION CONTROL ACT may determine, to be reasonably necessary to protect the life and health of employees on the job and the safety of the public and to This provision is applicable to all Federal-aid construction contracts protect property in connection with the performance of the work and to all related subcontracts. covered by the contract. By submission of this bid/proposal or the execution of this contract, 2. It is a condition of this contract, and shall be made a condition of or subcontract, as appropriate, the bidder, proposer, Federal-aid each subcontract, which the contractor enters into pursuant to this construction contractor, or subcontractor, as appropriate, will be contract, that the contractor and any subcontractor shall not permit deemed to have stipulated as follows: any employee, in performance of the contract, to work in surroundings or under conditions which are unsanitary, hazardous 1.That any person who is or will be utilized in the performance of this or dangerous to his/her health or safety, as determined under contract is not prohibited from receiving an award due to a violation construction safety and health standards (29 CFR 1926) of Section 508 of the Clean Water Act or Section 306 of the Clean promulgated by the Secretary of Labor, in accordance with Section AirAct. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM—EXHIBIT"A" PAGE 14 solicitations for lower tier covered transactions exceeding the 2.That the contractor agrees to include or cause to be included the $25,000 threshold. requirements of paragraph(1)of this Section X in every subcontract, and further agrees to take such action as the contracting agency h.A participant in a covered transaction may rely upon a certification of may direct as a means of enforcing such requirements. a prospective participant in a lower tier covered transaction that is not debarred,suspended, ineligible,or voluntarily excluded from the X. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, covered transaction, unless it knows that the certification is INELIGIBILITY AND VOLUNTARY EXCLUSION erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to This provision is applicable to all Federal-aid construction contracts, participate in covered transactions. To verify the eligibility of its design-build contracts, subcontracts, lower-tier subcontracts, principals, as well as the eligibility of any lower tier prospective purchase orders, lease agreements, consultant contracts or any participants, each participant may, but is not required to, check the other covered transaction requiring FHWA approval or that is Excluded Parties List System website(https://www.eL)ls.gov!),which estimated to cost$25,000 or more— as defined in 2 CFR Parts 180 is compiled by the General Services Administration. and 1200. i. Nothing contained in the foregoing shall be construed to require the 1.Instructions for Certification—First Tier Participants: establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and a.By signing and submitting this proposal, the prospective first tier information of the prospective participant is not required to exceed participant is providing the certification set out below. that which is normally possessed by a prudent person in the ordinary course of business dealings. b.The inability of a person to provide the certification set out below will not necessarily result in denial of participation in this covered j. Except for transactions authorized under paragraph (f) of these transaction. The prospective first tier participant shall submit an instructions, if a participant in a covered transaction knowingly explanation of why it cannot provide the certification set out below. enters into a lower tier covered transaction with a person who is The certification or explanation will be considered in connection with suspended, debarred, ineligible, or voluntarily excluded from the department or agency's determination whether to enter into this participation in this transaction, in addition to other remedies transaction. However, failure of the prospective first tier participant available to the Federal Government,the department or agency may to furnish a certification or an explanation shall disqualify such a terminate this transaction for cause or default. person from participation in this transaction. c.The certification in this clause is a material representation of fact 2. Certification Regarding Debarment,Suspension,Ineligibility upon which reliance was placed when the contracting agency and Voluntary Exclusion—First Tier Participants: determined to enter into this transaction. If it is later determined that the prospective participant knowingly rendered an erroneous a.The prospective first tier participant certifies to the best of its certification, in addition to other remedies available to the Federal knowledge and belief,that it and its principals: Government, the contracting agency may terminate this transaction for cause of default. 1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in d.The prospective first tier participant shall provide immediate written covered transactions by any Federal department or agency; notice to the contracting agency to whom this proposal is submitted if any time the prospective first tier participant learns that its(2) Have not within a three-year period preceding this proposal been certification was erroneous when submitted or has become convicted of or had a civil judgment rendered against them for erroneous by reason of changed circumstances. commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, e.The terms "covered transaction," "debarred," "suspended," State or local) transaction or contract under a public transaction; ineligible," "participant," "person," "principal," and "voluntarily violation of Federal or State antitrust statutes or commission of excluded," as used in this clause, are defined in 2 CFR Parts 180 embezzlement, theft, forgery, bribery, falsification or destruction of and 1200. "First Tier Covered Transactions'refers to any covered records,making false statements,or receiving stolen property; transaction between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier(3) Are not presently indicted for or otherwise criminally or civilly Covered Transactions" refers to any covered transaction under a charged by a governmental entity (Federal, State or local) with First Tier Covered Transaction (such as subcontracts). "First Tier commission of any of the offenses enumerated in paragraph (aK2) Participant"refers to the participant who has entered into a covered of this certification;and transaction with a grantee or subgrantee of Federal funds(such as the prime or general contractor). "Lower Tier Participant"refers any(4) Have not within a three-year period preceding this participant who has entered into a covered transaction with a First application/proposal had one or more public transactions (Federal, Tier Participant or other Lower Tier Participants (such as State or local)terminated for cause or default. subcontractors and suppliers). b.Where the prospective participant is unable to certify to any of the f. The prospective first tier participant agrees by submitting this statements in this certification, such prospective participant shall proposal that, should the proposed covered transaction be entered attach an explanation to this proposal. into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared 2.Instructions for Certification-Lower Tier Participants: ineligible, or voluntarily excluded from participation in this covered transaction,unless authorized by the department or agency entering (Applicable to all subcontracts, purchase orders and other lower tier into this transaction. transactions requiring prior FHWA approval or estimated to cost 25,000 or more-2 CFR Parts 180 and 1200) g.The prospective first tier participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding a.By signing and submitting this proposal,the prospective lower tier is Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower providing the certification set out below. Tier Covered Transactions," provided by the department or contracting agency, entering into this covered transaction, without b.The certification in this clause is a material representation of fact modification, in all lower tier covered transactions and in all upon which reliance was placed when this transaction was entered CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM—EXHIBIT"A" PAGE 15 into.If it is later determined that the prospective lower tier participant Certification Regarding Debarment, Suspension, Ineligibility knowingly rendered an erroneous certification, in addition to other and Voluntary Exclusion—Lower Tier Participants: remedies available to the Federal Government, the department, or agency with which this transaction originated may pursue available 1.The prospective lower tier participant certifies, by submission of this remedies,including suspension and/or debarment. proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or c.The prospective lower tier participant shall provide immediate written voluntarily excluded from participating in covered transactions by notice to the person to which this proposal is submitted if at any time any Federal department or agency. the prospective lower tier participant leams that its certification was erroneous by reason of changed circumstances. 2.Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective d.The terms "covered transaction," "debarred," "suspended;' participant shall attach an explanation to this proposal. ineligible;. "participant," "person," "principal," and "voluntarily excluded;' as used in this clause, are defined in 2 CFR Parts 180 and 1200. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. First Tier Covered Transactions"refers to any covered transaction XI. CERTIFICATION REGARDING USE OF CONTRACT FUNDS between a grantee or subgrantee of Federal funds and a participant FOR LOBBYING such as the prime or general contract). "Lower Tier Covered Transactions' refers to any covered transaction under a First Tier This provision is applicable to all Federal-aid construction contracts Covered Transaction(such as subcontracts). "First Tier Participant' and to all related subcontracts which exceed$100,000(49 CFR 20). refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds(such as the prime or 1.The prospective participant certifies, by signing and submitting this general contractor). "Lower Tier Participant" refers any participant bid or proposal,to the best of his or her knowledge and belief,that: who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants(such as subcontractorsa. No Federal appropriated funds have been paid or will be paid, by or and suppliers). on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal e.The prospective lower tier participant agrees by submitting this agency,a Member of Congress,an officer or employee of Congress, proposal that, should the proposed covered transaction be entered or an employee of a Member of Congress in connection with the into, it shall not knowingly enter into any lower tier covered awarding of any Federal contract, the making of any Federal grant, transaction with a person who is debarred, suspended, declared the making of any Federal loan,the entering into of any cooperative ineligible, or voluntarily excluded from participation in this covered agreement, and the extension, continuation, renewal, amendment, transaction, unless authorized by the department or agency with or modification of any Federal contract, grant, loan, or cooperative which this transaction originated.agreement. f. The prospective lower tier participant further agrees by submittingb. If any funds other than Federal appropriated funds have been paid this proposal that it will include this clause titled "Certification or will be paid to any person for influencing or attempting to Regarding Debarment, Suspension, Ineligibility and Voluntary influence an officer or employee of any Federal agency, a Member Exclusion-Lower Tier Covered Transaction,"without modification, in of Congress,an officer or employee of Congress,or an employee of all lower tier covered transactions and in all solicitations for lower tier a Member of Congress in connection with this Federal contract, covered transactions exceeding the$25,000 threshold. grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to g.A participant in a covered transaction may rely upon a certification of Report Lobbying,"in accordance with its instructions. a prospective participant in a lower tier covered transaction that is not debarred,suspended, ineligible,or voluntarily excluded from the 2.This certification is a material representation of fact upon which covered transaction, unless it knows that the certification is reliance was placed when this transaction was made or entered into. erroneous.A participant is responsible for ensuring that its principals Submission of this certification is a prerequisite for making or are not suspended,debarred,or otherwise ineligible to participate in entering into this transaction imposed by 31 U.S.C. 1352. Any covered transactions. To verify the eligibility of its principals,as well person who fails to file the required certification shall be subject to a as the eligibility of any lower tier prospective participants, each civil penalty of not less than $10,000 and not more than $100,000 participant may, but is not required to, check the Excluded Parties for each such failure. List System website (httos://www.eols.cov/), which is compiled by the General Services Administration. 3.The prospective participant also agrees by submitting its bid or proposal that the participant shall require that the language of this h.Nothing contained in the foregoing shall be construed to require certification be included in all lower tier subcontracts, which exceed establishment of a system of records in order to render in good faith $100,000 and that all such recipients shall certify and disclose the certification required by this clause. The knowledge and accordingly. information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph a of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government,the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 AGREEMENT FORM—EXHIBIT"A" PAGE 16 FEMALE AND MIONORITY GOALS The nationwide goal for female utilization is 6.9 percent. The goals for minority utilization [45 Fed Reg 65984(10/3/1980)] are as follows: MINORITY UTILIZATION GOALS Economic Area Goal-% Redding CA: 6.8 174 on-SMSA(Standard Metropolitan Statistical Area)Counties: CA Lassen; CA Modoc;CA Plumas;CA Shasta;CA Siskiyou;CA Tehama Eureka,CA 6.6 175 Non-SMSA Counties: CA Del Norte; CA Humboldt; CA Trinity San Francisco-Oakland-San Jose, CA: SMSA Counties: 28.9 7120 Salinas-Seaside-Monterey, CA CA Monterey 25.6 7360 San Francisco-Oakland CA Alameda; CA Contra Costa;CA Marin;CA San Francisco;CA San Mateo 7400 San Jose, CA 19.6 CA Santa Clara,CA 176 7485 Santa Cruz, CA 14.9 CA Santa Cruz 7500 Santa Rosa 9.1 CA Sonoma 8720 Vallejo-Fairfield-Napa, CA 17.1 CA Napa; CA Solano Non-SMSA Counties: 23.2 CA Lake;CA Mendocino; CA San Benito Sacramento,CA: SMSA Counties: 16.1 177 6920 Sacramento,CA CA Placer;CA Sacramento;CA Yolo 14.3 Non-SMSA Counties CA Butte; CA Colusa; CA El Dorado;CA Glenn; CA Nevada; CA Sierra; CA Sutter; CA Yuba Stockton-Modesto, CA: SMSA Counties: 5170 Modesto, CA 12.3 178 CA Stanislaus 8120 Stockton, CA 24.3 CA San Joaquin Non-SMSA Counties 19.8 CA Alpine; CA Amador;CA Calaveras; CA Mariposa; CA Merced; CA Tuolumne Fresno-Bakersfield,CA SMSA Counties: 0680 Bakersfield,CA 19.1 179 CA Kern 2840 Fresno,CA 26.1 CA Fresno Non-SMSA Counties: 23.6 CA Kings; CA Madera;CA Tulare For each July during which work is performed under the contract, you and each non material-supplier subcontractor with a subcontract of$10,000 or more must complete Form FHWA PR-1391 (Appendix C to 23 CFR 230). Submit the forms by August 15. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 AGREEMENT FORM-EXHIBIT"A" FEBRUARY 8,2018 PAGE 17 FEDERAL TRAINEE PROGRAM For the Federal training program, the number of trainees or apprentices is identified in Section 7-2.3 of the Special Provisions. This section applies if a number of trainees or apprentices is specified in Section 7-2.3 of the Special Provisions. As part of your equal opportunity affirmative action program, provide on-the-job training to develop full journeymen in the types of trades or job classifications involved. You have primary responsibility for meeting this training requirement. If you subcontract a contract part, determine how many trainees or apprentices are to be trained by the subcontractor. Include these training requirements in your subcontract. Where feasible, 25 percent of apprentices or trainees in each occupation must be in their 1st year of apprenticeship or training. Distribute the number of apprentices or trainees among the work classifications on the basis of your needs and the availability of journeymen in the various classifications within a reasonable recruitment area. Before starting work, submit to the City of Palm Springs: 1. Number of apprentices or trainees to be trained for each classification 2. Training program to be used 3. Training starting date for each classification Obtain the City of Palm Springs approval for this submitted information before you start work. The City of Palm Springs credits you for each apprentice or trainee you employ on the work who is currently enrolled or becomes enrolled in an approved program. The primary objective of this section is to train and upgrade minorities and women toward journeymen status. Make every effort to enroll minority and women apprentices or trainees, such as conducting systematic and direct recruitment through public and private sources likely to yield minority and women apprentices or trainees, to the extent they are available within a reasonable recruitment area. Show that you have made the efforts. In making these efforts, do not discriminate against any applicant for training. Do not employ as an apprentice or trainee an employee: 1. In any classification in which the employee has successfully completed a training course leading to journeyman status or in which the employee has been employed as a journeyman 2. Who is not registered in a program approved by the US Department of Labor, Bureau of Apprenticeship and Training Ask the employee if the employee has successfully completed a training course leading to journeyman status or has been employed as a journeyman. Your records must show the employee's answers to the questions. In your training program, establish the minimum length and training type for each classification. The City of Palm Springs and FHWA approves a program if one of the following is met: 1. It is calculated to: Meet the your equal employment opportunity responsibilities Qualify the average apprentice or trainee for journeyman status in the classification involved by the end of the training period CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 AGREEMENT FORM-EXHIBIT"A" FEBRUARY 8,2018 PAGE 18 2. It is registered with the U.S. Department of Labor, Bureau of Apprenticeship and Training, and it is administered in a way consistent with the equal employment responsibilities of Federal-aid highway construction contracts Obtain the State's approval for your training program before you start work involving the classification covered by the program. Provide training in the construction crafts, not in clerk-typist or secretarial-type positions. Training is allowed in lower level management positions such as office engineers, estimators, and timekeepers if the training is oriented toward construction applications. Training is allowed in the laborer classification 'if significant and meaningful training is provided and approved by the division office. Off-site training is allowed if the training is an integral part of an approved training program and does not make up a significant part of the overall training. The City of Palm Springs reimburses you 80 cents per hour of training given an employee on this contract under an approved training program: 1. For on-site training 2. For off-site training if the apprentice or trainee is currently employed on a Federal-aid project and you do at least one of the following: Contribute to the cost of the training Provide the instruction to the apprentice or trainee Pay the apprentice's or trainee's wages during the off-site training period 3. If you comply this section. Each apprentice or trainee must: 1. Begin training on the project as soon as feasible after the start of work involving the apprentice's or trainee's skill 2. Remain on the project as long as training opportunities exist in the apprentice's or trainee's work classification or until the apprentice or trainee has completed the training program Furnish the apprentice or trainee: 1. Copy of the program you will comply within providing the training Certification showing the type and length of training satisfactorily completed2. Cert YP 9 9 Y P9 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 AGREEMENT FORM-EXHIBIT"A" FEBRUARY 8,2018 PAGE 19 TITLE VI ASSURANCES During the performance of this Agreement, the contractor, for itself, its assignees and successors in interest hereinafter collectively referred to as CONTRACTOR) agrees as follows: 1) Compliance with Regulations: CONTRACTOR shall comply with the regulations relative to nondiscrimination in federally assisted programs of the Department of Transportation, Title 49, Code of Federal Regulations, Part 21, as they may be amended from time to time, (hereinafter referred to as the REGULATIONS), which are herein incorporated by reference and made a part of this agreement. 2) Nondiscrimination: CONTRACTOR, with regard to the work performed by it during the AGREEMENT, shall not discriminate on the grounds of race, color, sex, national origin, religion, age, or disability in the selection and retention of sub-applicants, including procurements of materials and leases of equipment. CONTRACTOR shall not participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices when the agreement covers a program set forth in Appendix B of the Regulations. 3) Solicitations for Sub-agreements, Including Procurements of Materials and Equipment: In all solicitations either by competitive bidding or negotiation made by CONTRACTOR for work to be performed under a Sub- agreement, including procurements of materials or leases of equipment, each potential sub-applicant or supplier shall be notified by CONTRACTOR of the CONTRACTOR'S obligations under this Agreement and the Regulations relative to nondiscrimination on the grounds of race, color, or national origin. 4) Information and Reports: CONTRACTOR shall provide all information and reports required by the Regulations, or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the California Department of Transportation or FHWA to be pertinent to ascertain compliance with such Regulations or directives. Where any information required of CONTRACTOR is in the exclusive possession of another who fails or refuses to furnish this information, CONTRACTOR shall so certify to the California Department of Transportation or the FHWA as appropriate, and shall set forth what efforts CONTRACTOR has made to obtain the information. 5) Sanctions for Noncompliance: In the event of CONTRACTOR's noncompliance with the nondiscrimination provisions of this agreement, the California Department of Transportation shall impose such agreement sanctions as it or the FHWA may determine to be appropriate, including, but not limited to: a) withholding of payments to CONTRACTOR under the Agreement within a reasonable period of time, not to exceed 90 days; and/or b) cancellation, termination or suspension of the Agreement, in whole or in part. 6) Incorporation of Provisions: CONTRACTOR shall include the provisions of paragraphs (1)through (6) in every sub-agreement, including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. CONTRACTOR shall take such action with respect to any sub-agreement or procurement as the California Department of Transportation or FHWA may direct as a means of enforcing such provisions including sanctions for noncompliance, provided, however, that, in the event CONTRACTOR becomes involved in, or is threatened with, litigation with a sub-applicant or supplier as a result of such direction, CONTRACTOR may request the California Department of Transportation enter into such litigation to protect the interests of the State, and, in addition, CONTRACTOR may request the United States to enter into such litigation to protect the interests of the United States. MAINTAIN RECORDS AND SUBMIT REPORTS DOCUMENTING YOUR PERFORMANCE UNDER THIS SECTION The Cargo Preference Act (CPA) requires that "... at least 50 percent of any equipment, materials, or commodities procured, contracted for or otherwise obtained with funds granted, guaranteed, loaned, or advanced by the U.S. Government under this agreement, and which may be transported by ocean vessel, shall be transported on privately owned United States-flag commercial vessels, if available." On January 7, 2016, the Federal Highway Administration (FHWA) advised Caltrans on the applicability of the CPA and implementing regulations (46 CFR 381) to the Federal-aid highway program. FHWA will use notice and CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 AGREEMENT FORM-EXHIBIT"A" FEBRUARY 8,2018 PAGE 20 comment rulemaking to implement appropriate contract clauses in the next revision of Form FHWA-1273 Required Contract Provisions Federal-Aid Construction Contracts." The following clause is hereby inserted into this Exhibit "A" to the construction contract requiring the Contractor's compliance with the CPA requirements and its implementing regulations in 46 CFR 381 for all Federal-aid projects. The clause should incorporate the recommended clauses in 46 CFR 381.7(a)-(b). Use of United States —flag vessels: The contractor agrees— 1) To utilize privately owned United States-flag commercial vessels to ship at least 50 percent of the gross tonnage (computed separately for dry bulk carriers, dry cargo liners, and tankers) involved, whenever shipping any equipment, material, or commodities pursuant to this contract, to the extent such vessels are available at fair and reasonable rates for United States-flag commercial vessels. 2) To furnish within 20 days following the date of loading for shipments originating within the United States or within 30 working days following the date of loading for shipments originating outside the United States, a legible copy of a rated, `on-board' commercial ocean bill-of-lading in English for each shipment of cargo described in paragraph (1) of this section to both the Contracting Officer (through the prime contractor in the case of subcontractor bills-of-lading) and to the Division of National Cargo, Office of Market Development, Maritime Administration, Washington, DC 20590. 3) To insert the substance of the provisions of this clause in all subcontracts issued pursuant to this contract. END OF EXHIBIT"A"*' CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 AGREEMENT FORM-EXHIBIT"A' FEBRUARY 8,2018 PAGE 21 BID DOCUMENTS Only the following listed documents, identified in the lower right corner as "Bid Forms" shall be fully executed and submitted with the Bid at the time of opening of Bids. Bid (Proposal) Bid Schedule Bidder's List of Subcontractors PART I Bidder's List of Subcontractors PART II Non-Collusion Declaration Non-Discrimination Certification Equal Employment Opportunity Certification Debarment and Suspension Certification Non-Lobbying Certification Disclosure of Lobbying Activities Bid Bond (Bid Security Form) Bidder's General Information Local Agency Bidder-DBE Commitment, Exhibit 15-G DBE Information — Good Faith Efforts, Exhibit 15-H Public Contract Code Section 10285.1 Statement Public Contract Code Section 10162 Questionnaire Public Contract Code Section 10232 Statement Failure of a Bidder to fully execute and submit all of the listed documents with the Bid will render a Bid as non-responsive and subject to rejection. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 COVER SHEET BID FORMS-PAGE 1 BID PROPOSAL BID TO: CITY OF PALM SPRINGS, CALIFORNIA The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with the City in the form included in the Contract Documents (as defined in Article 4 of the Agreement)to perform the Work as specified or indicated in said Contract Documents entitled: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEDERAL AID PROJECT NO. CML-5282 (044) Bidder accepts all of the terms and conditions of the Contract Documents, including without limitation those in the Notice Inviting Bids and the Instructions to Bidders dealing with the disposition of the Bid Security. This Bid will remain open for the period stated in the Notice Inviting Bids, unless otherwise required by law. Bidder will enter into an Agreement within the time and in the manner required in the Instructions to Bidders, and will furnish the insurance certificates, Payment Bond, Performance Bond, and all Permits required by the Contract Documents. Bidder has examined copies of all the Contract Documents, including the following Addenda receipt of which is hereby acknowledged): Number 1 Date 03/08/18 Number 2 Date 03/12/18 Number Date Number Date Number Date Number Date Number Date Bidder has familiarized itself with the nature and extent of the Contract Documents, the Work, the site, the locality where the Work is to be performed, the legal requirements (federal, state, and local laws, ordinances, rules, and regulations), and the conditions affecting cost, progress, or performance of the Work, and has made such independent investigations as Bidder deems necessary. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 COVER SHEET BID FORMS-PAGE 2 In conformance with the current statutory requirements of California Labor Code Section 1860, et seq., the undersigned confirms the following as its certification: I am aware of the provisions of Section 3700 of the Labor Code, which require every employer to be insured against liability for worker's compensation, or to undertake self- insurance in accordance with the provisions, before commencing the performance of the Work of this Contract. To all the foregoing, and including all Bid Schedule(s), List of Subcontractors, Non-Collusion Declaration, Bidder's General Information, and Bid Bond contained in these Bid Forms, said Bidder further agrees to complete the Work required under the Contract Documents within the Contract Time stipulated in said Contract Documents, and to accept in full payment therefor the Contract Price based on the Lump Sum or Unit Bid Price(s) named in the aforementioned Bidding Schedule(s). Dated: 03/15/18 Bidder: Superior Pavement Markings By: Sigature) Title: Operations Manager/Estimator CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 COVER SHEET BID FORMS-PAGE 3 BID SCHEDULE A Schedule of Prices for the Construction of the: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 SAN RAFAEL DRIVE From N. Palm Canyon Drive to Sunrise Way in Palm Springs, California Item Estimated Unit No. Description Quantity Unit Price Amount 1. Mobilization 1 LS R'58\ .0 2. Traffic Control 1 LS U I o 14 ,0 a 3. Paint Curb Red 800 LF lot .00 4 Install Post And Sign Per City Of Palm Springs Standard 624. Sign 19 EA $230-v0 $15244 60 Per Plan. 5. Remove and Salvage Existing Sign and Post to City Yard. 30 EA $]a.-O-0 $aa50 .00 Apply 6"White Thermoplastic Solid6. Line 11,220 LF $ . -40 $: R 4.0 0 7. Apply 6"White Thermoplastic Bike Lane Line Per Revised Caltrans 9,640 LF $ D ALO $ 5- -OO Standard Plan A20D, Detail 39. Apply 6"White Thermoplastic Bike Lane Intersection Line Per Caltrans 4,060 LF $ b 45 $122 00Rev. Standard Plan A20D, Det. 39A. Apply 6"White Thermoplastic 9. Diagonal Buffer Markings @ 24' 0 LF $mod $AL.00 Spacing. Apply 6" GFseA White Thermoplastic 10. Diagonal Buffer Markings @ 24'230 LF $ 0570 $ 1 Is©a Spacing. Apply 12"White Thermoplastic Basic 11 . Crosswalk (10' Width) Per Caltrans 950 LF $3 25 $ _ 69 S(3StandardPlanA24F. error 0 yiiw fila r rigs Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE A-ADDENDUM NO.2 CITY PROJECT NO.14-14 BID FORMS-PAGE 4 FEBRUARY 8,2018 Item Description Unit Estimated Unit Amount No. Quantity price Apply 12"White Thermoplastic Limit 12. Line Per City of Palm Springs 90 LF $3 a5 $gqa ,Standard 625. Construct Yellow Centerline (Raised 13. Markers) Per Caltrans Revised 1,450 LF $050 Q O Standard Plan A20A, Detail 2. Construct Double Yellow Lines 14. (Raised Markers) Per Caltrans Rev. 2,025 LF $ L o 25 $a J3 I aaS Standard Plan A20A, Detail 22. Construct Double Yellow Median 15. Island (Raised Markers) Per Caltrans 620 LF $ a g o $ 1 q &00 Rev. Standard Plan A206, Detail 29. Construct Yellow Two-Way Left Turn 16. Lane (Raised Markers) Per Caltrans 3,830 LF $a2a5 $ gpao .SO Rev. Standard Plan A2013, Detail 32. Construct White Lane Line (Raised 17. Markers) Per Caltrans Rev. Standard 0 LF $D 50 $ CQ •00 Plan A20A, Detail 9. Construct Solid White Line per Detail18. on Sheet 2. 0 LF $ O .00 Construct White Channelizing Line 19. (Raised Markers) Per Caltrans Rev. 1,870 LF $ as 5 DO Standard Plan A20D, Detail 38B. Apply White Thermoplastic Type IV 20. (Left) Arrow Per Caltrans Standard 19 EA $ OcPlanA24A. v Apply White Thermoplastic Type IV 21. (Right) Arrow Per Caltrans Standard 9 EA $ (05-00 $ Sg Y-oc Plan A24A. Apply White Thermoplastic Solid 22. Line Per Caltrans Revised Standard 2,880 EA $ .ko $ 00 Plan A2013, Detail 276. rror pr 4 &ings ame of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE A-ADDENDUM NO.2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 5 FEBRUARY 8,2018 Item Description Unit Estimated Unit Amount No. Quantity price Apply White Thermoplastic Type 23. VII(L) Arrow Pavement Marking Per 4 EA sff2.00 $ 4 4PS Od Caltrans Standard Plan A24A. 24. Apply Thermoplastic White "Bike Lane" Pavement Legend Per Caltrans Standard Plan A24D, White 34 EA $_750.00 $asp 00 Bike Lane Arrow Per A24A, & Green Backing Per Detail on Sht. 2. Apply White Thermoplastic "STOP" 25. Pavement Legend Per Caltrans 2 EA $q(P-Q 0 $ r y oc- 0 Standard Plan A24D. Apply White Thermoplastic "AHEAD" 26. Pavement Legend Per Caltrans 0 EA may o O $ 0 .6 0StandardPlanA24D. Sandblast Existing Striping or Paving27. Marking 84 SF $ 3 a 28. Remove Existing Raised Markers 1 LS $.3.3W00 $-3 ,-00 Apply White Thermoplastic Type VI 29. Arrow Pavement Marking Per 2 EA $ 5--oa $ 1 0 .p0CaltransStandardPlanA24A. Apply White Thermoplastic Type 1 30. 10'Arrow Pavement Marking Per 2 EA $ (, 0 1 0 Q $ 192 00CaltransRev. Standard Plan A20A. Install Type E and Type D Vehicle 31. Loop Detectors Per Rev. Caltrans 5 SF $ S o 0 $35 Od Standard Plan ES-513. Construct White Lane Drop Line 32. (Raised Markers) Per Caltrans Rev. 0 LF $L o S $ 0 0 Q Standard Plan A20C, Detail 37C. 33. Project Identification Sign 2 EA $ 100.60 $ Ja o _dd 34. Fog Seal 456,000 SF $ D. 14 OAACI •00 35. Adjust Traffic Signal Video Detection 2 EA $o30-6--do $-4446-00 Zones for Approach SU Per or Pa yayun Ina qS Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE A-ADDENDUM NO.2 CITY PROJECT NO.14-14 BID FORMS-PAGE 6 FEBRUARY 8,2018 4 Item Estimated Unit No. Description quantity Unit Price Amount 36. Water Pollution Control Plan 1 LS Q 0 -6 37. Field Orders 1 LS 3,125 TOTAL OF ALL ITEMS OF THE BID SCHEDULE A: l Ko, 1 Price In figures) arse Amd—red 617hAj 1Tw5anol 6 e Pundr Cia( Price In worils) iv-e as uT nor iupn en- ctr lnc s Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE A—ADDENDUM NO. 2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 7 FEBRUARY 8,2018 BID SCHEDULE B Schedule of Prices for the Construction of the: FEDERAL AID PROJECT NO. CML-5282(044) CMAQ/CVAG BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FARRELL DRIVE From Tahquitz Canyon Way to Ramon Road in Palm Springs, California Item Estimated Unit No. AmountDescription Quantity Unit price 1. Mobilization 1 LS A10-0() 2. Traffic Control 1 LS 9t63.0 3. Paint Curb Red 0 LF 6 . 0 O 4 Install Post And Sign Per City Of Palm Springs Standard 624. Sign 10 EA $92Cn.O0 $- -4-4W OdPerPlan. 5. Remove and Salvage Existing Sign and Post to City Yard. 1 EA $;5-0 D $ -7f5.0 Apply 6"White Thermoplastic Solid6. Line LF $ 0• 70 $ o•oO 7. Apply 6"White Thermoplastic Bike Lane Line Per Revised Caltrans 4,840 LF $-0, O sA04 0OStandardPlanA20D, Detail 39. 8 Apply 6" White Thermoplastic Bike Lane Intersection Line Per Caltrans 1,230 LF $ O.4 S $ Rev. Standard Plan A20D, Det. 39A. Apply 6"White Thermoplastic9. Dashed Line (2' Dash with 6' Gap). 0 LF $ O-J Q $ Lo .od Apply 6"Green White Thermoplastic 10. Diagonal Buffer Markings @ 24'200 LF $ 06d Spacing. tjpeyloya rte s Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE B-ADDENDUM NO.2 CITY PROJECT NO. 14-14 BID FORMS-PAGE B FEBRUARY 8,2018 Item Description Unit Estimated Unit Amount No. Quantity price Apply 12" White Thermoplastic Basic 11. Crosswalk (10' Width) Per Caltrans 860 LF $3.,5 $21a poStandardPlanA24F. Apply 12" White Thermoplastic Limit 12. Line Per City of Palm Springs 0 LF $ 3 5- $Standard 625. Construct Yellow Centerline (Raised 13. Markers) Per Caltrans Revised 0 LF $G.Sa $ 0 D Standard Plan A20A, Detail 2. Construct Double Yellow Lines 14. (Raised Markers) Per Caltrans Rev. 2,420 LF $ 2tF $2302 a0 Standard Plan A20A, Detail 22. Construct Double Yellow Median 15. Island (Raised Markers) Per Caltrans 0 LF $ 0 0 d Rev. Standard Plan A20B, Detail 29. Construct Yellow Two-Way Left Turn 16. Lane (Raised Markers) Per Caltrans 0 LF $ j $ 4 Rev. Standard Plan A20B, Detail 32. Construct White Lane Line (Raised 17. Markers) Per Caltrans Rev. Standard 3,780 LF $ 5 0 $ /0?6.p0 Plan A20A, Detail 9. Construct Solid White Line per Detail18. on Sheet 2. 350 LF $ Q•O Construct White Channelizing Line 19. (Raised Markers) Per Caltrans Rev. 760 LF $ 0 Standard Plan A20D, Detail 38B. Apply White Thermoplastic Type IV 20. (Left) Arrow Per Caltrans Standard 8 EA $Z?!5;0 p $5a0-00PlanA24A. Apply White Thermoplastic Type IV 21. (Right) Arrow Per Caltrans Standard 2 EA $ fP5,0 0 $ 130. d 0 Plan A24A. n6V gu l S Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE B-ADDENDUM NO.2 CITY PROJECT NO.14-14 BID FORMS-PAGE 9 FEBRUARY 8..2018 Item Description Unit Estimated Unit Amount No. Quantity price Apply White Thermoplastic Solid 22. Line Per Caltrans Revised Standard 0 EA $ D. C> $Q .O O Plan A2013, Detail 27B. Apply White Thermoplastic Type 23. VII(L) Arrow Pavement Marking Per 0 EA $JL7--o 0 $ 0 Q Caltrans Standard Plan A24A. 24. Apply Thermoplastic White "Bike Lane" Pavement Legend Per Caltrans Standard Plan A24D, White 16 EA $ 56).00 $ 12C)oD 0 Bike Lane Arrow Per A24A, & Green Backing Per Detail on Sheet 2. Apply White Thermoplastic "STOP" 25. Pavement Legend Per Caltrans 0 EA $q p.06 $ 09 60 Standard Plan A24D. Apply White Thermoplastic "AHEAD" 26. Pavement Legend Per Caltrans 0 EA $ p0 $ Q ,0 Q Standard Plan A24D. Sandblast Existing Striping or Paving27. Marking 0 SF $ 3 ° $-LLI"d 28. Remove Existing Raised Markers 1 LS sz2 $ Da Apply White Thermoplastic Type VI 29. Arrow Pavement Marking Per 0 EA $Q 0 $ Caltrans Standard Plan A24A. Apply White Thermoplastic Type I 30. 10' Arrow Pavement Marking Per 0 EA $ Caltrans Rev. Standard Plan A20A. Install Type E and Type D Vehicle 31 . Loop Detectors Per Rev. Caltrans 0 SF $ Standard Plan ES-513. Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE B-ADDENDUM NO.2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 10 FEBRUARY 8,2018 Item Estimated UnitDescriptionUnit Amount No. Quantity Price Construct White Lane Drop Line 32. (Raised Markers) Per Caltrans Rev. 500 LF $ 1-65 $ — s Standard Plan A20C, Detail 37C. 33. Project Identification Sign 2 EA $ 10 26D.dO 34. Fog Seal 160,000 SF $ b j4 35. Adjust Traffic Signal Video Detection 3 EA $ag-60-00 $ (P6060-0 0 Zones for A proach 36. Water Pollution Control Plan 1 LS 1606, 0o 37. Field Orders 1 LS 3,125 TOTAL OF ALL ITEMS OF THE BID SCHEDULE B: 14 , 1 Price In figures) 52wr Ay - s er-en -Mm6ana! We l4k cad A)-Pn44 4IfIY (],// Pr a In words) 1it Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE B-ADDENDUM NO.2 CITY PROJECT NO.14-14 BID FORMS-PAGE 11 FEBRUARY 8,2018 BID SCHEDULE C Schedule of Prices for the Construction of the: FEDERAL AID PROJECT NO. CML-5282(044) CMAQ/CVAG BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 CAMINO REAL From E. Palm Canyon Drive to La Verne Way in Palm Springs, California Item Estimated Unit No. Description Quantity Unit Price Amount 1. Mobilization 1 LS 345,5. 00 2. Traffic Control 1 LS o4,3Q-0 3 3. Paint Curb Red 330 LF 22• 4 Install Post And Sign Per City Of Palm Springs Standard 624. Sign 10 EA $216-0 6 $a4(06 wPerPlan. 5. Remove and Salvage Existing Sign and Post to City Yard. 0 EA $a5DO $ Q .00 Apply 6"White Thermoplastic Solid6. Line 4,380 LF $ 3 Q 00 7. Apply 6"White Thermoplastic Bike Lane Line Per Revised Caltrans 3,510 LF $ o?(o •Od Standard Plan A20D, Detail 39. 8 Apply 6"White Thermoplastic Bike Lane Intersection Line Per Caltrans 4,830 LF $ o4- 5 $ Rev. Standard Plan A20D, Det. 39A. Apply 6"White Thermoplastic9. Dashed Line (2' Dash with 6' Gap). 190 LF $ .5 0 $ Q Od Apply 6"Green White Thermoplastic 10. Diagonal Buffer Markings C@ 24'420 LF $ Spacing. S no Mlfe Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE C-ADDENDUM NO.2 CITY PROJECT NO.14-14 BID FORMS-PAGE 12 FEBRUARY 8,2018 Item Estimated Unit Description Unit Amount No. Quantity Price Item Estimated Unit Description Unit price Amount No. Quantity Apply 12"White Thermoplastic Basic 11 . Crosswalk (10' Width) Per Caltrans 360 LF $ems $ 11 Standard Plan A24F. Apply 12"White Thermoplastic Limit 12. Line Per City of Palm Springs 0 LF Q Standard 625. Construct Yellow Centerline (Raised 13. Markers) Per Caltrans Revised 0 LF $ G Standard Plan A20A, Detail 2. Construct Double Yellow Lines 14. (Raised Markers) Per Caltrans Rev. 520 LF $ , ace $ OG Standard Plan A20A, Detail 22. Construct Double Yellow Median 15. Island (Raised Markers) Per Caltrans 0 LF $ O O c) Rev. Standard Plan A20B, Detail 29. Construct Yellow Two-Way Left Turn 16. Lane (Raised Markers) Per Caltrans 1,740 LF $Z. 4Rev. Standard Plan A20B, Detail 32. Construct White Lane Line (Raised 17. Markers) Per Caltrans Rev. Standard 0 LF $ Q 50 $ O Plan A20A, Detail 9. Construct Solid White Line per Detail18. on Sheet 2. 0 LF $O $ O 0 Construct White Channelizing Line 19. (Raised Markers) Per Caltrans Rev. 400 LF $ Standard Plan A20D, Detail 38B. Apply White Thermoplastic Type IV 20. (Left) Arrow Per Caltrans Standard 3 EA $O $1qa_O OPlanA24A. Apply White Thermoplastic Type IV 21. (Right) Arrow Per Caltrans Standard 0 EA O O $QC)Plan A24A. Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE C-ADDENDUM NO 2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 13 FEBRUARY 8,2018 Item Description Unit Estimated Unit Amount No. Quantity price Apply White Thermoplastic Solid 22. Line Per Caltrans Revised Standard 0 EA so -(-Qb $Od Plan A2013, Detail 27B. Apply White Thermoplastic Type 23. VII(L) Arrow Pavement Marking Per 0 EA Caltrans Standard Plan A24A. Apply Thermoplastic White "Bike Lane" Pavement Legend Per 24. Caltrans Standard Plan A24D, White 13 EA $ o Bike Lane Arrow Per A24A, & Green Backing Per Detail on Sheet 2. Apply White Thermoplastic "STOP" 25. Pavement Legend Per Caltrans 3 EA $q(.P -06 $ a8s c)O Standard Plan A24D. Apply White Thermoplastic "AHEAD" 26. Pavement Legend Per Caltrans 2 EA $ I2,5 0cy $ a0 Standard Plan A24D. Sandblast Existing Striping or Paving27. Marking 25 SF $3,ad $ ( 00 28. Remove Existing Raised Markers 1 LS $$ oG $ Apply White Thermoplastic Type VI 29. Arrow Pavement Marking Per 0 EA $ C. 0CaltransStandardPlanA24A. Apply White Thermoplastic Type 1 30. 10' Arrow Pavement Marking Per 0 EA $1LL00. $ 0 0 0 Caltrans Rev. Standard Plan A20A. Install Type E and Type D Vehicle 31. Loop Detectors Per Rev. Caltrans 7 SF $1550 pp $ O O Standard Plan ES-513. rio Vz, Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE C-ADDENDUM NO.2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 14 FEBRUARY 8,2018 Item Estimated Unit Description Unit Amount No. Quantity Price Construct White Lane Drop Line 32. (Raised Markers) Per Caltrans Rev. 0 LF $L-D-45- $G Standard Plan A20C, Detail 37C. 33. Project Identification Sign 2 EA $ I pa .p $ 34. Fog Seal 170,700 SF $ • l 4 $ O 35. Adjust Traffic Signal Video Detection 0 EA $ G .o $0.0 0 Zones for A proach 36. Water Pollution Control Plan 1 LS 37. Field Orders 1 LS 3,125 TOTAL OF ALL ITEMS OF THE BID SCHEDULE C: a , 5 -q - 9C Price In figures) Price In words) or ?dawqLfflqrPqqs Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE C—ADDENDUM NO.2 CITY PROJECT NO.14-14 BID FORMS-PAGE 15 FEBRUARY 8.2018 BID SCHEDULE D Schedule of Prices for the Construction of the: FEDERAL AID PROJECT NO. CML-5282(044) CMAQ/CVAG BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 LA VERNE WAY From S. Palm Canyon Drive to Twin Palms Drive in Palm Springs, California Item Estimated Unit No Description Quantity Unit Price Amount 1. Initial Mobilization 1 LS 05® - 2. Traffic Control 1 LS I 4 . 00 3. Paint Curb Red 840 LF Z© 4 Install Post And Sign Per City Of Palm Springs Standard 624. Sign 10 EA $22a--00 $cg4(o0 -OG Per Plan. 5. Remove and Salvage Existing Sign and Post to City Yard.0 EA $35---ccj $QQO Apply 6"White Thermoplastic Solid6. Line 9,310 LF $ 0 $ 7 Apply 6"White Thermoplastic Bike Lane Line Per Revised Caltrans 7,480 LF $5---CQ C) $ o0StandardPlanA20D, Detail 39. 8 Apply 6"White Thermoplastic Bike Lane Intersection Line Per Caltrans 2,810 LF $QA. ,s $ .a(,e 4.s Rev. Standard Plan A20D, Det. 39A. Apply 6"White Thermoplastic9. Dashed Line (2' Dash with 6' Gap). 180 LF Apply 6"Green White Thermoplastic 10. Diagonal Buffer Markings Qa 24' 0 LF $ 0 © Spacing. Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE D-ADDENDUM NO.2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 16 FEBRUARY 8,2018 Item Description Unit Estimated Unit Amount No. Quantity price Apply 12"White Thermoplastic Basic 11. Crosswalk (10' Width) Per Caltrans 430 LF $3 25 $ ;9 5 Standard Plan A24F. Apply 12"White Thermoplastic Limit 12. Line Per City of Palm Springs 0 LF $O Standard 625. Construct Yellow Centerline (Raised 13. Markers) Per Caltrans Revised 0 LF $ O , Q 6 Standard Plan A20A, Detail 2. Construct Double Yellow Lines 14. (Raised Markers) Per Caltrans Rev. 860 LF $ ` $ 1g 2:,S aciStandardPlanA20A, Detail 22. Construct Double Yellow Median 15. Island (Raised Markers) Per Caltrans 0 LF $a p $ O ,o G Rev. Standard Plan A206, Detail 29. Construct Yellow Two-Way Left Turn 16. Lane (Raised Markers) Per Caltrans 4,040 LF $ Q 4 q q p Rev. Standard Plan A206, Detail 32. Construct White Lane Line (Raised 17. Markers) Per Caltrans Rev. Standard 0 LF $a-C) $ O.O Plan A20A, Detail 9. Construct Solid White Line per Detail18. on Sheet 2. 0 LF $0--,aQ $ © 0 o Construct White Channelizing Line 19. (Raised Markers) Per Caltrans Rev. 860 LF $ t- 0p $ qA .00StandardPlanA20D, Detail 38B. Apply White Thermoplastic Type IV 20. (Left) Arrow Per Caltrans Standard 11 EA $ I0 0 $ 1 5(DD Plan A24A. Apply White Thermoplastic Type IV 21. (Right) Arrow Per Caltrans Standard 2 EA $ 130.Od Plan A24A. Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE D-ADDENDUM NO.2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 17 FEBRUARY 8,2018 Item Estimated Unit Amount No. Description QuantityUnit price Apply White Thermoplastic Solid 22. Line Per Caltrans Revised Standard 0 EA $ D fy G $ 6. 0 0 Plan A2013, Detail 27B. Apply White Thermoplastic Type 23. VII(L) Arrow Pavement Marking Per 0 EA $LM, 0 $O,O a Caltrans Standard Plan A24A. 24. Apply Thermoplastic White "Bike Lane" Pavement Legend Per Caltrans Standard Plan A24D, White 30 EA $-95G cc) $2250 n Bike Lane Arrow Per A24A, & Green Backing Per Detail on Sheet 2. 25. Apply White Thermoplastic"STOP" Pavement Legend Per Caltrans 9 EA $ ace.oo $&A.—C)0StandardPlanA24D. 26. Apply White Thermoplastic "AHEAD" Pavement Legend Per Caltrans 3 EA $ l3 c $ 40-3 CC Standard Plan A24D. 27. Sandblast Existing Striping or Paving Marking 1,990 SF $ j 2Q $_4.0 28. Remove Existing Raised Markers 1 LS $L25-5 OC $LISS•Q:,G 29. Apply White Thermoplastic Type VI Arrow Pavement Marking Per 0 EA $ 6,5.0 j $-CL cf) Caltrans Standard Plan A24A. 30. Apply White Thermoplastic Type I 10' Arrow Pavement Marking Per 0 EA $ 00 $iaao Caltrans Standard Plan A20A. 31. Install Type E and Type D Vehicle Loop Detectors Per Rev. Caltrans 0 SF $ D l r $ C) Standard Plan ES-56. 32. Construct White Lane Drop Line Raised Markers) Per Caltrans Rev. 500 LF $ 0 S $ 00StandardPlanA20C, Detail 37C. Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE D-ADDENDUM NO.2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 18 FEBRUARY 8,2018 Item Estimated Unit Description Unit Amount No. Quantit Price 33. Project Identification Sign 2 EA $V-W-W $0% ,00 34. Fog Seal 354,000 SF $D---L $4-66 20.d 35. Adjust Traffic Signal Video Detection 0 EA $ Q pp $ O O Zones for Approach 36. Water Pollution Control Plan 1 LS 100,00 37. Field Orders 1 LS 3,125 TOTAL OF ALL ITEMS OF THE BID SCHEDULE D: Isg - III - Zd Price In figures) d Y - I/-P 0 drrfe Ir n r -phi i .s n h tisa . one h y r( pl v Price In words) snprlak u ll orlcIffvs Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE D-ADDENDUM NO.2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 19 FEBRUARY 8,2018 BID SCHEDULE E Schedule of Prices for the Construction of the: FEDERAL AID PROJECT NO. CML-5282(044) CMAQ/CVAG BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 CROSSLEY ROAD From Ramon Road to 34"' Avenue in Palm Springs, California Item Estimated Unit No. Description Quantity Unit price Amount 1. Initial Mobilization 1 LS 1 0 2. Traffic Control 1 LS a5S OO 3. Paint Curb Red 180 LF 030 4C 4. Install Post And Sign Per City Of Palm Springs Standard 624 Per Plan 31 EA $2_q(o,O C $ 60 5. Remove and Salvage Existing Sign and Post to City Yard. 4 EA $95Z00 $ 46 Apply 6" White Thermoplastic Solid6' Line 4,110 LF $ Q 0 $ OQ 7 Apply 6"White Thermoplastic Bike Lane Line Per Revised Caltrans 10,660 LF $0,-U-6 $&SgCo.©O Standard Plan A20D, Detail 39. 8 Apply 6"White Thermoplastic Bike Lane Intersection Line Per Caltrans 4,880 LF $d 4S $ 5 ( OO Rev. Standard Plan A20D, Det. 39A. Apply 6"White Thermoplastic r9' Dashed Line (2' Dash with 6' Gap). 110 LF $ u ' Q Apply 6"Green White Thermoplastic 10. Diagonal Buffer Markings CCU 24'740 LF $ 3 0( Spacing. 5 not Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE E-ADDENDUM NO.2 CITY PROJECT NO.14-14 BID FORMS-PAGE 20 FEBRUARY 8,2018 Item Description Unit Estimated Unit Amount No. Quantity price Apply 12" White Thermoplastic Basic 11. Crosswalk (10' Width) Per Caltrans 380 LF $ ;25 $ Q R5-00StandardPlanA24F. Apply 12" White Thermoplastic Limit 12. Line Per City of Palm Springs 0 LF $3_c - $ n-0OStandard625. Construct Yellow Centerline (Raised 13. Markers) Per Caltrans Revised 0 LF $ . 6 $ © 0 Standard Plan A20A, Detail 2. Construct Double Yellow Lines 14. (Raised Markers) Per Caltrans Rev. 860 LF $L2_4 5 $10-15 00StandardPlanA20A, Detail 22. Construct Double Yellow Median 15. Island (Raised Markers) Per Caltrans 470 LF $a Oo Rev. Standard Plan A206, Detail 29. Construct Yellow Two-Way Left Turn 16. Lane (Raised Markers) Per Caltrans 3,730 LF $ 3 10 (00Rev. Standard Plan A206, Detail 32. Construct White Lane Line (Raised 17. Markers) Per Caltrans Rev. Standard 230 LF $Q S $ //.S^0 0 Plan A20A, Detail 9. Construct Solid White Line per Detail18. on Sheet 2. 50 LF $D_- 3 S- ap Construct White Channelizing Line 19. (Raised Markers) Per Caltrans Rev. 760 LF $1_L6_ $ 836 0 Standard Plan A20D, Detail 38B. Apply White Thermoplastic Type IV 20. (Left) Arrow Per Caltrans Standard 10 EA $ ( P S-Q6 $ co Plan A24A. Apply White Thermoplastic Type IV 21. (Right) Arrow Per Caltrans Standard 6 EA $ J P-5. 6 $3q'0 QO Plan A24A. Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE E-ADDENDUM NO.2 CITY PROJECT NO, 14-14 BID FORMS-PAGE 21 FEBRUARY 8,2018 Item Estimated UnitDescriptionUnit Amount No. Quantity Price Apply White Thermoplastic Solid 22. Line Per Caltrans Revised Standard 0 EA $o—,-(0-0 $ ©OPlanA20B, Detail 27B. Apply White Thermoplastic Type 23. VII(L) Arrow Pavement Marking Per 3 EA $Lu--00 $ 6CaltransStandardPlanA24A. 24. Apply Thermoplastic White "Bike Lane" Pavement Legend Per Caltrans Standard Plan A24D, White 22 EA $q!—O-w $ 4—p5o oo Bike Lane Arrow Per A24A, & Green Backing Per Detail on Sheet 2. 25. Apply White Thermoplastic "STOP" Pavement Legend Per Caltrans 0 EA $ lQ•Q $ Standard Plan A24D. 26. Apply White Thermoplastic "AHEAD" Pavement Legend Per Caltrans 0 EA $ fj`d $ Standard Plan A24D. 27. Sandblast Existing Striping or Paving 960 SF $3•a6 $Marking 30 2.Op 28. Remove Existing Raised Markers 1 LS $ 1 300 $I-7-23.00 29. Apply White Thermoplastic Type VI Arrow Pavement Marking Per 0 EA $&50 O $ • D Caltrans Standard Plan A24A. 30. Apply White Thermoplastic Type I 10' Arrow Pavement Marking Per 0 EA $Z?La(f $ G ©O Caltrans Standard Plan A20A. 31. Install Type E and Type D Vehicle Loop Detectors Per Rev. Caltrans 5 SF s&Z 00 $ CGStandardPlanES-513. 32. Construct White Lane Drop Line Raised Markers) Per Caltrans Rev. 0 LF $coStandardPlanA20C, Detail 37C. 0 PaV,,0W4J r,wcas Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE E-ADDENDUM NO.2 CITY PROJECT NO. 14-14 BID FORMS-PAGE 22 FEBRUARY 8,2018 Item Estimated Unit Description Unit Amount No. Quantit Price 33. Project Identification Sign 2 EA $ 10JO $ ;QbC) .00 34. Fog Seal 302,200 SF $L $1210-e•60 35. Adjust Traffic Signal Video Detection 1 EA $ 5300,66 $0a Zones for A proach 36. Water Pollution Control Plan 1 LS 0Q .0 d 37. Field Orders 1 LS 3,125 TOTAL OF ALL ITEMS OF THE BID SCHEDULE E: O?Cf Iq D Price In figures)A Price In words) Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE E—ADDENDUM NO.2 CITY PROJECT NO.14-14 BID FORMS-PAGE 23 FEBRUARY 8,2018 PROPOSAL TOTAL ("BASIS OF AWARD") Bid Schedule A 1T ar S S Items 1-37 Bid Schedule B 3 •4 Items 1-37 Bid Schedule C T , 5 4q - lq 6 Items 1-37 Bid Schedule D Items 1-37 Bid Schedule E sq, Items 1-37 TOTAL OF ALL BID SCHEDULES A, B, C, D and E:4$..2 - OS no optional items shall be included) Price in figures) h Ye s x, W nd red Price in words) Bids must be submitted on all items, including optional items. Failure to bid on all items may result in the bid being rejected as non-responsive. QUANTITIES OF WORK: The quantities of work or material stated in the unit price items of the Bid Schedule are supplied only to give an indication of the general scope of the Work. The City does not expressly nor by implication agree that the actual amounts of work or material will correspond therewith, and reserves the right after award to increase or decrease the quantity of any unit price bid item, by an amount up to 25 percent of increase or decrease, without a change in the unit prices, and shall have the right to delete any bid item in its entirety, and receive full credit in the amount shown in the Bid Schedule for the deleted item of Work. SPECIAL NOTE: In the event of any "missing" bid items or scope of work not otherwise included or identified in the Bid Schedule, but indicated or required by the Plans and Specifications, the Contractor shall prosecute the work as required by the Plans and Specifications, and payment for any "missing" bid items or scope of work shall be included in the various bid items of work, and no additional payment will be allowed therefore. Surma- 1 ,Pt en rYlar,'r gs Name of Bidder or Firm CITY OF PALM SPRINGS BICYCLE LANE PROJECT UNIT PRICE BID SCHEDULE TOTAL CITY PROJECT NO. 14-14 BID FORMS-PAGE 24 FEBRUARY 8,2018 BIDDER'S LIST OF SUBCONTRACTORS—PART I The bidder shall list all subcontractors (both DBE and non-DBE), including those who will perform Work under this Bid for less than one-half of one percent of the Contractor's Total Bid Price. This required Bidder's List shall be provided in accordance with Section 2-3.1 of these Special Provisions and in accordance with Title 49, Section 26.11 of the Code of Federal Regulations. After the opening of Bids, no changes or substitutions will be allowed except as otherwise provided by law. The listing of more than one subcontractor for each item of Work to be performed with the words "and/or" will not be permitted. Failure to comply with this requirement will render the Bid as non-responsive and may cause its rejection. Special Note: The Prime Contractor shall perform not less than 50% of the Work identified in this Bid. In the event a Bidder lists subcontractors who will perform Work under this Bid in excess of 50% of the Work identified in this Bid, the Bid shall be considered non-responsive. A. BIDDER'S PORTION OF WORK Page 1 of 2 1. Name of Prime Contractor: Superior Pavement Markings 2. Bid Items/Portion of Work to be Self-Performed(if less than 100%of the contract): All bid items except#31,#35& Partial of#34 on all bid schedules 3. Dollar Amount of Work Self-Performed: 4. Percentage of Work Self-Performed: 5. Date: 455,438.05 76.4% 03/15/18 By signing the Bid Form,Contractor hereby certifies that it will perform not less than 50%of the Contract Work with its own forces. B. LIST OF SUBCONTRACTORS 1. Type of Subcontractor(Check One) Wirst Tier; Second Tier; Supplier, Service Contractor(e.g. Trucking) 2. Subcontractor Name: All American Asphalt 3. Address: PO Box 2229, Corona,Ca. 92878 4. Bid Items/Portion of Work: Partial item#34 on all bid schedules A-E 5. Phone No.:6. Contractor's License No.:7. Annual Gross Receipts: 951-736-7600 267073 A 1 M <$5M <$10M 8. Amount of Contracted Work: 9. DIR Public Works Contractor <$ 15M 13(>$15M 86,574.00 Registration No: 1000001051 10. Percentage of Contracted Work: 11. DBE Firm? Yes 3D(No 12. DBE Certification No.: 14.5% 1 N/A CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 15-18 FEBRUARY 8,2018 LIST OF SUBCONRACTORS-PART 1 BID FORMS-PAGE 2 BIDDER'S LIST OF SUBCONTRACTORS- PART I (Continued) Copy this page as needed to provide a complete listing. Page 2 Of 2 1. Type of Subcontractor(Check One) First Tier; Second Tier; Supplier; Service Contractor(e.g. Trucking) 2. Subcontractor Name: California Professional Engineering 3. Address: 929 Otterbein Ave, Unit E, La Puente, Ca. 91748 4. Bid Items/Portion of Work: Bid Items#31 &#35 5. Phone No.:6. Contractor's License No.:7. Annual Gross Receipts: 626-810-1338 793907 1 M <$5M <$10M 8. Amount of Contracted Work: 9. DIR Public Works Contractor <$ 15M QXX$15M 22,750.00 Registration No: 1000001980 10. Percentage of Contracted Work: 11. DBE Firm? R'es No 12. DBE Certification No.: 3.8% 1 31277 1. Type of Subcontractor(Check One) First Tier; Second Tier; Supplier; Service Contractor(e.g. Trucking) 2. Subcontractor Name: 3. Address: 4. Bid Items/Portion of Work: 5. Phone No.:6. Contractor's License No.:7. Annual Gross Receipts: 1 M <$5M <$10M 8. Amount of Contracted Work: 9. DIR Public Works Contractor <$ 15M >$15MRegistrationNo: 10. Percentage of Contracted Work: 11. DBE Firm? Yes No 12. DBE Certification No.: 1. Type of Subcontractor(Check One) First Tier; Second Tier; Supplier, Service Contractor(e.g.Trucking) 2. Subcontractor Name: 3. Address: 4. Bid Items/Portion of Work: 5. Phone No.:6. Contractor's License No.:7. Annual Gross Receipts: 0 <$1M 0 <$5M 0 <$10M 8. Amount of Contracted Work: 9. DIR Public Works Contractor <$ 15M >$15MRegistrationNo: 10. Percentage of Contracted Work: 11. DBE Firm? Yes No 12. DBE Certification No.: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 15-18 FEBRUARY 8,2018 LIST OF SUBCONRACTORS-PART I BID FORMS-PAGE 3 BIDDER'S LIST OF SUBCONTRACTORS — PART II Subcontractors not selected nor listed in the bid.) The bidder shall list all subcontractors (both DBE and non-DBE) who provided a quote or bid but were not selected to participate as a subcontractor on this project, including quotes or bids to perform Work under this Bid for less than one-half of one percent of the Contractors Total Bid Price. This required Bidder's List shall be provided in accordance with Section 2-3.1 of these Special Provisions and Title 49, Section 26 of the Code of Federal Regulations. Page 1 of 1 1. Type of Subcontractor(Check One) I$First Tier; Second Tier; Supplier; Service Contractor(e.g.Trucking) 2. Subcontractor Name: A Cone Zone 3. Address: 1640 Market St, Corona, CA. 92880 4. Bid Items/Portion of Work: Partial on Bid item#2 on all bid schedules 5. Phone No.:6. Contractors License No.:7. Annual Gross Receipts: 951-734-9535 851996 1 M [2fx$51VI <$10M 8. Amount of Contracted Work: 9. DIR Public Works Contractor <$ 15M >$15M not used Registration No: 1000006625 10. Percentage of Contracted Work: 11 DBE Firm? 9yes No 12. DBE Certification No.: 0% 36878 1. Type of Subcontractor(Check One) First Tier; Second Tier, Supplier; Service Contractor(e.g.Trucking) 2. Subcontractor Name: 3. Address: 4. Bid Items/Portion of Work: 5. Phone No.:6. Contractors License No.:7. Annual Gross Receipts: 0 <$1M 0 <$5M 0 <$10M 8. Amount of Contracted Work: 9. DIR Public Works Contractor <$ 15M >$15MRegistrationNo: 10. Percentage of Contracted Work: 11. DBE Finn? Yes No 12. DBE Certification No.: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 LIST OF SUBCONRACTORS-PART II BID FORMS-PAGE 4 A Cone Zone, Inc. QUOTATION aEMMMINC. Quote Date Quote ID 1640 Market St 311512018 EC180315 t Corona, CA 92880 951-734-9535 Valid Through:4/1412018 Fax 951-734-2887 LIC#851996 C-31 SUPERIOR PAVEMENT MARKINGS Job Location: DALE SCHULTS VARIOUS STREETS P. O. BOX 278 PALM SPRINGS BEAUMONT, CA 92223 Quote Created By: Elena Cisneros Phone: 951-845-2799 Fax: 951-845-6399 Email: dale@superiorpavementmarkings.com Item Description Price UOM Qty/Day Days Total Qty. Total TRAFFIC CONTROL SYSTEM;PW 1 MAN 1 TRUCK UP $925.00 PER/DAY 2 14 28 25,900.00 TO 8HRS UP TO 1000LF PORTAL-TO-PORTAL -OVERTIME 67.50 PER/HOUR/P 4 6 24 1,620.00 PER DIEM COSTS-2 TECHS 12 DAYS 350.00 PER DAY 1 12 12 4,200.00 Note:The'indicates taxable items. QUOTE BASED ON: Typical WATCH setups covering up to2,000 LF up to 8 HRS per day. NOTE: If traffic Control is required in two directions on the intersections, additional Techs and equipment may be required. NOTE: This quote was prepared without a Traffic Control Plan. If a Traffic Control Plan is prepared and approved, This quote will be revised per the approved plan. UDBE/WBE/SBE CERTIFIED Scope: Intersections requiring traffic control from two directions will be billed accordingly. Included: Setup per WATCH. Per Contractor, plans not required. Excluded: Changeable Message Sign (CMS) Standby Time Permits and Applicable Sales Tax No Parking, Public Notifications and Mailings Striping and/or pavement markings Does not include sand bags for securing of barricades. Add'I Terms: Invoices are payable with Terms of Net 30 Days. 4-Hour Minimum Charge, Portal-to-Portal Portal-to-Portal Rates at$45.00/pp/hr, $67.50/pp/hr Over-time, $90.00/pp/hr Dbl-time. AS OF JANUARY 1ST,2018-Prevailing Wage Labor Rates at$88.20/pp/hr,$113.40/pp/hr Over-time, $130.20/pp/hr Dbl-time. Quote based on regular business hours M-F, night&weekend work subject to over-time rates. Customer is responsible for Loss or Damage of Equipment while on rent. Fuel Surcharge may apply, not to exceed 8%of truck charges or delivery/pickup charges. Any job over$2,500 is mandatory to provide California 20-Day Preliminary Lien Information. Initials Page 1 of 2 Quote For: SUPERIOR PAVEMENT MARKINGS-Quote ID: EC180315-1 (cont.) MCI Terms: This quote is confidential and intended for addressed recipient only and is not to be disclosed to any other company(s)and/or person(s). See attached Exhibit A-Terms and Conditions made a part hereof. We are UDBE/WBE/SBE CERTIFIED! WBE#13030121; DBE#36878; SBE#1509840; DIR#1000006625 Contractor Ucense#851996 C-31 Accepted By: 3/15/2018 Elena Cisneros Date Signature Date A Cone Zone, Inc. Print Name Visit Our Website at www.AConeZone.com Title Company Page 2 of 2 NON-COLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the City of Palm Springs ENGINEERING SERVICES DEPARTMENT In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion Declaration is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non- collusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Bidder Superior Pavement Markings By Dale Shults 4 zz Title Operations Manager/Estimator Organization Corporation Address PO Box 278, Beaumont, Ca. 92223 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEBRUARY 8,2018 NON-COLLUSION DECLARATION BID FORMS-PAGE 6 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of Riverside On March 15, 2018 before me, Earl Smith, Notary Public Date Here Insert Name and Title of the Officer personally appeared Dale Shults Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. EARL SMITH SignaturCommission#21138621 : Notary Public-California i Signature of Notary Public Riverside County M Comm.Ex lies Jul 1 2019 Place Notary Seal Above OPTIONAL hough this section Is optional, completing this Infomtation can deter alteration of the document or fraudulent reattachment of this fort to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signers) Other Than Named Above: Capacity(ies)Claimed by Signer(s) Signer's Name:Signer's Name: Corporate Officer — Title(s): Corporate Officer — Titie(s): iJ Partner — Limited 71 General El Partner — Limited C General Individual Attorney In Fact Individual ri Attorney in Fact Cl Trustee Guardian or Conservator D Trustee D Guardian or Conservator Other: El Other: Signer Is Representing: Signer Is Representing: 02014 National Notary Association•www.NationaiNotary.org - 1-800-US NOTARY(1-800-876-6827) Item H5907 CERTIFICATION OF NON-DISCRIMINATION BY CONTRACTORS As suppliers of goods or services to the City of Palm Springs, the firm listed below certifies that it does not discriminate against any employee or applicant for employment because of race, religion, color, sex, age, marital status, ancestry, national origin, sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition; that it is in compliance with all federal, state, and local directives and executive orders regarding non-discrimination in employment; and that it agrees to demonstrate positively and aggressively the principle of equal employment opportunity in employment. We agree specifically: 1. To establish or observe employment policies, which affirmatively promote opportunities for minority persons at all job levels. 2. To communicate this policy to all persons concerned, including all company employees, outside recruiting services, especially those serving minority communities, and to the minority communities at large. 3. To take affirmative steps to hire minority employees within the company. FIRM Superior Pavement Markings NAME OF PERSON SIGNING Dale Shults TITLE OF PERSON SIGNING Operations Manager DATE March 15, 2018 Please include any additional information available regarding equal opportunity employment programs now in effect within your company. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 NON-DISCRIMINATION CERTIFICATION FEBRUARY 8,2018 BID FORMS-PAGE 7 THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH AREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Superior Pavement Markings and its proposed subcontractors (as listed on the bidder's list of subcontractors), hereby certify that they have xxx have not participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, the prime bidder has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 EEO CERTIFICATION FORM FEBRUARY 8,2018 BID FORMS-PAGE 8 DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; Has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; Does not have a proposed debarment pending; and Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 DEBARMENT AND SUSPENSION CERTIFICATION FEBRUARY 8,2018 BID FORMS-PAGE 9 NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 1) No federal appropriated funds have been paid or will be paid, by or on behalf of the .undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 NON-LOBBYING CERTIFICATION FEBRUARY 8,2018 BID FORMS-PAGE 10 DISCLOSURE OF LOBBYING ACTIVITIES COMPLE'I L'I I I1S FORM 1'O UISC'LOSL LOBBY ING ACf IV]I IES PURSUANT 10 31 U.S.C. 13S2 1. T-*pe of Federal Action: 2. Status of Federal Action: 3. Report Type: F1None None None a. contract Oa. bid/offer/ap lication a- initial b. grant b. initial award b. material change C. cooperativeagrccnient c. post-award d. loan For Material Change Only: c. loan guarantee year_ quarter_ L loan insurance chic of last report _ 4. Name and Address of Reporting Entity 5. If Reporting Enlity in No.4 is Subawardee, None Enter Name and Address of Prime: Rime Subawaidec Tier it-known None Congressional District.if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: None None CFDA Number,if applicable 8. Federal Action Number,il'known: 9. Award Amount,if known: None None 10. a. Name and Address of Lobin Entity b. Individuals Performing Services (including If individual,last name.first name,MI)address ifdillcrent from No. I Oa) last name,first name,MI) None attach C'onlinualion Shce9(s)if necessary) 11. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) S -0- actual planned a. retainer None b_ one-time foe 12. Form of Payment(check all that apply):c. commission ea. cash None d. contingent fee h. in-kind; specify: nature a deferred value f. other,spccil'y 14. Brief Description of Services Performed or to be performed and Datefs)of Service,including officer(s),employee(s),or member(&)contacted,for Payment Indicated in Item 11: n/A attach Continuation Sheet(s)if necessary) 15. Continuation Sheet(s)attached: Yes No 13 I& Information requested Through this lomi is authorized by'Fillc 31 U.S.0 Section 1352. This disclosure ul'lobbying reliance Signature: was placed by the tier ahoee when his transaction was na,k or entered into This disclosure is required pursuant to 31 ti.S.C- Print Name: Dale Shults 1352. This iulormation will be reported u+Cungrcss semiannually and will N available tbrpahhe inspection. Any Operations Manager person who leils w file the requacd disclo,ure shall be subject 1`rtk.- it)acivil penalty ofnot less than$Io,fln0a tit]nal more than 951-845-2799 03/15/18SI(NLOW foi each such failure. Telephone No.:Date:_ Authorized for Local Reproduction Federal Use Only: Standard pomp-LLL Stmxlanl Form LLL Rm°_09-12-97 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 DISCLOSURE OF LOBBYING ACTIVITIES FEBRUARY 8,2018 BID FORMS-PAGE 11 INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient,at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The tiling of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate.Complete all items that apply for both the initial tiling and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-tip report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name,address.. city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks"subawardee' then enter the full name,address,city. State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation,United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known,enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants,cooperative agreements,loans and loan commitments. S. Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g... Request for Proposal(RFP)number, Invitation for Bid(IFB)number,grant announcement number,the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes,e.g.,"RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address,city,State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. b) Enter the full names of the individual(s) perforating services and include full address if different from 10(a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made planned). Check all boxes that apply. If this is a material change report,enter tine cumulative amount of payment made of planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. if other.. specify nature. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 DISCLOSURE OF LOBBYING ACTIVITIES FEBRUARY 8,2018 BID FORMS-PAGE 12 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s)eniployee(s)or Member(s)of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of inforniation is estimated to average 30 minutes per response, including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of inforniation. Send comments regarding the burden estimate or any other aspect of this collection of infortnation, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project(0348-0046), Washington, D.C. 2050 3. SF-LLL-lnslructions Rev.06-04-40mENDtI-'» CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 DISCLOSURE OF LOBBYING ACTIVITIES FEBRUARY 8,2018 BID FORMS-PAGE 13 EXHIBIT 1 SG -LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: City of Palm Springs LOCATION: Palm Springs PROJECT DESCRIPTION: City of Palm Springs Bicycle Lane Project, City Project#14-14 TOTAL CONTRACT AMOUNT:$ 596,482.05 BID DATE: March 15, 2018 BIDDERS NAME: Superior Pavement Markings, Inc. CONTRACT DBE GOAL: 3% CONTRACT ITEM OF WORK AND DBE CERT NO.NAME OF EACH DBE DOLLAR AMOUNT ITEM NO. DESCRIPTION OR SERVICES TO AND EXPIRATION (Must be certified on the date DBE BE SUBCONTRACTED OR DATE bids are opened-include DBE MATERIALS TO BE PROVIDED address and phone number) or contracted if the bidder is a DBE) 31 Install Loop Detectors 31277 California Professional $22 750.00 35 Ad'ust Video Detection ZonE s Engineering 929 Otterbein Ave Unit E La Puente,Ca.91748 For Local Agency to Complete: Total Claimed DBE $22,750.00 Local Agency Contract Number:Participation Federal-aid Project Number. 3.8 Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and Signature of Bidder information is complete and accurate. 03-15-18 951-845-2799 Date Area Code)Tel.No. Print Name Signature Date Local Agency Representative Dale Shults Person to Contact Please Type or Print) Area Code)Telephone Number Local Agency Bidder DBE Commitment(Construction Contracts) Rev 6126l09) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 30 days of contract execution. Failure to send a copy to the DLAE within 30 days of contract execution may result in de- obligation of funds for this project. 2)Copy—Include in award package to Catrans District Local Assistance 3)Original—Local agency files CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 LOCAL AGENCY BIDDER-DBE COMMITMENT FEBRUARY 8,2018 BID FORMS-PAGE 17 INSTRUCTIONS - LOCAL AGENCY BIDDER DBE COMMITMENT(CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers. The form has a column for the Names of DBE contractors to perform the work who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First-Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions construction contracts), to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 LOCAL AGENCY BIDDER-DBE COMMITMENT FEBRUARY 8,2018 BID FORMS-PAGE 18 Exhibit 15-H DBE Information —Good Faith Efforts Federal-aid Project No. Project 14-14 Bid Opening Date 03-15-18 The City of Palm Springs established a Disadvantaged Business Enterprise (DBE) goal of 3% for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder(please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement None B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of Date of Follow Up Methods and DBEs Initial Dates Solicited Solicitation A Cone Zone 03-14-18 Phone Call 03-15-18 California Prof Eng 03-14-18 Phone Call 03-15-18 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 LOCAL AGENCY BIDDER-DBE COMMITMENT FEBRUARY 8,2018 BID FORMS-PAGE 19 Y C. The items of work which the bidder made available to DBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item Of Y/N) Contract 2 Partial Y Traffic Control 311720.00 5.3% 31 &#35 N Signal work 22,750.00 3.8% D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: A Cone Zone 1640 Market Street Corona CA 92880 951-734-9535 we reached our DBE goal without their work Names, addresses and phone numbers of firms selected for the work above: California Professional Engineering 929 Otterbein Ave, Unit E, La Puente, CA. 91748 626-810-1338 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 LOCAL AGENCY BIDDER-DBE COMMITMENT FEBRUARY 8,2018 BID FORMS-PAGE 20 E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: None F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: None G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Method/Date Results Agency/Organization of Contact None CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 LOCAL AGENCY BIDDER-DBE COMMITMENT FEBRUARY 8,2018 BID FORMS-PAGE 21 H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): None NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO.14-14 LOCAL AGENCY BIDDER-DBE COMMITMENT FEBRUARY 8,2018 BID FORMS-PAGE 22 Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _, has not XX been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT FEBRUARY 8,2018 BID FORMS-PAGE 23 Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No XXX If the answer is yes, explain the circumstances in the following space. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO.14-14 PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE FEBRUARY 8,2018 BID FORMS-PAGE 24 Public Contract Code Section 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 PUBLIC CONTRACT CODE SECTION 10232 STATEMENT FEBRUARY 8,2018 BID FORMS-PAGE 25 BID BOND KNOW ALL MEN BY THESE PRESENTS, That Superior Pavement Markings, Inc. as Principal, and Old Republic Surety Company as Surety, are held and firmly bound unto the City of Palm Springs, California, hereinafter called the"City" in the sum of: ten percent of amount bid-------_________ _________________________dollars not less than 10 percent of the total amount of the bid) for the payment of which sum,well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns,jointly and severally, firmly by these presents. WHEREAS, said Principal has submitted a Bid to said City to perform the Work required under the Bid Schedule(s) of the City's Contract Documents entitled: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEDERAL AID PROJECT NO. CML-5282 (044) NOW THEREFORE, if said Principal is awarded a Contract by said City, and within the time and in the manner required in the "Notice Inviting Bids" and the "Instructions to Bidders" enters into a written Agreement on the Form of Agreement included with said Contract Documents, furnishes the required Certificates of Insurance, and furnishes the required Performance Bond and Payment Bond, then this obligation shall be null and void, otherwise it shall remain in full force and effect. In the event suit is brought upon this Bond by said City, and City prevails, said Surety shall pay all costs incurred by said City in such suit, including a reasonable attorney's fee to be fixed by the court. SIGNED AND SEALED,this 14th day of March 2018 EXECUTED FOR THE PRINCIPAL: EXECUTED R THE SURETY: Superior Pavement Markin , Inc. OIF(NOTARIZED) mpany By Signature ignature NOTARIZED) Pant Name and Title: Print Name and Title:P lcr G( eCfe,}olrY Scott Salandi, Attorney-in-fact By nnature NO ARiZfD) Print Name and Title: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO.14-14 81D BOND(BID SECURITY FORM) FEBRUARY 8,2018 BID FORMS-PAGE 14 1 " 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 is,, -• County of ( VgrV On /l rrL t A3,,20f before me, Date H re Insert Name and Title of the Officer Upersonallyappeared o uG,zj- Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person whose named O'afe subscribed to the within instrument and acknowledged to me that(f seheAheyexecutedthesamein ha;4lR6r authorized capacity(io),and that by C'herltbeir signature()on the instrument the persor(a, or the entity upon behalf of which the person acted, executed the ir{strument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph LORENA B.BERUMEN is true and correct. NotaryPublic-California WITNESS m hand an fficial seal.Orange county y Commission es Jun 341 6,My Comm.Expires Jun 6,2021 Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document n Title or Type of Document: I 36"1 _Pr~44 Document Date: umber of Pages: Signer(s) Other Than Named Above: i'!'ryc Yr Capacity(ies) Claimed by Signer(s) Sigger's Name: W7 / Signer's Name: 4, Corporate Officer — Title(s): ?YGS, Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other: Other: Signer Is Representing: Signer Is Representing: 02016 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of Califor ' County/of d-l/1G11 On /fit 1/v lam, 1 before me, Z Or. • h l 0 7 G Date He Insert Name and Title o the Officer personally appeared 1.C.I'fi°l] r//7_, Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the persono whose nameJ,a')Q'aFe- subscribed to the within instrument and acknowledged to me thatd5Kshe/hey executed the same in i /hoo4i it authorized capacityqp4,and that b i it signatureo on the instrument the person , or the entity upon behalf of which the person 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. EORENAB.BERUMEN WITNESS my hand mind official seal. NotaryPublic—California g '"n orange County Commission Jun 341 6.2MyComm.Expirea s Jun6.2021 Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Docu nt Title or Type of Document: 13ai c Document Date: nAW4- /y/ ,2A1 Number of Pages: / Signer(s) Other Than Named Above: DHN Lr ay t Capacity(ies) Claimed by Signer(s) Siqp er'''s Name: 11 Signer's Name: R'Corporate Officer — Title(s): i!Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other: Other: Signer Is Representing: Signer Is Representing: 02016 National Notary Association •www.NationaiNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 U-Z POMFUBLIC SR"Wi COMP A NY SOW R OF ATTORNEY' ,e: KNOW ALLi7,i, el SE PPMENBY E ThatOLD REKM.UC SURETY 60MV.Ak'a Wisconsin stock itismatickoorporat ctoes toaistitute an appoint- i!-A_;EONAtT I MINSKY,SCOTT SALANDkDAVIU.,KQOBSOK OF IRVINE,CA its tree and ia%fW Aftmn6(s)-in-Fact,widfun power and audioiity,not and conipany as surety,to ind and,deliver;exceeding$50,000,000,for' .4.wbehajfpfdA.9: exec 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 de guaranty bonds guw%si-twy bondej mortgagg.,defi, ciancy bonds t gantees,of installment Per and note guaranty bo*,self-insurance workers I 01 ilds par"jrig, is,as t contract K Wei; roods, in ad renliedla '4 or black lungpa!j. I t inkfiag ent I kardii booopmpensatmaern as is ALL Av v"ItITM IMTRUIv11 NTa IN AN NAMOU NOT TO;'.EXCEEP TEN MILLION DOLLARS($10,000,000)------------------- FOR ANY SINGLE OBLIGATION F' ratifiedPANYthcieliy,and ali,0andt4bindoOREPUBLICSURETY ftheaft of said'Attorney-in- ac pupsuatit to these presents,are ratifi abdoonfuma,Attorneys-in-Fact, Thisdocunient isucrt' "'ducless printiMon'bolofed"badki and is ffitiltimcolored This a entiWaxitile-midet:oodby authority of the board of directors4iii_ onstaialniheldl February li;11981. This Power of,; is ilj i and facsfin"nader artd by the.suthority,of fd)lo*ing resolit adopted by the board of directors of the OLD REPUBLIC SURETY COMPANY on February 18,1982. UnD tfia",prestden_Vuiez-imidinit or assistant vice president,in WIP11011 assistant secret may appointRESOwiththesecretaryoranyasary,,.. I.. L ii, , a k I kwrdoysv.-m t or agents with Aooriig a$dellnetll or limited in the fusliturtent evidqneft th r,appom nent iqeach case.for and on behalf of the cornpany to: W,recoeiecuf,aridtleiiverind affix the i*4 pliatices and suretyship and said odctxa mayirenurvathecompanytopnOcitakuobligatiposicifallkinds any such attorney-m-fact or agent and revoke any Power of Attorney previously grimusi'to such person. RESOLVED FURTH61t that abybow4'.' Wertakin on shall be valid i' d the CompaoAn91M0091110110elorsuretyshipbligafipanNodi#gu i)V; jWe 'president !avice. dent banypregior1168101arnivicelncsidimandii6Qsealed(if a aeal e required)tr ass istantstant orsecretBy d or assistant vice: dent, add, 6if a`seal beii)when signed PME any1vW0 president prest secretary secretaryigaid countersigned required)by a duly authorized attorney-in-fact or agent;or iii)when du_ly,executed and sealed(ii bcmquired),_by one car more attorneys-an-fact or agents and within the limits of the authoritypursuantto edddncedby the Power ofAaWpoy issued,by,rho company to!such person orperamis..:, RESOLVED FURTHER,that the signina-6 ofazy authdrifttl nffieer'and the seal of thivoompanY. W affixed bPAYyfi6im!leto any Pow"fAftom:y'br' certification th adhofizm' g the,execution ind'464, obligations of thtic'ornpanr,andIucliy:of any bond,undertaking,rftogniz 46theisuretyship signature and seal when so used shall have the same,force and effect as though manually alfixed. IN Wit.m. S.W11,&MO,F,"OLD "Mll I LIC SURETY 6M6kqYbaa caused these ,spte wtguibe signed byltai offtc4r,skid corporate seal to be rj7g proper affixed this day of NdNTjVfBER.2019. OLD REPUBLIC SURETY::COMPANY SEA STATE OF WISCONSIN,COUNT 11 Y OF WAU I KFSHA-ss i President On a 2017 Willy cadneoef6re me 00 and fj vt6me,16iiiwit to b6 the indi duals and'offten oftha,OU3.11"OBLIC SU MFAN'Ywh6,exvcut4d the 4W eERgTYCO mottumetit'and ackrinviedg6a the ck"'pnof the sartiv,and being by me dulysworn,did kYoiely OP*0ASky; that theysm.the said officers of ftthey.each 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'OMMA-and stq*cobcdt6#ic,piidW"ment by the aultiorityof fimbnairdof directors of said corporation, A&, Nab"pubke My commission expires: 9/28/2018 CERTIFICATE EX01ration,coppiary comindanl§n does nirt 6011daft 00sInabuin"4 I the undersign ed,assistant secretary of thOOLP REPUBLIC SURETY:COM.P,0 a.. isconsm.corporation;CtkTItY that the foregoing and attached Power of:Attomey tv:inamis.in'full force and Iiiii not bun ravokbil,aiddAirthetmore,that the Resolutions of the of directors set forth in the Power of A noracy,are noww in force. Signed and,sed! attlie City 0f Brookfield, dayof MAR 1k AseleWa 2 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 Orange MAR 1 4 2018 Michele A. Fedoruk Notary PublicOnbeforeme, ry insert name and title of the officer) personally appeared Scott Salandi, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/am subscribed to the within instrument and acknowledged to me that he/sb[Mey executed the same in hls/liiglCXbak authorized capacity(i*, and that by his/kex/sbiek 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. MICHELE A.FEDORUK WITNESS m hand and official seal. 4 _ Notary ommission I2o62tz y Voary PIIWic-CalifornianlcrawCognty Mir 2&2018 r Signature Seal) BIDDER'S GENERAL INFORMATION The Bidder shall furnish the following information. Failure to complete all Items will cause the Bid to be non-responsive and may cause its rejection. 1. BIDDER/CONTRACTOR'S Name and Street Address: Superior Pavement Markings PO Box 278 Beaumont, CA 92223 Telephone Number: ( 951 ) 845-2799 Facsimile Number: ( 951 ) 845-6399 _ E-Mail: Dale@superiorpavementmarkings.com Tax Identification Number: 95-4518251 2. TYPE OF FIRM Individual Partnership XX Corporation (State CA ) Minority Business Enterprise (MBE) Women Business Enterprise (WBE) Small Disadvantaged Business (SDB) Veteran Owned Business Disabled Veteran Owned Business 3. CONTRACTOR'S LICENSE: Primary Classification C-32 State License Number(s) California Supplemental License Classifications C-31, C-610-38 4. BUSINESS LICENSE: Yes XX No License No.: 5. Surety Company and Agent who will provide the required Bonds: Name of Surety Patriot Risk& Insurance Service Address 2415 Campus Dr#200, Irvine, Ca. 92612 Surety Company Old Republic Surety Company Telephone Numbers: Agent( 949) 486-7901 Surety ( 949 ) 797-9020 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT 1414 BIDDER'S GENERAL INFORMATIONFEBRUARY8,201818 BID FORMS-PAGE 15 BIDDER'S GENERAL INFORMATION (Continued) 6. List the names and addresses of the principal members of the firm or names and titles of the principal officers of the corporation or firm; also include those who have greater than $2,000 interest in the firm: John Lucas President Robert Garcia Vice President Darren Veltz Secretary 7. Number of years experience as a contractor in this specific type of construction work: 18 8. List at least three related projects completed to date: a. Owner City of Menifee Address 29714 Haun Rd, Menifee Ca. 92586 Contact Carlos Geronimo Class of Work C-32 Phone 951-672-3843 Contract Amount $258, 120.00 Project Striping Services Date Completed 10/17 Contact Person Telephone number b. Owner City of La Quinta Address PO Box 1504, La Quinta, CA Contact Leonard St Sauver Class of Work C-32 Phone 760-777-7150 Contract Amount $316,148.00 Project Ave 52 &Jefferson Date Completed 04116 Contact Person Telephone number C. Owner Town of Apple Valley Address 14955 Dale Evans Parkway,AV, CA. 92307 Contact Brett Morgan Class of Work C-32 Phone 760-240-7000 Contract Amount $280, 714.00 Project Class II Bikeway Date Completed 01/18 Contact Person Telephone number 9. Name of Project Manager/Superintendent: Kenny Smith/James Camacho 10. Name(s) of person(s)who inspected job site: Dale Shultz CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT 1414 BIDDER'S GENERAL INFORMATIONFEBRUARY8,201818 BID FORMS-PAGE 16 Clty of Palm Apr P, CA ce 1D ABSTRACTalOAbobad Vendors& Bid Amounts PROJECT DUE DATE: 3as D6SCRIp7' lplV•Total of aB Bid chedule• Items witness:date g ih. CONTRACTORS STATE LICENSE BOARD Contractor's License Detail for License # 776306 DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information,you should be aware of the following limitations. CSLB complaint disclosure is restricted by law(B&P 7124.6)If this entity is subject to public complaint disclosure,a link for complaint disclosure will appear below.Click on the link or button to obtain complaint and/or legal action informatien. Per B&P 7071.17 only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply wrh the terms of the arbitration. Due to workload,there may be relevant information that has not yet been entered onto the Board's license database. Data current as of 411 9/201 8 8:17:48 AM Business Information SUPERIOR PAVEMENT MARKINGS INC 5312CYPRESS ST CYPRESS, CA 90630 Business Phone Number(714)995-9100 Entity Corporation Issue Date 03/17/2000 Reissue Date 08/13/2007 Expire Date 08131/2019 License Status This license is current and active. All information below should be reviewed. Classifications C32-PARKING AND HIGHWAY IMPROVEMENT C31 -CONSTRUCTION ZONE TRAFFIC CONTROL C-61 /D38-SAND AND WATER BLASTING Bonding Information Contractor's Bond This license filed a Contractor's Bond with AMERICAN CONTRACTORS INDEMNITY COMPANY. Bond Number: 100226797 Bond Amount:$15,000 Effective Date:0 110 112 016 Contractor's Bond History I Bond of Qualifying Individual The qualifying individual JOHN MATTHEW LUCAS certified that he/she owns 10 percent or more of the voting stocklmembership interest of this company;therefore,the Bond of Qualifying Individual is not required. Effective Date:07/11/2016 BQI's Bond History Workers'Compensation This license has workers compensation insurance with the SECURITY NATIONAL INSURANCE COMPANY Policy Number:SWC1154448 Effective Date:06/01/2017 Expire Date:06/01/2018 Workers'Compensation History Miscellaneous Information 08/13/2007-LICENSE REISSUED TO ANOTHER ENTITY I Other Personnel listed on this license(current or disassociated)are listed on other licenses. TE A EP CERTIFICATE OF LIABILITY INSURANCE DA anazow,a) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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). CONTACT PRODUCER Patriot Risk& Insurance Services NAME: 2415 Campus Drive, Suite#200 n/CNE FAX u_Eatl: (949)486-7900 we No: 949 486-7950 Irvine, CA 92612 E-MAILADDRESS: INSURER(Sl AFFORDING COVERAGE KAIC0 www.patrisk.com OK07568 INSURER A: Wesco Insurance Company 25011 INSURED INSURER B: Great American Insurance Company 16691 Superior Pavement Markings, Inc. 5312 Cypress St. NsuRERc: Security National Insurance Company 33120 Cypress CA 90630 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 41408326 REVISION NUMBER: 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 SUER ima POLICY NUMBER MWDCD MWI PLTRLIMITS A v COMMERCIAL GENERAL LIABILITY / V WPP168316100 9/18/2017 9/18/2018 EACHOCCURRENCE 1000000 DAMAGE TO RENTED CLAIMS-MADE F OCCUR PREMISES Ea occurrence $300 000 M ED EXP one person) $5 000 PERSONAL&ADV INJURY $1 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,000,000 POLICY PRO-JECT 7 LOC PRODUCTS-COMPlOP AGG $2000000PIOTHERIII A AUTOMOBILE LIABILITY WPP1573693 8/1/2017 8/1/2018 Eaa&dlItl GLELIMIT $1000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYDentAMAGE AUTOS ONLY AUTOS ONLY Per acdtl B / UMBRELLA LIAB OCCUR TUE219131500 9/18/2017 9/18/2018 EACH OCCURRENCE 000 000 EXCESS LIAB i CLAIMS-MADE AGGREGATE DOO 000 DELI RETENTION$ C WORKERS COMPENSATION SWC1154448 6/1/2017 6/1/2018 ,/ STATUTE EERH AND EMPLOYERS'LIABILITY YIN ANYPROPRI ETOR/PARTNEWEXECUTIVE E.L.EACH ACCIDENT 000000 OFFICEWMEMBER EXCLUDED? Y NIA Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 00,000 If yes,oescnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 OOD 000 DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:City of Palm Springs-Bicycle Lane Project,CP 14-14 The City of Palm Springs,its officials,employees and agents are named as an Additional Insured as respects to the General Liability&Auto Liability per the attached endorsements as required by written contract.This insurance is primary and non-contributory over any insurance or self-insurance the City may have for any and all work performed with the City.Waiver of Subrogation applies to the Workers'Compensation and in favor of The City of Palm Springs,its elected officials,officers,employees,agents and volunteers. "30 day notice of cancellation; 10 day for non-payment. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Celtyy of Palm Springs THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3200 E. Tahquitz Canyon Way ACCORDANCE WITH THE POLICY PROVISIONS. Palm Springs CA 92262 AUTHORIZED REPRESENTATIVE Leonard E.Ziminsk 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 41408326 1 17/18 GL/AU/m18/WC I Annette Romero 14/18/2018 8:48:05 AN (POT) I Page 1 Of 17 This certificate cancels and supersedes ALL previously issued certificates. POLICY NUMBER:WPP158316100 COMMERCIAL GENERAL LIABILITY Superior Pavement Markings,Inc. CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Y COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Pereonis) Or Organlzationis) Looatlon(s)Of Covered Operations Blanket as required by written contract. Blanket as required by written 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 required by the contract or agreement to include as an additional insured the person(s) or provide for such additional insured. organization(s) shown in the Schedule, but only B. With respect to the insurance afforded to with respect to liability for"bodily injury", "property these additional insureds, the following additional damage" or "personal and advertising injury" exclusions apply: caused, in whole or in part,by: This insurance does not apply to "bodily injury" or 1. Your acts or omissions; or property damage"occurring after. 2. The acts or omissions of those acting on your 1. All work, including materials, parts or behalf; equipment furnished in connection with such in the performance of your ongoing operations for work, on the project (other than service, the additional insured(s) at the location(s) maintenance or repairs) to be performed by or designated above. on behalf of the additional insured(s) at the location of the covered operations has been However: completed; or 1. The insurance afforded to such additional 2. That portion of "your work" out of which the insured only applies to the extent permitted by injury or damage arises has been put to its law;and intended use by any person or organization 2. If coverage provided to the additional insured other than another contractor or subcontractor is required by a contract or agreement, the engaged in performing operations for a insurance afforded to such additional insured principal as a part of the same project will not be broader than that which you are CG 20 10 0413 C Insurance Services Office, Inc., 2012 Page 1 of 2 41408326 11/1E GL/AU/UMB/WC I Annette Romero 14/18/2C18 8:48:08 AM (PDT) I Page 3 of 19 This certificate cancels and supersedes ALL previously issued certificates. C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Section Insurance shown in the Declarations; III-Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 0 Insurance Services Office, Inc.,2012 CG 20 10 0413 41408326 10/18 GL/AO/OMB/WC Annette Romero 4/_6/2018 8:48:05 A (PCT) I Page 3 of 17 This certificate cancels and supersedes ALL previously issued certificates. Superior Pavement Markings, Inc. POLICY NUMBER:WPP158316100 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 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 PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Blanket as required by written contract. Blanket as required by written contract. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A. Section 11 -Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s)or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III-Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is property damage" caused, in whole or in part, required by a contract or agreement, the most we by "your work" at the location designated and will pay on behalf of the additional insured is the described In the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 41408326 19/16 cL/AU/UMa/WC I Annette Romero 1 4/1a/2018 8:48:05 AM (PDT) I Page 4 of 10 This certl ficate cancels and supersedes ALL previously issued certificates. Superior Pavement Markings,Inc. WPP158316100 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BROADENED COVERAGE FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. PROPERTY DAMAGE TO BORROWED EQUIPMENT Paragraph (1), of j. Damage To Property, under 2. Exclusions, of SECTION I—COVERAGES COVERAGE A-BODILY INJURY AND PROPERTY DAMAGE"LIABILITY is amended to add the following: Paragraphs (3)and (4) of this exclusion do not apply to tools or equipment loaned to you, provided that they are not being used to perform operations at the time of the loss. With respect to"property damage"to borrowed equipment the following additional provisions apply: 1. The most we will pay for"property damage"to borrowed equipment is $100,000 for any and all such losses regardless of the number of: a. Insureds; b. Claims or"suits" brought; or c. Persons or organizations bringing claims or"suits". B. NON-OWNED WATERCRAFT EXTENSION Subparagraph (2) of g.Aircraft, Auto Or Watercraft, under 2. Exclusions, of SECTION I—COVERAGES, COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced with the following: This exclusion does not apply to: 2) a watercraft you do not own that is: a) Less than 51 feet long; and b) Not being used to carry persons or property for a charge. C. DAMAGE TO PREMISES RENTED TO YOU The last paragraph of 2. Exclusions of SECTION I -COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced with the following: Exclusions c. through n. do not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: 1. Fire; 2. Explosion; GL990078 Page 1 of 6 Ed 0912 41408324 17/18 GL/AJ/0 /WC I Annette Romero 14/18/2018 A 48 03 AM (POT) I Page 5 of 17 This certificate cancels and supersedes ALL previously issued cerlificates. 3. Lightning; 4. Smoke resulting from such fire, explosion or lightning; or 5. Water. A separate limit of insurance applies to this coverage as described in Section III Limits of Insurance. This insurance does not apply to damage to premises rented to you, or temporarily occupied by you, with permission of the owner caused by: 1. Rupture, bursting, or operation of pressure relief devices; 2. Rupture or bursting due to expansion or swelling of structural components or the contents of any building or structure, caused by or resulting from water; 3. Explosion of steam boilers, steam pipes, steam engines or steam turbines. Paragraph 6.of SECTION III LIMITS OF INSURANCE is deleted and replaced with the following: Subject to paragraph 5. of SECTION III —LIMITS OF INSURANCE, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY.for the sum of all damages because of"property damage"to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: fire; explosion; lightning; smoke resulting from such fire, explosion , or lightning; or water. The Damage To Premises Rented To You Limit will apply at all"property damage" proximately caused by the same"occurrence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented to You Limit will be the higher of: a. $300,000; or b. The amount shown on the Declarations for Damage To Premises Rented To You Limit. Paragraph a.of 9. "Insured Contract', under SECTION V— DEFINITIONS, is deleted and replaced with the following. An "Insured contract' means a contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: fire: explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water, is not an insured contract". D. PROPERTY DAMAGE COVERAGE FOR PERSONAL PROPERTY WHILE IN YOUR POSSESSION Sub-paragraphs(3) and (4) of Paragraph j. Damage To Property, of 2. Exclusions. of SECTION I— COVERAGES, COVERAGE A -BODILY INJURY AND PROPERTY DAMAGE LIABILITY do not apply to"property damage"to the property of others while in your possession. With respect to the insurance provided by this section of the endorsement, the following provisions apply: The limit of this coverage is $25,000 per"occurrence" and $25,000 aggregate in any annual policy period starting with the beginning of the policy period in the Declarations, regardless of the number of: a. Insureds; GL990078 Page 2 of 6 Ed 0912 41408326 14/18 GL/AU/CMS/WC I Annette Romero 14/18/2018 8:48:05 AM (PDT) I Page 6 of 17 This certificate cancels and supersedes ALL previously issued certificates. b. Claims or"suits" brought; or C. Persons or organizations bringing claims or"suits". We will pay for damages on your behalf, only to the amount of damages for each "occurrence"on your behalf applies only to the amount of damages for each "occurrence'which are in excess of a 1,000 deductible. We may pay any part, or all of the deductible amount, to effect settlement of any claim or"suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount, as has been paid by us. E. PROPERTY DAMAGE COVERAGE FOR TENANTS—REAL PROPERTY Sub-paragraph j. (5) Damage To Property, of 2. Exclusions of SECTION 1—COVERAGES, COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted and replaced with the following: While under your care, custody or control we will pay for"property damage"to property of others arising out of operations incidental to your business when a. Damage is caused by the insured; b. Damage occurs while in the insured's possession The most we will pay under this provision for loss or damage during the policy period is $25,000 per occurrence"and $25,000 aggregate in any annual policy period starting with the beginning of the policy period in the Declarations. We will pay damages on your behalf, only to the amount of damages for each "occurrence"which are in excess of a$1,000 deductible. The limits of insurance will not be reduced by the application of such deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or"suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us; or F. SUPPLEMENTARY PAYMENTS Paragraphs 1.b. and 1d. under SUPPLEMENTARY PAYMENTS—COVERAGES A AND B of SECTION I is amended as follows: a. In paragraph 1.b.,the amount we will pay for the cost of bail bond is increased to$2,500 b. In paragraph 1.d., the amount we will pay for loss of earnings is increased to$500 a day. G. NEWLY ACQUIRED OR FORMED ORGANIZATIONS Paragraph 3.a. of SECTION II—WHO IS AN INSURED is deleted and replaced with the following: Coverage under this provision is afforded until the 180'h day after you acquire or form the organization or the end of the policy period, whichever is earlier. H. PAST PARTNERSHIPS AND JOINT VENTURES The following is added to SECTION II—WHO IS AN INSURED: GL990078 Page 3 of 6 Ed 0912 414OE326 17/18 GL/AU/UP/WC I Annette Romero 14/18/2019 8:48u05 AM (PDT) I Page 7 of 17 This certificate cancels and supersedes ALL previcusly issued cercficates. If you are an insured, as shown in the Declarations, you are an insured for your interest in a partnership or joint venture that ended prior to this policy-period. This insurance applies: a. Only to the extent of your interest in the partnership or joint venture. b. Only if no other similar insurance is available to you for your interest in the joint venture or partnership. The last paragraph of SECTION II—WHO IS AN INSURED is deleted and replaced with the following: Except as provided in H. PAST PARTNERSHIPS AND JOINT VENTURES, no person or organization is an insured with respect to the conduct of any current or past partnership,joint venture or limited liability company that is not shown as a Named Insured in the Declarations. I.ADDITIONAL INSURED The following is added to SECTION II—WHO IS AN INSURED: Any person or organization with whom or with which you have agreed in writing in a contract or agreement that such person(s)or organization(s) shall be included as an additional insured on your policy is an additional insured. The contract must be executed before the"bodily injury or"property damage"occurs or the"personal injury" or"advertising injury' offense is committed, to name such person or organization as an additional insured, but only with respect to liability arising out any tenancy operation or use of equipment leased to you by such an additional insured. The following provisions apply to such additional insured: a. The limits of insurance afforded to the additional insured shall be the limits which you agreed to provide in the written contract, or the limits shown on the Declarations, whichever is less. b. The insurance afforded to the additional insured does not apply to: i. A ny"bodily injury" or"property damage"that occurs, or"personal injury"or"advertising injury'caused by an offense which is committed, after you cease to be a tenant in that premises; ii. Liability arising out of any premises for which coverage is excluded by endorsement; or iii. L iability arising out of structural alterations, new construction or demolition operations performed by or on behalf of such additional insured(s) The insurance afforded to the additional insured is excess over any valid and collectible insurance available to the insured, unless you have agreed in the written contract that this insurance must be primary or non-contributory with such other insurance. J. BROADENED NAMED INSURED Paragraph 1.d. of SECTION II—WHO IS AN INSURED is deleted and replaced with the following: The person or organization named in the Declarations, and any organization, other than a partnership,joint venture or limited liability company, of which you maintain ownership or in which you maintain the majority interest on the effective date of the policy. Your"executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. However, coverage for any such additional organization will cease as of the date, if any, during the policy GL990078 Page 4 of 6 Ed 0912 41408326 17/18 CL/AU/UMH/WC I Annette Romero 14/18/201B 8:48:05 AM (POT) I Page 8 of 17 This certificate Cancels and SunerSeae5 ALL PreviOUSlY issued certificates. period, that you no longer maintain ownership of, or the majority interest in, such organization. K. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following is added to paragraph 6. Representations of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS: Based on our reliance on your representations as to existing hazards, if you unintentionally fail to disclose any such hazards prior to the beginning of the policy period of this coverage part, we shall not deny coverage under this coverage part because of such failure. However, the provision does not affect our right to collect additional premium or to exercise our right of cancellation or nonrenewal in accordance with applicable state insurance laws, codes or regulations. L. BROADENED NOTICE OF OCCURRENCE The following is added to paragraph 2 Duties in the Event of Occurrence, Offense,Claim or Suit of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS: a. Notice of an "occurrence" or of an offense which may result in a claim covered by this policy, the failure to report such "occurrence"to us at the time of the"occurrence shall not be deemed a violation of this condition unless such "occurrence" or offense becomes known to. you, or one of the following if designated by you to give such notice: your"executive officers" (if you are a corporation), one of your partners who is an individual (if you are a partnership), one of your managers (if you are a limited liability company), or an "employee" (such as an insurance, loss control or risk manager or administrator)., However, you or your designated representative must give us notice as soon as practicable after being made aware that the particular claim. b. Knowledge by any other"employee" of an "occurrence" or offense does not imply that you also have such knowledge. c. This provision does not apply as respects the specific number of days within which you are required to notify us in writing of the abrupt commencement of a discharge, release or escape of pollutants"that causes"bodily injury' or"property damage"which may otherwise be covered under this policy. M. WAIVER OF SUBROGATION The following is added to paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: premises owned or occupied by or rented or loaned to you; ongoing operations performed by you or on your behalf, done under contract with that person or organization; "your work"; or"your products". We waive this right where you have agreed to do so as part of a written contract, executed by you before the"bodily injury"or"property damage' occurs or the"personal injury' or"advertising injury" offense is committed. N. BROADENED CONTRACTUAL LIABILITY—WORK WITHIN 50' OF RAILROAD PROPERTY Paragraph 9.c. of the definition "Insured Contract" under SECTION V— DEFINITIONS is deleted and replaced with the following: Insured contract" means any easement or license agreement in connection with construction or demolition operations on or within 50 feet of a railroad. GL990078 Page 5 of 6 Ed 0912 41409326 17/18 6L/AU/UM9/A7 I Annette Romero 14/18/2018 e:49:05 AM (PDT) I Page 9 of '_7 This certificate cancels and supersedes ALL previously issued certificates- Paragraph f.(1)of 9. "Insured contract' under SECTION V—DEFINITIONS is deleted. O. BODILY INJURY DEFINITION The definition of"bodily injury' in paragraph 3. of SECTION V—DEFINITIONS is deleted and replaced with the following: Bodily injury" means bodily injury, mental anguish, mental shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. GL990078 Page 6 of 6 Ed 0912 41406326 17/18 GL/AU/fNR/W[ I Annette Romero 1 4/18/2018 8:48:05 AM (=) I Page 10 of 19 This certificate cancels and supersedes ALL previously issued certificaces- WPP158316100 Superior Pavement Markings,Inc. COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance 2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance Is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: 1) The additional insured is a Named Insured under such other insurance;and CG 20 01 0413 0 Insurance Services Office, Inc.,2012 Page 1 of 1 41402326 17/18 GL,/AU/UMH/WC I Annette Romero 4/16/2o18 B:48-05 AM (PDTJ i Page 11 of 17i This certificate cancels and supersedes ALL previously issued certificates. Superior Pavement Markings,Inc. POLICY NUMBER:WPP1573693 COMMERCIAL AUTO CA990187 0715 This Endorsement Changes The Policy. Please Read It Carefully BUSINESS AUTO COVERAGE EXPANSION ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the COVERAGE FORM apply unless modified by the endorsement. A. Newly Acquired or Formed e. An"employee"of yours is an"insured" Organizations,Employee Hired Car while operating an"auto"hired or rented Liability and Blanket Additional Insured under a contract or agreement in that Status for Certain Entities. employee's"name,with your Item 1.Who is an Insured of Paragraph A. permission,while performing duties Coverage under SECTION II—COVERED related to the conduct of your business. AUTOS LIABILITY COVERAGE is f. Any person or organization you are amended to add: required by written contract or d. Any organization you newly acquire or agreement to name as an additional form,other than a partnership,joint insured", but only with respect to venture or limited liability company, and liability created in whole or in part by over which you maintain ownership of a such agreement. majority interest(greater than 50%),will B. Increase Of Loss Earnings Payment quality as a Named Insured; however, Subpart(4)of a.Supplementary Payments 1) coverage under this provision is of Item 2.Coverage Extensions of afforded only until the 18e day Paragraph A. Coverage under SECTION II after you acquire or form the COVERED AUTOS LIABILITY organization or the end of the policy COVERAGE is amended to read: period,whichever is earlier; 4) We will pay reasonable expenses 2) coverage does not apply to"bodily incurred by the"insured"at our injury","property damage"or request,including actual loss of covered pollution cost or expense" earnings up to$1,000 per day that results from an"accident"which because of time off from work. occurred before you acquired or C. Fellow Employee Injured By Covered formed the organization; and Auto You Own Or Hire 3) coverage does not apply if there is Item S. Fellow Employee of Paragraph B. other similar insurance available to Exclusions under SECTION II—COVERED that organization, or if similar AUTOS LIABILITY COVERAGE is insurance would have been amended to add: available but for its termination or the exhaustion of its limits of This exclusion does not apply if the"bodily insurance. injury"results from the use of a covered auto"you own or hire. Such coverage as This insurance does not apply if is afforded by this provision is excess over coverage for the newly acquired or any other collectible insurance. formed organization is excluded either by the provisions of this coverage form or by endorsement. CA990187 0715 Includes Copyrighted Material of Insurance Services Offices,Inc. Page 1 of 5 Used with permission 41408326 17/18 DL/AU/UMB/WC I Annette Romero 14/1B/2018 8:48c0S AM (PDT) I Page 12 of 17 This cer Lificate cancels and supersedes ALL previously issued certificates. D. Limited Automatic Towing Coverage G. "Personal Effects"Coverage Item 2.Towing,of Paragraph A. Coverage, Item 4.Coverage Extensions of Paragraph under SECTION III—PHYSICAL DAMAGE A. Coverage, under SECTION III- COVERAGE is amended to read: PHYSICAL DAMAGE COVERAGE,is amended to add: 2. Towing Personal Effects"Coverage We will pay for towing and labor costs each time that a covered"auto"is We will pay actual cash value for"loss"to disabled. All labor must be performed at personal effects"of the"insured"while in the place of disablement of the covered a covered"auto"subject to a maximum auto".limit of$2,500 per"loss",for that covered auto"caused by the same"accident". No a. The limit for towing and labor for deductible will apply to this coverage. each disablement is$500; H. "Downtime Loss"Coverage b. No deductible applies to this cover- age. Item 4.Coverage Extensions, of Paragraph A. Coverage, under SECTION E. Item 3.Glass Breakage—Hitting A Bird III. PHYSICAL DAMAGE COVERAGE,is Or Animal—Falling Objects or Missiles of amended to add: Paragraph A. Coverage under SECTION III PHYSICAL DAMAGE COVERAGE,is Downtime Loss"Coverage amended to add: We will pay any resulting"downtime loss" Glass Repair Coverage expenses you sustain as a result of a covered physical damage"loss"to a We will waive the Comprehensive covered"auto"up to a maximum of$100 deductible for Glass,if one is indicated on per day,for a maximum of 30 days for the your covered"auto",for glass repairs. We same physical damage"loss",subject to will repair at no cost to you, any glass that the following conditions: can be repaired without replacement, a. We will provide"downtime loss"beginningprovidedtheloss"arises from"a covered on the 5"'day after we have given youComprehensive"loss"to your auto".our agreement to pay for repairs to a F. Increase Of Transportation Expense covered"auto"and you have given the Coverage repair facility your authorization to make Subpart a.Transportation Expenses of repairs; Item 4.Coverage Extensions of Paragraph b. Coverage for"downtime loss"expenses A. Coverage under SECTION III— will end when any of the following occur: PHYSICAL DAMAGE COVERAGE is amended to read: 1) You have a spare or reserve"auto" available to you to continue your a. Transportation Expenses operations. We will pay up to$50 per day to a 2) You purchase a replacement"auto". maximum of$1,000 for temporary transportation expense incurred by you 3) Repairs to your covered"auto"have because of the total theft of a covered been completed by the repair facility and they determine the coveredauto"of the private passenger type. We will pay only for those covered auto"is road-worthy. autos"for which you carry either 4) You reach the 30 day maximum Comprehensive or Specified Causes of coverage. Loss Coverage or Theft Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration,when the covered"auto"is returned to use or we pay for its"loss". CA990187 0715 Includes Copyrighted Material of Insurance Services Offices,Inc. Page 2 of 5 Used with permission 41408326 17/18 GL/AU/UMB/WC I Annette Romero 14/18/2018 8:48:Di AM (PET) I Page 13 of 17 This certificate cancels and supersedes ALL previously issued certificates. I. Item 4.Coverage Extensions, of d. Contraband or property in the course Paragraph A. Coverage, under SECTION of illegal transportation or trade. III. PHYSICAL DAMAGE COVERAGE, is e. "Loss"caused by theft, unless there is amended to add: evidence of forced entry into the We will pay any resulting rental covered"auto"and a police report is reimbursement expenses incurred by you for filed. a rental of an"auto"because of"loss"to a K. Accidental Airbag Discharge Coverage covered"auto"up to a maximum of$100 per day,for a maximum of 30 days for the same Item 3.a. of Paragraph B. Exclusions under physical damage"loss",subject to the SECTION III—PHYSICAL DAMAGE following conditions: COVERAGE is amended to read: a. We will provide rental reimbursement a. Wear and tear,freezing, mechanical incurred during the policy period or electrical breakdown.The beginning 24 hours after the"loss"and exclusion relating to mechanical ending, regardless of the policy break-down does not apply to the expiration,with the number of days accidental discharge of an air bag. reasonably required to repair or replace L. Loan or Lease Gap Coverage the covered"auto". If the"loss"is Paragraph C. Limit Of Insurance under caused by theft,this number of days is SECTION III—PHYSICAL DAMAGE the number of days it takes to locate the COVERAGE is amended to add: covered"auto"and return it to you or the number of days it takes for the claim to If a covered"auto"is owned or leased and be settled,whichever comes first. if we provide Physical Damage Coverage b. Our payment is limited to necessary and on it,we will pay, in the event of a covered actual expenses incurred. total"loss",any unpaid amount due on the lease or loan for a covered"auto', less: c. This coverage does not apply while a. The amount paid under the Physical there are spare or reserve"autos"Damage Coverage Section of the available to you for your operations. policy; and d. If a"loss"results from the total theft of a covered"auto'of the private passenger b. Any. type,we will pay under this coverage 1) Overdue lease or loan only that amount of your rental payments including penalties, reimbursement expenses which is not interest or other charges already provided for under the Physical resulting from overdue Damage Coverage Extension. payments at the time of the J. "Personal Effects" Exclusion loss"; B. Exclusions under SECTION 2) Financial penalties imposed Paragraph under a lease for excessive use, Ill—PHYSICAL DAMAGE COVERAGE,is abnormal wear and tear or high amended to add: mileage; Personal Effects"Exclusion 3) Costs for extended warranties, We will not pay for"loss"to"personal Credit Life Insurance, Health, effects"of any of the following: Accident or Disability Insurance a. Accounts, bills,currency,deeds, purchased with the loan or evidence of debt, money, notes, lease; securities or commercial paper or 4) Security deposits not refunded other documents of value. by the lessor;and b. Bullion, gold,silver,platinum,or other 5) Carry-over balances from precious alloys or metals;furs or fur previous loans or leases garments;jewelry;watches; precious or semi-precious stones. c. Paintings,statuary and other works of art. CA990187 0715 Includes Copyrighted Material of Insurance Services Offices,Inc. Page 3 of 5 Used with permission 41408326 10/18 GL/AU/4H/WC I A ette Romero 1 4/18/2018 8:48:05 AM IPPT) I Page 14 of 17 This certificate cancels and supersedes ALL previously issued certificates. M. Aggregate Deductible 3) An"executive officer"or director,if Paragraph D. Deductible under SECTION you are a corporation; III—PHYSICAL DAMAGE COVERAGE is 4) A manager or member, if you are a amended to add:limited liability company; Regardless of the number of covered 5) Your insurance manager; or autos"involved in the same"loss", only 6) Your legal representative. one deductible will apply to that"loss". If the deductible amounts vary by"autos", P. Waiver Of Subrogation For Auto Liability then only the highest applicable deductible Losses Assumed Under Insured Contract will apply to that"loss". Item 5.Transfer Of Rights Of Recovery N. Diminishing Deductible Against Others To Us of Paragraph A. Loss Conditions under SECTION IV— Paragraph D. Deductible under SECTION BUSINESS AUTO CONDITIONS is III—PHYSICAL DAMAGE COVERAGE is amended to read: amended to add: Any deductible will be reduced by the 5. Transfer of Rights U Recovery Against Others To Us percentage indicated below on the first If any person or organization to or forloss"reported during the corresponding policy period: whom we make payments under this Coverage Form has rights to recover damages from another,those rights are Loss Free Policy Periods Deductible transferred to us.That person or With the Expansion Reduction on the organization must do everything Endorsement first"loss" necessary to secure our rights and must 1 0% do nothing after an"accident"or"loss" 2 25% to impair them. However, if the insured has waived those rights to recover 3 1 5D% through a written contract,we will waive 4 75% any right to recovery we may have 5 100% under this Coverage Form. If we pay a Physical Damage"loss"during Q. Insurance is Primary and the policy period under any BUSINESS Noncontributory AUTO COVERAGE FORM you have with Subpart a.of Item 5. Other Insurance of us,your deductible stated in the Paragraph B. General Conditions under Declarations page of each such SECTION IV—BUSINESS AUTO COVERAGE FORM will not be reduced on CONDITIONS is amended to read: any subsequent claims during the remainder of your policy period and your deductible a. This insurance is primary and reduction will revert back to 0%for each noncontributory, respects any other such COVERAGE FORM if coverage is insurance,if required in a written contract with you.renewed. O. Knowledge of Loss and Notice To Us R. Other Insurance—Hired Auto Physical Damage Subsection a.of Item 2. Duties In the Event Subpart b. of Item 5..Other Insurance of of Accident, Claim,Suit or Loss of Paragraph B. General Conditions under Paragraph A. Loss Conditions under SECTION IV—BUSINESS AUTO SECTION IV—BUSINESS AUTO CONDITIONS is amended to read: CONDITIONS is amended to add: However, prompt notice of the"accident', b. For Hired Auto Physical Damage claim,"suit'or"loss"to us or our Coverage,the following are deemed authorized representative only applies to be covered"autos you own: after the"accident", claim,"suit"or"loss"is 1) Any covered"auto"you lease, known to: hire,rent or borrow; and 1) You, if you are an individual; 2) A partner,if you are a partnership; CA990187 0715 Includes Copyrighted Material of Insurance Services Offices,Inc. Page 4 of 5 Used with permission 41409326 17/18 GL/AJ/U /WC I Annette Romero 1 4/18/2013 ee48:05 AM (PET) I Page 15 of 19 This certificate cancels and supersedes ALL previously issued certificates. 2) Any covered"auto"hired or rented by your "employee"under a contract in that individual employee's"name,with your permission,while performing duties related to the conduct of your business. However, any"auto"that is leased,hired, rented or borrowed with a driver is not a covered"auto". S. Unintentional Failure To Disclose Hazards Paragraph B.General Conditions under SECTION IV—BUSINESS AUTO CONDI- TIONS is amended to add: 9. Your failure to disclose all hazards existing as of the inception date of this policy shall not prejudice the coverage afforded by this policy, provided that such failure to disclose all hazards is not intentional. However,you must report such previously undisclosed hazards to us as soon as practicable after its discovery. T. Additional Definition SECTION V—DEFINITIONS is amended to add: Personal effects"means personal property owned by the"insured". Downtime loss"means actual loss of business income"for the period of time that a covered"auto": 1. Is out of service for repair or replacement as a result of a covered physical damage"loss"and 2. Is in the custody of a repair facility if not a total"loss". Business Income"means: 1. Net Income(Net Profit or Loss before income taxes)that would have been earned or incurred; and 2. Continuing normal operating expenses incurred, including payroll. In this endorsement, Headings and Titles are inserted solely for the convenience and ease of reference. They do not affect the coverage provided by this endorsement, nor do they constitute any part of the terms and conditions of this endorsement. All other policy wording not specifically changed, modified, or replaced by this endorsement wording remains in effect. CA990187 0715 Includes Copyrighted Material of Insurance Services Offices,Inc. Page 5 of 5 Used with permission 41409326 19/lE GWAU/{ B/WC I .lunette Romero 14/18/2018 6.4B:05 AM (POT) I Page 16 of 19 This certificate cancels and supersedes ALL previously issued certificates. ORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.00%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization as required by written contract This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Endorsement Effective 6/1/2017 Policy No.SWC1154448 Endorsement No. Insured Superior Pavement Markings, Inc. y Insurance Company Security National Insurance Company Countersigned by 41406326 1 17/18 GL/AU/I B/WC I Annette Romero i 4/18/2018 8:48'OE AM (PDT) I Page 17 of 17 This certificate cancels and supersedes ALL previously issued certificates. R t BID BOND KNOW ALL MEN BY THESE PRESENTS, That Superior Pavement Markings, Inc. as Principal, and Old Republic Surety Company as Surety, are held and firmly bound unto the City of Palm Springs, California, hereinafter called the"City" in the sum of: ten percent of amount bid---------------------------------------- ---------- --- ----- --- dollars not less than 10 percent of the total amount of the bid) for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns,jointly and severally, firmly by these presents. WHEREAS, said Principal has submitted a Bid to said City to perform the Work required under the Bid Schedule(s) of the City's Contract Documents entitled: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEDERAL AID PROJECT NO. CML-5282 (044) NOW THEREFORE, if said Principal is awarded a Contract by said City, and within the time and in the manner required in the "Notice Inviting Bids" and the "Instructions to Bidders" enters into a written Agreement on the Form of Agreement included with said Contract Documents, furnishes the required Certificates of Insurance, and furnishes the required Performance Bond and Payment Bond, then this obligation shall be null and void, otherwise it shall remain in full force and effect. In the event suit is brought upon this Bond by said City, and City prevails, said Surety shall pay all costs incurred by said City in such suit, including a reasonable attorney's fee to be fixed by the court. SIGNED AND SEALED, this 14th day of March 2018. EXECUTED FOR THE PRINCIPAL: EXECUTED R THE SURETY: Superior Pavement Markin sss, Inc. OI ur y mpany By Signature Signature NOTARIZED) NOTARIZED) P'NName and TRIe: 1 Print Name and Title: Q rtrt e 7 GC O('y Scott Salandi, Attorney-in-fact By rr ture NOTARIZED) Print Name and Title: p Ila CITY OF PALM SPRINGS BICYCLE LANE PROJECT BID BOND(BID SECURITY FORM) CITY PROJECT NO.14-14 BID FORMS-PAGE 14 FEBRUARY 8,2018 r 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 i County of o On Pb" 16'i f before me, Date H re Insert Name and Title of the Officer personally appeared U 1 T,G,qj- Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person whose nameof®'are— subscribed to the within instrument and acknowledged to me tha ey executed the same in is r authorized capacity(io),and that byC&bed4heir signature on the instrument the personal, or the entity upon behalf of which the person acted, executed the i strument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph LORENAB.BERUMEN is true and correct. Notary Publiange —California WITNESS my hand an fficial seal.ate'' Orange County Commission#2196341 My Comm.Expires Jun 6,2021 Signature 4 - / Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Documen Title or Type of Document: MO/- Pali,; Document Date: Wumber of Pages: / Signer(s) Other Than Named Above: Capacity(ies) Claimiso by Signer(s) Sigge r's Name: IZu9ff Signer's Name: C,?Corporate Officer — Title(s): ?YGSio Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other: Other: Signer Is Representing: Signer Is Representing: 02016 National Notary Association -www.NationalNotary.org - 1-800-US NOTARY(1-800-876-6827) Item#5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of Califor,, Countyof On /t16rtAiv before me, Z Oraj c_ - 7R l L Date Hee a Insert Name and Title o the Officer personally appeared re4,7 Vtl7z. Name(s) of Signers) who proved to me on the basis of satisfactory evidence to be the persono whose nameqg Q'are- subscribed to the within instrument and acknowledged to me that;<OVAhs tg y executed the same in f haatheir authorized capacity ii ,and that b f fr signatureo on the instrument the person , or the entity upon behalf of which the person 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. LORENAB.BERUMEN WITNESS my hand d official seal. Notary Public—California g Orange County Commission#219634, My comm.Expires Jun 6,2021 Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Docu Title or Type of Document: 77&,!y I Document Date: N1kYv4— Number of Pages: / Signer(s) Other Than Named Above: L,fe4r v Capacity(ies) Claimed by Signers) S__i w's Name: Signer's Name: Q"Corporate Officer — Title(s): Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other: Other: Signer Is Representing: Signer Is Representing: 02016 National Notary Association -www.NationaiNotary.org - 1-800-US NOTARY(1-800-876-6827) Item#5907 RE COW yPUIBLICSURETY V11 7 POWNR OF ATTORNEf... Ji 1 KNOW.ALL MENlfi 11&iE PR SENtSf That OLD RETYPLIC SUBETY't W* makaiOMPANY.0 onsin stoc-aisimmOd does constitute appoint: LfONARp 7JUINSKY,SCOTr,SALANPli DAVIQ JACOBSl3N qFIRVINF.CA Itsirdeand tawful Attomiy(s)-in-Fact, 060 000 for iox"n 6" tipd.4fifflpowerandaulbqIrit5no,ioidbeding$50, f of the as 5Ur0tY,1Q OE 0 olfver and affix the sea]of the company thereto(if a seal is required),bonds,undertakings,recognizances or other written obligations in the nature thereof,(other than bail bouds bank d% bodsrf!nortga lciFaigybonds mialga c.guarantyboads guarantees,of installment and note guaranty, bonds self'workersgo.defuu dontrad in azorikinw 11ren,mpenintinn, %guar'itnte black Inin$,09 ont tl, n7K-,, sate ia=daurebIimanagementbardswansi W:fbOpds) as f411W f, f ALL 'M likTR J- 1 SIN AN AMP NOT.TOWEEDWRITf.-Pei ...... TEN MILLION DOLLARS($10,000,000)------ FOR ANY SINGLE OBLIGATION kIlPUbI1C SUREtY COMPANY thereby, of said Attoe 46-17a'ot unit ratified and 0dadbia'O y,amdaItoftbii& D theiepMoM,are ridifi onrhma,A to Ip ys pum. , 0 ,, ,; presents, inti ithis, This inamesdiisnai"Vin colored. aT tunen,ism6detaideinasibyauthori f7oftheboardof directors gt.a sp&jW;i; held on February I 9j,1982. ThisTdfier ofAltornoy is signed and i ficsfinileunderfand bythe aiftority o the fitillowing resalutioits adopted by the board of directors of the OLD REPUBLIC SURETY COMPANY on February 18,1982. don niffivio oni secretary my appoint;&piesidentor,Lsi-Litant-vicb"i t,m4 or any assistant secretary, attbmys-with 14tim, ky citsc f r and on behalf of the toin-in 0 defined or limitedin 1 149 "al-lieluaiminenteviiienc— the mchagentswi ok6cutc*nd deliver and ii tionsaffixtheiapkaithe _.paAytD &;;UD4 gs,recograzatices,and,surOyslupol a kinds;and said officers"inay remove any such attorney-in-fact or agent and revoke any Power of Attorney previously grantedranted to SIL16 personsm 9014 W11 of be valid A bitift nyRESOMIDIJRTI4CfthatanYbdundfttaldng,reep re pb 'gahirtybli thP'. -940011-no Compoa aident or assi icp nesidprit 'd Ad"oil secretory -stalftid '.bd ie preajd&4atty v.we an attest if eci)w* any crewproIn s or stant(ii)wheij *ftp'm'side*;'zmyvtw:otesidentorasg vice'4 '11arygroad secretary,and couidpiiigtaed acid sealed'(tf a'sealbe required)by a duly authorized attomey-in-fact or agent;or i pus to and: ithin the limits of thwhenduly..executed and sealed(if asealbo,roquired w. e e authority.Q54y cqeurpiore attorneys n-fitaor ag". byissawevidenced abyl c4imyto,suchporson.klxiaci by.the Power of Atibriie fie to any of pergops. 0higan b ftesiMidSOLVE6hATHMthatthe.sigi.iaturouffany* d pffioer W the sea]oftlii b6inpigy'lailly, o affixed by W"f Attomeynr f 46rtificatilonther6iif authorizing tb ecution and delivery of My bond,undertaking, dir"other auretyship;obligations of the company-,:=d such signature and seal when so used shall have the same,force and effect as though manually affixed IN W0149*)p, 0 Loi*SURETY Of these piesciatcto be 91*91101 IDPW. COrilld corporat6sealtobe lCOMPANYcaused fproper a of. kp)"E 2017 OLD REPUBLIC SURETY:OiNiPANY F41ffl 77 SEAL fn, Z, Z ffo STATE OF wisCONSIN,COUNTY OF WAUKESHA-SS a President 9Tli piiviicV-17 Al ftorff , I .. and` 11 1 f' cann 100031re to jnej to'.bo.tfio indiAduats and officers of OI D I2EPUBLIC'.SUR$TY COMPANY,who executed the above" Anstruruaqt'a they Vich acknowle4oil the eiibc. 'of flier same,#0 being by me duLy sworn,did&yoiao Oppose Hrothe saidfom'. of the fnd. 04 say; that they 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 dio;afl"nted and slawribedtolhesaid by, of of said corpofltrion;•',. If VVA f bb My communion expires: 9/28/2018 not thvididate,dils InCERTIFICATEj0x#Ir"*n*fn_ A ifivf., I cwrmd"W does me nt) 2 hod ,fLtheundersigned,assistant sec tho,iGLDRW-ALIC$I=ly?corporation CtkTo),ffiat the f o PowTCOMPANY,a WAsconsk r foregoing attached or:secretary of the Ad,force and h&' .i&boedivvok6il;6i.AtIoli, in aiidhr"mme,that the Resdlul:knis ofithe board ofidirectimisdtwth in the I'movefof Attorney,are now fin force, WI740043 it' gay MAR t ,4 f2018f;lSignedi*aqlaod at the City of Orook4eld,*f this day o£ the board J:A- as SOf169KkIIR 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 Orange On MAR 1 4 2018 before me, Michele A. Fedoru NotarykNota Public insert name and title of the officer) personally appeared Scott Salandi, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/aFa subscribed to the within instrument and acknowledged to me that he/gb(0mw executed the same in his/hniftek authorized capacity(i*, and that by his/btw tb ek 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. MICHELEA.FEOORUK WITNESS m hand and official seal. t oauniPub 12082mi Z y QvjM&VWMw2& Notary P116Mc C alltunla 2018+ Signature Seal) BIDDER'S GENERAL INFORMATION The Bidder shall furnish the following information. Failure to complete all Items will cause the Bid to be non-responsive and may cause its rejection. 1. BIDDER/CONTRACTOR'S Name and Street Address: Superior Pavement Markings PO Box 278 Beaumont, CA 92223 Telephone Number: ( 951 ) 845-2799 Facsimile Number: ( 951 ) 845-6399 E-Mail: Dale@superiorpavementmarkings.com Tax Identification Number: 95-4518251 2. TYPE OF FIRM Individual Partnership XX Co r o Minority Business Enterprise (MBE) Women Business Enterprise (WBE) Small Disadvantaged Business (SDB) Veteran Owned Business Disabled Veteran Owned Business 3. CONTRACTOR'S LICENSE: Primary Classificatio State License Number(s) Califomia Supplemental License Classifications C-31, C-61 4. BUSINESS LICENSE: Yes XX No o.: 5. Surety Company and Agent who will provide the required Bonds: Name of Surety Patriot Risk& Insurance Service Address 2415 Campus Dr#200, Irvine, Ca. 92612 Surety Company Old Republic Surety Company Telephone Numbers: Agent( 949) 486-7901 Surety ( 949 ) 797-9020 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 BIDDER'S GENERAL INFORMATIONFEBRUARY8,2018 BID FORMS-PAGE 15 BIDDER'S GENERAL INFORMATION (Continued) 6. List the names and addresses of the principal members of the firm or names and titles of the principal officers of the corporation or firm; also include those who have greater than $2,000 interest in the firm: John Lucas President Robert Garcia Vice President Darren Veltz Secretary 7. Number of years experience as a contractor in this specific type of construction work: 18 8. List at least three related projects completed to date: a. Owner City of Menifee Address 29714 Haun Rd, Menifee Ca. 92586 Contact Carlos Geronimo Class of Work C-32 Phone 951-672-3843 Contract Amount $258, 120.00 Project Striping Services Date Completed 10117 Contact Person Telephone number b. Owner City of La Quinta Address PO Box 1504, La Quinta, CA Contact Leonard St Sauver Class of Work C-32 Phone 760-777-7150 ContractAmount $316,148.00 Project Ave 52 &Jefferson Date Completed 04/16 Contact Person Telephone number C. Owner Town of Apple Valley Address 14955 Dale Evans Parkway, AV, CA. 92307 Contact Brett Morgan Class of Work C-32 Phone 760-240-7000 Contract Amount $280, 714.00 Project Class II Bikeway Date Completed 01/18 Contact Person Telephone number 9. Name of Project Manager/Superintendent: Kenny Smith/James Camacho 10. Name(s)of person(s)who inspected job site: Dale Shultz CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO.14-14 BIDDER'S GENERAL INFORMATION FEBRUARY 8,2018 BID FORMS-PAGE 16 Bond No. 2134483 PERFORMANCE BOND— PUBLIC WORKS KNOW ALL. MEN BY THESE PRESENTS, WHEREAS, the City of Palm Springs, a charter city, organized and existing in the County of Riverside, California, as Obligee; (hereinafter referred to as the "City"), has awarded to the undersigned Contractor, (hereinafter referred to as the "Contractor"), an agreement for the work described as follows: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEDERAL AID PROJECT NO. CML-5282(044) hereinafter referred to as the"Public Work"): and WHEREAS, the work to be performed by the Contractor is more particularly set forth in that certain Agreement (Construction Contract) for the said Public Work awarded to the Contractor and approved by the City for the Project hereinabove named, (hereinafter referred to as the Contract"), which Contract is incorporated herein by this reference; and WHEREAS, the Contractor is required by said Contract to perform the terms thereof, and to provide a bond both for the performance and guaranty thereof. NOW, THEREFORE, we, the undersigned Contractor, as Principal, and: Old Reoublir,Surety Company a corporation organized and existing under the laws of the State of Wisconsin and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the City in the sum of Five hundred ninety six thousand four hundred eighty two and 05100_ Dollars ($ 596,482.05 said sum being not less than 100 percent of the total amount payable by the City under the terms to the said Contract, for which amount well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the bounden Contractor, his or its heirs, executors, administrators, successors, or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and agreements in the said Contract and any alteration thereof made as therein provided, on his or its parts, to be kept and performed at the time and in the manner therein specified, and in all respects according to their intent and meaning; and shall faithfully fulfill the one year guarantee of all materials and workmanship; and indemnify and save harmless the City, its officers and agents, as stipulated in said Contract, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. The said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the Contract or to the work to be performed thereunder or the Specifications accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration of addition to the terms of the Contract, or to the Public Work or to the Specifications. No final settlement between the City and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 PERFORMANCE BOND FEBRUARY 5,2018 PERFORMANCE BOND—PUBLIC WORKS CONTINUED) Contractor and Surety agree that if the City is required to engage the services of an attorney in connection with enforcement of the bond, each shall pay City's reasonable attorney's fees incurred,with or without suit, in addition to the above sum. SIGNED AND SEALED, this 12th day of April 20% CONTRACTOR: Superior Pavement Markings, Inc. Check one:individual, ____partnership, -xx corporation This Performance Bond must be signed by representatives and/or officers having appropriate authority to bind the Contractor and Surety to the terms of the Performance Bond,) CONTRACTOR. Superior Pavement Markings, Inc. SURETY: Old Republic Surety Company By: By signature nature NOTARIZED) NOTARIZED) Print.Name and Title: CC Print Name and Title: Gtl el^ Ve.l-(Az vTU Scott Salandi Attorney-in-fact By: signature NOTARIZED) Print Name and Title: By submitting this Performance Bond, the Contractor and Surety acknowledge the provisions of the Contract Documents with regard to Section 6-4 "Default by the Contractor", as further amended by the Special Provisions. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 PERFORMANCE BOND FEBRUARY 8,2018 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/rrnnia County of_(*..YA On llJ1 v7I D before me, L . po-5, 1, l C_, Date Here Insert Name and Title of the Officer personally appeared 1/, /y, — Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the personJ4 whose name(K War4a - subscribed to the within instrument and acknowledged to me that(Oisbe42J" executed the same in Ovhw Bair authorized capacity(i94,and that by 10heatheir signature(o on the instrument the person(pf, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph LORENAB.BERUMEN is true and correct. NotaryPublic—California Orangecounly q WITNESS my hand official seal. Commission P 2196341 My Comm,Expires Jun 6.2021 r"'1 Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached DorTitleorTypeofDocument: n Y an C'l Document Date: ADII 1 12- 2 olu Number of Pages: 7 Signer(s) Other Than Named Above: 1161' Capacity(ies) Claimed by Signer(s) Signer's Name:` 1 yam.., -,,e t 7 Signer's Name: C4<o-rporate Officer — Title(s): C D Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual Attorney in Fact Individual Attorney in Fact Trustee Guardian or Conservator Trustee Guardian or Conservator Other: Other: Signer Is Representing: Signer Is Representing: 02016 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 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 Orange On APR 1 2 2016 before me, Kelly A. Vincent, a Notary Public insert name and title of the officer) personally appeared Scott Salandi, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/ala subscribed to the within instrument and acknowledged to me that he/%fxe" executed the same in hislker f+[ek authorized capacity(j*, and that by his/Mex/ kok signature(%) 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. s¢"°':f r KELLY A,MCENT WITNESS my hand and official seal. e M COMM.#2201246;0 o NOTARY PUBUCCAUFORNIA NrORANGECOUNTYN MY COMM,EXP.JUNE 21,2021 Signature v t Seal) S PERFORMANCE BOND— PUBLIC WORKS CONTINUED) The rate of premium on this bond is $ N/A per thousand. The total amount of premium charged: $ NIA The above must be filled in by corporate surety), IMPORTANT: Surety companies executing bonds must possess a certificate of authority from the California Insurance Commissioner authorizing them to write surety insurance defined in Section 105 of the California Insurance Code, and if the work or project is financed„ in whole or in part, with Federal, grant, or loan funds, it must also appear on the Treasury Department's most current list(Circular 570 as amended), THIS IS A REQUIRED FORM. Any claims under this bond may be addressed to: Name and Address of Surety) Old Republic Surety Company 14728 Pipeline Avenue, Suite E Chino Hills, CA 91709 Name and Address of Agent or Patriot Risk&Insurance Services LLC Representative for service of process in California if 2415 Campus Drive, Suite 200 different from above) Irvine, CA 92612 Telephone Number of Surety and Surety-909-253-7752 Agent or Representative for service of process in California) Agent-949-486-7917 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT No.14-14 PERFORMANCEBOND FEBRUARY 8,2018 Bond No.2134483 PAYMENT BOND—PUBLIC WORKS KNOW ALL MEN BY THESE PRESENTS, WHEREAS, the City of Palm Springs, a charter city, organized and existing in the County of Riverside, California, as Obligee, (hereinafter referred to as the "City"), has awarded to the undersigned Contractor, (hereinafter referred to as the"Contractor"), an agreement for the work described as follows: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 FEDERAL AID PROJECT NO. CML-5282(044) hereinafter referred to as the"Public Work"); and WHEREAS, the work to be performed by the Contractor is more particularly set forth in that certain Agreement(Construction Contract)for the said Public Work awarded to the Contractor and approved by the City for the Project hereinabove named, (hereinafter referred to as the"Contract"), which Contract is incorporated herein by this reference; and WHEREAS, said Contractor is required to furnish a bond in connection with said Contract and pursuant to Section 9550 of the Califomia Civil Code. NOW,THEREFORE, we, the undersigned Contractor, as Principal, and. Old Republic Surety Company a corporation organized and existing under the laws of the State of Wisconsin and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the City, and to any and all persons, companies, or corporations entitled to file stop payment notices under Section 9100 of the California Civil Code, in the sum of Five hundred ninety six thousand four hundred eighty two and 05100 Dollars ($ 596 482.05 said sum being not less than 100 percent of the total amount payable by the City under the terms to the said Contract, for which amount well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors, and assigns,jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that, if said Contractor, his or its heirs, executors, administrators, successors, or assigns, or Subcontractors, shall fail to pay for any materials„ provisions or other supplies, implements, machinery, or power used in, upon, for, or about the performance of the Public Work contracted to be done, or to pay any person for any work or labor of any kind, or for bestowing skills or other necessary services thereon, or for amounts due under the Unemployment Insurance Code with respect to such work or labor, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of paid Contractor and his Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor as required by the provisions of Sections 9550 through 9560 of the Civil Code, the Surety or Sureties hereon will pay for the same in an amount not exceeding the sum specified in this bond, otherwise the above obligation shall be void. In addition to the provisions herein above, it is agreed that this bond will inure to the benefit of any and all persons, companies, and corporations entitled to serve stop payment notices under Section 9100 of the Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this bond. CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO. 14-14 PAYMENT BOND FEBRUARY 8,2018 PAYMENT BOND—PUBLIC WORKS CONTINUED) The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, or additions to the terms of the said Contract or to the work to be performed thereunder or the Specifications accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration, or addition to the terms of the Contract or to the work or to the Specifications. No final settlement between the City and the Contractor hereunder shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. Contractor and Surety, an admitted surety insurer, further agree that if the City or any entity or person entitled to file stop payment notices is required to engage the services of an attorney in connection with the enforcement of this bond, each shall be liable for the reasonable attorney's fees incurred, with or without suit, in addition to the above sum. SIGNED AND SEALED, this 12th day of April 2018 CONTRACTOR: Superior Pavement Markings, Inc. Check one: _individual, _partnership, xx corporation This Payment Bond must be signed by representatives and/or officers having appropriate authority to bind the Contractor and Surety to the terms of the Payment Bond.) EXECUTED FOR THE CONTRACTOR: EXECUTED FOR THE SURETY: BY Su ent Mar kingsIn By Old Republic Sure Company signature ignature NOTARIZED)NOTARIZED) Pe and Title:Print Name and Title: 1 Q rev, Ve Q F O Scott Salandi Attorney-in-fact By: signature NOTARIZED) Print Name and Title: CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO.14-14 PAYMENT BOND FEBRUARY 8,2018 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document. State of California County of / On Jar U before me, L 6ytp, 3• Date Here Insert Name and Title of the Officer JpersonallyappearedGtl 1 G / Z--- Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persono whose nameKGsOre-- su scribed to the within instrument and acknowledged to me thata/sheAl4ey executed the same in i heWtheir authorized capacity(iio,and that by j tiHeirsignature(a)on the instrument the person(s), or the entity upon behalf of which the person(g)'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. toRENAS RUMEN WITNESS my hand an official seal. NolaryPubk-California 1 Orange County My Cission# 2.... .Comm omm2021EpiresJun6 v GSignature r- Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Doc ent Title or Type of Document Document Date: Aj)vl I I U)t2 Number of Pages: 2-- Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signers) Signet's Name: I>Ayyt^ Ve l-4"z Signer's Name: C-orporate Officer — Title(s): CT-D Corporate Officer — Title(s): Partner — Limited General Partner — Limited General Individual Attorney in Fact Individual Attorney in Fact 7 Trustee IJ Guardian or Conservator Trustee Guardian or Conservator Ll Other: Other: Signer Is Representing: Signer Is Representing: 02016 National Notary Association •www.NationalNotary.org - 1-800-US NOTARY(1-800-876-6827) Item #5907 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 Orange On APR 1 2 2018 before me, Kelly A. Vincent, a Notary Public insert name and title of the officer) personally appeared Scott Salandi, Attorney-in-Fact who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/amy subscribed to the within instrument and acknowledged to me that he/sue" executed the same in his/koWtIneir authorized capacity(ieo, and that by his/keMkek signature(g)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. 9t"OF "`s KELLYA.VINCENTWITNESSmyhandandofficialseal. w ,COMM.#2201248 NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY N MY COMM.EXP.JUNE 21,2021 Signature Seal) PAYMENT BOND—PUBLIC WORKS CONTINUED) The rate of premium on this bond is $ N/A per thousand. The total amount of premium charged: $ N/A The above must be filled in by corporate surety). IMPORTANT: Surety companies executing bonds must possess a certificate of authority from the California Insurance Commissioner authorizing them to write surety insurance defined in Section 105 of the California Insurance Code, and if the work or project is financed, in whole or in part, with Federal, grant, or loan funds, it must also appear on the Treasury Department's most current list(Circular 570 as amended). THIS IS A REQUIRED FORM. Any claims under this bond may be addressed to: Name and Address of Surety) Old Republic Surety Company 14728 Pipeline Avenue, Suite E Chino Hills, CA 91709 Name and Address of Agent or Patriot Risk& Insurance Services LLC Representative for service of process in California if 2415 Campus Drive, suite zoo different from above)Irvine, CA 92612 Telephone Number of Surety and Surety-909-253-7752 Agent or Representative for service of process in California) Agent-949-486-7917 CITY OF PALM SPRINGS BICYCLE LANE PROJECT CITY PROJECT NO, 14-14 PAYMENT BOND FEBRUARY 8.2018 AGREEMENT AND BONDS-PAGE 6 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: LEONARD ZIMINSKY,SCOTT SALANDI,DAVID JACOBSON,OF IRVINE,CA its true and lawful Attomey(s)-in-Fact,with full power and authority,not exceeding$50,000,000,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 note guaranty bonds,self-insurance workers compensation bonds guaranteeing payment of benefits,asbestos abatement contract bonds,waste management bonds,hazardous waste remediation bonds or black lung bonds), as follows: ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED TEN MILLION DOLLARS($10,000,000)-------------------------FOR ANY SINGLE OBLIGATION and to bind OLD REPUBLIC SURETY COMPANY thereby,and all of the acts of said Attomeys-in-Fact,pursuant to these presents,are ratified and confirmed. This document is not valid unless printedon colored background and is multicolored This 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 attomeys-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 attomey-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 attomey-in-fact or agent;or iii)when duly executed and sealed(if a seal be required)by one or more attomeys-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 affixed this 9TH day of NOVEMBER,2017. OLD REPUBLIC SURETY COMPANY a c W1O1 4...re z SEAL - ASb54v1 H. •p STATE OF WISCONSIN,COUNTY OF WAUKESHA-SS 6` President On this 9TH day of NOVEMBER,2017 personally came before me, Alan Pavlic and Jane ernEetClytomeknowntobetheindividualsandofficersoftheOLDREPUBLICSURETYCOMPANYwhoexecutedtheabove 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. YA/ Notary PubliceePr My commission expires: 9/28/2018 CERTIFICATE Expiration of notary 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 fill force and has not been revoked;and furthermore,that the Resolutions of the board of directors set forth in the Power of Attomey,are now in force. APR 1 2 201874-0043 suRY;,. Signed and sealed at the City of Brookfield,WI this day of L v n.row.,• 'o s. g SEAL III A55+518nI $ V41M'H P` PATRIOT RISK&INSUR SERVICES W11111116 Ise • a e 22 R (5-le) CITY OF PALM SPRINGS CONTRACT CHANGE ORDER To: Superior Pavement Markings P.O. Box 2743 Beaumont, CA 92223 Date: Project No: Project: Change Order Purchase Order November 6,2018 14-14 CPS Bicycle Lane Project One (1) 18-1348 CHANGES IN WORK: Contract Change Order No.1; Contract quantities will be adjusted to reflect the actual amounts of work and material required to complete the project. In addition, New Item "A" Illustrates deductions are being made to the contract as liquidated damages for not completing the work within the specified amount of time. Changes to Bid Schedule Quantities; Item No.Description Quantity Unit Cost Per Unit Total Cost Schedule "A" 6 6" Thermoplastic Solid Line 142 LF $0.70 $99.40 7 6" White Bike Lane Line -17 LF $0.60 ($10.20) 8 Bike Lane Intersection Line 194 LF $0.45 $87.30 10 6" Diagonal Buffer Markings -50 LF $0.50 ($25.00) 11 12" Basic Crosswalk Line -49 LF $3.25 ($159.25) 12 12" Thermoplastic Limit Line -46 LF $3.25 ($149.50) 13 Yellow Center Line A20A-Det. 2 -25 LF $0.50 ($12.50) 14 Double Yellow Lines A20A-Det. 2 -5 LF $1.25 ($6.25) 15 Double Yellow Median A20B-29 -200 LF $2.40 ($480.00) 16 Yellow 2-Way Left Turn Lane A20B 247 LF $2.35 $580.45 19 WhLChannelizIng Line A20D-38B -31 LF $1.10 ($34.10) 22 Wht. Solid Line A20B-Det. 27B -278 LF $0.60 ($166.80) 31 Type E and D Veh. Loop Detector -1 EA $715.00 ($715.00) 34 Fog Seal 42,972 SF $0.14 $6,016.08 37 Field Order -.5097984 LS $3,125.00 ($1,593.12) TOta! Amount "A": $3,431.51 Schedule "B" 7 6" White Bike Lane Line 65 LF $0.60 $39.00 8 Bike Lane Intersection Line -32 LF $0.45 ($14.40) 10 6" Diagonal Buffer Markings -44 LF $0.50 ($22.00) 11 12" Basic Crosswalk Line -160 LF $3.25 ($520.00) 14 Double Yellow Lines A20A-22 10 LF $1.25 $12.50 17 White Lane Line A20A-Det. 9 10 LF $0.50 $5.00 19 WhtChannellzIng Line A20D-38B -10 LF $1.10 ($11.00) 27 Sandblast Existing Striping 537 LF $3.20 $1,718.40 34 Fog Seal -4,314 SF $0.14 ($603.96) 37 Field Order -1 LS $3,125.00 ($3,125.00) Totai Amount "B": ($2,521.46) Contract Change Order No. 1 DATE: 11/06/18 Page 2 Schedule "C" 6 6" Thermoplastic Solid Line -136 LF $0.70 ($95.20) a Bike Lane Intersection Line 1 to Oi LF $0.45 ($61.20) 9 6" White Thermo Dashed Line 64 LF $0.50 $32.00 10 6" Diaqonal Buffer Markings o OC 1 LF $0.50 ($65.00) 11 12' Basic Crosswaik Line -40 LF $3.25 ($130.00) 14 Double Yellow Lines A20A-22 108 LF $1.25 $135.00 16 Yeiiow 2-Wav Left Turn Lane A20B 37 LF $2.35 $86.95 34 Fog Seal -4,874 SF $0.14 ($682.36) 37 Field Order -1 LS $3,125.00 ($3,125.00) Total Amount "C": ($3,904.81) Schedule "D" 6 6" Theimopiastic Solid Line 28 LF $0.70 $19.60 7 6° White Bike Lane Line 11 LF $0.60 $6.60 8 Bike Lane Intersection Line -43 LF $0.45 ($19.35) 9 6" White Theimo Dashed Line -12 LF $0.50 ($6.00) 11 12" Basic Crosswaik Line -7 LF $3.25 ($22.75) 14 Double Yeiiow Lines A20A-Det. 2 167 LF $1.25 $208.75 16 Yeiiow 2-Wav Left Turn Lane A20B 63 LF $2.35 $148.05 19 WhtChannelizing Line A20D-38B -23 LF $1.10 ($25.30) 30 White Type 1-10' Arrow Marking 3 EA $61.00 $183.00 34 Fog Seal 2.946 SF $0.14 $412.44 37 Field Order -1 LS $3,125.00 ($3,125.00) Total Amount "D": ($2,219.96 Schedule "E" 6 6" Thermoplastic Solid Line -47 LF $0.70 ($32.90) 7 6' White Bike Lane Line 1 ODo> LF $0.60 ($111.60) 8 Bike Lane Intersection Line -351 LF $0.45 ($157.95) 9 6' White Thermo Dashed Line 120 LF $0.50 $60.00 10 6" Diagonal Buffer Markings -200 LF $0.50 ($100.00) 11 12" Basic Crosswalk Line -27 LF $3.25 ($87.75) 14 Double Yellow Lines A20A-Det. 2 -46 LF $1.25 ($57.50) 15 Double Yellow Median A20B-29 48 LF $2.40 $115.20 16 Yeiiow 2-Way Left Turn Lane A20B -29 LF $2.35 ($68.15) 17 White Lane Line A20A-Det. 9 -62 LF $0.50 ($31.00) 19 Wht.Channellzlna Line A20D-38B -68 LF $1.10 ($72.60) 30 White Type i -10' Arrow Marking 3 EA $61.00 $183.00 31 Type E and D Veh. Loop Detector -1 EA $660.00 ($660.00) 34 Fog Seal 1,989 SF $0.14 $278.46 37 Field Order -.5769728 LS $3,125.00 ($1,803.04) Total Amount "E": ($2,545.83) Contract Change Order No. 1 DATE: 11/06/18 Page 3 New Itenfi: "A" Assessment of Liquidated Damages Construction of this project was not completed within the specified contract completion time. Project Specifications allowed for 40 working days to complete all work identified in the contract. Working time along with ail applicable time extensions required completion of the work no later than August 13, 2018. Liquidated damages began to be accrued each following work day after the 13'". The accruement stopped on August 16. 2018 to allow time for the Fog Seal to Cure until August 23"' when accruement resumed. Actual acceptance and determination of substantial completion was on Friday August 31, 2018 resulting in an overage of eleven (11) calendar days. However additional work was approved under field orders one and two (attached) adding back two work days to the contract. In accordance with Section 6-9.1 of the Special Provisions liquidated damages are being assessed for nine (9) days at the specified rate of $1,900.00 per calendar day for a total of $17,100.00 Change Order Totals: Adjustments to Bid Quantities ($7,760.55) Liquidated Damages ($17,100.00) TOTAL NET DEDUCT AMOUNT: ($24,860.55) CHANGES TO CONTRACT TIME: Two additional working days are being added for work performed as indicated in the Field Orders One and Two and have been accounted for in the assessment of liquidated damages. SOURCE OF FUNDS: Account No(s). 261-4491-59469, 260-4500-59469 and 261-1395-59469 will be credited. SUMMARY OF COSTS: Original Contract Amount: This Change Order: Previous Change 0rder(8): Revised Contract Amount: 596,482.05 ($24,860.55) 0 571,621.50 Original Completion Days Added Previous Days Added: Revised Completion 40 Days 2 0 42 Days [SIGNATURES ON NEXT PAGE] Contract Change Order No. 1 DATE: 11/06/18 Page 4 I have received a copy of this Change Order and the above AGREED PRICES are acceptable to Superior Pavement Markings lnc» Signature Date' ' ThlpShufk. ^pofzzhis Printed Name and TlUe Citv of Palm Sorinqs Recommended Bv: Aooroved Bv: Attest Bv: Apthony Mi Marcus Fuller, City Engineer Date nlfi David H. Ready, City Manager Date n| n/zt-ig) Date Distribution: Orialnal Conformed Copv:Conformed - File Coov: Contractor (1)Engineering Pay File (1) City Clerk (1)Project City File (1) Purchasing (1) Finance (1) APPROVED BY DEPARMENT HEAD Ani>6 Notice requested by and return to Superior Pavement Markings, Inc. 5312 Cypress Street Cypress CA 90630 Job# 9057 Customer: Granite Con. (Indio) Project: 2022 Pavement Rehabilitation C Cart No: Return receipt requested CALIFORNIA PRELIMINARY 20-DAY NOTICE(Public Work) CALIFORNIA Civil Code Section 3098,3111,3241,and 3252 et Seq. THIS IS NOT A LIEN. THIS IS NOT A REFLECTION OF ANY CONTRACTOR OR SUBCONTRACTOR. TO OWNER OR REPUTED OWNER City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 TO ORIGINAL CONTRACTOR OR REPUTED CONTRACTOR Granite Con. (Indio) 38000 Monroe Street (Indio) Indio, CA 92203 TO LENDER, SURETY None Reported. 1. The following is a general description of the labor, service, equipment or materials furnished or to be furnished by the undersigned: Pavement Markings. 2. Estimated Price: $30,710.00 3. The name of the person who furnished that labor, service, equipment or material is: Superior Pavement Markings, Inc. 5312 Cypress Street Cypress CA 4. The name of the person who contracted for purchase of that labor, service, equipment or material is: Granite Con. (Indio) 38000 Monroe Street (Indio) Indio, CA 92203 5. The description of the job site is: 2022 Pavement Rehabilitation CP 22-08 Palm Springs, CA VERIFICATION I declare that I am authorized to file this PRELIMINARY 20-DAY NOTICE (PUBLIC WORK) on behalf of the claimant. I have read the foregoing document and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury under the laws of the State of Camia th the fore ing is true and correct. Executed at Cypress, CA for Superior Pavement Markings, Inc. By: 714.995.9100 Date Signed: '-)I> f' PROOF OF SERVICE BY MAIL AFFIDAVIT I declare that I served copies of the above PRELIMINARY 20-DAY NOTICE (PUBLIC WORK) by First Class Certified and/or Return Receipt Requested or Registered Mail Service, postage prepaid, (as required by law) addressed to each of the parties at the addresses shown above. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at Cypress, CA for 8-u—peniiipPevAent M4ings, Inc. By: /� � 7Td.995.9100 Date Signed: iy NOTICE TO PRIME OR GENERAL CONTRACTOR THIS IS NOT A LIEN. THIS IS NOT A REFLECTION OF ANY CONTRACTOR OR SUBCONTRACTOR. The undersigned has entered into a contract to perform labor of furnish materials for the above -described public project, and will look to you and your sureties for payment if the person ordering such materials and labor fails to pay for them. RECEIVED DEC 2 9 2021 City Hall Reception Desk