HomeMy WebLinkAbout4/4/2019 - AGREEMENTS •- �,.�ppLM sp�
p;cQ A CITY OF PALM SPRINGS
`'ir°A�. CONTRACT CHANGE ORDER
To: CT&T Concrete Paving Inc. Date: September 4, 2019
324 S. Diamond Bar Blvd. PMB 275
Diamond Bar. CA 91765 Proiect: No. 19-03. 2019 ADA Curb
(909) 629-8000 Ramp Improvements
Chanae Order 2 (two)
Purchase Order 19-1369
Account No.(s) 137-4820-63597
133-4298-50251
ITEM DESCRIPTION UNIT AMOUNT
Schedule A Item 6 Field Orders LUMP SUM -($15.00)
Schedule B Item 6 Field Orders LUMP SUM -($96.00)
TOTAL CHANGE ORDER DEDUCT AMOUNT: -($111.00)
Reason for Change:
This final/balancing change order credits unspent Field Order Funds to City.
SUMMARY OF COSTS:
Original Contract Amount: $298,800.00
Previous Change Order(s) Amount: $11,000.00
This Change Order Amount: $-(111.00)
Revised.Contract Amount: $309,689.00
** SIGNATURES ON NEXT PAGE ****
C
CP 19-03 2019 ADA Curb Ramp Improvements
Contract Change Order No.2
August 4,2019
Page 2
Citv of Palm Sprinas
Approved Bv:
l
Marc Os Fuller, Ass stant City Manager, Date
ol!44 q City Enaineer
01
Attest Bv: "' 2 lc!
nthony Meji , ity C erk Date
Distribution:
Original Conformed Copy: Conformed - File Copy:
Contractor (1) Engineering Pay File (1)
City Clerk (1) Project City File (1)
Purchasing (1)
Finance (1)
pp�M Sa
e . CITY OF PALM SPRINGS
CONTRACT CHANGE ORDER
To: CT&T Concrete Paving Inc. Date: July 17, 2019
324 S. Diamond Bar Blvd. PMB 275
Diamond Bar, CA 91765 Proiect: No. 19-03, 2019 ADA Curb
(909) 629-8000 Ramp Improvements
Chanqe Order 1 (one)
Purchase Order 19-1369
Account No.(s) 137-4820-63597
133-4298-50251
ITEM DESCRIPTION QUANTITY UNIT UNIT PRICE AMOUNT
New Construct Type "A" Curb Ramp 1 EA $5,500.00 $5,500.00
Item A N.W. Corner, Sunrise &Tachevah
New Construct Type "A" Curb Ramp 1 EA $5,500.00 $5,500.00
Item B S.W. Corner, Sunrise &Tachevah
TOTAL AMOUNT: $11,000.00
Changes in Work:
Contract Change Order No. 1 in the amount of $11,000.00 is for the construction of two additional
Type "A" ADA Ramps to be constructed on Sunrise Way at Tachevah Rd.. Total cost is inclusive of all
related work. USA locating coordination, traffic control, survey, saw cutting, concrete removals, clear
and grubbing the locations and cast in place of the ADA compliant Ramps. All work to be conducted
in accordance with contract documents and specifications.
Reason for Change:
The west side of the Intersection of Sunrise Way and Tachevah Rd. currently has no ADA ramps or
curb cuts to allow safe pedestrian access for crossing the street in either direction. The north west
and south west corners are unimproved however pedestrian push buttons exist for activating walk
ahead signals. The Contractor is to install two ramps in these locations to allow safe crossing both to
the north and south as well as across Sunrise to the east where ADA ramps already exist.
CP 19-03 2019 ADA Curb Ramp Improvements
Contract Change Order No.1
July 17,2019
Page 2
SUMMARY OF CONTRACT TIME:
No working days will be added to the contract.
Contract Time: 60 Working Days
Days Previously Added: 0
Days Added This Change Order: 0
Revised Contract Time: 60 Working Days
SOURCE OF FUNDS:
Funds are available in Account No.(s) 137-4820-63597
133-4298-50251
SUMMARY OF COSTS:
Original Contract Amount: $298,800.00
Previous Change Order(s) Amount: $0.00
This Change Order Amount: $11,000.00
Revised Contract Amount: $309,800.00
**** SIGNATURES ON NEXT PAGE ****
}
CP 19-03 2019 ADA Curb Ramp Improvements
Contract Change Order No. 1
July 17,2019
Page 3
I have received a copy of this Change Order d e AGREED PRICES are acceptable.
CT&T Concrete Pavina Inc.
Si nature Date
Printed Name and Title
Citv of Palm Sprinas C�r
Recommended Bv: Zq&q,; ` Z
%L �l �I Marcus Fulle , Assi nt City Manager, ate
I City Enqineer
Approved Bv: &C,
David H. ea y City Manager D Te
Attest Bv: Lmc�
AnthonW6jia, City I k Date
Distribution:
Original Conformed Copy: Conformed - File Copy:
Contractor (1) Engineering Pay File (1)
City Clerk (1) Project City File (1)
Purchasing (1)
Finance (1)
APPROVED BY Gffy COUNCIL
AGREEMENT
(CONSTRUCTION CONTRACT)
THIS AGREEMENT made this day of , 2019, 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
CT&T Concrete Paving, Inc., a California Corporation, hereinafter designated as the
Contractor.
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 furnish 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:
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO. 19-03
The Work comprises the removal of existing improvements for construction of new ADA curb
ramps and reconstruction of existing ADA curb ramps at the locations listed on the ramp lists
located in contract documents.
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.
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 ORIGINAL BID AGREEMENT FORM-PAGE 1
MARCH 15,2019
AND/OR AGREEMENT
ARTICLE 3 -- CONTRACT PRICE
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 TWO HUNDRED NINETY EIGHT THOUSAND
EIGHT.HUNDRED DOLLARS, ($298,800.00).
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 to , 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.
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
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 AGREEMENT FORM-PAGE 2
MARCH 15,2019
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.
ARTICLE 10 -- NON-DISCRIMINATION
Covenant Against 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
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 AGREEMENT FORM-PAGE 3
MARCH 15,2019
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
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 AGREEMENT FORM-PAGE 4
MARCH 15,2019
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, CONTRACTOR
CALIFORNIA
By:
CT&T CONCRETE PAVING, INC.
By
David H. Re
City Manager
ATTEST: By:
G,
(notarized)
BY Name:
Anthony ,
Ity Clerk '
APPROVED AS TO FORM: Title: Ire s i�f n
ByC By:
.-City Attorney ignature (notarized)
RECOMMENDED:
Name: ��,k-�e &r-yeL,��Q
/,
Y I s
Marcus Fuller, Title: wa c-c rer-
Assistant City Manager/City Engineer
APPROVED BY THE CITY COUNCIL:
Date m -V 1-(3-
Agreement No. a�D
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO. 19-03 MARCH 15,2019 AGREEMENT FORM-PAGE 5
CONTRACTOR
By: GT T Lvtc c-e te— PAV�!2�, I�r
Firm/Company Name
By: % By: Q0A V owwoh-0
e�g notarized) Signature (notarized)
Name: Name: J�,k�e_ Cap-V,,jlf
Title: �r'�Si� � Title: T*eCtsttre�r
A notary public or other officer completing this certificate verifies only the identity of the individual who
signed the document to which this certificate is attached, and not the truthfulness, accuracy or validity of
that document.
(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
/nto the terms of the Agreement.) Contractor to the terms of the Agreement.)
State of State of
County of_lam s AlkA2ty-e- )ss County of I-os, 62dA0_s )ss
On 3—Z5-19 On
before me, DAoi•e( Fkb1,'L_before me, D4VIt-z.1A ,3t)-,v„ il1.c.
personally appeared 4 o rva'� personally appeared CA rvc�t r. l
who proved to me on the basis of satisfactory who proved to me on the basis of satisfactory
evidence to be the personas whose name) evidence to be the person($) whose nameW
is re subscribed to the within instrument and Is are subscribed to the within instrument and
acknowledged to me that he she/they executed acknowledged to me that he/ he they executed
the same in(g/her/their authorized capacity(jes), the same in hi her their authorized capacitypeg),
and that by hi /her/their signaturesK on the and that by his e ltheir signaturesA on the
instrument the person(4, or the entity upon behalf instrument the personK, or the entity upon behalf
of which the personal acted, executed the of which the personX 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 and official seal. WITNESS my hand and official seal.
Notary Signature:/4 Notary Signature:
Notary Seal: ••-�' DANIELA.BUTLER otary Seal-
Commission
Commission No. 2239769 DANIELA.BUTLER.
NOTARY PUBLIC-CALIFORNIA '�•
r LOS ANGELES COUNTY �° Commission No. 2239769
�. My Comm.Expires Al 26,2022 j fi NOTARY PUBLIC•CALIFORNIA 2
LOS ANGELES COUNTY
a,....•�
2019 ADA CURB ENTS � My Comm.Expires APRIL 26,2022
CITY PROJECT NO. 19-03 AGREEMENT FORM—PAG
MARCH 15,2019
WORKER'S COMPENSATION CERTIFICATE
(AS REQUIRED BY SECTION 1861
OF THE CALIFORNIA LABOR CODE)
I am aware of the provisions of Section 3700 of the California 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 of said Code, and I will comply with such provisions before
commencing the performance of the Work of this Contract.
Contractor
By /AZON/
Title Ire`, — J o S,- C, ✓�� .�
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 Workers Compensation Certificate
MARCH 15,2019
Premium it subject to change based on the final contract amount Bond No.RCB0016762
Premium.$4,303.00
Executed in Duplicate
PERFORMANCE BOND—PUBLIC WORKS
KNOW ALL MEN BY THESE PRESENTS,
WHEREAS, the City of Palm Springs, a charter city, organized and existing in the County of
Riverside, California, as Obligee, (hereinafter referred to as the "City"), has awarded to the
undersigned Contractor, (hereinafter.referred to as the "Contractor"), an agreement for the work
described as follows:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO. 19-03
(hereinafter referred to as the"Public Work"); and
WHEREAS, the work to be performed by the Contractor is more particularly set forth in that
certain Agreement (Construction Contract) for the said Public Work awarded to the Contractor
and approved by the City for the Project.hereinabove named, (hereinafter referred to as the
"Contract"),which Contract is incorporated herein by this reference;and
WHEREAS, the Contractor is required by said Contract to perform the terms thereof, and to
provide a bond both for the performance and guaranty thereof.
NOW,THEREFORE,we,the undersigned Contractor, as Principal, and:
Contractors Bonding and Insurance Company
a corporation organized and existing under the laws of the State of Illinois , and duly
authorized to transact business under the laws of the State of California, as Surety, are held and
firmly bound unto the City In the sum of Two Hundred Ninety Eight Thousand Eight Hundred&00/100
Dollars ($ 206,800.00 ), said sum being not less than 100 ,vercent 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.
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.1"3 PERFORMANCE BOND
JANAURY 2019
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 attorneys fees
incurred,with or without suit, in addition to the above sum.
SIGNED AND SEALED,this 25th day of March ,2019
CONTRACTOR: CT&T Concrete Paving,Inc.
Check one: individual,,_partnership, x 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:cT&T Concrete Paving,Inc. SURETY:Contractors Bonding and Insurance Company
By: By
signature rMullid(�
ure
(NOTARIZED) IZED)
Print Name and Title: Print
1 mil'- Er,eS i d e d— ct
By:
signature
(NOTARIZED)
Print Name and Title:
` ez&k;-e- (Ar-✓
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.
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 JANAURY 2019 PERFORMANCE BOND
PERFORMANCE BOND—PUBLIC WORKS
(CONTINUED)
The rate of premium on this bond is$ ,4.4o per thousand.
The total amount of premium charged:$ 4.303.00
(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) Contractors Bonding and Insurance Company
111 Pacifica,Suite 350,Irvine,CA 92618
(Name and Address of Agent or The Bond Exchange and Insurance Agency
Representative for service of
process in California if 24800 Chrisanta Drive,Suite 160,Mission Viejo,CA 92691
different from above)
(Telephone Number of Surety and Surety:949-341-9110
Agent or Representative for
service of process in California) Agency:949-461-7000
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 PERFORMANCE BOND
JANAURY 2019
PERFORMANCE BOND—PUBLIC WORKS
(CONTINUED)
ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing
this certificate verifies only the identity of the
individual who signed the document to
which this certificate is attached,and not the
truthfulness, accuracy or validity of that
document.
State of
County of Lz S 2m4Q�(e S
On 19 before me,
Date /� N me,Title of Officer
personally appeared_ �o St l a r^yad(Al a n c( J e,c 'c (A r✓cLj;�f
NAME(S)OF SIGNER(S)
who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) i /are subscribed to the within
instrument and acknowledged tome that he/she he executed the same in his/her hei authodize`Jc'capacity(ies),and that by
his/her heir Ignatures(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 identified herein,that the foregoing paragraph is true and
correct.
Witness my hand and official seal.
.............. ��--�--
top,,L,- -- . -..,e DANIEL A.BUTLER
Signature of Notary Commission No. 2239769
NOTARY PUBLIC-CALIFORNIA
LOS ANGELES COUNTY
` i.o�•' My Comm Expires APRIL 26,2022
ATTENTION NOTARY: Although the information requested below is OPTIONAL,it could prevent fraudulent attachment of
this certificate to unauthorized document.
THIS CERTIFICATE Title or Type of Document
MUST BE ATTACHED
TO THE DOCUMENT Number of Pages DATE of DOCUMENT
DESCRIBED AT RIGHT:
Signer(s)Other Than Named Above
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 JANAURY 2019 PERFORMANCE BOND
h ,. . E
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
County of Orange
On March 25, 2019 before me, Irene Luong Notary Public,
Date Insert Name of Notary exactly as it appears on the official seal
personally appeared Yung T. Mullick
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)
IRENE LUONG acted, executed the instrument.
Notary Public-California
Orange County I certify under PENALTY OF PERJURY under the laws of
Commission#2207169 the State of California tha foregoin ph is true
My Comm.Expires Jul27,2021 and correct.
Witness my hand an i ' se
Signature
Place Notary Seal Above Signature of ota lic Ir a LUOng
OPTIONAL
Though the information below is not required by law, it may prove valuab a to persons relying on the document
and could prevent fraudulent removal and reattachment of the form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
❑ Individual ❑ Individual
❑ Corporate Officer—Title(s): ❑ Corporate Officer —Title(s):
❑ Partner ❑Limited ❑General ❑ Partner ❑Limited❑General
❑ Attorney in Fact ❑ Attorney in Fact RIGHTTHUMBPRINT
❑ Trustee • ❑ Trustee OF SIGNER i
❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here
❑ Other: ❑ Other:
Signer is Representing: Signer is Representing:
POWER OF ATTORNEY
RLI Insurance Company-
Contractors Bonding and Insurance Company
9025 N.Lindbergh Dr. Peoria,IL 61615
Phone: 800-645-2402
Know All Men by These Presents:
That this"Power of Attorney is not valid or in effect.unless attached to the bond which it authorizes executed, but may be detached:by the
approving offcef if desired.
That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and
together,the"Company")do hereby make,constitute and appoint:
James W Moilanen Yung T.Mullick Stephanie Hoang P.Austin Neff,jointly or severally.
in the.City of Mission Viejo. State of California its true and lawful Agent(s) and Attorney(s) in Fact,with
full power and authority hereby conferred, to sign, execute, acknowledge and deliver.for and on its behalf as Surety, in general, any and all
bonds.and undertakings;in an"amount not to.exceed Twenty Five Million Dollars
$25,000,000.00 )for any single obligation.
The acknowledgment-and execution of such bond by-the said Attorney in Fact shall be as binding upon the Company as if such bond had been
executed and acknowledged by the-regularly elected officers of the Company. .
RLI. Insurance"Company and/or Contractors Bonding and Insurance Company,-as applicable, have each.further certified that.the
following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation,and-is now in force;to-wit:
"All bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation shall be executed in the corporate name.of
the,Company by the President,Secretary,any Assistant Secretary,Treasurer,or any Vice President,.or by such other officers as the Board
of.Directors: may authorize. The President, any Vice President, Secretary, any: Assistant Secretary, or the _Treasurer may appoint
Attorneys"in Fact or Agents who shall have authority to issue bonds,policies or undertakings in:the name of the Company. The corporate
seal is not necessary for the validity of any bonds,policies,undertakings;Powers of Attorney or other obligations of the corporation. The
signature of any such officer and the corporate seal-may be-printed by facsimile."
IN WITNESS WHEREOF,.the.RLI Insurance Company and/or Contractors Bonding and Insurance Company,-as.applicable, have
caused these presents to be executed by its respective Vice President with its corporate seal affixed this - 26th day of
February 2019
` „arrnCf ����' RLI Insurance Company
G�GAND/,yS ' .``JPP;N. �. Contractors.Bonding and Insurance Company
. . . . . . Co .`oPpORgr�'.% -�J•dORP0HAr0
n• -•- e -�- = V .
Y�. SEAL 3= = ; SEAL : = By:
2 a, Barton W.Davis a . . . Vice President
.. . State of Illinois . . . �'�•�p LINO,Sr,,1%'` �'0�<<ruN,�u`'`�,`` . . . . . :
SS
County of Peoria CERTIFICATE
On this 26th day.of Februgy 2019 .before me,allotary Public, I,, the undersigned officer of RLI Insurance Company"and/or
personally appeared Barton W. Davis who being by:me duly sworn, Contractors-Bonding and-Insurance Company, do hereby certify
acknowledged that he signed the above.Power of Attomey-as the aforesaid that the'attached Power of Attorney is in full"force and:effect and is
officer of the RLI Insurance.Company and/or Contractors Bonding and irrevocable; and furthermore, that the Resolution of the Company as
Insurance Company and_acknowledged said instrument to be the voluntary. set forth in the Power of Attorney, is now in force.- In testimony
act and deed of said corporation. whereof,,I have"hereunto" set"my hand.and the seal of.the:RLI
Insurance" Company and/or Contractors.Bonding"and Insurance
Company:this�day of eonn a-r
By. t � - RLI Insurance Company
Gretchen L..Johnigk. " Notary Public Contractors Bonding and Insurance Company_
GRETCHEN L JOHNIGK
. - V,5'TAUTOF
'OFFICIAL.
- - 'OFFICIAL.sEAL, By:
M Commisclon irec.r Ew Jean M tephenson Corporate Secretary
.. - . . May 26,2020 "
.. 0475412020212
A0058817
Bond No.RCB0016762
t' Premium Listed on Performance Bond
Executed in Duplicate
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:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO. 19-03
(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 California Civil Code.
NOW, THEREFORE,we,the undersigned Contractor, as Principal, and:
Contractors Bonding and Insurance Company , a corporation
organized and existing under the laws of the State of Illinois , 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
Two Hundred Ninety Eight Thousand Eight Hundred&001100 Dollars ($ 298,800.00
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.
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO,19-03
JANAURY 2019 PAYMENT BOND
.. � _ ' f
r � �.
a .. � ,
i '!5 a t,
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 attorneys fees incurred, with or
without suit, in addition to the above sum.
SIGNED AND SEALED,this 25th day of March , 2019 .
CONTRACTOR: CT&T Concrete Paving,Inc.
Check one: individual,_partnership, x 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: Contractors Bonding and Insurance Company
CT&T Concrete Pavi jeInc
By: � By
` gnature na
- (NOTARIZED) (NOTARIZED)
Print Name and
'Title: Jr Print Nam nd Title:
�D�L. l /�[V Gk�.�l— FCC C s('tG YL Yung T Hick,Attomey-in-Fact
By:
4n4 pu 0.
signature
(NOTARIZED)
Print Name and Title:
— Ac,ICl' CA ry A.j —j rears L r�,✓
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 PAYMENT BOND
JANAURY 2019
PAYMENT BOND—PUBLIC WORKS
(CONTINUED)
The rate of premium on this bond is$ 14.4o per thousand.
The total amount of premium charged: $ 4,303.00
(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) Contractors Bonding and Insurance Company
111 Pacifica,Suite 350,Irvine,CA 92618
(Name and Address of Agent or The Bond Exchange and Insurance Agency
Representative for service of
process in California if 24800 Chdsanta Drive,Suite 160,Mission Viejo,CA 92691
different from above)
(Telephone Number of Surety and Surety:949341-9110
Agent or Representative for
service of process in California) Agency:949461-7000
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 PAYMENT BOND
JANAURY 2019
PAYMENT BOND—PUBLIC WORKS
(CONTINUED)
ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing
this certificate verifies only the identity of the
individual who signed the document to
which this certificate is attached, and not the
truthfulness,accuracy or validity of that
document.
State of
County of Lor, Awae,fies
On 3--27-1�'t before me, t 4ot'e, &4 , I\jo-�Lry Fct 1
Date Nipme,Tile of Office -r--
personally appeared .4 rilA'
NAME(S)OF Sl NER(S)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ re ubscribed to the within
instrument and acknowledged to me that he/she Rlexecuted the same in his/her eleilr.authorlze capacity(les), and that by
his/heg1FFr)sIgnatures(s) on the instrument the person(s), or the entity upon behalf oT which the person(s)acted, executed the
instrumeeM.—
I certify under PENALTY OF PERJURY under the laws of the State Identified herein, that the foregoing paragraph is true and
correct.
Witness my hand and official seal,
DANIEL A.BUTLER
�L` -_ '�• °': Commission No. 2239769
Signature of Notary NOTARY PUBLIC-CALIFORNIA
LOS ANGELES COUNTY
`'+iro••`� My Comm.Expires APRIL 26,2022
ATTENTION NOTARY: Although the information requested below is OPTIONAL,it could prevent fraudulent attachment of this
certificate to unauthorized document.
THIS CERTIFICATE Title or Type of Document
MUST BE ATTACHED
TO THE DOCUMENT Number of Pages DATE of DOCUMENT
DESCRIBED AT RIGHT:
Signer(s)Other Than Named Above
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19.03 PAYMENT BOND
JANAURY 2019
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
County of Orange
On March 25, 2019 before me, Irene Luong Notary Public,
Date Insert Name of Notary exactly as it appears on the official seal
personally appeared Yung T. Mullick
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)
IRENELUONG acted, executed the instrument.
Notary Public-California
Z c Orange County 1 certifyunder PENALTY OF PERJURY the laws of
Commission r 2207169
My Comm.ExpiresJu127,z021 the State of California t e fore g parag ph is true
and correct.
Witness m and an o c' s a.
Signature
Place Notary Seal Above Signature o otary Publi a LUOng
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of the form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
❑ Individual ❑ Individual
❑ Corporate Officer—Title(s): ❑ Corporate Officer —Title(s):
❑ Partner ❑Limited ❑General ❑ Partner ❑Limited❑General
❑ Attorney in Fact ❑ Attorney in Fact RIGHTTHUMBPRINT
❑ Trustee • ❑ Trustee OF
❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here
❑ Other: ❑ Other:
Signer is Representing: Signer is Representing:
POWER OF ATTORNEY
RLI Insurance Company
Contractors Bonding and Insurance Company
9625-N.Lindbergh Dr. Peoria,IL 61615
Phone: 800-645-2402
Know All Men by These Presents:
That-this Power of Attorney.is not valid or in effect-unless attached to the bond which it authorizes executed, but may be detached:by the
approving officer if desired.
That.RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and
together,the"Company")do hereby make,constitute and appoint:
James W Moilanen Yuue T.Mullick Stephanie Hoang,P.Austin Neff,jointly or severally
in the City of Mission Viejo: State of California its true and lawful Agent(s) and Attorney(s)in Fact,with
full'power and authority hereby conferred;to sign, execute, acknowledge and deliver,for and on its behalf as Surety,-in general, any and all
-bonds and undertakings in an amount not to exceed Twenty Five Million Dollars
( $A000.000.00 for any single"obligation.
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been
executed and acknowledged by the regularly elected officers of the Company.
RLI, Insurance. Company and/or Contractors Bonding and Insurance Company,"as applicable,.-have each-further certified-that.the
following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation,and is now in force,to-wit:
"All bonds,policies,undertakings,Powers of Attorney or other,obligations of the corporation shall be executed in.the corporate name-of
the Company by the'President,Secretary;any Assistant Secretary,Treasurer,or any Vice President,or by such other officers as the Board
of Directors may authorize. The"President, any Vice President, Secretary, any Assistant Secretary, or the .Treasurer may appoint"
Attorneys in Fact or Agents who shall have authority to issue bonds,policies or undertakings in.the name of the Company. The corporate
seal is not necessary for the validity of any bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation. The
signature of any such:officer and the corporate seal.may be.printed by facsimile.' . . . . ..
IN.WITNESS:WHEREOF, the RLI Insurance Company and/or Contractors. Bonding and Insurance Company,as applicable; have
caused these presents to be executed by its-respective Vice President with its corporate-seal affixed this 26th day of
February 2019 .
�,,�ruumn„� RLI Insurance Company.
�G0GAN0,�s�,, - - - �-A",4NCE CO,;� Contractors,Bonding and Insurance Company
i
. . . .. - Fy.'GOPQOR4r�;°�= tr:•GppPORAr� <_. /,/. . . . . . . .. . . . .
SEAL a BY: 4
a Barton W.Davis Vice President
y°u•• '<=mac
State:of Illinois ?cZIN
SS
County.of Peoria CERTIFICATE
On this 26th day of February 2019 ,before me,allotary Public, I, the undersigned officer of RLI Insurance _Company and/or.
personally appeared Barton W. Davis who being by:me duly sworn, Contractors Bonding and Insurance Company, do hereby certify
acknowledged that he signed the above Power of Attorney-as the aforesaid that the attached Power of Attorney is in full force and effect"and._is
officer of the RLI Insurance Company-and/or Contractors Bonding and irrevocable; and furthermore,that the Resolution of.the Company as.
Insurance Company and acknowledged said instrument to be the voluntary set forth-in-the Power of Attorney, is now in force. In testimony
act and deed of said corporation. whereof,:.I have hereunto.set set:my hand and the seal of.the .RLI
Insurance Compan and/or.Contractors Bonding-and Insurance
��/�� ��� ! Company this day of lih .
By: l L�[Al.i/+'L d� L � 'i' ! RLI Insurance Company
Gretchen L..Johnigk Notary Public Contractors Bonding and Insurance Company"
�— GRETCHEN LJOHNIGK --
- xoranr _ -
ausuc 'OFFICIAL SEAL° By:
�sTArt OF. M Commission Fxpires
,u,uos r Jean N10tephenson V Corporate Secretary
Mer 26,2020
0475412020212
A0058817
Bond No.RCB0016762
Premium listed on Performance Bond
Executed in Duplicate
WARRANTY 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:
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO. 19-03
(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 under the terms of the Contract to guarantee the costs of repair
and/or replacement of defective materials or defective workmanship in the Public Work, which
guarantee shall remain in effect for a period of one (1)year from date of acceptance of work by the City,
and to furnish a bond for the faithful performance of said Contract and the payment of all contractors,
subcontractors, laborers, materialmen, and other persons employed in the performance of any such
warranty work; and
WHEREAS, said Contractor has completed the Public Work and the City has accepted, or substantially
concurrently herewith is accepting the Public Work, subject to the requirement of delivery of this
obligation.
NOW,THEREFORE,we,the undersigned Contractor, as Principal, and:
Contractors Bonding and Insurance Company a corporation
organized and existing under the laws of the State of Illinois , 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 contractors, subcontractors, laborers, materialmen, and other persons employed in
the performance of the aforesaid Contract, for one (1) year from and after the date of completion and
acceptance of said work, in the penal sum of(TWENTY FIVE PERCENT[25%] OF FINAL CONTRACT
AMOUNT) Dollars ($ 74,700.00 ), lawful money of the United States, for replacement and
repair of any and all defective materials or defective workmanship within said improvements, and the
payment of all materials furnished or labor thereon of any kind, or for amounts due under the
Unemployment Insurance Act with respect to such work or labor in connection with any such warranty,
that said Surety will pay the same in an amount not exceeding the amount hereinabove set forth, for the
payment of which sum well and truly to be made, we bind ourselves, our heirs, successors, executors
and administrators,jointly and severally,firmly by these presents.
2019 ADA CURB RAMP IMPROVEMENTS WARRANTY BOND
CITY PROJECT NO.19-03
JANUARY 2019
r7.-
WARRANTY BOND—PUBLIC WORKS
(CONTINUED)
It is hereby expressly stipulated and agreed that this Warranty Bond shall inure to the benefit of any and
all persons, companies and corporations entitled to file claims under Title 15 (commencing with Section
3082) of Part 4 of Division 3 of the Civil Code, so as to give a right of action to them or their assigns in
any suit brought upon this Warranty Bond.
The condition of this obligation is such that if the above bonded Principal, 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 provisions in the said Contract respecting the repair and
replacement of defective workmanship and materials thereof made as therein provided, on its part to be
kept and performed at the time and in the manner therein specified, and in all respects save harmless
the City of Palm Springs, its officers, agents and employees, as therein stipulated, then this obligation
becomes null and void; otherwise it shall be and remain in full force and effect.
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 Warrant 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.
[SIGNATURES ON NEXT PAGE]
2019 ADA CURB RAMP IMPROVEMENTS WARRANTY BOND
CITY PROJECT NO.19-03
JANUARY 2019
s„
�.. t:.
• . . ,-. -
—,. . ' . �.
, . � =�
,. �.. ,.
_ �
WARRANTY BOND—PUBLIC WORKS
(CONTINUED)
SIGNED AND SEALED,this 25th day of March 2019 .
CONTRACTOR: CT&T Concrete Paving,Inc.
Check one: individual,_partnership, x 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:
CT&T Concrete Paving,Inc. Contractors Bonding and Insurance Company
By BY
signature si ature
(NOTARIZED) randu[Tftle.-:
NO ARIZED)
Print Name and Title: Print Nng . tomey-i ed �.
By:
signature
(NOTARIZED)
Print Name and Title:
2019 ADA CURB RAMP IMPROVEMENTS WARRANTY BOND
CITY PROJECT NO.19-03
JANUARY 2019
WARRANTY BOND—PUBLIC WORKS
(CONTINUED)
The rate of premium on this bond is$ 14.4o per thousand.
The total amount of premium charged: $ 4,303.00
(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) Contractors Bonding and Insurance Company
111 Pacifica,Suite 350,Irvine,CA 92618
(Name and Address of Agent or The Bond Exchange and Insurance Agency
Representative for service of
process in California if 24800 Chrisanta Drive,Suite 160,Mission Viejo,CA 92691
different from above)
(Telephone Number of Surety and SureW.949-341-9110
Agent or Representative for
service of process in California) Agency:949-461-7000
2019 ADA CURB RAMP IMPROVEMENTS WARRANTY BOND
CITY PROJECT NO. 19-03
JANUARY 2019
WARRANTY BOND—PUBLIC WORKS
(CONTINUED)
ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing
this certificate verifies only the identity of the
individual who signed the document to
which this certificate is attached,and not the
truthfulness,accuracy or validity of that
document.
State of
County of
On before me, ,
Date Name,Title of Officer
personally appeared
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 signatures(s)on the instrument the person(s),or the entlty upon behalf of which the person(s)acted,executed the
instrument.
I certify under PENALTY OF PERJURY under the laws of the State identified herein,that the foregoing paragraph is true and
correct.
Witness my hand and official seal.
Signature.of Notary
ATTENTION NOTARY: Although the information requested below is OPTIONAL,it could prevent fraudulent attachment of
this certificate to unauthorized document.
THIS CERTIFICATE Title or Type of Document
MUST BE ATTACHED
TO THE DOCUMENT Number of Pages DATE of DOCUMENT
DESCRIBED AT RIGHT:
Signer(s)Other Than Named Above
2019 ADA CURB RAMP IMPROVEMENTS WARRANTY BOND
CITY PROJECT NO.19-03
JANUARY 2019
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
County of Orange
On March 25, 2019 before me, Irene Luong Notary Public,
Date Insert Name of Notary exactly as it appears on the official seal
personally appeared Yung T. Mullick
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)
IRENE NG
acted, executed the instrument.
LUO
NotaryPublic-California z I certify under PENALTY OF PERJURY under the laws of
Z Orange County the State of California that the forego' ragraph is true
] Commission"2207169 and correct.
® My Comm.Expires Jul 27,2021
J•�was� Witness my hand an o ici al.
Signature
Place Notary Seal Above Sigriature of otary Pu is Ire Luong
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of the form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
❑ Individual ❑ Individual
❑ Corporate Officer—Title(s): ❑ Corporate Officer —Title(s):
❑ Partner ❑Limited ❑General ❑ Partner ❑Limited❑General
❑ Attorney in Fact - ❑ Attorney in Fact
❑ Trustee OF ❑ Trustee OF
❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here
❑ Other: ❑ Other:
Signer is Representing: Signer is Representing:
POWER OF ATTORNEY
RLI Insurance Company
a Contractors Bonding and-Insurance Company
9025:N.Lindbergh Dr. Peoria,IL 61615
.. . Phone: 800-645-2402
Know All Men by These Presents:
-That-this Power of Attorney is not valid or in effect:unless attached to the bond which.it authorizes executed, but may be detached:by-the
approving officer if desired.
That.RLI. Insurance Company_and/or Contractors.Bonding and Insurance Company,: each an Illinois corporation,_ (separately and
together,the"Company")do hereby make.-constitute and appoint:
James W Moilarien Yung T.Mullick Stephanie Hoana P.Austin Neff,jointly or severally . . .. .
in the City of. Mission Viejo- , State of- California.- its true and:lawful Agent(s)and Attorney(s) in Fact;with
full power and authority hereby conferred,to.sign, execute, acknowledge and deliver for and-on its behalf as Surety, in general, any and all "
bonds and undertakings in an amount not to exceed Twenty Five Million Dollars
( . $25,000,000.00 ):for any single obligation. .
The acknowledgment and execution of such-bond by the-said Attorney in Fact shall be as binding upon the Company as-if such bond had been -
executed and ackrrowledged.by the-regularly elected officers of the Company.
RLI-Insurance Company and/or Contractors Bonding and Insurance Company,as .applicable, have each further- certified that.-the
following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation,and is now in force;to-wit:
"All bonds;policies,undertakings,Powers of Attorney or other obligations of the corporation.shall.be executed in the corporate name.of
the Company by the President,Secretary;any Assistant Secretary,Treasurer,or any Vice President,or by such other officers as the-Board
of Directors_ may authorize. The President, any Vice President, Secretary, any Assistant Secretary,:or the Treasurer may appoint
Attorneys in Fact or Agents who-shall have authority to issue bonds,policies or undertakings inahe name of the Company. The corporate
seal is not necessary for the validity of any bonds,policies,undertakings;Powers of Attorney or other obligations of the corporation. The
signature of any such officer and.the corporate seal-may be.printed by facsimile."
IN.WITNESS'WHEREOF,.the.RLI Insurance Company and/or Contractors. Bonding and-Insurance"Company, as.applicable;: have
caused these presents to be-executed by its respective Vice President with its corporate seal affixed this - 26th day of
.February 2019 .
RLI Insurance Company
.
`OO�G�iGANO//�rsG9� ���J CZ
C0 W!,� Contractors and Insurance"Company -
. .. 0
�i..00QPORgT�..2m =a OpAPOggTF
.o❑
y. SEALSE-AL = By:
r^ •a' Barton W.Davis Vice President
-- LLINO1S Pam•" ',,,'<C.. 0111`,,�
State:ofIllinois .,, ,, '�nnu„N,,,�ar`
SS
County of Peoria CERTIFICATE.
On this 26th day of February 2019 .before me,allotary Public, I, the .undersigned: officer of RLT Insurance Company_and/or.
personally appeared Barton W. Davis . who being by me duly sworn, Contractors Bonding:and-Insurance Company, do hereby certify
acknowledged that'he signed the above.Power-of Attorney as-the aforesaid that the attached Power of Attorney is in full force and effect and,is-
officer of the RLI Insurance Company.and/or Contractors Bonding and irrevocable; and fintherinore, that the Resolution of.the Company as.
Insurance Company and acknowledged said instrument to be the.voluntary, set forth-in the Power of Attorney, is now in force.- In testimony
act and deed of said corporation. whereof, .I have-hereunto.set.my hand:and the seal of the .RLI
Insurance Company:and/or Contractors.Bonding and.-Insurance
. ompany:this�day of /�/V1 Lt�:(/ti C
By: t �" LY�ry�^a"� RLI Insurance Company
Gretchen L..Johnigk. : Notary Public Contractors Bonding,and Insurance Company
GRETC HEN L JOHNIGK
NOTAflY
PUBLIC "OFFICIALSEAL"
1 STA7EOF. M Commission F.x Tres
IL,rNos v a can
M tephenson Corporate Secretary
M8Y 26,2020 .
0475412020212 A0058817
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
Public Integrity Disclosure Form
Public Contract Code Section 10285.1 Statement
Public Contract Code Section 10162 Questionnaire
Public Contract Code Section 10232 Statement
Contractor Certification Regarding Status as Section 3 Business
Contractor Certification on Federal Contract Requirements
Certification of Bidder Regarding Segregated Facilities
Certification of Bidder Regarding Affirmative Action Program
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.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03
JANUARY 2019 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:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO. 19-03
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 Date
Number Date
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.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 BID PROPOSAL
JANUARY 2019 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).
02/27/2019
Dated:
Bidder: CT&T Concrete Paving, Inc.
By.
(Signature)
Title: Presdient
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 BID PROPOSAL
JANUARY 2019 BID FORMS-PAGE 3
BID SCHEDULE A
(COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS)
Schedule of Prices for Construction of the:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO. 19-03
Item Description Estimated Unit Unit Amount
No. Quantity Price
1. MOBILIZATION --- LS $ 1 al oo at o o
2. TEMPORARY TRAFFIC CONTROL --- LS $ � ���, e 0
Remove Existing Improvements and �,
3' Construct Curb Ramp Type A 6 EA $ 0-141 $
Remove Existing Improvements and
4' Construct Curb Ramp Type B 21 EA $ $ BQ
Remove Existing Improvements and p
5' Construct Curb Ramp Type C 1 EA $J�7 �0 $ Q� Qo
6. Field Orders --- AL $5,000.00
TOTAL OF ALL ITEMS OF THE BID SCHEDULE:
(Price in figures)
�i/71.����0�/ �,�ffl�I� r� - %�i C oiSG�/G1L �C1'�r�l!/I/'✓���.G�G/'�'�a.
(Price in words) "Delfc
Name of Bidder or Firm
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 BID PROPOSAL
JANUARY 2019 BID FORMS-PAGE 4
BID SCHEDULE B
(LOCAL PARTICIPARING FUNDS)
Schedule of Prices for Construction of the:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO. 19-03
Item Description Estimated Unit Unit Amount
No. Quantity Price
1. MOBILIZATION --- LS $ , -
2. TEMPORARY TRAFFIC CONTROL --- LS $
Remove Existing Improvements and
3' Construct Curb Ramp Type A 3 EA $ 1 It, $
Remove Existing Improvements and
4' Construct Curb Ramp Type B 39 EA $ $ ����,�5.04,
Remove Existing Improvements and
5' Construct Curb Ramp Type C 1 EA $ ,170000 Is "a
6. Field Orders --- 7AL $5,000.00
TOTAL OF ALL ITEMS OF THE BID SCHEDULE:
(Price in figures) a n
(Price in wo(ds) G-
Name of Bidder or Firm
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 BID PROPOSAL
JANUARY 2019 BID FORMS-PAGE 5
BASIS OF AWARD
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO. 19-03
TOTAL OF ALL ITEMS OF BID SCHEDULE A AND BID SCHEDULE B:
Price in Figures
Price i Words
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.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03
JANUARY 2019
BID SCHEDULE
BID FORMS-PAGE 6
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
1. Name of Prime Contractor:
CT&T Concrete Paving, Inc.
2. Bid Items/Portion of Work to be Self-Performed (if less than 100%of the contract):
3. Dollar Amount of Work Self-Performed: 4. Percentage of Work Self-Performed: 5. Date:
100% 02/27/2019
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) ❑ First Tier; ❑ Second Tier; Supplier; ❑ Service Contractor(e.g.Trucking)
2. Subcontractor Name:
3. Address: usanj
4. Bid Items/Portion of Work:
�,wv(
5 Phone•No.: 6. ontractgr's Lice se No.: 7. Annual Gross Receipts:
h60� nh ❑ <$1 M ❑ <$5M ❑ <$10M
8. Amount of Contracted Work: 9. DIR Public Works Contractor ❑ <$15M ❑ >$15M
Registration No: V\
10. Percentage of Contracted Work: 11. DBE Firm? ❑Yes No 12. DBE Certification No.:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03
JANUARY 2019 LIST OF SUBCONRACTORS-PART I
BID FORMS-PAGE 7
BIDDER'S LIST OF SUBCONTRACTORS-PART I (Continued)
Copy this page as needed to provide a complete listing. Page Of
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 ❑ >$15M
Registration No:
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:
❑ <$1 M ❑ <$5M ❑ <$10M
8. Amount of Contracted Work: 9. DIR Public Works Contractor ❑ <$15M ❑ >$15M
Registration No:
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:
❑ <$1 M ❑ <$5M ❑ <$10M
8. Amount of Contracted Work: 9. DIR Public Works Contractor ❑ <$15M ❑ >$15M
Registration No:
10. Percentage of Contracted Work: 11. DBE Firm? ❑Yes ❑ No 12. DBE Certification No.:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03
JANUARY 2019 LIST OF SUBCONRACTORS-PART I
BID FORMS-PAGE 8
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 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 Title 49,
Section 26 of the Code of Federal Regulations.
Page 1 of
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 ❑ >$15M
Registration No:
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:
❑ <$1 M ❑ <$5M ❑ <$10M
8. Amount of Contracted Work: 9. DIR Public Works Contractor ❑ <$15M ❑ >$15M
Registration No:
10. Percentage of Contracted Work: 11. DBE Firm? ❑ Yes ❑ No 12. DBE Certification No.:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03
JANUARY 2019 LIST OF SUBCONRACTORS-PART II
BID FORMS-PAGE 9
BIDDER'S LIST OF SUBCONTRACTORS-PART II (Continued)
Copy this page as needed to provide a complete listing. Page Of
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:
❑ <$1M ❑ <$5M ❑ <$10M
8. Amount of Contracted Work: 9. DIR Public Works Contractor ❑ <$15M El >$15M
Registration No:
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:
❑ <$1 M ❑ <$5M ❑ <$10M
8. Amount of Contracted Work: 9. DIR Public Works Contractor ❑ <$15M ❑ >$15M
Registration No:
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:
❑ <$1 M ❑ <$5M ❑ <$10M
8. Amount of Contracted Work: 9. DIR Public Works Contractor ❑ <$15M El >$15M
Registration No:
10. Percentage of Contracted Work: 11. DBE Firm? ❑ Yes ❑ No 12. DBE Certification No.:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03
JANUARY 2019 LIST OF SUBCONRACTORS-PART II
BID FORMS-PAGE 10
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
PUBLIC WORKS & ENGINEERING 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 CW co AOr'eaving, Inc.
By
v
Title Presdient
Organization Corporation
Address 324 S Diamond Bar Blvd PMB 275
Diamond Bar , CA 91765
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03
JANUARY 2019 NON-COLLUSION DECLARATION
BID FORMS-PAGE 11
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 CT&T Concrete Paving, Inc.
NAME OF PERSON SIGNING Jose Carvajal
TITLE OF PERSON SIGNING Presdient
DATE 02/27/2019
Please include any additional information available regarding equal opportunity
employment programs now in effect within your company.
N/A
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 NON-DISCRIMINATION CERTIFICATION
JANUARY 2019 BID FORMS-PAGE 12
(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 CT&T Concrete Paving, Inc.
and its proposed subcontractors (as listed on the bidder's list of subcontractors), hereby
certify that they have �_, 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.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 EEO CERTIFICATION FORM
JANUARY 2019 BID FORMS-PAGE 13
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.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 DEBARMENT AND SUSPENSION CERTIFICATION
JANUARY 2019 BID FORMS-PAGE 14
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.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 NON-LOBBYING CERTIFICATION
JANUARY 2019 BID FORMS-PAGE 15
N/A
DISCLOSURE OF LOBBYING ACTIVITIES
COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
Fla. contract Fla. bid/offer/application ❑ a. initial
b, grant b. initial award b. material change
c. cooperative agreement c. post-award
d. loan For Material Change Onh:
e. loan guarantee year_ quarter
f. loan insurance date of last report
4. Name and Address of Reporting Entity 5. If Reporting Entity in No,d is Subawardee,
Enter Name and Address of Prime:
Prime �Snbawardcc
Tier if known
Congressional District,if blown Congressional District,if known
6. Federal Department/Agency: 7. Federal Program Name/Description:
CFDA Number,if applicable
8. Federal Action Number,if known: 9. Award Amount,if known:
10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including
(If individual,last name,first name,MI) address if different from No. IOa)
(last name,first name,MI)
(attach Continuation Shect(s)if necessary)
11. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply)
S actual planned a. retainer
b. one-time fee
12. Form of Payment(check all that apply): c, commission
ea. cash d. contingent fee
b. in-kind; specify: nature c deferred
value f. other,specify
ld. Brief Description of Services Performed or to be performed and Datc(s)of Service,including
officer(s),employee(s),or member(s)contacted,for Payment Indicated in Item 11:
(attach Continuation Sltcet(s)if necessary)
15. Continuation Shect(s)attached: Yes ❑ No
16. Information requested through this form is authorized by Title
31 U.S.C.Section 1352. This disclosure of lobbying reliance Signature:
was placed by the tier above when his transaction was made or 6 /
entered into. This disclosure is required pursuant to 31 U.S.C. print i nte: 0 e Carvajal
1352. This information will be reported to Congress
semiannually and will be available for public inspection. Any Pre$dient
person who flails to file the required disclosure shall be subject Title:
to a civil penalty of not leis than S10,000 and not more than 909 629-8000 2 27 19
$100,000 for each such failure. Telephone No.: Datc:
Authorized for Local Reproduction
Federal Use Only: Standard Form-LLL
Standard Form LLL Rev.09-12-97
2019 ADA RAMP CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 DISCLOSURE OF LOBBYING ACTIVITIES
JANUARY 2019 BID FORMS-PAGE 16
INSTRUCTIONS FOR COMPLETION OF SF-LLL,
DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure forni.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 tiling 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 comlection 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 filing and material change report. Refer to the implementing guidance published by
the Office of Management and Budget for additional information.
I. 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-up 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 Rill 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. Suba"vards 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 Rill 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 naive, 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
Rill Catalog of Federal Domestic Assistance(CFDA) number for grants,cooperative agreements,loans
and loan commitments.
8. 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/loari 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)performing 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 the cumulative amount of
payment made or 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.
2019 ADA RAMP CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 DISCLOSURE OF LOBBYING ACTIVITIES
JANUARY 2019 BID FORMS-PAGE 17
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 ernployee(s)
-contacted or the officer(s)eniployee(s)-or Meniber(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 infoi-rnation 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 information. Send comments regarding the burden
estimate or any other aspect of this collectiori of irifoiination, including su<aQestioils for reducing this.burden, to
the Office of Management and Budget,Papelwgrk'Reduction Project(0348=0046). Washington, D.C.20503..
SF-LLL-lnstr<ictions Rev.06-04-90<<ENDIF»
2019 ADA RAMP CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 DISCLOSURE OF LOBBYING ACTIVITIES
JANUARY 2019 BID FORMS-PAGE 18
ID
No. 3000-7 copy
STATE,OF CALIFORNIA
DEPARTMENT OF INSURANCE
SAN FRANCISCO
Amended
Certificate of Authority
THIS IS TO CERTIFY that,pursuant to the Insurance Code Qfihe Stale ofC'alifornia,
Contractors Bonding and Insurance Company
oflllinois,organized under the latvs oflllinois,subjec•I to its Articles oflncorporation or wherfundantenial
organizational documents.is hereby authorized to transact within this State,subject to all provisions gfthis
Certificate,the following classes of insurance:
Fire,Marine,Surety,Plate Glass,Uithility,
Boiler and Machinery,Burglary,Sprinkler,
Team and Vehicle,Milomobile,Legal,and Miscellaneous
as such classes are now or stay hereafter be defined in the Insurance Laws of the State of California.
THIS CERTIFICATE is expressly conditioned upon(he holder heregfnow arrd herecjer•being in
full.complimue with all,and not in violation ofany,of the applicable lmvs and law faint requirements made
under authority of the laws of the State of California as long as such trans or requirements are in effect and
applicable,and cis such laws and requirements)?on,ure.or nroy hLrecifter be changed or amended.
IN WITNESS "'HEREOI',effeclive cis of the 20'day of March,
2015,1 have hereunto set my hand and caused my official seal to be
mp
� aft a cfffceed this 20'1i day of March,2015.
tINg
vsa4eg
+'rtwFd�4C E'"�i
� t Uave.tones
Ea F Y ��d�4�"^ Lisarnnru C'nnuni.;s;m�r
u
ihyRIR
�;.
3 By Valerie Sarfaty
for Nettie Hoge
rn,,j nepnn•
NOTICE:
Qualification with the Secretary of Stale must be accomplished as required by the California Corporations Code promptly after
issuance of this Certificate of Authority.pai lure m do so will be a violation of insurance Code section 701 and will be grounds for
revoking this Cerlificate or Authority pursuant to the covenants made in du•application therefor and the conditions contained
herein.
9906780.1
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:
CT&T Concrete Paving, Inc.
324 S Diamond Bar Blvd PMB 275
Diamond Bar , CA 91765
Telephone Number: ( 909 ) 629 -8000
Facsimile Number: ( 909 ) 629-8001
E-Mail: jose.cttinc@gmail.com
Tax Identification Number: 20-2642225
2. TYPE OF FIRM
Individual Partnership _ Corporation (State CA )
Minority Business Enterprise (MBE)
Women Business Enterprise (WBE)
Small Disadvantaged Business (SDB)
Veteran Owned Business
Disabled Veteran Owned Business
C8 / C12
3. CONTRACTOR'S LICENSE: Primary Classification
State License Number(s) 875627
Supplemental License Classifications N/A
4. BUSINESS LICENSE: Yes X _ No License No.:
5. Surety Company and Agent who will provide the required Bonds:
Name of Surety Contractors Bonding & Insurance Company
Address 9025 N Lindberg Dr. Peoria, IL 61615
Surety Company Local Agent : Julie Durkin
Telephone Numbers: Agent ( 949) 341-9110 Surety (309 ) 692-1000
2019 ADA RAMP CURB RAMP IMPROVEMENTS BIDDER'S GENERAL INFORMATION
CITY PROJECT NO.19-03 BID FORMS-PAGE 20
JAN UARY 2019
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 has greater than
$2,000 interest in the corporation or firm.
Jose Carvajal, President/Secretary
Jacqueline Carvajal, Treasurer
7. Number of years experience as a contractor in this specific type of construction work:
15 Years +
8. List at least three related projects completed to date:
a. Owner City of Diamond Bar Address 21810 Copley Dr. Diamond Bar, CA 91765
Contact 601968-18 Class of Work ADA Curb Ramp Imp.
Phone (909) 839-7040 Contract Amount 188,148.00
CDBG Area 6
Project ADA Curbs Ramps Date Completed 10/24/2018
Contact Person John Beshay Telephone number (909) 839-7040
b. Owner City of Lake Forest Address 25550 Commercentre Dr, Lake Forest, CA 92630
Contact 2017-09 Class of Work ADA Curb Ramp Imp.
Phone (949) 461-3490 Contract Amount 117,135.00
ADA Access Ramp
Project Imp Phase 11 Date Completed 10/18/2018
Contact Person Taylor Abernathy Telephone number (949)461-3490
C. Owner City of Hemet Address 450 E Latham Ave Hemet, CA
Contact 5591 Class of Work ADA Ramps
Phone (951) 765-2361 Contract Amount 138,827.50
Project ADA Access Ramps Date Completed 06/01/2015
Contact Person Jamie Cruz Telephone number (951) 765-2361
9. Name of Project Manager/Superintendent: Jose Carvajal
10. Name(s) of person(s) who inspected job site: Jose Carvajal
2019 ADA RAMP CURB RAMP IMPROVEMENTS BIDDER'S GENERAL INFORMATION
CITY PROJECT NO.19-03 BID FORMS-PAGE 21
JANUARY 2019
PUBLIC INTEGRITY DISCLOSURE APPLICANT DISCLOSURE FORM
1. Name of Entity
CT&T Concrete Paving, Inc.
2. Address of Entity (Principle Place of Business)
1054 E Third St. Pomona , CA 91766
3. Local or California Address (if different than #2)
324 S Diamond Bar Blvd PMB 275 Diamond Bar , CA 91765
4. State where Entity is Registered with Secretary of State
California
If other than California, is the Entity also registered in California? ❑ Yes ❑ No
5. Type of Entity
N/Corporation ❑ Limited Liability Company ❑ Partnership ❑ Trust ❑ Other(please specify)
6. Officers, Directors, Members, Managers, Trustees, Other Fiduciaries (please specify) Note: If
any response is not a natural person, please identify all officers, directors, members,managers
and otherfiduciaries forthe member,manager,trust orotherentity
Jose Carvajal Officer ❑ Director ❑ Member ❑ Manager
[name]
❑ General Partner ❑ Limited Partner
❑ Other President
Jose Carvajal /Officer ❑ Director ❑ Member ❑ Manager
[name]
❑ General Partner ❑ Limited Partner
❑ Other Secretary
Jacqueline Carvajal
/Officer ❑ Director ❑ Member ❑ Manager
[name]
❑ General Partner ❑ Limited Partner
❑ Other Treasurer/ HR
CITY OF PALM SPRINGS—PUBLIC INTEGRITY DISCLOSURE
APPLICANT DISCLOSURE FORM
Page 1 of 2
2019 ADA RAMP CURB RAMP IMPROVEMENTS PUBLIC INTEGRITY DISCLOSURE(APPLICANT DISCLOSURE FORM)
CITY PROJECT NO.19-03 BID FORMS-PAGE 22
JANUARY 2019
7. Owners/Investors with a 5% beneficial interest in the Applicant Entity or a related entity
A.
Jose Carvajal President / Owner
[name of owner/investor] [name of official with whom owner/investor has
material financial relationship]
FOR RELATIONSHIP A, EXPLANATION OF THE RELATIONSHIP:
B.
Jacqueline Carvajal Treasurer
[name of owner/investor] [name of official with whom owner/investor has
material financial relationship]
FOR RELATIONSHIP B, EXPLANATION OF THE RELATIONSHIP:
C.
[name of owner/investor] [name of official with whom owner/investor has
material financial relationship]
FOR RELATIONSHIP C, EXPLANATION OF THE RELATIONSHIP:
I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF
CALIFORNIA THA�THE FOREGOING IS TRUE AND CORRECT.
Signatu9d of is si g Party, Printed Name,Title Date
02/27/2019
'r �i� `Y e KJ'• ���7 Q N+�Y
CITY OF PALM SPRINGS Z.PUBLIC INTEGRITY DISCLOSURE
APPLICANT DISCLOSURE FORM
Page 2 of 2
2019 ADA RAMP CURB RAMP IMPROVEMENTS PUBLIC INTEGRITY DISCLOSURE(APPLICANT DISCLOSURE FORM)
CITY PROJECT NO.19-03 BID FORMS-PAGE 23
JANUARY 2019
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 V 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.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 PUBLIC CONTRACT CODE SECTIONS
JANUARY 2019 BID FORMS-PAGE 24
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
If the answer is yes, explain the circumstances in the following space.
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE
JANUARY 2019 BID FORMS-PAGE 25
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.
2019 ADA CURB RAMP IMPROVMENTS
CITY PROJECT NO.19-03 PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE
JANUARY 2019 BID FORMS-PAGE 26
SECTION 3 OF THE
HOUSING AND URBAN DEVELOPMENT ACT OF 1968
AS AMENDED
24 CFR PART 135
ECONOMIC OPPORTUNITIES FOR
LOW-AND VERY LOW-INCOME PERSONS
CONTACT REQUIREMENTS
EFFICTIVE JULY 1, 1994
The amendments to Section 3 of the Housing Act of 1968 supersede the Section 3
requirements as contained in the General Conditions of the Contract for
Construction, Administrative Requirements, Equal Opportunity for Businesses and
Lower-Income Persons.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS-PAGE 27
SECTION 3 CLAUSE
The work to be performed under this contract is subject to the requirements of section 3 of
the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (section 3).
A. The purpose of section 3 is to ensure that employment and other economic opportunities
generated by HUD assistance or HUD-assisted projects covered by section 3, shall, to the
greatest extent feasible,be directed to low- and very low-income persons, particularly
persons who are recipients of HUD assistance for housing.
B. The parties to this contract agree to comply with HUD's regulations in 24 CFR part 135,
which implement section 3. As evidenced by their execution of this contract, the parties to
this contract certify that they are under no contractual or other impediment that would
prevent them from complying with the part 135 regulations.
C. The contractor agrees to send to each labor organization or representative of workers
with which the contractor has a collective bargaining agreement or other understanding, if
any, a notice advising the labor organization or workers' representative of the contractor's
commitments under this section 3 clause, and will post copies of the notice in conspicuous
places at the work site where both employees and applicants for training and employment
positions can see the notice. The notice shall describe the section 3 preference, shall set
forth minimum number and job titles subject to hire, availability of apprenticeship and training
positions, the qualifications for each; and the name and location of the person(s) taking
applications for each of the positions; and the anticipated date the work shall begin.
D. The contractor agrees to include this section 3 clause in every subcontract subject to
compliance with regulations in 24 CFR part 135, and agrees to take appropriate action, as
provided in an applicable provision of the subcontract or in this section 3 clause,upon a finding
that the subcontractor is in violation of the regulations in 24 CFR part 135. The contractor will
not subcontract with any subcontractor where the contractor has notice or knowledge that the
subcontractor has been found in violation of the regulations in 24 CFR part 135.
E. The contractor will certify that any vacant employment positions, including training
positions, that are filled (1) after the contractor is selected but before the contract is
executed, and (2)with persons other than those to whom the regulations of 24 CFR part 135
require employment opportunities to be directed,were not filled to circumvent the contractor's
obligations under 24 CFR part 135.
F. Noncompliance with HUD's regulations in 24 CFR part 135 may result in sanctions,
termination of this contract for default, and debarment or suspension from future HUD
assisted contracts.
G. With respect to work performed in connection with section 3 covered Indian housing
assistance, section 7(b) of the Indian Self-Determination and Education Assistance Act(25
U.S.C. 450e) also applies to the work to be performed under this contract. Section 7(b)
requires that to the greatest extent feasible (i)preference and opportunities for training and
employment shall be given to Indians, and (ii)preference in the award of contracts and
subcontracts shall be given to Indian organizations and Indian-owned Economic Enterprises.
Parties to this contract that are subject to the provisions of section 3 and section 7(b) agree to
comply with section 3 to the maximum extent feasible, but not in derogation of compliance
with section 7(b).
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS-PAGE 28
SECTION 3 GOALS
A. during the term of this contract, when a person is hired to a full time position to work
all or part of their time on activities funded or generated in whole or in part by this
contract, Contractor and subcontractors commit to employ Section 3 residents as:
30 percent of the aggregate number of new hires for the one year period beginning
in HUD Fiscal Year 1998 and continuing thereafter.
B. Preference shall be provided to the hiring of Section 3 Residents in the following order
of priority:
1. Residents of the housing development or developments for which the Section 3
covered assistance is expended (Category I Residents);
2. Residents of other housing developments managed by the Housing Authority
(Category 2 Residents);
3. Participants in a HUD Youthbuild Program in Riverside of San Bernardino County
(Category 3 Residents);
4. Other Section 3 Residents (Category 4 Residents).
C. Should contractor and/or subcontractor contract our any portion or all of the work,
then contractor and/or subcontractors commit to award to Section 3 business concerns
(where they exist):
1. At least 10 percent of the total dollar amount of all Section 3 covered contracts
for building trades work for housing maintenance, repair, modernization, or
development, or for building trades work arising in connection with housing
rehabilitation, housing construction and other public construction.
2. At least 3 percent of the total dollar amount of all other Section 3 covered
contracts.
D. A Section 3 Resident is a person living in San Bernardino or Riverside County who is a
Public Housing resident or who is low income.
E. Low-Income Persons mean families (including single persons) whose income does not
exceed 80 percent of the median income, as adjusted by HUD, for Riverside and San
Bernardino Counties.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS-PAGE 29
F. Section 3 Business Concern means a business where:
1. 51 percent or more is owned by Section 3 residents; or
2. 30 percent of the permanent full-time employees are currently Section 3
residents or where Section 3 residents when first hired (if within the past three
years); or
3. The business commits in writing to subcontract over 25 percent of the total
dollar amount of all subcontractors to be let to businesses that meet the
requirements of paragraphs 1 and 2 of this definition;
AND
The Business was formed in accordance with the state law and is licensed under
state, county, municipal law to engage in the business activity for which it was
formed. H
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS-PAGE 30
FY 2018
HUD LOW-INCOME LIMITS-
-Effective July 1,2018 thruugh June 30,2019-
;B>amffy-...... ` Aanuopy Monthly .; Weekly ^� +001urly
1 $37,750 $3,145.83 $725.96 $18.15
2 $43,150 $3,595.83 $829.81 $20.74
3. S48,550 $4,045.83 $933.65 $23.34
4 $53,900 $4,491.67 $1,036.54 $25.91
5 $58,250 $4,854.17 $1,120.19 $28.00
T ,6 $62,550 S5,21250 $1;202.88 S30.07
$66,850 55;570.83 $1;285.58 $32.14
S _ $71,150 $5,929.17 $1,368.27 $34.21
HUD Issued April 1,2018
Monthly Income z 12=Annual Income
Weekly Income x 52=Annual Income
Hourly Income x 2,080=Annual Income
Annual Income Limit is increased by$2,700 for each person over 10 persons in the
family.
NOTE: The hourly income limit is based on full time (2,080 "hours/year)
.employment. If employee did not work full time for the previous year,use
total annual income as the limit.'
DaTc omu�S=3ImUntsFYISJanI9
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS—PAGE 31
CO NTRACTOgtCART[t?tCvt7`tl?!4
REGARDING SDI` TIUS AS A.SI-M- ON 31RUSiNESS CONCON
Jose Carvajal
(at�tt nae►e and title} .hambycertifpthatthebusinessen-tiry
'
knowmu CT&T Concrete Paving, Inc.
- �ri}ut�ingsneme� o - -
is sots "don 3 businms. (Please complete thebotain secftn.)
. is a SecSIat13 buss=b (c1=k akw of d1e fnpowbtg%)
51 petrrent ormere Is Owned by Swdaa 3 residents.or
34 p=eut Of the pe =E t f u-time mnployees M curtly section,3 residents .
a wore S w6n 3 mddruts when EM hh-ed(if wfthta the past tfasee years);or I
'i 0 bush==Mtits in wtitiatg to mbcantxact mer25 pe ntofthe total dollar
- amOunt of a mftaatracts to by let to bushmses Mgt meet the regaimmeuts of
PWz3rVh3 I and 2ofti& an;
AND
Iho bnguam was foahted is=0dw=with state law sad Is licensed under elute,county,
grMM11oilaal lave to MW lu ft-busims aGtavity€ur which it vos fbmed.
AAmOlmUkftm is specs u fift in 5aat Bemadina or Rivess}de County wilts is a PubUa
Rowing=kietator who isigWIMM= '
'" gMMF W n=n btnilfes Onaludtut single persons)wltase icoutc does Pt miowd 80
Pit of the Stan imam , edj d by RUD,for Riverside and San BemmdimA Counties.
(Sea next gage)
Si�ataaro Business Addrm _
' 24 S Diamon ar v B 275
02/27/209"9
Phone No:lgs�9) 629-a
2019 ADA Curb Ramp Imp Pending
S_
S040*3.caombn '. ADA improvements
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS—PAGE 32
Section 3 Contractur/Sub-Contractor Monthly Compliance Report
INDIVIDUAL N W HIRES
(submitted with each payroll)
Company Contact Person
Project Description Project No.CAI
Repott'Period:From to Program Code'(see bottom of page)
ANY NEW HIRES? 17 No If no,please sign and date.the bottom of the form.
17 Yes If yes,please complete the fallowing information:
1. Name Date—Hired—Fart Time FuiiTime
.Address
Sued City State Zip
Job/Craft/Trade Public Housing Resident? Yes No
*Income Qualified?(see+below)Yes No Section 3 Resident? Yes No
Preference Priority Code(see below) RacW Ethaic.Code(see below)
2. Name Date Hired Part Time Full Tung
Address
Street City State Zip
Job/Cmft/Tmde Public Housing Resident? Yes No
'Income Qualified?(see*Wow)Yes No Section 3 Resident? Yes No
Pref once Priority Code(see below) Racial Ethnic Code(see below)
Persons In Household 1 2 3 4 5 6 7 S
Toni Family Intone $37.750 $d3.150 S48 550 S53 or $58 Z50 S62 550 $66 850 S71 150
(last 12 months), .
$New Hire is income gnalrfnd as a Section 3 resident if hWber total family income is lea am the family income shown above for His/her
household site.
Pelham Codes: Codes: Rectal Ethnic Coda:
3. Public Housing I.Site Resident I. White Amerieaa
L Development 2.Other Housing Authority Residents 2.Blade American
b.operation 3. HUD Youthbu0d Participant 3.Native American
c. Modernization 4. Other Low-income Persons 4. Hispanic American
S. None 3. Asian Pacific American
Signature Date
Section 3.Form 6
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS—PAGE 33
Federal Labor Standards Provisions U.S.Department of Housing
and Urban Development
Office of Labor Relations
Applicability (1) The work to be performed by the classification
The Project or Program to which the construction work requested is not performed by a classification in the wage
covered by this contract pertains is being assisted by the determination;and
United Stales of America and the following Federal Labor (2) The classification is utilized In the area by the
Standards Provisions are Included In this Contract construction Industry;and
pursuant to the provisions applicable to 'such Federal
assistance. (3) The proposed wage rate. Including any bona fide
fringe benefits, bears a reasonable relationship to the
A. 1. (1) Minimum Wages, All laborers and mechanics wage rates contained in the wage determination.
employed or working upon the site of the work,will be paid (b) If the contractor and the laborers and mechanics to be
unconditionally and not less often than once a week, and employed in the classification (if known), or their
without subsequent deduction or rebate on any account representatives, and HUD or Its designee agree on the
(except such payroll deductions as are permitted by classification and wage rate (including the amount
regulations Issued by the Secretary of Labor under the designated for fringe benefits where appropriate),a report
Copeland Act (29 CFR Part 3), the full amount of wages of the action taken shall be sent by HUD or Its designee to
and bona fide fringe benefits(or cash equivalents thereof) the Administrator of the Wage and Hour Division,
due al time of payment computed at rates not less than Employment Standards Administration,U.S.Department of
those contained In the wage determination of the Labor,Washington,D.C. 20210. The Administrator,or an
Secretary of Labor which is attached hereto and made a authorized representative, will approve, modify, or
part hereof, regardless of any contractual relationship disapprove every additional classification action within 30
which may be alleged to exist between the contractor and days of receipt and so advise HUD or its designee or will
such laborers and mechanics. Contributions made or notify HUD or Its designee within the 30-day period that
costs reasonably anticipated for bona fide fringe benefits additional time Is necessary. (Approved by the Office of
under Section I(b)(2)of the Davis-Bacon Act on behalf of Management and Budget under OMB control number 1215-
laborers or mechanics are considered wages paid to such 0140.)
laborers or mechanics,subject to the provisions of 29 CFR (c) In the event the contractor,the laborers or mechanics
5.5(a)(1)(iv); also, regular contributions made or costs
Incurred for more than a weekly period(but not less often to be employed in the classification or their
than quarterly) under plans, funds, or programs, which representatives,and HUD or Its designee do not agree on
cover the particular weekly period, are deemed to be the proposed classification and wage rate (including the
constructively made or Incurred during such weekly period. amount designated for fringe benefits.where appropriate),
HUD or Its designee shall refer the questions, Including
Such laborers and mechanics shall be paid the appropriate the views of all interested parties and the recommendation
wage rate and fringe benefits on the wage determination of HUD or Its designee, to the Administrator for
for the classification of work actually performed, without determination. The Administrator, or an authorized
regard to skill, except as provided in 29 CFR 5.5(a)(4), representative,will Issue a determination within 30 days of
Laborers or mechanics performing work in more than one receipt and so advise HUD or Its designee or will notify
classification may be compensated at the rate specified for HUD or its designee within the 30-day period that
each classification for the time actually worked therein: additional time is necessary. (Approved by the Office of
Provided, That the employer's payroll records accurately Management and Budget under OMB Control Number
set forth the time spent In each classification In which 1215.0140.)
work Is performed. The wage determination(including any
additional classification and wage rates conformed under appropriate)
The wage rate (including fringe benefits where
29 CFR 5.5(a)(1)(11) and the Davis-Bacon poster (WH- appropriate) determined pursuant to subparagraphs
1321)shalt be posted at all times by the contractor and its workers
or r of this paragraph, shall classification
paid to all
subcontractors at the site of the work in a prominent and workers performing work !n the which
workIs under this
accessible, place where It can be easily seen by the contract from the first day on which work is performed in
workers, the classification.
(11) (a) Any class of laborers or mechanics which Is not (111) Whenever the minimum wage rate prescribed In the
listed In the wage determination and which Is to be contract for a class of laborers or mechanics includes a
employed under the contract shall be classified In fringe benefit.which Is not expressed as an hourly rate,the
conformance with the wage determination. HUD shall contractor shall either pay the benefit as stated In the
approve an additional classification and wage rate and wage determination or shall pay another bona fide fringe
fringe benefits therefor only when the following criteria benefit or an hourly cash equivalent thereof.
have been met: (iv) If the contractor does not make payments to a trustee
or other third person,the contractor may consider as part
form HUD-4010(0612DD9)
Previous editions are obsolete Page 1 of 5 ref.Handbook 1344.1
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS—PAGE 34
of the wages of any laborer or mechanic the amount of any communicated In writing to the laborers or mechanics
costs reasonably anticlpated In providing bona fide fringe affected, and records which show the costs anticipated or
benefits under a plan or program, Provided, Thal the the actual cost Incurred in providing such benefits.
Secretary of Labor has found, upon the written request of Contractors employing apprentices or trainees under
the contractor, that the applicable standards of the Davis- approved programs shall maintain written evidence of the
Bacon Act have been met. The Secretary of Labor may reglslralion of apprenticeship programs and certification of
require the contractor to set aside In a separate account trainee programs, the registration of the apprentices and
assets for the meeting of obligations under the plan or trainees, and the ratios and wage rates prescribed in the
program. (Approved by the Office of Management and applicable programs. (Approved by the Office or
Budget under OMB Control Number 1215-0140.) Management and Budget under OMB Control Numbers
2. Withholding. HUD or its designee shall upon Its own 1215.0140 and 1215-0017.)
action or upon written request of an authorized (II) (a) The contractor shall submit weekly for each week
representative of the Department of Labor withhold• or in which any contract work Is performed a copy of all
cause to be withheld from the contractor under this payrolls to HUD or its designee if the agency Is a party to
contract or any other Federal contract with the some prime the contract, but if the agency Is not such a party, the
contractor, or any other Federally-assisted contract contractor will submit the payrolls to the applicant
subject to Davis-Bacon prevailing wage requirements, sponsor,or.owner,as the case may be,for transmission to
which Is held by the same prime contractor so much of the HUD or its designee. The payrolls submitted shall set out
accrued payments or advances as may be considered accurately and completely all of (fie information required
necessary to pay laborers and 'mechanics, including. to be maintained under 29 CFR 5.5(a)(3)(1)except that full
apprentices, trainees and helpers, employed by the social security numbers and home addresses shall not be
contractor or any subcontractor the full amount of wages included on weekly transmittals. Instead the payrolls shall
required by the contract In the event of failure to pay any only need to Include an individually Identifying number for
laborer of mechanic, including any apprentice, lralnee.or each employee (e.g., the last four digits of the employee's
helper,employed or Working on the site of the work,all or social security number). The required weekly payroll
part of the wages required by the contract. HUD or Its information may be submitted In any form desired.
designee may,, after written notice to the contractor, Optional Form WH-347 Is available for this purpose from
sponsor, applicant, or owner, take such action as may be the Wage and Hour Division Web site at
necessary to cause the suspension of any further hito://www.dol.goylelplwhiflfpLmSLW11347ins.(r.htm or Its
payment, advance, or guarantee of 'funds until such successor site. The prime contractor is responsible for
violations have ceased, HUD or Its designee may, after the submission of copies of payrolls by all subcontractors.
written notice to the contractor, disburse such amounts Contractors and subcontractors shall maintain the full
withheld for and on account of the contractor or social security number and current address of each
subcontractor to the respective employees to whom they covered worker, and shall provide them upon request to
are due. The Comptroller General shall make such HUD or Its designee if the agency Is a party to the
disbursements In the case of direct Davfs-Bacon Act contract, but if the agency Is not such a party, the
contracts. contractor will submit the payrolls to the applicant
3. (1) Payrolls and basic records. Payrolls and basic sponsor,or owner,as the case may be,for transmission to
records relating thereto shall be maintained by the HUD or Its designee,the contractor,or the Wage and Hour
contractor during the course of the work preserved for a Division of the Department of Labor for purposes of an
period of three years thereafter for all laborers and Investigation or audit of compliance with prevailing wage
mechanics working at the site of the work. Such records requirements. It is not a violation of this subparagraph for
shall contain the name, address, and social security a prime contractor to require a subcontractor to provide
number of each such worker, his or her correct addresses and social security numbers to the prime
classification, hourly rates of wages paid (Including rates contractor for Its awn records, without weekly submission
of contributions or costs anticipated for bona fide fringe to HUD or Its designee. (Approved by the Office of
benefits or cash equivalents thereof of the types described Management and Budget under OMB Control Number
in Section I(b)(2)(B) of the Davis-bacon Act), daily and 1215-0149.)
weekly number of hours worked, deductions made and .(b) Each 'payroll submitted shall be accompanied by a
actual wages paid. Whenever the Secretary of Labor has 'Statement of Compliance,' signed by the contractor or
found under 20 CFR 5.5 (a)(1)(iv) that the wages of any subcontractor or his or her agent who pays or supervises
laborer or mechanic include the amount' of any costs the payment of the persons,employed under the contract
reasonably anticipated In providing benefits under a plan and shall certify the following:
or program described in Section I(b)(2)(B) of the Davis-
(1) That the payroll for the payroll period contains the
Bacon Act, the contractor shall maintain retards which information required to be provided under 29 CFR 5.5
show that the commitment to provide such benefits Is
enforceable, that the plan or program is financially under(I 2 the appropriate Information s being maintained
under 29 CFR 5.5(a)(3)(i), and that such Information is
responsible, and that the plan or program has been correct and complete;
Previous editions are obsolete form HUD4010(00r2009)
Page 2 of 5 ref,Handbook 1344.1
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS—PAGE 35
(2) That each laborer or mechanic(including each helper, Is not reglstered or otherwise employed as staled above,
apprentice. and trainee)employed on the contract during shall be paid not less than the applicable wage rate on the
the payroll period has been paid the full weekly wages wage determination for the classification of work actually
earned, without rebate, either directly or indirectly, and performed. In addition,any apprentice performing work on
that no deductions have been made either directly or the job site In excess of the ratio permitted under the
Indirectly from the full wages earned, other than registered program shall be paid not less than the
permissible deductions as set forth In 29 CFR Part 3; applicable wage rate on the wage determination for the
(3) That each laborer or mechanic has been paid not less work actually performed. Where a contractor is performing
than the applicable wage rates and fringe benefits or cash construction on a project in a locality other than that in
equivalents for the classification of work performed, as which its program is registered, the ratios and wage rates
specified in the applicable wage determination (expressed In percentages of the journeyman's hourly
Incorporated Into the contract. rate) specified in the contractor's or subcontractor's
(c) The weekly submission of a properly executed registered program shall be observed. Every apprentice
certification set forth on the'reverse side of Optional Form must be paid at not less than the role specified in the
WH-347 shall satisfy the requirement for submission of the registered program for the apprentice's lave! of progress,
'Statement of Compliance' required by subparagraph expressed as a percentage of the journeymen hourly rate
specified in the applicable wage determination.
A.3.(li)(b). Apprentices shall be paid fringe benefits to accordance
(d) The falsification of any of the above certifications may with the provisions of the apprenticeship program. If the
subject the contractor or subcontractor to civil or criminal apprenticeship program does not specify fringe benefits,
prosecution under Section 1001 of Title 18 and Section apprentices must be paid the full amount of fringe benefits
231 of Title 31 of the United States Code. listed on the wage determination for the applicable
(Ili) The contractor or subcontractor shall make the classification. If the Administrator determines that a
records required under subparagraph A.3.(1) available for different practice prevails for the applicable apprentice
inspection, copying, or transcription by authorized classification,fringes shall be paid in accordance with that
representatives of HUD or Its designee or the Department determination. In the event the Office of Apprenticeship
of Labor, and shall permit such representatives to Training, Employer and Labor Services, or a State
interview employees.during working hours on the job. if Apprenticeship Agency recognized by the Office,
the contractor or subcontractor falls to submit the required withdraws approval of an apprenticeship program, the
records or to make them available, HUD or its designee contractor will no longer be permitted to utilize
may, after written notice to the contractor, sponsor, apprentices at less than the applicable predetermined rate
applicant or owner,take such action as may be necessary for the work performed until an acceptable program is
to cause the suspension of any further.payment, advance, approved.
or guarantee of funds. Furthermore, failure to submit the (11) Trainees. Except as provided In 29 CFR 5.16.
required records upon request or to make such records trainees will not be permitted to work at less than the
available may be grounds for debarment action pursuant to predetermined tale for the work performed unless.they are
29 CFR 5.12. employed pursuant ',to and individually registered in a
4. Apprentices and Trainees. program which has received prier approval, evidenced by
(1) Apprentices. Apprentices will be permitted to work at formal certification by the U.S. Department of Labor,
less than the predetermined rate for the work they Employment and Training Administration.. The ratio of
performed when they are employed pursuant to and trainees to journeymen on the job site shall not be greater
Individually registered in a bona fide apprenticeship then permitted under the plan approved by the
program registered with the U.S. Department of Labor, Employment and Training Administration. Every trainee
Employment and Training Administration. Office of must be paid at not less than the rate specified In the
Apprenticeship Training, Employer and Labor Services, or approved program for the trainee's level of progress,
with a Slate Apprenticeship Agency recognized by the expressed as a percentage of the journeyman hourly rate
Office, or if a person Is employed In his or her first 90 specified in the applicable wage determination. Trainees
days of probationary employment as an apprentice In such shall be paid fringe benefits In accordance with the
an apprenticeship program, who Is not individually provisions of the trainee program. If the trainee program
registered In the program, but who has been certified by does not mention fringe benefits, trainees shall be paid
the Office of Apprenticeship Training, Employer and Labor the full amount of fringe benefits listed on the wage
Services or a State Apprenticeship Agency (where determination unless the Administrator of the Wage and
appropriate)to be eligible for probationary.employment as Hour Division determines that there Is an apprenticeship
an apprentice. The allowable ratio of apprentices to program associated with the corresponding journeyman
journeymen on the job site in any craft classification shall wage rate on the wage determination which provides for
not be greater than the ratio permitted to the contractor as less than full fringe benefits for apprentices. Any
to the entire work force under the registered program. Any employee listed on the payroll at a trainee rate who Is not
worker listed on a payroll at an apprentice wage rate,who registered and participating in a training plan approved by
Previous editions are obsolete form HU0 4010(0612009)
Page 3 of 5 ref,Handbook 1344.1
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS—PAGE 36
the Employment and Training Administration shall be paid awarded HUD contracts or participate In HUD programs
not less than the applicable wage rate on the wage pursuant to 24 CFR Part 24.
determination for the work actually performed. In addition, (11) No part of this contract shall be subcontracted to any
any trainee performing work on the job site in excess of person or firm ineligible for award of a Government
the ratio permitted under the registered program shall be contract by virtue of Section 3(a) of the Davis-Bacon Act
paid not less than the applicable wage rate on the wage or 29 CFR 5.12(a)(1) or to be awarded HUD contracts or
determination for the work actually performed. In the participate In HUD programs pursuant to 24 CFR Part 24.
event the Employment and Training Administration (111) The penalty for making false statements is prescribed
withdraws approval of a training program, the contractor In the U.S. Criminal Code, 18 U.S.C. 1001. Additionally,
will no longer be permitted to utilize trainees at less.than U.S. Criminal Code, Section 1 01 0, Title 18. U.S.C.,
the applicable predetermined rate for the work performed 'Federal Housing Administration transactions', provides In
until an acceptable program Is approved. part: 'Whoever, for the purpose of. . . Influencing in any
(Ili) Equal employment opportunity. The utilization of way the action of such Administration.....makes, utters or
apprentices,trainees and journeymen under 29 CFR Part 5 publishes any statement knowing the same to be false.....
shall be in conformity with the equal employment shall he fined not more than $5,000 or imprisoned not
opportunity requirements of Executive Order 11246, as more than two years,or both.'
amended,and 29 CFR Pert 30. 11. Complaints, Proceedings, or Testimony by
5. Compliance with Copeland Act requirements. The Employees. .No laborer or mechanic to whom the wage.
contractor shall comply with the requirements of 29 CFR salary,or other labor standards provisions of this Contract
Part 3 which are incorporated by reference in this contract are applicable shall be discharged or in any other manner
6. Subcontracts. The contractor or subcontractor will discriminated against by the Contractor or any
Insert In any subcontracts the clauses contained In subcontractor because such employee has filed any
subparagraphs 1 through 11 In this paragraph A and such complaint or Instituted or caused to be instituted any
other clauses as HUD or Its designee may by appropriate proceeding or has testified or Is about to testify in any
Instructions require, and a copy of the applicable proceeding under or relating to the labor standards
prevailing wage decision, and also a clause requiring the applicable under this Contract to his employer.
subcontractors to Include these clauses In any lower tier B. Contract Work Hours and Safety Standards Act. The
subcontracts. The prime contractor shall be responsible provisions of this paragraph 8 are applicable where the amount of the
for the compliance by any subcontractor or lower tier prime contract exceeds $100,000, As used In this paragraph,the
subcontractor with all the contract clauses in this terms'laborers'and'mechanlcs'include watchmen and guards.
paragraph.
7. Contract termination; debarment. A breach of the co Overtime requirements, No contractor or may
require
subcontractor
contracting for any part of the contract work which may require or
contract clauses in 29 CFR 5.5 may be grounds for Involve the employment of laborers or mechanics shall require or
termination of the contract and for debarment as a permit any such laborer or mechanic in any workweek in which the
contractor and a subcontractor as provided In 29 CFR individual is employed an such work to work in excess of 40 hours in
5.12. such workweek unless such laborer or mechanic receives
& Compliance with Davis-Bacon and Related Act Requirement% compensation at a rate not less than one and one-half times the bask
All rulings and interpretations of the Davis-Bacon and rate of pay for all hours worked In excess of 40 hours In such
Related Acls contained In 29 CFR Parts 1, 3, and 5 are workweek.
herein incorporated by reference In this contract (2) Violation; liability for unpaid wages; liquidated
9. Disputes concerning, labor standards. Disputes damages. In the event of any violation of the clause set
arising out of the labor standards provisions of this forth In subparagraph(1)of this paragraph, the contractor
contract shall not be subject to the general disputes and any subcontractor responsible therefor shall be liable
clause of this contract. Such disputes shall be resolved in for the unpaid wages. In addition, such contractor and
accordance with the procedures of the Department of subcontractor shall be liable to the United Slates (In the
Labor set forth in 29 CFR Parts 5, 6, and 7. Disputes case of work done under contract for the District of
within the meaning of this clause Include disputes between Columbia or a territory, to such District or to such
the contractor(or any of Its subcontractors) and HUD or territory), for liquidated damages. Such liquidated
its designee, the U.S. Department of Labor, or the damages shall be computed with respect to each individual
employees or their representatives, laborer or mechanic, Including watchmen and guards,
10. (1) Certification of Eligibility. By entering Into this employed in violation of the clause set forth in
contract the contractor certifies that neither It(nor he or subparagraph(1)of this paragraph, in the sumof$10 for each
she) nor any person or firm who has an Interest in the calendar day on which such individual was required or permitted to
contractor's firm Is a person or firm Ineligible to be work in excess of the standard workweek of 40 hours without payment
awarded Government contracts by virtue of Section 3(a)of of the overtime wages required by the clause set forth In sub
the Davis-Bacon Act or 29 CFR 5.12(a)(1) or to be paragraph(1)of this paragraph.
Previous editions are obsolete forth HU04010(06/2009)
Page 4 of 5 ref.Handbook 1344.1
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS—PAGE 37
(3) Withholding for unpaid wages and Ilquidatod
damages. HUD or Its designee shall upon Its own action
or upon written request of an authorized representative of
the Department of Labor withhold or cause to be withheld,
from any moneys payable on account of work performed by
the contractor or subcontractor under any such contract or
any other Federal contract with the same prime contract,
or any other Fedora llyassisted contract subject to the
Contract Work Hours and Safely Standards Act which.is
held by the same prime contractor such sums as may be
determined to be necessary to satisfy any liabilities of
such contractor or subcontractor for unpaid wages and
liquidated damages as provided in the clause set forth in
subparagraph(2)of this paragraph.
(4) Subcontracts. The contractor or subcontractor shall
insert In any subcontracts the clauses set forth In
subparagraph(1)through(4)of this paragraph and also a
clause requiring the subcontractors to include these
clauses In any lower tier subcontracts. The prime
contractor shall be responsible for compliance by any
subcontractor or lower tier subcontractor with the clauses
set forth In subparagraphs (1) through (4) of this
paragraph.
C. Health and Safety. The provisions of this paragraph C are
applicable where the amount of the prime contract exceeds$100,000.
(1) No laborer or mechanic shall be required to work In
surroundings or under working conditions which are
unsanitary, hazardous, or dangerous to his health and
safely as determined under construction safely and health
standards promulgated by the Secretary of Labor by
regulation.
(2) The Contractor shall comply with all regulations
Issued by the Secretary of Labor pursuant to Title 29 Part
1926 and failure to comply may result in imposition of
sanctions pursuant to the Contract Work Hours and Safely
Standards Act, (Public Law 91-54, 83 Slat 96). ae USC
3701 at seo.
(3) The contractor shall include the provisions of this
paragraph In every subcontract so that such provisions will
be binding on each subcontractor. The contractor shall
take such action with respect to any subcontractor as the
Secretary of Housing and Urban Development or the
Secretary of Labor shall direct as a means of enforcing
such provisions.
Previous editions are obsolete form HUD4010(06I2009)
Page 5 of 5 ref.Handbook 1344.1
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS—PAGE 38
CONTRACTOR(S) CERTIFICATION ON FEDERAL
CONTRACT REQUIREMENTS
I Jose Carvajal hereby certify that I have
reviewed the diversified Federal construction contract and related requirements
imposed on the Contractor(s) of HUD funded construction projects, and fully
understand all my obligations if the project is awarded to me.
Palm Springs City Project No. 19-03, 2019 ADA Curb Ramp Improvements
Bid Amount:
Date: 02/27/2019
Contractor: CT&T Concrete Pavi I c.
Contractor Signature:
Title: Presdient
Address: 324 S Diamond Bar Blvd PMB 275 Diamond Bar , CA 91765
Telephone: (909) 629-8000
Email: jose.cttinc@gmail.com
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS-PAGE 39
CERTIFICATION OF BIDDER REAGRDING SEGREGATED
FACILITIES
Palm Springs City Project No. 19-03
2019 ADA Curb Ramp Improvements
I,hereby certify that no segregated facilities will be maintained.
Contract Bid Amount:
Contractor:
CT&T Concret P ng, c.
Contractor Signature:
Date: 02/27/19
Contractor Title Presdient
Address: 324 S Diamond Bar Blvd PMB 275 Diamond Bar , CA 91765
Telephone: (909) 629-8000
Email Address: jose.cttinc@gmail.com
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS-PAGE 40
CERTIFICATE OF BIDDER REGARDING
AFFIRMATIVE ACTION PROGRAM
The Bidder hereby certifies that he or she is in compliance with the Civil Rights Act of 1964, Executive Order
No. 11246, The California Fair Employment Practices Act, and all other applicable Federal and State laws
and regulations relating to equal opportunity employment.
Bidders Name: CT&T Concrete Paving, Inc.
Address 324 S Diamond Bar Blvd PMB 275
Diamond Bar , CA 91765
Name and Title of
Signer: Jose Carvajal, President
02/27/2019
Signature and Date
The above certification of the Bidder regarding its affirmative action program shall be filled out completely,
signed, and submitted by each Bidder, and shall be a part of the Contract Documents.
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO.19-03 HOUSING AND URBAN DEVELOPMENT ACT
JANUARY 2019 BID FORMS—PAGE 41
1
BID BOND
COPY
KNOW ALL MIEN BY THESE PRESENTS,
That CT&T Concrete Paving, Inc. as Principal, and
Contractors Bonding and Insurance 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 Total Bid Amount 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:
2019 ADA CURB RAMP IMPROVEMENTS
CITY PROJECT NO. 19-03
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 12th day of February 20 19
EXECUTED FOR THE SURETY: .
EXECUTED R TH P I P Contractors Bonding and Insurance C any
CT&T Concr/ avi By
By
Sign ure
i ignature (NOT IZED)
(NOTARIZED)
Print N/eand itle:
Print Name and Title: YungAttorney-in-Fact
~-.I O SC- el vc y z-f r 0A -- Frp-S i 61 e-;
By
Signature
(NOTARIZED)
Print Name and Title:
2019 ADA CURB RAMP IMPROVEMENTS BID BOND(BID SECURITY FORM)
CITY PROJECT NO.19-03 BID FORMS-PAGE 19
JANAURY 2019
��e k.Uri
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California }
County of Los Angeles }
On Z-7—� before me, Daniel A. Butler, A Notary Public ,
jJere insert name ana tit el at the officer)
J personally appeared o sZ 6a_r Va . --------
who proved to me on.the basis of satisfactory evidence to be the person(e) whose
name(-) Is re subscribed to the within instrument and acknowledged to me that
the/they executed the same in Is er/their authorized capacity(ies), and that by
Is er/their signature(&) on the instrument the person(&), or the entity upon behalf of
which the person(e) 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. yi ...........
•""''� DANIEL A.BUTLER
o` Commission No. 2239769
WITNESS my hand and official seal. ? Cb% �: NOTARY PUBLIC-CALIFORNIA 2
a` LOS ANGELES COUNTY
My Comm.Expires APRIL 26,2022
1
Notary Public Signature (Notary Public Seal)
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This form complies with current California statutes regarding notary wording and,
DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the document.Acknowledgments
from other states may be completed for documents being sent to that state so long
!y f as the wording does not require the California notary to violate California notary
law.
(Title or description of attached document) • State and County information must be the State and County where the document
signer(s)personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s)personally appeared which
(Title or description of attached document continued) must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
Number of Pages Document Date commission followed by a comma and then your title(notary public).
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ol...................._..----.................._......_.._..---—-.........._............._._..._...--- ---.._._........._._,...---- _._. _.
' BY
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
County of Orange
On February 12, 2019 before me, Irene Luong Notary Public,
Date Insert Name of Notary exactly as it appears on the official seal
personally appeared Yung T. Mullick
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
IRENEWONG person(s), or the entity upon behalf of which the person(s)
NotaryPublic-California Z acted, executed the instrument.
Orange County
Commission#2207169 1 certify under PENALTY OF PERJURY under the laws of
MyComm.Expires Jul 27,2021 the State of California that the foregoing paragraph is true
and correct.
Witness my hand a Ida
Signature
Place Notary Seal Above Signature o Notary Pr
blic ne Luong
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of the form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages: j
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name: i
❑ Individual ❑ Individual I
❑ Corporate Officer—Title(s): ❑ Corporate Officer Title(s):
❑ Partner ❑Limited ❑General ❑ Partner ❑Limited ❑ General
❑ Attorney in Fact ❑ Attorney in Fact
❑ Trustee 0 ❑ Trustee
❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here
❑ Other: ❑ Other:
I
Signer is Representing: Signer is Representing:
I
POWER OF ATTORNEY C® PY
RLI Insurance Company IF]
Contractors Bonding and Insurance Company
9025 N.Lindbergh Dr. Peoria,IL 61615
Phone: 800-645-2402
Know All Men by These Presents:
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the
approving officer if desired.
That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and
together,the"Company")do hereby make,constitute and appoint:
James W.Moilanen Yuniz T.Mullick Stephanie Hoane P.Austin Neff,jointly or severally
in the City of Mission Vieio , State of California its true and lawful Agent(s) and Attorney(s) in Fact,with
full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all
bonds and undertakings in an amount not to exceed Twenjy Five Million Dollars
( $25.000.000.00 )for any single obligation.
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been
executed and acknowledged by the regularly elected officers of the Company.
RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the
following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation,and is now in force,to-wit:
"All bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of
the Company by the President,Secretary,any Assistant Secretary,Treasurer,or any Vice President,or by such other officers as the Board
of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint
Attorneys in Fact or Agents who shall have authority to issue bonds,policies or undertakings in the name of the Company. The corporate
seal is not necessary for the validity of any bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation. The
signature of any such officer and the corporate seal may be printed by facsimile."
IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have
caused these presents to be executed by its respective Vice President with its corporate seal affixed this 29th day of
November 2018
` ,,,,,,,,,,, „��,,,,,,,,,,,,� RI,I Insurance Company
�%iG AND, Cp�a", Contractors�Bonding and Insurance Company
4.
^may.'4011p OR4 r�•.2 ?� O°RPORq rF t91
_4, �_ _ By.
SEAL ;a,; _ SEAL .- _ Barton W.Davis Vice President
State of Illinois
SS
County of Peoria CERTIFICATE
On this 2 th day of November 2018 before me, a Notary 1, the undersigned officer of RLI Insurance Company and/or
Public, personally appeared Barton W. Davis who being by me duly Contractors Bonding and Insurance Company, do hereby certify
sworn, acknowledged that he signed the above Power of Attorney as the that the attached Power of Attorney is in full force and effect and is
aforesaid officer of the RLI Insurance Company and/or Contractors irrevocable; and furthermore, that the Resolution of the Company as
Bonding and Insurance Company and acknowledged said instrument to be set forth in the Power of Attorney, is now in force. In testimony
the voluntary act and deed of said corporation. whereof, I have hereunto set my hand and the seal of the RLI
Insurance Co and/or C atra�ctors Bond' lan�dy Insurance
ff II---- Company this of 14- n•1
By: t & jl. RLI Insurance Company
Gretchen L.Johnigk Notary Public Contractors Bonding and Insurance Company
--------------
BLIC
��', GRETCHENLJOHNIGK '
NOTAR 'OFFICIAL SEW By:
i ILLINBLIC
OF M Commission Ex Tres Corporate Secretary
rLUNO1.4 y p Jean M tephenson
May 26,2020
0475412020212 A0058817
City Of Pall n�n s'CA
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DUE DATE: Q-ar7-19
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4/4/2019 Check A License-License Detail
CONTRACTORS STATE LICENSE BOARD
m
Contractor's License Detail for License # 875627
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 information.
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 with 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 4/4/2019 2:31:24 PM
Business Information
CT&T CONCRETE PAVING INC
P M B#275
324 SOUTH DIAMOND BAR BLVD
DIAMOND BAR,CA 91765
Business Phone Number:(909)629-8000
Entity Corporation
Issue Date 04/05/2006
Expire Date 04/30/2020
License Status
This license is current and active.
All Information below should be reviewed.
Classifications
C12-EARTHWORK AND PAVING
C-8-CONCRETE
i
Bonding Information
Contractor's Bond
I his license filed a Contractor's Bond with SURETEC INDEMNITY COMPANY.
and Number:124368
and Amount:$15,000
ffective Date:01/01/2016
Contractor's Bond History
Bond of Qualifying Individual
he qualifying individual JOSE GUADALUPE CARVAJAL certified that he/she owns 10 percent or more of the voting stock/membership interest of this
ompany;therefore,the Bond of Qualifying Individual is not required.
Effective Date:04/16/2010
!BQI's Bond History
Workers'Compensation
Pn employee service group holds the workers compensation insurance.
L
umber:C65207205
Date:10/07/2018
ate:10/01/2019
Compensation History
Other
Personnel listed on this license(current or disassociated)are listed on other licenses.