The Honorable Board of Supervisors County of Los...

This action is to award construction contracts and authorize the Chief Engineer of the Los Angeles County Flood Control District or her designee to execute various construction contracts for work in the Cities of Covina and Diamond Bar and in the unincorporated community of Hacienda Heights.

SUBJECT

June 21, 2016

The Honorable Board of SupervisorsCounty of Los Angeles383 Kenneth Hahn Hall of Administration500 West Temple Street Los Angeles, California 90012 Dear Supervisors:

AWARD OF VARIOUS CONSTRUCTION CONTRACTSIN THE CITIES OF COVINA AND DIAMOND BAR AND

IN THE UNINCORPORATED COMMUNITY OFHACIENDA HEIGHTS

(SUPERVISORIAL DISTRICTS 4 AND 5)(3 VOTES)

IT IS RECOMMENDED THAT THE BOARD ACTING AS THE GOVERNING BODY OF THE LOS ANGELES FLOOD CONTROL DISTRICT:

1. Award and authorize the Chief Engineer of the Los Angeles County Flood Control District or her designee to execute various construction contracts and establish the effective dates following receipt of approved Faithful Performance and Labor and Material Bonds and insurance certificates filed by the contractors for the following:

• Project ID No. FCC0001192 – Walnut Creek Spreading Basin Pump Station Project, for excavation, transportation, and disposal of sediment to Manning Pit; construction of a pump station; and installation of flow measurement instrumentation, in the City of Covina, to Environmental Construction, Inc., in the amount of $1,396,266; and

• Project ID No. FCC0001236 – Hacienda Channel – Camino Channel, Low-Flow Channel and Invert Access Ramp and Private Drain T1203 Drainage Extension, for construction of a reinforced

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34 June 21, 2016

concrete low-flow channel, invert access ramp, driveway, retaining wall, headwall, and drainage structures; 30-inch and smaller reinforced concrete pipe; construction of a trash rack and chainlink fence, in the City of Diamond Bar and in the unincorporated community of Hacienda Heights, to Kaveh Engineering & Construction, Inc., in the amount of $435,800.

2. Delegate to the Chief Engineer of the Los Angeles County Flood Control District or her designee the following authority in connection with these contracts: (1) approve and execute change orders within the same monetary limits delegated to the Director of Public Works under Section 2.18.050 of the Los Angeles County Code relative to the construction of County buildings, (2) accept the project upon its final completion, and (3) release retention money withheld consistent with the requirements of State Public Contract Code Sections 7107 and 9203.

PURPOSE/JUSTIFICATION OF RECOMMENDED ACTION

The purpose of the recommended actions is to obtain approval of the projects from the Board, acting as the governing body of the Los Angeles County Flood Control District, to award these construction contracts, authorize the Chief Engineer of the Los Angeles County Flood Control District or her designee to execute the construction contracts, and establish the effective contract dates following receipt of approved Faithful Performance and Labor and Material Bonds and insurance certificates filed by the contractors for these projects.

The enclosures include the agenda dates and Item Nos. when the Board approved the projects, adopted the plans and specifications, called for bids to be received, and instructed the Executive Officer of the Board of Supervisors to advertise the projects.

The project descriptions, call for bids and bid opening dates, tabulation of bids, and financial information are included in the enclosures for each respective project. The certified record of receipt of bids and the original bid proposals for each project are also enclosed.

Implementation of Strategic Plan GoalsThe Countywide Strategic Plan directs the provisions of Operational Effectiveness/ Fiscal Sustainability (Goal 1) and Integrated Services Delivery (Goal 3). Awarding these construction contracts will provide improved infrastructure to better serve the public and enhance the quality of life in the affected Cities and community.

FISCAL IMPACT/FINANCING

There will be no impact to the County General Fund.

The enclosure for each project includes the amount of the recommended contract as compared with the engineer's estimate, the other bids received, and more detailed fiscal and financial information.

Sufficient funds for Project ID Nos. FCC0001192 and FCC0001236 are included in the Flood Control District Fund Fiscal Year 2015-16 Budget.

The Honorable Board of Supervisors6/21/2016

FACTS AND PROVISIONS/LEGAL REQUIREMENTS

The contract agreements will be in the form previously reviewed and approved as to form by County Counsel. The recommended contracts were solicited on an open-competitive basis and are in accordance with applicable Federal, State, and County requirements. The contractors are in compliance with the Chief Executive Officer's and the Board's requirements.

The award of these contracts will be in full compliance with Federal, State, and County regulations. These contracts contain terms and conditions supporting the Board's ordinances, policies, and programs including, but not limited to: the County of Los Angeles' Greater Avenues for Independence and General Relief Opportunities for Work Programs (GAIN and GROW), Board Policy No. 5.050; Contract Language to Assist in Placement of Displaced County Workers, Board Policy No. 5.110; Reporting of Improper Solicitations, Board Policy No. 5.060; Notice to Contract Employees of Newborn Abandonment Law (Safely Surrendered Baby Law), Board Policy No. 5.135; Contractor Employee Jury Service Program, Los Angeles County Code, Chapter 2.203; Notice to Employees Regarding the Federal Earned Income Credit (Federal Income Tax Law, Internal Revenue Service Notice 1015); Contractor Responsibility and Debarment, Los Angeles County Code, Chapter 2.202; the County's Child Support Compliance Program, Los Angeles County Code, Chapter 2.200; the County's Defaulted Property Tax Reduction Program, Los Angeles County Code, Chapter 2.206; Local Business Enterprise Preference Program, Los Angeles County Code,Chapter 2.204; and the standard Board directed clauses that provide for contract termination or renegotiation.

The State Public Contract Code requires the District to award construction contracts to a responsible contractor with the lowest responsive bid, which is defined as the firm that: (1) submits the bid with the lowest cost; (2) is deemed by the District to be responsive to specific criteria under the solicitation including, but not limited to, licensure, bonding, and insurance requirements; and (3) is determined by the District to be a responsible bidder by exhibiting the capability, capacity, experience, trustworthiness, and financial wherewithal to perform the work required under the bid solicitation.

To ensure these contracts are awarded to a responsible contractor with a satisfactory history of performance, bidders are required to report violations of the False Claims Act, criminal convictions, civil litigation, defaulted contracts with the County, complaints filed with the Contractor's State License Board, labor law/payroll violations, and debarment actions. As provided for in Board Policy No. 5.140, the information reported by each respective contractor was considered before making this recommendation to award.

The plans and specifications include the contractual provisions, methods, and material requirements necessary for these projects and are on file with the Department of Public Works.

ENVIRONMENTAL DOCUMENTATION

Each of these projects were found to be categorically exempt from the provisions of the California Environmental Quality Act at the time the Board called for bids.


CONTRACTING PROCESS

The contracts were solicited on an open-competitive basis in accordance with the provisions of the State Public Contract Code.

To further increase contractor awareness of contracting opportunities with Public Works, these projects were listed on both the County's "Doing Business with Us" and Public Works' "Contract Opportunities" websites for upcoming bids. Public Works also coordinated with the Office of Small Business to maximize outreach.

Public Works will review and approve the Faithful Performance and payment bonds filed by the contractors.

IMPACT ON CURRENT SERVICES (OR PROJECTS)

These construction contracts will result in improved infrastructure in the Cities and community where the work is performed.

CONCLUSION

Please return one adopted copy of this letter to the Department of Public Works, Construction Division.

GAIL FARBER

Director

Enclosures

c: Chief Executive Office (Rochelle Goff)County CounselExecutive OfficeInternal Services Department (Countywide Contract Compliance)

Respectfully submitted,

GF:JTS:ma


AWARD OF CONSTRUCTION CONTRACTJune 21, 2016

PROJECT ID NO. FCC0001192 —Walnut Creek Spreading Basin Pump Station Project(in the City of Covina), Supervisorial District 5.

TYPE OF WORK: Excavation, transportation, and disposal of sediment to Manning Pit;construction of a pump station; installation of flow-measurementinstrumentation; and the performance of other appurtenant work.

CALL FOR BIDS DATE: March 29, 2016 (Agenda Item 39)

BID OPENING DATE: May 3, 2016

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Low Environmental Construction, Inc. $1,396,266.0021550 Oxnard Street, Suite 1050Woodland Hills, California 91367(818) 449-8920

2 Minco Construction $1,755,400.003 Mike Bubalo Construction Co., Inc. $2,288,600.00

Kaveh Engineering &Construction, Inc., submitted a bid of $944,790; however, it didnot use the correct Schedule of Prices. Therefore, its bid was considerednonresponsive and rejected as provided in the Instructions to Bidders.

FINANCIAL INFORMATION:

Amount of estimate $1,154,000.00Amount of recommended contract $1,396,266.00Amount of recommended contract above the estimate $ 242,266.00

The amount of the recommended contract is 21 percent above the estimate, which wasbased on recent average contract prices for similar items of work. A review of theestimate indicates prices of several material items were below current market prices.Readvertising the project will result in increased contract administration costs and delayconstruction with no guarantee that lower bids will be received. Therefore, werecommend award of the contract to the low bidder.

The project was awarded Proposition 84 grant funds. The Flood Fund will provide therequired $870,985 minimum funding match for construction. Additional constructioncosts above that amount will be reimbursed with Proposition 84 grant funds.

Financing for this project is included in the Flood Control District FundFiscal Year 2015-16 Budget.

SCHEDULE:

The contract specifications require the work to be completed in 80 working days. It isanticipated the work will start in September 2016 and be completed in January 2017.

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AWARD OF CONSTRUCTION CONTRACTJune 21, 2016

PROJECT ID NO. FCC0001236 —Hacienda Channel -Camino Channel Low-FlowChannel and Invert Access Ramp and Private Drain T1203 Drainage Extension (in theCity of Diamond Bar and in the unincorporated community of Hacienda Heights),Supervisorial District 4.

TYPE OF WORK: Construction of a reinforced concrete low-flow channel, invert accessramp, driveway, retaining wall, headwall, and drainage structures;30-inch and smaller reinforced concrete pipe; construction of a trashrack and chainlink fence; and the performance of other appurtenantwork.

CALL FOR BIDS DATE: March 29, 2016 (Agenda Item 40)

BID OPENING DATE: May 3, 2016

. ~ ,.• ___..

Low Kaveh Engineering &Construction, Inc. $435,800.0022600 Savi Ranch Parkway, Suite A17Yorba Linda, California 92887(714) 793-6655

2 Mike Bubalo Construction Co., Inc. $483,985.003 GMZ Engineering Inc.* $487,950.004 Access Pacific, Inc.* $489,195.005 Rio Jordan Construction, Inc.* $549,995.006 KEC Engineering $563,120.00

*Local Small Business Enterprise (LSBE)

LNA Concrete Structures, Inc., was the apparent low bidder with a bid in the amount of$415,800.00; however, it requested that its bid be withdrawn due to a clerical errorresulting in a underbid. Our review conformed that a bonafide clerical error was made,and LNA Concrete Structures, Inc., should be relieved of its bid proposal as provided inthe Instructions to Bidders. Therefore, we recommend award of the contract to the newlowest responsible bidder.

FINANCIAL INFORMATION:

Amount of estimate $445,870.00Amount of recommended contract $435,800.00Amount of recommended contract below estimate $ 10,070.00

The amount of recommended contract is 2.3 percent below the estimate.

Financing for the construction contract cost of the project is included in the FiscalYear 2015-16 Flood Control District Fund Budget.

There will be no impact to the County General Fund.

SCHEDULE:

The contract specifications require the work to be completed in 60 working days. It isanticipated the work will start in September 2016 and be completed in November 2016.

AH:maO:\Projects\Programs -Flood\Hacienda Channel and PD_T1203 {FCC0001236)\Board~Award Hacie~da.docx

Plan Holders

Los Angeles CountyDepartment of Public WorksFCCo0o1192 -Walnut Creek Spreading Basin PumpStation Project

Page 1 of 5

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~ .Packages Sold Contractor Information Bid ReceivedFirst box contains number Company Name, Mailing Address,of packages sold to City, State, Zip Code,

(Date) (Time)

contractor Telephone Number and Contact(Bid Amount)

Date :4/20/2016 2:00:29 Name : Access Pacific Inc.PM Address: 755 E. Washington Blvd.Amt Sold: $0.00 (1) Pasadena , CA 91104Receipt #:Pick up: 1-

TEL: (626)792-0616

Mailed: FAX: (626)792-0896

Downloaded: ATTN: Tomas [email protected]

Date :4/5/2016 3:17:48 Name : August Construction &Shoring, Inc.PM Address: 667 Calle MiramarAmt Sold: $0.00 (1) Redondo Beach, CA 90277Receipt #:Pick up: 1-

TEL: 424-270-0370

Mailed: FAX: 310-988-2891

Downloaded: ~ ATTN: Jim [email protected]

Date :4/28/2016 1:18:20 Name : Beador Construction Company, Inc.PM Address: 26320 Lester CircleAmt Sold: $0.00 (1) Corona, CA 92883Receipt #:Pick up: I-

TEL: 951-674-7352

Mailed: FAX: 951-674-7495

Downloaded: ~~~! ATTN: David [email protected]

Date :3/30/2016 3:48:09 Name : Big Bear Electric IncPM Address: 644 W Fairway Blvd, Ste #6Amt Sold: $0.00 (1) Big Bear City, CA 92314Receipt #:Pick up:

TEL: 909 547-6363

Mailed: 1 FAX: 909 547-6413

Downloaded: ~ ATTN: Ethan [email protected]

Date :4/18/2016 1:35:49 Name : Charles P. Crowley Company, Inc.PM Address: 15861 Business Center DriveAmt Sold: $0.00 (1) Irwindale, CA 91706Receipt #:Pick up: I~

TEL: (626) 856-5656

Mailed: 1~ FAX: (626) 856-5658

Downloaded: ~' ATTN: ]on [email protected]

Date :4/1/2016 10:08:54 Name : Clarke Contracting CorporationAM Address: 4646 Manhattan Beach Blvd.Amt Sold: $0.00 (1) Lawndale, California 90260Receipt #:Pick up: 1`

TEL: 3105427724

Mailed• ~ FAX: 3105422188

Downloaded: ~' ATTN: Brian [email protected]

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Plan Holders Page 2 of 5

FCCo0o1192 -Walnut Creek Spreading Basin Pump Bid Date:Station Project 5/3/2016Packages Sold Contractor Information Bid ReceivedFirst box contains number Company Name, Mailing Address,of packages sold to City, State, Zip Code,

(Date) (Time)

contractor Telephone Number and Contact(gid Amount)

Date :3/31/2016 Name : Construction Bid Source12:03:11 AM Address: 6265 Hwy 9Amt Sold: $0.00 (1) Felton, CA 95018Receipt #:Pick up: ~``

TEL: (888) 786-9450

Mailed: FAX: 800-560-7266

Downloaded: ATTN: Martha [email protected]

Date :3/31/2016 6:43:59 Name : Construction Bidboard, Inc.AM Address: 11622 EI Camino Real, Suite 100Amt Sold: $0.00 (1) San Diego, CA 92130Receipt #:Pick up: ~W

TEL: 8004795314

Mailed: 1"~` FAX: 6196880585

Downloaded: ~ ATTN: Kristi Rpla n room @ebid boa rd. com

Date :4/21/2016 Name : Cora Constructors Inc11:26:45 AM Address: 75140 St. Charles Place Suite AAmt Sold: $0.00 (1) Palm Desert, CA 92211Receipt #:Pick up: t-

TEL: 760-674-3201

Mailed: FAX: 760-674-3202

Downloaded: ATTN: [email protected]

Date :4/18/2016 Name : Environmental Construction, Inc tl` r ~12:06:53 PM Address: 21550 Oxnard St #1050Amt Sold: $0.00 (1) Woodland Hills, CA 91367

QeReceipt #:Pick up: 1~

TEL: 818-449-8920~ ~- ~~

~~Mailed:l~' FAX: 818-703-9073

Downloaded: ~' ATTN: Lara ][email protected]

Date :4/8/2016 11:32:41 Name : Flow N Control, IncAM Address: 4452 Ocean View Blvd, Suite 200Amt Sold: $0.00 (1) Montrose, CA 91020Receipt #:Pick up: l"

TEL: 818-330-7425

Mailed: 1~ FAX: 818-330-9739

Downloaded ~ ATTN: Catherine [email protected]

Date :4/18/2016 3:22:20 Name : Gierlich-Mitchell, Inc.PM Address: 10533 Progress Way, Ste AAmt Sold: $0.00 (1) Cypress, CA 90630Receipt #:Pick up: l``

TEL: 714-236-6070

Mailed: FAX: 714-236-6080

Downloaded• ATTN: [email protected]

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Plan Holders

FCCoo01192 -Walnut Creek Spreading Basin PumpStation Project

Page 3 of 5

Bid Date:5/3/2016

Packages Sold Contractor Information Bid ReceivedFirst box contains number Company Name, Mailing Address,

(Date) (Time)of packages sold to City, State, Zip Code,(Bid Amount)contractor Telephone Number and Contact

Date :4/19/2016 6:51:39 Name : Houalla Enterprises Ltd. DBA MetroP~"1 Builders &Engineers Group, Ltd.Amt Sold: $0.00 (1) Address: 2610 Avon St.Receipt #:Pick up: 9~

Newport Beach, CA 92663

Mailed:TEL: 9495154350

Downloaded: C' FAX: 9495154351ATTN: Shelly Irvine

[email protected]

Date :4/13/2016 2:21:43 Name : Joha ConstructionPM Address: 19934 Rhona PlaceAmt Sold: $18.00 (1) Santa Clarita, CA 91350Receipt #: F570470Pick up:

TEL: (661) 263-1739

Mailed: ~~~ FAX: (661) 263-8057

Downloaded: ~ ATTN:[email protected]

Date :4/1/2016 3:32:31 Name : Kaveh Engineering &Construction, Inc.~PM Address: 22600 Savi Ranch Pkwy Suite A17 ~ c

Amt Sold: $0.00 (1) Yorba Linda, CA 92887

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TEL: 714-793-6655.. ,

~; " ~ ̀j C~ ~Mailed: l FAX: 714-637-7520

Downloaded• ~ ATTN: Fred Bashardoost [email protected]

Date :4/6/2016 4:12:05 Name : KEC EngineeringPM Address: 200 N. Sherman AvenueAmt Sold: $0.00 (1) Corona, CA 92882Receipt #:Pick up: 1~`

TEL: 951-734-3010

Mailed: 1~ FAX: 951-7347987

Downloaded:l+'! ATTN: [email protected]

Date :4/11/2016 7:36:49 Name : Layne ChristensenAM Address: 1717 W Park AveAmt Sold: $0.00 (1) Redlands, CA 92373Receipt #:Pick up: 1-

TEL: 9093902833

Mailed• 1"` FAX: 9093905540

Downloaded: I~' ATTN: Steve [email protected]

Date :4/27/2016 4:24:27 Name : Leed Electric, Inc.PM Address: 13138 Arctic CircleAmt Sold: $0.00 (1) Santa Fe Springs, California 90670Receipt #:Pick up: T-

TEL: 5622709500

Mailed: I~ FAX: 5628635723

Downloaded: ~ ATTN: Rod [email protected]

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FCCOo0l~92 -Walnut Creek Spreading Basin Pump eid Date:Station Project 5/3/2016Packages Sold Contractor Information Bid ReceivedFirst box contains number Company Name, Mailing Address,

(Date) (Time)of packages sold to City, State, Zip Code,(B~d Amount)contractor Telephone Number and Contact

Date :4/8/2016 3:09:58 Name : LNA CONCRETE STRUCTURES INC.PM Address: 15455 TERN STREETAmt Sold: $0.00 (1) CHINO HILLS, CA 91709Receipt #:Pick up: ~`r

TEL: 9093931493

Mailed: FAX: 9093939363

Downloaded: l+~` ~►TTN: Lolo [email protected]

Date :4/4/2016 3:06:21 Name : LOS ANGELES ENGINEERING, INC.PM Address: 633 N BARRANCA AVENUEAmt Sold: $0.00 (1) COVINA, CA 91723Receipt #:Pick up: ~``

TEL: 626-454-5222

Mailed: FAX: 626-454-5226

Downloaded: ATTN: 7ESSICA [email protected]

Date :4/29/2016 1:32:03 Name : Mehta mechanical company Inc DBAPM DBA MMC, IncAmt Sold: $0.00 (1) Address: 5901 Fresca Dr., La Palma, CA. 90623Receipt #: La Palma, California 90623Pick up: ~-Mailed: f`"`

TEL: 7145212022

Downloaded:l~: FAX: 7145212440ATTN: Jay (Jagat) S Mehta

[email protected] :3/30/2016 Name : Mike Bubalo Construction Co., Inc. ~,'~~

~~ ~+~-11:38:55 AM Address: 5102 Gayhurst Avenue °Amt Sold: $0.00 (1) Baldwin Park, CA 91706 ~ r'Receipt #:Pick up: ~~`

TEL: 626-960-7787 =.-P~ ~

Mailed: l~ FAX: 626-960-7897

Downloaded: ATTN: Anton [email protected]

Date :4/27/2016 1:08:08 Name : Minako America Corporation DBA Minco ~ ~ jP~"1 ConstructionAmt Sold: $0.00 (1) Address: 522 E Airline WayReceipt #: Gardena, CA 90248

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Pick up: 1-Mailed:

TEL: 310-516-8100

Downloaded: ~' FAX: 310-516-7404ATTN: Raffi Thomassian

[email protected] :4/20/2016 7:16:38 Name : SSC Construction, Inc.AM Address: 2073 Railroad StreetAmt Sold: $0.00 (1) Corona, CA 92880Receipt #:Pick up: 1~

TEL: (951) 278-1177

Mailed: 1- FAX: (951) 278-3307

Downloaded ATTN: Kristina De La [email protected]



FCC0001~92 -Walnut Creek Spreading Basin Pump Bid gate:Station Project 5/3/2016Packages Sold Contractor Information Bid ReceivedFirst box contains number Company Name, Mailing Address,

(Date) (Time)of packages sold to City, State, Zip Code,(B~d Amount)contractor Telephone Number and Contact

Date :4/5/2016 8:45:16 Name : Torres Construction Corp.AM Address: 7330 North Figueroa StreetAmt Sold: $0.00 (1) Los Angeles, California 90041Receipt #:Pick up: 1~

TEL: 323-257-7460

Mailed: FAX: 323-257-8044

Downloaded: ATTN: Max [email protected]

Date :4/5/2016 11:27:57 Name : Torres Construction CorporationAM Address: 7330 North Figueroa StreetAmt Sold: $18.00 (1) Los Angeles, CA 90041Receipt #: F570229Pick up: l+~

TEL: (323) 257-7460

Mailed• FAX: (323) 257-8044

Downloaded: ~~ ATTN:

Date :4/3/2016 11:58:41 Name : West Pacific ConcreteAM Address: 6453 Fairfield StreetAmt Sold: $0.00 (1) LOS ANGELES, CA 90022Receipt #:Pick up: ~-

TEL: 3236746170

Mailed: FAX: 3234100490

Downloaded: ~ ATTN: Anthony [email protected]

I hereby certify that the above are all

and theof BidstCoc' trig

received prior to the deadlene far sub►nittin ~

project»

Gait Farber, Director of Public t~A=~~;gLos tln~P` (%ounty p ,-

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COUNTY OF LOS ANGELESDEPARTMENT OF PUBLIC WORKS

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Table of Contents: Page

Proposal to the Board of Supervisors .......................................1Bidder Information Sheet ..........................................................2-3Acknowledgment of Addenda Received ...................................4Noncollusion Affidavit ................................................................5Request for Local SBE Preference Program Considerationand CBE Firm/Organization Information Form .......................6

List of Subcontractors ...............................................................7Bidder Seif-Performance Verification Form ...............................8Schedule of Prices ....................................................................9-11

All Bid Proposal forms listed above shall be completely filled out and submitted withthe Bid. Failure to do so may result in rejection of the Bid.

Los Angeles County Department of Public WorksCashier's Office, Mezzanine Level900 South Fremont AvenueAlhambra, California 91803

PROJECT ID NO. FCC0001192

i

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To the Board of Supervisors of theCounty of Los Angeles:

The Undersigned hereby declares:

(a) That the only persons or parties interested in this Proposal as principals are thoseidentified on the Bidder Information Sheet.

(b} That he has carefully examined the Project site and has familiarized himself with allof the physical and climatic conditions, and makes this Proposal solely upon his ownknowledge.

(c} That he has carefully examined the Plans, Specifications, Bid Proposal, NoticeInviting Bids, and all other information furnished by the Agency and makes this Proposalaccordingly.

(d) That, in the event this Contract is awarded to him, he will enter into a Contract withthe /Board of Supervisors of the County of Los Angeles to perform the Work in accordancewith the Plans and the terms of the Specifications, and will furnish or provide all materials,labor, tools, equipment, apparatus, and other means necessary so to do, except as mayotherwise be furnished or provided under the terms of said Specifications, for the pricesstated in the Schedule of Prices.

(e} That he has included with the Proposal a certified or cashier's check, or a suretybond, payable to the County of Los Angeles in an amount of $equivalent to at least 10 percent of the total aggregate Bid price shown on the Schedule ofPrices. Furthermore, he agrees that, should he fail to properly execute and return theContract Agreement, together with the required bonds, within ten business days after it hasbeen delivered or mailed to him or his authorized agent, the Agency will be damaged bythe delay in an amount that is impossible to definitely ascertain and which is thereforeestablished to be not less than that of the aforementioned check or bond and that in suchevent the amount of said check or bond shall become the property of the Agency and maybe collected thereby, but that otherwise it shall be returned in accordance with theprovisions of the Instructions to Bidders.

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lay t't lS~ ~~-~ ~/~~ ~--Bidder's Name idder's Si ature

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All information shall be typed or printed legibly.

PART A -Complete the appropriate portion below:

1. Bidder is a SOLE PROPRIETORSHIP:

Name of Individual(First Name, Middle Initial, Last Name)

Doing Business as

2. Bidder is a CORPORATION:

Exact legal business °~"name of Corporation ~Y~ U►'~" m~,~ °~ ~ ~~/7 ~ ~~ ~" .

Doing Business as ~`'t~ Vr~~t~ry~a~ ~r f C~~ ~~2r C-~i~U~, ~~ ~

Name of President ~ ~->~~~~p~~(i

Name of Vice President ~~~-,'~~ ~dr ~ ua~j!

Name of Secretary ____ ~C~'fi~ ~ ,S~r-~uC~` >~

Name of Assistant Secretary ~/ j~-

Name of Treasurer ~G"i~r`~ ~ c,rl~

Name of Responsible Managing Officer ~~!(''~ ~r~ t ~ l~~ - r'-O

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Exact legal businessname of Limited Partnership

Names of persons or parties composing the Limited Partnership (Indicate whether anindividual or corporation):


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Exact legal businessname of General Partnership

Names of persons or parties composing the General Partnership (Indicate whether anindividual or corporation):

5. Bidder is a JOINT VENTURE:

Exact legal businessname of Joint Venture

Names of persons or parties composing the Joint Venture (Indicate whether an individualor corporation):

PART B -Complete the following:

Street Address: Mailing Address:

•

~1 California Contracto 'sCounty Vendor ID No. ~ot~b ~~(.~~ License No. ~--r~~(p~--~-/

Telephone No. ~`~~~~' License Expiration Date ~/-~1~ r

Fax No. ~I ~ ~b.,~~Il~ ~ ~ License Class ~ ~ l?sf Clt~ C ~~~- Z,~-S~

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The Bidder shall acknowledge the receipt of addenda by placing an "x" by each addendumreceived.

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Addendum No. 3

Addendum No. 4

Addendum No. 5

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If an addendum or addenda have been issued by the Agency and not noted above as beingreceived by the Bidder, the Bid Proposal may be rejected.

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State of CaliforniaSS.

County of Los Angeles

~ ~~ t D ~~ ,being first duly sworn, de oses and says that he or she is

t e party making the foregoing bid that the bid is not made in the interest of, or on behalf of,any undisclosed person, partnership, company, association, organization, or corporation; thatthe bid is genuine and not collusive or sham; that the bidder has not directly or indirectlyinduced or solicited any other bidder to put in a false or sham bid, and has not directly orindirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in asham 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 thebid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of thebid price, or of that of any other bidder, or to secure any advantage against the public bodyawarding the contract of anyone interested in the proposed contract; that all statementscontained 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 divulgedinformation 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 agentthereof to effectuate a collusive or sham bid."

certify under penalty of perjury under the laws of the State of California that the foregoing istrue and correct.

~a~ Subscribed at:e .~o~ .

~daLos Ar -n„~u~nf~~ ~~~~~~il l~.i(! ~~J~ t.~'~'• __~~'~

rRr ~ E , za - (City) (County) (State)~-

NOTARY TO AFFIX SEALAND CERTIFICATE OFACKNOWLEDGMENT

on ~ 20 —~~(Da )

-~(Bidder' ~ ature)

Contractor License Class ~ ~~,~;~~

Contractor s License Number~~ c.-

'''

License Expiration Date ~}/r~ /~- f ~

-5-

' ~ ~ 1 1''' .`~

Sta~z of California

~ouniy oz ~ C ~ ~.

~ '< ° 6~n ~ — ~ ~- beior~ me, ~ - T"; ~_ ~ r~ - -(I3~;a inset mine and~::a „i the o~icer)

personally ap~eared~ -- ~' r~,̀ _`~~

who proved ~o me on the basis of saiisfac~ory evidencz ~o be ~.e ~aerson whose na~ne~"isla~subscribed to

the within insia-~ent and acknowledged to me that he/ % y e~ecuied the same in his/~ef/ ll authorized

ca~aciiy i~,~}, and iha~ by hist~Fl u si~atzu- on the u~s~uznent the person(~j; or the en~ity upon behalf ~z

which she person acted, executed the instru~ne~~.

I ceriii~ under 1 ENALTY d~~` FERTtTRY under the laws oz the S gate of California that the foregoing para~ aph

is ~.-ue and correct.

~l'T1`~I.~SS my hand and oi~.cial seal.

,r''' ~° frt ~ ~ _ (Iyo~ry Se~I)

SiEna~e oiNot~y ~'~,~c ~~ ~l

v

AD~I"I"I~~i~ OPlIOl~AL Il~QTI~l~t

DES CtZII'~l~ON OF 'TI-~ ~T I'ACI7~D DOCUMBN-'I'

(rifle ar description of a~3ched docusani)

(Title ar dascripa'on of auached docLueeni co~~anuea)

~Tn~ber of Pajes Document Dai.e

(Addifional sioima~on)

INS 1'~iUCTIONS FOR COMPLETING TI-~S FORM~~y aciczmv7ede~rzerzt conzp7eted in CaliJ"or~zicz must corztazn verbiage exactly as

appe~-s abrn~e ias the nofary sections or a s ~aruale ackrzo7s~ledgnzent fornz nsyst be

properly rompleted acid crttacl ed fo that docznneru_ The o~Iy zxcepiio~z is f a

doczarte,l is to be recordad ouiside of Cal~onzia. bs sziLh nastm:ces, mry alten~ire

4c~sotvZedgrrseast verbicrgz as nsay bs prfnted o~z such a documeizt so latsg as t1 e

verbiage does not recjuire tT e notary fo do sorneJ nsg ;hnt is iTZega1 for- a rsotary vz

Cat jortzia (z.z czrtjyzri~ the m~tlzoriae2' CLL~JL7LIf)7 O,f iFie szg~zer). Ptease check the

docan~zer t ccrrefzrlZy jot proper ~sotarinl ~rordiazg mzd attach skis jo~~nz ifregun•ed.

a 3ta~e ~d Cousiy iniarmzfion must be she S~f~ aid County where ue document

signers) personally appe2red beforz the rotzry public for acimowledement

a Date of no~u~zazion must be the dam fliat flze si9ner(s) personally appeared ̀~hich

rmust also Ue the sama date die ac?mowled~nenf is complied.

o The no~asy public nusi print his or leer name as it appev~ ~ui~i~ his or her

commission followed by a cozuna and then you title (no~}+public}.

o Print the names) of document signers) ~aho personally appezr at flee tune of

notarizarion.

• Indicate the c~~act singular or plw-al Toms by crossing oft incoarect forms (ie.

'~../she/~~ 3= is (~ ~ } or circling ~I~e cored iorns. Failure to corzcfly indicata this

in=orr~ztion ;nay lead io rejection of doc~enr rzcording.

s The no~ry seal impression ~usi be clear and phofographicalIy reproducible.

Lipsession must not cover teas or Imes. ~f se~i impression smudges, re-seal u z

sL~icieni area permit, otherwise conpleie a ditfere~f acl~owledgrmzni form.g• Sign~`ure of the noary public must match file signatura on file vJish she o,-fice of

she covniy clerk.Additional informa~on is not requirzd but could help to enswe ilus

acimowled~ment is not misused or zzached to a di~erant docunent

Indicafa iifle or Type of aizci~ed doc~men~ number of pages and dare.

o Indicate the capacity claimed by the suer. If ~e Claimed capacity is a

corporate ofricer, indicate the file {i.e. CEO, CFO, 5ecretzry).

SEcurzly attach this document to the signed document

Cr'~.PAC'I'I-Y CLA1l~D BY 1Z3E SIUfi~R

❑ I~divZdual (s)❑ Corpora~e Omcer

{1 ii18)

❑ Paruer(s)❑ Aitorney-in-Face❑ Trusiee(s} .❑ Oiher


WALNUT CREEK SPREADING BASIN PUMP STATION PROJECT (READVERTISE}

Request for Local SBE Preference Program Consideration andCBE Firm/Organization Information Form

INSTRUCTIONS: All Bidders responding to this solicitation shall complete this form for proper consideration of the Bid.

I. LOCAL SMALL BUSINESS ENTERPRISE PREFERENCE PROGRAM:

F 1 R M NAME: ~t_Li(r ~ t} t"y ,-~ S'~c ̀ C ~ ̀ ~, ~"} ~' .

AM NOT a local SBE certified by the County of Los Angeles Countywide Contract Compliance, InternalServices Department (formerly Office of Affirmative Action Compliance) as of the date of this Bidsubmission.

❑ I AM a Local SBE certified by the County of Los Angeles Countywide Contract Compliance; InternalServices Department (formerly Office of Affirmative Action Compliance} as of the date of this Bidsubmission, and request this bid be considered for the focal SBE Preference.

My County of Los Angeles Local SBE Certification Number:

II. F(RM/ORGANIZATION INFORMATION: The information requested below is for statistical purposes only. On final analysisan consi era ion o awar ,con rac or vendor will be selected without regard to gender, race, creed, or color.

Business Structure: ❑Sole Proprietorship ❑PartnershipCorporation ❑Non-Profit ❑FranchiseOther (Please Specify)

Total Number of Employees (Including owners): ~-

RacelEthnic Composition of Firm. Please distribute the above total number of individuals into the following categories:

Owners/Partners/Race/Ethnic Composition Associate Partners Managers All Others II

Male ' Female Male Female Male Female

BlacklAfrican American

Hispanic/Latino __

~ ~~-

Asian or Pacific Islander

American Indian/Alaskan Native

Filipino American

White _

f,,,,~

111. PERCENTAGE OF OWNERSHIP IN FIRM Please indicate by percentage {%) how ownership of the firm is distributed.

Black/African Hispanic/ Asian or Pacific American Indian/ FilipinoAmerican Latino Islander Alaskan Native American White

Men % % % % %o ~ ~~

Women~

°/a ~ % % % % %~

IV.ry i ttcrrtists: it your term is current~y certitied as a minority, women, disadvantaged or disabled vBusiness enterprise by a public agency, complete the following and attach a copy of your proof of ce(Use back of form, if necessary.)

■ . -.fi

Dis- DisabledAgency Name Minority Women advantaged Veteran Expiration Date

V. DECLARATION: I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OFCALIFORNIA THAT THE ABOVE INFORMATION IS TRUE AND ACCURATE.

Authorized Si ture a Y i Title: ~ ~ Date:i

Rev. 09!18102~~s

LIST OF SUBCONTRACTORS

Name of Bidder:PROJECT ID NO. FCC0001192 ---

~~? Iii r't~n r» ~~r'1WALNUT CREEK SPREADING BASIN

TISE)~i'~?~~tuG7~r'~, ~i~ .

In accordance with Division 2, Part 1, Chapter 4 of the Public Contract Code, the prime Contractorshall submit with its Bid a list of subcontractors who will perform work in excess of one-half of1 percent of the prime Contractor's total Bid.

Subcontractors listed must be properly licensed for the type of work they are to perform, and theirlicense numbers must be indicated below. Do not list alternate subcontractors for the same work.

Bidders are requested to voluntarily denote whether a listed subcontractor is a Small BusinessEnterprise by entering a "Y"for "yes" or "N"for "no" irr the designated column. Leaving the columnblank will not result in the Bid being considered non-responsive.

Name underwhich

Subcontractoris Licensed

LicenseNumberandClass

Sma!lBusiness

Enterprise.

Address of Office,Mill or Shop

Bid ItemNo(s}.

DollarValue

~~o ~Lfcial;c 37~0~` y$s, S~3E{~3656 ~

~3~i3~ ~ r'e ~'~ -~S~J'~j-Qe s j~lL:v sn6~a

33 S°~ ao~` _

r~1

PROJECT ID NO. FCC0001'192

.. .~~ ~ ..~

Tf~is form is intended to assist the Bidderin verifying its compliance with Subsection 2-3 of tl7eStandard Specifications for Public Works Construction and the Special Provisions.

(1) Total $amount of the Work to be performed by subcontractors:

(2) Specialty Items (to be performed by subcontractors):

Item No. 28 $ /=. S

Item No. 29 $ •~- ~ S

Item No. 31 $ ~- (—• S

Item No. 32 $ ~- T=~ S

Item No. 33 $ S ~,,, a-a ~. —

Subtotal $ ~, ~-a~. °—

(3) Net subcontracted amount(Line 1 -Line 2): $ T-- d —

(4) Contract Price (Grand Total from the Schedule ofPrices): $ I~~.r~, S'G G . --

(5) Contract Price less Specialty Items to be performed by subcontractors:(~ine4—Line 2) $ /T,~,~La_—

(6) Percentage to be self-performed:([Line 5 —Line 3]/Line 5 x 100) laD °/0

If Line 6 is less than 50%, the amount of work to beself-performed is not in confon~nance withSubsection 2-3 of the Standard Specifications forPublic Works Construction and the SpecialProvisions.

0'\Contract Documents\Bid Proposals\CurrentWon-Federal (11-20-14),doc

i

LOS ANGELES COUNTY DEPARTMENT OF PUBLIC WORKS

SCHEDULE OF PRICES Name of Bidder:

~,n U 1` rr~ 2-n ~'CPROJECT ID NO. FCC0001192 /

WALNUT CREEK SPREADING BASIN PUMP STATIONPROJECT (READVERTISE)

Item Description Unit Quantity Unit Price Amount

~ CONSTRUCTION SCHEDULE (BASELINE)LS 1 LS $1,000.00

(STIPULATED UNIT PRICE OF $1,000)

2 ,CONSTRUCTION SCHEDULE (UPDATE)MTH 2 $1,000.00

(STIPULATED UNIT PRICE OF $500/MTN)

3 CONSTRUCTION SCHEDULE (AS-BUILT)LS 1 LS $1,000.00

(STIPULATED UNIT PRICE OF $1,000)

4 IMPLEMENTATION OF BMPS LS 1 LS 7~f~8D. --

5 STREET SWEEPING HRS 320 PS'7~ - ~/~ J~~ ̀"

6 WATER TRUCKS (CITY OF IRWINDALE PERMIT} HRS 320 17 - 3 /~ aNO.

7 TIRE WASH EA ! 1 /g 760.- l ~, 760, -

8 SHORING OF OPEN EXCAVATIONS ~ LS 1 LS ~~~v . "

9 OFFICE FACILITIES ~' LS 1 LS ~~ r~'~1~, --

10 MOBILIZATION LS 1 LS '70~ ll~. —

11 CLEARING AND GRUBBING LS 1 LS i~~o29~.

12 'TREE REMOVAL (1-12" DIAMETER) EA 2 l~ n~~." a, ~~. "'

13 TREE REMOVAL (13-24" DIAMETER) T EA 2 ~~ boo,- ' 3~~•'

14 UNCLASSIFIED EXCAVATION CY 150 ~-S: ~' 3, ~S ~- "'~

" denotes Final Pay ItemNotes:

1. Please type or print legibly in spaces provided.2. Use black ribbon or black ink.3. Unit Prices shall be entered to 2 decimal places only.

-9-



~f7 V / YC~~n'7--~'. n 'i ~,PROJECT ID NO. FCC0001192

WALNUT CREEK SPREADING BASIN PUMP STATIONPROJECT IREADVERTISEI

CY

CY;- -CY

CY

CY

LB

LF

EA

EA

LB

EA

LF

EA

190 d2 f ̀ -- ~, 7 .~U .

7,120 p2~, '/?d ~j~l,~.

340 ~ S~, " ~~ )J̀ ~ d , "

60 '~)__

a~~o0 ~'"____

120 5'Sa. - G 6, rr~v , -

15,000 ~,rrnri ~S~ ~T7J?~, "

30 3a~. -' 9~ rrv-~ . --

~ (~~ ado ~ / ~~ ~o o ~ -

__

420 ~, ~ a, S~~d..-____

5_ __~,G~ _ ~,as~...-

30o ran_ - t s3, rr~ —

49,~~a._ 3~~oQ



PROJECT ID NO. FCC0001192 ~~ ~j ~~~ m~~

~'c~rS~-uC-~i cY), ~hC .WALNUT CREEK SPREADING BASIN PUMP STATIONPROJECT (READVERTISE)

31 'OPERATIONAL TEST

32 MISCELLANEOUS MECHANICAL WORK

33 'ELECTRICAL WORK

34 CITY PERMIT AND INSPECTION FEES(ALLOWANCE OF $10,000)

LS 1 LS

LS 1 LS

LS 1 LS

~~ ̀ ~ - .!

Lf// ~ U~.

GRAND TOTAL $ ~~~ — ~ S

`denotes Final Pay ItemNotes:


-11-

6~~ ~-r, -

AL 10,000 $1.00 $10,000.00

a~n=AIA ~ocumentA3~oTM —2010

Init.

:.:. ,~

CONTRACTOR:fR~arate, legal statzrs c~nd acicfress)

Environmental Construction, Inc.21550 Oxnard St., Ste. 1050Woodland Hills, CA 91367

OWNER:

11~~nt~re. legal status arrcl acic~i•ess}

LA County of Public Works900 S. Fremont Ave.,Alhambra, CA 91803

SURETY: -1tanze, legcrl.stnttks ~a~d principal dace

o}'ht~si~aessj

Vigilant Insurance Company15 Mountain View RoadWarren, NJ 07059

BOND AMdUNT: (10%) Ten percent of the attached bid amount

This document has important legal

consequences. Consultation with

an attorney is encouraged with

respect to its completion or

modification..

Any singular reference to

Contractor, Surety, Owner or

other party shall be considered

plural where applicable.

PROJECT:('1'ar~re, Ic~catior~ yr nciclr•ess, anr~ Project r~i~nzGer, if a~~yiWalnut Creek Spreading Grounds Basin Pump Station Project Number, i f any: N/A

The Contractor and Si~ret5r are bound to the Owner in the amount set forth ~ibove, fc~r d1e payment of ~v}uch theContractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly andseverally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractorwithin the time specified in the bid documents, or within such time period as may be agreed to by the Owner andContractor, and the Contractor either (1) enters into a contract with the t?wner in accordance with the teems of suchbid, a~ld gives such bond oi• bands as ma~F be specified in the biddill~ or Contract Docui~~enfis, tivith a surety admittedin Che jurisdiction of the Project and othen~~ise acceptable to the O~~~ner, for the faithful perfnrniance of such Contractaiad for the prompt payment of labor and material fiirnisl~ed in the prosecution d~ereoE; or (2) pays to the O~tirn~r thedifference, not to exceed the amount ol'this Bond, bet~~~een the amount specified in said bid and such lamer amountl~~r ~ahicli the Owner may in good Eai[h contract ~aid~ another party to perform die ~m•orlc covered by said bid, flier thisobligation sl}a11 be null and void, otherwise to remain in fiill force and effect. The Surety hereby u-aives any notice ofan agreement bet~~reen the Oil-uer and Contractor to extend flee ti~1~e in which floe O~-ner map accept the bid, Waiver o€notice by tl~e Surety shall not applti~ to any extznsion exceeding silty (60) days in the aggregate beyond the time foracceptance of bids specified in tl~e bid documents, and the O~~ner and Contractor shall obtain the Surety's consent foran extension beyond sixty (60} days.

if this Bond is issued iu eoi~nection ~~riCh a subcontractor's bid to a Contractor, tL~e term Contractor iu this Baud shallbe deemed to he Scibcontractor and the term Owner shall he deemed to be Contractor.

When this Bond has been Eiirnished to comply ~~vidl a statutory or other legal requirement in the location of rl~e Project,any provision in this Bind conflicting wide said statutory or legal requirement shall be deemed deleted herefi-om andprovisions coirfonnin; to sue:h statutory or other legal requirement shall be deemed i~~corporated herein. When s~furnished, the i3~tei~t is that this Bond shall be construed as a statutory bond and nat~ as a common la~v bond.

"~ned an e~ fed t~iis 27t~`t day of April, 2016

Environmental Construction, Inc.- -- - - -

_ ~~.- _~ (Pr etrci ~ ~,. (Seal)ttn ~ ss

—~ ~~ ~.~~ —.r~- - -

Vigi I urance Company

~•~, ' ~ uret) _

(Berl)(if'' arV~ ardson

(Ti~(el St phanie H ,Attorney-in-Fact

AIA Document A310'TM — 2010. Copyright O 1983, 1970 and 2010 by The American Institute of Arohit~e~ts:-FTPI rights reserved. 1fYARY~fIh3G: 3his F~3A~O~~i~ment is ~rotert~d by U.S. ~;o{~yri~hF t.av~ and 3rternatEonaE Treaties, Urai3ihar zeci repreducEfen or distr k~iftinn of this AlA ̀ ~foci3mer,,, orarty Martian of iY, Enay 3aGc~It i;3 s~vare civil and rr:minal ~enalfias. arc€ ~riEl be ~€osecs:fad 4a ?!3e anaxis'~Ktn 2x.?enE pecsi~€e sntier tl~s lope, Thisdocument was created on 01127/2012 0723:12 under the terms of AIA documents-on-Demand T"' order no 2008397483 ,and is not forresale. This document is licensed by The American Institute of Architects for one-time use oNy, and may rat be reproduced nrinr to its romoletion. c~,,,n

State of California

County oi~ d,,

m

—' (I3~ra inseR na~n ~ d rle of the officer)

personally appeared 3~,~ -~m ~~ '~

who proved ~o ~e ou the basis of satisfac~ory evidence ~o be ~e person whose na~ne,,~ ism subscribed to

~e within ins~ument and acknowledged to one that h% /~x~y executed the same in his/ It, authorised

ca~aciy(i 'j, and t~ia~ by lus/ /fir siD a~.u-e,(~ on the ins~umellt the verso ; or the enfity upon behalf oz

which she person aced, executed the instrumen~.

I certi~ under 1 EN.ALT~ ~F FERJTI-RY under the laws of the S ~a~e of Calizalnia that the foregoing para~-aph

is tr~ze and correct.

1~IT1~SS my Band and aiizcial seal.

t ;' ,

5idz~~ ofNo(Hoary Seal) ,

AlC nmis ~n :. 2G" ' ~4Notary F'ubfic - Cali~ornia

Las Anr-gin- Gaur``'~mrn. ~..~r~~ cF,, 73 , .i7

AI~I~3I'TIC)1_erTA.L~ ~P1IOl~AL Il~UlI~I°~T

DESCRIl'I'ION QF 'TIC ~TTACI~D DOCITMEN-'T

(iifle or d~scripaon of a~ached document)

(Ti~Ie ar descri~5on of ~~zched document continuzd)

N~ber of Pajes Documen~ Daie

(Addiional insor*na~on}

CAPACI'T"Y GLAD BY THi ~IG1~R❑ IIlC~tY~It~Z13I ~S~

❑ Corpara~e Officer

(Tile)

❑ Pzr~er(s)❑ Aitomey-in-Foci❑ TTCISiBZ~S~ .

❑ Other

LNSTRUCTIOh~S FOR COMPLETLr:G TFIIS FO1~Mpity ackiimvZedgrzent conp7eted itz Califonucz trztst cw~tairz i~erbiaaa exactly asappears above iax the ~2otmy secrio~z or a separa~e acT~ao~nledo zent fornz mast bzpropeJ•Zy conzpleted msd at~a~T.~d to tFiat doczmee~zt TFie ofzly zxc~?io7z is f a

docz~ne,1 is to be record d ozrtside of Calfonzia. In .szrrh insfmzces, crry alt~~?afireackr:ovrled~Qnzet~t rerbuage as nzay be printed oaz such a docunzeizt so long as t7 e

rzrbiage does not rec~zrire tT e taotmy to d..o so7net7 Azo tfiat is illegal fora 7so%ary z7zCalifonzia (i.e. cerz`ijyrng the czuilzori~ed_ capa~itJ+ of zFie sio~2etJ. Ptease check. thedoczn~zerztcar•efzrZyjorgroper;zotm-inI~t~o7•dnz,~mzdat~crchthisforrs jrequired

• State end Co~~ iniomafion Host be iha S~t-~ ~d Co~mty where the documentsi,~;e,(s) personally appeared befora the notary public for aci~owledg~en~

a Da;e ofno~ization must be she date ~lia4 flze signers) p~rsonaIly appe~ad ~alvchmust also be the s~,-na da~a the zclfliowledgapnt is complytad.

* The no~ry pubIio musi print his or her n2ma as it appevs within his or hercommission followed by a coma and teen you ~tle (noisy public).

• PriLt the nrse(s) of document signers) Zaho pe,~onally appear at the tnve ofnotzr2arion.

o Tndicat~ tUe co~~ect singular or phial ior_ms by crossing on incorect ioms (ie.

~..Ishe/=~~ is /~) o: circling tI~e corrzct forms. Failue io corracfly indica~z ~izis

information mzy lead io rejzcrion of docuu~ent racort~ing.

The ~o'~ary seal impression oust be clear and phoio~zpfucally reproducible.rL~pressioa must not cover iza~ or lines. Lr seat is~pression smudgas, re-seal u a

si*fficient area peru-~i~, otherwise conpleie a different acknowledgmzn~ form.

0 Signature ofihe not2ry pvbiic ra~.~st match flee signzture on fi1z with the ofrice of

ihz county clerk.< Additional informa~on is no# required but could help io ensure this

aclmowledgnent is not misused or ached to a dirierant documento Indicata tifle or Type of aLLaeLed document, number ofpag~s and daia.

e Indicazz the capacity cIaizied by the suer. If tha elair,~~d capacity is a

corporate office ,indicate flee title (i.e. CEQ, CFO, 5ecret2ry).

a 5ecw-eIy aitach This document to the signed document

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE 1189

A notary public or other officer completing this cert~cate verifies only the identity of the individual wlio signed thedocument to which this certificate is attached and not the trutlifiihiess, accuracy, or validity of that document.

State of California )

Caunt~~ of Orange )

On ~- ~, before me, Barbara Copeland Natary Public,

personally appeared Stephanie HoangNames} of Signers)

who proved to me on the basis of satisfactory evidence to be the personO whose names) is/~~e subscribed to the

within instnuneiit and aclaiowledged to nie that he/she/t~~y executed the same in liis~lier/t~ir authorized

capacity(ies), and that by h~isfherlth~ir signature(sj on the instrument the persot~(s~, or the entity upon behalf ofwhich the person(s~ acted, executed the iilstnimeilt.

I certify tuider PENALTY OF PERJURY under thelaws of the State of California that the foregoingparagraph is true aid correct.

Place Notary Seal Above

WITNESS my hand and official seal.

~`r'Signariire~ '~r,.~-. ~ ~..~ t ~.

Signahire of''~:otai ~:l'ublic

------------------------------------------------------------ OPTIONAL ---------------------------------------------------Though the information below is not required b_y lace, it may prove valuable to persons relying on the document

and could present fraudulent quid reattachment of this form to another document.

Description of Attached Document

Type or Title of Document:

Doclunent Date:

Signers) Ot11er Than Named Above:

Capacity(ies) Claimed by Signer{s)

Signer's Name: Stephanie Hoang

❑ Individual

❑ Corporate Officer — Title(s):

❑ Partner: ❑Limited ❑General~ Attonley in Fact

❑ Tnistee

❑ Guardian or Conservator

❑ Other:

Siglier Is Representing:

Number of Pages:

Capacity(ies) Claimed by Signers)

Signer's Name:

❑ Individual

❑ Corporate Officer — Tit1e(s):

❑ Partner: ❑Limited ❑General❑ Attoniev in Fact

❑ Trustee

❑ Guardian or Conservator

❑ Other:

Signer Is Representing:

Rev. 1-15

~1 Chubb POWER Federal Insurance Company Attn: Surety DepartmentOF Vigilant Insurance Company 15 Mountain View Road

a„J Surety ATTORNEY pacific Indemnity Company Warren, NJ 07059p~IM

Know All by Theae Presenb, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCECOMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute andappoint Shawn Blume, Kevin Cathcart, Eric Lowey, Stephanie Hoang and Mark Richardson of Costa Mesa, California— -----

each as their true and lawful Agomey- fn- Fact to execute under such designa~on in their names and to alFuc their corporate seals to and deliver for and on their behalf as suretythereon w otherwise, bonds and undertakings and other wrifings obligatory in the nature thereof (other than ball bonds) given or executed in the course of business, and anyinstruments amending a aNeriny the same, and consents to the modification or alteration of arty instrument referred to in said bonds or obligations.In WlNess Whereof, said FEDERAL INSURANCE COMPA~Y, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attestedthese presents and aifaced their corporate seals on this 29 day or April, 2015.

Cpl\ l J 7l MJ ' ~'~ / /)il`l/1 i~.~i// ~ ~Dawn M. Chloros, Assistant Secretary

~M';~ • r ,~~,e~F

STATE QF NEW JERSEYss.

Courrty of Somerset

On this 29~ say or April, 20 5 before me, a Notary Public of New Jersey, personalty came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERALINSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the campanles which executed the foregoing Power of Attorney, and thesaid Dawn M. Chloros, being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCECOMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the eeab affixed to the foregoing Power of Attorney are such corporate sealsand were thereto aftfxed by authority o/the By- Laws of said Companies; and that she signed said Power olAttomey as Assistant Secretary of said Companies by like auUwrity;and that she is acquainted wiM David B. Norris, Jc, and knows him to be Vice President of said Companies; and that the signature of David B. NoMs, Jr., subscribed to saWPower of Attorney is In the genuine handwritlng of David B. Nortis, Jr., and was thereto subscribed by authority of said By- Laws and in deponent's presence.

Notarial Seal

,~ ~aT,~~, ~ KATHERINE J. ADELAAR /~,~~ NOTARY PiJBLIC OF NEW JERSEY dG~

PUBl1 No. 2316685Commiaslon E~fres July t8.2019 Notary Public

~~~g CERTIFICATIONExtract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY:

"All poweB of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company, either by the Chairman or thePresident or a ~ce President or an Assrstent Vice President, jointly wHh the Secretary or an Assistant Secretary, under their respecdve designations. Thesignature of such ofRcen may be engraved, printed or litlwpraphed. The sipnaWre W each of the following officers: Chairman, President, arty vce President, anyAssistant Vice President, any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile m arty power of attorney or to anycertificate relating thereto appointing Assistant Secretaries or Attorneys- in- Fact for purposes only of executing and altes6np bonds and undertakings and otherwritir►gs obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimUe signature or facsimile seal shall be valid and bindingupcm the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Compamwith respect to arty bond or undertaking to which h is attached.'

I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies'do hereby certify that

(i) the foregoing extract of the By- Laws of the Companies is Vue and correct,(ii) the Companies are duty 8cenaed and authorized to transact surety business in all 50 of the United States of America and the DistriG of Columbia and are

authorized by the U.S. Treasury Deparimerrt; further, Federal end ~l~gilant are licensed in the U.S. Vrgin Islands, and Federal Is Ilcensed in, Guam, PuertoRico, and each of the Provinces of Canada except Prince Edwarcl Island; and

(HI) the foregoing Power of Attorney is true, eortect and in full force and eRect

Given under my hand and seals of said Companies at Warren, N~ mss April 27, 2 16

.~;_.: ~,

'~!!"'►,,s~.z

Dawn M. Chloros, Assistant Secre ry

IN THE EVENT YOU WISH TO NOTIFY US OF A CUUM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER PLEASE CONTACT US AT ADDRESS

Form 15-10- 02258- U GEN CONSENT (rev. 12-14)


___Los Angeles CountyDepartment of Public WorksFCCoo01236 -Hacienda Channel -Camino Channel:Low-flow Channel and Invert Access Ramp, PD Bid Date:T1203: Draina4e Extension 5i3iznl~

Packages Sold Contractor Information BidReceived

First box contains number Company Name, Mailing Address, (Date)of packages sold to City, State, Zip Code, (Time)contractor Telephone Number and Contact (Bid Amount)Date :4/6/2016 9:36:19 Name : ABNY General EngineeringAM Address: 200 n minnesota ave, #4Amt Sold: $0.00 (1) Glendora, CALIFORNIA 91741Receipt #:Pick up:

TEL: 6265862020

Mailed: ~~ FAX:

Downloaded: ~ ATTN: Sam [email protected]

Date :4/20/2016 Name : Access Pacific Inc. ~°~ ~1:53:09 PM Address: 755 E. Washington Blvd.

~~

Amt Sold: $0.00 (1)Receipt

Pasadena , CA 91104 ' t#:

Pick up: ~"TEL: (626)792-0616

- , e ~

Mailed: FAX: (626)792-0896

Downloaded• l~'' ATTN: Tomas [email protected]

Date :4/25/2016 Name : Bali Construction, Inc.2:12:18 PM Address: 9852 East Joe Vargas WayAmt Sold: $15.00 (1) South EI Monte, CA 91733-1742Receipt #: F570744Pick up: ~+~'

TEL: (626) 442-8003

Mailed: 9~'" FAX: (626) 442-8315

Downloaded: ATTN:

Date :4/28/2016 Name : Beador Construction Company, Inc.1:35:14 PM Address: 26320 Lester CircleAmt Sold: $0.00 (1) Corona, CA 92883Receipt #:Pick up: l-

TEL: 951-674-7352

Mailed: ~ FAX: 951-674-7495

Downloaded: ATTN: David [email protected]

Date :4/1/2016 Name : Clarke contracting core.10:46:06 AM Address: 4646 MANHATTAN BEACH BLVD.Amt Sold: $0.00 (1) LAWNDALE, CA 90260Receipt #:Pick up: 1-

TEL: 310-542-7724

Mailed: J~`` FAX: 310-542-2188

Downloaded: ~' ATTN: BOB [email protected]

http://apps.Intranet/PRJMGT/P1anHolders/CashierPlanHolderReport.aspx?proj ect_id=FCCO... 5/2/2016


FC000o~236 -Hacienda Channel -Camino Channel:Low-flow Channel and Invert Access Ramp, PD Bid Date:T1203: Drainage Extension 5/3/2016


First box contains number Company Name, Mailing Address, (Date)of packages sold to City, State, Zip Code, (Time)contractor Telephone Number and Contact (Bid Amount)Date :4/1/2016 Name : Clarke Contracting Corporation10:57:56 AM Address: 4646 Manhattan Beach Blvd.Amt Sold: $0.00 (1) Lawndale, California 90260Receipt #:Pick up: 1`~

TEL: 3105427724

Mailed: FAX: 3105422188

Downloaded: ATTN: Brian [email protected]

Date :3/31/2016 Name : Construction Bid Source12:01:07 AM Address: 6265 Hwy 9Amt Sold: $0.00 (1) Felton, CA 95018Receipt #:Pick up: ~~

TEL: (888) 786-9450

Mailed: FAX: 800-560-7266

Downloaded• ~ ATTN: Martha [email protected]

Date :3/31/2016 Name : Construction Bidboard, Inc.6:29:51 AM Address: 11622 EI Camino Real, Suite 100Amt Sold: $0.00 (1) San Diego, CA 92130Receipt #:Pick up: 1~``

TEL: 8004795314

Mailed: 1-! FAX: 6196880585

Downloaded: ATTN: Kristi [email protected]

Date :4/6/2016 Name : CPO Enterprises Inc11:37:38 AM Address: 846 N Charter DriveAmt Sold: $0.00 (1) Covina, CA 91724Receipt #:Pick up: 1-

TEL: 626-967-4300

Mailed• ~ FAX: 626-967-4303

Downloaded: ~' ATTN: Christine [email protected]

Date :3/31/2016 Name : Palp, Inc. DBA Excel Paving Company8:40:14 AM Address: 2230 Lemon AvenueAmt Sold: $15.00 (1) Long Beach, CA 90806-5195Receipt #: F570161Pick up: ~

TEL: (562) 599-5841

Mailed: FedEx FAX: (562) 591-7485

Downloaded: ATTN:

Date :4/13/2016 Name : GRFCO, INC.10:26:58 AM Address: PO BOX 1747Amt Sold: $0.00 (1) Brea, CA 92822Receipt #:Pick up: 1~'

TEL: 951-657-8887

Mailed: 1~~ FAX: 951-657-0777

Downloaded: ~ ATTN: Jim [email protected]

http://apps.Intranet/PRJMGT/PlanHolders/CashierPlanHolderReport.aspx?prof ect_id=FCCO... 5/2/2016


FCCo001236 -Hacienda Channel -Camino Channel:Low-flow Channel and Invert Access Ramp, PD Bid gate:T1203: Drainage Extension 5/3/2016


First box contains number Company Name, Mailing Address, (Date)of packages sold to City, State, Zip Code, (Time)contractor Telephone Number and Contact (Bid Amount)Date :4/18/2016 Name : Horizons Construction Co. Int'I, Inc.11:37:03 AM Address: 432 W. Meats Ave.Amt Sold: $0.00 (1) Orange, CA 92865Receipt #:Pick up: ~

TEL: 714-626-0000

Mailed: I~ FAX: 714-626-0006

Downloaded: ~~' ATTN: Kinan [email protected]

Date :4/12/2016 Name : Houalla Enterprises Ltd. DBA Metro Builders &4:27:33 PM Engineers Group, Ltd.Amt Sold: $0.00 (1) Address: 2610 Avon St.Receipt #:Pick up: 1~~`

Newport Beach, CA 92663

Mailed:TEL: 9495154350

Downloaded: ~` FAX: 9495154351ATTN: Shelly Irvine

[email protected] :4/4/2016 9:59:16 Name : Jeremy Harris Construction, Inc.AM Address: 19466 burin AvenueAmt Sold: $0.00 (1) Riverside, CA 92508Receipt #:Pick up: !-

TEL: 951-215-0771

Mailed: FAX: 951-789-0089

Downloaded: ATTN: Jeremy [email protected]

Date :4/13/2016 Name : ]oha Construction2:21:43 PM Address: 19934 Rhona PlaceAmt Sold: $15.00 (1) Santa Clarita, CA 91350Receipt #: F570470Pick up:

TEL: (661)263-1739

Mailed: 1`~`` FAX: (661) 263-8057

Downloaded: ~ ATTN:[email protected]

Date :4/11/2016 Name : John S. Meek Company Inc.2:25:43 PM Address: 14732 S. Maple Ave.Amt Sold: $0.00 (1) Gardena, CA 90248Receipt #:Pick up: C`

TEL: 310-830-6323

Mailed: 1- FAX: 310-835-2163

Downloaded: ~ ATTN: Jeremiah [email protected]

http://apps.Intranet/PRJMGT/P1anHolders/CashierPlanHolderReport.aspx?prof ect_id=FCCO... 5/2/2016

Plan Holders

FCCoo0~236 -Hacienda Channel -Camino Channel:Low-flow Channel and Invert Access Ramp, PDT1203: Drainage Extension

Page 4 of 6

Bid Date:5i3iznl~


First box contains number Company Name, Mailing Address, (Date)of packages sold to City, State, Zip Code, (Time)contractor Telephone Number and Contact (Bid Amount)Date :4/1/2016 3:50:34 Name : Kaveh Engineering &Construction, Inc. >, ~$PM Address: 22600 Savi Ranch Pkwy Suite A17

~ ~ ~

Amt Sold: $0.00 (1) Yorba Linda, CA 92887T~1P ck u t ~

p~TEL: 714-793-6655 ~ ~

Mailed: FAX: 714-637-7520

Downloaded: ~ ATTN: Fred Bashardoost [email protected]

Date :3/31/2016 Name : KEC Engineering ""~ '"~ ~~ ~~~r ~~9:28:57 AM Address: 200 N. Sherman Avenue

Amt Soid: $0.00 (1) Corona, CA 92882Receipt #:Pick up: ~'~`

TEL: 951-734-3010 ~° ~'-~? ~~ .~Mailed• ~ FAX: 951-7347987 f

Downloaded: ~ ATTN: [email protected]

Date :4/28/2016 Name : The Adjul Corporation DBA Lee Construction7:20:47 AM CompanyAmt Sold: $19.00 (1) Address: 4288 Adam RoadReceipt #: F570824 Simi Valley, CR 93063Pick up: 1`~`Mailed: UPS

TEL: (805) 522-5195

Downloaded: 1'i FAX: (805) 522-5495ATTN:

Date :4/8/2016 2:34:02

PMName : LNA CONCRETE STRUCTURES INC. / ~ fr ,B

~ ~ ~ ~~Address: 15455 TERN STREETAmt Sold: $0.00 (1) CHINO HILLS, CA 91709Receipt #:

.~

TEL: 9093931493 - _ ''~~

Ma led FAX: 9093939363 ~ ~

Downloaded• 1~' ATTN: Lolo [email protected]

Date :4/13/2016 Name : LOS ANGELES ENGINEERING, INC.8:08:51 AM Address: 633 N BARRANCA AVENUEAmt Sold: $0.00 (1) COVINA, CA 91723Receipt #:Pick up: 1-

TEL: 626-454-5222

Mailed: FAX: 626-454-5226

Downloaded: ~ ATTN: JESSICA [email protected]

Date :3/30/2016 Name : Mike Bubalo Construction Co., Inc.12:17:33 PM Address: 5102 Gayhurst Avenue ~{ ! `~rAmt Sold: $0.00 (1) Baldwin Park, CA 91706Receipt #:Pick up: ~

TEL: 626-960-7787 ~ ~ "'~ }~ `~Mailed: ~` FAX: 626-960-7897 '~~

Downloaded: ~' ATTN: Anton [email protected]

'~e,

http://apps.Intranet/PRJMGT/P1anHolders/CashierPlanHolderReport. aspx?prof ect_id=FCC 0... 5/2/2016

Plan Holders

FCCOo01236 -Hacienda Channel -Camino Channel:Low-flow Channel and Invert Access Ramp, PDT1203: Drainage Extension

Page 5 of 6

Bid Date:5/3/2016

Packages Sold Contractor Information gadReceived

First box contains number Company Name, Mailing Address, (Date)of packages sold to City, State, Zip Code, (Time)contractor Telephone Number and Contact (Bid Amount)Date :4/13/2016 Name : MIKE PRLICH &SONS INC.9:23:13 AM Address: 5103 ELTON STREETAmt Sold: $15.00 (1) BALDWIN PARK, CA 91706Receipt #: F570449Pick up:

TEL• 626-813-1700

Mailed: FAX: 626-813-1770

Downloaded: ~ ATTN:

Date :4/22/2016 Name : Pyramid Building &Engineering, Inc.8:41:22 AM Address: 10975 G. Ave.Amt Sold: $0.00 (1) Hesperia, Ca 92345Receipt #:Pick up: l~~

TEL: 760 949-9005

Mailed: FAX: 760 949-9855

Downloaded ~ ATTN: Devin [email protected]

Date :4/2/2016 2:09:38 Name : Rio JordanConstruction, Inc fPM Address: 7432 Lemoran Avenue ~ ~Amt Sold: $0.00 (1)Receipt #:

Pico Rivera, CA 90660TEL: 5629420228 ~"~~~ l

Pick up: ~~`Mailed: 1- FAX: 8883080936

Downloaded• ~" ATTN: Jordan [email protected]

Date :4/13/2016 Name : Ted W. Page Enterprises DBA Concrete11:18:58 AM Coring CompanyAmt Sold: $0.00 (1) Address: 14005 Orange AvenueReceipt #:Pick up: 1~`

Paramount, CA 90723

Mailed:TEL: 562 634-4021

Downloaded: 1~► FAX: 562 634-2305ATTN: David Richens

[email protected]

Date :4/21/2016 Name : TORO ENTERPRISES, INC12:34:35 PM Address: 2101 E. Ventura BlvdAmt Sold: $0.00 (1) Oxnard, California 93036Receipt #:Pick up:

TEL: 8054834515

Mailed: 1r FAX: 8054832001

Downloaded: ~ ATTN: MATT [email protected]

Date :4/5/2016 9:09:16 Name : Torres Construction Corp.AM Address: 7330 North Figueroa StreetAmt Sold: $0.00 (1) Los Angeles, California 90041Receipt #:Pick up: l~

TEL: 323-257-7460

Mailed: FAX: 323-257-8044

Downloaded: ~ ATTN: Max [email protected]

http://apps.Intranet/PRJMGT/P1anHolders/CashierPlanHolderReport.aspx?proj ect_id=FCCO... 5/2/2016

Plan Holders

F00000~236 -Hacienda Channel -Camino Channel:Low-flow Channel and Invert Access Ramp, PDT1203: Drainage Extension

Page 6 of 6

Bid Date:5/3/2016

Packages Sold Contractor Information gadReceived

First box contains number Company Name, Mailing Address, (Date)of packages sold to City, State, Zip Code, (Time)contractor Telephone Number and Contact (Bid Amount)Date :4/5/2016 Name : Torres Construction Corporation11:27:57 AM Address: 7330 North Figueroa StreetAmt Sold: $15.00 (1) Los Angeles, CA 90041Receipt #: F570229Pick up:

TEL: (323)257-7460

Mailed: FAX: (323) 257-8044

Downloaded: ATTN:

Date :5/2/2016 9:23:40 Name : Vido Samarzich IncAM Address: 4972 Crestview PlaceAmt Sold: $0.00 (1) Alta Loma, Ca 91701Receipt #:Pick up:

TEL: 9099876377

Mailed: FAX: 9099878988

Downloaded ATTN: Vido [email protected]

Date :4/29/2016 Name : West Coast Structures Inc DBA Western9:01:24 AM StructuresAmt Sold: $0.00 (1) Address: 6005 Tyler StreetReceipt #:Pick up: ~~

Corona, CA 92503

Mailed: 1-`TEL: 9513524300

Downloaded: ~' FAX: 9095099390ATTN: Brian Skajem

haydeews4300@sbcglobal. netDate :4/3/2016 Name : West Pacific Concrete12:24:53 PM Address: 6453 Fairfield StreetAmt Sold: $0.00 (1) LOS ANGELES, CA 90022Receipt #:Pick up:

TEL: 323-674-6170

Mailed: I~~ FAX: 323-410-0490

Downloaded: ATTN: Anthony [email protected]

.~

jff v jf (j,,y~' JJ_. ~ tom+ 9 ~ ~B ~~P t ~ ~~~ ~ ~.~ ~9 ~"'"

~t4

I hereby certify that the atsave are atl and the only Bidsreceived prime to the deacilic~ for submitting of I3id~ for tfiisP~J~~

Gait Fac~Cr, Dt .IAS A r !eS ~OUnty ~ -:: c Of ~4.tb1iC-~.1~- ~' ,,s~ f o

ttuthorirec~Repre~~~t~; ~J̀ °~--

~~~ ~ ~~

http:l/apps.Intranet/PRJMGT/P1anHolders/CashierPlanHolderReport.aspx?proj ect_id=FCCO... 5/2/2016

COUNTY OF LOS ANGELESDEPARTMENT OF PUBLIC WORKS

~ •-~-~

~C'~~~


HACIENDA CHANNEL- CAMINO CHANNELLOW FLOW CHANNEL AND INVERT ACCESS RAMP

9 ~

PD T1203 DRAINAGE EXTENSION

Table of Contents: Page

Proposal to the Board of Supervisors .......................................1Bidder Information Sheet ..........................................................2-3Acknowledgment of Addenda Received ...................................4Noncollusion Affidavit ................................................................5Request for Local SBE Preference Program Considerationand CBE Firm/Organization Information Form .......................6

List of Subcontractors ...............................................................7Schedule of Prices ....................................................................8-10

All Bid Proposal forms listed above shall be completely filled out and submitted withthe Bid. Failure to do so may result in rejection of the Bid.

Los Angeles County Department of Public WorksCashier's Office, Mezzanine Level900 South Fremont AvenueAlhambra, California 91803

Non-Federal (11-20-14)

-1-

PROJECT ID NO. FCC0001236HACIENDA CHANNEL- CAMINO CHANNEL

LOW FLOW CHANNEL AND INVERT ACCESS RAMPPD T1203 DRAINAGE EXTENSION

To the Board of Supervisors of theCounty of Los Angeles:

The Undersigned hereby declares:

(a) That the only persons or parties interested in this Proposal as principals are thoseidentified on the Bidder Information Sheet.

(b) That he laas carefully examined the Project site and has familiarized himself with allof the physical and climatic conditions, and makes this Proposal solely upon his ownknowledge.

(c) That he has carefully examined the Plans, Specifications, Bid Proposal, NoticeInviting Bids, and all other information furnished by the Agency and makes this Proposalaccordingly.

(d) That, in the event this Contract is awarded to him, he will enter into a Contract withthe /Board of Supervisors of the County of Los Angeles to perform the Work in accordancewith the Plans and the terms of the Specifications, and will furnish or provide all materials,labor, tools, equipment, apparatus, and other means necessary so to do, except as mayotherwise be furnished or provided under the terms of said Specifications, for the pricesstated in the Schedule of Prices.

(e) That he has included with the Proposal a certified or cashier's check,. or a suretybond, payable to the County of Los Angeles in an amount of $ ~,. ,~' ~; ~ ,equivalent to at least 10 percent of the total aggregate Bid price shown on the Schedule ofPrices. Furthermore, he agrees that, should he fail to properly execute and return theContract Agreement, together with the required bonds, within ten business days after it hasbeen delivered or mailed to him or his authorized agent, the Agency will be damaged bythe delay in an amount that is impossible to definitely ascertain and which is thereforeestablished to be not less than that of the aforementioned check or bond and that in suchevent the amount of said check or bond shall become the property of the Agency and maybe collected thereby, but that otherwise it shall be returned in accordance with theprovisions of the Instructions to Bidders.

Kaveh Engineering &Construction, Inc

22600 Savi Ranch Pkwy. Suite A17 Yorba Linda, CA 92887

Farhad Bashardoost

Bidder's Name B~ict~r's Signature

-1-



t 1 •' ~ •

All information shall be typed or printed legibly.

PART A -Complete the appropriate portion below:

1. Bidder is a SOLE PROPRIETORSHIP:

Name of Individual(First Name, Middle Initial, Last Name)

Doing Business as O

Exact legal businessname of Corporation Kaveh Engineering &Construction, Inc

Dotng Business as Kaveh Engineering &Construction, Inc

Name of President Farhad Bashardoost

Name of Vice President Farhad Bashardoost

Name of Secretary Farhad Bashardoost

Name of Assistant Secretary Farhad Bashardoost

Name of Treasurer

Name of Responsible Managing Officer

3. Bidder is a LIMITED PARTNERSHIP:

Exact legal businessname of Limited Partnership

Names of persons or parties composing the Limited Partnership (Indicate whetheran individual or corporation):

'~



~~ ~ •~ ~ • ~

4. Bidder is a GENERAL PARTNERSHIP:

Exact legal businessname of General Partnership

Names of persons or parties composing the General Partnership (Indicate whether anindividual or corporation):

5. Bidder is a JOINT VENTURE:

Exact legal businessname of Joint Venture

Names of persons or parties composing the Joint Venture (Indicate whether an individualor corporation):

PART B -Complete the following:

Street Address:

22600 Savi Ranch Pkwy. Suite A17

Yorba Linda, CA 92887

County Vendor ID No. 15496401

Telephone No. 714-793-6655

Fax No. X14-926-8646

Mailing Address:

22600 Savi Ranch Pkwy. Suite A17

Yorba Linda, CA 92887

California Contractor'sLicense No. 769962

License Expiration Date 10-31-2016

License Class A,B

-3-



The Bidder shall acknowledge the receipt of addenda by placing an "x" by each addendumreceived.

Addendum No. 1 X

0

Addendum No. 2 X

Addendum No. 3

Addendum No. 4n

Addendum No. 5

Addendum No. 6

Addendum No. 7

~..-

If an addendum or addenda have been issued by the Agency and not noted above as beingreceived by the Bidder, the Bid Proposal may be rejected.

C~



"NONCOLLUSION AFFIDAVIT TO BE EXECUTEDBY BIDDER AND SUBMITTED WITH BID

State of CaliforniaSS.

County of Los Angeles

Farhad Bashardoost ,being first duly sworn, deposes and says that he or she isPresident Of Kaveh Engineering &Construction, Inc

the party making the foregoing bid that the bid is not made in the interest of, or on behalf of,any undisclosed person, partnership, company, association, organization, or corporation; thatthe bid is genuine and not collusive or sham; that the bidder has not directly or indirectlyinduced or solicited any other bidder to put in a false or sham bid, and has not directly orindirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in asham 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 thebid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of thebid price, or of that of any other bidder, or to secure any advantage against the public bodyawarding the contract of anyone interested in the proposed contract; that all statementscontained 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 divulgedinformation 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 agentthereof to effectuate a collusive or sham bid."

certify under penalty of perjury under the laws of the State of California that the foregoing istrue and correct.

Subscribed at:

Yorba Linda, Orange CA(City) (County) (State)

on 2p 16NOTARY TO AFFIX SEAL ~ (DateAND CERTIFICATE OFACKNOWLEDGMENT

id sig ature)

Contractor License Class A~B

Contractor's License Number 769962

License Expiration Date 10-31-2016

-5-

CALIFORNIA JURAT WITH AFPIANT STATEMENT GOVERNMENT CODE § 8202

.See Attached Document (Notary to cross out lines 1-6 below)❑ See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary)

Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any)

A notary public or other officer completing this certificate verifies only the identity of the individual who signed thedocument to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

State of Calif~.,rnia

County of ,~` " -? rE

T~~-_ - a a ...~-: coR~ ~~vi~vsoN

Commission # 2022763 Z

a - Notary Pubisc -California z~

z ' ` - ~ ~~ Orange County

My Gomm. Expires May 29, 2Q17

SealPlace Notary Sea! Above

Subscribed and sworn to (or affirmed) before me

on this day of i'~ ~ , 20 ,by Date Month Year

(and (2) ),Names) of Signers)

proved to me on the basis of satisfactory evidenceto be the pe son(s) who appeared before me.

Signature Y' ~ 'v _t~---'1

Signature of Notary Public ~

OPTIONALThough this section is optional, completing this information can deter alteration of the document or

fraudulent reattachment of this form to an unintended document.Description of Attached Document

Title or Type of Document:

Number of Pages: Signers) Other Than Named Above:

Document Date:

..., < _ z ~:~,02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5910



Request for Local SBE Preference Program Consideration andCBE Firm/Organization Information Form

-- - ----i ers respon ing o is so ici a ion s a comp e e is orm or proper consi era ion o e i .

I. LOCAL SMALL BUSINESS ENTERPRISE PREFERENCE PROGRAM:

FIRM NAME: Kaveh Engineering &Construction, Inc

~ I AM NOT a Local SBE certified by the County of Los Angeles Countywide Contract Compliance, InternalServices Department (formerly Office of Affirmative Action Compliance) as of the date of this Bidsubmission.

❑ I AM a Local SBE certified by the County of Los Angeles Countywide Contract Compliance, InternalServices Department (formerly Office of Affirmative Action Compliance) as of the date of this Bidsubmission, and request this bid be considered for the Local SBE Preference.

My County of Los Angeles Local SBE Certification Number:

II. FIRM/ORGANIZATION INFORMATION: The information requested below is for statistical purposes only. On final analysisan consi era ion o away ,con rac or vendor will be selected without regard to gender, race, creed, or color.

Business Structure: ❑Sole Proprietorship ❑Partnership C~Corporation ❑Non-Profit ❑Franchise❑ Other (Please Specify)

Total Number of Employees (Including owners): 5 v

RacelEthnic Composition of Firm. Please distribute the above total number of individuals into the following categories:

OwnerslPartnerslRacelEthnic Composition Associate Partners Managers All Others

Male I Female Male ! Female Male Female

Black/African American

Hispanic/Latino 1

Asian or Pacific Islander

American Indian/Alaskan Native iFilipino American iWhite ~ 3 ~ 4

III. PERCENTAGE OF OWNERSHIP IN FIRM Please indicate by percentage (%) how ownership of the firm is distributed.

BlacklAfrican Hispanic/ ~ Asian or Pacific American Indianl----

FilipinoAmerican Latino Islander

_ Alaskan Native American WhiteMen % % % % % 100

Women % % % % % ~

IV.ned

Ois- DisabledAgency Name Minority _Women ', advantaged . Veteran Expiration Date__ _ _ __ __

~ ~-~

V. DECLARATION: I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OFCALIFORNIA THAT THE ABOVE INFORMATION IS TRUE AND ACCURATE.

n ,

Authorized Signature ~ _ Title:-- Date:i President 5/2/2016~ i

/ V ~~' Rev. 09/18/02

-6-

LIST OF SUBCONTRACTORS

-• . • ~~~

~ 1t ~ it ■ 1 1 . \ ~

\1 ■1\

1 / t 7• ~ •

Name of Bidder:



In accordance with Division 2, Part 1, Chapter 4 of the Public Contract Code, the prime Contractorshall submit with its Bid a list of subcontractors who will perform work in excess of one-half of1 percent of the prime Contractor's total Bid.

Subcontractors listed must be properly licensed for the type of work they are to perform, and theirlicense numbers must be indicated below. Do not list alternate subcontractors forthe same work.

Bidders are requested to voluntarily denote whether a listed subcontractor is a Small BusinessEnterprise by entering a "Y" for "yes" or "N" for "no" in the designated column. Leaving the columnblank will not result in the Bid being considered non-responsive. t

Name underwhich

Subcontractoris Licensed

LicenseNumberandClass

SmallBusiness

Enterprise?

Address of Office,Mill or Shop

Bid ItemNo(s).

DollarValue

O:\Projects\Programs -Flood\Hacienda Channel and PD_T1203 (FCC0001236)\Specs\BP Non-Federal (03-12-15).doc





22600 Savi Ranch Pkwy. Suite A17Yorba Linda, CA 92887

Hacienda Channel -Camino Channel: Low-flow Channeland Invert Access Ramp, PD T1203: Drainage E~ctension

Location: PD T1203

Item Descri tion Unit Quanti Unit Price Amount

~CONSTRUCTION SCHEDULE (BASELINE)

~S 1i

LS~

$1,000.00i STIPULATED UNIT PRICE OF $1,000)~~ f

i

2i

CONSTRUCTION SCHEDULE (UPDATE)MTH 1 $500.00 $500.00

(STIPULATED UNIT PRICE OF $500/MTH) ~

3 ~ CONSTRUCTION SCHEDULE (AS-BUILT) I LS i 1~ LS ~ $1,000.00(STIPULATED UNIT PRICE OF $1,000) ~

4 IMPLEMENTATION OF BMPSi

LS 1 ~ LS i $1,000

5 ;SHORING OF OPEN EXCAVATIONS ~ LS ~ 1 LS $1,000

6 'CLEARING AND GRUBBING ii

LS 1 ~ LS $1,000

7 CONCRETE REMOVAL (NON-REINFORCED) CY 6 ~ $300 $1,800

j 8 ~ UNCLASSIFIED EXCAVATION CY i 2,100 ~ $44 $92,400

9 ;UNCLASSIFIED FILL~

CY 36 ~ $75 ~ $2,700 I'

10 JUNCTION STRUCTURE PER STD PLAN 331 ~ EA 1 ~ $5,800 $5,800

11;REINFORCED CONCRETE RETAINING WALL

CY 13 ~ $2,000 $26,000;TYPE 1

12 'METAL HAND RAILINGS PER STD. PLAN 606 ~ LF i 31 $200 $6,200

' 13CHAIN LINK FENCE, 5' HIGH PER STD PLAN

LF 2p j $250 $5000600 ~ i

Notes







Hacienda Channel -Camino Channel: Low-flow Channeland Invert Access Ramp. PD T1203: Drainage E~ctension

14 j 14' DOUBLE DRIVE GATE EA ' ~ $6,400 ' $6,400

15 18" RCP, 2000 D LF 15 ~ X200 ~ $3,000

16 30" RCP, 2000 D ~ LF ~ 31 $500 ~ $15,500

~ 7

i ,REINFORCED CONCRETE HEADWALL '

i CY 1 I X2,000 $2,000(CALTRANS STD PLAN D89 (MOD))

18REINFORCED CONCRETE ACCESS ROAD

~ CY 47 $1,500 i $70,500AND DRIVEWAY

19REINFORCED CONCRETE INLET ~

LS !I

1 LS ~ $4,000STRICTURE

20 SALVAGE MATERIALS ~ LS 1 I~ LS $5,000i

Location: Hacienda Channel -Camino Channel

Item Descri tion Unit Quanti Unit Price Amount

21 'CONSTRUCTION SCHEDULE (BASELINE)i

LS i 1 LS ~ $1,000.00 j(STIPULATED UNIT PRICE OF $1,000) ~

22CONSTRUCTION SCHEDULE (UPDATE) ~ MTH 1 $500.00 ~ $500.00(STIPULATED UNIT PRICE OF $500/MTH)

23CONSTRUCTION SCHEDULE (AS-BUILT)

~S 1 LS $1,000.00 I(STIPULATED UNIT PRICE OF $1,000) i

24 ;IMPLEMENTATION OF BMPS ~ LS 1 LSi

X2,000

~ 25 SHORING OF OPEN EXCAVATIONS LS ' 1 !i

LS $4,000

26 ~ OFFICE FACILITIES i LS 1 I LS $3,000 ~

Notes:






22600 Savi Ranch Pkwy. Suite A17 Yorba Linda,CA 92887

Hacienda Channel -Camino Channel: Low-flow Channeland Invert Access Ramp, PD T1203: Drainage Extension

27 ;CLEARING AND GRUBBING j LS 1i

LS j $2,000

28 CONCRETE REMOVAL (REINFORCED) CY ' 110 ~ $100 $11,000

29 j UNCLASSIFIED EXCAVATIONi

CY 130 ~i

X70 j $9,100

PREPARATION OF THE SURFACE WATER30 ~ DIVERSION PLAN (STIPULATED UNIT PRICE LS ~ 1 ~ LS $1,000

j OF $5,000) I

31IMPLEMENTATION OF SURFACE WATER

i LS I 1 LS ~ $9,900DIVERSION PLAN

32REINFORCED CONCRETE INVERT ACCESS ~ CY 30 ~ $1,500 $45,000RAM P

~ 33REINFORCED CONCRETE LOW FLOW

CY i 102 $900 $91,800;CHANNEL

34 i SALVAGE MATERIALS I LS 1 ~ LS $1,700

35 TRAFFIC CONTROL LS ~ 1 ' LS ! X1,000

GRAND TOTAL $43rJ~~OO.O~

Notes:


-10-

Banding Company Name: American Contractors Indemnity Company

BdCl(~itl~ ~~3T11p8I7y At~C~I'e55: 625 The City Drive So., Ste. 130

Orange, CA 92868

l:Ci~.~

6SNO1N ALR MAN t~Y THESE F'R~SENTS: That we Kaveh Engineering &Construction, Inc.

2s Principal, end

American Contractors Indemnity Company , as Surefy, ire h id and frmly bound untt~tFae Ct~UNTY t~F Lt~s A~JG~L~~, Sta#e of C~ii'ftrt'ni~, as Q~ligee, ,n fh~ €urn o~ Ten F~~rc~nt of the Bid Prue ofthe Principal for the payment of which sum we bind ourselves, our heirs, executors, adminis~r~tur~, ~ucces~or~and ~SSI~r1S, ~~~ntly and severally, firmly oy these presents.

The c~ri~ition pf the above r~6fig~ti~n is such i~at W~1~R~,SS the Fr~nc[pal f~~.s subrnit~~c~ or is abou# to submit abid to the t~~li~ee fQr the work described in

Fry~~j,~~~ ~~~~: HACIENDA CHANNEL- CAMINO CHANNEL -LOW FLOW CHANNEL ~,ND INVERT ACCESS RAMP

PD T1203 DRAINAGE EXTENSION

pr~~g~ ~d ~;p, FCC0001236

and to which refer~r~ce is hereby made far all partirul~rs,

NC7W, TEI~REFt7t~, i~ the t~bligee shall ~ccupt the did of the Prinoi~~l within the time specified in the GontraciDocuments and the Princfp~l sh~il en#er Into ~ ~ontr~c~ with the Obiit~ee in ~e~brdance wiff~ fihe terms of said Bidand give bonds w~zh ~ursty acc~p#abi~ to fhe C7biigee ,or the faiif'rful perform~n+;e o'F tine ~ont[aat and for thepram~t payment of 1~bor as~d maierials furnished in thy; prosecuuari thereof, tf~en this obli~atian shall be Huff andvoid; otherwise to remain in fiull force and effiecf.

WI~t~~S~ our Ft~rtds fihis 20th day d{ April ~ 2U16

{W i~n~s~~

Kaveh Engineering &Construction, Inc.

{Principal)

Sy(Signafure and title}

American Contractors Indemnity Company(Surefy} —

g

~Jj~~~gg~ Arturo Ayala (SI~t]~11ITE; a11C~ ~It18~ Mi~f eI Castan~da, Aiiomey-in-Fact

~~~$~~'a~9~~i~~ C~~' E'E~If~~Pi~~L ~§~~ S1Jl~~?~I" ~1l~T €~!~ ~IT~9~~~~~ ~`~' ~193~ A ~.~'~f(~~~~~i~ a~~~apr~~~e ~~~€~~V~tE~c~~~~t~$J

POWER OF ATTORNEY"AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY

UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY

KNOW ALL MEN BY THESE PRESENTS; 'That ~~nerican Contractors Indemnity Company, a California corporation, TexasBonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Con~pauy, a i~1 arylandcorporation and U.S. Specialty Insurance Company, a "Texas corporation (collectively, the "Companies"), do by these presents snake,constitute and appoint:

Daniel Huckabay, Andrew Waterbury, Arturo Ayala, Dwight Reilly,Shaunna Burchfiel or Michael Castaneda of Orange, California

its trite and lawful ~~ttorney(s)-in-fact, each in their separate capacity if more than one is named above, with full power and authorityhereby conferred in its name, place and'stead, to execute,'acknowledge and deliver an~~ and .~11 bonds, recognizances, undertakingsor other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond~~enalty does not exceed *****Twenty Million***** Dollars ($ **20,000,000.00** )

This Power of Attorney shall expire without further action on December 20, 2017. This Power of Attorney is granted under and byauthority of the following resolutions adopted by the Boards of Directors of the Companies:

Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with fullpower and authority to appoint any one or more suitable persons ,u Attomey(s)-in-Fact to represent and act for and on behalf of the Compan}~ subj~cf io the ftillo~ci~~eprovisions; y

Attorney-in-Fact may be given full power and authority for mil in the name of and on behalf ofthe Company, to execute, acknowledge and cteln er. am and all binds,recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retainedpercentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liabilitythereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effectedby the Corporate Secretary.

Be i~ Resolved. th;~t the signature of any authorized officer and seal of the Company hereCofore or hereafter affixed to aqy power of attorney or any certificate relatingthereto by facsunile, and any power of attorney ar certificate bearing facsimile signature or fusimile seal shall t>e ~ alid and binding upon the Company with respect touny bond or undenaking to which it is attached.

IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this1st day of December, 2014.

AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY

Corporate Seals UNITED STATES Si?RI:TY CO~TPANY U.S. SPECIALTY. INSURANCE COMPANY

~~ ~~~.•`~,~F.S

SUR£ly .'~`~ O f ~.. ... 1n5~ a~~

P

```~4~.~gPCTO/i8~y,.~

`~i~9~epeeoutEn :y'`~

~q.~ .~ ~~~i o/~ ' ~

~ . ~/ ~ p ya'~

w ~ Z ~/

E -t' 3 B

n' ~' -~-L~R a

~"'' ~~n'~', ~"r '4~

" ~i'~_~rjpM~~M~Sk

Y ~ ~'`~:2+, o" ;~ • ..`~.~

s Daniel P. Aguilar Vice Pres~id''.~~AL /FORN~Ao

...*'. pF,~~~p̀~~.t ....*...

'~~iuumuuoo~~ uW~a`P

,re

r nuu~~~~o~•

A notary public ~~r other officer completing this certi~ficata verifies only the identity of the individual wl~o signed the~~ocume~~t to w°Mich this certificate is attached, and not the truthfulness, accuracy, or validity of th~it document.

State of CalilomiuGouvty of Los Angeles SS:

On this 1st day of December, 2014, before me, Maria G. Rodriguez-Wong, a notary public, personally appeared Dan P. Aguilaz, Vice President of AmericanContractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me onthe basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executee4 the snore inhis authorized capaciCy, and that by his signature on die instrmnent the person, or the entity upon behalf of which the person acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of tl~e Mate of California Chat the foregoing paragraph is true and correct.WITNESS my hand and official seal.

ARIA G ROD~RI~6UE2•WOtiG~ Commission ~ 20 9171

Signature (Seal) Z :~i_~ ~ Notary Public •California zl.os Angeles County

M Comm. Ex irei QeC 20, 2017

I, Michael Chalekson ,Assistant Secretary of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Companyand U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed bysaid Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are infull force and effect.

In Witness ~'Vhereof, I have hereunto set my hand and aftiaed the seals of said Companies at Los Angeles, Califar;iia this 2 Qth _ dayof April 201 ~

Co orate Seals '~T`°"~~~r.,,, su . ̀ o~N ' " i~ ̂ /

x'eaerawar[o z= aW ry' ~~I' ~:0- ?~~` z- 0rnr E ~

Bond No. NIA ;,,:. sEPT.=9~,~::,; _ .-',t ,a= .r; . ~ ~ , lYIi~.haet Chalekso~, Assistant Secretary~d.., y~ ~") r

8472 ~~ ~ ~ ~`'_ ~__. __.— 'nigl~FORNti~ 'rri~OF Sao

~~~}~,nun~uo~~

~,

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT

A notary public or other officer completing this certificate verifies only the identity of the individual who signed thedocument to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

STATE OF CALIFORNIA

County of Oran e

On April 20, 2016 before me, Karen L. RittoDate Insert Name of Notary exactly as it appears on the official seal

Notary Public,

personally appeared Michael CastanedaNames) of Signers)

who proved to me on the basis of satisfactory evidence tobe the person() whose name() is/~ subscribed to thewithin instrument and acknowledged to me that he/sin~(4t~eHcexecuted the same in his/~ authorized capacity(ies~,and that by his# t c signature() on the instrument theperson(s), or the entity upon behalf of which the person($)acted, executed the instrument.

KAREN L. RITfOCOMM. #2138527 M

~~. ~ Notary Publio-California ~'`'-~ µ ~ ORANGE COUNTY ~

` My Comm. Expires Dec 30, 2019~c~~~~v

Place Notary Seal Above

certify under PENALTY OF PERJURY under the laws ofthe State of California that the foregoing paragraph is trueand correct.

Witness my han fficial seal.

SignatureSignature of N t P~en~ Karen L. Ritto

OP710NALThough the information below is not required by law, it may prove valuable to persons relying on the documenf

and could prevent fraudulent removal and reattachment of the form to another document.

Description of Attached Document

Title or Type of Document: Bidder's Bond

Document Date: April 20, 2016 Number of Pages: One

Signers) Other Than Named Above:

Capacity(ies) Claimed by Signers)

Signer's Name: Michael Castaneda❑ Individual❑ Corporate Officer —Title(s):❑ Partner ❑Limited ❑General[~ Attorney in Fact T❑ Trustee ~❑ Guardian or Conservator Top of thumb here❑ Other:

Signer is Representing:

Signer's Name:❑ Individual❑ Corporate Officer —Title(s): _❑ Partner ❑Limited ❑General❑ Attorney in Fact❑ Trustee❑ Guardian or Conservator

❑ Other:

Signer is Representing:

PROJECT ID Nc?, Fccaoa~23s

FALSE CLAIMS

Bidder shall complete the False Claims Act Cent"rfication below or in the alternative,provide the information requested under Fatse Claims Ac# Vialations below. Failure tocertify or provide the requested information may result in a determination that theBidder is nonresponsive. Failure to fully and accurately provide the requestedcertificafion or information may resul# in a defiermina#ion tha# the Bidder is notresponsible.

"False Claims Act" as used herein is defined as either or bath the federal False Claims Act,31 U.S.C. Section 3729, et seq., and the California Fa[se G[aims Act, Government CadeSection 12650, et seq.

FALSE CLA{MS ACT CERTlF1CATt4N

if the Bidder has no False Claim Act violations as described above, complete the following:

E, Farhad Bashardoost hereby certify that neither(prin# name of owner, officer, manager or licensee responsible for the Bid Propasa~)

Kaveh Engineering &Constriction, !nc

Bidder's namenp~ Farhad Bashardoost

(name of qualifying person licensed by Cantracfors' State License Board}

has been determined by a court or tribunal of competent jurisdiction to have violated theFalse Claims Act as defined above.

i declare under penalty of perjury that the above information is true and correct.

Exacuted this 10

by

day of ~aY 2fl~~ at Yorba Linda, CA{month and year} (City and State)

{Bidder's signature)

FALSE CLAIMS ACT V10LATlONS

With regard to any determinations by a tribunal ar court of competent jurisdiction that theFalse Clairrrs Act, as defined above, has been violated by {1) the Bidder submitfiing this BidProposal, including any person who is an officer of, or in a management position with, orhas an ownership interest m the contracting enfifiy which is submitting this Sid Proposal, ar(2) the qualifying person licensed by the State Contractors' License Board to perf'ortn thework described in this Bid Proposal, including any such person when they were an officer,manager, owner, ar responsible managing employee of a construction canfractor other thanthe Bidder submitting thEs Bid Proposal, Bidder shall provide on the following page Eabeled"False Claim Act Violations Irtforrrtation:" (1) the date of the determination of the violation,(2) the identity of the tribunal or court and the case name or number, if any, (3) the ident[tyof the government contract or project involved, (4) the identity of the governmentdepartment involved, {5) the amount of fine imposed, and (6) any exculpatory information ofwhich the Agency should be aware.

O:\Contract Documents~Bid Proposals\Website FormslFafse Claims (2.5-13).doc

Pt~C~JECT ID NO. FCGOOU1236

ClVtL LITIGAT[C}NHISTQRY lNF4RMATI~N

(1) Name of Case:

Ka~eh v. Batache, et al.

Court case identification number: 14K13413

(2) Jurisdiction in which case was filed:

Superior Court of CA of Los Angeles

(3) Outcome of the case:

Pending

(9) Name of Case:

Court case identification number:

{2} Jurisdiction in which case was fried:

{3) Outcome of the case:

Declaration: I declare under penalty of perjury that the above information is true andcorrect.

a ~,, ., ~~Executed this = ~.; ~ ~ ~ day of ~~ ~ ~.~ L; ~. ~-~_- ~ ~.~' at ~ ~; ~` ~~f~ ~~ ~~ i ~~ 1~~ ,

fit;;_.

~ ~.., _~ (month and year} (city and state}

by ~ 1 ~",' ~ ~,~ ~~ ~-~'' '"`~"(Bidder's signature)

0:1Contract DocumenEsl$id ProposafslWebsite PortnsVCivi1 Litigation History Information (2-5-i3}.dac

PROJECT ID NO. Fccooa~23s

CRIMINAL CONV[CTI{~3NS

Bidder shall provide the certification or information requested below. Failure to providesuch certification or information may resu[fi in a determination that the Bidder isnonresponsive. Failure to fiully and accurately provide the reques#ed certification orinformation may result in a determination that the Bidder is nat responsible.

For the five (5) years preceding the date this Bid Proposal is due, identify ~n the followingpage any criminal conviction in any jurisdiction of the United States for a violation of lawarising out of the performance of a construction contract (~) by the Bidder submitting this BidProposal, including any person who is an officer afi, or in a management position with, or hasan ownership interest in the contracting entity which is submitting this Bid Proposal, or (2) bythe qualifying person licensed by the State Contractors' License Boarc! to perForm the workdescribed in the Bid Proposal, including any such person when they were an officer,manager, owner, or responsible managing employee of a construction contractor other thanthe Bidder submitting this Bad Proposal. Provide an the following page labeled "CriminalGanvictions Information:" (7) the date ofi conviction, (2} the Warne and court caseidentification number, (3} the identity of the law violated, (4) the identity of the prosecutingagency, (5} the contract or project involved, (6) the punishment imposed, and (7} anyexculpatory informafiion of which the Agency shaulc! be aware.

CRIMINAL CONV[CT[ON CERTtFICATI{)N

[f the Bidder has no criminaE convictions to report as described above, complete thefollowing:

~~ Farhad Bashardoost ,hereby certify that neither(print name of owner, officer, manager or licensee responsible for the Bid Proposal}


(Bidder's name)

nor Ferhad Bashardoost

(Warne 4f qualifying person licensed by Contractors' State License Board)

has been convicted of a criminalviolation as described above.

l declare under penalty of perjury #hat the fioregoing is true and correct.

Executed this ~ ~ day of May 2016

(month and year)

'~J

(city and state)

~t Yorba Linda, CA

Q:\Contract Documents\Sid Praposats\Websife FormslCriminal Convictions (2-5-i3).doc

PROJECT ID NO. FCC000'! 236

~ ,.

Bidder shall provide the certification or the infiormation requested below. Failure to providesuch certificafion ar information may result in a determination that the Bidder isnanrespansive. Failure to fully anti accurately provide the reques#ed certification orinformation may result in a defiermination tha#the Bidder is not responsible.

Far the ten (10) years preceding the date this Bid Proposal is due, identify on the fo([owingpage any debarment by any FederaE, State, or focal public agency arising out of theperformance of a construction contract (1) by the Bidder submitting this Bid Proposal,including any person who is an officer af, or in a management position with, or has anyownership interest in the contracting entity which is submitting this B'sd Proposal, ar (2) by fhequalifying person licensed by the Contractors' State License Board fa perform the workdescribed in the Bid Proposal, including any debarment of any such person when they werean officer, manager, owner, or responsible managing employee of a construction contractorother than the Bidder submitting this Bid Proposal. Provide an the following page labeled"Debarment lnforma~ion:" (1 J the date ofi debarment and the duration of the debarment, (2)the project name or contract from which the debarment arose, (3) the identify of the debarringagency, (4} stated reason for debarment, and (5} any exculpatory information of which theAgency should be aware.

HISTORY OF DEBARMENT GERTIFICATlON

If the Bidder has na debarments to report as described above, complete the following:

~, Farhad Bashardoast ,hereby CeCtify that neitheC{print name of owner, officer, manager or Licensee responsible far#he Bid Proposal)

Kaveh Engineering & Construction, fine(Bidder's Name)

Nor ~arhad Bashardoost(name of qualifying person Licensed by Contractors' State License Board}

has been debarred as described above.

DecEaration: I declare under penally of perjury that the foregoing is true and correct.

Executed this ~~ day of May 2076 at Yorba Linda, CA 92887,~ (month and year) (city and state)

i ~--- ~r~ ~ ' ; ,-.

(Bidder's signature)

0:1Contract Documentsl6id PropasalslWebsiFe Formslaebarments (2-5-13}.dac

PROJEGT ID NO. ~~C000~2ss

LABOR LAW/PAYRQL.L ViC}LATIONS

The Bidder shall provide the certification or the information requested below. Failure toprovide such certification ar information may result in a determine#ion that the Bidderis nonresponsive. Failure Ya fuiiy and accurately provide the requested certificatican orinformation may result in a determination that the Bidder is not respansi6le.

"Labor lawlpayrall violation" means for purposes of this disclosure a violation of theDavis-Bacon Act (40 USC section 276a} and/or a violation of California Labor Cadesections 1720 through 186'iconceming the payment a#' prevailing wages, employment ofapprentices and hours and working conditions.

Far the three (3) years preceding the date this Bid Proposal is due, identify on the followingpage any determination made by any Federal, State, ar local public agency of a lobarlawlpayroll violation arising out of the performance of a construction contract (1} by theBidder submitting this Bid Proposal, including any person who is an officer of, or in amanagement position with, ar has any ownership interest in the con#reefing entity which issubrnifting this Bid Proposal, or (2) by the qualifying person licensed by the Contractors'State License Board to perfiorm the work described in the Bid Proposal, including suchperson when they were an offcer, manager, owner, or responsible managing employee of aconstruction contractor other than the Bidder submitting this Bid Proposal. Provide an thefollowing page IabeEed "Labor Law/Payroll Violations Information:` (1} the date of thedetermination of the violation, (2) the case number, if any, or other identifying information forthe proceeding, (3} the identity of fihe government contractor project involved, (4) the identityof the government department involved, (5) a description of tyre violation, (6} the amount o~any civil wage and penalty assessment, and (7} any exculpatory information of which theAgency should be aware.

LABOR LAW/PAYROLL VI4L.ATI~N CERTIFICATION

Ifi the Bidder has no labor ]awlpayrol! violations to report as described above, complete thefollowing:

~, Farhad Bashardoost ,hereby certify thaf neither(print name of owner, affcer, manager or licensee responsible forthe Bid Proposal)

Kaveh Engineering & Gonstruction, Inc(Bidder's Name)

nor Farhad Bashardoost

(name of qualifying person licensed by Confractors' State License Board)

has been determined to have violated any Federal, State, or local labor laws as describedabove.

f declare under penalty of perjury that the foregoing is true and correct.

Executed this ~ o day of

by

May 20'16 at Yarba Linda, CA

PROJECT ID NO. Fccaoo~23s

COUNTY OF LOS ANGELESCONTRACTC?R EMPLOYEE JURY SERVICE PROGRAM

APPI.IGATlON F(JR EXCEPT[t}N AND CERTiF1CATIQN FORM

This Contract is subject to the County of Los Angeles Contractor Employee Jury ServiceProgram (Program} (Los Angeles Gounfy Code, Chapter 2.203). All Bidders must cam~letethis farm to either cer~i~v compliance or request an exception from the Program requirements.Upon review of the submitted form, the Agency will determine, in ifs sole discretion, whetherthe Bidder is excepted from the Program.

Appiicatian for Exception

Company Name:Kaveh Engineering &Construction; Inc

Company Address:2260U Savi Ranch Pkvey. Suite A17

City: State: Zip Code:Yorba L[nda CA 92887

Telephone Number:714-793-6655

Project !D No.:FCCOdQ9 236

request an exception from the Program for the following reasons} (check the appropriatebax{es) and attach documentation that supports your claim):

o My business does not meet the definition of "contractor," as defined in the "Program,"because my business has not received an aggregate sum of $50,000 ar more in any12-month period under one or more County contracts ar subcontracts (this excepfiianis not available if the cantract/purchase order itself will exceed $50, 00 in any 12month period). Also, if my business is awarded the contract or purchase order andsecures additional County business that in the aggregate exceeds $5,000 in any 12-month period, then f understand that the exception will be lost and my business shallat that time implement a written policy consistent with the Program.

~ My business is a small business as defined ire the Program. It 1) has ten or feweremployees; and 2) has annual gross revenues in the preceding twelve months which,if added to the annual amount of this Contract is less than $500,000; and 3) is not anaffiliate or subsidiary of a business domPnant in its field of operation, as defined below.If during the contract period my business exceeds ten employees or $50Q,000 annualgross revenues. I understand that the exception will be lost and my business shall atthat time implement a written policy consistent with the Program.

PROJECT 1D NC?. FCCOo01236

"t7ominant in its field of operation" means having more than ten employees and annual grassrevenues in the preceding twelve months, which, if added to the annual amount of the Contractawarded, exceed ~50~,000.

"Affil#ate or subsidiary at a business dominant in its field of operation" means a businesswhich is at least 20 percent owned by a business dominant in its field of operation, or bypartners, officers, directors, majority stockholders, or their equivalent, of a business dominant inthat fled of operation.

❑ My business is subjec# fa a Collective Bargaining Agreement (attach agreement} thatexpressly provides that it supersedes all provisions of the Program.

Certification of Compliance

~' My business has and adheres to a written policy that provides, on an annual basis, noless than eve days of regular pay for actual jury service far full-time employees ofi thebusiness who are also Ca(ifomia residents, or my company wiI! have and adhere tosuch a policy prior to award of the Contract.

1 declare under penalty of perjury under the laws of the State of California that fheinformation stated above is true and correct

Print Name: TitEe:Farhad Bashardoost ,, President

Bidder's Signature: ~~~ ~~ ~' -- ~ ~ - _.Date:

r~ %~ ~ ̀ `~--, _.,,~ ,. 5110/2016

o:lContraci Documentsl8id FraposalslWebsiYe FormslContractor Empioyea Jury Service Aragram {2-513).doc

PROJECT [D NO. FCCOOD1236

This information must include all consfruciion work undertaken in fhe State of California by the Bidder and any partnership, joint venture orcorporation tfiat any principal of the Bidder participated in as a principal or owner for the last five calendar years and the current calendaryear prior to the date of Bid submittal. Separate information shall be submitted for each particular partnership, Joint venfure, corporate orindividual Bidder. The Bidder may attach any additional information or explanation of data which he would like taken into consideration inevaluating the safeEy record. An explanation must be attached of khe circumstances surrounding any and all fatalities.

BIDDER'S INDUSTRIAL SAFETY RECORD _. ; ; ~,

5-Calendar Years Prior t~ Currgnt Year ~~

2011 2012 2013 2414 2Q15 TOTAL ~ CIJRRENTYFAR

1. No. of contracts ,.~ ~~, ~} ~ ~ p'

2. Total dollar amount of~~ -'-~ta~r S ~,~`?~F! '~~°` ̀~~``

!f,.~, r t="~_?contracts in thousands of$ _~` ;''i~:~

3. No. of fatalities (~ ~ ~ {') ~ ~} Q

4. Na. of lost workda cases a ~ d ~} ~} ~ ~

5. No. of [ost workday casesinvolving permanent transfer to

Q~ ~ Q ~ ~ O

another job or termination ofem to ment

6. No. of lost workdays ~ ~ (} ~ ~ (~ ~

The above information was compiled from the records that are available to me at this tine and i declare under penalEy of perjury that theinformation is true and accuraEe within the limitations of those records. ~ ~ ~,

Kaveh Engineering &Construction, tnc ~ ,~ .m,~-,-•„~,~~A~ - f~':~.Name of Bidder (prinE) Bidder's Sigr~at~

2260D Savi Ranch Pkwy. Suite A17 X769962 A.BAddress State Contractors' Lic. No. &Classification

Yorba Linda, CA 92fi87 714-793-BB55City Zip Code Telephone

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PROJECT ID NO. FC00001236

DEFAULTED TAX PROGRAM

Bidder shall complete the CerEificafion of Compliance with the County's Defaulted PropertyTax Reduction Program below or in the alternative, certify that it is exempt from the De€aultedTax Program. Failure to certify or provide the requested information may result in adetermination that the Bidder is nanrespansive. Failure to fully and accurately providethe requested certification or irsformation may result in a determination thafi the Bidder isnot responsible.

"Defaulted Tax Program" as used herein is defined as ~.os Angeles County Code, CFtapter2.206.

DEFAULTED PROPERTY TAX REDUCTt4N PRQGRAM CERTIFfCATI4N

)~ Farhad Bashardoast hereby certify that{print name of owner, ofificer, manager or licensee responsible for the Sid Proposal)

Kaveh Engineering &Construction, IncBidder's name

C~ is familiar with the terms afi the County of Los Angeles Defaulted Property Tax ReductionProgram, Las Angeles County Cade Chapter 2.206; AND

~~to the besfi of my knowledge, after a reasonable inquiry, is not in default, as that term isdefined in has Angeles County Code Section 2.206.020.E, an any Las AngeEes Countyproperty tax obligation; AND

Q"~~agrees to comply wi#h the County's Defaulted Property Tax Reduction Program duringthe term of the Contract.

-O R-

O is exempt from the County of Los Angeles Defaulted Property Tax Reduction Program,pursuant to Las Angeles County Cade Section 2.206.060, for the following reason:

! declare under penalty of perjury that the above information is true and correct.

Executed this ~ ~ day of May 2D16 ~t Yorba Linda, CA,{month and year} (city and state)

~ysignature)

O:lCon{ract DocumentslBid ProposalslWebsite Forzns',DefaulEed Tax Program (2-5-13}.doc

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