HomeMy WebLinkAbout2022-02-08 - AGENDA REPORTS - CITY HALL RESTROOM REMODELAgenda Item: 10
1. CITY OF SANTA CLARITA
AGENDA REPORT
CONSENT CALENDAR
CITY MANAGER APPROVAL: �1 A11�443
DATE: February 8, 2022
SUBJECT: CITY HALL RESTROOMS REMODEL, PHASE I, PROJECT M1037 -
APPROVE PLANS AND SPECIFICATIONS AND AWARD
CONSTRUCTION CONTRACT
DEPARTMENT: Public Works
PRESENTER: Shannon Pickett
RECOMMENDED ACTION
City Council:
1. Approve the plans and specifications for the City Hall Restrooms Remodel, Phase I, Project
M1037.
2. Award the construction contract to G2K Construction, Inc., in the amount of $207,000 and
authorize a contingency in the amount of $20,700, for a total contract amount not to exceed
$227,700.
3. Appropriate one-time funds in the amount of $130,000 from the General Fund - Capital
Projects Fund (Fund 601) to expenditure account M1037601-516101.
4. Authorize the City manager or designee to execute all documents, subject to City Attorney
approval.
BACKGROUND
The City Hall Restrooms Remodel project is broken into three phases and will replace old and
deteriorating tile, paint, counters, urinals, bathroom fixtures, lighting, and partitions in the
bathrooms at City Hall. The existing tile finishes have been in place since the building was
constructed in 1986, and minimal ADA improvements were made approximately seven years
ago. Phase I of the project will address the men's and women's restrooms on one floor of the
building. The improvements will include new energy efficient plumbing fixtures, laminate
partitions, new paint, porcelain floor and wall tile, and grout. New "hands free" type fixtures will
be used for the faucets, soap dispensers, and fixture flushing devices. Existing equipment for
Page 1
Packet Pg. 119
paper towel dispensers, toilet tissue dispensers, and grab bars will also be replaced with new
equipment. All construction work will take place after normal business hours.
An invitation to bid was prepared and published twice, on November 11 and 18, 2021, and
posted on BidNet. Two bids were submitted and opened on December 14, 2021. The results are
shown below:
Company Location Bid Amount`
G2K Construction, Inc. Agoura Hills, CA $207,000
Summer Systems Valencia, CA $256,020
(`Phase I Bid Amount includes the grand total of construction costs and Alternate 1, added costs
for performing all construction work after hours.)
Upon reviewing the bids, staff determined the response from the apparent low bidder, G2K
Construction, Inc., to be appropriate and recommends awarding the project to this contractor.
G2K Construction, Inc., possesses a valid state contractor's license and is in good standing with
the Contractors State License Board. This bid has been reviewed for accuracy and conformance
to the contract documents and was found to be complete.
While the City of Santa Clarita (City) maintains a Support of Local Businesses policy that can be
utilized by the City Council when warranted, the City is governed by the California Public
Contract Code with regard to public works project procurement. In this type of procurement, the
California Public Contract Code does not permit a city to utilize a Support of Local Businesses
policy and instead requires the contract be awarded to the lowest responsible bidder.
The total project cost is $236,300. Of this amount, $227,700 is designated for the construction
contract and contingency. The additional $8,600 is allotted for construction support costs, which
include labor compliance services, staff oversight, construction engineering, inspection, and
project management. The requested construction contingency will cover the cost of unforeseen
site conditions, potential utility conflicts, and any change order requests made by the City.
ALTERNATIVE ACTION
Other action as determined by the City Council.
FISCAL IMPACT
Upon approval of the recommended actions, adequate funds will be available in project
expenditure account M1037601-516101 to support the recommended contract and all anticipated
project costs.
ATTACHMENTS
Location Map
Bid Proposal for G2K Construction, Inc. (available in the City Clerk's Reading File)
Page 2
Packet Pg. 120
Santa Clarita City Hall Restrooms Remodel — Phase I
Estimated Contract Value ($200000)
Total Awarded Value $ 0.00
Project 1
111
Code
Description
1
Mobilization/Demobilization
2
Demolition
3
Gyp Board/Cement Backer Board
4
Tile Installationn - Walls and Floors
5
Quartz Countertop Installation
6
Painting
7
Toilet Compartments
8
Schluter Tile Trim
9
Restroom Accessories
10
Existing Door Resurfacing
11
Electrical/Lighting
12
Plumbing (Toilets, Urinals, Sinks,
Faucets, Soap Dispensers)
Project 1 Project 1
IsGeneral (Bid Schedule), General (Bid Schedule) Mill Ad
UOM I Code Quantity Price Total Cost Code Quantity Price Total Cost
Lump -Sum
1
1
44700
44700
1
1
13480
13480
Lump -Sum
2
1
19240
19240
2
1
24730
24730
Lump -Sum
3
1
3700
3700
3
1
15914
15914
Lump -Sum
4
1
29600
29600
4
1
4445
4445
Lump -Sum
5
1
8880
8880
5
1
12650
12650
Lump -Sum
6
1
7400
7400
6
1
5123
5123
Lump -Sum
7
1
7400
7400
7
1
14980
14980
Lump -Sum
8
1
7400
7400
8
1
30222
30222
Lump -Sum
9
1
8880
8880
9
1
28341
28341
Lump -Sum
10
1
7400
7400
10
1
4250
4250
Lump -Sum
11
1
14800
14800
11
1
18568
18568
Lump -Sum
12
1
29600
29600
12
1
52117
52117
Group Total: $189000 Group Total: $ 224820
Project Total : $ 189000 Project Total: $ 224820
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Addendum No.1
BID # ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
Addendum No.1
December 6, 2021
This addendum must be acknowledged via BidNet and should be included with the bid response..
The purpose of this addendum is to address the following for this Bid:
1. BID CLOSING DATE
The Bid Closing Date of December 8, 2021 at 11:00 AM will be moved to Tuesday, December 14, 2021 at
11:00 AM PST.
-11. PRE -BID MEETING
There was a non -mandatory, pre -bid meeting on November 18, 2021 beginning at 5:30 PM. The meeting
was located at Santa Clarita City Hall, 23920 Valencia Boulevard, CA 91355.
Attending Staff:
• Alan Stump —Senior Engineer, Public Works
• Danielle Marquez — Buyer, Administrative Services
Attending Vendors:
• Tim Goodman, Summer Systems
The following questions were asked and answered:
Q1) Are the prevailing wage rates under LA County?
Al) The wage determinations will fall under either Statewide, Southern California, or Los Angeles County
(depending on the craft/classification).
Q2) Are there freight elevators?
A2) There are no freight elevators.
Q3) Will the water to the second floor restrooms be able to be turned off without affecting other
restrooms or coffee bars?
A3) Yes, and we can confirm prior to start of construction.
Q4) Can we use a storage area in the building to store materials during the work?
A4) Yes, and we can confirm prior to start of construction.
BID # ENG-21-22-M1037
ISKNTA
The following was reviewed:
Bidding Guidelines
e Project scope of work
Working hours
1. SPECIAL PROVISIONS
Addendum No. 1
December 6, 2021
Please see the attached Special Provisions as an addition to the bid package.
H. EXHIBITS Al AND A2
Please see the attached Exhibits Al and A2 as an addition to the bid package.
END OF ADDENDUM
This addendum must be acknowledged via BidNet and should be included with the response.
lZ �L
Contractor's Representative Date
Company Name
BID # ENG-21 22 M1037
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
ALTERNATE BID SCHEDULE
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, California
Do NOT include this pricing in the total base bid amount. Fill out this form completely and upload it with
your bid. In the event any mathematical discrepancies are found in the pricing forms submitted, the unit
price shall govern. Do NOT enter this pricing on BidNet.
ITEM DESCRIPTION
NO.
Extra cost to provide all work after hours
1 (swing shift)
Savings to remove, reuse and replace existing
faucets, soap dispensers, grab bars and all
2 existing "Bobrick" equipment to same
locations.
CITY I UNIT I UNIT PRICE I TOTAL
1 LS 1 $ K, — $ ��b�Z) .� C- /
Extra cost to provide work in two phases.
Phase 1-Demolition during swing shift to limit
3 noise. Phase 2 - All installation work to be 1 LS $; ` $
t
performed during regular working hours.
TOTAL BID: 1 $ 3-D1 om
TOTAL BID AMOUNT IN WORDS: 1�� c),L
The award of contract, if made, will be to the lowest responsive BIDDER determined solely by the
AGENCY.
The AGENCY also reserves the right to add/delete the quantities to the existing bid items, or delete the
entire bid item if they are found not required by the Agency during the course of the construction, or
add new bid items or scope of work by Contract Change Order at any time during the project up to the
last contract working day.
The BIDDER agrees to hold all unit prices in this Alternate Bid Schedule constant throughout the
duration of the project up to the last contract working day.
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
Bond No.: CMGB00012541
PROPOSAL GUARANTEE BID BOND
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase 1
City Project No. M1037
City of Santa Clarita, California
KNOW ALL PERSONS BY THESE PRESENTS that G2K Construction, Inc. as BIDDER, and
Argonaut Insurance Company as SURETY, are held and firmly bound unto the
City of Santa Clarita, as CITY, in the penal sum of Ten * dollars ($10%0 of G.A.B.), which is ten percent (10%)
of the total amount bid by BIDDER to CITY for the above -stated project, for the payment of which sum, BIDDER and
SURETY agree to be bound, jointly and severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to submit a bid to CITY for the
above -stated project, if said bid is rejected, or if said bid is accepted and the contract is awarded and entered into
by BIDDER in the manner and time specified, then this obligation shall be null and void, otherwise it shall remain in
full force and effect in favor of CITY.
IN WITNESS WHEREAS, the parties hereto have set their names, titles, hands, and seals, this
6th Day of December 20 21 .
CONTRACTOR: 'J�141A- 6�' /-Fl /y /'''i
Name and Title of Signatory Si -re
G2K Construction, Inc.
Legal Name of Bidder
28348 Roadside Drive, Suite 205, Agoura Hills, CA 91301
Bidder Address
(818)889-6046 90-0507646
Telephone Number Federal Tax I.D. No.
SURETY*: Argonaut insurance Company
Name
(866)363-2642, surety@cmgia.com
Phone Number and Email
c/o CMG 20335 Ventura Blvd., Ste. 426, Woodland Hills, CA 91364
Address
Steph le Hope Shear, Attorney -in -Fact, ,20335 Ventura Blvd., Ste. 426, Woodland Hills, CA 91364, (866)3
*Provide BIDDER and SURETY name, phone number, email, and the name, title, address, and phone number for
authorized representative. IMPORTANT - Surety_ Companies executing Bonds must appear on the Treasury
Department's most current list (Circular 570, as amended) and be authorized to transact business in the State where
the project Is located.
This document must be notarized prior to submittal.
* Percent of Their Greatest Amount Bid
STATE Or CALIFORNIA
EPAR7"MENT OF INSURANCE NQ U 6 33 0
SAN FRANCISCO
Amended
Certificate of Authority
THIS IS TO CERTIFY THAT, Pnrstrant to the hrsra•ance Code of the State of calilboria,
Argonaut Insurance Company
of Illinois organized wider the
krtvs of Illinois strbfect to its Articles of hicorporation or
other falnclantentctl orvalizational doctonents, is hereby authorized to transact ivilh�in the State, snlafect to
all provisions of this Certificate, the follom4its classes of insctranee: lire, Marine,
Surety, Disability, Plate Glass, Liability, Workers' Compensation,
Common Carrier Liability, Boiler and Machinery, Burglary, Credit,
Sprinkler, Team and Vehicle, Automobile, Aircraft, and Miscellaneous
as such classes are now or ntay hereafter be defined in the hrsarance Laws o0he State gj'C'al�flrrnio.
Tins CERTIFICATE is &vpressll' c:ondflionetl upon the holder hereof nrnv and hereafter hein,I, in
f idi conrplialive with (1/1, ano'nof in violation ofai?); glthe applicable laws and latvfid requir•enteras inade
under authority o%the laws cif the Stead of C'cdifarnia as long cis strch laws or requirements are in eJ%cc•t
and applicable, and as svrc:h laws and reclaireinents now are, or instil hereq%ter he chan,w,d or untended.
IN WITNESS W HI-REOR e, ctive as q%the ._. _31 s t—_T. —
dcn� o%_ December 20Q6 / have herrurrlo
set nry hand and caused inv off%cial seal to be affixed this
�13th chfy cif. December —___,._, _ 2006
John Garamendi
Ins)rrunc'cC011ll)1t.1',ciuner
Patricia K. Staggs
for Richard D. Baum lk!pwxx
Chief Deputy
QLI[IIii'ic.11ioil with 1110 Suvrel;uy of State nn.txl he acaoasplklied as required by ilto CtiIil'orniit Corpormiotm Code pramprly
Idle] ksuanue ol'thisi'ertil'icate ol'Atithority, I''ailur4 to do sa will he a vi0huion of h}surtuice Code Section 701 mul will he
;01-uunds fol. revokilig this Conitic:nte ol`Aulhurity pco;sumit to the convennnis made.. in the aplaliewion therefor and [Ile
Conditionscnatained herein.
s^ 95P 00 3080 1
Bond No.: CMGB00012541
Argonaut Insurance Company
Deliveries Only: 225 W. Washington, 24th Floor
Chicago, IL 60606
United States Postal Service: P.O. Box 469011, San Antonio, TX 78246
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the Argonaut Insurance Company, a Corporation duly organized and existing under be laws of the State
of Illinois and having its principal office in the County of Cook, Illinois does hereby nominate, constitute and appoint: ��
v
Their true and lawful agent(s) and attorney(s)-in-fact, each in their separate capacity if more than one is named 'a ove't lake, execute, seal and deliver for
3 age e .
and on its behalf as surety, and as its act and deed any and all bonds, contracts, agreements of indemnity ard'otherrdert ngs in suretyship provided,
however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of
$15,000,000.00
This Power of Attorney is granted and is signed and sealed under and by the authority of the fo wings ire olu on adopted by the Board of Directors of
Argonaut Insurance Company: 4R",
r
'RESOLVED, That the President, Senior Vice President, Vice President, Assistant Vice P es dent, Secretary, Treasurer and each of them hereby is
authorized to execute powers of attorney, and such authority can be executed by up( of fac"Vile signature, which may be attested or acknowledged by any
officer or attorney, of the Company, qualifying the attorney or attorneys name n tl givon ower of attorney, to execute in behalf of, and acknowledge as
the act and deed of the Argonaut Insurance Company, all bond undertaking& detracts of suretyship, and to affix the corporate seal thereto."
IN WITNESS WHEREOF, Argonaut Insurance Company has caused its' ffrcial3Seal to be hereunto affixed and these presents to be signed by its duly
authorized officer on the 1st day of June, 2021. qfi16V Argonaut Insurance Company
STATE OF TEXAS
COUNTY OF HARRIS SS
"0
by:
Joshua C. Betz, Senior Vice President
On this 1st day of June, 2021 A D.. ,lief > me, Notary Public of the State of Texas, in and for the County of Harris, duly commissioned and qualified,
a(� 2H,
came THE ABOVE OFFICER O�fi� COlV7PANY, to me personally known to be the individual and officer described in, and who executed the preceding
instrument, and he acknowledged tll wVecution of same, and being by me duly sworn, deposed and said that he is the officer of the said Company aforesaid,
and that the seal affixed Oi ced'rfig instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as officer were
duly affixed and sub�scriled to tote said instrument by the authority and direction of the said corporation, and that Resolution adopted by the Board of
Directors of said,ompan'referred to in the preceding instrument is now in force,
IN TEST1�Iv1O1igYEOF, I have hereunto set my hand, and affixed my Official Seal at the County of Harris, the day and year first above written,
?G1 K.Ai"Hi..ir�{V M MEF-KS °" `\�'r' °�'� `�� • �A�/J
�"� �U�` Nt]TAt3Y �UBL1G
STATE Ci.F 7'��CAS
•'�"'+;: �;��;: PvtY CK7Fwih+t, F_'XP, U7/7.5l2�
NCSTAFY to 55�o-s (Notary Public)
I, the undersigned Officer ofthe Argonaut Insurance Company, Illinois Corporation, do hereby certify that the original POWER OF ATTORNEY of which
the foregoing is a full, true and correct copy is still in full force and effect and has not been revoked.
IN WITNESS WHEREOF, I have hereunto set my hand, and affixed the Seal of said Company, on the 6th day of December 12021
James Bluzard , Vice President -Surety
IF YOU HAVE QUESTIONS ON AUTHENTICITY OF THIS DOCUMENT CALL (833) 820 - 9137..
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 11
.c� .�•_c� .s�`.c C/.yC .c�•.c�S.wS.� �•.s. S�C��Y,a` ..�'_.�%a�`C/..�` .c�•.�•.c�..<a . C/.w� _.�'_s� .c� _c�•,wC/_A+-u��Cr.�� .� .e�S,�.'� .c�CrwC� .c: +.rat/,
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On DE O � ® before me, _
Date-'
Lucas Patterson, Notary Public
Here Insert Name and Title of the Officer
personally appeared Stephanie Hope Shear
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s),
or the entity upon behalf of which the person(s) acted, executed the instrument.
certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand qdol I_seal.( r LUCASPA�NotaryPublic C-orn a z Signature-
ii Los Anele County m Signature of Nota Public
w s r Commission 215220. g ry
ii� cx hky Comm Expire filar 19 20'5
rl --^<w ���,�nG3 s�,Y..iaivaZ �,.:v�=� �?: •n
Place Notary Seal Above
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Description of Attached Document
Title or Type of Document:
Number of Pages: Signer(s)
Other Than Named Ab
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorne act
❑ Trustee ❑ G Ian or Conservator
❑ Other:
Signer Is esenting:
Docum
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
02014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907
California All Purpose Acknowledgement
Civil Code 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On Yf/ q C��l before me, Jeremy Allan Schwartz, Notary Public,
Date Name and Title of Officer
personally appeared C2F
Name(s) of Signer(l) y
who proved to me on the basis of satisfactory evidence to be the person(j) whose name(j) is/ark
subscribed to the within instrument and acknowledged to me that hk/she/tlyhy executed the same in
his/her/th,*ir authorized capacity(iks), and that by qs/her/tV it signature(o on the instrument the
person(j), or the entity upon behalf of which the person(s/j acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
JEREMY ALLAN SCNWARTZ
w Notary Public • California 2
Z s'+ Los Angeles County n Witness my hand and official seal
Commission # 2293525
z My Comm. Expires Jun 1 b, 2023
oft Signature,
Signature of ary Public
----- ----- Optional Information --------------------------------------- ----------:-
Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this
acknowledgement to an unauthorized document and may prove useful to persons relying on the attached document.
Description of Attached Document
Title or Type of Doc ume t,� 4L ��(�/ ✓�/
Document Date 2 Number of Pages:
Signer(s) Other than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's NamePM/(-(A - L,F
Corporate Officer- Title(s) -
Signer's Name
—Corporate Officer- Title(s)
Partner------- Limited General
Partner ----- Limited General
_ _
TOP dividual _Attorney In Fact
_ _
Individual Attorney In Fact
_Trustee —Guardian or Conservator
_Trustee _ Guardian or Conservator
Other:
Other:
Signer is Representing
Signer is Representing-
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
BIDDER'S INFORMATION AND CERTIFICATION
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, CA
Bidder certifies that the representations of the bid are true and correct and made under penalty of perjury.
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE
Bidder certifies that in all previous contracts or subcontracts, all reports which may have been due under
the requirements of any CITY, State, or Federal equal employment opportunity orders have been
satisfactorily filed, and that no such reports are currently outstanding.
AFFIRMATIVE ACTION CERTIFICATION
Bidder certifies that affirmative action has been taken to seek out and consider minority business enterprises
for those portions of the work to be subcontracted, and that such affirmative actions have been fully
documented, that said documentation is open to inspection, and that said affirmative action will remain in
effect for the life of any contract awarded hereunder. Furthermore, Bidder certifies that affirmative action
will be taken to meet all equal employment opportunity requirements of the contract documents.
CERTIFICATION REGARDING DIR CONTRACTOR/SUBCONTRACTOR REGISTRATION
By my signature hereunder, as the Contractor, I certify that Contractor, and all Subcontractors listed on the
Subcontractor Designations form are the subject of current and active contractor registrations pursuant to
Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code. Contractor's
registration number is indicated below. Subcontractors' registration numbers are indicated on the
Subcontractor Designations form.
Bidder's Name:
Business Address: LLl`44� \, x - 5 C L� A "C` t 1
Telephone No.: CS' 8� S 1KL"A u)
State CONTRACTOR's License No. & Class: �C�2 R
DIR No: I ZnL� _% 2-1
Original Date: Expiration Date: 2 )23
The following are the names, titles, addresses, and phone numbers of all individuals, firm members,
partners, joint ventures, and/or corporate officers having a principal interest in this proposal:
-tWl`lA 6, ���r
DocuSign Envelope ID. BAAAF1FF-HF24E04-A070-06ME9591EF5
A ova ro d #VU61 02 21 ?D l
iX- 8q-
The dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in
this proposal, or any firm, corporation, partnership orjoint venture of which any principal having an interest
in this proposal was an owner, corporate officer, partner orjoint venture are as follows:
All current and prior DBAs, alias, and/or fictitious business names for any principal having an interest in this
proposal are as follows:
IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, title, hands, and seals
of all aforementioned principals this day of 0-v-c.20-^kt.
BIDDER: (
re
U'-\\1 C--- i l VV�-r�������n
Name and Title of Signatory
Legal Name of Bidder
Address
a-w-6, DI& (IC)- O501.345
Telephone Number Federal Tax I.D. No.
This document must be notarized prior to submittal.
California All Purpose Acknowledgement
Civil Code 1189 _
A notary public or other officer completing this certificate verifies only the identlty of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On :�o2
Date
personally appeared
before me, Jeremy Allan Schwartz, Notary Public,
Name and Title of Officer
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person() whose name(so is/arA
subscribed to the within instrument and acknowledged to me that he/she/ti�y executed the same in
hi�/her/t eir authorized capacity(ils), and that by �s/her/tkir signature(91 on the instrument the
person( , or the entity upon behalf of which the person() acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
KREMY ALLAN SCHWARTZ
taryPublic-California Witness my hand and official seal
Los Angeles Countyommission x 2293525mm. Expires Jun 16, 2023 Signature
Signature of OVtary Public
- -Optional Information -
Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this
acknowledgement to an unauthorized document and may prove useful to persons relying on the attached document.
Description of Attached Doc ent
Title or Type of Document / 1Vr- Aj /C4J 441)
Document Date 2 2 Number of Pages:
Signer(s) Other than Named Above:
Capacity(ies) Cllmed by Signer(s)
9Si ner's Name IM&j
1VAr . 4f V '�
Corporate Officer- Title(s)
_Partner------ _ Limited _General
_Individual _Attorney In Fact
Trustee Guardian or Conservator
Other:
Signer is Representin
Signer's Name
Corporate Officer- Title(s) o`------
-Partner ----- — Limited — General
Individual —Attorney In Fact
Trustee Guardian or Conservator
Other:
Signer is Representing `_
DocuSign Envelope ID: BAAAF1 FF-E8F2-4E04-A070-06D3E9591 EF5
BIDDER'S QUESTIONNAIRE
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, California
( II 1
1. Submitted by: L� l� (,C1� V CAA 4Y Telephone: )
Principal Office Address:
2. Type of Firm:
❑ C Corporation
; d S Corporation
❑ Individual/Sole Proprietor or Single —Member LLC
❑ Partnership
❑ Limited Liability Company "C" C-Corp
❑ Limited Liability Company "S" S-Corp
❑ Limited Liability Company "P" Partnership
❑ Other
` L04L
3a. If a corporation, answer these questions:
Date of Incorporation: �,�
�i rC State of Incorporation:��
President's Name: F_VA \ w\ C-5 il _e
Vice -President's Name: i�
Secretary or Clerk's Name: -7. L- U L!
Treasurer's Name:
3b. If a partnership, answer these questions:
Date of organization: State Organized in:
Name of all partners holding more than a 10% interest:
Designate which are General or Managing Partners.
C
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
BIDDER'S QUESTIONNAIRE (cont'd)
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, California
4. Name of person holding CONTRACTOR'S license:
License number: qq�LZ Class: Expiration Date:
D.I.R. Registration # 1 MM 21 C
5. CONTRACTOR'sRepresentative: L-1A'l\
Title: 1 c -`y )L�
Alternate: IN%Q
Title:
6. List the major construction projects your organization has in progress as of this date: ��1
A.
Owner:
Project Location: _
Type of Project:
B.
Owner:
Project Location:
Type of Project:
C.
Owner:
Project Location:
Type of Project:
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
CERTIFICATION OF NON -SEGREGATED FACILITIES
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, California
The BIDDER certifies that it does not maintain or provide for its employees any segregated facilities at any
of its establishments, and that it does not permit its employees to perform their services at any location,
under its control, where segregated facilities are maintained. The BIDDER certifies further that it will not
maintain or provide for its employees any segregated facilities at any of its establishments, and that it will
not permit its employees to perform their services at any location, under its control, where segregated
facilities are maintained. The BIDDER agrees that a breach of this certification is a violation of the Equal
Opportunity clause in this Contract. As used in this certification, the term "segregated facilities" means any
waiting rooms, work areas, rest rooms, and wash rooms, restaurants and other eating areas, time clocks,
locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or
entertainment areas, transportation, and housing facilities provided for employees which are segregated
by explicit directive or are in fact segregated on the basis of race, creed, color, or national origin, because
of habit, local custom, or otherwise. The BIDDER agrees that (except where it has obtained identical
certifications from proposed subcontractors for specific time periods) it will obtain identical certifications
from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt
from the provisions of the Equal Opportunity clause, and that it will retain such certifications in its files.
G,2-K 2'�2Yuc
BIDDER
Required by the May 19, 1967 order on Elimination of Segregated Facilities, by the Secretary of Labor —
32 F.R. 7439, May 19, 1967 (F.R. Vol. 33, No. 33 — Friday, February 16, 1968 — p. 3065).
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
BIDDER'S INFORMATION AND CERTIFICATION
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, CA
Bidder certifies that the representations of the bid are true and correct and made under penalty of perjury.
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE
Bidder certifies that in all previous contracts or subcontracts, all reports which may have been due under
the requirements of any CITY, State, or Federal equal employment opportunity orders have been
satisfactorily filed, and that no such reports are currently outstanding.
AFFIRMATIVE ACTION CERTIFICATION
Bidder certifies that affirmative action has been taken to seek out and consider minority business enterprises
for those portions of the work to be subcontracted, and that such affirmative actions have been fully
documented, that said documentation is open to inspection, and that said affirmative action will remain in
effect for the life of any contract awarded hereunder. Furthermore, Bidder certifies that affirmative action
will be taken to meet all equal employment opportunity requirements of the contract documents.
CERTIFICATION REGARDING DIR CONTRACTOR/SUBCONTRACTOR REGISTRATION
By my signature hereunder, as the Contractor, I certify that Contractor, and all Subcontractors listed on the
Subcontractor Designations form are the subject of current and active contractor registrations pursuant to
Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code. Contractor's
registration number is indicated below. Subcontractors' registration numbers are indicated on the
Subcontractor Designations form.
Bidder's Name:
Business Address: LLl`44� \, x - 5 C L� A "C` t 1
Telephone No.: CS' 8� S 1KL"A u)
State CONTRACTOR's License No. & Class: �C�2 R
DIR No: I ZnL� _% 2-1
Original Date: Expiration Date: 2 )23
The following are the names, titles, addresses, and phone numbers of all individuals, firm members,
partners, joint ventures, and/or corporate officers having a principal interest in this proposal:
-tWl`lA 6, ���r
DocuSign Envelope ID. BAAAF1FF-HF24E04-A070-06ME9591EF5
A ova ro d #VU61 02 21 ?D l
iX- 8q-
The dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in
this proposal, or any firm, corporation, partnership orjoint venture of which any principal having an interest
in this proposal was an owner, corporate officer, partner orjoint venture are as follows:
All current and prior DBAs, alias, and/or fictitious business names for any principal having an interest in this
proposal are as follows:
IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, title, hands, and seals
of all aforementioned principals this day of 0-v-c.20-^kt.
BIDDER: (
re
U'-\\1 C--- i l VV�-r�������n
Name and Title of Signatory
Legal Name of Bidder
Address
a-w-6, DI& (IC)- O501.345
Telephone Number Federal Tax I.D. No.
This document must be notarized prior to submittal.
California All Purpose Acknowledgement
Civil Code 1189 _
A notary public or other officer completing this certificate verifies only the identlty of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On :�o2
Date
personally appeared
before me, Jeremy Allan Schwartz, Notary Public,
Name and Title of Officer
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person() whose name(so is/arA
subscribed to the within instrument and acknowledged to me that he/she/ti�y executed the same in
hi�/her/t eir authorized capacity(ils), and that by �s/her/tkir signature(91 on the instrument the
person( , or the entity upon behalf of which the person() acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
KREMY ALLAN SCHWARTZ
taryPublic-California Witness my hand and official seal
Los Angeles Countyommission x 2293525mm. Expires Jun 16, 2023 Signature
Signature of OVtary Public
- -Optional Information -
Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this
acknowledgement to an unauthorized document and may prove useful to persons relying on the attached document.
Description of Attached Doc ent
Title or Type of Document / 1Vr- Aj /C4J 441)
Document Date 2 2 Number of Pages:
Signer(s) Other than Named Above:
Capacity(ies) Cllmed by Signer(s)
9Si ner's Name IM&j
1VAr . 4f V '�
Corporate Officer- Title(s)
_Partner------ _ Limited _General
_Individual _Attorney In Fact
Trustee Guardian or Conservator
Other:
Signer is Representin
Signer's Name
Corporate Officer- Title(s) o`------
-Partner ----- — Limited — General
Individual —Attorney In Fact
Trustee Guardian or Conservator
Other:
Signer is Representing `_
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
DESIGNATION OF SUBCONTRACTORS
Bid # ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase 1
City Project No. M1037
City of Santa Clarita, California
Listed below are the names and locations of the places of business of each subcontractor, supplier, and vendor who will perform work or labor or render
service in excess of/: of 1 percent, or $10,000 (whichever is greater) of the prime contractor's total bid. If no Subcontractors will be used fill out the form
with NA. Add addt. sheets if needed.
Subcontractor
DIR Registration No.* Dollar Value of Work
Location and Place of Business 21 � rnV� ehk(O (-il, \k C-G - 351
Bid Schedule Item o's:
Description of Work '
License No.
Exp. Date: / / -
Phone
01-? 1
01 1-,3`2022-
Subcontractor
DIR Registration No.*
Dollar Value of Work
33 3010C C> --
Location and Place of Business
i C n1� - G02
Bid Schedule Item No's:
Description of Work
LA 04) l n
Exp. Date: / / Phone ( )
License No.
Q1 1 31 2-U2 Z 5 62- - +
Subcontractor
T C I
DIR Registration No.*
Dollar Value of Work
�
`0
ow �5cJ6
cs OL .
Location and Place of Business
12C1 4oXT C
_ --
Bid Schedule Item No's:
Description of Work
ElV cc+�
License No.
Exp. Date: / /
Phone ( )
ciEDk
NOTE: A BIDDER or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the
Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and
qualified to perform public work pursuant to Section 172S.S of the Labor Code. It is not a violation of this section for an unregistered BIDDER to
submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract
Code, provided the BIDDER is registered to perform public work pursuant to Section 1725.5 of the Labor Code at the time the contract is
awarded. *Pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code.
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
BIDDER'S INFORMATION AND CERTIFICATION
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, CA
Bidder certifies that the representations of the bid are true and correct and made under penalty of perjury.
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE
Bidder certifies that in all previous contracts or subcontracts, all reports which may have been due under
the requirements of any CITY, State, or Federal equal employment opportunity orders have been
satisfactorily filed, and that no such reports are currently outstanding.
AFFIRMATIVE ACTION CERTIFICATION
Bidder certifies that affirmative action has been taken to seek out and consider minority business enterprises
for those portions of the work to be subcontracted, and that such affirmative actions have been fully
documented, that said documentation is open to inspection, and that said affirmative action will remain in
effect for the life of any contract awarded hereunder. Furthermore, Bidder certifies that affirmative action
will be taken to meet all equal employment opportunity requirements of the contract documents.
CERTIFICATION REGARDING DIR CONTRACTOR/SUBCONTRACTOR REGISTRATION
By my signature hereunder, as the Contractor, I certify that Contractor, and all Subcontractors listed on the
Subcontractor Designations form are the subject of current and active contractor registrations pursuant to
Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code. Contractor's
registration number is indicated below. Subcontractors' registration numbers are indicated on the
Subcontractor Designations form.
Bidder's Name:
Business Address: LLl`44� \, x - 5 C L� A "C` t 1
Telephone No.: CS' 8� S 1KL"A u)
State CONTRACTOR's License No. & Class: �C�2 R
DIR No: I ZnL� _% 2-1
Original Date: Expiration Date: 2 )23
The following are the names, titles, addresses, and phone numbers of all individuals, firm members,
partners, joint ventures, and/or corporate officers having a principal interest in this proposal:
-tWl`lA 6, ���r
DocuSign Envelope ID. BAAAF1FF-HF24E04-A070-06ME9591EF5
A ova ro d #VU61 02 21 ?D l
iX- 8q-
The dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in
this proposal, or any firm, corporation, partnership orjoint venture of which any principal having an interest
in this proposal was an owner, corporate officer, partner orjoint venture are as follows:
All current and prior DBAs, alias, and/or fictitious business names for any principal having an interest in this
proposal are as follows:
IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, title, hands, and seals
of all aforementioned principals this day of 0-v-c.20-^kt.
BIDDER: (
re
U'-\\1 C--- i l VV�-r�������n
Name and Title of Signatory
Legal Name of Bidder
Address
a-w-6, DI& (IC)- O501.345
Telephone Number Federal Tax I.D. No.
This document must be notarized prior to submittal.
California All Purpose Acknowledgement
Civil Code 1189 _
A notary public or other officer completing this certificate verifies only the identlty of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On :�o2
Date
personally appeared
before me, Jeremy Allan Schwartz, Notary Public,
Name and Title of Officer
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person() whose name(so is/arA
subscribed to the within instrument and acknowledged to me that he/she/ti�y executed the same in
hi�/her/t eir authorized capacity(ils), and that by �s/her/tkir signature(91 on the instrument the
person( , or the entity upon behalf of which the person() acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
KREMY ALLAN SCHWARTZ
taryPublic-California Witness my hand and official seal
Los Angeles Countyommission x 2293525mm. Expires Jun 16, 2023 Signature
Signature of OVtary Public
- -Optional Information -
Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this
acknowledgement to an unauthorized document and may prove useful to persons relying on the attached document.
Description of Attached Doc ent
Title or Type of Document / 1Vr- Aj /C4J 441)
Document Date 2 2 Number of Pages:
Signer(s) Other than Named Above:
Capacity(ies) Cllmed by Signer(s)
9Si ner's Name IM&j
1VAr . 4f V '�
Corporate Officer- Title(s)
_Partner------ _ Limited _General
_Individual _Attorney In Fact
Trustee Guardian or Conservator
Other:
Signer is Representin
Signer's Name
Corporate Officer- Title(s) o`------
-Partner ----- — Limited — General
Individual —Attorney In Fact
Trustee Guardian or Conservator
Other:
Signer is Representing `_
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
Fringe Benefit Statement
Contract/Proposal No:
1 � _Nc�-2I 22-Mio3
Proje Na e:
� C ��c�c\ a 11 11 t 1 � u T
ate:
B2/0 ZO21
INSTRUCTIONS: Fringe Benefit rates can be used for checking payrolls or applied to Force Account work which may
be done on the above contract the hourly rates for fringe benefits, subsistence and/or travel allowance payment (as
required by collective bargaining agreements) made for employees on the various classes of work are tabulated below.
THIS DOCUMENT CONTAINS PERSONAL INFORMATION AND, PURSUANT TO CIVIL CODE 1796.21, IT SHALL
BE KEPT CONFIDENTIAL IN ORDER TO PROTECT AGAINST UNAUTHORIZED DISCLOSURE.
Classification., LaL-c'weY co\� .
Effective Date:
zzlZI�2I
Subsistence or Travel Pay:
Health and Welfare
$
Trust Fund Paid to:(Name) � , \ �, 1 4
Address:
Pension
$ �—
Trust Fund Paid To:(Name) C -
Address:
Vacation/Holiday
$
Trust Fund Paid to:(Name) no CC —Mo 777777
Address:
Training
$
Trust Fund Paid To:(Name) C 4C: Gl\ t�.� G t"l .
Address: c -2 A `�—, 9 00-5 3
Other
is a �1
Trust Fund Paid To:(Name) cl — J C � C� 11 C)
Address:
Classification:
Effective Date:
Subsistence or Travel Pay:
Health and Welfare
$
Trust Fund Paid to:(Name)
Address:
Pension
$
Trust Fund Paid To:(Name)
Address:
Vacation/Holiday
$
Trust Fund Paid to:(Name)
Address:
Training
$
Trust Fund Paid To:(Name)
Address:
Other
$
Trust Fund Paid To:(Name)
Address:
Classification:
Effective Date:
Subsistence or Travel Pay -
Health and Welfare
$
Trust Fund Paid to:(Name)
Address:
Pension
$
Trust Fund Paid To.(Name)
Address:
Vacation/Holiday
$
Trust Fund Paid to:(Name)
Address:
Training
$
Trust Fund Paid To:(Name)
Address -
Other
$
Trust Fund Paid To:(Name)
Address -
Supplemental statement must be submitted during the progress of work should a change in rate of any of the classifications be made -
I CERTIFY THAT THE FRINGE BENEFIT PAYMENTS ARE MADE TO THE APPROVED PLANS, FUND OR PROGRAMS LISTED ABOVE
(Contractor/Subcontractor) By (Name and Title) Signature
'\CW Lcuq I V)VEJ
City of Santa Clanta Form HC-50 FBS
DocuSign Envelope ID: BAAAF1 FF-E8F2-4E04-A070-06D3E9591 EF5
NON -COLLUSION AFFIDAVIT
Bid..#ENG-21-22-M 1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, California
TO BE EXECUTED BY EACH BIDDER OF A PRINCIPAL CONTRACT
STATE OF CALIFORNIA )
COUNTY OF LOS ANGELES )
-F—\-"\''ka G LC Qu\ being first duly sworn deposes and says that he/she is
the Y- EtfA t s n (sole owner, a partner, president, etc.) of
G2 �w�� -YI�C tC)<ly" the party making the foregoing bid; that such
bid is not made in the interest of or behalf of any undisclosed person, partnership, company, association,
organization or corporation, that such bid is genuine and not collusive or sham, that said BIDDER has not
directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, or that anyone shall
refrain from bidding, that said BIDDER has not in any manner, directly or indirectly sought by agreements,
communication or conference with anyone to fix the bid price of said BIDDER or of any other BIDDER, or to
fix the overhead, profit, or cost element of such bid price, or of that of any other BIDDER, or to secure any
advantage against the public body awarding the Contract or anyone interested in the proposed Contract;
that all statements contained in such bid are true, and further, that said BIDDER has not, directly or indirectly,
submitted its bid price, or any breakdown thereof, or the contents thereof, or divulged information or date
relative thereto, or paid and will not pay any fee in connection, therewith to any corporation, partnership,
company, association, organization, bid depository, or to any member or CITY thereof, or to any other
individual information or date relative thereto, or paid and will not pay any fee in connection, therewith to
any corporation, partnership, company association, organization, bid depository, or to any member or CITY
thereof, or to any other individual, except to such person or persons as have a partnership or otherfinancial
interest with said BIDDER in his general business.
�.o
Bidder:
Sign,aWre
Title W51 1'
This document must be notarized prior to submittal.
California All Purpose Acknowledgement
Civil Code 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document,
State of California
County of Los Angeles
On 2 ,z before me, Jeremy Allan Schwartz, Notary Public,
Date _ Name and Titre of officer
personally appeared
1 > L-FV
Name(s) of Signets)
who proved to me on the basis of satisfactory evidence to be the person(y) whose nameO is/ark
subscribed to the within instrument and acknowledged to me that V/she/tP(ey executed the same in
qis/her/toieir authorized capacity(ips), and that by his/her/their signature(4 on the instrument the
person(, or the entity upon behalf of which the person(j) acted, executed the instrument.
a , . JEREMY ALLAN SCHWARTZ
Notary Public - California
z
Los Angeles County z
Commission k 2293525
My
Comm. Expires Jun 16, 2023
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct,
Witness my hand and official seal
Signature
Signature of Rotary Public
------------- Optional Information --------------------------------------------------- --------
Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this
acknowledgement to an unauthorized document and may prove useful to persons relying on the attached document,
Description of Attached Document
Title or Type of Docu
Document Date
Signer(s) Other than
Capacity(ies) Claimed by Signer(r)
Signer's Name ' o L
'Corporate Officer- Title(s) I b
; v
ir
—Partner ------- _ Limited _General l�
_Individual —Attorney In Fact
Trustee Guardian or Conservator
—Other:
Signer is Representing
Signer's Name
_Corporate Officer-Title(s) .
----
_Partner ----- _ Limited _ General
`individual _Attorney In Fact
Trustee Guardian or Conservator
Other;
Signer is Representin
DocuSign Envelope ID: BAAAF1 FF-EU24E04-A070-06WE9591 EF5
NOTICE TO BIDDERS REGARDING CONTRACTUAL REQUIREMENTS
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, California
SUMMARY OF INDEMNITY AND INSURANCE REQUIREMENTS
1. These are the Indemnity and Insurance Requirements for Contractors providing services or supplies to
City of Santa Clarita (City). By agreeing to perform the work or submitting a proposal, you verify that you
comply with and agree to be bound by these requirements. If any additional Contract documents are
executed, the actual Indemnity language and Insurance Requirements may include additional provisions
as deemed appropriate by City's Risk Manager.
2. You should check with your Insurance advisors to verify compliance and determine if additional
coverage or limits may be needed to adequately insure your obligations under this agreement. These are
the minimum required and do not in any way represent or imply that such coverage is sufficient to
adequately cover the Contractor's liability under this agreement. The full coverage and limits afforded
under Contractor's policies of Insurance shall be available to Buyer and these Insurance Requirements
shall not in any way act to reduce coverage that is broader or includes higher limits than those required.
The Insurance obligations under this agreement shall be: 1—all the Insurance coverage and limits carried
by or available to the Contractor; or 2—the minimum Insurance requirements shown in this agreement,
whichever is greater. Any insurance proceeds in excess of the specified minimum limits and coverage
required, which are applicable to a given loss, shall be available to City.
3. Contractor shall furnish the City with original Certificates of Insurance including all required amendatory
endorsements and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy
endorsements to City before work begins. City reserves the right to require full -certified copies of all
Insurance coverage and endorsements.
I. INDEMNIFICATION:
City and its respective elected and appointed boards, officials, officers, agents, employees, and volunteers
(individually and collectively, "Indemnitees") shall have no liability to CONTRACTOR or any other person
for, and CONTRACTOR shall indemnify, defend, protect, and hold harmless Indemnitees from and against,
any and all liabilities, claims, actions, causes of action, proceedings, suits, damages, judgments, liens,
levies, costs, and expenses of whatever nature, including reasonable attorney's fees and disbursements
(collectively, "Claims"), which Indemnitees may suffer or incur or to which Indemnitees may become
subject by reason of or arising out of any injury to or death of any person(s), damage to property, loss of
use of property, economic loss, or otherwise occurring as a result of or allegedly caused by the
CONTRACTOR'S performance of or failure to perform any services under this Agreement, or by the
negligent or willful acts or omissions of CONTRACTOR, its agents, officers, directors, or employees,
committed in performing any of the services under this Agreement.
If any action or proceeding is brought against Indemnitees by reason of any of the matters against which
CONTRACTOR has agreed to indemnify Indemnitees as provided above, CONTRACTOR, upon notice from
City, shall defend Indemnitees at its expense by counsel acceptable to City, such acceptance not to be
unreasonably withheld. Indemnitees need not have first paid for any of the matters to which Indemnitees
are entitled to indemnification in order to be so indemnified. The limits of the insurance required to be
DocuSign Envelope ID: BAAAF1 FF-EW2-4E04-A070-06WE9591 EF5
maintained by CONTRACTOR in this Agreements hall not limit the liability of CONTRACTOR hereunder. The
provisions of this section shall survive the expiration or earlier termination of this agreement.
The provisions of this section do not apply to Claims occurring as a result of the City's active negligence or
acts of omission.
II. INSURANCE
CONTRACTOR shall maintain and submit certificates of all applicable insurance including, but not limited
to, the following and as otherwise required by law. The terms of the insurance policy or policies issued to
provide the above insurance coverage shall provide that said insurance may not be amended or canceled
by the carrier, for non-payment of premiums or otherwise, without thirty (30) days prior written notice
of amendment or cancellation to the CITY. In the event the said insurance is canceled, the CONTRACTOR
shall, prior to the cancellation date, submit to the City Clerk new evidence of insurance in the amounts
established.
Liability Insurance
During the entire term of this agreement, the CONTRACTOR agrees to procure and maintain General
Liability insurance at its sole expense to protect against loss from liability imposed by law for damages on
account of bodily injury, including death therefrom, suffered or alleged to be suffered by any person or
persons whomsoever, resulting directly or indirectly from any act or activities, errors or omissions, of the
CITY, or CONTRACTOR or any person acting for the CITY, or under its control or direction, and also to
protect against loss from Liability imposed by law for damages to any property of any person caused
directly or indirectly by or from acts or activities of the CITY, or CONTRACTOR or any person acting for the
CITY, or under its control or direction. Such public liability and property damage insurance shall also
provide for and protect the CITY against incurring any legal cost in defending claims for alleged loss. Such
General, Public and Professional liability and property damage insurance shall be maintained in full force
and effect throughout the term of the AGREEMENT and any extension thereof in the amount indicated
above or the following minimum limits:
A combined single limit liability policy in the amount of$2,000,000 or a commercial general liability policy
with a $2,000,000 occurrence limit and a $4,000,000 aggregate limit will be considered equivalent to the
required minimum limits.
All of such insurance shall be primary insurance and, shall name the City of Santa Clarita as additional
insured. A Certificate of Insurance and an additional insured endorsement (for general and automobile
liability), evidencing the above insurance coverage with a company acceptable to the City's Risk Manager
shall be submitted to City prior to execution of this Agreement on behalf of the City.
Should CONTRACTOR, for any reason, fail to obtain and maintain the insurance required by this
Agreement, City may obtain coverage at CONTRACTOR'S expense and deduct the cost of such insurance
from payments due to CONTRACTOR under this Agreement or terminate. In the alternative, should
CONTRACTOR fail to meet any of the insurance requirements under this agreement, City may cancel the
Agreement immediately with no penalty.
Should Contractor's insurance required by this Agreement be cancelled at any point prior to expiration of
the policy, CONTRACTOR must notify City within 24 hours of receipt of notice of cancellation.
Furthermore, CONTRACTOR must obtain replacement coverage that meets all contractual requirements
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
within 10 days of the prior insurer's issuance of notice of cancellation. CONTRACTOR must ensure that
there is no lapse in coverage.
If the operation under this Agreement results in an increased or decreased risk in the opinion of the City
Manager, then the CONTRACTOR agrees that the minimum limits herein above designated shall be
changed accordingly upon request by the City Manager.
The CONTRACTOR agrees that provisions of this paragraph as to maintenance of insurance shall not be
construed as limiting in any way the extent to which the CONTRACTOR may be held responsible for the
payment of damages to persons or property resulting from the CONTRACTOR's activities or the activities
of any person or persons for which the CONTRACTOR is otherwise responsible.
Worker's Compensation Insurance
The CONTRACTOR shall procure and maintain, at its sole expense, Worker's Compensation Insurance in
the amount of $1,000,000 per occurrence or in such amount as will fully comply with the laws of the State
of California and which shall indemnify, insure and provide legal defense for both the CONTRACTOR and
the CITY against any loss, claim or damage arising from any injuries or occupational diseases happening
to any worker employed by the CONTRACTOR in the course of carrying out the work within the
AGREEMENT. Such insurance shall also contain a waiver of subrogation naming the City of Santa Clarita.
Automotive Insurance
The CONTRACTOR shall procure and maintain, at its sole expense, throughout the term of this
AGREEMENT, and any extension thereof, public liability and property damage insurance coverage for
automotive equipment with coverage limits of not less than $1,000,000 combined single limit. All such
insurance shall be primary insurance and shall name the City of Santa Clarita as an additional insured.
Fire and Extended Coverage Insurance (Services involving real property only)
CONTRACTOR also agrees to procure and maintain, at its sole expense, during the term of this
Agreement, and any extension thereof, a policy of fire, extended coverage and vandalism insurance.
have read and understand the above requirements and agree to be bound by them for any work
performed for the City. ��
Authorized Signature: Date:
Printed Name: b-y\\yA & Le—�i u
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E959lEF5
PROPOSAL FORM
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, California
TO THE CITY OF SANTA CLARITA, AS CITY:
In accordance with CITY's NOTICE INVITING BIDS, the undersigned BIDDER hereby proposes to furnish all materials,
equipment, tools, labor, and incidentals required for the above -stated project as set forth in the plans, specifications,
and contract documents therefore, and to perform all work in the manner and time prescribed therein.
BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications,
INSTRUCTIONS TO BIDDERS, and all other contract documents. If this proposal is accepted for award, BIDDER agrees
to enter into a contract with CITY at the unit and/or lump sum prices set forth in the following BID SCHEDULE. BIDDER
understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to CITY of
the proposal guarantee accompanying this proposal.
BIDDER understands that a bid is required for the entire work that the estimated quantities set forth in BID SCHEDULE
are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the
actual quantities of work satisfactorily completed. THE CITY RESERVES THE RIGHT TO INCREASE OR DECREASE THE
AMOUNT OF ANY QUANTITY SHOWN AND TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or
lump sum price(s) bid include all appurtenant expenses, taxes, royalties, and fees for the project's duration. In case of
discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures.
If awarded the contract, the undersigned further agrees that in the event of the Bidder's default in executing the
required contract and filing the necessary bonds and insurance certificates within ten working days after the date of
the CITY's notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become
the property of the CITY and this bid and the acceptance hereof may, at the CITY's option, be considered null and void.
Company Name: tDov
Company Address: 2 i), oc. � _ ,V.S i2
qq.
Phone:
Email:
By: i=>�11�.�L7 L-C— �J
Print Name
Title: A n'4
Signature: V��
Date:
DocuSign Envelope ID: BAAAF1FF-E8F2-4E04-A070-06D3E9591EF5
Qrrrornirrc
Bid #ENG-21-22-M1037
Santa Clarita City Hall Restrooms Remodel — Phase I
City Project No. M1037
City of Santa Clarita, California
The following are the names, addresses, and telephone numbers of three public agencies for which bidder
has performed and completed work of a similar scope and size within the past 3 years. If the scope of
work/specifications requests references different than instructions above, the scope of work/specifications
shall govern: Y1C���� js �. L�►' I � �Ci r�C1C��L�tc� S C �5�0
1. Cc FCC! o\ c1'� O'C�C��C�l1TlGi'1 ��5 � ��cS; Cfj - qco l5
2.
3.
Name and Address of Owner / Agency
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Name and Telephone Number of Person Familiar with Project
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Contract Amount
Name and Address of Owner /'Agency
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Name and Telep one Number of Person Familiar with Project
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Contract Amount
Type of Work
Dafe Completed
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Name and Addres's f Owner /-)Agency
ame and Telephone Number of Person F miliar with Project 4
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ntract Amount Type of Work ,f rK• Date Completed
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The following are the names, addresses, and telephone numbers of all brokers and sureties from whom
bidder intends to procure insurance bonds: JMC-i-�A o Q ' '
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