HomeMy WebLinkAbout2023-09-26 - AGENDA REPORTS - BUS STOP SIGN REPLACEMENTO
Agenda Item: 6
1. CITY OF SANTA CLARITA
AGENDA REPORT
CONSENT CALENDAR
CITY MANAGER APPROVAL: -rill
DATE: September 26, 2023
SUBJECT: QUICK RESPONSE CODE BUS STOP SIGN REPLACEMENT
DEPARTMENT: Economic Development
PRESENTER: Adrian Aguilar
RECOMMENDED ACTION
City Council:
1. Authorize the City Manager or designee to execute a contract with Sterndhal Enterprises,
LLC, for the removal of old/damaged signs and installation of new Quick Response code
signs at 692 bus stops in an amount of $196,740, and authorize a 10 percent project
contingency of $19,674, for a total contract amount not to exceed $216,414.
2. Authorize the City Manager or designee to execute all contract documents and extensions,
subject to City Attorney approval.
BACKGROUND
In 2011, the City of Santa Clarita (City) purchased Quick Response (QR) code signs and
installed them at approximately 700 bus stops within the City limits and at commuter bus stops
outside of Santa Clarita. The QR code signs are an easy and effective way for riders to receive
real-time bus arrival information while waiting for a bus at any bus stop by simply scanning the
code sign using their smartphones. With riders preferring to use contactless methods to receive
real-time bus arrival information, staff has seen an increase in usage of these signs over the past
two years. The current QR code signs are past their useful life and many stops have damaged or
missing signs. Additionally, with the City's recent transition to santaclarita.gov, the existing
signs will no longer be functional.
The City released Bid #TRT-23-24-03 to solicit bids from qualified vendors for the QR Code
Bus Stop Sign Replacement Project. The bid was advertised on the City's website on July 14,
2023, and in The Signal newspaper on July 14 and July 21, 2023. Notifications were also sent to
727 vendors. The bid was downloaded by 23 vendors, with the results as follows:
Page 1
Packet Pg. 30
O
Company Location Cost
Sterndhal Enterprises, LLC Sun Valley, CA $196,740
In response to receiving only one bid, staff reached out to vendors who downloaded but
ultimately did not submit a bid. The general feedback received was that due to low staffing
levels, they were unable to prepare and submit a proposal on time, or that after downloading and
reviewing the bid packet, their company was no longer interested in the project.
As a result, staff recommends Sterndahl Enterprises, LLC, to be awarded the contract for the
replacement and installation of the QR code signs at bus stops throughout the City.
ALTERNATIVE ACTION
Other action as determined by the City Council.
FISCAL IMPACT
There is no impact to the General Fund. The City has budgeted Federal 5307 Transit Grant
Funds to cover 80 percent of the project costs. The remaining 20 percent will be funded using
Municipal Operator Service Improvement Program (MOSIP) funds. Adequate funds are
available in the Transit Capital Outlay — Contractual Account 7003702-516101.
ATTACHMENTS
Bid Response-QR Code Bus Stop Sign Replacement - Sterndhal (available in the City Clerk's
Reading File)
Page 2
Packet Pg. 31
PROPOSAL FORM
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
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 BI D 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:
Company Address:
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Phone:
3
Email:
By:
Print Name
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Title:
Signature: V""
NOTICE TO BIDDERS REGARDING CONTRACTUAL REQUIREMENTS
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
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 Purchasing Agent.
Questions and requests for modification of these terms must be negotiated and approved prior to bid
submission and are at the full discretion of the City.
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.
1. 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
maintained by CONTRACTOR in this Agreement shall 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.
11. 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:
Commercial General Liability Insurance, including coverage for Premises and Operations, Contractual
Liability, Personal Injury Liability, Products/Completed Operations Liability, and Independent Contractors'
Liability (if applicable), in an amount of not less than two million dollars ($2,000,000.00). per occurrence,
four million dollars ($4,000,000.00) annual aggregate, written on an occurrence form.
Products/Completed Operations coverage shall extend a minimum of three (3) years after project
completion. Coverage shall be included on behalf of the CONTRACTOR for covered claims arising out of
the actions of independent contractors. If the CONTRACTOR is using subcontractors, the policy must
include work performed "by or on behalf" of the CONTRACTOR. Policy shall contain no language that
would invalidate or remove the CONTRACTOR'S duty to defend or indemnify for claims or suits expressly
excluded from coverage. Policy shall specifically provide for a duty to defend on the part of the
CONTRACTOR.
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 for each accident. All
such insurance shall be primary insurance and shall name the City of Santa Clarita as an additional insured.
Builder's Risk
Upon commencement of construction and with approval of CITY, CONTRACTOR shall obtain and maintain
Builder's Risk Insurance for the entire duration of the Project until only the CITY has an insurable interest.
The Builder's Risk coverage shall include the coverages as specified below:
The named insureds shall be CONTRACTOR and CITY, including its officers, officials, employees, and
agents. All subcontractors (excluding those solely responsible for design work) of any tier and suppliers
shall be included as additional insureds as their interests may appear. CONTRACTOR shall not be required
to maintain property insurance for any portion of the Project following transfer of control thereof to CITY.
The policy shall contain a provision that all proceeds from the Builder's Risk Policy shall be made payable
to the CITY. The CITY will act as a fiduciary for all other interests in the Project.
Policy shall be provided for replacement value on an "all risk" basis forthe completed value of the project.
There shall be no coinsurance penalty or provisional limit provision in any such policy. Policy must include-
(1) coverage for any ensuing loss from faulty workmanship, nonconforming work, omission or deficiency
in design or specifications; (2) coverage against machinery accidents and operational testing; (3) coverage
for removal of debris, and insuring the buildings, structures, machinery, equipment, materials, facilities,
fixtures and all other properties constituting a part of the Project; (4) Ordinance or law coverage for
contingent rebuilding, demolition, and increased costs of construction; (5) transit coverage (unless
insured by the supplier or receiving contractor), with sub -limits sufficient to insure the full replacement
value of any key equipment item; (5) ocean marine cargo coverage insuring any Project materials or
supplies, if applicable; (7) coverage with sub -limits sufficient to insure the full replacement value of any
property or equipment stored either on or off the site or any staging area. Such insurance shall be on a
form acceptable to CITY to ensure adequacy of terms and sub -limits and shall be submitted to the CITY
prior to commencement of construction.
Fire and Extended Coverage Insurance Services involving real Property only)
CONTRACTOR 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.
Pollution Liabilitv and/or Asbestos Pollution Liability and/or Errors & Omissions
Contractors Pollution Liability and/or Asbestos Pollution Liability and/or Errors & Omissions with limit no
less than $2,000,000 per claim or occurrence and $2,000,000 aggregate per policy period of one year.
Coverage must be included for bodily injury and property damage, including coverage for loss of use
and/or diminution in property value, and for clean-up costs arising out of, pertaining to, or in any way
related to the actual or alleged discharge, dispersal, seepage, migration, release or escape of
contaminants or pollutants, arising out of or pertaining to the services provided by CONTRACTOR under
this Agreement, including the transportation of hazardous materials or contaminants.
Professional Liability if Design -Build)
Professional Liability Insurance, insuring against professional errors and omissions arising from
CONTRACTOR'S work on the Project, in an amount not less than [$2,000,000j combined single limit for
each occurrence. If CONTRACTOR cannot provide an occurrence policy, CONTRACTOR shall provide
insurance covering claims made as a result of performance of work on this Project and shall maintain such
insurance in effect for not less than three years following final completion of the Project.
Waiver of Subrogation
All insurance coverage maintained or procured pursuant to this Agreement shall be endorsed to waive
subrogation against the CITY, its elected or appointed officers, agents, officials, employees and volunteers
or shall specifically allow CONTRACTOR or others providing insurance evidence in compliance with these
specifications to waive their right of recovery prior to a loss. CONTRACTOR hereby waives its own right of
recovery against the CITY, and shall require similar written express waivers and insurance clauses from
each of its subconsultants.
Separation of Insureds
A severability of interests provision must apply for all additional insureds ensuring that CONTRACTOR'S
insurance shall apply separately to each insured against whom claim is made or suit is brought, except
with respect to the insurer's limits of liability. The policy(ies) shall not contain any cross -liability exclusions.
Pass Through Clause
CONTRACTOR agrees to ensure that its subconsultants, subcontractors, and any other party involved with
the project who is brought onto or involved in the project by CONTRACTOR, provide the same minimum
insurance coverage and endorsements required of CONTRACTOR. CONTRACTOR agrees to monitor and
review all such coverage and assumes all responsibility for ensuring that such coverage is provided in
conformity with the requirements of this section. CONTRACTOR agrees that upon request, all Agreements
with consultants, subcontractors, and others engaged in the project will be submitted to the CITY for
review.
Self -Insured Retentions
Any self -insured retentions must be declared to and approved by the CITY. The CITY reserves the right to
require that self -insured retentions be eliminated, lowered, or replaced by a deductible. Self-insurance
will not be considered to comply with these specifications unless approved by the CITY.
Primary and Additional Insured
All of such insurance shall be primary 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 Purchasing Agent shall
be submitted to the CITY prior to execution of this Agreement on behalf of the CITY.
Requirements
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 canceled at any point prior to expiration
of the policy, CONTRACTOR must notify CITY within 24 hours of receipt of notice of cancelation.
Furthermore, CONTRACTOR must obtain replacement coverage that meets all contractual requirements
within 10 days of the prior insurer's issuance of notice of cancelation. 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's
Purchasing Agent, then the CONTRACTOR agrees that the minimum limits herein above designated shall
be changed accordingly upon request by the City's Purchasing Agent.
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.
I 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:
BID SCHEDULE
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
Fill out this form completely and submit with the bid response. Line item pricing must be entered on
BIdNet. In the event any mathematical discrepancies are found, please refer to Section B, Bid
Instructions.
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 Bid Schedule constant throughout the duration of the
project up to the last contract working day.
ITEM
NO.
DESCRIPTION
QTY
UNIT
UNIT PRICE
TOTAL
REMOVAL OF SIGNS
1. Remove QR Code Sign
543
EA
$
$ i P
2. Remove Bus Stop ID Number Placard
1
545
EA
$
$
INSTALLATION OF SIGNS
3. lnstall QR Code Sign 692 LS $ yo $ 3 gn �-
CONSTRUCTION ITEMS
4
Traffic Control and other construction related
elements"
1
LS
$ riajr PIZ)
$
5.
Mobilization/Demobilization
1
LS
$ u )7 —
$ i,at5
7.
Other Associated Items (Please describe):
1
LS
$
$
TOTAL. BASE BID AMOUNT.
$ L �C+� ?►I c .�
*Price must include tax and delivery to transit bus yard (25250 Constellation Rd., Santa Clarita, CA 91355).
*Work to be performed under this Section covers all labor, materials, tools, equipment, transportation
and incidentals necessary to maintain and control all pedestrian and vehicular traffic through the
construction site.
TOTAL BASE BID AMOUNT IN WORDS:
BIDDER'S INFORMATION AND CERTIFICATION
Biel #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarlta, 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
Biddercertifies 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: V-AA4- L��
Business Address: ] 1 . - PAW-9 1-�b J `I 1 1'AO VAI" �A , c(15
Telephone No.: 'ff. 9)t NP�
State CONTRACTOR's License No. & Class: �� 11 r� )) -,u c"I /
DIR No.:
Original Date: Expiration Date:
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:
The dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in
this proposal, or any firm, corporation, partnership or joint venture of which any principal having an interest
in this proposal was an owner, corporate officer, partner or joint 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 a ,submits this proposal with the names, title, hands, and seals
of all aforementioned principals this f day ofA4L 200.
BIDDER: 0---R , _
Signature
Name and Title of Signatory
�
Legal Name of Bidder
lkm
Address
Telephone Number Federal Tax I.D. No.
el7r)--
BIDDER'S QUESTIONNAIRE
Bid ##TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
--��,.� E� c
1. Submitted by: � i��- �rr M.- Telephone:
—Zy
Principal Office Address:i I . 17Wlay!
2. Type of Firm:
❑ C Corporation
❑ S Corporation
❑ Individual/Sole Proprietor or Single -Member LLC
❑ Partnership
❑ Limited Liability Company "C" C-Corp
A Limited Liability Company "S" S-Corp
❑ Limited Liability Company "P" Partnership
❑ Other
3a. If a corporation, answer these questions:
Date of Incorporation: I I F)- State of Incorporation: /- A
President's Name: .2,
Vice -President's Name:
Secretary or Clerk's Name:
Treasurer's Name: r �.-
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.
BIDDER'S QUESTIONNAIRE cont'd
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
4. Name of person holding CONTRACTOR'S license:
License number: %143 Class: (,)-31&piration Date:
D.I.R. Registration # (cAb_C
5. CONTRACTOR's Representative:
Title:
Alternate:
Title:
b. List the major construction projects your organization has in progress as of this date:
A.
Owner:
Project Location: f�--,-OKDD
Type of Project: y t
B.
Owner: ((''
Project Location: J ~• rr
Type of Project:
O
Owner:
Project Location: J
Type of Project: (0" ) ycv xL 1._ M"i-1 Al
CERTIFICATION OF NON -SEGREGATED FACILITIES
Bid #TRT-23-24.03
Quick Response MR) Code Bus Stop Sign Replacement Project
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.
\1 b LL
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).
DESIGNATION OF SUBCONTRACTORS
Bid # TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
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 Yz of 1 percent, or $10,000 (whichever is greater) of the prime contractor's total bid: DBE status, age of firm and annual gross receipts
are required if sub -contractor is participating as a DBE. If no Subcontractors will be used fill out the form with NA. Add addt. sheets if needed.
Subcontractor
!�lC�
DIR Registration No.*
Dollar Value of Work
Age of firm:
DBE: Yes No
Certifying Agency:
Annual Gross Receipts:
Location and Place of Business
Bid Schedule Item No's:
Description of Work
License No.
Exp. Date: / /
Phone { }
Subcontractor
DIR Registration No.*
Dollar Value of Work
Age of firm:
DBE: Yes No
Certifying Agency:
Annual Gross Receipts:
Location and Place of Business
Bid Schedule Item No's:
Description of Work
License No.
Exp. Date: /
Phone { }
Subcontractor
DIR Registration No.*
Dollar Value of Work
Age of firm:
DBE: Yes No
Certifying Agency:
Annual Gross Receipts:
Location and Place of Business
Bid Schedule Item No'$:
Description of Work
License No.
Exp. Date: / /
Phone ( )
NOTE: A BIDDER or subcontractor shall not be qualities to wo on, be iisteo in a Nd proposal, Suuicul W u- [ C 1-1- CII 6— UI ==,L .. -.-- -, ..._
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 1725.5 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 101E4 or 20103.5 of the Public Contract
C d 'd d th BIDDER is re ictered to perform public work pursuant to Section 1725.5 of the Labor Code at the time the contract is
o e, prow e e g
awarded. *Pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720) of the California Labor Code.
REFERENCES
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
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:
Name and Address of Owner / Agency
Name and Telephone Number of Person Familiar with Project
NE
Amount
2. R-
Name Ad Address of Owner/ Agency
J0 5, gj---k- S
Type of Wo k
Name and Telephone Number of Person Familiar with Project
Contract Amount Type 4 Work
3. C 7 L.6 rLEJ
Namend Address of Owner / Agency
AL
Name and lephone Number of Person Familiar with Project
``
Amount
Type of
�-�L" DL'(
Date Completed
Date Completed
�g��ba3i
op.���,
Date Completed
The following are the names, addresses, and telephone numbers of all brokers and sureties from whom
bidder intends to procure insurance bonds:
m
EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
This bidder J 1:`t�"' i_ l�l.' , proposed subcontractor hereby certifies
that it hasy�, has not participated in a previous contract or subcontract subject the equal
opportunity clause, as required by Executive Orders 10925.11114, or 11246, and that it has X has not
, filed with the Joint Reporting Committee, and Director of Office of Federal Contract Compliance, a
Federal Government contracting or administering AGENCY, or the former President's Committee on Equal
Employment Opportunity, all reports that are under the applicable filing requirements.
Company:
���� L.LL
Title: tAVE ll-�—,f, .
QQ
Date: /.) —( (- �--y
Note: The above certification is required by the Equal Employment Opportunity of the Secretary of
Labor (41 CFR 60-1.7(b)(1)) and must be submitted by bidders and proposed subcontractors only in
connection with contracts and subcontracts which are subject to the equal opportunity clause as set forth
in 41 CFR 60-1.5, (Generally only contracts or subcontracts of $10,000 or under are exempt.)
Currently, the Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their
implementing regulations.
Proposed prime CONTRACTORS/BIDDER and subcontractors who have participated in a previous contract
or subcontract subject to the Executive Orders and have not filed the required reports should note that 41
CFR 60-1.7(b)(1) prevents the award of contracts and subcontracts unless such BIDDER submits a report
covering the delinquent period or such other period specified by the Federal Highway Administration or by
the Director, Office of Federal Contract Compliance, U.S. Department of Labor.
NON -COLLUSION AFFIDAVIT
(Title 23 United States Code Section 122 and Public Contract Code Section 7106)
Bid #TRT-23-24.03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
To the CITY OF SANTA CLARITA:
In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106, the
Bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person,
partnership, company, association, organization, or corporation; that the bid is genuine and not
collusive or sham; that the Bidder has not directly or indirectly induced or solicited any other bidder
to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed
with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that
the Bidder has not in any manner, directly or indirectly, sought by agreement, communication, or
conference with anyone to fix the bid price of the Bidder or any other bidder, or to fix any overhead,
profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage
against the public body awarding the contract of anyone interested in the proposed contract; that all
statements contained in the bid are true; and, further, that the Bidder has not, directly or indirectly,
submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged
information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership,
company association, organization, bid depository, or to any member or agent thereof to effectuate
a collusive or share bid.
THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THE 'BIDDER'S CERTIFICATION" SHALL
ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH FORM A
PART OF THE PROPOSAL. BIDDERS ARE CAUTIONED THAT MAKING A FALSE CERTIFICATION MAY
SUBJECT THE CERTIFIER TO CRIMINAL PROSECUTION.
NON -COLLUSION AFFIDAVIT
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
TO BE EXECUTED BY EACH BIDDER OF A PRINCIPAL CONTRACT
STATE OF CALIFORNIA )
COUNTY OF LOS ANGELES )
b�►) jV -PrAN'- being first duly sworn deposes and says that he/she is
the VkkV "A (sole owner, a partner, president, etc.) of
L 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 sucl`i person or persons as have a partnership or other financial
interest with said BIDDER in his general bush/s.
Bidder:
Signature
ONE- Q
Title
BIDDER'S BOND
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
Proposals must be accompanied by a proposal guarantee consisting of a certified check, cashier's check
or BIDDER's bid bond payable to the CITY or cash deposit in the amount not less than ten (10) percent of
the total amount bid. Certified check, cashier's check or Bidder's bid bond must be received at City Wall,
23920 Valencia Blvd., Santa Clarita, CA 91355, Attn: Purchasing, Suite 120, and marked with the words
"BID BOND FOR" and the bid #, no later than the bid closing date and time, for the BIDDER to be
considered resoonsive.
NOTE: The following farm shall be used in case check accompanies bid.
Accompanying this Proposal s a *certified/cashier's check payable to the order of the City of Santa Clarita
for: dollars ($ )., this amount being not
less than ten percent (10%) of th total amount of the bid. The proceeds of this check shall become the
property of said CITY provided this oposal shall be accepted by said CITY through action of its legally
constituted contracting authorities, an the undersigned shall fail to execute a contract and furnish the
required bonds within the stipulated time, therwise, the check shall be returned to the undersigned.
Project Name: Quick Response (QR) Code Bkstop sign Replacement Project
Bid No. TRT-23-24-03
Bidder's Signature
CONTRACTOR/BIDDER
Address
City, State, Zip Code
* Delete the inapplicable work.
MOTE: If the bidder desires to use a bond instead of a check, the following form shal a executed.
The sum of this bond shall be not less than ten percent (10%) of the total amount of the bid.
PROPOSAL GUARANTEE BID BOND
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
KNOW ALL PERSONS BYE THESE PRESENTS that
as BIDDER, and
s SURETY, are held and firmly bound unto the
City of Santa Clarita, as CITY, in a penal sum of dollars ($ ), which is ten percent (10%)
of the total amount bid by BIDDERqo CITY for the above -stated project, for the payment of which sum, BIDDER and
SURETY agree to be bound, jointly aN severally, firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION RE SUCH that, whereas BIDDER is about to submit a bid to CITY for the
above -stated project, if said bid is rejecteN or if said bid is accepted and the contract is awarded and entered into
by BIDDER in the manner and time specified, hen 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
Day of
CONTRACTOR:
Name and Title of Signatory
Legal Name of Bidder
Bidder Address
Telephone Number
SURETY*:
Name
Phone Number and Email
Address
eir names, titles, hands, and seals, this
2023.
Signature
Federal Tax gip. No.
*Provide BIDDER and SURETY name, phone number, email, and the name, title, address, d phone number for
authorized representative. IMPORTANT - Surety Companies executing Bonds must app r on the Treasury
Department's most current list (Circular 570, as amended) and be authorized to transact busines �inthe State where
the project is located.
Contractor and Suret signatures must be notarized prior to submittal.
GOVERNMENT -WIDE DEBARMENT AND SUSPENSION (NONPROCURMENT)
Bid #TRi-23-24-03
Quick Response MR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
Instructions for Certification: By signing and submitting this bid or proposal, the prospective lower tier
participant is providing the signed certification set out below.
(1) It will comply and facilitate compliance with U.S. DOT regulations, "Nonprocurement Suspension
and Debarment," 2 CFR part 1200, which adopts and supplements the U.S. Office of Management and
Budget (U.S. OMB) "Guidelines to Agencies on Governmentwide Debarment and Suspension
(Nonprocurement)," 2 CFR part 180,
(2) To the best of its knowledge and belief, that its Principals and Subrecipients at the first tier:
Are eligible to participate in covered transactions of any Federal department or agency and are
not presently:
(1) Debarred,
(2) Suspended,
(3) Proposed for debarment,
(4) Declared ineligible,
(5) Voluntarily excluded, or
(6) Disqualified,
Its management has not within a three-year period preceding its latest application or proposal
been convicted of or had a civil judgment rendered against any of them for:
(1) Commission of fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public (Federal, State, or local) transaction, or contract under a
public transaction,
(2) Violation of any Federal or State antitrust statute, or
(3) Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making any false statement, or receiving stolen property,
It is not presently indicted for, or otherwise criminally or civilly charged by a governmental entity
(Federal, State, or local) with commission of any of the offenses listed in the preceding subsection
2.b of this Certification,
d. It has not had one or more public transactions (Federal, State, or local) terminated for cause or
default within a three-year period preceding this Certification,
e. If, at a later time, it receives any information that contradicts the statements of subsections 2.a ---
2.d above, it will promptly provide that information to FTA,
It will treat each lower tier contract or lower tier subcontract under its Project as a covered lower
tier contract for purposes of 2 CFR part 1200 and 2 CFR part 180 if it:
(1) Equals or exceeds $25,000,
(2) Is for audit services, or
(3) Requires the consent of a Federal official, and
g. It will require that each covered lower tier contractor and subcontractor:
(1) Comply and facilitate compliance with the Federal requirements of 2 CFR parts 180 and
1200, and
(2) Assure that each lower tier participant in its Project is not presently declared by any Federal
department or agency to be:
a. Debarred from participation in its federally funded Project,
b. Suspended from participation in its federally funded Project,
c. Proposed for debarment from participation in its federally funded Project,
d. Declared ineligible to participate in its federally funded Project,
e. Voluntarily excluded from participation in its federally funded Project, or
f. Disqualified from participation in its federally funded Project, and
(3) It will provide a written explanation as indicated on a page attached in FTA's TEAM -Web or the
Signature Page if it or any of its principals, including any of its first tier Subrecipients or its Third Party
Participants at a lower tier, is unable to certify compliance with the preceding statements in this
Certification Group.
Certification
Contractor 11�1tlhTifi`� L_
Signature of Authorized Official
Date LA_�
Dame and Title of Contractor's Authorized Official s �, J `" (-- v� �"t� f `
CERTIFICATIONS AND RESTRICTIONS ON LOBBYING
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
I, hereby certify on behalf of
(Name and title of official)
f ` -�LOJ'.J that:
(Name of Proposer/Company Name)
No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to
any person for influencing or attempting to influence an officer or employee of any agency, a Member
of Congress, and officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any federal contract, the making of any federal grant, the making of
any federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.
• If any funds other than federal appropriated funds have been paid or will be paid to any person
influencing or attempting to influence an officer or employee of any agency, a Member of Congress,
and officer or employee of Congress, or an employee of a Member of Congress in connection with the
federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form — LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
The undersigned shall require that the language of this certification be included in the award
documents for all sub -awards at all tiers (including sub -contracts, sub -grants and contracts under
grants, loans, and cooperative agreements) and that all sub -recipients shall certify and disclose
accordingly..
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by 31 U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Anyperson
who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
The undersigned certifies or affirms the truthfulness and accuracy of the contents of the statements submitted
on or with this certification and understands that the provisions of 31 U.S.C. Section 3501, et seq., are applicable
thereto.
Name of Proposer/Company Name
Type or print name_
Signature of authorized representative _ 6Z_:�:K2Date��� J
Signature of notary and SEAL
CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
(CALIFORNIA 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 Santa Barbara
On 08/11/2023 before me,
Danielle R Gutierrez, Notary Public
(Date) (Here Insert Name and Title of the Officer)
personally appeared Dennis Randall Sterndahl
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument
the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
*my
DANIELLE R, GU71ERREZ
Signature of Notary Public � - (Notary SeaE) Notary Public - California
Santa Barbara County iE
Commission k 2435155
Comm. Expires Feb 17, 2027
ADDITIONAL OPTIONAL INFORMATION
Description of Attached Document
Title or Type of Document:
Number of Pages
Additional Information:
Document Date:
Signer(s) Other Than Named Above:
revision date 01/01/2015
SUBCONTRACTORS
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Ciarita, California
I. SUBCONTRACTORS. The BIDDER performs not less than 30% percent of the original contract work
with the bidder's own organization.
2. LIST OF SUBCONTRACTORS. No more than 70% of the work, as defined by the contract price, maybe
done by subcontractors. Copies of subcontracts will be provided to the City Engineer upon his request.
2.1. Each BIDDER must submit with his bid the following:
2.1.1.The Full name of each subcontracting firm as required by Government Code, Sec. 4201,
typed or legibly printed.
2.1.2.The address of each firm.
2.1.3.The telephone number at the place of business.
2.1.4.Work to be performed by each subcontracting firm.
2.1.5.Total approximate dollar amount of each subcontract.
2.2. Submit the "Designation of Subcontractors" form enclosed herewith. No Contract shall be
considered unless such list is submitted as required.
3. PROMPT PROGRESS PAYMENT TO SUBCONTRACTORS. A prime contractor or subcontractor shall pay
to any subcontractor, not later than seven days after receipt of each progress payment, unless
otherwise agreed to in writing, the respective amounts allowed the contractor on account of the work
performed by the subcontractors, to the extent of each subcontractor's interest therein in accordance
with the provision in Section 7108.5 of the California Business and Professions Code concerning
prompt payment to subcontractors. In the event that there is a good faith dispute over all or any
portion of the amount due on a progress payment from the prime contractor or subcontractor to a
subcontractor, the prime contractor or subcontractor may withhold no more than 150 percent of the
disputed amount. Any violation of this section shall constitute a cause for disciplinary action and shall
subject the licensee to a penalty, payable to the subcontractor, of 2 percent of the amount due per
month for every month that payment is not made. In any action for the collection of funds wrongfully
withheld, the prevailing party shall be entitled to his or her attorney's fees and costs. The sanctions
authorized under this section shall be separate from, and in addition to, all other remedies, either
civil, administrative, or criminal.
4. CALIFORNIA DEBARRED CONTRACTORS AND SUBCONTRACTORS. Sections 1720 et seq. of the Labor
Code and Section 6109 of the Public Contract Code apply to the Contract, and each potential bidder
and Subcontractor is responsible to be in full compliance with those laws. If a potential bidder or
subcontractor has been found by the California Labor Commissioner to be in violation of Section 1720
et seq. of the Labor Code, in accordance with Section 1777.1of the Labor Code, the potential bidder
shall be ineligible to bid or be awarded a contract or to perform work on any City public works project.
In accordance with Section 6109 of the Public Contract Code any subcontractor who is ineligible to
perform work on a public works project pursuant to Section 1777.1 or 1777.7 of the Labor Code is
prohibited from performing work on any City public works project. Pursuant to Section 6109(b) of the
Public Contract Code, any contract on a City public works project entered into between a bidder and
a debarred subcontractor is void as a matter of law. A debarred subcontractor may not receive any
City money for performing work as a subcontractor on a City public works contract, and any City
money that may have been paid to a debarred subcontractor by a bidder on the project shall be
returned to the City. The bidder shall be responsible for the payment of wages to workers of a
debarred subcontractor who has been allowed to work on the City project.
5. PERFORMANCE OF SUBCONTRACTORS.
5.1. The subcontractors listed by the Contractor in conformance with Section 3-3, "Subcontracts"
of the (SSPWC), shall perform the work and supply the materials for which they are listed,
unless the Contractor has received prior written authorization to perform the work with other
forces or to obtain the materials from other sources.
5.2. The subcontractors listed by you in the Contract Documents shall list therein the name and
address of each subcontractor to whom the bidder proposes to subcontract portions of the
work in an amount in excess of one-half of one percent of the total bid or $10,000, whichever
is greater, in accordance with the Subletting and Subcontracting Fair Practices Act,
commencing with Section 4100 of the Public Contract Code. The bidder's attention is invited
to other provisions of the Act related to the imposition of penalties for a failure to observe its
provisions by using unauthorized subcontractors or by making unauthorized substitutions.
6. DISADVANTAGED BUSINESS ENTERPRISE DBE) PARTICIPATION. At the time of contract execution,
Contractor committed to utilize Disadvantaged Business Enterprise(s) ("DBE") in the performance of
this DOT -assisted contract, and further agrees to ensure that any DBE subcontractors listed on the
"DBE Participation Commitment Form," will perform work and/or supply materials in accordance with
original commitments, unless otherwise directed and/or approved by City prior to Contractor
effectuating any changes to its race -conscious DBE participation commitment(s). Contractor shall
comply with all the requirements set forth in the "DBE CONTRACT PROVISIONS FOR DOT -ASSISTED
CONTRACTS WITH DISADVANTAGED BUSINESS ENTERPRISE (DBE) GOALS" which is attached to and,
by this reference, incorporated in and made a part of this Agreement.
7. SMALL AND DISADVANTAGED BUSINESS ENTERPRISE PROGRAM. The City of Santa Clarita (City) has
adopted a Disadvantaged Business Enterprise (DBE) Program, in conformance with Title 49 CFR Part
26, "Participation by Disadvantaged Business Enterprises in Department of Transportation (DDT)
Financial Assistance Programs."
This DOT -assisted contract is subject to these stipulated regulations and the City's DBE program, which
are incorporated in their entirety by this reference.
In the event of any conflicts or inconsistencies between the Federal Regulations and the City's DBE
Program with respect to DOT -assisted contracts, the Federal Regulations must prevail.
7.1. DBE Goal. In conformance with the City's DBE Policy and Program, the City has established a 0%
DBE contract -specific goal on this project.
DBE PARTICIPATION COMMITMENT FORM
THIS FORM MUST BE COMPLETED AND SUBMITTED WITH THE BID AS A CONDITION
OF DBE RESPONSIVENESS
NOTE: Refer to instructions on the reverse side of this form. This page can be duplicated to fist all
participating DBEs.
Bidder to ComplEte this Section
1. IFB No.:
2. Project Name/Description:
3. Prime Bidder Name:
4. Contract DBE Goal %: (if applicable)
5. Bidder's Total Bid Price (if applicable)
Required DBE Commitment Information
6. DBE Firm T DBE 8. Description of Scope of S. Bid Item 10. Dollar Value 11, Dollar Value ($)
(Name, Address, E-Mail, Phone) Certification ServicesNVork (#) ($) or Percent or Percent (%) of
Number (%) of Eligible DBE
Participation Participation/
Commitment
Note: As a condition of responsiveness, the bidder is required to submit with the 12. Total Dollar Value ($) or Percent (°/a) of
Bid a Letter of Intent and Affirmation signed and dated from each DBE listed in Eligible DBE Participation:
Column 6 acknowledging that the DBE is participating in the contract for the
specified dollar value ($) or percent (%), and scope of work. If DBE goal is over 0%,
the dollar amount in the Letter of Intent and Affirmation and the amount shown on 13. Eligible DBE Participation Represented as
this form MUST match identically. Percentage (%) of Bidder's Total Bid Price:
Bidder Assurance: The bidder certifies that information on this form is complete and accurate, that it has verified the listed DBE(s) certification
status and is only crediting eligible DBE participation towards meeting the contract DBE" goal.
14. Preparer's Name (Print) 15. Preparer's Signature 16. Preparer's Title
17. Date 18. Telephone No, 19. Email Address
INSTRUCTIONS - DBE Participation Commitment Form
Bidder is required to ensure all information is complete and accurate:
1. IFB No. - Enter the IFB Number.
2. Project Name/Description - Enter the name and/or description of the project.
3. Prime Bidder Name - Enter the bidder's firm name.
4. Contract DBE Goal % - Enter the contract DBE goal percentage (if applicable).
5. Bidder's Total Bid Price — Enter the bidder's total bid price (if applicable).
6. DBE Firm — Enter name and address of the proposed DBE firm. Identify all DBE firms being claimed
for credit, regardless of tier.
7. DBE Certification Number - Enter the DBE's certification identification number. All DBEs must have
a valid DBE certification at time of bid opening.
8. Description of Scope of ServicesNVork — Enter the scope of services/work for each DBE firm listed
to participate on this contract.
9. Bid Item (#) - Enter bid item number.
14. Dollar Value ($) or Percent (%) of Participation - Enter the total dollar value of participation for each
listed DBE firm,
11. Dollar Value ($) or Percent (%) of Eligible DBE Participation/Commitment - Enter the dollar value
of participation eligible to count towards meeting the contract DBE goal. This value should exclude work
performed by lower tier subcontractors and account for the DBE's capacity based on their certification
type in conformance with the DBE crediting provisions set forth in Title 49 CFR Part 26.55.
12. Total Dollar Value ($) or Percent (%) of Eligible DBE Participation - Enter the sum of all eligible
participation listed in column 11.
13. Eligible DBE Participation Represented as a Percentage (%) of Bidder's Total Bid Price - Enter
the corresponding percentage of the total eligible DBE participation that the bidder is counting towards
the bidder's DBE goal commitment (Formula: Item (12) Total Value of Eligible DBE Participation / Item
(6) Bidder's Total Bid Price = Bidder's DBE Goal Commitment Percent (%)).
14. Preparer's Name (Print) - Clearly enter the name of the authorized person preparing the form on
behalf of the bidder.
15. Preparer's Signature - Authorized person's signature.
16. Preparer's Title - Enter the position/title of the authorized person signing the form on behalf of the
bidder.
17. Date - Enter the date the form is signed.
18. Telephone No. - Enter the area code and telephone number of the authorized person signing the form
on behalf of the bidder.
19. Email Address - Enter the email address of the authorized person signing the form on behalf of the
bidder.
Bidders List
The Department of Transportation requires the City to create and maintain a "Bidders List" containing information about all firms (DBE and Nan -DBE) that bid, propose or quote on the
City's DOT -assisted contracts, in accordance with 49 CFR Part 26,11. The "Bidders List' is intended to be a count of all firms that are parficipating, or attempting to participate, on
DOT -assisted contracts, whether successful or unsuccessful in their attempt to obtain a contract
The bidder is to complete all requested information for every firm who submitted a bid, proposal or quote, including the primary bidder, and submit this information
to the City no later than 48 hours following the Citys bid due date, or as otherwise specified in the solicitation. The City will utilize this information to assist in the CiVs DBE goal -
setting process
Prime Name and Location
Type Of
WorklSerAceslMaterials
Provided:
Subcontract
Amount
Percentage of
Bid Item
Sub -contracted
Contractor
License No.
DBE
(YIN)
Phone:
Annual Gross
Receipts
NAICSIWCC
DIR Reg
DBE
E-malk
Number
Certification ID
Prime Bidder.
Less than $1 million
Less than $5 million
Contact Name:
Less than $10
million
Less than $15
million
Address
Ej More than $15
million.
Age of Firm: vrs.
Subcontractor Name and
Location
Type of
Worki-ServiceslMateriafs
Provided:
Subcontract
Amount
Percentage of
Bid Item
Sub -contracted
Contractor
License No,
DBE
(YIN)
Phone:
Annual GroS9
Receipts
NAICSrWCC
DIR Reg
DBE
Email:
Number
Certification ID
Firm blame:
Les& than $1 million
Less than $5 million
Contact Narne:
❑ Leas than $10
million
Less than $15
million
Address:
❑ More than $15
million
Age of Firm: yrs_
N�
Bidders List
Subcontractor Name and
Location
Type of
Worwseri icesfMaterlals
Subcontract
Amount
Percentage of 1
Bid item
Contractor
License No:
DBE
(YIN)
Phone:
Annual Dross
Receipts
Provided.
Sub -contracted
NAICSIWCC
AIR Rey
Number
DBE
Certification ID
E-mail:
Firm Nam:
Less than $1 million
Less than $5 million
Less than $10
million
Contact Name:
❑ Less than $15
million
Address:
More then $15
million
Age of Firm:yrs,
Firm Name:
Less than $1 million
Less than $5 million
❑ Less than $10
million
Contact Name:
Less than 515
million
❑ More than S15
million
Address:
Age of Firm; yrs.
Name:
Less than $1 million
Less than $5 million
❑ Less than $10
million
Contact Name:
Lj Less than $15
million
More than 515
million
Address:
Age of Firm: Yrs.
n�ac I icr
oCl11 IICC9RChFTC
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SECTION E
Auvardee Sam fe Forms .
Addendum No. 1
July 18, 2023
Addendum. No. 1
BID # TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
This addendum must be acknowledged via BidNet and should he included with the hid response.
The purpose of this addendum is to address the following for this Bid:
i. UPDATED SCOPE OF WORK
Please see the attached updated scope of work.
END OF ADDENDUM
This addendum must be ackna�edged via BidNet and should be included with the response.
Contractor's Representative Date
S-�WN E. �tEawv!�J
Company Name
BID # TRT-23-24-03
IV
SCOPE OF WORK
Bid # TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
1. BACKGROUND
THIS PROJECT IS FEDERALLY FUNDED. The City of Santa Clarita (City) is soliciting bids for a bus
stop improvement program that will include replacing 700 Quick Response (QR) code bus stop
signs at 692 bus stop locations, 83 of which are in the surrounding Los Angeles area commuter
bus stops, See Exhibit "A" for locations list.
The project will include:
1. Remove existing Bus Stop ID placards (described in Exhibit C)
2. Remove existing QR code stop signs (described in Exhibit B).
3. Install QR code stop sign with ready to install customized bus stop sign. NOTE: Quick
Response (QR) Code signs will be provided by the City, the sign will be ready to install,
however, the contractor shall be responsible for ALL hardware materials needed to
install signs. See Exhibit "A" for locations list.
• 692 Bus stop signs
It. SIGN STANDARDS
Generally, the Scope of Work to be performed includes removal and installation of new bus stop
signs.
111. GENERAL WORK TO BE PERFORMED
REMOVE QR CODE SIGN
A. Scope
The scope of work under this bid item shall include removal and transportation of existing sign
to the Transit Maintenance Facility for recycling. CONTRACTOR's attention is directed to Exhibit
A of these for specifications for the installation of signs.
B. Measurement and Payment
Removal, replacement and transportation of existing sign shall be paid for at the contract unit
price bid for Each sign removed price paid for "REMOVE AND REPLACE SIGN" and shall include
all labor, materials, equipment, and incidentals necessary to complete the work and no
additional compensation shall be made therefore,
REMOVE BUS STOP ID #t PLACARD
A. Scope
The scope of work under this bid item shall include removal, and transportation of existing sign
to the Transit Maintenance Facility for recycling. CONTRACTOR's attention is directed to Exhibit
C of these for specifications for the installation of signs.
B. Measurement and Payment
Removal of bus stop ID placard shall be paid for at the contract unit price bid for Each placard
removed price paid for "REMOVE BUS STOP ID # PACARD" and shall include all labor, materials,
equipment, and incidentals necessary to complete the work and no additional compensation
shall be made therefore.
INSTALL NEW SIGN
A. Scope
The scope of work under this bid item shall include the installation of a new sign, location as
indicated on the plans. CONTRACTOR's attention is directed to Exhibit C of these for
specifications for the installation of signs.
S. Measurement and Payment
Installation of signr shall be paid for at the contract unit price bid for Each sign installed price
paid for "INSTALL NEW SIGN" and shall include all labor, materials, equipment, and incidentals
necessary to complete the work and no additional compensation shall be made therefore.
RECYCLING OF QR CODE SIGNS AND BUS NUMBER ID'S
All bus sign materials including previously installed bus stop signs should be brought back to the
Transit Maintenance Facility for recycling, located at 28250 Constellation Road, Santa Clarita,
CA, 91355,
IV. LOCATION OF WORK
All stops are located in the City of Santa Clarita and surrounding Los Angeles area commuter bus
stops. Exact locations are shown in Exhibit A.
V. TIME OF COMPLETION
The CONTRACTOR shall complete all work in every detail within one hundred and fifty (150)
working days after the date stated in the Notice to Proceed with Work.
VI. LIQUIDATED DAMAGES
Contractor shall pay $10 per day, per sign not installed by the end of the completion date.
Completion date shall be stated in the Notice to Proceed with work notification.
VII. NOTIFICATION
The CONTRACTOR shall notify the AGENCY not less than (2) working days prior to start of work.
ti
Contractor shall provide a list of bus stops to City Project Manager so bus stops can be
temporarily closed and community patrons can be notified.
Quantities of Bus Stop Signs and locations are Subject to Change. The City reserves the right to
change the actual number of bus stop locations included in the project. Furthermore, additional
items may be required before conclusion of the project. As a result, all proposers shall include
detailed and itemized price quote (with cost per unit information) for the installation of bus stop
sign, and the removal, and recycling of used bus stop signs, this shall include transportation and
other costs associated with any worked to be performed.
Bidder has, by investigation of the site of the work and otherwise, understands the nature and
location of the work and has fully informed the City as to all conditions and matters, which can
in any way affect the work or cost thereof.
A. Project Management
The bidder shall be responsible for setting up a timeline to complete the project within 15 days
of project award. The contractor will be expected to provide supervisory assistance during
fabrication and installation of shelters, benches and trash receptacles. The contractor shall
provide management during the course of the work to include, but not be limited to,
coordination of all relevant activities, general consulting, permit application preparation and
submittal, notification to adjacent property owners where the impacted bus stops are located,
coordination and facilitation with and between relevant City departments and other
stakeholders, and other tasks necessary for the successful implementation of the project. Since
Federal Transportation Administration (FTA) dollars are being used in this project, Contractor
shall ensure that the project will be in compliance with all FTA rules and regulations and shall
assist in providing all necessary information and documentation for invoicing and grant
management purposes.
Contractor shall assign a Project Manager (Contractor Project Manager) to implement, manage,
facilitate, and coordinate all aspects of the Project and other tasks as necessary to implement
the Project. Contractor Project Manager shall be the point of contact for all project -related
issues and communications and shall provide regular project status update to City's Project
Manager. Regular meetings between Contractor and City shall be held to ensure the Project is
being implemented per schedule and all project -related issues are resolved.
Vlll. EMERGENCY INFORMATION
The names, addresses, and telephone numbers of the CONTRACTOR and SUBCONTRACTORS
shall be filed with the City.
IX. TRAFFIC CONTROL
A. Scope
Contractor shall prepare a traffic control plan and detour route for pedestrian accessibility (THE
PLAN) if the existing pedestrian path of travel will be impacted with the proposed
improvements. THE PLAN shall ,.be,submitted to the City's Proiect Manager for approval at least ,,
two week prior to the start of the construction.
Traffic control shall be provided in accordance with the WATCH manual or the MUTCD.
Contractor shall provide electronic message board (1) and the location of a message board shall
be included in the traffic control plan.
The contract lump sum price paid for traffic control system (including THE PLAN and one
electronic message board), shall include full compensation for furnishing all labor, materials,
tools, any relocation or adjustment or removal of traffic control signs and/or an electronic
message board if requested by the City Traffic Engineer during the course of construction,
equipment, and incidentals and for doing all the work involved in traffic control system.
Work to be performed under this Section covers ail labor, materials, tools, equipment,
transportation and incidentals necessary to maintain and control all pedestrian and vehicular
traffic through the construction site. In addition, this work shall include all work as outlined in
Section 7-10 "Public Convenience and Safety" of the Greenbook Standard Specifications and
these Contract Documents.
B. Materials and Method
All such work shall conform to the applicable provisions of the Greenbook Standard
Specifications and these Special Provisions.
The criteria for controlling traffic movements in the work areas are contained in "A Guide to
Temporary Traffic Control in Work Zones", 4th Edition, published by the American Traffic Safety
Services Association (ATSSA). The manual prescribes MINIMUM standards forthe application of
uniform traffic control devices such as traffic cones, barricades, regulatory signs, warning signs
and guide signs.
The CONTRACTOR shall have at the worksite a copy of The Manual on Uniform Traffic Control
Devices MUTCD 2012 Edition and the 2012 California Supplement to the MUTCD and shall
comply with its_prro_visions.
X. TRAFFIC MAINTENANCE
The CONTRACTOR shall be responsible for handling vehicular and pedestrian traffic in
accordance with Subsection 7-10 of the Greenbook Standard Specifications and these Special
Provisions. Vehicular traffic must be maintained at all times to all businesses and residences,
except as noted below.
The CONTRACTOR shall notify the CITY'S PROJECT MANAGER of his intention to begin work at
least two (2) working days before starting any work at each street location.
The CONTRACTOR shall cooperate with the CITY'S PROJECT MANAGER relative to handling
traffic through the areas and shall make his own arrangements relative to keeping the working
area clear of parked vehicles and to clear access to driveways.
CONTRACTOR's equipment and personal vehicles of the CONTRACTOR's employees shall not be
parked on the traveled way nor on any street where traffic is restricted at any time. If
construction equipment is parked in the parking lanes overnight, barricades and other suitable
warning devices shall be required.
XI. PORTABLE DELINEATORS
Portable delineators shall be either cones or tubular markers. Delineators to be used at night or
in low light conditions shall be reflectorized. The minimum height of either cones or tubular
markers shall be 37 inches above the road surface.
All portable delineators shall comply with the current version of the Caltrans Traffic Manual.
The portable delineators shall be spaced as necessary for proper delineation; however, in no
case shall the spacing between portable delineators exceed 50 feet on tangents or 25 feet on
curves.
C. Measurement and Payment
Full compensation for conforming to the provisions in this section shall be considered as
included in the Lump Sum price paid for "TRAFFIC CONTROL", and shall include full
compensation for furnishing all labor, materials, tools and equipment necessary to complete the
specified work involved and no additional compensation will be allowed therefore. The above
contract price and payment shall include all costs for installation and maintenance of traffic
control and temporary signing and striping if necessary, including flagmen, signing barricades,
temporary pavement or steel plates and temporary facilities required for the safe handling of
pedestrian and vehicular traffic for 24 hours per calendar day for the duration of the Work. No
additional compensation will be allowed. Traffic control shall be per California MUTCD, 2012.
The lump sum price paid for Traffic Control.
PROPOSAL GUARANTEE BID BOND
Bid #TRT-23-24-03
Quick Response (QR) Code Bus Stop Sign Replacement Project
City of Santa Clarita, California
KNOW ALL PERSONS BY THESE PRESENTS that Sterndahl Enterprises, LLC as BIDDER,
and Liberty Mutual Insurance Company as SURETY, are held and firmly bound unto
the
Ten percent of the
City of Santa Clarita, as CITY, in the penal sum oftotal bid amount dollars ($ 1o%oftotal Nclamourt), 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
BIDDER:
9th Day of August Z0 23
Sterndahl Enterprises, LLC
Signature"
Name and Title of Signatory
11861 Branford St. Sun Valley, CA 91352; Phone: 818-834-8199
Address
-1/p ,
SURETY* Liberty Mutual Insuranc2,C_ompany;,1LJ Berkeley Street, Boston, MA 02116; Phone (617) 357-9500
Yung T. Mullick, Attorney -in- ct; The Bond Exchange and Insurance Agency
248 00 Chnsanta Drive, . e 160 Mission Viejo, CA 92691: Phone: 949-461-7000
*Provide BIDDER and SURETY name, address, and telephone number and the name, title, address, and telephone
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.
Contractor and Surety signatures must be notarized prior to submittal.
CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document
to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document,
State of California
County of Orange
-- -- — ---------
before me, J. Smith, Notary Public
Dote Here Insert Nome and Title of the Officer
personally appeared _Yung T Mullick
Nwne(s) of Signer( s)
who proved to me on the basis of satisfactory evidence to be. the person(s):whose name(s) islare su bscribed
to the within instrument and acknowledged to me that he/she/they oxecoted the same in his/heritheir .
authorized capacity(ies), and that by his/he.r/their signature(s) on the instrument the person(s), Or the entity
upon behalf of which the person(s) acted, eXeCLited the instrument.
J. SMITH
Notary Pubik - COW*
Orange county
Commissfon # 2358196
'zi My Comm, Expires may 19, 1025
Place Notary Seol an&br Stomp Above
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
Signuture.of Notary Public
LWj';&BLU!j
Compieting thIs information can deter alteration of the document or
fraudulent reattachment of This for: to i0n Uniritended document.
Description of Attached Document
Tite or Type of Document:
Document Date: Number of Panes: .... .... .... .... ..... .... . .. .... . .. ..... .
Signer(s) Other Than Named Above:
Capaclty(ies) Claimed by Signer(s)
Sl
Igner's Name:
0 Corporate Officer— TitlL4(s).
D Partner — n Limited 1-1 General
0 individual [) Attorney in Fact
0 Trustee a Guardian or Conservator
a Other: _
Signer is. Roprosenting:
(,2019 National Notary Ass,od,�tion
Signer's Name:.
0 Corporate Officer — Titte(s),'
0 Partner — 11 Limited 0 General
0 individual 0 Attorney in Fact
a Trustee n Guardian or Conservator
0 Other.,
Signer is Represenfing: . . .......
1. 10�
Liberty
Mutual®
SURETY
This Power of Attorney limits the acts of those named herein, and they have no authority to
bind the Company except in the manner and to the extent herein stated.
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
West American Insurance Company
POWER OF ATTORNEY
Certificate No: 8209482.024096
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint,
Alexander R. Holsheimer, Christine Woolford; Danielle Hanson; Emilie George; Irene Luong; James W. Moilanen; P. Austin Neff; Yung T, Mullick
all of the city of Mission Viejo state of CA each inditidually if there be more than one named, its true and lawful attorney -in -fact to make,
execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 23rd day of February , 2023 .
N
c
m
`m State of PENNSYLVANIA
County of MONTGOMERY ss
Liberty Mutual Insurance Company
P� tNSUg4 P,0 INS& � t9SUga The Ohio Casualty Insurance Company
hJ r,°RpOR�r yn g`� c°`iPO�r "9y �Vp�°�POr �p West American Insurance Company
a3 Qom Q3 fan � 2 Fom
1912 0 " 1919 rn
o a A 1991 0
Yd 9s'eACHUsy SDh4MP5,aa� '�s �N°IANr"
David M. Carey, Assistant Secretary
. � On this 23rd day of February , 2023 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance
� iu Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes
therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year first above written.
p �p PAST
NVIC �{ Commonwealth of Pennsyivama- Notary$Rai
p ur o` ,eTeresa Montgomery
Notary Public /aVL
� MontgomeryCounly
U� My commission expires March 28, 2025 By: PXU-1)
Commission number 1126044 erase Pastella, Notary Public
N L�xfSYL`IQ �G Member, Pennsylvania Association of Notaries
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
E•s- Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
o` ro ARTICLE IV— OFFICERS: Section 12. Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the
President may prescribe, shall appoint such aftorneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety
any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of attomey, shall
o - have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such
Z u instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the
provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE All — Execution of Contracts: Section 5. Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings,
bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant -Secretary to appoint such attorneys -in -
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shalt be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 8th day of August , 2023 .
- INS
QUR _I,( Ii 1T18r/R
�Jooepagyr Qy JP aRaor Pq Pa RpoR 9y
a 3 Fo C)m
1912 o y 1919 o a 1991
vb. Pe CHtISF' as �0 N° ��h4 M45a� /IATIA a By' ..�
�aL * a Renee C. Llewellyn, Assistant Secretary
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S7i A 'a OF C ILLIFORNIA
DEPARTMENT OF INSURANCE
SAN FRANCISCO
kMOED
Certificate of Authority
THrs IS as CmTwy, I6aat, pursvrant to the dmsuranc'e Code of the State of CAifornia,
LIBERTY MUTUAL INSURA14CE C0.61PANY
of BOSTON, MAS,SACHU5ETTS , orgappivri aandrr the
larua of MASSACHUSE TT5 : a-aelrpec:t 10 its Articles of Incorl),orartium or
caber fundamental or,{aauzational dorwysc as, is hcrebr} uraboriNed do trossact ,within this Sty, e, srdr era
eo;all lirovisivrasof this cxrtireate, the folimvin.g classes of insire rrm r: FIRE, MARINE, SURETY,.
DISABILITY, PLACE GLASS., LIABILITY, WORKhtENIS 00)6PFI�SATj6?I, CC1,1I,10N
CARRIED. LIABILITY, BOILER AND MACHINERY, .BURGLARY, CREDIT, SPRINKLER,.
TEAM AND VEHICLE, AUT0140BILE, AIRCRAFT and MISCELLANEOUS
as such classes are now or pppay hereafter be de floed in. The Insacrance Laws of the Sfr a a/ Cal€forma .
Tars CEF.,rjpicA,rE is exlpreasiy conditioned sadp(nt tdar bolder &rvo f now and hereafter being in frail
rorealrfiance ay.ith all, w;d not in Hofa 4on of any, of the applicable lenvs and lawful requirement; ,pSade
under aaratbvrity of t1m fawn of flat* State of California ax lo,rg as smelt laws err rrsgwira ment.s ,are in effect
and applicable, and as sracb laws and r4% psirrme.niis vow are, +sa- may bt veuf ter be ebarrged or amended
I-4 WITNESS ��E Fu�c�2 , e,fec•live in of the ...__.15T1 .. . day
Of- _....._.:..-ROVDIDW------- -------- ----- 1961 : ; I Bat-e ltera'7 n1 o
sri roy hatatd and ratesed in), rafficial ser:l to be airl-verd Abii .1 aT'F
day of._._..��
F. BRI"I`TON MoCONNFLLL
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