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2014-04-22 - AGENDA REPORTS - SIGNAL MOD/IMPROVS PROJ C4011 (2)
CONSENT CALENDAR DATE: SUBJECT: DEPARTMENT: Agenda Item: 13 CITY OF SANTA CLARITA AGENDA REPORT City Manager Approval: Item to be presented by April 22, 2014 SIGNAL MODIFICATIONS AND IMPROVEMENTS AT GOLDEN VALLEY ROAD AT ROBERT C. LEE PARKWAY, BOUQUET CANYON ROAD AT CENTRAL PARK, AND VIA PRINCESSA AT VISTA DEL CANON, PROJECT C4011 - AWARD CONSTRUCTION CONTRACT Public Works RECOMMENDED ACTION City Council: Approve the plans and specifications for the HSIP-5450(079) Golden Valley Road at Robert C. Lee Parkway, Bouquet Canyon Road at Central Park, and Via Princessa at Vista Del Canon Signal Modifications and Improvements, Project C4011. 2. Award the construction contract to Palp, Inc., DBA Excel Paving Company, in the amount of $491,007 and authorize a 15 -percent contingency in the amount of $73,650, for a total contract amount not to exceed $564,657. 3. Decrease Miscellaneous Grant Revenue in Account 259-4621.001 by $459,500, and decrease Expenditure Account C4011259-5161.001 by $459,500; increase Miscellaneous Federal Grant Revenues in Account 229-4424.009 by $459,500 and appropriate $459,500 to Expenditure Account C4011229-5161.001 4. Increase Miscellaneous Federal Grant Revenues in Account 229-4424.009 by $26,000 and appropriate $26,000 to Expenditure Account C4011229-5161.001. 5. Authorize the City Manager or designee to execute all documents, subject to City Attorney approval. APPROWED BACKGROUND The proposed project will upgrade the traffic signal at the three intersections to provide protected left -tum phasing. Work at all locations will include the improvements of protected left -tum phasing, modifications to the turn pockets, and modifying all pedestrian ramps to be compliant with the Americans with Disabilities Act. The medians will be modified at Bouquet Canyon Road at Central Park and Via Princessa at Vista Del Canon, and a second left tum will be striped at Golden Valley Road at Robert C. Lee Parkway to increase capacity for left turns. This project will improve the overall safety at the three intersections. This project is federally funded under the Highway Safety Improvement Program (HSIP). This program is managed by the State of California with the purpose of mitigating high -collision locations. Cities and counties are eligible to apply for this competitive grant, and projects with a high safety index rating are given priority. The project was selected and awarded an HSIP grant in the amount of $459,500. The City of Santa Clarita (City) successfully secured additional HSIP grant funds in the amount of $26,000 for total HSIP grant funds in the amount of $485,500 for the project. On January 28, 2014, the City received authorization from the California Department of Transportation to proceed with an invitation to bid for construction. An invitation to bid was published three times, January 31, February 3, and February 5, 2014, and was noticed on the City's website. Plans and specifications were also sent to area plan rooms. Two bids were submitted to the City and opened by Purchasing on March 5. The results are shown below: Comp anv Location Base Bid Amount Palp, Inc., DBA Excel Paving Company Long Beach, CA $491,007 CPO Enterprises, Inc. Covina, CA $549,123 Staff recommends the project be awarded to Palp, Inc., DBA Excel Paving Company, the lowest responsive bidder. This contractor possesses a valid state contractor's license and is in good standing with the Contractors State License Board. The contractor's bid has been reviewed for accuracy and conformance to the contract documents and was found to be complete. The requested construction contingency will cover costs of unforeseen site conditions uncovered during the median excavation, conflict with unknown utilities, additional modification to the existing irrigation systems, and the removal of unsuitable soil. It may also be used to make improvements to the drive approach at Golden Valley High School, which is not included in the plans. Budgeted funds in the amount of $86,241 are available for construction engineering, materials testing, inspection, labor compliance, staff oversight, and miscellaneous project costs. ALTERNATIVE ACTIONS Other action as determined by the City Council. 14 FISCAL IMPACT Revenue Account 259-4621.001 is being decreased by $459,500 and Revenue Account 229-4424.009 is being increased by $459,500. Expenditure Account C4011259-5161.001 is being decreased by $459,500 and Expenditure Account C4011229-5161.001 is being increased by $459,500. This action is to correct the HSIP grant funds from Miscellaneous Grants (Fund 259) to Miscellaneous Federal Grants (Fund 229). Federal grant revenues are increased by $26,000 in Account 229-4424.009 and federal grant expenditures are increased by $26,000 in Account C4011229-5161.001. The above actions create a total federal HSIP grant expenditure account of $485,500. This amount, in addition to the existing $165,398 appropriated in account C4011233-5161.001 (TDA Article 8) creates a total project budget of $650,898. Expenditures to date are $7,048, leaving $643,850 available for awarding the contract, and for construction engineering, materials testing, inspection, labor compliance, staff oversight, and miscellaneous project costs. ATTACHMENTS Location Map Bid Proposal for Palp, Inc., DBA Excel Paving Company available in the City Clerk's Reading File Contract for Palp, Inc., DBA Excel Paving Company available in the City Clerk's Reading File D O PMaz12, xKresu Cuy-f SANTA Ti C r..—._................ L1LAKl lA Signal Modifications & mR , I__, i� Improvements C4011 p! 90 f– IOR 1 wK t ', 1.� V eo ARYM MRN I p Sg i r• PPS (. 1r—•'J, °p CH Bouquet Canyon at RRSH° { po h Central Park i—_•— J I a,ox J�4° •—_• I ' AR - _ JF' P L j MN9 gPPixo tw AH•K—� a(J•tet La^L. OPO PwK NEWHALL RANC" P . ` K a date Tt�rP o .. ngR�AY ni ' M R NG SOLE AO CANYON ROPO CITY Via Princessa at C HALp 9� Vats Del Canon ;atw 1 o • R � 9F OGLFEOYP �..hx lid -446 yyj F,RN i� P S s Golden Valley Road at Uf r t Robert C. Lee. d -----i ° ° NE LL TL L 4 RRWIP L DRONR0 WAK ! N FWN i J i 4 +, — .�..—..—i S N rte......\ _1 Project Locations i-- y �-•—� City of Santa Clarita Tod....... �..i Boundary oa Santa Clara River ,;� M'cry elaM.cYMa-Ob iw+feb 0:WRO,IECTSW1M14=7a1YnxdIsignal modKiealions.mxd ADDENDUM NO. I HSIP-5450(079) Golden Valley at Robert C Lee & Bouquet Canyon Rbad at Central Park & Via Princessa at Vista Del Canon Signal Modifications and Improvements Bid No. ENG -13-14-C4011 Project No. C4011 City of Santa Clarita, California DATE 212512014 This Addendum fors a part of the Contract Documents for the above -identified project and modifies the original Specifications and Contract Documents, as noted below. Portions of the Contract, not specifically mentionedin the Addendum, remain'in force. All trades affected shall be fully advised of these changes, deletions, and additions.' CHANGES TO CONTRACT DOCUMENTS AND SPECIAL PROVISIONS 1, Section C — BID SCHEDULE See attached updated Project Bid Schedule 2. Section F — GENERAL PROVISIONS; 6-7.2 - Worldng following: TABLE I AGENCY -DESIGNATED HOLIDAYS Martin Luther King Day Monday, January 20, 2014 Presidents' Day Monday, February 17, 2014 Memorial Day Monday, May 26, 2014 Independence Day Friday, July 4, 2014 Labor Day Monday, September 1, 2014 Veteran's Day Tuesday, November 11, 20I4 Thanksgiving Day Thursday, November 27, 2014 Day after Thanksgiving Friday, November 28, 2014 Day, Table l should read the 3. Section F —GENERAL PROVISIONS; 7-10.1 Traffic and Access —Add the following: Upon saw -cutting and excavating the pavement for the road section adjacent the proposed medians, the Contractor shall either have all base in place, or establish a 4:1 slope transition to existing pavement by the end of same working day. Any deviation from the above shall only be made at Engineer's discretion. Golden Valley Road and Robert C Lee Parkway: The CONTRACTOR shall coordinate work activities at the Golden Valley and Robert C Lee location with the Contractor for the Golden Valley Medians to minimize public inconvenience. Bouquet Canyon Road at Central Park: Bouquet Canyon Road at Central Park: All striping work required at this locatign shall be done between 9:00 pm and 4:30 am. The CONTRACTOR shall coordinate work activities with the City staff in regards to the park use for special events such as Concerts in the Park and sport team events. 4. Section G — SPECIAL PROVISIONS, BID ITEM 6. 13. & 36: ASPHALT CONCRETE (AC OVER CRUSHED AGGREGATE BASE (CAB). MEASUREMENT AND PAYMENT: replace the first Paragraph with: Measurement for AC and CAB shall be based upon completion of such work as per Square Foot basis. The final Payment quantities shall be based on the actual square footage measured on the job. HSIP 5410-(079) 04011 Addendum 1, Page 1 5, Delete the following Section: Section. G — SPECIAL PROVISIONS, BID ITEM 33: MOVE EyIsTING IRAMC SIGNAL BO this work is included in the signal modification line item of work. 6. Section G — SPECIAL PROVISIONS, CONSTRUCT CONCRETE CURB. CURB & GUTTER. SPANDREL GUAR AND MODIFIED LOCAL DEPRESSION, MATERIALS AND METHOD: Add the following: Base material shall be Crushed Aggregate Base (CAB) 7. Section G — SPECIAL PROVISIONS, BID ITEM 8 CONSTRUCT MODIFIED LOCAL DEPRESSION: Contractor is to use River Rock not washed pea gravel at the splash pad transition. The river rock will take the shape of the old edge of pavement The river rock is to he installed is to be approximately 2' from splash pad and 2' from back of curb (North-South Direction) with a minimum depth of 3". River Rock embedment shall be 3 to 4" deep. See rough sketch attached to addendum for shape and location of the river rock. Also the 1/" Drain rock is to be included in the unit price for the line item, and is to be installed to a compaction of 90%. 8. Section G — SPECIAL PROVISIONS, BID ITEM 29 REMOVE AND REPLACE CONCRETE SPANDREL: Replace with.' The contract price paid per Square Foot shall be full compensation for wet saw cutting, removal, disposal, furnishing all labor, materials, tools, and equipment, and incidentals and for doing all the work involved in constructing removal and replacement of concrete spandrel gutter and curbs complete in place, including compacted base materials as shown on the plans, as specified in the Standard Specifications, these Special Provisions, and as directed by the Engineer. 9. Section G — SPECIAL PROVISIONS, BID ITEMS 21 & 31 REMOVE AND REPLACE MATERIALS AND METHOD: Add the following: All new curb ramps shall use the replaceable / cast in place tile. Surface mount tiles and specifications of for tile only applications. Mods the following.- Ramps shall be constructed in accordance to sections 300 and 303 of the Standard Specifications for Public Works Construction, 2012 edition and according to plans per APWA 2009 Standard Plans 111-5. 10. Section G — SPECIAL PROVISIONS, BID ITEM 10 & 23 INSTALL TRUNCATED DOMES: Modify the following.- Payment for "Install Truncated Domes," shall be made per each and shall include full compensation for furnishing all labor, materials, tools and incidentals and performing the work involved in placing of the components, as shown on the plans, as specified in the Standard Specifications and the Special Provisions, and as directed by the Engineer. 11. Section G — SPECIAL PROVISIONS, BID ITEM 9 & 24 should read: BID ITEM 9 &.24 INSTALL 12" WIDE BORDER WITH '/" GROOVES PER STANDARS PLAN 111-5 ON EXISTING CURB RAMPS 12. Section G — LANDSCAPE AND IRRIGATION The plans for Bcunet Canyon Road do not indicate any existing sprinkler systems; however there is an existing 2" PVC mainline in the Bouquet Canyon median and crossing the intersection at Central Park at an approximate depth of 3 feet from existing grade. The Contractor will be responsible for lowering and installing a new 2" PVC mainline inside a 3" PVC sleeve under all new hardscape areas. Please see approximate location of irrigation gate valve on sheet 10 of the plans. The Contractor is to notify Dave Colburn (661-673-6100) with Stay Green, at least 1 week before work starts. All adjustments to the irrigation mainline shall be completed within a two week period. The Contractor shall confirm' with Stay Green the reestablishment of the water connection to the medians two weeks after the water is turned off. Addendum 1, Page 2 BID ITEM 20 should read: BID ITEM 20 REMOVE(MODIFY EXISTING LANDSCAPE. IRRIGATION AND SOIL MEDIA: The contract price paid per Lump Sum for "Remove/Modify Existing Landscaping. and Irrigation" shall be full compensation for furnishing all labor, materials, tools, and equipment, and incidentals and for doing all the work involved in removing existing landscaping, including roots, irrigation lines and extra soil needed to obtain the proper grades for the new improvements, and reinstall the 2" PVC irrigation mainline inside a3" PVC sleeve for the new hardscape areas, as specified in the Standard Specifications, these Special Provisions, and as directed by the Engineer. Prior to complete line item payout the irrigation shall be check to ensure it is in working order and providing proper coverage for remaining landscape areas. 13. Section G — SPECIAL PROVISIONS, BID ITEM 27 should read: BID ITEM 27 REMOVE EXISTING LANDSCAPING AND IRRIGATION: The contract price paid per Lump Sum for "Remove Existing Landscaping and Irrigation" shall be full compensation for furnishing all labor, materials, tools, and equipment, and incidentals and for doing all the work involved in removing existing landscaping, including roots, capping of the irrigation system and providing a 2" riser, as specified in the Standard Specifications, these Special Provisions, and as directed by the Engineer. 14. Section G — SPECIAL PROVISIONS, BID ITEM 34 — EXPORT SOIL FROM MEDIAN. this work will be paid as Lump sum. 15. Section. G — SPECIAL PROVISIONS, Section 310 — Painting traffic striping, pavement markings, and markers, and curb markings: Add the following: When removal of any conflicting existing striping or markings is required in accordance with Section 310-5.6 of the SSPWC, as shown on the Plans, as directed by the City Traffic Engineer, and according to the following regulations: a) Prior to the removal of any existing traffic markings and lines the Contractor shall determine by the appropriate laboratory analysial if the paint for thermoplastic residue. containslead. Lead is a common constituent in many traffic paints and thermoplastic; when lead is present the Contractor will be subject to a lead compliance plan (CCR Title 8, §1532.12) prepared and signed by a Certified Industrial Hygienist. Depending on the lead concentration, the paint and/or thermoplastic, residue may be hazardous waste end require special handling and disposal. The Contractor shall submit analytical test results of the residue from removal of yellow thermoplastic and yellow painted traffic stripe and pavement marking, including chain of custody documentation, for review and acceptance by the City. b) The Contractor shall provide the appropriate equipment to completely remove all existing traffic striping or markings that may be confusing to the public. This equilimisnt shall meet all requirements of the air pollution control district having jurisdidtion and the lead compliance plan, if applicable. All residual material shall be removed from the pavement without delay as the removal operation progresses. Removal of striping by alternative methods may be permitted when in compliance with the lead compliance plan (if applicable) and approved by the Engineer. c) Existing markings and striping which are to be abandoned or obliterated shall be a) ' Make necessary arrangements to teat the yellow thermoplastic and yellow paint hazardous waste residue as required by the disposal facility and these Special Provisions. Testing must include, at a minimum, total lead by EPA Method 0010C, total chromium by US EPA Method 7000 series, soluble lead by California Waste Extraction Test, soluble chromium by California Waste Extraction Test, soluble lead by. Toxicity Characteristic Leaching Procedure, and soluble' chromium by Toxicity Characteristic Leaching Procedure. b) 2 http://www.dir.ce.govMtieg/I63LI.html Addendum 1, Page 3 removed by appropriate methods. I£ lead is not present wet sandblasting shall be used. Alternate methods of paint removal are required to be in compliance with the lead compliance plan (if applicable) and receive prior approval of the Engineer. Obliteration of traffic striping with black paint or light emulsion oil shall be done only with the prior approval of the Engineer. 16. APPENDIX B — Federal Prevailing Wage Rates Replace Appendix B in its entirety with the attached updated wage rates dated 2/2112014. CHANGES TO PLANS 1. Sheet 2: Delete 2" Mill and Overlay on all three typical sections on Golden Valley Road. 2. Sheet 4, Note 2 modifications / clarifications . 3. Sheet 10, Note 12: Remove and replace sidewalk; access ramp, and spandrel from BCR to ECR. Construct Case B Type 2 curb ramp per SPPWC Standard Plan 111-5, with Cast in Place replaceable tiles. 4. Sheet 10, Section AA can be found on Sheet 2. 5. Sheet 10, Added approximate location of installed irrigation main line gate valve. 6. Sheet 13, Add Note: Utilities shown on sheet 15 — signal modification plan Construction Note Changes 7. Sheet 14, Add Note: Utilities shown on sheet 15 — signal modification plan Construction Note Changes PROPOSER QUESTIONS: The following are CITY S answers to questions submitted by prospective bidders: Question: Bid items 9 and 24 "Install 12" wide border with 1/4" grooves approximately 3/4" OC per APWA standard plan 1114" will require removing the existing ramp and re -pouring so the correct grooving can be installed. Is the removal of the existing curb ramp part of the bid item? Answer: The ramps where grooves only are called out meet all ADA requirements except for. the border (and/or tiles). All items required to install the grooves shall be covered in the bid item. No additional compensation will be given for any items not covered on the line item specification. Means and methods for the installation are to be determined by the contractor. A'T'TACHMENTS Proposal —Bid Schedule Location of River Rock Sketch Appendix B —Updated Federal Prevailing Wage Rates, dated 02/21/2014. Updated Plans Pages: 2, 4, 10, 13 & 14 G Robert G. Newman Director of Public Works City of Santa Clarita Addendum 1, Page 4 al1TA1 es _ HSIP-5450(079) Golden Valley at Robert C Lee & Bouquet Canyon Road at Central Park & Via Princessa at Vista Del Canon Signal Modifications and Improvements Bid No. ENG -13-14-C4011 Project No. C4011 City of Santa Clarita, California DATE 2/25/2014 This Addendum forms a part of the Contract Documehtg for the above -identified project -and modifies the original Specifications and Contract Documents, as noted below. Portions of the Contract, not specifically mentioned in the Addendum, remain in force. All trades affected shall be fully advised of these changes, deletions, and additions. 010-0 Iy NVYnI I acknowledge receipt of this Addendum No.1 and accept the aforementioned. MAR - 5 2014 2014 Date Bidders Signature C.P. BROWN, P€BESI@ENT THIS PAGE OF THE DOCUMENT TO BE SUBMITTED WITH PROPOSAL Addendum 1, Page 5 34. PRECONSTRUCTION DOCUMENTS CHECKLIST The following documents are required to be completed and submitted by the Contractor at the times specified by an X opposite each title. If no column is marked, document will not be required. With Bid Proposal (All Bidders) With Agreement (Awardee only) Prior to Starting Construction (Awardee only) Post Starting Construction (Awardee only) X Proposal Forms (Cover Sheet, Bid Schedule, References, Bidders Certification) X Non -collusion Affidavit, Non -lobbing Certification and Disclosure, Certification of Non- segregated Facilities X Debarment and Suspension Certifications X Addendums (If any) X Designation of Subcontractors & 12-G Bidder's List of Subcontractors X Local Agency Bidder DBE Commitment (Construction Contracts)- Exhibit 15-G (or by 4:00 PM of 4th business day after bid opening) X DBE Utilization report and Good Faith Effort (or by 4:00 PM of 4'h business day after bid opening) X EEO Certification (by 4:00 PM of 4"' business day after bid opening for subcontractors) X Bidder's Bond or Bidders Security X ContractAgreement X Bond for Faithful Performance X Payment Bond.(for Labor and Material) X Certification of Public Liability and Property. Damage Insurance X Certification of Worker's Compensation Insurance X Construction Schedule X SWPPP)Water Pollution Control Program X Traffic Control Plan X List of all Subcontractors X Materials List and Manufacturer's Brochures (As Required) X Permits X Emergency Contact Information X Construction and Demolition Materials Management Plan X CEM -2402f- Final Utilization Report—(DBE/UDBE) Exhibit 17-F X CEM -2403f — Certification Status Change — (DBE/UDBE) (if needed) X CEM -2404f— Monthly DBE Trucking Verification (if needed) 8-17 HSIPLL W(Wo) Pm(at 04011 SECTION C: PROPOSAL FOR HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 TO THE CITY OF SANTA CLARITA, AS AGENCY: In accordance with AGENCY'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 AGENCY 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 AGENCY 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 AGENCY 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 prices bid include all appurtenant expenses, taxes, royalties, and fees. In the 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 AGENCY's notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Company Name: P", Vile. DEA 5tft WHO COMRIM Company Address: 2230 LEMON AVENUE LONG BEACH, CA 90806 ' Print Name Title: 6•P• BR06YIly, PRESIDENT Signature: Date: MAR — 5 711% BID SCHEDULE HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via PrincessalVista Dei Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 C-2 HSIPL 5450 (079) A dum1 Pmje G011 ITEM • • CITY UNIT COST•COST MOBILIZATION, INCLUDING BONDS, 1 INSURANCES (NOT TO EXCEED 3°/d OF LS 1 G� oc? , p BOO _/ TOTAL BID) WATER POLLUTION CONTROL AND --777,9 5aoo• 2 IMPLEMENT BEST MANAGEMENT LS 1pp 5aD0,� PRACTICES (BMPs) 3 TRAFFIC CONTROL LS 1 /-7m80�� /-7 08D. Subtotal GOLDEN VALLEY ROAD @ ROBERT C. LEE PARKWAY 'CIVIL WORK 4 CONSTRUCT CURB AND GUTTER 8" LF 35 7.2 , c Zp 5 CONSTRUCT CURB 8" LF 30 , e2 CONSTRUCT TAC 6 PAVE MENT(1.5"C2PG 64-10 & 5.5" BPG SF 120 ;z 9 64-10) AND 20" CAB 7 SAWCUT AND REMOVE EXISTING AC SF 120 PAVEMENT 8 CONSTRUCT MODIFIED LOCAL DEPRESSION WITH STRESS RELIEF EA 1 PER SHEET 4 9 INSTALL 12" WIDE BORDER WITH 1/4" EA 1 g Z O 9 7 O GROOVES PER STANDARD PLAN 111-5 10 INSTALL TRUNCATED DOMES EA C-2 HSIPL 5450 (079) A dum1 Pmje G011 C-3 HSIPL-5450(079) Proal C4011 PtlEeneum 1 CONSTRUCT 8.5" AC PAVEMENT 13 1 .5'CA26PG 64-10 & 5.5" BPG 64-10) AND SF 2970 14 CONSTRUCT 4" CONCRETE CURB LF 290 3 / 8o 15 REMOVE EXIST. INTERIOR MEDIAN CONCRETE SF 2000 16 CONSTRUCT 4" STAMPED MEDIAN PCC "BOUQUET FLAGESTONE" SF 1100 �p 17 REMOVE TREES EA 9 590 , 18 SAWCUT AND REMOVE EXISTING AC PAVEMENT SF 1100 4.'2 C) 7370 19 REMOVE EXISTING CURB AND GUTTER LF 290 $ , $p 5SZ Z. 20 REMOVE/MODIFY LANDSCAPING/ LS 1 IRRIGATION AND SOIL MEDIA 5300, / 5 Seo, REMOVE AND CONSTRUCT NEW 21 CURB RAMP PER PLAN, INCLUDING EA 1 �' S8p' / !�y TRUNCATED DOMES ND SPANDREL 22 REMOVE AND REPLACE 4" PCC SIDEWALK SF 550 23.1 INSTALL TRUNCATED DOMES EA 1 '� i X95, 23'2 INSTALL TRUNCATED DOMES on EA 1 �gS Private Property 24.1 INSTALL 12" WIDE BORDER WITH 1/4" GROOVES PER STANDARD PLAN 111-5 EA 0.5 / �f,2 p � J p / INSTALL 12" WIDE BORDER WITH 1/4" 24.2 GROOVES PER STANDARD PLAN 111-5 EA 0.5 7J p, on Private Property C-3 HSIPL-5450(079) Proal C4011 PtlEeneum 1 All 5:SIGNING 4ND STRIPING sn IGNAL, 25.1 MODIFY TRAFFIC SIGNAL LS 1 & 3 / G 0,_1 25 2 MODIFY TRAFFIC SIGNAL on Private LS 1 / ;, 8 iib. Property 26.1 FURNISH, INSTALL, REMOVE, LS 1 REFURBISH SIGNING AND STRIPING FURNISH, INSTALL, REMOVE, 26.2 REFURBISH SIGNING AND STRIPING LS 1 &SLO, & SSC) on Private Property Subtotal CANONVIA PRINCESSA @ VISTA DEL s : 34%'$'+ •} m+''.Sn MT,'� �1 �,.s CIVILWOkK w v 9 27 REMOVE EXISTING LANDSCAPING LS 1 53004 �3pp. AND IRRIGATION 28 REMOVE TREES EA 3 / /ZD. 29 REMOVE AND REPLACE CONCRETE SF 1800 ZZr 6S yQ X70 SPANDREL , 30 REMOVE CONCRETE CURB & GUTTER LF 640 ZS, REMOVE AND REPLACE CONCRETE 31 CURB RAMP, INCLUDING TACTILE EAE45 7- 8001 7, 00. MATERIAL REMOVE AND REPLACE CONCRETE SF 32 SIDEWALK 33 No Used 34 EXPORT SOIL FROM MEDIAN LS 1 35 REMOVE EXIST. INTERIOR MEDIAN SF 1500 CONCRETE 36 CONST. 4.5" AC PVMT. (1.5" C2PG 64- S F 915 /D, 30 ���4�• $D 10 & 3" BPG4-10 AND 6 6" CAB 37 CONSTRUCT CURB AND GUTTER 4" LF 65 �'D, S�' � MODIFIED 38 CONSTRUCT CURB AND GUTTER 6" LF 350 y7, 16, C/5-0, 39 CONSTRUCT CURB AND GUTTER LF 90 53 q7-704' TRANSITION 40 2" ORGANIC MULCH Cy 60 55. 3 3 00. C-4 HSIP4"W (078) Addendum 1 Project C4011 SIGNAI,,SIGNING qND STRIPING ?,r' s { t BATTERY BACK-UP SYSTEM FOR 41 MODIFY TRAFFICE SIGNAL LS 1 GOLDEN VALLEY ROAD AT ROBERT C 5701 ?o SD/-�C),� X880 FURNISH, INSTALL, REMOVE, LEE 42 REFURBISH SIGNING AND STRIPING LS 1 (p `/.30, (y Y3D. 44 BOUQUET CANYON AT CETNRAL Subtotal 1 Base Bid Total q-9 / OL9( �V 77 Base Bid + S�`7 G �F4. Sro Alternates Total TOTAL BAES BID + ALTERNATES IN FIGURES $ Sl -7 & 4 b E -V "TOTAL BASE BID +ALTERNATES IN WORDS: - 9rm The award of contract, if made, will be to the lowest responsible BIDDER determined solely by the AGENCY as follows: The basis for award of contract shall be the Contractor's Base Bid plus the alternates. The Agency reserves the right to award the contract for the base bid and those alternatives, if any, which the City may select In its sole discretion. The AGENCY also reserves the right to add any of the additive Alternates 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 bid for Additive Alternates constant throughout the duration of the project up to the last contract working day. No additional compensation will be allowed for Alternates added by Contract Change Order beyond the amount shown on the original bid. C-5 HSIPL-5450(079) Praje 04011 Mdmdum 1 t BATTERY BACK-UP SYSTEM FOR 43 GOLDEN VALLEY ROAD AT ROBERT C LS 1 X880 r� 88© LEE BATTERY BACK-UP SYSTEM FOR 44 BOUQUET CANYON AT CETNRAL LS 1 PARK 45 BATTERY BACK-UP SYSTEM FOR VIA LS 1 8804' 8 $ $©. / PRINCESSA AT VISTA DEL CANON Subtotal �` (o (v c/p Base Bid + S�`7 G �F4. Sro Alternates Total TOTAL BAES BID + ALTERNATES IN FIGURES $ Sl -7 & 4 b E -V "TOTAL BASE BID +ALTERNATES IN WORDS: - 9rm The award of contract, if made, will be to the lowest responsible BIDDER determined solely by the AGENCY as follows: The basis for award of contract shall be the Contractor's Base Bid plus the alternates. The Agency reserves the right to award the contract for the base bid and those alternatives, if any, which the City may select In its sole discretion. The AGENCY also reserves the right to add any of the additive Alternates 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 bid for Additive Alternates constant throughout the duration of the project up to the last contract working day. No additional compensation will be allowed for Alternates added by Contract Change Order beyond the amount shown on the original bid. C-5 HSIPL-5450(079) Praje 04011 Mdmdum 1 DESIGNATION OF SUBCONTRACTORS HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 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 $10,000 (whichever is greater) of the prime contractor's total bid: DBE status, age of firm and annual gross receipts are required if sub contractor is participating as a DBE. Subcontractor DBE STATUS. Dollar Value of Work RAI 0 y F-C2/';i &00 Age of firm: Certifying Agency: Annual Gross Receipts: �L-1 Location and Place of Business /0 rh Location and Place of^Business / `�-' �l7ww Qta V0 I&I$z Cost Schedule Item Nos: Description of Work License No.3 07 -Exp. L4NOSt.aPf, it ��Z/L�i• License No�V U I22 Lv1 Exp. Date: Phonle, a L4 I,, S Subcontractor DBE STATUS: Dollar Value of Work Dollar Value of Work Cq s61405 S✓X✓,Ey Age of firm: Certifying Agency: Annual Gross Receipts: '5S Annual Gross Receipts: - M Location and Place of Business -jln R.S-T• N.i.Q ap6 Cost Schedule Item Nos: Description of Work Cost Schedule Item Nos: 57"R7 Pi u l7 License No.3 07 -Exp. Date: PhoreoS 6 -7 -Li --7 3 4I S Subcontractor DBE STATUS: Dollar Value of Work Cq s61405 S✓X✓,Ey u a 40 3 60 , -/' Age of firm: Certifying Agency: Annual Gross Receipts: 3d 5 4tit Location and Place of Business rt* (R (`i N. Cost Schedule Item Nos: Description of Work SvrtV6� License No.,I.- hLk -\\ Exp. Date: PhO(� C-6 HSIPLZ4 (O]I) Project 04011 DESIGNATION OF SUBCONTRACTORS HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 Subcontractor DBE STATUS: Value of Work Age of firm: Certifying Agency: -7 8-2o,iAge of firm: teffi� I� --:::�Dollar : Annual Gross Receipts: License No, Exp. Date: / M Location and Place of Business Pm f3v,c 3328.0 owr3vwce 4a . Cost Schedule Item Nos: Description of Work Age of firm: Certifying Agency: Cees 8 6 License No.�5c 50& Exp. Date: License No. Phon,�/Y 9 9 0 4'V3 Subcontractor S1�1/ DBE STATUS: o , Dollar Value of Work /16 Age of firm: Certifying Agency: Annual Gross Receipts: Location and Place of Business Cost Schedule Item Nos: Description of License No, Exp. Date: Phone Subcontractor C 1 1— br`v� DBE STATUS: Dollar Value of Work Age of firm: Certifying Agency: Annual Gross Receipts: Location and Place of Business Cost Schedule Item Nos: Description of Work License No. Exp. Date: Phone Subcontractor DBE STATUS: Dollar Value of Work Age of firm: Certifying Agency: Annual Gross Receipts: Location and Place of Business Cost Schedule Item Nos: Description of Work License No. Exp. Date: Phone C-7 HSIPL-5450 (079) P'qW C4011 DESIGNATION OF SUBCONTRACTORS HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 Subcontractor DBE STATUS: Dollar Value of Work Age of firm: Certifying Agency: Annual Gross Receipts: Location and Place of Business Cost Schedule Item Nos: Description of Work License No. Exp. Date: Phone Subcontractor DBE STATUS: Dollar Value of Work Age of fine: Certifying Agency: Annual Gross Receipts: Location and Place of Business Cost Schedule Item Nos: Description of Work License No. Exp. Date: Phone C-7 FOPL-54M (Dla) PM04011 Local Assistance Procedures Manual -- EXHIBIT 12-G Bidder's List of SubcontractorsBE and Non -DBE BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE). PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. LPP 06-06 EXHIBIT 12-G user suns) C-8 Purled anti Page 12-111 November 14, 2006 Local Assistance Procedures Manual i Local Assistance Procedures Manual v EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. r Address/ _' �, Crty =State Name } & �s .Fax Phone � s'�ro9s' e U<$1 numon Des�4�ip�lo�fPorhnn'bf�R'orkt"o he�Zsdiiormed� lJYBS&ODBE #: <$5 million ❑ <$10 million Address Fax <$15 million - Age of irm (Yrs.) CiryState ZlP > $15 malion Name Phone <$l million - lis1DBE A <$5 million <$10 tollion Address Fax <$15 million City State ZIP >$15million AsCo am rs. Name Phone <$1 million list DBE #: <$5 million Address <$30 million Fax <$15million City State ZIP > $15 million geo tan rs. Nome Phone<$Imillion H - H<$5 million Address Lj<slornfllion Ll'YESEstDBE& Fax ❑<$15 million City State ZrP ❑> $15 million Distribution: l) Original -Local Agency File UP 06-06 EXHIBIT 12-G C-8 MIPL3180 (079) Pmlea Goii Page 12-111 November 14, 2006 Local Assistance Procedures Manual Local Assistance Procedures Manual -- EXHIBIT 12-G Bidder's List of SubcontractorsBE and Non -DBE BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. rno LPP 06-06 Page 12-111 EXHIBIT 12-G Novemher 14, 2006 N H51%. C-8 Local Assistance Procedures Manual Na (Q)8) Pmlec! C4o11 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (I)BE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 40, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: l) Original -Local AgencyFile LPP 06-06 EXHIBIT 12-G C-8 HSIPLb 50 rorel Pn4WC4011 Page 12-111 November 14, 2006 Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were net Qeie,,fPj t.. 9. :__._ -- - __t _ _ _ . .. . Duarainnon: 1) Original —Local Agency File Page 12-112 November 14, 2006 HSIPLS4W (9]9) C-9 P.Jwt e4911 Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DOE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project This is required for compliance with Title ,9.Section zoo,mcCode ovfFederal Remdaeons. 2 Photoco this fom for ARM —5,1 1 IMh firms. fled orhon of Name 4 A Phone <$1 million Address IfYES1&tDDff* rYES ffstmz Fax ❑< $15 minion citystatsap <$1 minion Name Phone <$5 million hfdr <$10 million Fax <$15 minion CRY State Zip >$I5million Name phone <$1 million If YES ha DBE W. - <$5 million Address <$10 million Fax <$15 rnifflon City State ZIP _—TS-15millon Name Phone El < $1 million []<$5 million Address []<$10million F_ list DBE Fax []<$15mflKGn City State 71P > $15 million Distribution! 1) Original —Local Agency File rage IL -111, C-9 Hslms saws) PfojmtcAall November 14, 2006 Bidder's List of Subcontractors (DBE and BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 urs.nuumn: it M91cal—Local Ageary File Page 12-112 November 14, 2006 HBIPLSEW ]ma) C-9 p,gcaGiatl Bidder's List of Subcontractors (DBE and Non -DDE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NOWDBE} PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to oartieivate as a subcontractor run this nrnixet Thic i,rnli—rl f . ,.,.. I;..,,.o ,,,:H Distribution: 1) Original — Local Agency File Page 12-112 November 14,2006 C-9 HSI PI -5450(079) Pmiect C4011 REFERENCES HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 City of Santa Clarita, California The following are the names, addresses, and telephone numbers of three public agencies for which BIDDER has performed similar work within the past 3 years: 2. 3. 0. ress Payu- CA er/Agency The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance bonds: MY MCMA EXCEL. PAIANG CGR iPAW Contractors Name TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 DEBARMENT AND SUSPENSION CERTIFICATION HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 City of Santa Clarita, California The bidder under penalty of perjury, certified that except as noted below, he/she or any person associated therewith in the capacity of owner, partner, director, office manager: is not currently under suspension, debarment, voluntary exclusion or determination of ineligibility by any federal AGENCY; has not been suspended, debarred, voluntarily excluded, or determined ineligible by any federal AGENCY within past three years; does not have a proposed debarment pending; and has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidders' responsibility. For any exception noted above, indicate below to whom it applies, initialing AGENCY, and dates of action. 0lh- NOTE: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-11 HSIPL-5450(0]9) Prje C 011 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION * * * (Must be filled out by the Bidder and ALL subcontractors over $10,000) * * * HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via PrincessafVista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 City of Santa Clarita, California This bidders3�`I � jNC.Q aaNm proposed subcontractor hereby certifies that he has , has not participated in a previous contract or subcontract subject to the equal opportunity clause, as required by Executive Orders 10925.11114, or 11246, and that he has / , 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. PALP jAIC,09A Company: OCCEL P/��1.3ING COMPANY By: ( —U • .t Title: G. P. BROWN,PRE31DENT Date: MAR - 5 2014 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 and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1) prevents the award of contracts and subcontracts unless such CONTRACTOR submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Note: This form must be received by the AGENCY from all subcontractors no later than 4:00 PM on the 4tb business day after the bid opening. Prime contractor is to submit certificate at bid opening. C-12 HSI PLS450 (079) PrOlICG011 BIDDER'S INFORMATION AND CERTIFICATION 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 AGENCY, 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. Bidder's Name: ?ALP, INC. DBA EXCEL PAVING COMPANY .9 Business Address: LONG BEACH, CA 90806 Telephone No.: (1562) 599-5841 State CONTRACTOR's License No. & Class: STATE LIC. 688659 "A' Original Date: ti Jtt� S 44 Expiration Date: J3r11fl14 The following are the names, titles, addresses, and phone numbers of all individuals, firm members, partners, joint venturers, and/or corporate officers having a principal interest in this proposal: Curtis P. Brown President and Chief Executive officer Curtis P. Rrnwn in a mg tier Bruce E. Fla tt Vice President and Chief financial Giffcer Marcia S. Miller Secretary m ee E. Ilrakulich Assistant Secretary 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: N I- C -13 HSIPL-54M(079) Pmienl 04011 All current and prior DBAs, alias, and/or fictitious business names for any principal having an interest in this proposal are as follows: PALP INC 06A EXCEL MING COMPANY IN WITNESS WHEREOF, BIDDER executes and submits this proposal with the names, title, hands, and seals of all aforementioned principals this MA - , 7111(1ay of _ 294-3' 14 BIDDER: S i g -n -al ure C. P, BROWN, PRESIDENT PALP IN ®BA Name and Title of Signatory EXCEL PAVING COMPRly Legal Name of Bidder 2230 LEMON AVENUE LGNG dEACti, CA 90906 Address _I5R9I rciQ-SRdt FFD. 95-3672914 Telephone Number Federal Tax I.D. No. SIGNATURES MUST BE MADE AND NOTARY ACKNOWLEDGMENTS OF EXECUTION OF BIDDER MUST BE ATTACHED Subscribed and sworn to this MAR ` 5 2014' day of , 2013. Notary C-14 HSIPL5 M(0]9) PmjKI C4011 (SEAL) ILLIPS. #1996177 roblic-California WCPH:LL'P5 ELES COUNTY apires OCC 920 BID SECURITY FORMS FOR CHECK OR BOND TO ACCOMPANY BID `" NOTE: The following form shall be used in case check accompanies bid. Accompanying this Proposal is 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 the total amount of the bid. The proceeds of this check shall become the property of said AGENCY provided this Proposal shall be accepted by said AGENCY through action of its legally constituted contracting authorities, and the undersigned shall fail to execute a contract and furnish the required bonds within the stipulated time; otherwise, the check shall be returned to the undersigned. Project Name: HSI PL -5450 (079) Golden Valley/Robert C Lee, Via PrincessalVista Del Canon, Bouquet Canyon Rd/Central Park City Project C4011 Federal -Aid No. HSIPL-5450 (079) Bidder's Signature CONTRACTOR Address City, State, Zip Code * Delete the inapplicable work. NOTE: If the bidder desires to use a bond instead of a check, the following form shall be executed. The sum of this bond shall be not less than ten percent (10%) of the total amount of the bid. C-15 HSIPLS W(079) Pm)ectr4011 PROPOSAL GUARANTEE BID BOND HSIPL-5450 (079) Golden Valley.Rd/Robert C Lee, Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-04011 Project No. 04.011 City of Santa Claritai California KNOW ALL MEN BY THESE PRESENTS that PALP Inc. dba Excel Paving Company , as BIDDER, and _ Federal Insurance Company as SURETY, are held arid firmly bound .unto the City of Santa Clarita, as. AGENCY, in the penal sum of Ten. percent of thetotal amount bid dollars. ($ 1o% ),which is ten percent (10%) of the total. amount bid by BIDDER to AGENCY 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 AGENCY for the above -stated project, if said bid. is rejected, or If said bid is accepted and the contract is awarded and entered info. 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 AGENCY. IN WITNESS WHEREAS, the parties hereto have set their names, titles, hands, and seals, this loth day of February 2014 PALP Inc. dba Excel Paving Cortf�a BIDDER: Sionature 2230 Lemon Avenue, Long Beach, CA 90806. (562) 59MB41 Address SURETY* Douglas A. Rapp, A,tlomey in Fact . - (908) 903-2000 Subscribed and sworn to this day of 20_. NOTARY PUBLIC (SEAL) *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. C-16 HSIPL.59b0(079) Pio)ecI 01011 ACKNOWLEDGMENT State of California County of Orange ) On 02/10/2014 before me, Debra Swanson, Notary Public (insert name and title of the officer) personally appeared Douglas A Rapp who proved to me on the basis of satisfactory evidence to be the person($) whose name($) isfafe subscribed to the within instrument and acknowledged to me that he/sl-,- h executed the same in his/4&s4„e;r authorized capacity(ieaj, and that by hiseisignature(yr) on the instrument the person($), or the entity upon behalf of which the person(o) 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. I `�y.or,yfe. DEBRASWANSON WITNESS my hand and official seal. a S COMM. # 1997119 M d R NOTARYPUSUGCAUFORNIA g % h ORANGE COUNTY hi rlChubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 l+Yl1RQ' Know All by These Presents, That FI COMPANY, a New York corporation, and P appoint Douglas A, Rapp and Timothy Ina corporation, VIGILANT INSURANCE corporation, do each hereby Constitute and each as their We and lawful Attorney- In. Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or other Wise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the course of business, and any instruments amending or altering the same, and conaents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and daaffifixxeeedddtheir corporate seals on this 16th day of December, 2011. /r.lns� i G✓ A Kenneth C. Wendel, Assistant Secretary /j)aw . Norris, Jr., Vice Prescient STATE OF NEW JERSEY ` ss. County of Somerset On this 16th day of December, 2011 before me, a Notary Public of New Jersey, personally came Kenneth C. Wendel, tome known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duly sworn, did depose and say that he is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By. Laws of said Companies; and that he signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that he is acquainted with David S. Norris, Jr., and Knows him to be Vice President of said Companies; and that the signature of David B. Norris, Jr., subscribed to said Power of Attorney is in the genuine handwriting of David S. Norris, Jr., and was thereto subscribed by authority of said By- Lam yLaws and in deponent's presence. .Notarial Seal C ` KATHERINE J. ADELAAR NOTARY PUBUc OF NEW JFRSFI 9Nn,2316685 G'Commiuion Expires July 16, 20M ,gr� CERTIFICATION Extract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY: `All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company, either by the Chairman or the President or a Vice President or an Assistant Vice President, jointly with the Secretary or an Assistant Secretary, under their respective designations. The signature of such officers may be engraved, printed or lithographed. The signature of each of the following officers: Chairman, President any Vice President, any Assistant Vice President any Secretary, any Assistant Secretary and the seal of the Company may be affbied by facsimile to any power of attorney or to any certificate relating thereto appointing Assistant Secretaries or Attorneys. in. Fact far purposes only of executing and attesting bonds and undertakings and other writings obligatory In the nature thereof, and any such power of attorney or cerfi irate bearing such farsiMle signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which It is attached.' I, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the'Compantee) do hereby certify that III the foregoing extract of the By. Laws of the Companies is true and correct, (i) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S. Treasury Department; further, Federal and Vigilant are teemed In Puerto Rico and the U.S. Virgin Islands, and Federal is licensed in American Samoa, Guam, and each of the Provinces of Canada except Prince Edward Wand; and (X) the foregoing Power of Attorney is true, correct and in full force and effect. Gwen under my hand and seals of said Companies at Warren, NJ this 10th day of February, 2014. ytyYaAWrY, x:nl'� je�Mx'C,e Wd1ANh QrryxSM ` �WFWYDR�'- ice". S/l •• /`r.Gs�!/l/r®L(i� a Kenneth C. We el, Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903- 3493 Fax (908) 903- 3656 e-mail: suretychubb.conn Form 15-10- 0225B- U (Ed. 5- 03) CONSENT CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County Of Inc Anvales On MAR -52014 personally appeared before me, C.. Phillips Notary Public (Hae invert name and Ode of the officer) who proved to me on the basis of satisfactory evidence to be the persorlW whose name(ct) islix subscribed to the within instrument and acknowledged to me that he&h&6tkt% executed the same in hiS�1bi:k authorized capacityQtO, and that by his/iterdhei€ signature( on the instrument the person(g), 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 Cal ifomia that the foregoing paragraph is true and correct. WITNESS m hand and official seal. a PHILLIPS y r �• �'- COMM - #1996177 „ Notary Public-Callromia (Notary Sal) My COMM. Expires Oct. 2B, 2016 Signa o Notary Public ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or desaiption of attached document) (Title or description of attached document continued) Number of Pages _ Document Date (Additional information) CAPACITY CLAIMED EY THE SIGNER ❑ Individual (s) ❑ Corporate Officer .(rite) ❑ Parther(s) ❑ Attomey-in-Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM ,iny acknowledgment completed in California murt contain verbiage erectly err appears above In the muoy .rection or a separate oc)nowledgmem form mast be properly completed and attached to that document. rhe only erception is f a document is to be recorded ordeide ofCalfomia In such iratonces, mry alremarive acknowledgmem verbiage err may be printed on such a document so long err the verbiage does nal require the mmry to do something that is diegalfor a notary in Califomia (i. e. candying the aashorleed eapad(Y of the signer). PIC= cheek the docvmem carejullyfor proper norarial wording and attach thirform (required • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date ofnorsrisadon must be the date that the signer(s) personally appeared which most also be the same date the acknowledgment Is completed. • The notary, public must print Ids or her name as it appears within his or her commission followed by a comma and than your title (notary public). • Print the name(s) of document signer(&) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (Le. hdshelthey,— is /ere) or circling the correct forms. Failure to correctly indicate this information may lad to rojeotion of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover tont or lines. If seal impression smudges, reseal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. Additional hdonnation is not required but could help to more this acknowledgment is not misused or attached to a different document. Indicate title or type of tamplsed documem, cumber of pages and date. d Indicate the capacity claimed by the signer. If the claimed apacity is e corporate officer, indicate the ate (Le. CBO, CFO, Seorotery). • Securely attach this document In the signed document _-,�QOB_VersiPn CAI'PA y12_10.07800.B73-9665 ,w,vw_NotaryClesaw.com,.. _. _..,. __, NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 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 sham 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 FORMA PART OF THE PROPOSAL. BIDDERS ARE CAUTIONED THAT MAKING A FALSE CERTIFICATION MAY SUBJECT THE CERTIFIER TO CRIMINAL PROSECUTION. C-17 HSIPL5M(Mg) Project 04011 NON -COLLUSION AFFIDAVIT HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid_ No. ENG -13-14-C4011 Project No. C4011 City of Santa Clarita, California TO BE EXECUTED BY EACH BIDDER OF A PRINCIPAL CONTRACT STATE OF CALIFORNIA ) COUNTY OF LOS ANGELES C.P. BROW14 being first duly sworn deposes and says that he is the Tsai P thy, fIRA (sole owner, a partner, president, etc.) of ,� en n the party making the foregoing bid; that such bid is not made in t€st ° f° b dl 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, profrt, 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 his 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 AGENCY 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 AGENCY thereof, or to any other individual, except to such person or persons as have a partnership or other financial interest with said BIDDER in his general business. Bidder: Signature Title C.P. MOWN, PRESWENT Subscribed and sworn to ^before me this day of MAR m 5 2014 20 n _. 1' !'n�5 L C. Phillips, Notary Public C. PHILLIPS X coMM.#1996177 m Notary PublicCall OM12 K LOS ANGELES COUNTY u v Comm. Expires Oct 29, 20166 C-18 HSIPL-5450 (079) P°gecl C4o11 BIDDER'S QUESTIONNAIRE HSIPL-5450 (079) Golden Valley Rd/Robert C Lee. Via Princessa/Vista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 City of Santa Clarita, California If the bidder has answered the questionnaire within the past year and there are no significant changes in the information requested, then the bidder need not file a new questionnaire. If there are changes, indicate those changes. Should the space provided not be adequate, so indicate and complete information on a separate page(s) and attach hereto. 1. Submitted by: Telephone: (552) 599.5841 Principal Office Address: 22311 I FianN AvFuiip 2. Type of Firm: COl1PORATIOM LONG BEACH, CA 90805 ual: 3a. If a corporation, answer thesequestions: CALIFORNIA Date of incorporation: q--)- preStatgatJh1wgg*t#�pniiveOfficer President's Name: SeirFt�P nr"w" m Vice President and Chief Operating Officer Vice -President's Name: Fr e F Flett Vice President and Chief Financial Officer Secretary or Clerk's Name: Ma'0a', ca s. Miller secretary Treasurer's Name: Michele E. Drakulich Assistant 5crolary 3b. If a partnership, answer these questions: Date of organization. State Organized Name of all partners holding more than a 10% interest: Designate which are General or Managing Partners. 4. Name of person holding CONTRACTO 's license: C. P. HOWN, PRESIDENT License number. Class:�Ll. i�t_i_6 piration Date: STATE LIC, Title: _ Alternate: Title: Vire President 6. List the major on tructi n projects your organization as in rogress as of this date: Project Location: MoApdo ST Type of Project: I i" C-19 HSIPLS 50 (079) P.Jec 04011 CERTIFICATION OF NON -SEGREGATED FACILITIES HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via PrincessafVista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 City of Santa Clarita, California The CONTRACTOR certifies that he does not maintain or provide for his employees any segregated facilities at any of his establishments, and that he does not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The CONTRACTOR certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The CONTRACTOR 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 CONTRACTOR agrees that (except where he has obtained identical certifications from proposed subcontractors for specific time periods) he 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 he will retain such certifications in his files. PW. @ UBA EXCEL PAVING CONTRACTOR ".P. BROWN PRESIDENT 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). C-20 ntj pm Pmecl04011 NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS HSIPL-5450 (079) Golden Valley Rd/Robert C Lee, Via PrincessalVista Del Canon, Bouquet Canyon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 City of Santa Clarita, California The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that., (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure of Lobbying Activities;' in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub -recipients shall certify and disclose accordingly. THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THE "BIDDER'S CERTIFICATION" SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH FORMA PART OF THE PROPOSAL. BIDDERS ARE CAUTIONED THAT MAKING A FALSE CERTIFICATION MAY SUBJECT THE CERTIFIER TO CRIMINAL PROSECUTION. C-21 HSIPL5450(079) Pm(M 04011 DISCLOSURE OF LOBBYING ACTIVIMS THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT 1. Type of Federal Action: ® a. contract b. grant c. cooperative agreement d loan e. loan guarantee f. lose insurance 2. Status of Federal Action: a. bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity EPrime FiSubawardee PALPr ING DBA EXCEL PAVING COMPAVIff ' if known 2230 LEN ON AVENUE res LONG CH' CA CoBgasional District'ifknown 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (]f individual, last name, fast name, MI) -3. Report Type: 171 ffy 1 a. initial u b. material change For Material Change Only: year _ quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, ifknown: b. Individuals PerformingServices (including address if different from No. 1Oa) (last name, first name, MI) (attach Continuation Sheets) if necessary) 11. Amount of Payment (check all that apply) $ [] actual E] planned 12. Form of Payment (check all that apply): ea. cash b. in-kind; specify: nature 13. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes 11 No B' 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure oflobbying reliance was placed by the tier above what his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available forpublic inspection. Any person who fails to file the required disclosure shall be subject to a civil penahy of not less than $10,000 and not more than $100,000 for each such failure. Signal=: Print Name: C.P. BROWN, PRESIDENT Title: Telephone No.: (582)599-5841 DacMAR — 5 201 Authorized for Local Reproduction Standard Form - LLL C-22 HSIPL-4w (ora) PnJeot 04011 INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C, section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. S. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g, Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL,1. ww"e= RN. OGM-90d ND1Fn EXHIBIT 17-F Local Assistance Procedures Manual Final Report -Utilization of Disadvantaged Business Enterprises (DBE), First -Tier Subcontractors FINAL REPORT — UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE), FIRST-TIER SUBCONTRACTORS CEM 2402(F) (Rev. 02/2008) The form requires specific information regarding the construction project: Contract Number, County, Route, Post Miles, Federal -aid Project No., the Administering Agency, the Contract Completion Date and the Estimated Contract Amount. It requires the prime contractor name and business address. The focus of the form is to describe who did what by contract item number and descriptions, asking for specific dollar values of item work completed broken down by subcontractors who performed the work both DBE and non -DBE work forces. DBE prime contractors are required to show the date of work performed by their own forces along with the corresponding dollar value of work. The form has a column to enter the Contract Item No. (or Item No's) and description of work performed or materials provided, as well as a column for the subcontractor name and business address. For those firms who are DBE, there is a column to enter their DBE Certification Number. The DBE should provide their certification number to the contractor and notify the contractor in writing with the date of the decertification if their status should change during the course of the project The form has six columns for the dollar value to be entered for the item work performed by the subcontractor. The Non -DBE column is used to enter the dollar value of work performed for firms who are not certified DBE. The decision of which column to be used for entering the DBE dollar value is based on what program(s) status the firm is certified. This program status is determined by the California Unified Certification Program by ethnicity, gender, ownership, and control issues at time of certification. To confirm the certification status and program status, access the Department of Transportation Civil Rights web site at: http://www.dotca.goy/hii/bep or by calling (916) 324-1700 or the toll free number at (888) 810-6346. Based on this DBE Program status, the following table depicts which column to be used: DBE Program Status Column to be used If prograrn status shows DBE only with no other programs listed I DBE If a contractor performing work as a DBE on the project becomes decertified and still performs work aftutheir decertification date, enter the total dollarvalue performed by this contractor under the appropriate DBE identification column. If a contractor performing work as a non -DBE on the project becomes certified as a DBE, enter the dollar value of all work performed after certification as a DBE under the appropriate identification column. Enter the total of each of the six columns in Form CEM -2402(F). Any changes to DBE certification must also be submitted on Form -CEM 2403(F). Enter the Date Work Completed as well as the Date of Final Payment (the date when the prime contractor made the "final payment" to the subcontractor for the portion of work listed as being completed). The contractor and the resident engineer sign and date the form indicating that the information provided is complete and correct. C-30 HSIPL-5M(O791 Pmwc104011 STATE OF CALIFORNIA —DEPARTMENT OF TRANSPORTATION DISADVANTAGED BUSINESS ENTERPRISES (DBE) CERTIFICATION STATUS CHANGE CP -CEM -2403(F) (New. 10199) Attach DBE certification/Decerfifirafinn lafte, i., CONTRACT ITEM NO. SUBCONTRACT NAME AND BUSINESS ADDRESS BUSINESS PHONE CERTIFICATION NUMBER AMOUNT PAID WHILE CERTIFIED DECERTIFICATION DATE Letter attached $ $ $ Comments: $ I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE, THE ABOVE INFORMATION IS COMPLETE AND CORRECT MPL- Mso(On) ".1 tcMo• unglnal copy-ULAE Copy -1) Business Enterprise Program 2) Pdme Contactor 3) Local Agency 4) Resident Engineer C-31 STATE OF CALIFORNIA- DEPARTMENT OF TRANSPORTATION bdoulIttly DBE Trucking Verification MONTHLY DBE TRUCKING VERIFICATION cP- CEM-2404(F)(NEW 12/99) CONTRACT NO. MONTH YEAR Truck Owner DBE Company California H Commission Data Lease Cert No. Name and Address Tmck No. PatroICA No. Or Paid arrangement Amount Paid- If ap Iicab'a) Lease Agreement C $ with Non -DBE C with DBE D Lease Agreement C $ wHhNon-DBE D wHhDBE D Lease Agreement D $ with Non -DBE C with DBE D Lease Agreement C $ wHh Non -DBE with DBE D Lease Agreement C $ with Non -DBE C with DBE D Lease Agreement f $ wHh Non -DBE LC wHhDBE Lease Agreement C $ with Non -DBE c with DBE D Lease Agreement C $ with Non -DBE C wHhDBE D Lease Agreement ❑ $ with Non -DBE o with DBE D TOTAL AMOUNT PAID S PRIME CONTRACTOR BUSINESS ADDRESS BUSINESS PHONE NO. "Upon request all Lease Agreements shell be made available. in accordance with the Snacial PmNsrnne ceM-Navoew Iwo) L,PP 0407 HSIPL34W (olhl) Prrja 04011 COPY DISTRIBUTION: ORIGINAL- RESIDENT ENGINEER C-32 Page 16-117 August 12, 2004 EXHIBIT 16-Z Monthly DBE Trucking Verification Local Assistance Procedures Manual Foran CP -CEM 2404 (F)MW 12/99) - MONTHLY DBE TRUCKING VERIFFICATION The top of Form CEM -2404(F) contains boxes to put in the Contract Number, the Month of the reporting period and the Year of the reporting period. The Form CEM -2404(F) has a column to enter the name of the Truck Owner, the DBE Cert. No. (if DBE certified) and the Name and Address of the trucking company. The Form CEM -2404(F) also requires the Truck No. and the California Mghway Patrol CA No. Form CEM -2404(F) is to be submitted prior to the 15th of each month and must show the dollar amount paid to the DBE trucking company(s) for trucking work performed by DBE certified trucks and for any fees or commissions of nonDBE trucks utilized each month on the project. The amount paid to each trucking company is to be entered in the column called "Commission or Amount Paid," in accordance with the Special Provisions Section 5-I.X. Payment information is derived using the following: 1.) 100% for the trucking services provided by the DBE using trucks it owns, operates and insures. 2.) 100% for the trucking services provided by the trucks leased from other DBE firms. . 3.) The fee or commission paid to nonDBEs for the lease oftrucks. The Prime does not receive 100% credit for these services because they are not provided by a DBE company. The total dollar figure of this column is to be placed in the box labeled "Total Amount Paid." The column "Date Paid" requires a date that each trucking company is paid for services rendered. The next column contains information that must be completed if a lease arrangement is applicable. Located at the bottom of the form is space to put the name of the "Prime Contractor," their `Business Address" and their `Business Phone No." At the bottom of the formthere is a space for the Contractor or designee "Contractor Representative's Signature, Title and Date" certifying that the information provided on the form is complete and correct. Page 16-118 August 12, 2004 LPP 04-07 HSIPL-se (07e)- C-33 P.JWC 011 PALO, INC. DBA EXCEL PAVING COMPANY 3330 LEMON AVENUE LONG BEACH, CA 9080E CITY OF SANTA CLAMTA 20111 MAA -5 A 10: 51 RECEM D PURCHASING a � l r CAPITAL IMPROVEMENT PROJECT AGREEMENT Contract 14-00140 HSIPL-5450 (079) Golden Valley Rd/Robert CLee, Via PrincessaJVista,Del Canon, Bouquet Canvon Rd/Central Park Bid No. ENG -13-14-C4011 Project No. C4011 This AGREEMENT is made and entered into for the above -stated project this day of 20 , BY AND BETWEEN the City of Santa Clarita, as CITY, and Palp Inc, DBA; Excel Paving Company, as CONTRACTOR. CITY and CONTRACTOR have mutually agreed as follows: ARTICLE I That contract documents for the aforesaid project shall consist of the Notice Inviting Bids, Instructions to Bidders, Proposal, General Specifications, Standard Specifications, Special Provisions, Plans, and all referenced specifications, details, standard drawings, special drawings, appendices, and City's Labor Compliance Program; together with this AGREEMENT and all required bonds, insurance certificates, permits, notices, and affidavits; and also including any and all addenda or supplemental agreements clarifying or extending the work contemplated as may be required to insure its completion in an acceptable manner. All of the provisions of said AGREEMENT documents are made a part hereof as though fully set forth herein. ARTICLE II For and in consideration of the payments and agreements to be made and performed by CITY, CONTRACTOR agrees to famish all materials and perform all work required for the above -stated project, and to fulfill all other obligations as set forth in the aforesaid contract documents. ARTICLE III CONTRACTOR agrees to receive and accept the prices set forth in the Proposal as full compensation for furnishing all materials, performing all work, and fulfilling all obligations hereunder. Said compensation shall cover all expenses, losses, damages, and consequences arising out of the nature of the work during its progress or prior to its acceptance including those for well and faithfully completing the work and the whole thereof in the manner and time specified in the aforesaid contract documents; and also including those arising from actions of the elements, unforeseen difficulties or obstructions encountered in the prosecution of the work, suspension or discontinuance of the work, and all other unknowns or risks of any description connected with the work. Revised lune 2011 Page 1 of 13 ARTICLE IV CITY hereby promises and agrees to employ, and does hereby employ, CONTRACTOR to provide the materials, do the work, and fulfill the obligations according to the terms and conditions herein contained and referred to, for the prices aforesaid, and hereby contracts to pay the same at the time, in the manner, and upon the conditions set forth in the contract documents. ARTICLE V 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. ARTICLE VI CONTRACTOR affirms that the signatures set forth hereinafter in execution of this AGREEMENT represent all individuals, firm members, partners, joint venturers, or corporate officers having principal interest herein. ARTICLE VII Nature of Relationship CONTRACTOR shall not be subject to day-to-day supervision and control by CITY employees or officials. CONTRACTOR shall perform services in accordance with the rules, regulations and Revised 7we 2011 page 2 of 13 policies of CITY respecting such services, and in accordance with appropriate standards of professional conduct, if any, applicable to the services provided. CITY shall not be responsible for withholding any payroll or other taxes on behalf of CONTRACTOR. It is understood and agreed that the CONTRACTOR is, and at all times shall be, an independent CONTRACTOR and nothing contained herein shall he construed as making the CONTRACTOR, or any individual whose compensation for services is paid by the CONTRACTOR, an agent or employee of the CITY, or authorizing the CONTRACTOR to create or assume any obligation of liability for or on behalf of the CITY. ARTICLE VIII 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. 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. Should CONTRACTOR for any reason, fail to obtain and maintain the insurance required by this Agreement. City may obtain coverage at CONTARCTOR'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 within 10 days of the prior insurer's issuance of notice of cancellation CONTRACTOR must ensure that there is no lapse in coverage. 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: Revised lune 2011 Page 3 of 13 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. 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, inure 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. Revised June 2011 Page 4 of 13 ARTICLE IX Pursuant to Senate Bill 542, chaptered in 1999, the Employment Development Department (EDD) of the State of California requires that a W-9 Form be filed by all vendors for all AGREEMENTS entered into with the City. CONTRACTOR agrees to complete all required forms necessary to comply with EDD regulations. ARTICLE X Term This AGREEMENT shall be effective for a period beginning on the date shown in the Notice to Proceed, and ending on 35 days after the date of recordation of the Notice of Completion unless sooner terminated. Modification/Termination No modification, amendment or other change in this AGREEMENT or any provision hereof shall be effective for any purpose unless specifically set forth in writing and signed by duly authorized representatives of the parties hereto. This AGREEMENT may be terminated with or without cause by CITY giving CONTRACTOR thirty (30) days advance written notice. Any reduction of services shall require thirty (30) days advance written notice unless otherwise agreed in writing between CONTRACTOR and CITY. In the event of termination, CONTRACTOR shall be entitled to compensation for all satisfactory services completed and materials provided to the date of the notice of termination. Non -Effect Waiver CONTRACTOR's or CITY's failure to insist upon the performance of any or all of the terms, covenants, or conditions of this Agreement, or failure to exercise any rights or remedies hereunder, shall not be construed as a waiver or relinquishment of the future performance of any such terms, covenants, or conditions, or of future exercise of such rights or remedies, unless otherwise provided for herein. Severability In the event that any one or more of the provisions contained in this AGREEMENT shall for any reason be held to be unenforceable in any respect by a court of competent jurisdiction, such holding shall not affect any other provisions of this AGREEMENT, and the AGREEMENT shall then be construed as if such unenforceable provisions are not a part hereof. Governing Law This AGREEMENT shall be construed and interpreted and the legal relations created thereby shall be determined in accordance with the laws of the State of California. Revised )we 2011 Page 5 of 13 Compliance with Law CONTRACTOR shall comply with all applicable laws, ordinances, codes, and regulations of the federal, state, and local government, including City's Labor Compliance Program (LCP). CONTRACTOR shall comply with all aspects of the National Pollutant Discharge Elimination System (NPDES) in order to prevent pollution to local waterways. Failure to implement NPDES Requirements shall result in project delays through City issued Stop Work Notices and/or fines levied against the CONTRACTOR. Conflict of Interest CONSULTANT will comply with all conflict of interest laws and regulations including, without limitation, CITY'S conflict of interest regulations. Prevailing Wages If required by applicable state law including, without limitation Labor Code §§ 1720 (as amended by AB 975 (2001)), 1771, 1774, 1775, and 1776, CONTRACTOR must pay its workers prevailing wages. It is CONTRACTOR's responsibility to interpret and implement any prevailing wage requirements and CONTRACTOR agrees to pay any penalty or civil damages resulting from a violation of the prevailing wage laws. In accordance with Labor Code § 1773.2, copies of the prevailing rate of per diem wages are available upon request from CITY's Engineering Division or the website for State of California prevailing wage determination at www.dir.ca.gov/DLSR/PWD. A copy of the prevailing rate of per diem wages must be posted at the job site. This contract is subject to both federal and state prevailing wage requirements of the California Labor Code including Sections 1770 and 1773, the Davis -Bacon and Related Acts and the City's California Department of Industrial Relations (DIR) approved Labor Compliance Program. All covered work classifications required in performance of this contract will be subject to prevailing wage provisions. If there is a difference between the federal and state wage rates, the Contract and its subcontractors shall pay not less than the higher wage rate. Contractor shall further adhere to the requirements contained in the City's Labor Compliance Program. A copy of the Labor Compliance Program is available for review upon request at the Office of the City Clerk. All pertinent federal and State of California statues and regulations, including, but not limited to those referred to in this contract and in the City's Labor Compliance Program, are incorporated herein as though set forth in their entirety. Additionally, the Contractor is responsible for obtaining a current edition of all applicable federal and State of California statues and regulations and adhering to the latest editions of such. Protection of Resident Workers The City of Santa Clarita actively supports the Immigration and Nationality Act (INA), which includes provisions addressing employment eligibility, employment verification, and nondiscrimination. Under the INA, employers may hire only persons who may legally work in the United States (i.e., citizens and nationals of the U.S.) and aliens authorized to work in the U.S. Revised June 2011 Page 6 of 13 The employer must verify the identity and employment eligibility of anyone to be hired, which includes completing the Employment Eligibility Verification Form (I-9). The Contractor shall establish appropriate procedures and controls so no services or products under the Contract Documents will be performed or manufactured by any worker who is not legally eligible to perform such services or employment. Federal Prevailing Wages The work being done pursuant to this Contract is paid for in part by the United States of America. Therefore, pursuant to the provisions applicable to such federal assistance, Contractor acknowledges and agrees that the services, construction, and maintenance pursuant to this Contract is, or may become, subject to certain federal laws and regulations, including, but not limited to, provisions of the Davis -Bacon Act, and particularly 29 Code of Federal Regulations Section 5.5 in part as follows: (a) The Agency head shall cause or require the contracting officer to insert in full in any contract in excess of $2,000 which is entered into for the actual construction, alteration and/or repair, including painting and decorating, of a public building or public work, or building or work financed in whole or in part from federal funds or in accordance with guarantees of a federal agency or financed from funds obtained by pledge of any contract of a federal agency to make a loan, grant or annual contribution (except where a different meaning is expressly indicated), and which is subject to the labor standards provisions of any of the acts listed in Section 5.1, the following clauses (or any modifications thereof to meet the particular needs of the agency provided that such modifications are first approved by the Department of Labor): (1) Minimum wages. (i) All laborers and mechanics employed or working upon the site of the work (or under the United States Housing Act of 1937 or under the Housing Act of 1949 in the construction or development of the project), will be paid unconditionally and not less often than once a week, and without subsequent deduction or rebate on any account (except such payroll deductions as are permitted by regulations issued by the Secretary of Labor under the Copeland Act (29 CFR Part 3)), the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment computed at rates not less than those contained in the wage determination of the Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics. Contributions made or costs reasonably anticipated for bona fide fringe benefits under. Section 1(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of paragraph (a)(1)(iv) of this section; also, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to skill, except as provided in Section 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: provided that the employer's payroll records accurately set forth the time spent in each classification in which work is performed. The wage determination (including any additional Revised June 2011 Page 7 of 13 classification and wage rates conformed under paragraph (a)(1)(ii) of this section) and the Davis - Bacon poster (WH -1321) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the workers. (ii)(A) The contracting officer shall require that any class of laborers or mechanics, including helpers, which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefore only when the following criteria have been met: (1) The work to be performed by the classification requested is not performed by a classification in the wage determination; and (2) The classification is utilized in the area by the construction industry; and (3) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination. (B) If the contractor and the laborers and mechanics to be employed in the classification (if known), or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the contracting officer to the Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of Labor, Washington, DC 20210. The Administrator, or an authorized representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30 -day period that additional time is necessary. (C) In the event the contractor, the laborers or mechanics to be employed in the classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation of the contracting officer, to the Administrator for determination. The Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advice the contracting officer or will notify the contracting officer within the 30 -day period that additional time is necessary. (D) The wage rate (including fringe benefits where appropriate) determined pursuant to paragraphs (a)(1)(ii) (B) or (C) of this section, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. (iii) Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. (iv) If the contractor does not make payments to a trustee or other third person, the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, provided that the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. (2) Withholding. The CITY shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld from the contractor under this contract or any other federal contract with the same prime contractor, or any other federally -assisted contract subject to Davis -Bacon prevailing wage requirements, which is held by the same prime contractor, so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event Revised June 2011 Page 8 of 13 of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of the work (or under the United States Housing Act of 1937 or under the Housing Act of 1949 in the construction or development of the project), all or part of the wages required by the contract, the CITY may, after written notice to the contractor, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. (3) Payrolls and basic records. (i) Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work (or under the United States Housing Act of 1937, or under the Housing Act of 1949, in the construction or development of the project). Such records shall contain the name, address, and social security number of each such worker, his or her correct classification, hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in section 1(b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(1)(iv) that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in Section 1(b)(2)(B) of the Davis -Bacon Act, the contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. (ii)(A) The contractor shall submit weekly for each week in which any contract work is performed a copy of all payrolls to the City. The payrolls submitted shall set out accurately and completely all of the information required to be maintained under Section 5.5(a)(3)(i) of Regulations 29 CFR Part 5. This information may he submitted in any form desired. Optional Form WH -347 is available for this purpose and may be purchased from the Superintendent of Documents (federal stock number 029-005-00014-1), U.S. Government Printing Office, Washington, DC 20402. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. (B) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (1) That the payroll for the payroll period contains the information required to he maintained under Section 5.5(a)(3)(i) of Regulations 29 CFR Part 5 and that such information is correct and complete; (2) That each laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in Regulations 29 CFR Part 3; (3) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as specified in the applicable wage determination incorporated into the contract. (C) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH -347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph (a)(3)(ii)(B) of this section. (D) The falsification Revised June 2011 Page 9 of 13 of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecution under Section 1001 of Title 18 and Section 231 of Title 31 of the United States Code. (iii) The contractor or subcontractor shall make the records required under paragraph (a)(3)(i) of this section available for inspection, copying, or transcription by authorized representatives of the CITY or Department of Labor, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the required records or to make them available, the CITY may, after written notice to the contractor, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds. Furthermore, failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. (4) Apprentices and trainees --(i) Apprentices. Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S. Department of Labor, Employment and Training Administration, Office of Apprenticeship Training, Employer and Labor Services, or with a State Apprenticeship Agency recognized by the Office, or if a person is employed in his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is not individually registered in the program, but who has been certified by the Office of Apprenticeship Training, Employer and Labor Services, or a State Apprenticeship Agency to be eligible for probationary employment as an apprentice. The allowable ratio of apprentices to journeymen on the job site in any craft classification shall not be greater than the ratio permitted to the contractor as to the entire work force under the registered program. Any worker listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. Where a contractor is perforating construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman's hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification. If the Administrator determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. In the event the Office of Apprenticeship Training, Employer and Labor Services, or a State Apprenticeship Agency recognized by the Office, withdraws approval of an apprenticeship program, the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is approved. (ii) Trainees. Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration. The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved Revised lune 2011 Page 10 of 13 by the Employment and Training Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Administration withdraws approval of a training program, the contractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. (iii) Equal employment opportunity. The utilization of apprentices, trainees, and journeymen under this part shall be in conformity with the equal employment opportunity requirements of Executive Order 11246, as amended, and 29 CFR Part 30. (5) Compliance with Copeland Act requirements. The contractor shall comply with the requirements of 29 CFR Part 3, which are incorporated by reference in this contract. (6) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses contained in 29 CFR 5.5(a)(1) through (10) and such other clauses as the FHWA may by appropriate instructions require, and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR 5.5. (7) Contract termination: debarment. A breach of the contract clauses in 29 CFR 5.5 may be grounds for termination of the contract, and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. (8) Compliance with Davis -Bacon and Related Act requirements. All rulings and interpretations of the Davis -Bacon and Related Acts contained in 29 CFR Parts 1, 3, and 5 are herein incorporated by reference in this contract. (9) Disputes concerning labor standards. Disputes arising out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR Parts 5, 6, and 7. Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors) and the contracting agency, the U.S. Department of Labor, or the employees or their representatives. (10) Certification of eligibility. (i) By entering into this contract, the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or Revised June 2011 Page I I of 13 firm ineligible to be awarded Government contracts by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). (ii) No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). (iii) The penalty for making false statements is prescribed in the U.S. Criminal Code, IS U.S.C. 1001. (b) Contract Work Hours and Safety Standards Act. The Agency Head shall cause or require the contracting officer to insert the following clauses set forth in paragraphs (b)(1), (2), (3), and (4) of this section in full in any contract in an amount in excess of $100,000 and subject to the overtime provisions of the Contract Work Hours and Safety Standards Act. These clauses shall be inserted in addition to the clauses required by Section 5.5(a) or 4.6 of Part 4 of this title. As used in this paragraph, the terms laborers and mechanics include watchmen and guards. (1) Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. (2) Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph (b)(1) of this section, the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. (3) Withholding for unpaid wages and liquidated damages. The CITY shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other federal contract with the same prime contractor, or any other federally -assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph (b)(2) of this section. (4) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph (b)(1) through (4) of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (b)(1) through (4) of this section. Revised lune 2011 Page 12 of 13 The parties hereto for themselves, their heirs, executors, administrators, successors, and assigns do hereby agree to the full performance of the covenants herein contained and have caused this AGREEMENT to be executed in duplicate by setting hereunto their names and titles this day of 20 CONTRACTOR: CONTRACTOR Name: Address: Phone & Fax No. ALL SIGNATURES MUST BE Signed By: WITNESSED BY NOTARY CITY: Attest: Approved as to Form: Print Name & Title: CONTRACTOR's License No. Class Mayor/City Manager of the City of Santa Clarita City Clerk of the City of Santa Clarita City Attorney of the City of Santa Clarita Date: Date: Date: Revised June 2011 Page 13 of 13