The URL can be used to link to this page

Home My WebLink About0009_3_Gunnerson Rehab - Exhibit B ProposalB ' PRQPOSAL GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4530 FEDERAL -AID PROJECT NO. STPL 5074 (017) Company: R.J. NOBLE COMPANY TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF LAKE ELSINORE: In compliance with the annexed Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work, and improvements therein described, and to famish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications therefore which are on file in the office of the City Engineer of the City of Lake Elsinore; and the undersigned agrees to perform the work and improvements therein mentioned to the satisfaction of and under the supervision of the City Engineer of the City of Lake Elsinore duly appointed, and further agrees to enter into a contract therefore in the time, form and manner provided by law at the following prices with the undersigned that the time within which the aforementioned work must be completed by the undersigned is fixed at SIXTY (00) WORKING DAYS, starting from the date of Issuance of the Notice to Proceed by the City to the Contractor. NCO. ITEM CODE DESCRIPTION OF ITEMS UNIT ESTIMATED UNIT QUANTITY PRICE AMOUNT 1 Protect In -Place Existing Improvements as Specified on Plans LS 1 500.00 500.00 2 Fumish and Install Project Construction sign EA 1 1,500.00 1,500.00 3. Public Notification LS 4• Mobilization (Not to Exceed 5% of Total Bid) LS 1 z,000.00 rT, �- 2, 000.00 2c�'VCp,C0 5. Work Area Traffic Control LS 6 Storm Water and Non -Storm Pollution Control LS 1 4,500.00 4,500.00 7. S Construction Survey and Monument Preservation LS 1 Perform Mitigations Measures per Approved 10,000.00 10,000.00 8• CE (10/08/2015) -Section G, complete in LS 1 place a rise ea- �'' a,dea ae ToN 9• Coldmill Existing AC Pavement (2") SF 15,450 10. Coldmill Existing AC Pavement (21/2") SF 28,750 11. Coldmill Existing AC Pavement (3") SF 135,950 12 Construct HMA (Type A, PG 64-1 �, 314 Max TN 1,375 �°° �q I 13. Construct ARHM Overlay (Type GFG TN 2,600 oo Ileo �1 Grind Existing AC Pavement and truct14. ARHM Overlay (i.5" Max) to ElimiLips SF 627 at Both Ends of Concrete Pavement 1.00 527.00 C-1 ITEM ITEM DESCRIPTION OF ITEMS NO. CODE 15 Adjust to Grade Existing Water Valve, 16. 17. 18. 19. 20. 21, 22. 23. 24. 25. 26. 27. 28. complete In place Adjust To Grade Existing Storm Drain Manhole, complete in place Adjust to Grade Existing Sewer Manhole, complete in place Adjust to Grade Existing Gas Valve, complete in place Remove Traffic Striping/Pavement Markings and Markers, Weeds Kilt, and Crack Fill and Crack Seal Apply Slurry Seal (Type 2) Construct Curb Ramp per County of Riverside Standard No. 403 Case B, S Complete in place (Remove Any Interfering Portions of Existing Curb/Gutter/Sidewalk and Remove/Restore AC Pavement Slot) Full Depth Pavement Repair as Directed UNIT ESTIMATED UNIT AMOUNT QUANTITY PRICE EA 16 150.00 2,400.00 EA 3 29,500 00 I Apply 474" Double Yellow hermoplastic 600.00 2,400.00 EA 8 600.00 6,400.00 EA 3 150.00 450.00 LS 1 9,000.00 9,000.00 SY 2,300 6.25 14,375.00 S Edgeline per Caltrans Standard Plan A208, LF EA 1 2 7,500.00 15,000.00 by Engineer, Complete in place 29,500 00 I Apply 474" Double Yellow hermoplastic S Lines per Caltrans Standard Plan A20A, LF 5,675 l p0 �j�(p 00 Detail 22 Apply 4' tohermopl tic Rlght - — — S Edgeline per Caltrans Standard Plan A208, LF 11,235 �� '�, $D Detail 27B S Apply White Thermoplastic Pavement Word Marking per Caltrans Standard Plan A24D EA 20 Va o0 S Apply 12" White Thermoplastic Limit Line per Caltrans Standard Plan A24E SF 300 oa 2 • �p�QaO S Furnish and Install Sign (Standard Size or as Indicated) per CA-MUTCD EA 11 200 3300 Clean and Remove All Debris from Existing Inlet and Pipe (Approximate 60') LS 1 6,500.00 6,500.00 TOTAL BID PRICE $ (Based on Estimated Quantities of items 1 to 28) Note: Estimated quantities are for the purpose of Bid comparison only; payments will be made on the basis Of actual measurement of Work completed, except for lump sum (LS) and final pay (F) quantities. (S) denotes a specialty item. The Bid Price shall Include, but not be limited to, sales tax and all other applicable taxes and fees. n Total Bid: C� C�- lfco (Figures') The undersigned agrees to enter into and execute a contract, with necessary bonds, at the unit prices set forth herein and in case of default in executing such contract, with necessary bonds, the check or bond accompanying this bid and the money payable thereon shall be forfeited thereby to and remain the property of the City of Lake Elsinore. The above unit prices include all work appurtenant to the various items as outlined in the Specifications and all work or expense required for the satisfactory completion of said items. In case of discrepancies between unit prices and totals, the unit prices shall govern. The undersigned declares that it has carefully examined the Plans, Specifications, and Contract Documents, and has investigated the site of the work and is familiar with the conditions thereon. Date: 11/09/16 To STEVE MENDOZA, SECRETARY Contractor's State License No.: 782908 R.J. NOBLE COMPANY Contractor By: immm- Federal Employer Identication : 33-0866299 Address: 15505 E. LINCOLN AVENUE ORANGE, CA 92865 Phone: 714-637-1550 Email: jenniferdeiongh@rjnoblecompany.com C-3 Class: A & C-12 0C -CO& z N O J OD m n � �52 � rn n o v� 0 FCL [its a B a 3. �~ g n 0 Pubiic Works Contractor [PWC] Registration Search Tftna mftatlurt.6tw4{Mar"npm.gpv Otr.ni.lml7kanY 2. part I.0mw1N.earac.IrpeEq main 12M WV4 cw4 Lala cee.j FYYkI.WQd.N✓�a'LNigNrWYw11Fe M0ade�pKK.a+!!YM•A'N{kNYM'91 bawn+f "Wall- y"', 11f111f.yq FIULIL Taer r0ldf2 �v� PW R.phiratkn N,Akrr rDl.r60r; 17]•i%H�G Contractor Lepel Nem.: kJ.1YL?BLLNNI! Contractorllrsnae Lockup Llcenee Number, . example: 123466 County: •13elact County ;VI E,pal HS: JW Excel I -j PDF Beacon Ras H, One regtatered contractor round 1 Dat.11. L..1 Name R"IMMUon County cityR"I.tmUw Eeplregon N -b., D.N 0." View R.J. NOBLE COMPANY 1O0WZ35 ORAY60 ORANGE 06/16/2016 06/30/2017 �Yl�i[•Di11iR OUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4630 FEDERAL -AID PROJECT NO. STPL lf074 (017) The Bidder shall acknowledge the receipt of addenda by placing an 'Dr by each addendum received. Addendum No. 1 Addendum No. 2 Addendum No. 3 Addendum No. 4 If an addendum or addenda have been issued by the City and not noted above as being received by the Bidder, the Bid Proposal may be rejected. STEVE MENDOZA Print Name C4 11/09/16 Date SECRETARY Tate BIDDER'S SOND GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4530 FEDERAL -AID PROJECT NO. STPL 5074 (017) KNOW ALL MEN OR WOMEN BY THESE PRESENTS: That We R.J. NOBLE COMPANY as PRINCIPAL, Western Surety Company hereinafter referred to as "Contractor", and a duly authorized corporate as "Surety," are held and firmly bound unto the City of Lake Elsinore in the penal sum of TEN PERCENT (10%) OF THE TOTAL AMOUNT OF THE BID of the Contractor above named, submitted by said Contractor to the City of Lake Elsinore for the work for said project entitled above, for the payment of which sum in lawful money of the United States, well and truly to be made., to the City of Lake Elsinore to which Bald bid was submitted, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. In no case shall the liability of the surety hereunder exceed the amount of ton percent of kid arnount [---- 10%— — THE CONDITION OF THIS OBLIGATION IS SUCH. That whereas the Contractor has submitted the above-mentioned Bid to the City of Lake Elsinore as aforesaid for the work for said project entitled above. NOW, THEREFORE, if the aforesaid Contractor is awarded the Contract and, within the time and manner required under the Contract documents, after the prescribed forms are presented to him or her for signature, enters into a written Agreement in the prescribed form and in accordance with the Contract documents, and files two bonds with the City of Lake Elsinore, one to guarantee faithful performance and the other to guarantee payment for labor and materials, in accordance with said Contract documents, and as required by law, and files the required insurance certificate(s) in accordance with said Contract documents, then this obligation shall be null and void; otherwise, it shall be and remain in full force and effect until execution of the Agreement or forfeiture pursuant to the Provisions of Sections 20172 and 20174 of the Public Contract Code. In the event suit is brought upon this bond by the City and judgment is recovered, the Surety shall pay all costs incurred by the City in surh suit, including a reasonable attorney fee to be fixed by the court. (SIGNATURE PAGE FOLLOWS) C-5 !! !L! ■- i GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4530 FEDERAL -AID PROJECT NO. STPL 6074 (017) IN WITNESS WHEREOF, we have hereunto set our hands and seals on this 20 day of October 201g BIDDER: CiontraCtor Name: R.J. NOBLE COMPANY Address: 15505 E. LINCOLN AVENUE ORANGE, CA 92865 Telephone No.: 714-637-1550 Pont Name: STEVE MENDOZA Title: SECRETARY Signature: X Date: 6 l CORPORATE SURETY: Company Name: Western Surety Company Address: 915 Wilshire Blvd, Suite 1650 Los Angeles, CA 90017 Telephone No.: 866-404-7926 Print Name: James Scott Salandi Title: Attorney -in -Fact Sig Date: October 20, 2016 SIGNING ffiTFRUCTIONSTO r CON T C Bidder's Bond must be accompanied by notary certificates for EACH signature. Note the description of the document on the notary certificate. Attach BOTH notary certificates Imrnedlateiy following this page. Corporate Seal may be affixed hereto. The sttcrney-in-fact for corporate surety must be registered, as such, in at least one county In the State of California. Attach an■ original Power of Attorney immediately following the notary certificates. If the Bidder fails to property sign or omits the required signatures, the bid will be considered non-responsive and will be rejected. C-6 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of ORANGE On _ 10/25/2016 before me, Date personally appeared STEVE MENDOZA J. DE IONGH, NOTARY PUBLIC Here Insert Name and Title of the Officer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose names} Ware - subscribed to the within instrument and acknowledged to me that he/she/they- executed the same in hisfheN#ffeiF authorized capacity(ies} and that by his/lier/their=signature(oon the instrument the person(s); or the entity upon behalf of which the person(s) acted, executed the instrument. J. DE IQA3GH Commission # 2128504 ^ Notary Public - California a z ' Orange County My Comm. Expires Oct 28, 2019 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official Signature 1 y J. DE IONGH Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document:. Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: _ ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: _ ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: _ Signer Is Representing: 02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On October 20, 2016 before me, Lauren Emily Bierman, A Notary Public (insert name and title of the officer) personally appeared James Scott Salandi, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/stoat subscribed to the within instrument and acknowledged to me that he/9""y "y executed the same in his/b[ax*& authorized capacity(i*, and that by his/fKNWi ok signature(sq on the instrument the person(a), or the entity upon behalf of which the person(s) acted, executed the i nstrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Sig ►` °"',, LAUREN EMILY BIERMAN ", COMM. $ 2097240 . ww ; NOTARI►PUE CCUOMM re ORANGE COUNTY N MY COMM, EXP.JAN 15, 2019 Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint James Scott Salandi, Leonard Ziminsky, David Jacobson, Individually of Irvine, CA, its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 16th day of June, 2016. WESTERN SURETY COMPANY rs SCAV fk'oaK� sident State of South Dakota ss County of Minnehaha On this 16th day of June, 2016, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires J. MOHR KOTARYPUW.I0(R June 23, 2021 60M DAKOTA CERTIFICATE I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law of the corporatitonnjprinted on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this [JAL] day of Q CAV � , 2 �:D 1 (9- . "lr WESTERN SURETY COMPANY W � �r$arA>t. P drk t?AM1 Axa �Z. 17 L. Nelson, Assistant Secretary Farm F4280-7-2012 GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4530 FEDERAL -AID PROJECT NO. STPL 5074 (017) The bidder is required to fill in the following blanks in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Chapter 2 of Division 5, Title 1 of the Government Code of the State of California) and should familiarize itself with Sections 2-3 of the Standard Specifications. Name Under Which Subcontractor is Licensed: CL SURVEY License Number. 8231 & 8294 Address of Office, MITI or Shop: 1289 POMONA ROAD STE. 108, CORONA, CA 92882 Spedfic Description of Sub -Contract: and Bid Items of Work: SURVEY ~� Name Under Which Subcontractor is Licensed: PAVEMENT COATINGS License Number 303809 Address of Office, Mill or Shop: 10240 SAN SEVAINE WAY, JURUPA VALLEY, CA 91752 Specific Description of Sub -Contract: and Bid Items of Work SLURRY SEAL Name Under Which Subcontractor is Licensed: ` License Number. ip Address of Office, Mill or Shop: t7. u+ �titi Speck Deacription of Sub -Contract: and Bid Items of Work: r' 7 -4 -m -?b C -1'0 o o -P 19 a 3- a Name Under Which Subcontractor is Licensed: _7 License Number: Address of Office, Mill or Shop:_ 1 Q Specific Description of Sub -Contract: and Bid Items of Work: C-onr_rp "L+p.4 , 1 Subcontractors listed in accordance with the provisions of Section 2-3 must be properly licensed under the laws of the State of California for the type of work that they are to perform. Do not list itemate subcontractors for the same work. C-7 GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4630 FEDERAL -AID PROJECT NO. STPL 5074 (017) The bidder is required to fill in the following blanks In accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Chapter 2 of Division 5, Title 9 of the Government Code of the State of Califomia) and should familiarize itself with Sections 2-3 of the Standard Specifications, Name Under Which Subcontractor is Licensed: License Number. Address of Office, Mill of Shop: SpwMc Description of Sub -Contract: and Bid Items of Work: Name Under Which Subcontractor is Licensed: License Number. Address of Office, Mill or Shop: Specific Description of Sub -Contract: and Bid Items of Work Name Under Which Subcontractor is Licensed: License Number Address of Office, Mill or Shop: Speck Description of Sub -Contract: and Bid Items of Work: Name Under Which Subcontractor is Licensed: License Number: Address of Office, Mill or Shop: Specific Description of Sub -Contract: and Bid Items of Work: Subcontractors listed in accordance with the provisions of Section 2-3 must be properly licensed under the laws of the State of Califontia for the type of work that they are to perform. Do not list afternate subcontractors for the some work. C-7 REFERENCES GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4530 FEDERAL -AID PROJECT NO. STPL 6074 1017) List below three public agencies for which bidder has performed similar work within the past three years. 1. Project Title ANNUAL PAVEMENT MAINTENANCE Contract Amount $2.8 MILLION Type of Work CLASS A, ASPHALT PAVING Client CITY OF ORANGE Agency Project Manager ALAN TRUONG Dated Completed 02/2014 % Sub Contracted 45% Pone 714-744-5573 2. Project Title STREET REHABILITATION OF CITY PROJECT NO. 13-01 Contract Amount $3.6 MILLION Type of Work CLASS A, ASPHALT PAVING Client CITY OF COSTA MESA Agency Project Manager IRINA GUROVICH Dated Completed 09/2015 % Sub Contracted 41% Phone 714-754-5324 3. Project Title MINOR STREET MAINTENANCE PH I Contract Amount $2.6 MILLION Type of Wort( CLASS A, ASPHALT PAVING Client CITY OF RIVERSIDE Agency Project Manager STEVE HOWARD Dated Completed 10/2015 Phone 951-826-5567 % Sub Contracted 40% C-8 G NTRACTOR I-NEORMATION GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4530 FEDERAL -AID PROJECT NO. STPL 6074 (017) Contractors License No.: 782908 Class: AIC -12 a. Date first obtained: AUGUST 2000 b. Has License ever been suspended or revoked? NO If yes, describe when and why: C. Any current claims against License or Bond? NO If yes, describe claims: NSA E)iration AUGUST 31, 2018 PrinciDala in Company (List all — attach additional sheets if necessary): AM Tim LIC N NO. (If Applicable) MICHAEL J. CARVER PRESIDENT 782908 CLASS A & C-12 CRAIG PORTER VICE PRESIDENT STEVE MENDOZA SECRETARY JAMES N. DUCOTE TREASURER C-9 (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH AREA PART OF THIS PROPOSAL) EWPLOYMENT OPPORTUNITYURTIFICATION GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 45M FEDERAL -AID PROJECT NO. STPL 5074 (017) The bidder R.J. NOBLE COMPANY subcontractor proposed hereby certifies that he has_, has not—, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, wt►ere required, he has tiled with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Nota: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause aro set faith in 41 CFR fi0.1,5. (Generally only contracts or subcontracts of $10, 000 or under are exempt.) Currently, Standard Form 100 (EEO -1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. STEVE MENDOZA -"tw SECRETARY Print Name Title R.J. NOBLE COMPANY Contractor Name C-10 PUBLIC D GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4630 FEDERAL -AID PROJECT NO. STPL 5074 (017) Public Contract Code Section 10285.1 Statement In accordance with Public Contract Code Section 10285.1 (Chapter 376, State. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has , has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon. award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term `bidder" is understood to include any partner, member; officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has' or "has not' in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Quesdonnairt In accordance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation: Yes_ No x If the answer is yes, explain the circumstances in the following space. Public Contract Cycle 10232 Statement In accordance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been Issued against the Contractor within the immediate preceding two-year period because of the C-11 Contrectoes failure to comply with an order of federal court which orders the Contractor to comply with an order of the National Labor Rele ions Board. Note: The above Statement and Questionnaire are pat of the Proposal. Signing this Proposal on the signature portion thereof shall also constiMe signature of this Statement and Questionnaire. Bidders are cautioned that making a faire cerdc tion may subject the cert W to criminal prosecution. STEVE MENDOZA SECRETARY Print Name Title R.J. NOBLE COMPANY Contractor Name C-12 NON -COLLUSION (DAVIT GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 45M FEDERAL -AID PROJECT NO. STPL 5074 (017) STATE OF CALIFORNIA } } SS COUNTY OF ORANGE } (NAME) STEVE MENDOZA 1wWant being first duly sworn, deposes and says: That he arAft is SECRETARY (sob owner, partner or other proper title) .711 R.J. NOBLE COMPANY the party making the foregoing Bid, that the Bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corpora#ion; 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 associations, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham Bid. (Public Contract Code Section 71 06) Address: 15505 E. LINCOLN AVENUE, ORANGE, CA 92865 Telephone No.: 714-637-1550 Print Name: STEVE MENDOZA Signature: Title: SECRETARY Date: 11/09/16 Non -Collusion Affidavit must be accompanied by notary certificates for signature. Nota the description of the document on the notary certificate.certificate immadigi It If the Bidder falls to properly sign or omits the required signature, the bid will be considered non-responaly* and will be rejected, C-13 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 d. ��.a :.e. rn v.. v t re �i.e..n - A -n v, x s. r, -'^---•--- .h .. . A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of ORANGE On 11/09/2016 Date before me, J. DE IONGH, NOTARY PUBLIC personally appeared STEVE MENDOZA Here Insert Name and Title of the Officer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose names} is/are subscribed to the within instrument and acknowledged to me that he/she/they- executed the same in histher/their authorized capacity(ies}, and that by his/her/their signatures) -on the instrument the personfs); or the entity upon behalf of which the person(s) acted, executed the instrument. J. DE IONGH Commission # 2128504 a =m Notary Public - California D z Orange County M Comm. Expires Oct 28, 2019" Place Notary Seal Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and of ficial seal. , Signature ruQuc J. DE IONGH OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Docume 11 I C Title or Type of Document: Ua)NU2,im, Document Date: ` Number of Pages: � Signer(s) Other Than Named Above: Capacity(ies) Clai`ed by S" ner(s) Signer's Name: �)�r corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: - - .. _ El Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02014 National Notary Association - www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 UTILITY AGREEMENI GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4630 FEDERAL -AID PROJECT NO. STPL 5074 (017) HONORABLE MAYOR AND CITY COUNCIL CITY OF LAKE ELSINORE, CALIFORNIA The undersigned hereby promises and agrees that in the performance of the work specified in this contract for Project No. 453, Gunnerson Street Rehabilitation FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE, (I) (wqe) (it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary, primary or transmission facilities. The terra 'Qualified person" is defined in Title 8, California Administrative code, Section 2700, as follows. -Qualified Person. A person who by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved." The undersigned also promises and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. L011V14 41 By; STEVE MENDOZA Name SECRETARY Title R.J. NOBLE COMPANY Contractor Name C-14 DMIUALIFICATION OR DE8RMENT GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO, 4530 FEDERAL -AID PROJECT NO. STPL 5074 (017) Has your firm, any officer of your firm, or any employee who has a proprietary interest in your firm ever been disqualified, removed, or otherwise prevented from bidding on, performing work on, or completing a federal, state or local project because of a violation of law or a safety regulation? YES / 'NO (circle one) If yes, provide the following information (if more than once, use separate sheets): Date: Location: Reason: Entity: Provide Status and any Supplemental Statement: Has your firm been reinstated by this entity? YES / NO (circle one) N' A Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. STEVE MENDOZA, SECRETARY Print Name Title R.J. NOBLE COMPANY Contractor Name C-15 GUNNERSON STREET REHABILITATION FROM LAKESHORE DRIVE TO RIVERSIDE DRIVE CITY PROJECT NO. 4530 FEDERAL -AID PROJECT NO. STPL 5074 (017) Has your firm or its officers been assessed any penalties by an agency for noncompliance or violations of Federal, State or Local labor laws and/or business or licensing regulations within the past five (5) years relating to your construction projects? YES ! NO (circ% one) Federal / State / Local (dircle one) If "YES," identify and describe, (including agency and status): Have the penalties been paid? YES / NO (circle one) 2. Does your firm or its officers have any ongoing investigations by any public agency regarding violations of the State Labor Code, California Business and Professions Code or State Licensing Laws? YES Q!q) (cWe one) Section/Article: If 'yes," identify and describe, (including agency and status): STEVE MENDOZA SECRETARY Print Name Title R J. NOBLE COMPANY Contractor Name C-16 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 Farm -LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any parson 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 $1GO, 000 and that all such sub -recipients shall certify and disclose accordingiy C-17 DISCLOSURE OF LOBHYIN fi ACTNITIE,S L vinrl.c a c I nia rvl%M Iy VtAL.L JaZ LVOVI J14U RL.1 vii ira rt,f"vANi ivii 11.x.[ w; 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑ a contract ❑ a. bid/offer/application ❑ a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Ch ge Only: e. loan guarantee year quarter f, loan insurance date of I t report 4. Name and Address of Reporting Entity S. If Reporting Leahy In No. 4 Subawardea, Prime Subawardee Tier , if known Congressional Distrlct, if known 6. Federal Department/Ageocy: 8. Federal ActioaNumber. ifknown: Enter Name and Address f Prime: Cortgression 1 District, if known 7. Federal P 0gram Name/Deacriptios: C A Number, if applicable 9. and Amount, if known: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (if individual, last name, first name, Ml) address if different from No. IOa) (last name, first name, MI) /thapply): attach sinuation Sheets) if necessary) H. Amount of Paymll that a ly) 13. Type of Payment (check all that apply) S planned a retains b. one-time fee 12. Fore of Paymenth apply): c. commission L rah d. contingent fee b. in-kindture a deferred value f. other, specify14. Brief DescriptionPerformed or to be perforated and Datgs) ofService, includingofBeer(s), employnber(s) contacted, for Payment Indicated In Item 11: (attach Continuation Sheet(s) if necessary) 1S./isinflor.mation atlo Sheat(a) attached: Yes No 16. nested through This form is authorized by Title ion 1352. This disclosure of lobbying reliance Signature: x y the tier above when his transaction wo made or This disclosure is required punuam to 31 U.S.C. information will be reported to Congress Print Natme:TEand will be available for public inspection MySECRETARY fails to file the required disclosure AM be subject Title: to a civil penalty of not leu than $10,00D and not more than S 100,000 for each such failure. Telephone No.: 714-637-1550 Date: 11-09-16 1 Federal Use Only: C-16 Authorized for Local Reproduction Standard Form - LLL SWdud Fam LLL Rev 09-12-97 INSTRUCTIONS FOR COMPLETION .LI_ t318CLQSURE OF LOBBYIN� ACTIWnEa 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 We 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 Dice 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 narne, 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 suhaward 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, I 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. i. Enter the federal program name or descriptlon 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. 8. Enter the most appropriate federal identifying number available for ft 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 S. 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(e) performing services and include full address if different from 10 (a). Enter fast 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 - C -19 kind contribution, sped y 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 Moe of Management and Budget. Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF -LLL -Instructions C-20 Rev. 06-0490 r. m W wI t a O U 0 e s 8 F wgl rs p, I tm t— 4 Q q 44 E o a 10 ` I �f t a o > O � 1 I � 'L JJ O Q a a ;� O O 0 0� Q a :� a � O O s7 O p O a O RO G a O a O a O ovitn o�n�n a H6969 V fie fie 69HHiA V V A V V V V if) 6969 ov,v, HH HHH o�n�n d9H V V V V A V V V V A o + � ❑ ; .�� ,.9 S� a 44 4 g 0. z0� •� 3 cl- g e, _ 6 r. m w ° w 0 ;.j !4 .�.'t7I o• lO o. Q i 0 Y a a � 0 O e. E I Z t Q Q a a q q a q a 0Q o�tnV V V'V A V VV V ❑ A V ❑ I❑❑ V V )JAV V V ❑ VAI❑I❑ ❑8 a o a 0 4 E 0 o 4 K e 4 \ 96 �\N �r J d v F 00 t a H 9 0 ao s I W f� a G 3 44 u � f gAw �y u ag a o 0 46 ZZ>. •C � L J 1 t I GA V K44 V O iA V h h K 49 49 V O iA h 49 h O h h i9 i9 69 i9 G9 W% 69 -[A Q .60) h K v1 H A V V V V V V V V A V V V V IA g LZ 0. �� a ' 4 �a S S t N n L T T PC a I? W- N � � A Z o° Zz W C a C 0 s o N i3 L4 ` U W .� a ❑ Ono E � O s C O f jIi a o i l�y� I o g'� � aaa� aaa aaa aaa 49 69 fA G9.'�E iA fA H9 G9 G9 G9 i9 G9 i9 i9 i9 i9 H K K .p V V V V A V V V V n V V V V n V V V V A ❑1L ] � ❑L7ICJ L7 ❑QQ❑ b� N G ~ u o O o c � 0 3 � aG � d bw qw b V w iw u y y d PC c r t 00 s r � � 3 �u. t!os p of u w a wa r f E z � a 3 � o j y Ld b w � � o o,0 0 0 0 0 0 c a ______� G/J V O vl h O kn v1 y 7 O Yl vl � ^ O �n tr1 `r ►, P Gig 69 G9 GA fA fA G9 i9 i9 GA G9 f9 GA GA i9 G9 !9 ir9 (A G9 .� vvvvnvvvvn vvvvn vvvvn ❑❑❑❑� ❑❑❑�❑i❑❑i❑❑❑❑ ❑❑�❑i❑ 0 "a w - p of u a wa r 3 � b q � O 14 �1 The work site was inspected by BRADEN PORTER, ESTIMATOR of our office on 11/01/2016 20 Accompanying this proposal is 10% BIDDER'S BOND (No'ncE WSERT POE WORDS'CASNr 1CASW5R H K- 'CERrIf1EA CHECK. • OR '81U*AS &OND, • A$ 7Wi CASEANY BEJ in amount equal to at least ten percent of the total of the bid. The names of all persons interested in the foregoing proposal as principals are as follows: H bidder or ocher lniernsted person is a corporation, state regal name of carparadian. also names of ft proakfam,-"Mtary, trsasurar, and menager thereof,- if a COPArUNKShip, stater true name of Rina, also names of AN individual COPer0mrs composing firm; K bidder oe W -her lydormsted person is an M&A", state #W end last names In Ad/. R.J. NOBLE COMPANY A CALIFORNIA CORPORATION MICHAEL J. CARVER, PRESIDENT CRAIG PORTER, VICE PRESIDENT STEVE MENDOZA, SECRETARY JAMES N. DUCO A ER In case of discrepancy between words and figures, the words shall prevail. The undersigned further agrees, in case of award to him, or it, to the execution of the contract for the within described work and improvements within ten (10) days excluding weekends and holidays following award of contract, said work will be commenced within fifteen (15) calendar days after the Notice to Proceed of the contract and thereafter diligently prosecuted to completion within the period in Section C. Licensed in conformance with an act providing for the registration of Contractors, License No. 762906 Class ification(S) A & C-12 The undersigned are prepared to satisfy the Council of the City of Lake Elsinore of their ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. By my signature on this proposal I oerft under penalty of perjury under the taws of the State of Califomis, that the fpregoing questionnaire and stslerrwnh of Public Contrata Code Sedfons 10162. 113232 End 10285.1 ore true and cnmect and that tiro Mar hes complied wRh the requirements of Section 5103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of rho Caiearnls Adminietrativa Code). By my signature on this proposal I further cart . under penally of paryury under the laws of the Stobo of Caitlbmie and the United states. of America, that the Noncolusiort Affidavit rmqulmd by Title 23 United States Coda, Section 112 and Publlc Contract Code Sectan 7108; and the Title 49 Coda of Federal Regulations, Part 29 Debamw t and Suapenalon Cedif rtlon are true and corned. R J. NOBLE COMPANY Company Name x Signature pf Bidden STEVE MENDOZA, SECRETARY Printed or Typed Signature 15505 E. LINCOLN AVENUE, ORANGE, CA 92665 Address of Bidder 714-637-1550 Telephone Number Dated 11-09-16 .20 C-28 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 :r c rx ter: cccnc c� s rrs:os.ri:•cc�.r�rrrsr� c s fid�cr cr c c c c e� or rcr cct rre�c tct�tcrccs; ,C.N^C *1 cc:re1hrs A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of ORANGE On 11/09/2016 before me, . J. DE IONGH, NOTARY PUBLIC _ _ _ Date Here Insert Name and Title of the Officer personally appeared STEVE MENDOZA Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose name* is/are- subscribed s/ar$subscribed to the within instrument and acknowledged to me that he/she/they- executed the same in his/her/their authorized capacity(tes}, and that by hisAwltheif signature(s)•on the instrument the person(s); or the entity upon behalf of which the person(s) acted, executed the instrument. J. DE IONGH Commission # 2128504 Notary Public - California z Orange County My Comm. Expires Oct 28, 2019' I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and Signature J. DE IONGH Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: %4'e�{)(-%{:`L:{..Y,%i,'l�C:til,`c%[:'4e�i`!.C.Y1C.ti,,:�,v-Lirt.S•i4Y <7a;LY`�;4'(."{,T.' �. • y. Y• y • , 02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907