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HomeMy WebLinkAboutItem No. 07 PWCA HSIP Cycle 8 Traffic Signal ImprovementsCity Council Agenda Report City of Lake Elsinore 130 South Main Street Lake Elsinore, CA 92530 www.lake-elsinore.org File Number: ID# 21-275 Agenda Date: 8/10/2021 Status: Approval FinalVersion: 1 File Type: Council Consent Calendar In Control: City Council / Successor Agency Agenda Number: 7) Construction Contract Award for the HSIP Cycle 8 Traffic Signal Improvements Project - CIP No. Z10054 Federal Project No. 5074(019) 1.Award the Public Works Construction Agreement for the HSIP Cycle 8 Traffic Signal Improvements Project CIP No. Z10054 to Elecnor Belco Electric, Inc.; 2.Authorize the City Manager to execute the Agreement in the amount of $589,101 to Elecnor Belco Electric, Inc.; 3.Authorize the City Manager to execute change orders not to exceed 10% contingency amount of $58,910.10; and 4.Authorize City Engineer to record the Notice of Completion once it is determined the work is complete and the improvements are accepted into the City maintained roadway network. Page 1 City of Lake Elsinore Printed on 8/5/2021 REPORT TO CITY COUNCIL To: Honorable Mayor and Members of the City Council From: Jason Simpson, City Manager Prepared By: Remon Habib, City Engineer Date: August 10, 2021 Subject: Award Public Works Construction Contract for the HSIP Cycle 8 Traffic Signal Improvements Recommendation 1. Award the Public Works Construction Agreement for the HSIP Cycle 8 Traffic Signal Improvements Project to Elecnor Belco Electric, Inc. for $589,101 plus 10% contingency for a not to exceed the amount of $648,011.10; and, 2. Authorize City Engineer to record the Notice of Completion once it is determined the work is complete and the improvements are accepted into the City maintained roadway network. Background The City applied for and received grant funding to design and construct improvements at eight (8) traffic signals throughout the City using funds from the federal Highway Safety Improvement Program Cycle 8. The federal funds for this program are administered by Caltrans. The design plans for the eight traffic signal improvement locations were completed by STC Traffic, Inc. and subsequently reviewed and approved by staff. The eight locations are as follows: 1. Railroad Canyon Road / Church Road 2. Lake Street / Alberhill Ranch Road 3. Lake Street / Lakeshore Drive 4. Lincoln Street / Machado Street 5. Railroad Canyon Road / Grape Street 6. Railroad Canyon Road / Canyon Hills Drive 7. Diamond Drive / Auto Center-Casino 8. Diamond Drive / Mission Trail Construction Agreement HSIP Cycle 8 August 10, 2021 Page 2 Discussion Contractor Bids were secured via the city’s electronic bidding portal on July 14, 2021, at 2:00 PM, results were made publicly visible. The City received twelve (12) bids from qualified contractors. Staff recommends awarding the project to the apparent low bidder Elecnor Belco Electric, Inc. All bidders submitted acceptable bids and were technically qualified to do the work. Staff recommends awarding the project to the apparent low bidder Elecnor Belco Electric, Inc., with a bid of $589,101.00. The bid results are summarized below: Contractor (Bidder) Total Bid Amount 1. Elecnor Belco Electric, Inc. $589,101.00 2. Crosstown Electrical & Data, Inc. $620,525.00 3. Siemens Mobility, Inc. $625,930.00 4. International Line Builders, Inc. $667,248.00 5. Sierra Pacific Electrical $669,848.00 6. Select Electric, Inc. $675,950.00 7. Alfaro Communications Construction, Inc. $680,552.00 8. California Professional Engineering, Inc. $682,688.00 9. Asplundh Construction, Inc $729,849.00 10. DBX, Inc. $749,965.00 11. Calpromax Engineering, Inc. $834,730.00 12. PTM General Engineering Services, Inc. $849,046.00 Fiscal Impact Public Works Construction Agreement will result in a cost of $589,101 plus an additional 10% contingency of $58,910.10. Funding for this project is allocated within the adopted CIP Budget. Exhibits A – Agreement 1 Agreement No. __________ AGREEMENT FOR PUBLIC WORKS CONSTRUCTION Elecnor Belco Electric, Inc. For the HSIP Cycle 8 Traffic Signal Improvements Project CIP PROJECT NO. Z10054 Federal Project No. 5074(019) This Agreement for Public Works Construction (“Agreement”) is made and entered into as of 08/10/2021 by and between the City of Lake Elsinore, a municipal corporation (“City”) and Elecnor Belco Electric, Inc. (“Contractor”). The City and Contractor, in consideration of the mutual promises and covenants set forth herein, agree as follows: 1. The Project and Project Documents. Contractor agrees to construct the following public improvements (“work”) identified as: HSIP Cycle 8 Trafic Signal Improvements (the “Project”) The City-approved plans for the construction of the Project, which are incorporated herein by reference and prepared by STC Traffic, Inc., are identified as: HSIP Cycle 8 Traffic Signal Improvements The Project Documents include this Agreement and all of the following: (1) the Notice Inviting Bids, Instructions to Bidders, Bid Documents including Bidder’s Proposal as submitted by the Contractor, Contract Documents, General Specifications, Special Provisions, and all attachments and appendices; (2) everything referenced in such documents, such as specifications, details, standard plans or drawings and appendices, including all applicable State and Federal requirements; (3) all required bonds, insurance certificates, permits, notices, and affidavits; and (4) any and all addenda or supplemental agreements clarifying, amending or extending the work contemplated as may be required to insure completion in an acceptable manner. All of the provisions of the above-listed documents are made a part of this Agreement as though fully set forth herein. 2. Compensation. a. For and in consideration of the payments and agreements to be made and performed by City, Contractor agrees to construct the Project, including furnishing all materials and performing all work required for the Project, and to fulfill all other obligations as set forth in the Bidder’s Proposal, such contract price being Five Hundred Eighty Nine Thousand One Hundred and One Dollars ($589,101.00). 2 b. 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 set forth, and hereby contracts to pay the same at the time, in the manner, and upon the conditions set forth in the Project Documents. c. Contractor agrees to receive and accept the prices set forth in the Bidder’s Proposal as full compensation for furnishing all materials, performing all work, and fulfilling all obligations hereunder. Such compensation shall cover all expenses, losses, damages, and consequences arising out of the nature of 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 Project 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. 3. Completion of W ork. a. Contractor shall perform and complete all work within Ninety (90) working days from the date of commencement specified in the Notice to Proceed, and shall provide, furnish and pay for all the labor, materials, necessary tools, expendable equipment, and all taxes, utility and transportation services required for construction of the Project. b. All work shall be performed and completed in a good workmanlike manner in strict accordance with the drawings, specifications and all provisions of this Agreement as hereinabove defined and in accordance with applicable laws, codes, regulations, ordinances and any other legal requirements governing the Project. c. Contractor shall not be excused with respect to the failure to so comply by any act or omission of the City, the City Engineer, a City inspector, or a representative of any of them, unless such act or omission actually prevents the Contractor from fully complying with the requirements of the Project Documents, and unless the Contractor protests at the time of such alleged prevention that the act or omission is preventing the Contractor from fully complying with the Project Documents. Such protest shall not be effective unless reduced to writing and filed with the City within three (3) working days of the date of occurrence of the act or omission preventing the Contractor from fully complying with the Project Documents. d. City and Contractor recognize that time is of the essence in the performance of this Agreement and further agree that if the work called for under the Agreement is not completed within the time hereinabove specified, damages will be sustained by the City and that, it is and will be impracticable or extremely difficult to ascertain and determine the actual amount of damages the City will sustain in the event of, and by reason of, such delay. It is, therefore, agreed that such damages shall be presumed to be in the amount of $500 per calendar day, and that the Contractor will pay to the City, or City may retain from amounts otherwise payable to Contractor, such amount for each calendar day by which the Contractor fails to complete the work, including corrective items of work, under this Agreement within the time hereinabove specified and as adjusted by any changes to the work. 3 4. Changes to Work. City and Contractor agree that the City may make changes to the work, or suspend the work, and no matter how many changes, such changes or suspensions are within the contemplation of the Contractor and City and will not be a basis for a compensable delay claim against the City nor be the basis for a liquidated damage claim against the Contractor. Any change to the work shall be by way of a written instrument (“change order”) signed by the City and the Contractor, stating their agreement to the following: a. The scope of the change in the work; b. The amount of the adjustment to the contract price; and c. The extent of the adjustment to the Schedule of Performance. The City Engineer is authorized to sign any change order provided that sufficient contingency funds are available in the City’s approved budget for the Project. All change in the work authorized by the change order shall be performed under the applicable conditions of the Project Documents. City and Contractor shall negotiate in good faith and as expeditiously as possible the appropriate adjustments for such changes. 5. Bonds. Contractor shall provide, before commencing work, a Faithful Performance Bond and a Labor and Material Bond, each for one-hundred percent (100%) of the contract price in the form that complies with the Project Documents and is satisfactory to the City Attorney. 6. Non-Assignability. Neither this Agreement nor any rights, title, interest, duties or obligations under this Agreement may be assigned, transferred, conveyed or otherwise disposed of by Contractor without the prior written consent of City. 7. Licenses. Contractor represents and warrants to City that it holds the contractor’s license or licenses set forth in the Project Documents, is registered with the Department of Industrial Relations pursuant to Labor Code Section 1725.5, and holds such other licenses, permits, qualifications, insurance and approvals of whatsoever nature which are legally required of Contractor. Contractor represents and warrants to City that Contractor shall, at its sole cost and expense, keep in effect or obtain at all times during the term of this Agreement, any licenses, permits, insurance and approvals which are legally required of Contractor to practice its profession. Contractor shall maintain a City of Lake Elsinore business license. 8. Indemnity. Contractor shall indemnify, defend, and hold harmless the City and its officials, officers, employees, agents, the County and Board Supervisors, and volunteers from and against any and all losses, liability, claims, suits, actions, damages, and causes of action arising out of any personal injury, bodily injury, loss of life, or damage to property, or any violation of any federal, state, or municipal law or ordinance, to the extent caused, in whole or in part, by the willful misconduct or negligent acts or omissions of Contractor or its employees, subcontractors, or agents, by acts for which they could be held strictly liable, or by the quality or character of their work. The foregoing obligation of Contractor shall not apply when (1) the injury, loss of life, damage to property, or violation of law arises from the sole negligence or willful misconduct of the City or its officers, employees, agents, or volunteers and (2) the actions of Contractor or its employees, subcontractor, or agents have contributed in no part to the injury, loss of life, damage to 4 property, or violation of law. It is understood that the duty of Contractor to indemnify and hold harmless includes the duty to defend as set forth in Section 2778 of the California Civil Code. Acceptance by City of insurance certificates and endorsements required under this Agreement does not relieve Contractor from liability under this indemnification and hold harmless clause. This indemnification and hold harmless clause shall apply to any damages or claims for damages whether or not such insurance policies shall have been determined to apply. By execution of this Agreement, Contractor acknowledges and agrees to the provisions of this Section and that it is a material element of consideration. 9. Insurance Requirements. a. Insurance. Contractor, at Contractor’s own cost and expense, shall procure and maintain, for the duration of the Agreement, unless modified by the City’s Risk Manager, the following insurance policies. i. Workers’ Compensation Coverage. Contractor shall maintain Workers’ Compensation Insurance and Employer’s Liability Insurance for his/her employees in accordance with the laws of the State of California. In addition, Contractor shall require each subcontractor to similarly maintain Workers’ Compensation Insurance and Employer’s Liability Insurance in accordance with the laws of the State of California for all of the subcontractor’s employees. Any notice of cancellation or non-renewal of all Workers’ Compensation policies must be received by the City at least thirty (30) days prior to such change. The insurer shall agree to waive all rights of subrogation against City, its officers, agents, employees and volunteers for losses arising from work performed by Contractor for City. In the event that Contractor is exempt from Worker’s Compensation Insurance and Employer’s Liability Insurance for his/her employees in accordance with the laws of the State of California, Contractor shall submit to the City a Certificate of Exemption from Workers Compensation Insurance in a form approved by the City Attorney. ii. Commercial General Liability Coverage. Contractor shall maintain commercial general liability insurance in an amount not less than one million dollars ($1,000,000) per occurrence for bodily injury, personal injury and property damage. If a commercial general liability insurance form or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to the work to be performed under this Agreement or the general aggregate limit shall be at least twice the required occurrence limit. Required commercial general liability coverage shall be at least as broad as Insurance Services Office Commercial General Liability occurrence form CG 0001 (ed. 11/88) or Insurance Services Office form number GL 0002 (ed. 1/73) covering comprehensive General Liability and Insurance Services Office form number GL 0404 covering Broad Form Comprehensive General Liability. No endorsement may be attached limiting the coverage. iii. Automobile Liability Coverage. Contractor shall maintain automobile liability insurance covering bodily injury and property damage for all activities of the Contractor arising out of or in connection with the work to be performed under this Agreement, including coverage for owned, hired and non-owned vehicles, in an amount of not less than one million dollars ($1,000,000) combined single limit for each occurrence. Automobile liability coverage must be at least as broad as Insurance Services Office Automobile Liability form CA 0001 (ed. 12/90) Code 1 (“any auto”). No endorsement may be attached limiting the coverage. 5 iv. Builder’s Risk Coverage. Prior to the commencement of any construction of the Project, Design-Builder shall obtain (or cause to be obtained) and keep in force during the term of any construction, builder’s risk insurance insuring for all risks of physical loss of or damage (excluding the perils of earthquake and flood). v. Professional Liability Coverage Contractor shall maintain professional errors and omissions liability insurance appropriate for Contractor’s profession for protection against claims alleging negligent acts, errors or omissions which may arise from Contractor’s services under this Agreement, whether such services are provided by the Contractor or by its employees, subcontractors, or sub consultants. The amount of this insurance shall not be less than one million dollars ($1,000,000) on a claims-made annual aggregate basis, or a combined single limit per occurrence basis. b. Endorsements. Each general commercial liability and automobile liability insurance policy shall be with insurers possessing a Best’s rating of no less than A:VII and shall be endorsed with the following specific language: i. The City, its elected or appointed officers, officials, employees, agents and volunteers are to be covered as additional insured with respect to liability arising out of work performed by or on behalf of the Contractor, including materials, parts or equipment furnished in connection with such work or operations. ii. This policy shall be considered primary insurance as respects the City, its elected or appointed officers, officials, employees, agents and volunteers. Any insurance maintained by the City, including any self-insured retention the City may have, shall be considered excess insurance only and shall not contribute with it. iii. This insurance shall act for each insured and additional insured as though a separate policy had been written for each, except with respect to the limits of liability of the insuring company. iv. The insurer waives all rights of subrogation against the City, its elected or appointed officers, officials, employees or agents. v. Any failure to comply with reporting provisions of the policies shall not affect coverage provided to the City, its elected or appointed officers, officials, employees, agents or volunteers. vi. The insurance provided by this Policy shall not be suspended, voided, canceled, or reduced in coverage or in limits except after thirty (30) days written notice has been received by the City. c. Deductibles and Self-Insured Retentions. Any deductibles or self-insured retentions must be declared to and approved by the City. At the City’s option, Contractor shall demonstrate financial capability for payment of such deductibles or self-insured retentions. d. Certificates of Insurance. Contractor shall provide certificates of insurance with original endorsements to City as evidence of the insurance coverage required herein. Certificates of such insurance shall be filed with the City on or before commencement of 6 performance of this Agreement. Current certification of insurance shall be kept on file with the City at all times during the term of this Agreement. 10. Notices. Any notice required to be given under this Agreement shall be in writing and either served personally or sent prepaid, first class mail. Any such notice shall be addressed to the other party at the address set forth below. Notice shall be deemed communicated within 48 hours from the time of mailing if mailed as provided in this section. If to City: City of Lake Elsinore Attn: City Manager 130 South Main Street Lake Elsinore, CA 92530 With a copy to: City of Lake Elsinore Attn: City Clerk 130 South Main Street Lake Elsinore, CA 92530 If to Contractor: Elecnor Belco Electric, Inc. Attn:John Wong 14320 Albers Way Chino, CA 91710 11. Entire Agreement. This Agreement constitutes the complete and exclusive statement of agreement between the City and Contractor. All prior written and oral communications, including correspondence, drafts, memoranda, and representations, are superseded in total by this Agreement. 12. Amendments. This Agreement may be modified or amended only by a written document executed by both Contractor and City and approved as to form by the City Attorney. 13. Assignment and Subcontracting. Contractor shall be fully responsible to City for all acts or omissions of any subcontractors. Assignments of any or all rights, duties for obligations of the Contractor under this Agreement will be permitted only with the express consent of the City. Nothing in this Agreement shall create any contractual relationship between City and any subcontractor nor shall it create any obligation on the part of the City to pay or to see to the payment of any monies due to any such subcontractor other than as otherwise is required by law. 14. Waiver. Waiver of a breach or default under this Agreement shall not constitute a continuing waiver of a subsequent breach of the same or any other provision under this Agreement. 15. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. 16. Controlling Law Venue. This Agreement and all matters relating to it shall be governed by the laws of the State of California and any action brought relating to this Agreement shall be held exclusively in a state court in the County of Riverside. 7 17. Litigation Expenses and Attorneys’ Fees. If either party to this Agreement commences any legal action against the other party arising out of this Agreement, the prevailing party shall be entitled to recover its reasonable litigation expenses, including court costs, expert witness fees, discovery expenses, and attorneys’ fees. 18. Mediation. The parties agree to make a good faith attempt to resolve any disputes arising out of this Agreement through mediation prior to commencing litigation. The parties shall mutually agree upon the mediator and share the costs of mediation equally. If the parties are unable to agree upon a mediator, the dispute shall be submitted to JAMS or its successor in interest. JAMS shall provide the parties with the names of five qualified mediators. Each party shall have the option to strike two of the five mediators selected by JAMS and thereafter the mediator remaining shall hear the dispute. If the dispute remains unresolved after mediation, either party may commence litigation. 19. Authority to Enter Agreement and Administration. Contractor has all requisite power and authority to conduct its business and to execute, deliver, and perform the Agreement. Each party warrants that the individuals who have signed this Agreement have the legal power, right, and authority to make this Agreement and to bind each respective party. The City Manager is authorized to enter into an amendment or otherwise take action on behalf of the City to make the following modifications to the Agreement: (a) a name change; (b) grant extensions of time; (c) non-monetary changes in the scope of services; and/or (d) suspend or terminate the Agreement. The City Engineer shall act as the Project administrator on behalf of the City. 20. Prohibited Interests. Contractor maintains and warrants that it has not employed nor retained any company or person, other than a bona fide employee working solely for Contractor, to solicit or secure this Agreement. Further, Contractor warrants that it has not paid nor has it agreed to pay any company or person, other than a bona fide employee working solely for Contractor, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Agreement. For breach or violation of this warranty, City shall have the right to rescind this Agreement without liability. For the term of this Agreement, no member, officer or employee of City, during the term of his or her service with City, shall have any direct interest in this Agreement, or obtain any present or anticipated material benefit arising therefrom. 21. Equal Opportunity Employment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex or age. Such non-discrimination shall include, but not be limited to, all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination. 22. Prevailing W ages. a. Contractor and all subcontractors shall adhere to the general prevailing rate of per diem wages as determined and as published by the State Director of the Department of Industrial Relations pursuant to Labor Code Sections 1770, 1773, and 1773.2. Copies of these rates and the latest revisions thereto are on file in the office of the City Clerk of the City of Lake Elsinore and are available for review upon request. 8 b. Contractor's attention is directed to the provisions of Labor Code Sections 1774, 1775, 1776, 1777.5 and 1777.6. Contractor shall comply with the provisions of these Sections. The statutory provisions for penalties for failure to comply with the State's wage and the hours laws will be enforced. c. Labor Code Sections 1774 and 1775 require the Contractor and all subcontractors to pay not less than the prevailing wage rates to all workmen employed in the execution of the contract and specify forfeitures and penalties for failure to do so. The minimum wages to be paid are those determined by the State Director of the Department of Industrial Relations. Labor Code Section 1776 requires the Contractor and all subcontractors to keep accurate payroll records, specifies the contents thereof, their inspection and duplication procedures and certain notices required of the Contractor pertaining to their location. The statutory penalties for failure to pay prevailing wages will be enforced. If the Project has been awarded to Contractor on or after April 1, 2015, Contractor and its subcontractors must furnish electronic certified payroll records to the Labor Commissioner. Beginning January 1, 2016, Contractor and its subcontractors must furnish electronic certified payroll records to the Labor Commissioner without regard to when the Project was awarded to Contractor. d. Labor Code Section 1777.5 requires Contractor or subcontractor employing tradesmen in any apprenticeable occupation to apply to the Joint Apprenticeship Committee nearest the site of the public works project, which administers the apprenticeship program in that trade for a certificate of approval. The certificate will also fix the ratio of apprentices to journeymen to be used in the performance of the Agreement. The Contractor is required to make contributions to funds established for the administration of apprenticeship programs if the Contractor employs registered apprentices or journeymen in any apprenticeable trade and if other contractors on the public works site are making such contributions. Information relative to apprenticeship standards, contributions, wage schedules and other requirements may be obtained from the State Director of Industrial Relations or from the Division of Apprenticeship Standards. Labor Code Section 1777.6 provides that it shall be unlawful to refuse to accept otherwise qualified employees as registered apprentices solely on the grounds of race, religious creed, color, national origin, ancestry, sex, or age. e. Eight hours labor constitutes a legal day's work, as set forth in Labor Code Section 1810. 23. Execution. This Agreement may be executed in several counterparts, each of which shall constitute one and the same instrument and shall become binding upon the parties when at least one copy hereof shall have been signed by both parties hereto. In approving this Agreement, it shall not be necessary to produce or account for more than one such counterpart. [Signatures on next page] 9 IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the date first written above. “CITY” CITY OF LAKE ELSINORE, a municipal corporation “CONTRACTOR” Elecnor Belco Electric, Inc. a Corporation City Manager ATTEST: By: John Wong Its: Vice President City Clerk APPROVED AS TO FORM: By: Click or tap here to enter text. Its: Click or tap here to enter text. City Attorney Director of Administrative Services EXHIBIT A CONTRACTOR’S PROPOSAL [ATTACHED] EXHIBIT B LIST OF SUBCONTRACTORS [ATTACHED] CITY OF LAKE ELSINORE CIP Project No. Z10054 APPENDIX B Exhibit 15-G: Construction Contract ❑BE Commitment Exhibit 15-H: Proposer/Contractor Good Faith Efforts CITY OF LAKE ELSINORE CIP Project No. Z10054 EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: City of Lake Elsinore 2. Contract DBE Goal: o 3. Project Description: HSIP Cvcle 8 Traffic Signal Improvements 4. Project Location: Various Locations 5. Bidder's Name: Elecnor Belco Electric, Inc. 6. Prime Certified DBE: ❑ 7. Bid Amount: $ 589 , 101 . 00 8. Total Dollar Amount for ALL Subcontractors: 9. Total Number of ALL Subcomtaclam-. 10. Bid Item Number 11. Description of Work, Service, or Materials Supplied 12. DBE Certification Number 13. DBE Contact Information (Must be certified on the date bids are opened) 14. DBE Dollar Amount Furnish Opticom GPS and Solar TEK Services LLC 10,12 Flashing Beacqn 405404749 E. Wesley Dr. $37,427.40 Anaheim, CA 92807 60e of $62,379.00 Local Agency to Complete this Section upon Execution of Award 21. Local Agency Contract Number: 37,427.40 15. TOTAL CLAIMED DBE PARTICIPATION 6.3 22. Federal -Aid Project Number: 23. Bid Opening Date: IMPORTANT: Identify all DBE firms being claimed for credit, regardless 24. Contract Award Date: 25. Award Amouril: of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed above must be consistent, where applicable with the Local Agency certifies that all DBE certifications are valid and information on this names and [mgmpf the W rk in the "Subcontractor List" submitted with form is complete and accurate- you 'd- W to confi ation of each listed DBE is required. 7/14/2021 26. Local Agency Representative's Signature 27. Date I Pre revs Si ature 17. Date 28. Local Agency Representative's Name 29. Phone np 909-993-5470 1 I Prep tees Nai 19. Phone Vice President 30. Local Agency Representative's Title 20. Preparer's Title DISTRIBUTION: 1.Original -Local Agency 2. Copy - Caltrans District Local Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days of contract execution may result in de -obligation of federal funds on contract. 3. Include additional copy with award package. ADA Notice: For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916) 654-3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814. July 15, 2021 To: Elecnor Belco Electric, Inc. 14320 Albers Way Chino, CA 91710 (909)993-5470 Re: HSIP Cycle 8 Traffic Signal Improvements - Lake Elsinore TEK Services LLC is pleased to provide you with the following materials and equipment for the referenced project: Bid Item Qty Description Unit Price Total 10 7 764 Phase Selector $ 3,009.00 $ 21,063.00 10 7 768 Aux Panel $ 556.00 $ 3,892.00 10 7 3100 GPS Antenna $ 2,897.00 $ 20,279.00 10 7 AB-1055 Clamp $ 77.00 $ 539.00 10 1 7 GPS Opticom Cable 500' $ 592.00 $ 4,144.00 10 7 Technical Support $ 816.00 $ 5,712.00 12 3 Carmanah R247-E Solar Engine $ 2,250.00 $ 6,750.00 Top of Pole Mount, 3.5" - 4.5" OD Round, No Side Holes, No Arms Standard Battery, 7 AHR, E Series Only LED Enhanced Sign Mount Kit Banding to Pole Not Included, Banding LED Harness., 4" (Std. for Integrated Signal Head and LED Enhanced Signs) LED Sign V2, W3-3, 36", YLW DG3, YLW LED-DG401 Note: Type 1B Poles and Anchor Bolts Not Included Total $ 62,379.00 Notes: • TEK Services, LLC is Metro certified WBE/UDBE/SBE. Certification No. 40540. • NAICS Work Codes C0686, C0600 • Quotation valid for 30 days subject to re -quote thereafter. • Delivery 18 - 22 Weeks after submittal approval. • Terms: Net 30 Days, Pending Credit Verification. • Sales tax is not included. Thank you for the opportunity. M 5/2021 UCP Web Application - List Skip to Main Content Back To (Zuerv,���( Search Returned 1 Records Query Criteria Certification Types: DBE Firm ID: 40540 Firm ID 40540 DBA Name TEK SERVICES, LLC Firm Name TEK SERVICES, LLC Address Line1 5680 VAN GOGH WAY Address LIne2 city YORBA LINDA State CA Zip Cadet 92887 Zip Code2 Mailing Address LIne1 5680 VAN GOGH WAY Mailing Address LIne2 Mailing City YORBA LINDA Mailing State CA Mailing Zip Code1 92887 Mailing Zip Code2 Certification Type DBE EMail kim.teksew@Gmail.com Contact Name KIM KING Area Code 714 Phone Number 336-0536 Extension Alt Area Code Alt Phone Number Extension Fax Area Code 714 Fax Phone Number 694-0116 Agency Name LOS ANGELES COUNTY METRO TRANSPORTATION AUTHORITY (MTA) Counties 19; 30; 33:37; Districts 07; 08; 11; 12; DBE NAICS 423610; 423B40; ACDBE NAICS Work Codes C0686 ELECTRICAL & SIGNALS SUPPLIER; C0600 MISC SUPPLIERS; Licenses Trucks Gender F Ethnicity CAUCASIAN Firm Type DBE Thu Jul 1514:12:29 PDT 2021 https://ucp.dot.ca.gov/querySubmit.htm 1 /1 CITY OF LAKE ELSINORE CIP Project No. Z10054 INSTRUCTIONS — CONSTRUCTION CONTRACT DBE COMMITMENT CONTRACTOR SECTION 1. Local Agency - Enter the name of the local agency that is administering the contract. 2. Contract DBE Goal - Enter the contract DBE goal percentage as it appears on the project advertisement. 3. Project Location - Enter the project location(s) as it appears on the project advertisement. 4. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab, Overlay, Widening, etc). 5. Bidder's Name - Enter the contractor's firm name. 6. Prime Certified DBE - Check box if prime contractor is a certified DBE. 7. Bid Amount - Enter the total contract bid dollar amount for the prime contractor. 8. Total Dollar Amount for ALL Subcontractors — Enter the total dollar amount for all subcontracted contractors. SUM = (DBEs + all Non -DBEs). Do not include the prime contractor information in this count. 9. Total number of ALL subcontractors — Enter the total number of all subcontracted contractors. SUM = (DBEs + all Non -DBEs). Do not include the prime contractor information in this count. 10. Bid Item Number - Enter bid item number for work, services, or materials supplied to be provided. 11. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials to be provided. Indicate all work to be performed by DBEs including work performed by the prime contractor's own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 12. DBE Certification Number - Enter the DBE's Certification Identification Number. All DBEs must be certified on the date bids are opened. 13. DBE Contact Information - Enter the name, address, and phone number of all DBE subcontracted contractors. Also, enter the prime contractor's name and phone number, if the prime is a DBE. 14. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service to be provided. Include the prime contractor if the prime is a DBE. See LAPM Chapter 9 for how to count full/partial participation. 15. Total Claimed DBE Participation - $: Enter the total dollar amounts entered in the "DBE Dollar Amount" column. %: Enter the total DBE participation claimed ("Total Claimed DBE Participation Dollars" divided by item "Bid Amount"). If the total % claimed is less than item "Contract DBE Goal," an adequately documented Good Faith Effort (GFE) is required (see Exhibit 15-H DBE Information - Good Faith Efforts of the LAPM). 16. Preparer's Signature - The person completing the DBE commitment form on behalf of the contractor's firm must sign their name. 17. Date - Enter the date the DBE commitment form is signed by the contractor's preparer. 18. Preparer's Name - Enter the name of the person preparing and signing the contractor's DBE commitment form. 19. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 20. Preparer's Title - Enter the position/title of the person signing the contractor's DBE commitment form. CITY OF LAKE ELSINORE CIP Project No. Z10054 LOCAL AGENCY SECTION 21. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 22. Federal -Aid Project Number - Enter the Federal -Aid Project Number(s). 23. Bid Opening Date - Enter the date contract bids were opened. 24. Contract Award Date - Enter the date the contract was executed. 25. Award Amount — Enter the contract award amount as stated in the executed contract. 26. Local Agency Representative's Signature - The person completing this section of the form for the Local Agency must sign their name to certify that the information in this and the Contractor Section of this form is complete and accurate. 27. Date - Enter the date the DBE commitment form is signed by the Local Agency Representative. 28. Local Agency Representative's Name - Enter the name of the Local Agency Representative certifying the contractor's DBE commitment form. 29. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 30. Local Agency Representative Title - Enter the position/title of the Local Agency Representative certifying the contractor's DBE commitment form. EXHIBIT 15-11: PROPOSER/CONTRACTOR GOOD FAITH EFFORTS Cost Proposal Due Date Federal -aid Project No(s). 5074(019) Bid Opening Date July 14, 2021 CON PE/CE The City of Lake Elsinore established a Disadvantaged Business Enterprise (DBE) goal of -3— ( % for this contract. The information provided herein shows the required good faith efforts to meet or exceed the DBE contract goal. Proposers or bidders submit the following information to document their good faith efforts within five (5) business days from cost proposal due date or bid opening. Proposers and bidders are recommended to submit the following information even if the Exhibit 10-01: Consultant Proposal DBE Commitments or Exhibit 15-G: Construction Contract DBE Commitment indicate that the proposer or bidder has met the DBE goal. This form protects the proposer's or bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions, please attach additional sheets as needed: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement DBE Goal Met B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Solicitation Follow Up Methods and Dates TEK Services LLC 672272021 7 7 2021, 7 14 2021 Email, Phone C. The items of work made available to DBE firms including those unbundled contract work items into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation in order to meet or exceed the DBE contract goal. Items of Proposer or Bidder Work Normally Performs Item (Y/N) Furnish Opticom GPS and Solar Flashing Beacon Y Breakdown of Amount Percentage Items M Of Contract 10, 12 $62,379.00 0.00% 10.5% 0.00% 0.00% 0.00% D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: DBE Goal Met Names, addresses and phone numbers of firms selected for the work above: TEK Services LLC 4749 E. Wesley Dr. Anaheim, CA 92807 (714) 336-0536 E. Efforts (e.g. in advertisements and solicitations) made to assist interested DBEs in obtaining information related to the plans, specifications and requirements for the work which was provided to DBEs: DBE Goal Met F. Efforts (e.g. in advertisements and solicitations) made to assist interested DBEs in obtaining bonding, lines of credit or insurance, necessary equipment, supplies, materials, or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: DBE Goal Met G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results DBE Goal Met H. 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O N o v o d =3 ny n .-. 'rt =r O CD m Co G1 a ti O_ m 3 N (n N c Q 0 0 7 N O 0 m a CD o v o a C m 0 a m Z� c c 3 0 Q fD fD O cr K m a 0 N m m m n O m x 3 N r O 0 m D N VJ N d a CD M O n m n c f�D Ul 3 m 7 c m m63 CITY OF LAKE ELSINORE CIP Project No. Z10054 SECTION C BID DOCUMENTS CITY OF LAKE ELSINORE CIP Project No. Z10054 BIDDER'S PROPOSAL HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) Company: Elecnor Belco Electric, Inc. Honorable Mayor, Members of the Council: In accordance with the Notice Inviting Bids pertaining to the receiving of sealed proposals by the City Clerk of the City of Lake Elsinore for the above titled improvement, the undersigned hereby proposes to furnish all Work to be performed in accordance with the Specifications, Standard Drawings, and the Contract Documents, for the unit price or lump sum set forth in the following schedule: Time of Completion: Ninety (90) Working Days from Issuance of Notice to Proceed (NTP) by City to Contractor. BID SCHEDULE ITEM ESTIMATED UNIT NO. DESCRIPTION OF ITEMS UNIT 1 QUANTITY I RICE I AMOUNT GENERAL OVERHEAD & MOBILIZATION/DEMOBILIZATION 1 Mobilization. LS 1 (�/ (W 0 6 00a 2 Traffic Control. LS 1 3 Signing and Striping Improvements. LS 1 G q3q l� 3q 4 Rewire Intersection EA 3 gJ 000 5q t rer() Furnish and Install Iteris Mast Arm Mounted 5 Vantage Next Video Detection System (3 Leg).. EA 2 '31 6"00 6; 000 Furnish and Install Iteris Mast Arm Mounted 6 Vantage Next Video Detection System (4 EA 6 7 Furnish and Install CAT5 Cable. LF 5740 i 5 -2q0 8 Remove and Salvage Existing Video EA 5 �� �/ 4200 _Detection Camera System. Remove and Salvage Existing Traffic Signal 9 Controller. Furnish and Install 2070LX Traffic EA 2 61 000 ��% (�U _Signal Controller with Omni EX Software. Furnish and Install Opticom GPS Antenna, J idd 10 Control Unit, and 764 Multimode Phase EA 7 �% DOO �7 / U/ V U© Selector. Remove and Salvage Existing PPB 11 Assemblies. Furnish and Install APS EA 6 10 VOV 6v;j j900 Assemblies and Control Unit. 12 Furnish and Install Solar Flashing Beacon EA 3 171 Q�Q Complete. EA 4 13 Furnish and Install New Mast Arm Sign. 50 1 G 000 C- CITY OF LAKE ELSINORE CIP Project No. Z10054 14 Remove Existing TS Pole and Break Down EA 1 3,, ow 3� (�pC7 Foundation 18" Below Grade. Furnish and Install Type 24-4-100 TS Pole 15 (30' Ht). 35' Signal Mast Arm, 15' Luminaire EA 1 3 �� �p� 3 610 ov Mast Arm, and Equipment Per Plan. Install Foundation Complete Per Caltans Standards. 16 Remove and Salvage Existing Safety Light Fixtures. Furnish and Install LED Safety Light _ EA 3 050 Zj550 Fixtures. Relocate Existing EVP Detector. Remove and Salvage Existing Mast Arm 17 EA EA 1 ) 00 200 18 4 � � _Sign. Remove and Salvage Existing Vehicle Head. 19 EA 4 100 q do 20 Relocate Existing Vehicle Heads EA 3 L100 I zoo 21 Furnish and Install Vehicle Head. EA 11 , „2� *;LO (l(� 3. 33 ; L- 22 Clean -out Existing Pull Box. EA 1 f Total Bid Price (Based on estimated quantities of Items 1 through 22)' TOTAL BID PRICE: TOTAL BID PRICE BASED ON BID SCHEDULE TOTAL OF UNIT PRICES FOR HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS $ S09 f0l Total Bid Price in Numbers $ rive n dV-cd e' i,yl _�y 111, h 4oL,(Sz;cs4J vh� h�r.►dre� Total Bid Price in Written Form In case of discrepancy between the written price and the numerical price, the written price shall prevail. 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. All work described on the plans and in the specifications and other incidentals necessary to complete the project shall be paid under items above. No additional payments will be allowed. *BID MAY BE REJECTED IF TOTAL IS NOT SHOWN FOR BOTH FIGURES AND WORDS. C-8 CITY OF LAKE ELSINORE CIP Project No. Z10054 BIDDER'S SIGNATURE HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) 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. Elecnor Belco Electric, Inc. Contractor Date: July 7.2021 By: Contractor's State License No.: Class: A. B_ C-10 �- Department of Industrial Relations Registration No: 1000004804 Registration Date: _ 7/O1/2019 Expiration Date: 6/30/2022 Address: 143?0 A[hers Way Phone: 909-993-5470 C-9 .holm 11'oFw, CITY OF LAKE ELSINORE CIP Project No. Z10054 ACKNOWLEDGMENT OF ADDENDA RECEIVED HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) The Bidder shall acknowledge the receipt of addenda by placing an "X" by each addendum received. Addendum No. 1 X Addendum No. 2 01501=0R"I, 41150 ] 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. W, John Wont-, B dd r' nature C-10 July 7, 2021 Date CITY OF ., LAI-E ILSIftOKE DREAM EXTREME ADDENDUM NUMBER 1 PROJECT TITLE: HSIP Cycle 8 Traffic Signal Improvements — Z10054 DATE: June 18, 2021 The following is an ADDENDUM to the contract documents for the above referenced project. 1. The DBE Goal requirement for the project is 6%. Prospective bidders are required to acknowledge receipt of this addendum to the contract on the bid proposal form. Sincerely, 04ofL'- Remon Habib City Engineer \J"Rl , John Wong 1ec. 03- Belco Electric, Inc. CITY OF LAKE ELSINORE CIP Project No. Z10054 NON -COLLUSION AFFIDAVIT HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) STATE OF CALIFORNIA } ) SS COUNTY OF San Bernardino ) (NAME) John Wong, affiant being first duly sworn, deposes and says: That he or she is Vice President _ of 4 (sole owner, partner or other proper title) Elecnor Belco Electri ,. Inc. the party making the foregoing Bid, that the Bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; 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 7106) Address: 14320 Albers Way, Chino, CA 91710 Telephone No.: 909-993-5470 Print Signature: Title: Date: July 7, 2021 SIGNING INSTRUCTIONS TO THE CONTRACTOR Non -Collusion Affidavit must be accompanied by notary certificates for signature. Note the description of the document on the notary certificate. Attach notary certificate immediately following this page. If the Bidder fails to properly sign or omits the required signature, the bid will be considered non -responsive and will be rejected. C-11 CALIFORNIA ALL- PURPOSE CERTIFICATE OF 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 San Bernardino On July 7, 2021 before me, Elisa Beth Lim, Notary Public (Here insert name and title of the officer) personally appeared John Wong who proved to me on the basis of satisfactory evidence to be the person( whose name( -,)(Dare subscribed to the within instrument and acknowledged to me that e he/they executed the same in Is er/their authorized capacity(ie-s), and that by 1s er/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person( acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. � ELISA B T M WITNESS l'ny hand and official seal. a Commission No. 2281937 r� NOTARY PUbUC-CALIFORNIA SAN BERNARDINO COUNTY My Comm. Expires MARCH 21, 2023 Notary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT City of Lake Elsinore (Title or description of attached document) Non -Collusion Affidavit (Title or description of attached document continued) Number of Pages Document Date _ CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other www NotaryClasses corn 800-873-9865 INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, if needed, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that stale so long as the wording does not require the California notary to violate California notary /m,-- • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. Ile/she/they,— is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal 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 information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple- CITY OF LAKE ELSINORE CIP Project No. Z10054 BOND NO. N/A BIDDER'S BOND HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) KNOW ALL MEN OR WOMEN BY THESE PRESENTS: That we Elecnor Belco Electric, Inc. as PRINCIPAL, hereinafter referred to as "Contractor", and Fidelity and Deposit Company of Maryland 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 said 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 Ten Percent of Amount Bid (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 such suit, including a reasonable attorney fee to be fixed by the court. (SIGNATURE PAGE FOLLOWS) C-12 CITY OF LAKE ELSINORE CIP Project No. Z10054 BIDDER'S BOND SIGNATURE PAGE HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) IN WITNESS WHEREOF, we have hereunto set our hands and seals on this 8th day of July 2021 Contractor Name: Elecnor Belco Electric, Inc. Address: 14320 Albers Wav Chino, CA 91710 Telephone No.: (909) 993-5470 Print Name: John Wong Title: Vice President Signature: )VIVI ) (� Date: 7`8 0`' CORPORATE SURETY. - Company Name: Fidelity and Deposit Company of Maryland Address: 1299 Zurich Way, 5th Floor Schaumburg, IL 60196 - 1056 Telephone No.: (847) 605-6000 Print Name: Kathryn Pryor Title: Attorney -in -Fact Signature: Date: 7/8/2021 SIGNING INSTRUCTIONS TO THE CONTRACTOR 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 immediately following this page. Corporate Seal may be affixed hereto. The attorney -in -fact for corporate surety must be registered, as such, in at least one county in the State of California. Attach one original Power of Attorney immediately following the notary certificates. If the Bidder fails to properly sign or omits the required signatures, the bid will be considered non -responsive and will be rejected. C-13 CALIFORNIA ALL- PURPOSE CERTIFICATE OF 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 San Bernardino On July 7, 2021 before me, Elisa Beth Lim, Notary Public (Here insert name and title of the officer) personally appeared John Wong who proved to me on the basis of satisfactory evidence to be the person(s) whose names-) Is re subscribed to the within instrument and acknowledged to me that ire he/they executed the same in Is er/their authorized capacity(ies), and that by Is er/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ELISA BETH LIM I-T.�IESS hand and official seal. �_ _' �� Commission No. 2281937 NOTARY PUBLIGOALIFORNIA 0 1• SAN BERNARDINO COUNTY My Comrm Expires MARCH 21, 2023 Notary Public 5ignatur (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT City of Lake Elsinore Bid Bond (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other www NotaryClasses com 800-873-9865 INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, if needed, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary /mr • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. #te/she/4wy- is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal 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 information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple 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. Connecticut State of 6afiR ex)!zK Hartford Count of ) On July 8, 2021 before me, Bryan Caneschi, Notary Public (insert name and title of the officer) personally appeared Kathryn Pryor who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal BRYAN CANESCHI NOTARPPUBLIC- cr182475 lf My Commission Expires Nov. 30, 2025 Signature (Seal) Notary Public ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL, MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert D. Murray, Vice President, in pursuance ofauthority granted by Article V, Section 8, of [lie By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Donna M. PLANETA, Bethany STEVENSON, Joshua SANFORD, Aimee R. PERONDINE, Bryan NI. CANESCIII, Alexis R. APOSTOLIDIS, Michelle Anne MCMAHON, Rebecca M. STEVENSON, Brendan W. FLETCHER, Cassandra BAEZ., Jacqueline R. SUSCO, Jance WRIGHT, Kathryn PRYOR, Nicholas TURECAMO, Phillip M. KNOWER of Hartford, Connecticut, EACI1, its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as stn-ety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and puaposcs, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice-president has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 22ND day of December, A.D. 2020. ATTEST: ZURICH AMERICAN INSURANCE: COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDE' 1,tTY AND DEPOSIT COMPANY Of MARYLAND BY: Robert D. Xturray Vice President kn.- Dann L. Brown Secrelari, State of Maryland County of Baltimore On Ibis 22nd day of December, A.D. 2020, before the subscriber, a Notary Public of the State ol'Maryland, duly commissioned and (1ualified, Robert 1). Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to nu personally known to be the individuals and officers described in and who executed the preceding insninncnt, and acknowledged the execution of same, and being by me duty sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction oflhe said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Scal the day and year first above written. Q a C:onslance A. Dunn. Notary Public Authenticity of this band can be confirmed"uf'liand'yalidator.zurichna.com or 410-559-8790 My Commission Expires: Ally 9, 2023 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Allomeys-in-Facl. The Chief Executive Officer, the President, or any FXCCuIiVC Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate sea] thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE 1, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws oftlre Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE, COMPANY at a meeting duly called and held on the 15th day of December 1999. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorncy...Any such Power or any certificate thereof bearing such facsimile signature and scat shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994. and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the I Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this— 8th•___ clay of July 2021 �X 0; SEAL 'I n} By: Brian M. Hodges Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg, TL 60196-1056 �`nvw.i� �trt•tsfchtints cci.xu •ic:lt 3a.ccim 800-626-4577 Authenticity of this bond can be confirmed art haudvalidator.zurichna.com or 410-559-8790 CITY OF LAKE ELSINORE CIP Project No. Z10054 LIST OF SUBCONTRACTORS HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) 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: _�;en Ur nuel' e,4 License Number: __VF 7 6 3 0 to Address of Office, Mill or Shop: 190,600k 27�4 1e'IL4 "iO`g Specific Description of Sub -Contract: and Bid Items of Work: S f r i )O n y r .64 -gym 1*3 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: _ Specific 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 California for the type of work that they are to perform. Do not list alternate subcontractors for the same work. C-14 CITY OF LAKE ELSINORE CIP Project No. Z10054 REFERENCES HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) Failure to demonstrate adequate experience may result in rejection of the bid. For all public agency projects with a similar scope of work which you have worked on (or are currently working on) in the past three (3) years, provide the following required information: 1. Name (Firm/Agency): City of Glendale Address: 633 E. Broadway Room 205 Glendale CA 91206 Contact Person: Sarkis Oganesyan _ Telephone No.: 81 - 4 - 94 Title of Project: N. Verdugo Rd Traffic Signal Improvements Project Location: N. Verdu o Rd Date of Completion: February 2021 Contract Amount: $2,844,613 2. Name (Firm/Agency): Address: 73-510 Fred Waring Dr. Palm Desert CA 92260 Contact Person: Randy Bowman Telephone No.: 760-346-061 l Title of Project: Traffic Signal Modifications and Interconnect Improvements Project Location: Various Locations Date of Completion: August 2020 Contract Amount: 3. Name (Firm/Agency): Address: 6550 Miles Ave. Huntington Park, CA 90255 Contact Person: Cesar goldan Telephone No.: 323-584-6320 Title of Project: %gwl Synchronization and Bus Speed provements Project Location: Various Locations Date of Completion: _ April 2020 Contract Amount: $1.013.928 C-15 CITY OF LAKE ELSINORE CIP Project No. Z10054 4. Name (Firm/Agency): _ City_ of Huntington Beach Address: 2000 Main ton Beach CA 92648 Contact Person: Jim Escutia Telephone No.: 714-536-5525 Title of Project: Traffic Signal Modification and Interconnect Conduit Installation Project Location: Gothard Street and Center Ave Date of Completion: September 2019 Contract Amount: $320,055 5. Name (Firm/Agency): City of Rancho Cucamonga Address: 10500 Civic Center Drive, Rancho Cucamonga CA 91730 Contact Person: Sandra Salazar Telephone No.: 909-7-4068 Title of Project: Street Lighting for Terra Vista Parkway at Spruce Ave Project Location: Terra Vista Parkway at Spruce Ave Date of Completion: January 2019 Contract Amount: $117.728 6. Name (Firm/Agency): City of Indio Address: 100 Civic Center Mall, Indio CA 92201 Contact Person: Eric Weck Telephone No.: 760-625-1838 Title of Project: Monroe Street Traffic Signal Interconnect Project Project Location: Monroe Street Date of Completion: August 2019 Contract Amount: $684,000 7. Name (Firm/Agency): City of Palm Springs Address: 3200 East Tahquitz Canyon Way, Palm Springs, CA 92262 Contact Person: Mike Lytar Telephone No.: 760-902-4861 Title of Project: Indian Canyon Dr. Two Way Conversion Project Location: Indian Canyon Dr, Date of Completion: June 2019 Contract Amount: $4,464,857 C-16 CITY OF LAKE ELSINORE CIP Project No. Z10054 List any other projects (private, older than three (3) years, etc.) that may represent qualifying or similar experience: 1. Name (Firm/Agency): City of Diamond Bar Address: 218I0 Coy Drive, Diamond Bar CA 9L765 Contact Person: Christian Malpica Telephone No.:909-839-704) Title of Project: Traffic Signal Infrastructure Upgrades Phase III Project Location: Various Locations Date of Completion: September 2018 Contract Amount: $415,975 2. Name (Firm/Agency): Address: _I Civic Center Plaza, Irvine CA 92623 Contact Person: Anthony Caras,eo Telephone No.: 949-724-7555 Title of Project: protected - Permissive Left Turn Phasing Traffic Modification Project Location: Various Locations Date of Completion: November 2018 Contract Amount: $875,693 3. Name (Firm/Agency): City of Burbank Address: 275 East Olive Ave. Burbank CA 91510 Contact Person: Vikki Davtian Telephone No.: 818-238-3965 Title of Project: Media District signal Project - Phase 1 Project Location: Various Locations Date of Completion: February 2019 Contract Amount: $2,029,080 C-17 CITY OF LAKE ELSINORE CIP Project No. Z10054 CONTRACTOR INFORMATION HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) Contractor's License No.: 738519 Class: _ A. B, C-10 a. Date first obtained: 7/28/1997 Expiration 7/31/2021 b. Has License ever been suspended or revoked? If yes, describe when and why: c. Any current claims against License or Bond? If yes, describe claims: No. rea Principals in Company (List all — attach additional sheets if necessary): NAME TITLE LICENSE NO. (If Applicable) Alberto Garcia de los Angeles President John Wong Vise President 7395 Pedro Enrile Secretary C-18 UNANIMOUS WRITTEN CONSENT IN LIEU OF 2021 ANNUAL MEETING OF THE BOARD OF DIRECTORS OF ELECNOR BELCO ELECTRIC, INC. January 1, 2021 The undersigned, being all of the members of the Board of Directors (the "Board") of Elecnor Belco Electric, Inc., a California corporation (the "Company"), in lieu of holding a meeting of the Board, hereby take the following actions and adopt the following resolutions by unanimous written consent: WHEREAS, the Board has determined that it is in the Company's best interests to appoint a revised slate of Officers of the Company. NOW, THEREFORE, BE IT RESOLVED, that the following persons be, and hereby are, elected to the offices set forth opposite their respective names, to hold such offices until their respective successors are elected and qualified at or before the next annual meeting of the Board, or until their earlier respective deaths, resignations or removals: NAMES Alberto Garcia De Los Angeles Jeroni Gervilla Roger DeVito Pedro Enrile Leonardo Sancho Frances John Wong OFFICE President and Chief Executive Officer Chief Financial Officer Senior Vice President, General Counsel and Assistant Secretary Secretary Vice President Vice President for Construction FURTHER RESOLVED, that Alberto Garcia De Los Angeles, Jeroni Gervilla, Alberto Garcia and Roger DeVito in their respective capacities (listed above) subject to such supervisory powers of the Board of Directors, hereby are authorized and directed to perform all the duties commonly incident to that office; shall have authority to execute in the name of the Company contracts, leases and other written instruments to be executed by the Company; and, shall perform such other duties as the Board of Directors may from time to time determine. FURTHER RESOLVED, that the President and Chief Executive Officer may delegate authority to any Chief Financial Officer or Chief Operating Officer or Senior Vice President or Vice President as and within their authority levels as set forth in the Company's Bylaws, as the same may be amended from time to time; FURTHER RESOLVED, that Roger DeVito, in his capacity of Senior Vice President, or Leonardo Sancho Frances in his capacity of Vice President are hereby authorized and directed to: 1. Negotiate, sign, amend and terminate agreements in connection with the purpose of the Company, for all contracts up to $250,000.00, and acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla for all contracts in amounts greater than $250,000.00. 2. Execute, amend and finalize bid proposals in connection with the purpose of the Company, for all proposals up to $1,000,000.00, and acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla for all proposals in amounts greater than $1,000,000.00. 3. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla, execute, amend and finalize purchase orders for materials and equipment in connection with the purpose of the Company. 4. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla, execute, amend and terminate agreements for the lease of real estate to be used as offices or job related temporary yards. 5. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla, execute, amend and terminate insurance and/or bid bonds arrangements in connection with the purpose of the Company. 6. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla, hire, suspend, impose sanctions and dismiss the administrative personnel of the Company, setting forth their employment terms and conditions, obligations and remuneration. 7. Acting jointly with Alberto Garcia De Los Angeles or Jeroni Gervilla, settle and claims on behalf of the Company. AND IT IS FURTHER RESOLVED, that all actions heretofore taken by the officers of the Company on behalf of and in the name of the Company, relating to the conduct of the business of the Company, the expenditure of money, the making of contracts and all other acts taken or omitted in the performance of their duties to the Company be, and the same hereby are, in all respects, approved, ratified and affirmed, as of the date taken, done or omitted, respectively. The actions taken by the Board Consent shall have the same force and effect as if taken by the undersigned at a meeting of the Board of Directors, duly called and constituted pursuant to the Bylaws of the Company and the laws of the State of California. This Board Consent may be executed in counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same document. IN WITNESS WHEREOF, the undersigned, being all of the members of the Board of Directors of Elecnor Belco Electric, Inc., have executed these actions by written consent as of the date first written above. 1 Ar im' o Ramon, Director Luis Alcibar, Director Alexander Arrola, Director CITY OF LAKE ELSINORE CI Project No. Z10054 VIOLATIONS OF FEDERAL, STATE OR LOCAL LAWS HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) 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 /e (circle one) Federal / State / Local (circle one) If "YES," identify and describe, (including agency and status) Have the penalties been paid? YES / O (circle one) N/A 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 / NO (circle one) Code/Laws: Section/Article: If "yes," identify and describe, (including agency and status). C-19 CITY OF LAKE ELSINORE CIP Project No. Z10054 DISQUALIFICATION OR DEBARMENT HSIP CYCLE 8 TRAFFIC SIGNAL IMPROVEMENTS CIP PROJECT NO. Z10054 FEDERAL PROJECT NO. 5074(019) 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 /(O (circle one) If yes, provide the following information (if more than once, use separate sheets): Date: N/Entity: Location: Reason: Provide Status and any Supplemental Statement: N/A Has your firm been reinstated by this entity? YES / NO (circle one) C-20