Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Item No. 15 - Final Change Order Camino Del Norte Guardrail - SR
City Council Agenda Report City of Lake Elsinore 130 South Main Street Lake Elsinore, CA 92530 www.lake-elsinore.org File Number: ID# 22-224 Agenda Date: 6/14/2022 Status: Approval FinalVersion: 1 File Type: Council Consent Calendar In Control: City Council / Successor Agency Agenda Number: 15) Final Construction Change Order for the Camino Del Norte Guardrail Project #Z10030 Authorize the City Manager to execute the final construction contract change order for Aneen Construction, Inc. for the Camino Del Norte Guardrail Project in the amount of $49,755. Page 1 City of Lake Elsinore Printed on 6/9/2022 Page 1 of 2 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: June 14, 2022 Subject: Final Construction Change Order for the Camino Del Norte Guardrail Project #Z10030 Recommendation Authorize the City Manager to execute the final construction contract change order for Aneen Construction, Inc. for the Camino Del Norte Guardrail Project in the amount of $49,755. Background On April 12, 2022, City Council authorized the original contract Agreement with Aneen Construction, Inc. for $252,490.00 plus an additional $25,249 in contingency. The project consists of guardrail installation in Camino Del Norte in both northbound and southbound travel lanes. There will be approximately eight guardrail segments to be installed totaling nearly 2000 linear feet. Project limits are from Main Street to Franklin Avenue along Camino Del Norte. Backfill behind existing mountable asphalt berms is part of the construction documents where guardrails are installed. Discussion The additional funding, along with previously authorized contingency will allow the contractor to backfill behind mountable Asphalt berms previously constructed along Camino Del Norte. This allows vehicles to mount the berms and use the dirt shoulders in case of emergencies more safely. Mountable asphalt berm backfill consists of a 4’ wide section from the back of the dike on both north and southbound directions along Camino Del Norte for a total of 17,648 square feet of graded dirt shoulders. Fiscal Impact Fiscal impact results in an additional $49,755 which will be funded as part of the adopted CIP Budget. Exhibits A - Change Order B - Original Agreement Final Construction Change Order - Camino Del Norte Guardrail Project CIP No. Z10030 June 14, 2022 Page 2 Page 2 of 2 CONSTRUCTION CONTRACT CHANGE ORDER Date 06/14/2022 C.C.O No. 1 951-674-3124 130 S. MAIN STREET LAKE ELSINORE, CA 92530 WWW.LAKE-ELSINORE.ORG PROJECT NAME Camino Del Norte Guardrail CIP#Z10030 CONTRACTOR: Aneen Construction, Inc. In conformance with and as part of the existing Agreement for this project the City of Lake Elsinore authorizes and directs changes to the Agreement as described below. 1) EXTRA WORK ORDER (EWO) (Unknown or Unforeseen Work not covered by Contract) a) Extra Work Item A: Additional scope of work added to 17,648 square feet of backfill behind existing mountable asphalt berms that were installed originally with Camino Del Norte Improvements project. Lump Sum = $49,755 2) CHANGED WORK ORDER (CWO) (Significant increases in quantity of Unit-Price items; greater than 25%): a) Changed Work Item A i) Time for completion will be increased/decreased by (+-) Zero (0) Working Days 3) CLOSING SUMMARY ORDER (CSO) (Final adjustment of original estimated contract quantities based on final measured quantities): a) Closing Summary Order: i) Payment for this work is paid as follows: Total = $75,004 AGREEMENT AMOUNT: Compensation as set forth in the Agreement and as amended by this and prior Contract Change Order(s) is: $302,245.00 Original Contract Amount: $252,490.00 Amount All Previous CCOs (+-): $0.00 Amount This CCO (+-): $49,755.00 Total Contract Amount: $302,245.00 CITY’S ACCEPTANCE: The above described work is hereby approved and directed to be completed in accordance with the Contract Documents. City of Lake Elsinore Rec.: ______________________________ City Engineer Date App.: _____________________________ City Manager Date CONTRACTOR’S ACCEPTANCE: Contractor agrees to perform the above work as directed, in accordance with the Contract Documents, and accept payment described above as full compensation for work described subject to additions and reductions of the quantities of various items. Contractor: Aneen Construction, Inc. By _________________________________________ Title: President_______________________________ Date: _______________________________________ DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B1620C5A Agreement No. AGREEMENT FOR PUBLIC WORKS CONSTRUCTION Aneen Construction, Inc. Forthe Camino Del Norte Guardrail Project CIP PROJECT NO. Z10030 This Agreement for Public Works Construction ("Agreement") is made and entered into as of April 12, 2022 by and between the City of Lake Elsinore, a municipal corporation ("City") and Aneen Construction Inc. a Corporation ("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: Camino Del Norte Guardrail Protect (the "Project") The City -approved plans for the construction of the Project, which are incorporated herein by reference and prepared by the City of Lake Elsinore, are identified as: Camino Del Norte Guardrail Plans 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 two -hundred fifty two thousand, four hundred -ninety dollars ($252,490.00). DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A 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 Work. a. Contractor shall perform and complete all work within Thirty -Five (35) 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 Five Hundred dollars ($500.00) 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. DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A 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 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B1620C5A 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. 1 nsurance 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. 4 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A 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 DocuSign Envelope ID: OB8CB6BA-D163-4086-AMB-5296131620C5A 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: Aneen Construction Inc. Attn: Tamer Khalil 9860 Indiana Ave. # 18 Riverside, Ca 92503 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. N. DocuSign Envelope ID: 0B8CB6BA-D163-4086-A2DB-529681620C5A 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 ortermination. 22. Prevailing Wages. 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. DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A 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] DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B1620C5A 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" [insert Contractor name], a [insert entity type] 0—w9 gucd by: Docu5ignvd by: jA,s6v, S(,KA fS A, 4/23/2022 1 8: 33 PM PCT 4/23/2022 1 6:08 PM PDT By: Tamer Khalil Its: President ATTEST: FDocuSfgned by: 4/25/2022 1 8:45 AM PDT I y er By: APPROVED AS TO FORM Its: FZUftnee by: ".1, loa 4/23/2022 1 5:57 PM PDT Clty Drney rS oocusigned by: "V, 4/19/2022 1 8:46 AM PDT Director of Administrative Services 9 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B1620C5A EXHIBITA CONTRACTOR'S PROPOSAL [ATTACHED] DocuSign Envelope ID: OBBCB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CI Project No. Z10030 SECTION C BID DOCUMENTS W. DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A Company: CITY OF LAKE ELSINORE CIP Project No. Z10030 CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 ANEEN CONSTRUCTION, INC. Honorable Mayor, Members of the Council: In accordance with the Notice Inviting Bids pertaining to the receiving of bid proposals by 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: Thirty -Five (35) Working Days from Issuance of Notice to Proceed (NTP) by City to Contractor. BID SCHEDULE A ITEM NO. DESCRIPTION UNIT CITY UNIT COST TOTAL COST 1 MOBILIZATION, DEMOBILIZATION AND CLEANUP LS 1 20,000 20,000 2 CLEARING AND GRUBBING LS 1 10,000 10.000 3 TRAFFIC CONTROL LS 1 10,000 10,000 4 DUST ABATEMENT LS 1 5,000 5,000 5 K-RAIL REMOVAL COORDINATION L1 1 1.00 1.00 6 DELINEATOR REMOVAL EA 52 61.00 3.172,00 7 MIDWEST GUARDRAIL SYSTEM- TYPE 11 B STEEL POST LF 1948 53.50 104.218 8 MIDWEST GUARDRAIL SYSTEM- TYPE 11 E STEEL POST LF 136 62.00 8,432.00 9 GUARD RAILING DELINEATOR EA 102 20.00 2,040.00 10 END TERMINAL SYSTEM SRT M10 EA 9 5,403 48,627 11 BACKFILL AC DIKE 4' WIDE MIN. AND COMPACT SOIL TO 90% SF 8200 5.00 41,000 TOTAL BID PRICE 252,490.00 TOTAL BID PRICE BASED ON BID SCHEDULE TOTAL OF UNIT PRICES FOR CAMINO DEL NORTE GUARDRAIL PROJECT Z10030 $ 252,490.00 v� Total Bid Price in Numbers two hundred fifty two thousand, four hundred ninety dollars and zero cents 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 REJEQTED IF TOTAL IS NOT SHOWN FOR BOTH FIGURES AND WORDS. C-7 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CI Project No. Z10030 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: MARCH-22-2022 By: Contractor's State License No.. 1004775 Class: CLASS A Department of Industrial Relations Registration No: Registration Date: Address: Phone: FAX: DEC-30-2020 ANEEN CONSTRUCTION, INC. Contractor TAMER KHALIL 1000033880 Expiration Date: 9860 INDIANAAVE. #18 RIVERSIDE, CA92503 909-913-3024 C-8 JUN-30-2022 DocuSign Envelope ID: OBBCB68A-D163-4086-A2DB-5296B1620C5A CITY OF LAKE ELSINORE CIP Project No. Z10030 CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 The Bidder shall acknowledge the receipt of addenda by placing an "X" 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. r Bidder's Signature TAMER KHALIL Print Name C-9 MARCH-22-2022 Date PRESIDENT Title DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CIP Project No. Z10030 Me "INGNMEORK-3 CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 STATE OF CALIFORNIA ) jCOUNTY OF SS (NAME)TAMER KHALIL affiant being first duly sworn, deposes and says: That he or she is PRESIDENT of (sole owner, partner or other proper title) ANEEN CONSTRUCTION, 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: 9660 INDIANAAVE. 016 RIVERSIDE, CA 92503 Telephone No.: 909-913-3024 Print (dame: TAI)EA KHALIL Signature: Title: PRESIDENT Date: MARCHO 2022 Non -Collusion Affidavit must be accompanied by notary certificates for signature. Note the description of the document on the notary certificate. If the Bidder fails to properly sign or omits the required signature, the bid will be considered non -responsive and will be rejected. C-10 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CALIFORNIA CERTIFICATE OF ACKNOWLEDGMENT A notarydlpublic or other officer completing this certificate verifies only the identity of the in who sfgned the document to which this certificate is attached, and not the truthfulness, accuracv. or validity aif that document. State of Calif I r 'a } County of �_ ) On i/" t'`" before me, + L�It There assert nam a ir, o thr ir+Cer) personally appeared!��/� who proved to me on the basis of satisfactory evidence to be the pej59jjW whose names is/are subscribed to the within instrument and acknowledged to me that here/they executer the same in er/their authorized capacit ies that by his/her/their signatures on the instrument the rye so), or the entity upon behalf of which the arson s) acte-cr, —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 and and official seal. Signature c�}sw H. DUNN COMM. #2290617 zz ;;". _- Notary Public - California o Riverside County t M Ccmm, E : Tres June 24, 2023 (Seal) Optional Information Although the information In this section is not required by law, It could prevent fraudulent removal and reattachment of this acknowledgment to an unauthoiized document and may prove useful to persons relying on the attached document Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document titled/for the purpose of containing pages, and dated The signer(s) capacity or authority is/are as: Individual(s) �f Attorney -in -tract Corporate Officer(s) 4 l� Guardian/Conservator Partner- Limited/General Trustee(s) wi. Other: representing: _ Name(;1 ur Person(,: ur a (,T r,os1 Sipnei i� rte�rc.entinq Method of Signer Identification Proved to me on the basis of satisfactory evidence: 0, form(s) of identification U credible witness(es) Notarial event is detailed in notary journal on: Page # Entry N Notary contact: Other AdditionalSignerb) Signer(s)Thumbprint(s) .�l: play ri�hi M%1l 4l IN N�.t,,y Rrn ark N' 41400, DI, MI[.II1.'t IA 01W; All Ri,)hr� p-, veil .rani iN on,ho, r.,! y:'1_ Plea,e 7,)nra C: yo�Il Authorized neseller tc, purchase -opie, of rhii fJrr DocuSign Envelope ID: OBBCB6BA-D163-4086-A2DB-5296B162005A CITY OF LIKE ELSINORE CiP Project No. Z10030 BOND No. NIA DIQDFR'S BOHh CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 KNOW ALL MEN OR WOMEN BY THESE PRESENTS- That we Aneen ens ction Inc, as PRINCIPAL. here nOm teerfed to as "contrador", and -AM i-can Cant ctors Indemnity Company a duty authorized corporate as "Surety.- are held and firmly bound unto the City of take Elsinore in the penal sum of TEN PERCENT (10%) OF THE TOTAL AMOUNT OF THE 1310 of the Contractor above nand, 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 hind ourselves, our heirs, executors, administrators and successors, joilltiy and severally, rtm)ly by these presents. in no case shall the liability of the surety hereunder exceed the amount of Ten Percent 10% of the Total Amount of the Bid THE CONDITION OF THIS OBLIGATION IS SUCH: Thai 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 farms 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 pefibrmance 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 certiffrate{s) in accordance with said Contract docurents, then this obligation shall be null and void; Werwise, It small be and remain in full force and effect until execution of the Agreemenl ar forlehure 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)i C-11 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CIF Project No. Z10030 a DEL NORTEM •;s C1P PROJECT NO. Z10030 IN WITNESS WHEREOF, we have Hereunto set our Hands and seals on this 22n-d day of March .2o22 BIDDER,. CwtnXlor Name: APeen Canstruckn, Inc. Address: 2§UIndiana 8 Telephone No,: Print flamc. Sa�r+atdte: - Date: —t,i A" . tl- 24 -z-"2_ CORPORATE SURETY, Company Name: American Contractors Indemnity Company Address: 801S_ figuerca St__ Suite 700 1Q Telephone No.: f3101649-0990 Print Name: Patncia Zengo .--- Tilte' Attorney -in -Fact Signature:414-- Dale., l�srcle 22. 2D22 StQN!NG lsTRUCTIQNS TQ 114l C0NT ACTOR 8idder's Bond must be accompanied by notary certificates for EACH signature. Note the description of the document on the notary certificate. Attach ROTH notary certl11ca%e5 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 cartificates. If the Bidder falls to properly sign or omits the required signatures, the bid will be considered non -responsive and will be rejected. C-12 DocuSign Envelope ID: OBBCB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CIP Project No. Z1003 07 :1.i�� =TiN FOW ICI : 1 CIP PROJECT NO. Z10030 IN WITNESS WHEREOF, we havO hereunto set our hands and seals on this 22nd day of March 4 Contractor Nance: Aneen Construction, Inc. Addre-SS: is A 1 Telephow No.: soa)g1.3, Q24 Print Name: _ !1�E 0- I �_.1 Title; pace, tir 1, �— Sttatt�re: I Dad: 11 4 - 7 a z - -- CORPORATE SURETY: Company Dame: American Contractors Inderni Address: SU S-_Eiguaron St._ Suite 700 Tetephone No.; (310) 649-0990 Print Nance: Patricia Zenizo TrHe: Attorney -In -Fad signature: Date: rch 22 2022 SIGNIh1GMTRl1CTION5TOTHE CONTRACT013 Bidder's Bond must be accompanied by notary cartlflcates for EACH signature. Note the description of the document on the notary certificate. Attract► BOTH notary certificates immediately fallowing this page. Corporate Seel may be affixed Hereto. The attorney-in-fac# for corporate surety must be registered, as such, in at least nne county In the State of California. Attach one original Power of Attorney Irnmediatety fottowing the notary certificates, If the Bidder fails to properly sign or omits the requ[red signatures, the bid will be considered non -responsive and will be rejected. C-12 DocuSign Envelope ID: 0B8CB6BA-D163-4086-AWB-529661620C5A or CALUF010" ALL-PURMW ACKN0WLgUX=NT CfYtir CODE § 1189 A not" pu611tD or Other dkw oompieft ft oereiicete verifies only the klerrtity of the Indivlcfual who signed the do mWd to which this oertllicele is attached, and riot the truthfulness, accu 1 a4y or vaf de y Of that docu w#. State of California County of _ Los Anaeies r On MAR 2 2 L022 before Me. _ —ELSE to Salazar Nat Public DatehtM kmt.Abme and Tale of the Offrc r filly appeared __i'atri is .�nizo _ Name(s) of &gner(s) who proved to me on the basis of satisfactory evidence to be the person($) whose name() Waft¢ subscribed to the within instrument and acknoWkKk d to me that da/shelft executed the same in t79t h Alyffir authorized capacity(IM). and that by Ws/herWr signature(p) on the instrument the person(g), or the entity upon behalf of which the person(s) acted, executed the Instrument. EUSABETE WA20 Hptatr Publk - CaRfarnta LbsAng*W Canary Comrrdigan 12342511 - MX Comm. fgim 31n M 2025 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hard and official seal. 940 e, �x WN iArt .2 Mace Afotaty Sea! Above OMONAL i t Though rhrs section is optional, compleitng this Info►rnarion calirll-deferaneration of the document or fraudulent reattachment of this forrn to an urlfntended document. Description of Attached Document Title or Type of Document; Document Date: Number of Pages: _- _ _ Signer(s) Other Than Named Above: CapacftOes) Clainwd by Signor(s) Signer's Name: Corporate Officer — Title(s): Partner -- F Limited i i General Individual n Attorney in Fact Trustee ❑ Guardian or Conservator r m hv.r- Signer Is Representing: Signer's Dame: Cl Corporate Officer — Titie(sj: ❑ Partner -- :.I Urn4ted i_I General 1-7 Individual F1 Attorney in tract L) 'Trustee 1-1 Guardian or Conservator El Other: Signer is Representing: (*014 National Notary Association , www.NationalNotaq.org • i-8D0-US NOTARY (1.804-876-6827) Item #5907 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A roKIOMARiNE Il, NCC 0 POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS SONINNO COMPANY #1NITEO STATES SURETY COMPANY U.S, SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, "texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surely Company, a M alyland ca"falion and U.S specialty Insurance Company, a Texas cofparstion (Collectively, the "Campanies'), do by "se pfesents make, comlifule and appoint PATRICIA Z£NIZO, PIETRO MICCICHE, ELISASETE SALAZ4R Of GLENDALE, CALIFORNK its true and lawful AttorneY4sHn tact, each In their separate capacity if mare than one is named above, with full power and authodly 4ereby conferred in "sts name, place and stead, to execrate, acknowledge and deliver any and all bonds, recognkances, undertakings Of outer Instrument or contracts of suretyship to Include riders, amendments, and consents of surety, prGridtng the bond penalty does not exceed -Five Million ... - Dollars •. fl�6 • This Poftr of Aitomey shah expire whit ul further action on April 23:4, 2022 This Power ot.A4MO ited under and by ate mrty of the fo Wrlg rl�lttiions adopted by the Boards of Direcors of the comp anies: that the PrhCSidesri, an ViCe•A .•.•••-_'��� rested , luu y residenl, any Assistant vice•Presidem, any Secretary or any Assistant Secrelary shah be and Is hereby Power following awing p to appoint any onti3 ❑r mare suitable persons as Atlomey(s)-In.Fact to represent and act far and an behalt of the Camparey aub�ct i0 rite follpwiag prayssions: A;tr,mMi4rh-Fact may be given hull power and authority roc and In the name of and on behalf 0rthe Company, to oxerule. aeknowiedge and dellyer, any &W all bands. recngntzances, corrlracis. agreements or indemnity and other conditional or obligatory undodakings, including any and all consents for On ratetse of min ined peraeniagea endlor final estimates on eng{n"riq and construction contrdcls, and any and all notices and documents CWK*kQ or larminatnp the Company's habGity thereunder, and any such instruments so executed by any such Attorneydn-Fact shell be binding upon t}1rt CbffVNW as if signed by the President and sealed and effected by the Corperata Secretary. lb&Dkvd that the slanalwe of any authorized otfrcer and seal of the Company hereto M or heranner affixed to any power of attomey or any vW 'he M�tkg thereto by facsimile, and any power orattorney or certificate bearing facsimfte signature or facsimlte seal shal[ he valid and binding WI with reaped to any bond or undertaking In which it is attached. IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and Iheir corporate sea is to be hereto affixed, this 111 day of dune. 2018 AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING OMPANY tlhiITE0Cie, SUIt>=T�'- _#.PANY EClAL lH URANCt CpNipgNY n dyecC l • t 7xSt' ate of Calffomia '! N°�r County of Los Angelesma's i1T.� B ~�— Daniel P, Agullar, Vice President A Notary Prafilie or other ofircer completing (his cerfdreafe vigrifies.only the tdenaty or fhe individual who signed the dr =menf to wlrkh this aertficafe 15 8R died, and not the truflifulnes$ &Xumc , or wilklitV oflha( document On tars 1" day of June, 2018, before roe, Sonia O. Caire}o, a notary public, personally appeared Daniel R Aguilar, Vice President of Arrtefk= Convectors Intiesmiity Company, Texas Bonding Company, United States Surely Company and U.S. Specialty Insurance Company witio proved tocreon the basis of satisfactory evidanc;a to be the person whose name is subscribed to the within instrument and acW to n* oral he eKeculed the same In his authorized Capacity, and that by his algnatum on the Instrument PWWL Of gritty Capon behalf of which the person acted, executed the Instrument I certify under PENALTY OF PERJURY under the lawis of the State of Calilomis that ilia foregoing paragraplh is true and correct. WITNESS my hand and ofireiat Seal. 1Pr4 Aa�q • �I.wrkyHn [w.Y � _ Signature I {Seatj wor..�f+whirisr� 1, Kio Lo, Assistant Secretary American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Spedalty Insurance Company, do hereby Wily that the above and foregoing is a true and correct copy of a Power of Attorney exeevted by sotd Comp anies• ►vhlch is Still In full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Alto mey are in full force and effect. InWitne$s Where , I have hereunto set my, hand and affixed the seals of said Companies at Los Angeles, California this L2 day of ,rCk iµct. rail �7y�LA vrw_ y�4 Corporate Seals f .. •�q- . c4 �y_ �rF �� Band No.i'_ '' �f' ,{ y + l �i " Agency N9. $ $7 r` ��r` � r' � � K10 Lo. Asel Socrotary 9 Y 06n,. osit trnhcc.cornlsurety for more inforinatiori DocuSign Envelope ID: OB8CB68A-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CIP Project No. Z10030 BOND NO. 1001148682 PREMIUM $4,545.00 FAITHFUL PERFORMANCE BOND Premium Based on Final Conlracl Amount (100% of Total Contract Amount) WHEREAS, the City Council of the City of Lake Elsinore, State of California, has awarded to and entered into an Agreement with Aneen Construction, Inc. (hereinafter designated as "Principal") whereby Principal agrees to construct or install and complete certain designated public improvements, which said Agreement, effective on the date signed by the City Manager, and identified as CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 is hereby referred to and made a part hereof; and WHEREAS, said Principal is required under the terms of said Agreement to furnish a bond guaranteeing the faithful performance of said Agreement. NOW THEREFORE, we the undersigned Principal and American Contractors Indemnity Company as Surety, are held and firmly bound unto the City of Lake Elsinore (hereinafter designated as "City") in the penal sum ofF,nr Iwo andNW100 dollars ($252 490 00 ), lawful money of the United States, for which payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the above bounded Principal, his or her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and provisions in said Agreement and any alterations thereof made as therein provided, on his or her or their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless the City, its officers, agents and employees, as therein stipulated, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. As a part of the obligation secured hereby and in addition to the face amount specified therefor, there shall be included costs and reasonable expenses and fees, including reasonable attorneys' fees, incurred by City in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered. The Surety hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the Agreement or to the work to be performed thereunder, or the specifications accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Agreement or to'the work or the specifications. (SIGNATURE PAGE FOLLOWS) D-34 DocuSign Envelope ID: 0B8CB6BA-D163-4086-A2DB-5296B1620C5A CITY OF LAKE ELSINORE CIP Project No. Z10030 BOND NO.1001148682 SIGNATURE PAGE TO FAITHFUL PERFORMANCE BOND IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and Surety above named and we have hereunto set our hands, and seals on this 22nd day of April 2022 . BIDDER/PRINCIPAL- Principal Name: Aneen Construction, Inc. Address: 9860 Indiana Ave., #18 Riverside, CA 92503 Telephone No.: (909) 913-3024 SURETY: Name: American Contractors Indemnity Company Address: 801 S. Figueroa St., Suite 700 Los Angeles, CA 90017 Telephone No.- (310) 649-0990 Print Name: Tamer khalil Print Name: Pietro Micciche . Attorney- in-Fa�� Signature: Signatur �_ '^� Approved as to Form this day of 20 City Attorney City of Lake Elsinore NOTE: This bond must be executed by both parties. Corporate seal may be affixed hereto. All si natures must be acknowledged before a notaEy public attach acknowledgments). The attorney -in -fact for the corporate surety must be registered, as such, in at least one county in the State of California. (Attach one original Power of Attorney sheet for each bond). D-35 DocuSign Envelope ID: 0B8CB6BA-D163-4086-AMB-5296131620C5A 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 _LOS-Allaeles On before me, Elisabete Salazar, Notary Public — Date Here Insert Name and Title of the Officer personally appeared Pietro Micciche Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(!) whose narnei is/ajlte subscribed to the within instrument and acknowledged to me that hefjMp* executed the same in his/y(O"Xauthorized capacityi W, and that by hi-�){e Ml(signatureM on the instrument the personK, or the entity upon behalf of which the personoQ acted, executed the Instrument. 0my ELISABUE SALAIM Notary Public - Callfornla Los Angeles County Commission N 2342511 Comm. Expim Jan 19, 2025 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature _ —�- r g t?ign rre of Notary Place Notary Seal Above OPTfONAL Though this section is optional, compieting 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: Number of Pages: Signer(s) Document Date: Other Than Named Above: Capecity(ies) Claimed by Signer(s) Signer's Name: Corporate Officer — Title(s): Partner — __ Limited J General Individual F1 Attorney in Fact --,'Trustee LJ Guardian or Conservator Other: Signer Is Representing: Signer's Name: _ Corporate Officer — Title(s): L Partner — 1 Limited i General l Individual Attorney in Fact i Trustee i Guardian or Conservator Other: Signer Is Representing: 3M 02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) ttem #5907 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A f� . TOKIOMAKINE ►� H C C POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, Texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a Maryland corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the "Companies"), do by these presents make, constitute and appoint: PATRICIA ZENIZO, PIETRO MICCICHE or ELISABETE SALAZAR of GLENDALE, CALIORNIA its true and lawful Attomey(s)-in-fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to Include riders, amendments, and consents of surety, providing the bond penalty does not exceed *****Five Million***** Dollars ( "15,000,000.00*** ). This Power of Attorney shall expire without further action on January 3151, 2024. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attomey-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 23'd day of September, 2021. AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY 1s b% O 9r State of California ((#J� aCounty of Los Angeles �_4 a ' By: Daniel P. Aguilar, Vice President A Notary Public or other ofcer 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 On this 23rd day of September, 2021, before me, D. Littlefield, a notary public, personally appeared Daniel P. Aguilar, Vice President of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the S ate of California that the foregoing paragraph is true and correct. a. �>rr�EFuro WITNESS my hand and offi ' I seal. _ - :-- Signaturer'AuOrk-c.ura,,,,, ,v�.u. raeisty f I t710707 p- (seal) I, Kio Lo, Assistant Secretary op American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set,:ny h, nd' and affixed the seals of said Companies at Los Angeles, California this Z n` day of ,, i [ _ __ _ `—, "1L & Z e- Corporate Seals Bond No. Kjo l..o. HCCSMANPOA09/2021 Visit tmhcc.com/surety for more information DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CIP Project No. Z10030 BOND NO. 1001148682 PREMIUM $Included in Performance Bond LABOR AND MATERIALS BOND (100% of Total Contract Amount) WHEREAS, the City Council of the City of Lake Elsinore, State of California, has awarded to and entered into an Agreement with Aneen Construction. Inc. (hereinafter designated as "Principal") whereby the Principal agrees to construct or install and complete certain designated public improvements, which said Agreement, effective on the date signed by the City Manager, and identified as CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 is hereby referred to and made a part hereof; and WHEREAS, under the terms of the Agreement, said Principal is required before entering upon the performance of the work, to file a good and sufficient payment bond with the City of Lake Elsinore to secure the payment of claims to which reference is made in Title 3 (commencing with Section 9000) of Part 6 of Division 4 of the Civil Code. NOW, THEREFORE, we the undersigned Principal and American Contractors Indemnity Company , as Surety are held and firmly bound unto the City of Lake Elsinore (hereinafter designated as "City") and all contractors, subcontractors, laborers, material suppliers, and other persons employed in the performance of the Agreement as referred to in Title 3 (commencing with Section 9000) of Part 6 of Division 4 of the California Civil Code, In the sum of Two Hundred Fifty Two Thousand Four Hundred Ninety and Nol100 dollars ($252.490.00 J, lawful money of the United States, for materials furnished or labor thereon of any kind, or for amounts due under the Unemployment Insurance Code with respect to such work and labor, that the Surety will pay for the same in an amount not exceeding the sum specified in this bond. In the event suit is brought upon this bond, the Surety shall pay in addition to the face amount thereof, all costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by the City in successfully enforcing this obligation, to be awarded fixed by the court, and to be taxed as costs and to be included in the judgment therein rendered It is expressly stipulated and agreed that this bond shall inure to the benefit of any of the persons, companies, and corporations entitled to file claims under Title 3 (commencing with Section 9000) of Part 6 of Division 4 of the California Civil Code, to give a right of action to such persons or their assigns in any suit brought upon this bond. Should the condition of this bond be fully performed, then this obligation shall become null and void, otherwise it shall be and remain in full force and effect. The surety hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the agreement or the specifications accompanying the same shall in any manner affect its obligation on this bond, and it does hereby waive notice of any such change, extension, alteration, or addition. (SIGNATURE PAGE FOLLOWS) D-36 DocuSign Envelope ID: 0138C136BA-D163-4086-AMB-5296131620C5A CITY OF LAKE ELSINORE CIP Project No. Z10030 BOND NO. 1001148682 SIGNATURE PAGE TO LABOR AND MATERIALS BOND IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and Surety above named and we have hereunto set our hands, and seals on this22nd day of April 2022. BIDDER/PRINCIPAL: Principal Name: Aneen Construction, Inc Address: 9860 Indiana Ave., #18 Riverside, CA 92503 Telephone No.: (909) 913-3024 Print Name Signature: Approved a day of City Attorney City of Lake Elsinore 20_ SURETY: Name: American Contractors Indemnity Company Address: 801 S. Figueroa St., Suite 700 Los Angeles, CA 90017 Telephone No.: (310) 649-0990 Print Name: Pietro Micciche Attacciay-in-Fact Signature� 0;r��L NOTE: This bond must be executed by both parties. Corporate seal may be affixed hereto. All signatures must be acknowledged before a notary public attach acknowledgments). The attorney -in -fact for the corporate surety must be registered, as such, in at least one county in the State of California. (Attach one original Power of Attorney sheet for each bond). D-37 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CML 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 _- I Os Anae1eji.___. On _APR 22 _2022 _ before me, _ _Elisabete Salazar, Notary Public Date Here Insert Name and Tide of the Officer personally appeared Pietro Micciche Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the personQQ whose name% is/4)(0 subscribed to the within instrument and acknowledged to me that he/)MW executed the same In hislp(otj, )(authorized capacityQW, and that by hisi)(O(MMsignal urepQ on the instrument the person¢Q, or the entity upon behalf of which the person( acted, executed the Instrument. 01. EUSAU7E SAIAZO Notary Public - California n Los ArWies County Commission 0 2342511 my Comm. Expires Jan 19, 2025 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 official seal. Signature, ..Signaturpf of Nof 'Ou OPTlOAML 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: Number of Pages: Document Date. Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Corporate Officer — Title(s): Partner — _ Limited _J General Individual ❑ Attorney in Fact Trustee IJ Guardian or Conservator Other: Signer Is Representing: Signer's Name: Corporate Officer — Title(s): I_ Partner — I Limited F General 11 Individual ! Attorney in Fact Trustee Guardian or Conservator . Other: Signer Is Representing: �cwzc�aac:csd 02014 National Notary Association - www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A TOKIOMARINE H C C POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, Texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a Maryland corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the "Companies"), do by these presents make, constitute and appoint: PATRICIA ZENIZO, PIETRO MICCICHE or ELISABETE SALAZAR of GLENDALE, CALIORNIA its true and lawful Attomey(s)-in-fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond penalty does not exceed *****Five Million***"* Dollars ( " 15,00.0,000.00"** ). This Power of Attorney shall expire without further action on January 3131, 2024. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Aftorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attomey-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 23,d day of September, 2021. AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY Sy,Cippy roiHac su1� State of California °� r` t, 41 "Z_ County of Los Angeles �.$d�� " a By: *+' 'T+43 Daniel P. Aguilar, Vice President A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document fo which this certificate is attached and not the truthfulness, accuracy, or validity of that document On this 23rd day of September, 2021, before me, D. Littlefield, a notary public, personally appeared Daniel P. Aguilar, Vice President of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. D.lrrTtE�1Er,0 WITNESS my hand and offi I seal. 1+c[!ry, Public . Cely�,ys CW "los COunry 6.CorRn Ision 1 t.}"M7 uY COMM- Gans An 11, =4 Signature (seal) I, Kio Lo, Assistant Secretary o American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, whirtl is MA in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are irr f ill lomrt;p and of vt. In Witnigss Whereof, I have heratirtc, set my hand &nd affixed the seals of said Companies at Los Angeles, California this t' day of n6_ Corporate Seals 0o?1pt"Qca tiwiu� r�r(.*", I Bond No. I ( 1 `I LP`6" �� �7 1 1 } k Agency No. 3057 �; ;,i�, `�,,��::a•� �� ' * io o, si acre ary HCCSMANPOA09/2021 visit tmhcc.com/surety for more information DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CIP Project No. Z10030 CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 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: DIR NO 1000001986 License Number: 122954 EXP. FEB-26-2022 Address of Office, Mill or Shop: ALCORN FENCE COMPANY 6445 PEDLEY ROAD, RIVERSIDE, CA 92509 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: Name Under Which Subcontractor is Licensed: License Number: Address of Office, Mill or Shop: _ Specific Description of Sub -Contract: and Bid Items of Work: GUARDRAIL, LINE ITEMS 7-10 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-13 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A 1 2 3 CITY OF LAKE ELSINORE CIP Project No. Z10030 REFERENCES CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 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 two (2) years, provide the following required information: Name (Firm/Agency) CITY OF CORONA PUBLIC WORKS Address 400 SOUTH VICENTIAAVE., CORONA, CA, 92879 Project Title OVERLOOK Project Location CITY OF CORONA SOUTH Type of Work STREET IMPROVEMENT, GURADRAIL, RETAINING WALLS AND GRADING Project Manager Contact PETER RAMEY Phone 909-855-1720 Dated Completed FEB-2021 Contract Amount 890,000 Name (Firm/Agency) CITY OF RIVERSIDE PUBLIC WORKS Address 3900 MAIN ST, RIVERSIDE, CA, 92522 Project Title Project Location Type of Work Project Manager Contact Dated Completed JUL-2021 Name (Firm/Agency) WILLIAM ST IMPROVEMENTS CITY OF RIVERSIDE STREET IMPROVEMENTS DAVID HATCH Phone Contract Amount CITY OF CORONA Address 400 SOUTH VICENTIAAVE., CORONA, CA, 92879 Project Title Project Location Type of Work . Project Manager Contact Dated Completed DEC-2020 ONTARIO AVE. CITY OF CORONA STREET IMPROVEMENT PETER RAMEY Phone Contract Amount C-14 951-288-3633 320,00 909-855-1720 780,000 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B1620C5A CITY OF LAKE ELSINORE CIP Project No. Z10030 List any other projects (private, older than three (3) years, etc.) that may represent qualifying or similar experience: 4 5 Name (Firm/Agency) Address Project Title Project Location Type of Work Project Manager Contact Dated Completed Name (Firm/Agency) Address Project Title Project Location Type of Work Project Manager Contact Dated Completed Name (Firm/Agency) Address Project Title Project Location Type of Work Project Manager Contact Dated Completed Phone Contract Amount Phone Contract Amount Phone Contract Amount C-15 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CIP Project No. Z10030 CONTRACTOR INFORMATION CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 Contractor's License No.: 1004775 Class: CLASS a. Date first obtained: JUN-26-2015 Expiration b. Has Bidder's 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 NO JUN-30-2023 Principals in Company (List all — attach additional sheets if necessary): NAME TITLE LICENSE NO. (If Applicable) TAMER KHALIL PRESIDENT C-16 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B1620C5A CITY OF LAKE ELSINORE CIP Project No. Z10030 VIQLATIONS OF FEDERAL STATE OR LOCAL LAW CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 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 40 (circle one) Federal / State / Local (circle 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 N❑ (cit0e one) Code/Laws: Section/Article: If "yes," identify and describe, (including agency and status): 3. Has Bidder been "default terminated" by an owner (other than for convenience), or has a Surety completed a contract for Bidder within the last five (5) years? YES NO (circle one) If "yes,' ase explain: _ 4. Has Bidder been cited more than twice for failure to pay prevailing wages in the last five (5) years? YES NO (circle one) If "yes," ase explain: C-17 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CIP Project No. Z10030 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 therepf shall also constitute signature of this Certification. Al .. .. MARCH-22-2022 Signature Date TAMER KHALIL Print Name ANEEN CONSTRUCTION, INC Contractor Name C-18 PRESIDENT Title DocuSign Envelope ID: 01218C66BA-D163-4086-A2D13-5296131620C5A CITY OF LAKE ELSINORE CIP Project No. Z10030 DISQUALIFICATION OR DEBARMENT CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 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 0 (circle one) 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. MARCH-22-2022 Signatur Date TAMER KHALIL PRESIDENT Print Name Title ANEEN CONSTRUCTION, INC. Contractor Name If the Bidder fails to properly sign or omits the required signature, the bid will be considered non -responsive and will be rejected. C-19 DocuSign Envelope ID: 0 BBC B6BA-D 1 63-4086-A2 DB-5296B 1 62005A CITY OF LAKE ELSINORE CIP Project No. Z10030 UTILITY AGREEMENT CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 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. Z10030, CAMINO DEL NORTE GUARDRAIL PROJECT, (1) (we) (it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary, primary or transmission facilities. The term "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. )k"� Signature By. TAMER KHALIL Name PRESIDENT Title ANEEN CONSTRUCTION, INC Contractor Name C-20 DocuSign Envelope ID: OB8CB6BA-D163-4086-A2DB-5296B162005A CITY OF LAKE ELSINORE CIP Project No. Z10030 PUBLIC CONTRACT CODE CAMINO DEL NORTE GUARDRAIL PROJECT CIP PROJECT NO. Z10030 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 X 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 Questionnaire 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 Code 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 Contractor's failure to comply with an order of federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making aJalse certification may subject the certifier to criminal prosecution- ... 11.. MARCH-22-2022 Signature Date PRESIDENT TAMER KHALIL Print Name Title ANEEN CONSTRUCTION, INC Contractor Name C-21 DocuSign Envelope ID: OBBCB6BA-D163-4086-A2DB-5296B162005A ACaRl7Q, CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 4/16/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONIAU1 NAME: Chubb Customer Service Center KRAFT LAKE INSURANCE AGENCY INC A/C No EXt : 866-972-2727 A/C. No): ADDRESS: chubbcscLchubb.com PO BOX 1426 INSURER(S) AFFORDING COVERAGE NAIC # GRAND RAPIDS MI 49501 INSURER A : ACE Property And Casualty Insurance Company 20699 INSURED INSURER B ANEEN CONSTRUCTION INC. INSURER C : 9860 Indiana Ave Ste 18 INSURER D : INSURER E : RIVERSIDE CA 92503-0203 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE iINSD WVD POLICY NUMBER (MM/DD/YYYY) 1MM/DDIYYYY) LIMITS A A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE DKOCCUR SERCAD962083273N 06/11/2021 06/11/2022 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PEQLOC �OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 21000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS '.HIRED NON -OWNED AUTOS ONLY K AUTOS ONLY SERCAD962083273N 06/11/2021 06/11/2022 Ee accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X per acddent) $ Occurrence/Aggregate $ Inc] Win GL Limits UMBRELLA LIAB EXCESS LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DED I RETENTION $ $ NORKFRS COMPENSATION %NO EMPLOYERS' LIABILITY Y / N \NY PROPRIETOR/PARTNER/EXECUTIVE DFFICER/MEMBER EXCLUDED? ❑ Mandatory in NH) f yes, describe under DESCRIPTION OF OPERATIONS below N / A STATUTE I ER E L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies above. The insurance afforded by the policies described herein is subject to all terms, exclusions and conditions of such policies ER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Lake Elsinore ACCORDANCE WITH THE POLICY PROVISIONS. 130 south Main Street AUTHORIZED REPRESENTATIVE LaXe hismore, W&",O a Rvak,i,ek ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 0B8CB6BA-D163-4086-A2DB-5296B1620C5A ` AD DATE(YYYY) A r��CERTIFICATE OF LIABILITY INSURANCE o4/18/2022 2ozz THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: BIBERK PHONE 84472-0967 WC 203=654-3613 -4 P.O. Box 113247 EE-MAIL customersery ce@�biBERK.com N� Stamford, CT 06911 A INSURERS] AFFORDING COVERAGE INSURERA: Berkshire Hathaway Dlmd Insurance Company INSURER B: SUPA rleen Construction, Inc. INSURER C' INSURER D:- 9860 indiana ave 18 INSURER E: Riverside, CA 92503 INSURER F : rnvFaer_�c rI=PTIFIr`CTI= NIIMRFR• REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLI INSR TYPE OF INSURANCE ADDL S VDBRI POLICY NUMBER ill DICDY FF . mAlymCY EXP LIMITS I,iRINSID COMMERCIALGENERALLIABILITY EACH OCCURRENCE $ 0 CLAIMS -MADE El OCCUR SES!Ea o $ 0 MED PCP (Any oneperson) $ 0 PERSONAL & ADV INJURY $ 0 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 0 PRODUCTS - COMP/OP AGG $ 0 POLICY ❑ (BET ::1 LOC $ OTHER: AUTOMOBILE LIABILITY Ea act ccidED SINGLE LIMIT !Ea aent) $ _ BODILY INJURY (Per person) ANY AUTO $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPER-YDAMAGE Per a ciden $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION X PER OTH- A AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA N9WC562902 04/19/2022 04/19/2023 E.L EACH ACCIDENT $1 rOOO,OOO EL DISEASE- EA EMPLOYEE $1,000,000 EL DISEASE- POLICY LIMIT 1 000,000 $ r IF yes, describe under DESCRIPTION OF OPERATIONS below Professional Liability (Errors & Per Occurrence/ Omissions): Claims -Made I Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Contractor License #:1004775 Exclusions: Tamer Khalil; CERTIFICATE HOLDER CANCELLATION City of Lake Elsinore 130 S Main street Lake Elsinore, CA 92530 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J Ilk 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: OBBCB6BA-D163-4086-A2DB-5296B162005A BUSINESS LICENSE This business license is issued for revenue purposes only and does not grant authorization to operate a business, This business license is issued without verification that the holder is subject to or exempted from licensing by the state, county, federal government, or any other governmental agency. Business Name: ANEEN CONSTRUCTION, INC. Business Location: 9860 INDIANA AVE UNIT 18 RIVERSIDE, CA 92503-5515 Owner Name(s): ANEEN CONSTRUCTION, INC ANEEN CONSTRUCTION, INC 9860 INDIANA AVE UNIT 18 RIVERSIDE, CA 92503-5515 CITY OF LAKE ELSINORE Administrative Services - Licensing 130 South Main Street, Lake Elsinore, CA 92530 PH (951) 674-3124 BUSINESS LICENSE NO. 026788 Business Type: GENERAL ENGINEERING CONTRACTOR Issue Date: 4/15/2022 Expiration Date: 4/30/2023 Starting January 1, 2021, Assembly Bill 1607 requires the prevention of gender -based discrimination of business establishments A full notice is available in English or other languages by going to: https://www dca ca gov/publications/ TO BE POSTED IN A CONSPICUOUS PLACE THIS IS YOUR LICENSE • NOT TRANSFERABLE