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HomeMy WebLinkAboutVan Engineering PWCA City Park Improvements I & II CIP Z40037 08-12-2025_r Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Agreement No.Click or tap here to enter text. AGREEMENT FOR PUBLIC WORKS CONSTRUCTION Van Engineering, Inc. For the CIP PROJECT NO. Z40037 City Park Improvements I & II This Agreement for Public Works Construction ("Agreement") is made and entered into as of August 12, 2025, by and between the City of Lake Elsinore, a municipal corporation ("City") and Van Engineering, Inc. a corporation ("Contractor"). The City and Contractor, in consideratio 6e cif?he 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: CIP PROJECT NO. Z40037 The City-approved plans for the construction of the Project, which are incorporated herein by reference and prepared by Engineering Resources of Southern California, Inc. are identified as: City Park Parking Lot 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 five hundred twenty-six thousand two hundred ninety-two dollars ($526,292.00). 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 1 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 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 all work within 80working days from the date of commencement specified in the Notice to Proceed and shall complete all work within eighty (80) working days, 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 goed wo,,,kmanlike manner in strict accordance with the drawings, specifications and all provisions of th4 ,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 Director of Public Works, 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 Fifteen Hundred Dollars ($1,500) per calendar day, and that the Contractor will pay to the City, or City may retain from amounts otherwise payable to Contractor, such amount for each calendar day by which the Contractor fails to complete the work, including corrective items of work, under this Agreement within the time hereinabove specified and as adjusted by any changes to the work. 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 claims 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 Director of Public Works 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 2 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Documents. City and Contractor shall negotiate in good faith and as expeditiously as possible the appropriate adjustments for such changes. 5. Special Federal Requirements a. Contractor and Owner do hereby acknowledge that this project will be partially or fully funded with Community Development Block Grant (CDBG) funds [24 CFR 570] and is therefore subject to applicable Federal procurement, labor, environmental, equal opportunity, and other regulations. b. Contractor shall maintain and keep books and records on a current basis, recording all transactions pertaining to this agreement in a form in accordance with generally acceptable accounting principles. Said books and records shall be made available to the County, the State of California, the Federal government, and to any authorized representative thereof for the purposes of audit at all reasonable times and places. All such books and records shall be retained for such periods of time as required by law, provided, however, notwithstanding any shorter periods of retention, all books, records, and supporting detail shall be retained for a period of at least four (4) years after the expiration of the term of this Agreement. c. Contractor shall comply with the Davis-Bacon Fair Labor Stand^rd!�-- A.e# (40 USC a-276, a-5) and the implementation regulations thereof. Contractor corgl i y with the U.S. Department of Housing and Urban Development's Federal Laioor Stems rds Provisions (HUD 4010). d. Contractor acknowledges that work under this contract is subject to the payment of prevailing wages pursuant to Section 1770 and 1773 et seq. of the Labor Code of the State of California, the Director of Industrial Relations (State Prevailing Wages), and the U.S. Department of Housing and Urban Development's Federal Labor Standards Provisions (Davis-Bacon Act Prevailing Wages). The Contractor to whom the contract is awarded, and all subcontractors under him, shall pay the higher of the Federal or State prevailing wage rate for any given classification employed in the performance of this contract. e. Contractor acknowledges that the applicable Wage Determination for this project is: General Decision Number: CA20250025 Modification Number: 7 Date: 06/06/2025 6. Section 3 Compliance: The Contractor hereby acknowledges that this federally funded project is subject to Section 3 of the Housing and Urban Development Act of 1968 [12 U.S.C. 1701 u and 24 CFR Part 135] and agrees to the following: a. The work to be performed under this contract is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701 u (Section 3). The purpose of Section 3 is to ensure that employment and other economic opportunities generated by HUD assistance or HUD-assisted projects covered by Section 3, shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly persons who are recipients of HUD assistance for housing. 3 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 b. The parties to this contract agree to comply with HUD's regulations in 24 CFR Part 135, which implement Section 3. As evidenced by their execution of this contract, the parties to this contract certify that they are under no contractual or other impediment that would prevent them from complying with the Part 135 regulations. c. The contractor agrees to send to each labor organization or representative of workers with which the contractor has a collective bargaining agreement or other understanding, if any, a notice advising the labor organization or workers' representative of the contractor's commitments under this Section 3 clause, and will post copies of the notice in conspicuous places at the work site where both employees and applicants for training and employment positions can see the notice. The notice shall describe the Section 3 preference, shall set forth minimum number and job titles subject to hire, availability of apprenticeship and training positions, the qualifications for each; and the name and location of the person(s) taking applications for each of the positions; and the anticipated date the work shall begin. d. The contractor agrees to include this Section 3 clause in every subcontract subject to compliance with regulations in 24 CFR Part 135, and agrees to take appropriate action, as provided in an applicable provision of the subcontract or in this Section 3 clause, upon a finding that the subcontractor is in violation of the regulations in 24 CFR Part 135. The contractor will not subcontract with any subcontractor where the contractor has notice or knowledge that the subcontra.for has been found in violation of the regulations in 24 CFR Part 135. e. The contractor will certify that any vacant employment positions, including training positions, that are filled (1) after the contractor is selected but before the contract is executed, and (2) with persons other than those to whom the regulations of 24 CFR Part 135 require employment opportunities to be directed, were not filled to circumvent the contractor's obligations under 24 CFR Part 135. f. Noncompliance with HUD's regulations in 24 CFR Part 135 may result in sanctions, termination of this contract for default, and debarment or suspension from future HUD assisted contracts. g. With respect to work performed in connection with Section 3 covered Indian housing assist.��t ,:�, Section 7(b) of the Indian Self-Determination and Education Assistance Act (25 U-S3,C".. 450e) also applies to the work to be performed under this contract. Section 7(b) requires that to the greatest extent feasible (i) preference and opportunities for training and employment shall be given to Indians, and (ii) preference in the award of contracts and subcontracts shall be given to Indian organizations and Indian-owned Economic Enterprises. Parties to this contract that are subject to the provisions of Section 3 and Section 7(b) agree to comply with Section 3 to the maximum extent feasible, but not in derogation of compliance with Section7(b). 7. Additional Federal Requirements Whereas, the work under this Agreement is subject to applicable Federal, State, and local laws and regulations, including but not limited to the regulations pertaining to the Community Development Block Grant program (24 CFR Part 570) and 2 CFR Part 200. Contractor, sub-contractors, Consultants, and sub-consultants agree to comply with, and are subject to, all applicable requirements as follows: 4 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 a. Equal Employment Opportunity - Compliance with Executive Order 11246 of September 24, 1965, entitled "Equal Employment Opportunity", as amended by Executive Order 11375 of October 13, 1967, and as supplemented in Department of Labor regulations (41 CFR chapter 0 . The Contractor/Consultant will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. Contractor/Corr, vltant will ensure that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex or national origin. The Contractor/Consultant will take affirmative action to ensure that applicants are employed, and the employees are treated during employment, without regard to their race color, religion, sex, or national origin. Such actions shall include, but are not limited to, the following: employment, up-grading, demotion, or transfer; recruitment or recruitment advertising; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor/Consultant agrees to post in a conspicuous place, available to employees and applicants for employment, notices to be provided by the County setting forth the provisions of this non-discriminating clause. b. Copeland "Anti-Kickback" Act (18 U.S.C. 874 and 40 U.S.C. 276c: All contracts and utorants in excess of $2,000 for construction or repair awarded by recipients and subrecipients shall include a provision for compliance wits the Copeland "Anti-Kickback" Act (18 U.S.C. 874), as supplemented by Department of L.Slty�3 regulations (29 CFR part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that each contractor or subrecipient shall be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. The recipient shall report all suspected or reported violations to HUD. c. Davis-Bacon Act, as amended (40 U.S.C. 276a to a-7: When required by Federal program legislation, all construction contracts awarded by the recipients and subrecipients of more than $2000 shall include a provision for compliance with the Davis- Bacon Act (40 U.S.C. 276a to a-7) and as supplemented by Department of Labor regulations (29 CFR part 5, "Labor Standards Provisions Applicable to Contracts Governing Federally Financed and Assisted Construction"). Under this Act, contractors shall be required to pay wages to laborers and mechanics at a rate not less, tt`an the minimum wages specified in a wage determination made by the Secretary of t==7,bor. In addition, contractors shall be required to pay wages not less than once a week. The recipient shall place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation and the award of a contract shall be conditioned upon the acceptance of the wage determination. The recipient shall report all suspected or reported violations to HUD. d. Contract Work Hours and Safety Standards Act (40 U.S.C. 327 through 333: Where applicable, all contracts awarded by recipients in excess of $2000 for construction contracts and in excess of $2500 for other contracts that involve the employment of mechanics or laborers shall include a provision for compliance with Sections 102 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333), as supplemented by Department of Labor regulations (29 CFR part 5). Under Section 102 of the Act, each contractor shall be required to compute the wages of every mechanic and laborer on the basis of a standard workweek of 40 hours. Work in excess of the standard workweek is permissible provided that the worker is compensated at a rate of not less than 1 1/2 times the basic rate of pay for all hours worked in excess of 40 hours in the workweek. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not 5 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. e. Rights to Inventions Made Under a Contract or Agreement— Contracts of agreernents for the performance of experimental, developmental, or research work shall provide :`car the rights of the Federal Government and the recipient in arty resulting invem�.€cn in accordance with 37 CFR part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by HUD. f. Rights to Data and Copyrights — Contractors and consultants agree to comply with all applicable provisions pertaining to the use of data and copyrights pursuant to 48 CFR Part 27.4, Federal Acquisition Regulations (FAR). g. Clean Air Act (42 U.S.C. 7401 et seq.) and the Federal Water Pollution Control Act (33 U.S.C. 1251 et seq.), as amended Contracts and subgrants of amounts in excess of $100,000 shall contain a provision that requires the recipient to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401 et seq.) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251 et seq.). Violations shall be reported to HUD and the Regional Office of the Environmental Protection Agency (EPA). h. Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)— Contractors who apply or bid for an award of $100,000 or more shall file the required ce.,1i.kation. Ead tier certifies to the tier above that it will not and has not used Federal apprf.,rpriated ftnd to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier shall also disclose any lobbying with non- Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the recipient. i. Debarment and Suspension (E.O.s 12549 and 12689)—No contract shall be made to parties listed on the General Services Administration's List of Parties Excluded from Federal Procurement or Nonprocurement Programs in accordance with E.O.s 12549 and 12689, "Debarment and Suspension," as set forth at 24 CFR part 24. This list contains the names of parties debarred, suspended, or otherwise excluded by agencies, and contractors declared ineligible under statutory or regulatory authority other than E.O. 12549. Contractors with awards that exceed the small purchase threshold shall provide the required certification regarding its exclusion status and that of its principal employees. j. Drug-Free Workplace Requirements—The Drug-Free Workplace Act of 1988 (42 U.S.C. 701) requires grantees (including individuals) of federal agencies, as a prior condition of being awarded a grant, to certify that they will provide drug-free workplaces. Each potential recipient must certify that it will comply with drug-free workplace requirements in accordance with the Act awl v i h HUD's rules at 24 CFR part 24, subpart F. k. Access to Records and Records Retc�athart: +hc'!Consultant or Contractor, and any sub- consultants or sub-contractors, shaL �l.w. .zRt duly authorized Federal, State, and/or County officials or authorized representatives access to the work area, as well as all books, documents, materials, papers, and records of the Consultant or Contractor, and any sub-consultants or sub-contractors, that are directly pertinent to a specific program for the purpose of making audits, examinations, excerpts, and transcriptions. The 6 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Consultant or Contractor, and any sub-consultants or sub-contractors, further agree to maintain and keep such books, documents, materials, papers, and records, on -a current basis, recording all transactions pertaining to this agreement in a form in accordance with generally acceptable accounting principles. All such books and records shall De retained for such periods of time as required by law, provided, however, notwithstanding any shorter periods of retention, all books, records, and supporting detail shall be retained for a period of at least four (4) years after the expiration of the term of this Agreement. I. Federal Employee Benefit Clause: No member of or delegate to the congress of the United States, and no Resident Commissioner shall be admitted to any share or part of this agreement or to any benefit to arise from the same. m. Energy Efficiency: Mandatory standards and policies relating to energy efficiency which are contained in the State energy conservation plan issued in compliance with the E—nergy Policy and Conservation Act (Pub. L. 94A 163, 89 Stat. 871). n. Procurement of Recovered Materials (2 CFR 200.322.) A non-Federal entity that is a state agency or agency of a political subdivision of a state and its contractors must comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired by the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. 8., Ellonds. Contractor shall provide, before commencing work, a Faithful Performance Bond and a Lt-ib,,rw r 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. 9. 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. 10. Licenses. Contractor represents and warrants to City that it holds tie con"'Vactor's license or licenses set forth in the Project Documents, is registered with the Department sa& E'ndustrial Relations pursuant to Labor Code Section 1725.5 as of March 1, 2015, and holds sue< c-.41heri~ I;Mnryes, permits, qualifications, insurance and approvals of whatsoever nature which are legaiI rlNiuiiristdd 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. 11. Indemnity. Contractor shall indemnify, defend, and hold harmless the City and Riverside County and its officials, officers, employees, agents, 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 7 ?Do,usilpE velope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 ;-' law arises from the sole negligence or willful misconduct of the City or its officers, %­.ni-iyees, agents, or volunteers and (2) the actions of Contractor or amptoyees, subcontractor, or agents have contributed in no part to the injury, loss of life, damage, to t=rcps ly, or violation of law. It is understood that the duty of Contractor to indemnify and hold har Mass "Pa..,,hicles the duty to defend as set forth in Section 2778 of the California Civil Code. Acco tarvice by City of insurance certificates and endorsements required under this Agreement does not rz,-,-4iev�e 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. 12. Insurance Requirements. a. Insurance. Contractor, at Contractor's own cost and expense, shall procure and maintain, for the duration of the Agreement, unless modified by the City's Risk Manager, the following insurance policies. i. Workers' Compensation Coverage. Contractor shall maintain Workers' Compensation Insurance and Employer's Liability Insurance for his/her employees in accordance with the laws of the State of California. In addition, Contractor shall require each subcontractor to similarly maintain Workers' Compensation Insurance and Employer's Liability Insurance in accordance with the laws of the State of California for all of the subcontractor's employees. Any notice of cancellation or non-renewal of all Workers' Compensation policies must be received by the City at least thirty (30) days prior to such change. The insurer shall agree to waive all rights of subrogation against City, its officers, agents, employees and volunteers for losses arising from work performed by Contractor for City. In the event that Contractor is exempt from Worker's Compensation Insurance and Employer's Liability Insurance for his/her employees in accordance with the laws of the State of California, Contractor shall submit to the City a Certificate of Exemption from Workers Compensation Insurance in a form approved by the City Attorney. ii. 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 "piy separately to the work to be performed under this Agreement or the general aggregate %emit, :>,all be at least twice the required occurrence limit. Required commercial general liability ,n�le,s'age shall be at least as broad as Insurance Services Office Commercial General Liability occurr'ance form CG 0001 (ed. 11/88) or Insurance Services Office form number GL 0002 (ed. 017 333, 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. iv. Professional Liability Coverage [if applicable]. 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 8 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 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 liability and automobile liability policy shall be with insurers possessing a Best's rating of no less than A: VII and sh&6 ern em:�.lrsed with the following specific language: i. The City and Riverside County, its elected or appolml d 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 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. 13. 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. 14. If to City: City of Lake Elsinore with a copy to: City of Lake Elsinore Attn: City Manager Attn: City Clerk 130 South Main Street 130 South Main Street Lake Elsinore, CA 92530 Lake Elsinore, CA 92530 9 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 to Contractor: Van Engineering, Inc. Attn: Sara Sanders 36520 Villa Del Sol Wildomar, CA 92595 15. Entire Agreement. This Agreement constitutes the complete and exclusive statement of agreement betwe.-an, the City and Contractor. All prior written and oral communications, including correspondence,.d -:efts, memoranda, and representations, are superseded in total by thisAgreement. 16. 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. 17. Assignment and Subcontr&�_ry ," Contractor shall be fully responsible to City for all acts or omissions of any subcontractors. Assigni ne,its of any or all rights, duties or 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. 18. 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. 19. 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 torce and effect. 20. ControNng Law VenU_ Fhis 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 cG,"rtt in the County of Riverside. 21. Liti Galion Expenses and Attorneys' Fees. If either party to this Agreement commences any legal action again.4 the other pail's a°ls2Mg 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. 22. Mediation. The partieF= ��ree to make a good faith attempt to resolve any disputes arising out of this Agreement through me,,191hon prior to commencing litigation. The parties shall mutually agree upon the mediator and share the . of mediation equally. If the parties are unable to agree upon a mediator, the dispute shall be submitted to Jr4tv1S oir its successor in interest. JAMS shall provide the parties with the names of five qualified mediaro,a- . each party shall have the option to strike two of the five mediators selected by JAMS and thereafter ihe mediator remaining shall hear the dispute. If the dispute remains unresolved after mediation, either party may commence litigation. 23. 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 Director of Public Works shall act as the administrator on behalf of the City. 10 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 24. 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 sedum ttsl.4� Agreement. Further, Contractor warrants that it has not paid nor, has it agreed to pay any company a,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. 25. Equal Opportunity Employment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex or age. Such non-discrimination shall include, but not be limited to, all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination. :='revailinq 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. 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 Pnd 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 Lnereof, 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 E,-°~trvnic 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. 11 Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 e. Eight hours labor constitutes a legal day's work, as set forth in Labor Code Section 1810. 27. 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. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the date first written above. "CITY" "CONTRACTOR" CITY OF LAKE ELSINORE, a municipal Van Engineering, Inc. corporation DocuSigned by: Signed by: ,�asew �iw,psetn, 1Fs tF63E6FF41? Ity anager E0B7F2E761E44D2 By: Vincenzo Nanci Its: President ATTEST: —DocuSigned by: i �—City ldcr15C4L9 `derk APPROVED AS TO FORM: Signed by: -,- 1. F Signed by t��6A/W W v, Assistants ity Manager 12 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 ADDENDUM No. 2 City Park Parking Lot Notice Inviting BIDDER'S PROPOSAL CI- PROJECT NO. Z40037 CITY PARS, P, IRKING LOT AND ACCESS CITY OF LAKE ELSINORE 130 South Main Street Lake Elsinore, CA 92530 (951) 674-3124 June 9, 2025 The following changes and/or additions shall be made to the plans and/or specifications. All other requirements of the contract documents shall remain the same. The bidder shall acknowledge receipt of the addendum by inserting its number and date in the Bid Submittal. Revised Bidders Proposask Line Item 13 added: (Remove and replace existing manhole (Line 9 on sheet 4) Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 BIDDER'S PROPOSAL CIP PROJECT NO. Z40037 CITY PARK PARKING LOT AND ACCESS Van Engineering Inc Company: Honorable Mayor Members of the Council: In accordance with the Notice Inviting Bids pertaining to the submitting of sealed proposals in PlanetBids, 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: BID SCHEDULE A— Item Lump Sum Total Bid ($) No. Description Mobilization & Demobilization Including 1 Construction Schedules 1 $ 15,000.00 i 1 2 Performance Bonds ads Labor& Material Bonds $ 15,000.00 3 1 $ 60,129.00 Clear and grub site and haul off 4 1 $ 7500.00 Make site cuts and fills 1 5 10,000.00 6 Finish grade $1 Ex $ 5000.00 ;:Bvatf bio basin 7 � 1 $ 10,000.00 Install bio basin material and piping 8 Ecopure biofilter wetland, pump station 1 $ 175,000.00 9 Furnish and install asphalt & base material 1 $ 90,068.00 10 Strip control lines & parking stalls 1 $ 8000.00 11 Install retaining wall 1 $ . 24,600.00 Reconstructing an ADA accessible Sidewalk 1 $ 12 (observe on job walk) 83,995.00 Remove and replace existing manhole (Line 9 on 13 sheet 4) 1 $ 22,000.00 SCHEDULE A Total Bid: a 7_igures*) SCHEDULE A Total Bid:, Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 (Words*) GRAND Total (SCHEDULES A) Bid: Type text here (Figures*) GRAND Total (SCHEDULES A) Bid: Five hundred twenty six thousand two hundred ninety two dollars zero cents (Words*) *BID MAY BE REJECTED IF TOTAL IS NOT SHOWN FOR BOTH FIGURES AND WORDS. 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 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 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 Contract Documents 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 Specifications, and Contract Documents, and has investigated the site of the work and is familiar with the conditions thereon. Van Engineering Inc Date: 06-18-2025 By: Contractor Contractor's State License No.: 1102034 Class: A Address: 3F.521)^;,,a Del Sol, Wildomar CA 92595 Phone: 949-558-6186 FAX: Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 ACKNOWLEDGMENT OF ADDENDA RECEIVED CIP PROJECT NO. Z40037 CITY PARK PARKING LOT AND ACCESS The Bidder shall acknowledge the receipt of addenda by placing an "X" by each addendum received. Addendum No. 1 X Addendum No. 2 X Addendum No. 3 X x 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. 06-18-2025 Bidder's Signature Date Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 NON-COLLUSION AFFIDAVIT CIP PROJECT NO. Z40037 CITY PARK PARKING LOT AND ACCESS \N CtS ) STATE OF C IA SS COUNTY OF (NAME)vincenzo nanci Affiant being first duly sworn, deposes and says: That he or she is president of (Sole owner, partner or other proper title) Van Engineering 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. 36520 Villa Del Sol, Wildomar CA 92595 Telephone No.: 949-558-6186 Print Name:yin enzo nanci Signature: Title: president Date: SIGNING INSTRUCTIONS TO THE CONTRACTOR Non-Collusion Affidavit must be accompanied by notary certificates for signature. Note the description of the document on the notary certificate. Attach notary certificate immediately following this page. If the Bidder fails to properly sign or omits the required signature, the bid will be considered non-responsive and will be rejected. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 WASHINGTON NOTARY ACKNOWLEDGEMENT (REPRESENTATIVE) State of Washington County of S4tiunz- I certify that I know or have satisfactory evidence thaty14(enLo%, �4L a [Name of Person] is the person who appeared before me, and said person acknowledged that (h she) signed this instrument, on oath stated tha�e/she) was authorized to execute e instrument and acknowledged it as the21t%I [Type of Authority, e.g., officer, trustee, etc.] of 4 net Name of Party on Behalf of Whom Instrument was Executed] to be the free and volu ary act of such party for the uses and purposes mentioned in the instrument. Dated: lv 1'5'2-S Fcornrn!�ssiun RA D BLUM otary Public of Washington Signature (Sea[ or stamp) iVumbar22005104mmission Expires09129/2025 Title My appointment expires:to-2-19 • 7 S Copyright©2018 NotaryAcknowledgement.com.All Rights Reserved. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 BOND NO. N/A BIDDER'S BOND CIP PROJECT NO. Z40037 CITY PARK PARKING LOT AND ACCESS KNOW ALL MEN OR WOMEN BY THESE PRESENTS: That we Van Engineering, Inc. as PRINCIPAL, United Surety Insurance Company hereinafter referred to as "Contractor", and a duly authorized corporate as "Surety," are held and firmly bound unto the City of Lake Elsinore in the penal sum of TEN PERCENT (10%) OF THE TOTAL AMOUNT OF THE BID of the Contractor above named, submitted by said Contractor to the City of Lake Elsinore for the work for said project entitled above, for the payment of which sum in lawful money of the United States, well and truly to be made, to the City of Lake Elsinore to which said bid was submitted, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. In no case shall the liability of the surety hereunder exceed the amount of Ten Percent of Attached Bid(10%) THE CONDITION OF THIS OBLIGATION IS SUCH: That whereas the Contractor has submitted the above-mentioned Bid to the City of Lake Elsinore as aforesaid for the work for said project entitled above. NOW, THEREFORE, if the aforesaid Contractor is awarded the Contract and, within the time and manner required under the Contract documents, after the prescribed forms are presented to him or her for signature, enters into a written Agreement in the prescribed form and in accordance with the Contract documents, and files two bonds with the City of Lake Elsinore, one to guarantee faithful performance and the other to guarantee payment for labor and materials, in accordance with said Contract documents, and as required by law, and files the required insurance certificate(s) in accordance with said Contract documents, then this obligation shall be null and void; otherwise, it shall be and remain in full force and effect until execution of the Agreement or forfeiture pursuant to the Provisions of Sections 20172 and 20174 of the Public Contract Code. In the event suit is brought upon this bond by the City and judgment is recovered, the Surety shall pay all costs incurred by the City in such suit, including a reasonable attorney fee to be fixed by the court. (SIGNATURE PAGE FOLLOWS) Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 BIDDER'S BOND SIGNATURE PAGE CIP PROJECT NO. Z40037 CITY PARK PARKING LOT AND ACCESS IN WITNESS WHEREOF, we have hereunto set our hands and seals on this 18th day of June 2025 BIDDER: CORPORATE SURETY: Contractor Name: Van Engineering, Inc. Company Name: United Surety Insurance Company Address: Telephone No.: Telephone No.: Print Name: Ul�lc � Na�L,Q Print Name: Mark D. Leskanic Title: �l�-S{�2 Title: Attorney-in-Fact Signature: Signature: Date: �I 12� Date: June 18, 2025 SIGNING INSTRUCTIONS TO THE CONTRACTOR Bidder's Bond must be accompanied by notary certificates for EACH signature. Note the description of the document on the notary certificate. Attach BOTH notary certificates immediately following this page. Corporate Seal may be affixed hereto. The attorney-in-fact for corporate surety must be registered, as such, in at least one county in the State of California. Attach one original Power of Attorney immediately following the notary certificates. If the Bidder fails to properly sign or omits the required signatures, the bid will be considered non-responsive and will be rejected. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 ------------------------------------------------------------------------------------------------------------------ Surety Acknowledgment State of Massachusetts } } ss: County of Middlesex On this 1 Sth day of June, 2025, before me personally came Mark D. Leskanic to me known, who, being by me duly sworn, did depose and say that he/she is an attorney-in-fact of United Surety Insurance Company the corporation described in and which executed the within instrument; that he knows the corporate seal of said corporation; that the seal affixed to the within instrument is such corporate seal, and that he signed the said instrument and affixed the said seal as Attorney-in-Fact by authority of the Board of Directors of said corporation and by authority of this office under the Standing Resolutions thereof. My commission expires October 26, 2029 Notary Public y�.'y`� My CCr i��Ssion�xprtr=C-chuber 26,2029 1 Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 WASHINGTON NOTARY ACKNOWLEDGEMENT (REPRESENTATIVE) State of Washington County of l�l I certify that I know or have satisfactory evidence thatVI vm2-6 *(� [Name of Per n] is the person who appeared before me, and sad person acknowledged that (h she) signed this instrument, on oath stated that e/she) was authorized to execute e instrument and acknowledged it as the c5 [Type of Authority, e.g., officer, trustee, etc.] of V6rn LfV3r..m knA;Narne of Party on Behalf of Whom Instrument was Executed] to be the free and volun ary act of such party for the uses and purposes mentioned in the instrument. Dated: V 116 17:�- Fcommilssion ARAD BLUM Signature (Seal or stamp) Notary Public te o.Washington Number 22005104 ommission Expires 06129/2025 Title My appointment expires: �g 2 G • 7 Copyright©2018 NotaryAcknowledgement.com.All Rights Reserved. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 �4 ucs POWER OF ATTORNEY 171333 KNOW ALL MEN BY THESE PRESENTS:That United Casualty and Surety Insurance Company,a corporation of the State of Nebraska,and US Casualty and Surety Insurance Company and United Surety Insurance Company,assumed names of United Casualty and Surety Insurance Company(collectively,the Companies),do by these presents make,constitute and appoint: Mark D.Leskanic,Matthew Leskanic,Greg Angel,Colin Warner, Lauren Leskanic its true and lawful Attorney(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&00/100 Dollars ( $5,000,000.00 ). This Power of Attorney shall expire without further action on December 31",2026, This Power of Attorney is granted under and by authority of the following resolutions adopted by the Board of Directors of the Companies at a meeting duly called and held on the 1"day of July,1993: Resolved that the President,Treasurer,or Secretary be and they are hereby authorized and empowered to appoint Attorneys-in-Fact of the Company,in its name and as its acts to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances,contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company. Any such writings so executed by such Attorneys-in-Fact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected Officers of the Companyin their own proper persons. That the signature of any officer authorized by Resolutions of this Board and the Company seal may be affixed by facsimile to any power of attorney or special power of attorney or certification of either given for the execution of any bond,undertaking,recognizance or other written obligation in the nature thereof;such signature and seal, when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereunto affixed,this 14th day of January,2025 UNITED CASUALTY AND SURETY INSURANCE COMPANY US Casualty and Surety Insurance Company United Surety Insurance Company a ro lip•, Corporate Seals R.Kyle F ler,Treasurer Commonwealth of Massachusetts County of Suffolk ss: On this 14th day of January,2025 before me,Colleen A.Cochrane,a notary public,personally appeared,R.Kyle Fowler,Treasurer of United Casualty and Surety Insurance Company,US Casualty and Surety Insurance Company and United Surety Insurance Company,who proved tome 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(s),or the entity on behalf of which the person(s)acted,executed the instrument. I certify under PENALTY OF PERJURY under the laws of the Commonwealth of Massachusetts that the foregoing paragraph is true and correct. WITNESS my hand and seal. CODER LCOCHWE (Seal) IKc�'AaK;amtr�,Wey�,o►�rusac>w,;�m 14 Crntrvstior Et;•es W 203 otary Public Commis ion Expires:10/27/2028 I,Robert F.Thomas,President of United Casualty and Surety Insurance Company,US Casualty and Surety Insurance Company and United Surety 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 Board of Directors,set out in the Power of Attorney are in full force and effect. In Witness Whereof,I have hereunto set my hand and affixed the seals of said Companies at Boston,Massachusetts this 1 8th day of June 2025 Corporate Seals Robert F.Thomas,President r TO CONFN;MAUTHENTICITY OF THIS BOND OR DOCUMENT ENIAP.CONFIRMBOND@UNITEDCASUALTY.COM Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 United Casualty and Surety Insurance Company DBA United Surety Insurance Company DBA US Casualty and Surety Insurance Company Statement of Assets, Liabilities, and Surplus Year Ended December 31 Year Ended 2024 2023 Admitted Assets Cash and Short Term Investments $41,394,126 $36,321,994 Stocks 19,798,138 2,176,755 Bonds 4,936,241 6,738,979 Uncollected Premiums & Agents' Balance 3,880,950 2,272,570 Other Assets 780,356 2,402,610 Total Net Admitted Assets $70,789,811 $49,912,908 Liabilities Funds Held as Collateral $9,973,991 $14,101,531 Unearned Premium 10,494,364 8,098,812 Losses 2,879,260 1,919,898 Other Expenses 549,747 528,056 Taxes, Licenses, and Fees 208,961 147,927 Loss Adjustment Expenses 1,190,067 530,475 Payable to Parent or Affiliates 1,766,168 1,001,040 Ceded Reinsurance Payable 1,822,923 1,277,138 Other Liabilities 1,179,840 442,295 Total Liabilities $30,065,321 $28,047,172 Capital and Surplus Paid In Surplus $34,850,639 $17,364,311 Unassigned Surplus 3,378,106 2,005,680 Common Stock 2,600,000 2,600,000 Less:Treasury Stock 104,255 104,255 Total Capital and Surplus $40,724,490 $21,865,736 Total Liabilities and Capital and Surplus $70,789,811 $49,912,908 I, Raymond Kyle Fowler,Treasurer and Secretary of United Casualty and Surety Insurance Company, hereby certify that the above is an exact copy of the financial statements of the Company dated December 31, 2024 and is a true and correct statement of the condition of United Casualty and Surety Insurance Company as of that date. IN TESTIMONY WHEREOF, I have set my hand and affixed the seal of the Company this 7`' day of March 2025. By R. Kyle Fowler, Treasurer and Secretary Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 LIST OF SUBCONTRACTORS CIP PROJECT NO. Z40037 CITY PARK P **91bT AND ACCESS 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: Chrisp Company License Number: 374600 Address of Office, Mill or Shop: 2280 South Lilac Ave, Bloomington CA 92316 Specific Description of Sub-Contract: and Bid !+ems of Work: item 10 Name Under Which Subcontractor is Licensed: License Number: Address of Office, Mill or Shop: Specific Dese7iption c.1Sub-C-ontreact: and Bid Items of Name Und-ar- icf£ &ibcorttpaax?r its Licensed: f�' n se N um�ner: Address of O ine, mill x Shop'- -' Specific De:�,csipt on of ut.-Contract: and Bid Items of Work: Name Under Which Subcontractor is Licensed: License Number: Address of Office, Mill or Shop: Specific Description of Sub-Contract: and Bid Items of Work: Subcontractors listed in accordance with the provisions of Section 2-3 must be properly licensed under the laws of the State of California for the type of work that they are to perform. Do not list alternate subcontractors for the work. Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 REFERENCES CIP PROJECT NO. Z40037 CITY PARK PARKING LOT AND ACCESS Failure to demonstrate adequate experience may result in rejection of the bid. For all public agency projects with a similar scope of work which you have worked on (or are currently working on) in the past three (3) years, provide the following required information: 1. Name (Firm/Agency): City of Wildomar Address: 23873 Clinton Keith Rd suite 110 Wildomar ca 92595 Contact Person: Cameron Luna Telephone No.: 951-677-7751 Title of Project: Palomar street widenir q project Project Location: City of Wildomar Date of Completion: 2025 Contract Amount. 7,800,000.00 Name (r)MK/Agency): Town of Yucca Valley Address:: 56928 Business Center Drive Yuct_ia Vdley CA 92284 Contact Person: Alex Qishta Telephone No.: 750-3R?'9-0801 X 307 Title of Project: Old Town Beautification Project Project Location: yucca valley Date of Completion: 2025 Contract Amount: 3,100,000.00 3. Name (Firm/Agency): Palm Desert Address: 73510 Fred Waring Dr, Palm Desert CA 92260 Contact Person..: (,hris Gerry Telephone No.: 760-776-6335 Title of Project: Vilalia traffic signal Project Location: Palm Desert Date of Completion: 2G^5 Contract Amount: 220,000.00 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 4. Name (Firm/Agency): Address: Co.,t c- Person: Telephone No.: Title of Project: Project Location: Date of Completion: Contract Amount: 5. Name (Firm/Agency): Address: Contact 'elsan: Telephone No.: Tkle cif Project: Pr�jw 'Location: Date of Completion: Contract Amount: 6. Name (Firm/Agency): Address: Contact Person: Telephone No.: Title of Project: Project Location: Date of Completion: Contract Amount: (Firm/A�cmgj): Address: Contact Person: Telephone No.: Title of Project: Project Location: Date of Completion: Contract Amount: Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 List any other projects (private, older than three (3) years, etc.) that may represent qualifying similar experience: 1. Name (Firm/Agency): Address: Contact Person: Telephone No.: Title of Project: Project Location: Date of Completion: Contract Amount: 2. Name (Firm/Agency): Address: Contact Person: Telephone No.: Title of Project: Project Location: Date of Completion: Contract Amount: 3. Name (Firm/Agency): Address: Contact Person: Telephone No.: Title of Project: Project Location: Date of Completion: Contract Amount: Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 CONTRACTOR'S INFORMATION CIP PROJECT NO. Z40037 CITY PARK PARKING LOT AND ACCESS Contractor's License No.: 1102034 Class: A a. Date first obtained: 3-2-2023 Expiration 0( '026 b. Has License ever been suspended or revoked? no If yes, describe when and why: c. Any current claims against License or Bond? no If yes, describe claims: Principals in Company (List all — attach additional sheets if necessary): NAME TITLE LICENSE NO. (If Applicable) vincenzo nanci president Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 SPECIAL FEDERAL PROVISIONS DOCUMENT INDEX 526,292 General Information 1. General Summary 2. Hold Harmless Clause and Additional Insured-Insurance Requirements 3. B-1 Federal Labor Standards Provisions (HUD 4010) 4. B-2 Federal Prevailing Wage Decision (CA Mod. ) S. B-3 Project Sign (SAMPLE) 6. B-5 County of Riverside Section 3 Program Overview (Applicable for Projects$200,000 or more) 7. Additional Federal Requirements Bid Forms 8. B-4 Certification of Bidder Regarding Non-Segregated Facilities (Required for all Projects) 9. B-6 Section 3 Implementation Plan (Required for Projects $200,000 or more) 10. B-7 Certification for Section 3 Compliance (Required for Projects $200,000 or more) 11. B-8 Bidder's Certification on Federal Contract Requirements (Required for all Projects) 12. B-8 Questionnaire Regarding Bidders (Required for all Projects) 13. B-10 List of Subcontractors and Suppliers (Required for all Projects) Must be completed by all Subcontractors 14. B-6 Section 3 Implementation Plan (Required for Projects $200,000 or more) 15. B-7 Certification for Section 3 Compliance (Required for Projects $200,000 or more) Post-Award Forms 16. PA-1 Performance Bond (100% of contract price) (Required for Projects $200,000 or more) 17. PA-2 Payment Bond (Required for Projects $200,000 or more) 18. PA-3 Subcontractor Questionnaire (Required for all Projects) 19. PA-4 Subcontractor Certification Regarding Non-segregated Facilities (Required for all Projects) 20. PA-5 List of Permanent Employees/Section 3 Worker Employer Certification (Required for Projects $200,000 or more) 21. PA-6 Documentation of Qualitative Efforts (Required for Projects $200,000 or more) 22. PA-7 Davis-Bacon Classifications and Pay Rates (Required for all Projects) Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 EXHIBIT B-4 Required Bid Form CERTIFICATION OF BIDDER REGARDING NONSEGREGATEC= a ILITIES Project Name: CITY PARK PARKING LOT & ACCESS Z40037 Name of Bidder: V4 gineering Inc The above-named Bidder hereby certifies that: do not maintain or provide for my employees any segregated facilities at any of my establishments, and that I do not permit my employees to perform their services at any location, under my control, where segregated facilities are maintained. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, rest rooms, wash rooms, restaurants and other eating areas, time clocks, locker rooms or other dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, national origin, or bear sc of habits, local customs, or otherwise. further agree to obtain identical certifications from all proposed subcontractors prior to the award of subcontracts exceeding $10,000. � Signature: Name (Print): vincenzo nand Title: President Date: 06-18-2025 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 EXHIBIT B-5 COUNTY OF RIVERSIDE'S DEPARTMENT OF HOUSING AND WORKFORCE SOLUTIONS SECTION 3 PROGRAM OVERVIEW AND REQUIREMENTS The work to be performed under this contract is subject to the requirements of section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (section 3). The purpose of section 3 is to ensure that employment and other economic opportunities generated by HUD assistance or HUD-assisted projects covered by section 3, shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly persons who are recipients of HUD assistance for housing or residents of the community in which Federal assistance is spent. APPLICABILITY • Recipients and sub-recipients of Section 3 covered assistance, including contractors and subtonttactQrs that perform work on Section 3 covered contracts/projects, are required to comply �Vjth Section 3 requirements. • Section 3 requirements do not apply to contractors who furnish only materials or suppits�-s end do ttot undertake the installation of the materials or supplies. SECTION 3 GOALS Contracts over $200,000 trigger Section 3. When triggered, best efftbft i i made to extend Section 3 opportunities to verified Section 3 residents and business concerns to rYt� ti''�u 'sfe harbor benchmarks: 1. Twenty-five percent (25%) of the total hours on a Section 3 project must be worked by Section 3 workers; and 2.Five percent (5%)of the total hours on a Section 3 project must be worked by Targeted Section 3 workers. Contractors and subcontractors must make their best efforts to provide employment and training opportunities to Section 3 Workers and document such efforts to realize the Section 3 benchmarks. Contractors and subcontractors will be considered to have complied with Section 3, if they meet or exceed the Section 3 benchmarks, or certify that they have followed the prioritization of efforts in 24 CFR 75.9 and 24 CFR 75.19. SECTION 3 REQUIREMENTS FOR BIDDERS/PROPOSERS Section 3 Protect Implementation Plan I. Submittal of Section 3 Implementation Plan: Bidder/Proposer AND its first-tier subcontractor -, afe� `o submit a completed Section 3 Implementation Plan in bid. A "non-responsive" determination A,,Zt°L';>> made due to non-submittal. II. Submittal of Supporting Documentation: Bidder/Proposer AND its first-tier subcontractors whose Utilization Plans indicate no subcontract awards to certified Section 3 Business Concerns wilt be required to submit, upon request by HWS supporting documentation for review and approval verifying efforts to outreach to and award subcontracts to Section 3 Business Concerns. A "non-responsive" determination shall be made due to a lack of documented outreach to Section 3 Business Concerns by the /Propcy,,�., it-my be deemed "non-responsive" if Implementation Plan indicates the following: (1) Existing employees do not meet the definition of a Section 3 Worker; and (2) Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Bidder/Proposer does not agree to make a documented good faith effort to hire Section 3 Workers (when there is a need to hire new employees). SECTION 3 REQUIREMENTS FOR AWARDEES Section 3 Contract Language All Section 3 covered contracts and subcont.raCt�r'sl931t f^_1(i.Uving language: I. The work to be performed under this li? a j wt. otho irt�quirements of Section 3 of the Housing and Urban Development Act of 1968, ac am 22" (Section 3). The purpose of Section 3 is to ensure that employment and other s_coviii'n'it generated by HUD assistance, or HUD- assisted projects covered by SectiorI feasible be directed to low and very low-income persons, particularly per;.ain°a : al sire HUD assistance for housing. II.The parties to this contract agree to c pl! Mtti F;AYs rq,p ^ .tions in 24 CFR part 75, which implement Section 3. As evidenced by their e:xr!,_- ,',zm o i`is r_ontL*ar3, zhe parties to this contract certify that they are under no contractual or other impediment that would prevent them from complying with the part 75 regulations. III. The contractor agrees to send to each labor organization or representative of workers with which the contractor has a collective bargaining agreement or other understanding, if any, a notice advising the labor organization or workers' representative of the contractor's commitments under this Section 3 Clause and will post copies of the notice in conspicuous places at the work site where both employees and applicants for training and employment positions can see the notice. The notice shall describe the Section 3 preference, shall set forth minimum numb^r. a.nd job titles subject to hire,, >?L,ailab lity �)f apprenticeship and training positions, the qualifications'; s`: ach; the name and location of the taking applications for each of the positions; and the anL i'rsa+Q1d date the work shall begin. _ A- IV. The contractor agrees to include this Section 3 Clause in every subcontract subject to coeva;l� tce > � regulations in 24 CFR part 75, and agrees to take appropriate actions, as provided ii; an afp[cca e provision of the subcontract or in this Section 3 Clause, upon a finding that the subcontr�ctvir Its in violation of the regulations in 24 CFR part 75. The contractor will not subcontract with arnzr svtc,tNrri:r:,�cti-,.= where the contractor has notice or knowledge that the subcontractor has been found in 1t-ne regulations in 24 CFR part 75. V.The contractor will certify that any vacant employment positions, including training positions, that are filled (1) after the contractor is selected but before the contract is executed, and (2) with persons other than those to whom the regulations of 24 CFR part 75 require employment opportunities to be directed, were not filled to circumvent the contractor's obligations under 24 CFR part 75. VI. Noncompliance with HUD's regulations in 24 CFR part 75 may result in sanctions, termination of this contract for default, and debarment or suspension from future HUD assisted contracts. VI I. With respect to work performed in connection with Section 3 covered Indian housing assistance, section 7(b) of the Indian Self-Determination and Education Assistance Act (25 USC 450e) also applies to the work to be performed under this contract. Section 7(b) requires that to the greatest extent feasible (i) preference and opportunities for training and employment shall be given to Indians and (ii) preference in the award of contracts and subcontracts shall be given to Indian organizations and Indian-owned Economic Enterprises. Parties to this contract that are subject to the prow—lions of Section 3 and section 7(b) agree to comply with Section 3 to the maximum extent feasible, but �►st in derogation of compliance with section 7(b). Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Section 3 Quarterly La`: e + urs Report Contractors and subcontractors are to m*e g?ood faith assessments of employees' labor hours on Section 3 covered contracts/projects for the following.. • Total labor hours worked by all employees (excludes the total labor hours from professional services) • Total labor hours worked by Section 3 Workers • Total labor hours worked by Targeted Section 3 Workers Cvn4e' actors and subcontractors are to report their good faith assessments of labor hours on the Section 3 Q>arre,'ly Labor Hours Report. Exception: Contractors and subcontractors whose contracts are subject to prevailing wage laws are to submit their weekly certified payroll reports, instead of the Section 3 Quarterly Labor Hours Report. Compliance Monitoring Section 3 compliance monitoring will be performed by HWS Section 3/EOC Unit. Contractors and subcontractors who submitted approved Utilization Plans shall maintain their approved percentages of Section 3 participation throughout the term of the contract/project. Contractors and/or subcontractors whose Utilization Plans projected no new hires must, to the greatest extent feasible, hire certified Section 3 Workers or Targeted Section 3 Workers,when the need to hire occurs. FREQUENCY OF MONITORING 1+ 1 g EFC33T sg.19tion Contract Award/ Monthly C4apletion Negotiation Construction and::N.9atirtic,�,rea;ic-A s),)bject to prevailinFwage, X X X Non-Constructions(<-s rn.00th5 plUformance) X I X Non-Construction(>3 months'performance) X X X Noncompliance with HUD's regulations in 24CFR75 may result in sanctions, termination of contract for default, and debarment or suspension from future HUD-assisted contracts. Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 EXHIBIT B-6 Required Bid Norm General Submittal Instructions: Bidder/Proposer AND its first-tier subcontractors are to submit a completed Section 3 Implementation Plan(s) in bid. If not,A "non-responsive" determination may be made due to non-submittal. Project Information: Project Name: Bid/Solicitation #: CITY PARK PARKING LOT & ACCESS Z40037 ®Contractor ❑ Subcontractor Information Company Name: Address: Van Engineering Inc Authorized Representative: Title: vincenzo nanci president Phone: Ern?il: Proposed Dollar Value of Contract or Subcontract: List if ELBE, DBE, DVBE, MBE, SB, SLBE o ,' 11 t-.1gJA"if non-applicable): Section 3 Requirements Employment and Training To the greatest extent feasible, employment ar;d training c,pportunities arising in connection with Section 3 projects shall be provided to Section 3 workers within the County of Riverside. Where feasible, priority for employment and training will be given to: 1. Section 3 workers residing within the service area or neighborhood of the project, and 2. Participants in Youth Build programs. Contracting To the greatest extent feasible, work contracts awarded in connection with Section 3 projects shall be provided to business concerns that provide economic opportunities to Section 3 workers residing within the County of Riverside. Where feasible, priority for contracting opportunities will be given to: 1. Section 3 business concerns that provide economic opportunities to Section 3 workers residing within the service area or the neighborhood of the project, and 2. Youth Build programs. Compliance Benchmarks To demonstrate compliance with Section 3, contractors are required to follow the prioritization of effort outlined above and meet or exceed the following safe harbor benchmarks: 1. 25 percent or more of the total number of labor hours worked by all workers on the project shall be performed by Section 3 workers, and 2. 5 percent or tTi+~•rn of the total number of labor hours worked by all workers on the project shall be perfcn-rf pci by Targeted Section 3 workers. Definitions • Section 3 worker: Any worker who currently fits or when hired within the past three years fits at least one of the following categories, as documented: Docusign Envelope ID:D42068FF-8AFF-4160-A2A9-F10EE7D29DA2 EX!lIIII I B-6 (Continued) (1) The worker's income for the previous or annualized calendar year is below the income limit established by HUD (see Income Limits table below). (2) The worker is employed by a Section 3 business concern. (3) The worker is a Youth Build participant. • Targeted Section 3 worker: A Section 3 worker who is: (1) A worker employed by a Section 3 business concern; or (2) A worker who currently fits or when hired within the past three years fit at least one of the following categories, as documented: (i) Living within the service area or the neighborhood of the project; or (ii) A Youth Build participant. •Service area or the neighborhood of the project: An area within one mile of the Section 3 project or, if fewer than 5,000 people live within one mile of a Section 3 project, within a circle centered on the Section 3 project that is sufficient to encompass a population of 5,000 people according to the most recent U.S. Census. HUD Income Limits The table below shows the income limits set by HUD that determine eligibility for certain programs, including Section 3. HUD develops income limits based on Area Median Income (AMI) estimates and Fair Market Rent (FMR) area definitions. For more information, please see the HUD Income Limits Documentation System online at www.huduser.gov/portal/datasets/il.html. Riverside County, CA MSA Fiscal Year 2023 2022 2021 Low-income (80% AM I) $52,000 $49,300 44,250 1. Does your business qualify as a Section 3 business concern? YES ® NO If you answered YES, complete the attached Section 3 Business Concern Form (Pg. 6), and submit with this Plan. A Section 3 business concern is a business that satisfies at least one of the following criteria, as documented within the last six-month period: a. The business is at least 51% owned and controlled by low-or very low-income persons; b. The business is at least 51% owned and controlled by residents who currently live in public housing or Section 8-assisted housing; or c. Over 75% of the labor hours performed for the business over the prior three-month period were performed by Section 3 workers — i.e., workers who currently are, or when hired within the past three years were: (i) low-income persons or (ii) Youth Build participants. 2. Do you have current employees whose annual income is below the income limit? See HUD Income Limits table. ❑ YES ® NO If"YES," prior to contract execution,the names of qualifying employees shall be provided to HWS. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 EXHIBIT B-6 (Continued) 3. Do you plan to hire new employees to perform on or support the contract, if a..__ contract? ❑ YES ® NO If"YES," at a minimum, you must contact the HWS Section 3 Unit at RivCoCDBG(cl)rivco.ork to obtain examples of qualitative efforts to create employment. 4. Do you agree that when there is a need to hire new employees, a documented good faith effort shall be made to hire Section 3 Workers? ® YES❑ NO Implementation Plans that indicate a "No" response for question #4 may be deemed "non-responsive." 5. How many workers are needed to complete the project? Please list the job classifications and number of workers your company will need to complete the contract work.Attach additional sheets if necessary. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Job classification Total estimated Number of Estimated (Office/Clerical, Manager, Engineer, number of workers in current number of Technician,Supervisor/Foreman, Electrician, Plumber, Laborer,Trainee, workers needed workforce additional Security, etc.) workers needed laborer 8 � 20 0 Cement mason 6 15 0 Operator 2 4 0 EXHIBIT B-6 (Continued) 8. Will you be using subcontractors on this project? ® YES ❑ NO If "Yes", Bidder/Proposer is required, to the greatest extent feasible, to outreach to and award subcontracts to Section 3 Business Concerns. AT A MINIMUM, YOU MUST, CONTACT THE HWS SECTION 3/EOC UNIT AT RivCoCDBG@rivco.org OR GO TO https://rivcoeda.org/Departments/Housing/ Community-Development-BlockGrant/CommunityDevelopment/Section-3-Program TO OBTAIN "Examples of Efforts to Create Employment and Contracting Opportunities." Section 3 Business Concerns must complete the Section 3 Business Concern Form and must be certified by HWS. For ELBE, SLBE, SB, DBE, MBE, WBE or DVBE firms, please attach a copy of their certification(s). List ALL proposed subcontractors (including subconsultants) for this project on the table below. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Scope of work (trade or Section 3Estimated contract Business name business? service description) Yes/No value Chrisp Company striping no $6600.00 S $ $ $ 4. Do you commit to engage in good faith efforts to meet or exceed the Section 3 Benchmarks? ® YES ❑ NO Such qualitative efforts may include, but are not limited to: • Applicant Outreach— EXHIBIT B-6 • Engage in outreach efforts to generate job applicants who are Target (Continued) including posting job openings at the job site, HUD Opportunity Portal, social media pages, and other platforms. • Clearly indicate Section 3 eligibility on all job postings, notifications, and advertisements with the following statement: "This is a Section 3 eligible job opportunity. We encourage applications from individuals that are low-income, live in public housing, and/or receive a Section 8 voucher." • Include the Section 3 Worker Self-Certification form in all job postings. • One-Stop / Youth Build Outreach — Engage in outreach or referrals with local YouthBuild programs, or other community organizations to assist with training and recruiting Section 3 and Targeted Section 3 workers. • Training and Apprenticeship— Provide training or apprenticeship opportunities. Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 • Job Fairs— Hold one or more job fairs or sponsor a job informational meeting in the project area. • Business Concern Outreach— • Engage in outreach efforts to identify and secure bids from Section 3 businesses by advertising notices of contracting opportunities and related information in local community papers. ■ Provide written notice t-D all known Section 3 business concerns, with sufficient time for interested businessest_o respond to bid invitations. • Ze31d ettt?cG of iontractiv- opportunities to local community development organizations, business deveiapme:nt organizations, or minority contracting associations. • rtatp clearly in all rtoaces that the contracting opportunity is Section 3 eligible and include a copy of the Section 3 Business Concern Certification form. • Com Ctt cep A s's Ianr -- Provide technical assistance to help Section 3 business concerns understand and bid on contracts. • Contract Sizing — Size, split, or divide contracts into smaller jobs to f:: 'h '' ;, ' participation by Section 3 business concerns, particularly where ecori.o trees of scale or efficiency of delivery are not factors. [2 CFR 200.321(b)(3)] • Bidder Viability Support — Provide bonding assistance, guaranties, or other efforts to support viable bids from Section 3 business concerns. • Business Registries— Promote the use of business registries designed to create opportunities for disadvantaged and small businesses. Additional activities and efforts aimed at increasing economic opportunities for Section 3 workers and businesses may include, but are not limited to: • Employment Assistance — Provide technical assistance to help Section 3 workers compete for jobs, or connect them with assistance in seeking employment, including resume assistance, interview preparation, coaching, or job placement services. • Work Readiness and Retention — Provide or refer Section 3 workers to services supporting work readiness and retention, such as interview clothing, licensing or testing fees, transportation, or childcare. • Financial Literacy— Help Section 3 workers obtain financial literacy training or coaching. • Education Assistance — Assist Section 3 workers to apply for or attend community college, four- year educational institution, or vocational/technical training. 5. Do you commit to prioritize your efforts in hiring, training, and contracting as required by the Section 3 regulations and outlined on page 1 of this Plan? ® YES ❑ NO Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 SECTION 3 BUSINESS CONCERN FORM Please complete this form to determine if your business may qualify as a Section 3 Business. Businesses that qualify will be contacted by HWS Section 3 Coordinator to complete a Section 3 Business Application and asked to provide additional documentation to verify their status as a Section 3 Business. What is Section 3? Section 3 is a provision of the Housing and Urban Development Act of 1968 (24 CFR Part 75) that requires recipients of certain HUD financial assistance, to the greatest extent possible, to provide job training, employment, and contract opportunities for low- or very low-income residents in connection with projects and activities in their neighborhood. A business can qualify as Section 3 if it meets one of the following criteria: A. It is at least 51% owned and controlled by low-or very low-income persons; B. Over 75% of the labor hours performed for the business over the past three-month period were performed by workers who met at least one of the criteria below; or C. It is at least 51% owned and controlled by current public housing residents or residents who currently live in Section 8-assisted housing. Workers must meet one of the following criteria for a business to qualify as Section 3 under item B above: • Reside within one mile of the Section 3 project (or, if fewer than 5,000 people live within one mile of the Section 3 project, within a circle centered on the Section 3 project that is sufficient to encompass a population of 5,000 people according to the most recent U.S. Census); • Be a HUD Youth Build participant; or • Income for the previous or annualized calendar year is below 80%of the current area median income for the area in which the worker resides. (Use the worker's annual gross income based on AMI for a single-person household.) HUD income limits can be found at https://www.huduser.gov/portal/datasets/ii.html.) Company Name:Van Engineering Inc Contact Person:vincenzo nand Address: City: Wildomar State: CA Zip: 92595 Phone: Email: ❑ I have reviewed the above information and my business MAY QUALIFY as a Section 3 Business. Please contact me about completing an application and certification. 6-18-2025 Signature of Business Owner Date EXIT I BIT B-7 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Required Bid Form Certification for Secti��w,-,, fompliance (Required for Bidder and-' " � contractors) Project Information: Project Name:CITY PARK PARKING LOT & ACCESS Bid/Solicitation #: Z40037 Contractor/Subcontractor Infr =- Company Name: r= Address: Van Engin Authorized Representative: Title: Vincenzo nanci p_r.? ent Phone: Email: a ; i.By completing and signing this form, I agree to comply with all applicable requirements of SVL1 'qn-"' oe Housing and Urban Development Act of 1968 (24 CFR Part 7S) and HWS' Section 3 requiretrfertt' INITIAL HIRE 11.1 understand that "to the greatest extent feasible," work contracts awarded in connection with Secfio`n 3 projects shall be provided to business concerns that provide economic opportunities to Section 3 workers following the prioritization efforts outlined in Section 3 regulation. lt— � INITIAL HERE 111.1 understand that in the event any new employment opportunities are created as a result of this CDBG- funded project then "to the greatest extent feasible" employment and training opportunities shall be provided to Section 3 workers following the prioritization efforts outlined in Section 3 regulation o. INITIAL HERE IV.I understand the safe harbor benchmarks for Section 3 compliance and that if these benchmarks are not met the contractor will be required to report on the qualitative efforts made to meet the benchmarks. INITIAL HERE1� V.I understard &:1* 44.be required to make good faith assessments of employee labor hours on Section 3 covered, submit quarterly and final Section 3 reports and supporting documentation. INITIAL HERE �� V1.1 understat.,.. :-1 od all sub-contracts and sub-tier agreements resulting from this CDBG-funded project are also subfeci lci'Section 3 compliance and that it will be the General/Prime Contractor's responsibility to ensure compliance from all subcontractors. INITIAL HERE U VII. rstand that noncompliance with HUD's regulations in 24 CFR Part 75 may result in sanctions, ation of contract for default, and debarment or suspension from future HUD-assisted contracts. INITIAL HERE I declare that all statements contained in this form and any accompanying documents are true and correct and made with full knowledge that all statements given are subject to investigation and that any false or dishonest answer to any question may be grounds for denial or revocation of funding or other penalties as prescribedunder 18 U.S. Code§1001. Vincenzo nanci Van Engineering Inc Name of President or Authorized Officer Company Name president 6-18-2025 and Title Date EXHIBIT B-8 .Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Required Bid Form BIDDER CERTIFICATION ON T I?RnTITTlFIIi/FNTC Project Name: v `;l '` �i;?K PARKIN-ID SOT & ACCESS Bid/Solicitation #: Z40037 CERTIFICATION: I hereby certify tsar g have ro.viewed anti understand the diversified Federal construction contract- related requirements imposed on, the Contractor(s) of HUD-funded construction projects, including but not limited to the foiln°v>ing, 1. The subject project is being financed with Community Development Block Grant funds (24 CFR Part 570); and 2. This project and all relateT_A :,:.,�:;truction contracts are subject to the U.S. Department of Housing and Urban Development's Federal Labor Standards Provisions (HUD 4010 — revised 10/2023); and 3. This project is subject to all applicable laws and regulations as listed in the General Summary of these Special Federal Provisions; and 4. If my bid is $200,000 or more, this project and all related contracts will be subject to Section 3 requirements (12 U.S.C.1701u); and 5. If the project is $250,000 or more, this project and all related contracts will be subject to comply with the requirements of the Build America, Buy America (BABA) Act (41 USC 8301). CONTRACTOR'S, `:ANTE: 'fan Engineering Inc CONTRACTOR'S LICENSE NO.: 1102034 ADDRESS: AUTHORIZED REPRESENTATIVE: vincenzo nanci (Print Name) SIGNATURE: DATE: 06-18-2025 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 EXHIBIT B-9 Required Bid Form QUESTIONNAIRE REGARDING BIDDERS Bidder has been engaged in the contracting business under the present name of Van Engineering Inc , since 03/02/2023 (Date). Present business address is: Federal Tax ID: 84-3232610 Amount of Bid $ California Contractor's License No.: 1102034 Expiration Date: 06-30-2026 UEI Number: H5D9C7MDNCX1 or CAGE Code: OP2Q3 Because this project is Federally fund€-cf, it is necessary to obtain information concerning minority and other group partic�'*paton fm statistical purposes. The U.S. Department of Housing and Urban Development (HUD) uses this information to determine the degree to which its programs are being utilized by minority business enterprises and targeted group contractors. A minority enterprise is defined by the Federal Government as a business that is fifty-one percent (51%) or more "minority-owned". Please check the applicable box concerning the ownership of your business: ❑ American Indian or Native Alaskan ❑ Asian or Pacific Islander/Native Hawaiian ❑ Black/African American ❑ Hispanic ® White ❑ Hasidic Jews ❑ Other A woman-owned enterprise is defined by the Federal Government as a business That is fifty- one percent (51%) or more woman-owned. Please check appiic:ab e box concerning the ownership of your business: ❑ Woman/Female owned ® Male owned A Section 3 Contractor or Subcontractor is a business concern that rs: aq ,,e tartan fifty-one per<�,ent (51%) owned by a low or very low-income person, or over 75 percent of the labor hoLirs performed for the business over the prior three-month period are performed by Section 3 workers. Please check the applicable box concerning the ownership of your business: ❑ Section 3 Business concern ® Non-Section 3 Business concern The United States Department of Ht using and Urban Dtm54.anent (HUD) is authorized to solicit the information requested in this form by virtue of "title 12, United States Code, Section 1701 et seq., and other regulations. It will not be disclosed or released outside of HUD without your consent, except as required or permitted by law. Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 EX1111311' 13-III Required Bid Form 900.1.1.1.1.1.1.1 LIST OF SUBCONTRACTORS SUBCONTRACTOR FED. I.D.# AMOUNT ADDRESS/PHONE NO. Chrisp Company 6600.00 2280 South Lilac Ave, Bloomington CA SUPPLIERS NAME OF SUPPLIER ADDRESS/PHONE NO. CONTRACT ANII,�UNT Robertsons Ready Mix P.O. Box 3600, Corona, CA 92878 <yt € = 50,000 Core and Main 3155 Indian Ave, Perris, CA 92571 �Approx 105,000.00 If the project is$250,000 or more, this project and all related contracts will be subject to comply with the requirements of the Build America, Buy America (BABA)Act(41 USC 8301). This form is to be completed and submitted with the bid package. Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 EXHIBIT B-5 COUNTY OF RIVERSIDE'S DEPARTMENT OF HOUSING AND WORKFORCE SOLUTIONS SECTION 3 PROGRAM OVERVIEW AND REQUIREMENTS The work to be performed under this contract is subject to the requirements of section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (section 3). The purpose of section 3 is to ensure that employment and other economic opportunities generated by HUD assistance or HUD-assisted projects covered by section 3, shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly persons who are recipients of HUD assistance for housing or residents of the community in which Federal assistance is spent. APPLICABILITY • Recipients and sub-recipients of Section 3 covered assistance, including contractors and subtonttactQrs that perform work on Section 3 covered contracts/projects, are required to comply �Vjth Section 3 requirements. • Section 3 requirements do not apply to contractors who furnish only materials or suppits�-s end do ttot undertake the installation of the materials or supplies. SECTION 3 GOALS Contracts over $200,000 trigger Section 3. When triggered, best efftbft i i made to extend Section 3 opportunities to verified Section 3 residents and business concerns to rYt� ti''�u 'sfe harbor benchmarks: 1. Twenty-five percent (25%) of the total hours on a Section 3 project must be worked by Section 3 workers; and 2.Five percent (5%)of the total hours on a Section 3 project must be worked by Targeted Section 3 workers. Contractors and subcontractors must make their best efforts to provide employment and training opportunities to Section 3 Workers and document such efforts to realize the Section 3 benchmarks. Contractors and subcontractors will be considered to have complied with Section 3, if they meet or exceed the Section 3 benchmarks, or certify that they have followed the prioritization of efforts in 24 CFR 75.9 and 24 CFR 75.19. SECTION 3 REQUIREMENTS FOR BIDDERS/PROPOSERS Section 3 Protect Implementation Plan I. Submittal of Section 3 Implementation Plan: Bidder/Proposer AND its first-tier subcontractor -, afe� `o submit a completed Section 3 Implementation Plan in bid. A "non-responsive" determination A,,Zt°L';>> made due to non-submittal. II. Submittal of Supporting Documentation: Bidder/Proposer AND its first-tier subcontractors whose Utilization Plans indicate no subcontract awards to certified Section 3 Business Concerns wilt be required to submit, upon request by HWS supporting documentation for review and approval verifying efforts to outreach to and award subcontracts to Section 3 Business Concerns. A "non-responsive" determination shall be made due to a lack of documented outreach to Section 3 Business Concerns by the /Propcy,,�., it-my be deemed "non-responsive" if Implementation Plan indicates the following: (1) Existing employees do not meet the definition of a Section 3 Worker; and (2) Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Bidder/Proposer does not agree to make a documented good faith effort to hire Section 3 Workers (when there is a need to hire new employees). SECTION 3 REQUIREMENTS FOR AWARDEES Section 3 Contract Language All Section 3 covered contracts and subcont.raCt�r'sl931t f^_1(i.Uving language: I. The work to be performed under this li? a j wt. otho irt�quirements of Section 3 of the Housing and Urban Development Act of 1968, ac am 22" (Section 3). The purpose of Section 3 is to ensure that employment and other s_coviii'n'it generated by HUD assistance, or HUD- assisted projects covered by SectiorI feasible be directed to low and very low-income persons, particularly per;.ain°a : al sire HUD assistance for housing. II.The parties to this contract agree to c pl! Mtti F;AYs rq,p ^ .tions in 24 CFR part 75, which implement Section 3. As evidenced by their e:xr!,_- ,',zm o i`is r_ontL*ar3, zhe parties to this contract certify that they are under no contractual or other impediment that would prevent them from complying with the part 75 regulations. III. The contractor agrees to send to each labor organization or representative of workers with which the contractor has a collective bargaining agreement or other understanding, if any, a notice advising the labor organization or workers' representative of the contractor's commitments under this Section 3 Clause and will post copies of the notice in conspicuous places at the work site where both employees and applicants for training and employment positions can see the notice. The notice shall describe the Section 3 preference, shall set forth minimum numb^r. a.nd job titles subject to hire,, >?L,ailab lity �)f apprenticeship and training positions, the qualifications'; s`: ach; the name and location of the taking applications for each of the positions; and the anL i'rsa+Q1d date the work shall begin. _ A- IV. The contractor agrees to include this Section 3 Clause in every subcontract subject to coeva;l� tce > � regulations in 24 CFR part 75, and agrees to take appropriate actions, as provided ii; an afp[cca e provision of the subcontract or in this Section 3 Clause, upon a finding that the subcontr�ctvir Its in violation of the regulations in 24 CFR part 75. The contractor will not subcontract with arnzr svtc,tNrri:r:,�cti-,.= where the contractor has notice or knowledge that the subcontractor has been found in 1t-ne regulations in 24 CFR part 75. V.The contractor will certify that any vacant employment positions, including training positions, that are filled (1) after the contractor is selected but before the contract is executed, and (2) with persons other than those to whom the regulations of 24 CFR part 75 require employment opportunities to be directed, were not filled to circumvent the contractor's obligations under 24 CFR part 75. VI. Noncompliance with HUD's regulations in 24 CFR part 75 may result in sanctions, termination of this contract for default, and debarment or suspension from future HUD assisted contracts. VI I. With respect to work performed in connection with Section 3 covered Indian housing assistance, section 7(b) of the Indian Self-Determination and Education Assistance Act (25 USC 450e) also applies to the work to be performed under this contract. Section 7(b) requires that to the greatest extent feasible (i) preference and opportunities for training and employment shall be given to Indians and (ii) preference in the award of contracts and subcontracts shall be given to Indian organizations and Indian-owned Economic Enterprises. Parties to this contract that are subject to the prow—lions of Section 3 and section 7(b) agree to comply with Section 3 to the maximum extent feasible, but �►st in derogation of compliance with section 7(b). Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Section 3 Quarterly La`: e + urs Report Contractors and subcontractors are to m*e g?ood faith assessments of employees' labor hours on Section 3 covered contracts/projects for the following.. • Total labor hours worked by all employees (excludes the total labor hours from professional services) • Total labor hours worked by Section 3 Workers • Total labor hours worked by Targeted Section 3 Workers Cvn4e' actors and subcontractors are to report their good faith assessments of labor hours on the Section 3 Q>arre,'ly Labor Hours Report. Exception: Contractors and subcontractors whose contracts are subject to prevailing wage laws are to submit their weekly certified payroll reports, instead of the Section 3 Quarterly Labor Hours Report. Compliance Monitoring Section 3 compliance monitoring will be performed by HWS Section 3/EOC Unit. Contractors and subcontractors who submitted approved Utilization Plans shall maintain their approved percentages of Section 3 participation throughout the term of the contract/project. Contractors and/or subcontractors whose Utilization Plans projected no new hires must, to the greatest extent feasible, hire certified Section 3 Workers or Targeted Section 3 Workers,when the need to hire occurs. FREQUENCY OF MONITORING 1+ 1 g EFC33T sg.19tion Contract Award/ Monthly C4apletion Negotiation Construction and::N.9atirtic,�,rea;ic-A s),)bject to prevailinFwage, X X X Non-Constructions(<-s rn.00th5 plUformance) X I X Non-Construction(>3 months'performance) X X X Noncompliance with HUD's regulations in 24CFR75 may result in sanctions, termination of contract for default, and debarment or suspension from future HUD-assisted contracts. Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 EXHIBIT B-6 Required Bid Norm General Submittal Instructions: Bidder/Proposer AND its first-tier subcontractors are to submit a completed Section 3 Implementation Plan(s) in bid. If not,A "non-responsive" determination may be made due to non-submittal. Project Information: Project Name: Bid/Solicitation 4: CITY PARK PARKING LOT & ACCESS Z40037 ❑Contractor ® Subcontractor Information Company Name: Address: Chrisp Company ­, - 1 Authorized Representative: Title: I John Marek Phone: Email: Proposed Dollar Value of Contract or Subcontract:6600.00 List if ELBE, DBE, DVBE, MBE, SB, SLBE o (or"N/A" if non-applicable): Section 3 Requirements Employment and Training To the greatest extent feasible, employment and training opportunities arising in connection with Section 3 projects shall be provided to Section 3 workers within the County of Riverside. Where feasible, priority for employment and training will be given to: 1. Section 3 workers residing within the service area or neighborhood of the project, and 2. Participants in Youth Build programs. Contracting To the greatest extent feasible, work contracts awarded in connection with Section 3 projects shall be provided to business concerns that provide economic opportunities to Section 3 workers residing within the County of Riverside. Where feasible, priority for contracting opportunities will be given to: 1. Section 3 business concerns that provide economic opportunities to Section 3 workers residing within the service area or the neighborhood of the project, and 2. Youth Build programs. Compliance Benchmarks To demonstrate compliance with Section 3, contractors are required to follow the prioritization of effort outlined above and meet or exceed the following safe harbor benchmarks: 1. 25 percent or more of the total number of labor hours worked by all workers on the project shall be performed by Section 3 workers, and 2. 5 percent or tTi+~•rn of the total number of labor hours worked by all workers on the project shall be perfcn-rf pci by Targeted Section 3 workers. Definitions • Section 3 worker: Any worker who currently fits or when hired within the past three years fits at least one of the following categories, as documented: Docusign Envelope ID:D42068FF-8AFF-4160-A2A9-F10EE7D29DA2 EX!lIIII I B-6 (Continued) (1) The worker's income for the previous or annualized calendar year is below the income limit established by HUD (see Income Limits table below). (2) The worker is employed by a Section 3 business concern. (3) The worker is a Youth Build participant. • Targeted Section 3 worker: A Section 3 worker who is: (1) A worker employed by a Section 3 business concern; or (2) A worker who currently fits or when hired within the past three years fit at least one of the following categories, as documented: (i) Living within the service area or the neighborhood of the project; or (ii) A Youth Build participant. •Service area or the neighborhood of the project: An area within one mile of the Section 3 project or, if fewer than 5,000 people live within one mile of a Section 3 project, within a circle centered on the Section 3 project that is sufficient to encompass a population of 5,000 people according to the most recent U.S. Census. HUD Income Limits The table below shows the income limits set by HUD that determine eligibility for certain programs, including Section 3. HUD develops income limits based on Area Median Income (AMI) estimates and Fair Market Rent (FMR) area definitions. For more information, please see the HUD Income Limits Documentation System online at www.huduser.gov/portal/datasets/il.html. Riverside County, CA MSA Fiscal Year 2023 2022 2021 Low-income (80% AM I) $52,000 $49,300 44,250 1. Does your business qualify as a Section 3 business concern? YES ® NO If you answered YES, complete the attached Section 3 Business Concern Form (Pg. 6), and submit with this Plan. A Section 3 business concern is a business that satisfies at least one of the following criteria, as documented within the last six-month period: a. The business is at least 51% owned and controlled by low-or very low-income persons; b. The business is at least 51% owned and controlled by residents who currently live in public housing or Section 8-assisted housing; or c. Over 75% of the labor hours performed for the business over the prior three-month period were performed by Section 3 workers — i.e., workers who currently are, or when hired within the past three years were: (i) low-income persons or (ii) Youth Build participants. 2. Do you have current employees whose annual income is below the income limit? See HUD Income Limits table. ❑ YES ® NO If"YES," prior to contract execution,the names of qualifying employees shall be provided to HWS. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 EXHIBIT B-6 (Continued) 3. Do you plan to hire new employees to perform on or support the contract, if a..__ contract? ❑ YES ® NO If"YES," at a minimum, you must contact the HWS Section 3 Unit at RivCoCDBG(cl)rivco.ork to obtain examples of qualitative efforts to create employment. 4. Do you agree that when there is a need to hire new employees, a documented good faith effort shall be made to hire Section 3 Workers? ® YES❑ NO Implementation Plans that indicate a "No" response for question #4 may be deemed "non-responsive." 5. How many workers are needed to complete the project? Please list the job classifications and number of workers your company will need to complete the contract work.Attach additional sheets if necessary. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Job classification Total estimated Number of Estimated (Office/Clerical, Manager, Engineer, number of workers in current number of Technician,Supervisor/Foreman, Electrician, Plumber, Laborer,Trainee, workers needed workforce additional Security, etc.) workers needed laborer 0 10 0 EXHIBIT B-6 (Continued) 8. Will you be using subcontractors on this project? ❑ YES® NO If "Yes", Bidder/Proposer is required, to the greatest extent feasible, to outreach to and award subcontracts to Section 3 Business Concerns. AT A MINIMUM, YOU MUST, CONTACT THE HWS SECTION 3/EOC UNIT AT RivCoCDBG@rivco.org OR GO TO https://rivcoeda.org/Departments/Housing/ Community-Development-BlockGrant/CommunityDevelopment/Section-3-Program TO OBTAIN "Examples of Efforts to Create Employment and Contracting Opportunities." Section 3 Business Concerns must complete the Section 3 Business Concern Form and must be certified by HWS. For ELBE, SLBE, SB, DBE, MBE, WBE or DVBE firms, please attach a copy of their certification(s). List ALL proposed subcontractors (including subconsultants) for this project on the table below. Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Business name Scope of work (trade or Section 3 business? Estimated contract service description) value Yes/No Highway, Street and Parkin No $ Chrisp Company Lot Improvement $ 4. Do you commit to engage in good faith efforts to meet or exceed the Section 3 Benchmarks? ® YES ❑ NO Such qualitative efforts may include, but are not limited to: • Applicant Outreach— EXHIBIT B-6 • Engage in outreach efforts to generate job applicants who are Target (Continued) including posting job openings at the job site, HUD Opportunity Portal, social media pages, and other platforms. • Clearly indicate Section 3 eligibility on all job postings, notifications, and advertisements with the following statement: "This is a Section 3 eligible job opportunity. We encourage applications from individuals that are low-income, live in public housing, and/or receive a Section 8 voucher." • Include the Section 3 Worker Self-Certification form in all job postings. • One-Stop / Youth Build Outreach — Engage in outreach or referrals with local YouthBuild programs, or other community organizations to assist with training and recruiting Section 3 and Targeted Section 3 workers. • Training and Apprenticeship— Provide training or apprenticeship opportunities. Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 • Job Fairs— Hold one or more job fairs or sponsor a job informational meeting in the project area. • Business Concern Outreach— • Engage in outreach efforts to identify and secure bids from Section 3 businesses by advertising notices of contracting opportunities and related information in local community papers. ■ Provide written notice t-D all known Section 3 business concerns, with sufficient time for interested businessest_o respond to bid invitations. • Ze31d ettt?cG of iontractiv- opportunities to local community development organizations, business deveiapme:nt organizations, or minority contracting associations. • rtatp clearly in all rtoaces that the contracting opportunity is Section 3 eligible and include a copy of the Section 3 Business Concern Certification form. • Com Ctt cep A s's Ianr -- Provide technical assistance to help Section 3 business concerns understand and bid on contracts. • Contract Sizing — Size, split, or divide contracts into smaller jobs to f:: 'h '' ;, ' participation by Section 3 business concerns, particularly where ecori.o trees of scale or efficiency of delivery are not factors. [2 CFR 200.321(b)(3)] • Bidder Viability Support — Provide bonding assistance, guaranties, or other efforts to support viable bids from Section 3 business concerns. • Business Registries— Promote the use of business registries designed to create opportunities for disadvantaged and small businesses. Additional activities and efforts aimed at increasing economic opportunities for Section 3 workers and businesses may include, but are not limited to: • Employment Assistance — Provide technical assistance to help Section 3 workers compete for jobs, or connect them with assistance in seeking employment, including resume assistance, interview preparation, coaching, or job placement services. • Work Readiness and Retention — Provide or refer Section 3 workers to services supporting work readiness and retention, such as interview clothing, licensing or testing fees, transportation, or childcare. • Financial Literacy— Help Section 3 workers obtain financial literacy training or coaching. • Education Assistance — Assist Section 3 workers to apply for or attend community college, four- year educational institution, or vocational/technical training. 5. Do you commit to prioritize your efforts in hiring, training, and contracting as required by the Section 3 regulations and outlined on page 1 of this Plan? ® YES ❑ NO Docusign Envelope ID:D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 SECTION 3 BUSINESS CONCERN FORM Please complete this form to determine if your business may qualify as a Section 3 Business. Businesses that qualify will be contacted by HWS Section 3 Coordinator to complete a Section 3 Business Application and asked to provide additional documentation to verify their status as a Section 3 Business. What is Section 3? Section 3 is a provision of the Housing and Urban Development Act of 1968 (24 CFR Part 75) that requires recipients of certain HUD financial assistance, to the greatest extent possible, to provide job training, employment, and contract opportunities for low- or very low-income residents in connection with projects and activities in their neighborhood. A business can qualify as Section 3 if it meets one of the following criteria: A. It is at least 51% owned and controlled by low-or very low-income persons; B. Over 75% of the labor hours performed for the business over the past three-month period were performed by workers who met at least one of the criteria below; or C. It is at least 51% owned and controlled by current public housing residents or residents who currently live in Section 8-assisted housing. Workers must meet one of the following criteria for a business to qualify as Section 3 under item B above: • Reside within one mile of the Section 3 project (or, if fewer than 5,000 people live within one mile of the Section 3 project, within a circle centered on the Section 3 project that is sufficient to encompass a population of 5,000 people according to the most recent U.S. Census); • Be a HUD Youth Build participant; or • Income for the previous or annualized calendar year is below 80%of the current area median income for the area in which the worker resides. (Use the worker's annual gross income based on AMI for a single-person household.) HUD income limits can be found at https://www.huduser.gov/portal/datasets/ii.html.) Company Name: Chrisp Company Contact Person:John Marek Address: City: Phone: Email: I have reviewed the above information and my business MAY QUALIFY as a Section 3 Business. Please contact me about completing an application and certification. 6/18/2025 Robert Chrisp - President/CEO Signature of Business Owner Date EXIT I BIT B-7 Docusign Envelope ID: D4206BFF-8AFF-4160-A2A9-F10EE7D29DA2 Required Bid Form Certification for Secti��w,-,, fompliance (Required for Bidder and-' " � contractors) Project Information: Project Name:CITY PARK PARKING LOT & ACCESS Bid/Solicitation #: Z40037 Contractor/Subcontractor Information: Company Name: Address: Chrisp Company Authorized Representative: Title: John Marek Estimator Phone: Email: i.By completing and signing this form, I agree to comply with all applicable requirements of 9`"" .,,:I e Housing and Urban Development Act of 1968 (24 CFR Part 7S) and HWS' Section 3 requirem,6 t's. INITIAL HEW 11.1 understand that "to the greatest extent feasible," work contracts awarded in connection with Section 3 projects shall be provided to business concerns that provide economic opportunities to Seccttiio�n 3 workers following the prioritization efforts outlined in Section 3 regulation. I INITIAL HERE 111.1 understand that in the event any new employment opportunities are created as a result of this CDBG- funded project then "to the greatest extent feasible" employment and training opportunities shall be provided to Section 3 workers following the prioritization efforts outlined in Section 3 regulation. INITIAL HERE IV.I understand the safe harbor benchmarks for Section 3 compliance and that if these benchmarks are not met the contractor will be required to report on the qualitative efforts made to meet the benchmarks.19 INITIAL HERE /=(� V.I understand &a.w.44be required to make good faith assessments of employee labor hours on Section 3 covered, submit quarterly and final Section 3 reports and supporting documentation.��//�� INITIAL HERE A�E - V1.1 understat.,.. :.1 od all sub-contracts and sub-tier agreements resulting from this CDBG-funded project are also subfeci lci'Section 3 compliance and that it will be the General/Prime Contractor's responsibility to ensure compliance from all subcontractors. INITIAL HERE IC VII. rstand that noncompliance with HUD's regulations in 24 CFR Part 75 may result in sanctions, s nation of contract for default, and debarment or suspension from future HUD-assisted contracts. INITIAL HERE I declare that all statements contained in this form and any accompanying documents are true and correct and made with full knowledge that all statements given are subject to investigation and that any false or dishonest answer to any question may be grounds for denial or revocation of funding or other penalties as prescribedunder 18 U.S. Code§1001. Robert Chrisp C h r i pany Name of Presid nt or Authorized Officer Compa",j n,'- 2 6/18/2025 President/CEO Signature and Title Date CITY OF LAKE ELSINORE CIP Project No. Z40037 BOND NO. UCSX333X6241 PREMIUM $ 10,526.00 FAITHFUL PERFORMANCE 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 van Engineering, 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 City Park Improvements I &II - City Park Parking Lot CIP PROJECT NO. Z40037 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 United Surety Insurance Company as Surety, are held and firmly bound unto the City of Lake Elsinore (hereinafter designated as"City") in the penal sum of dollars ($ 526.292 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) CITY OF LAKE ELSINORE CIP Project No. Z40037 BOND NO. UCSX333X6241 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 16th day of September 2025 . BIDDER/PRINCIPAL: SURETY.- Principal Name: Van Engineering, Inc. Name: United Surety Insurance Company Address: Telephone No.: ( Telephone No.: ( 1 Print Name: (4n�n_ I \I(AKx Print Name: Mark D. Leskanic Attorney-in-Fact Signature: Signature: Approved as to Form this �R_day of `a Q� 20�5 City Attorney City of Lake Elsinore 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). BOND NO. UCSX333X6241 PREMIUM $ 10,526.00 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 Van Engineering, 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 City Park Improvements I & II -City Park Parking Lot CIP PROJECT NO. Z40037 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 United Surety Insurance 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 Biu%&V4 of the California Civil Code, in the sum of Fw.H�nd.ad THe y-s:x Thaws rd T—c HundrM N.nety-Two and=100 dollars ($ 526,292.00 ), 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) CITY OF LAKE ELSINORE CIP Project No. Z40037 BOND NO. UCSX333X6241 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 this 16th day of September 20 25 . BIDDER/PRINCIPAL: SURETY: Principal Name: Van Engineering, Inc. Name: United Surety Insurance Company Address: Boston, MA 02210 Telephone No.: ( Telephone No.: ( Print Name: V 1 �l��riU I. V(74 r � Print Name: Mark D. Leskanic Attorney-in-Fact Signature: Signature: Approved as to Form this 1 day of 2.1n 20 Z J City Attorney City of Lake Elsinore 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). ----------------------------------------------------------------------------------------------------------------- Surety Acknowledgment State of Massachusetts } ss: County of Middlesex ; On this 16th day of September 2025, before me personally came Mark D. Leskanic to me known,who,being by me duly sworn,did depose and say that he/she is an attorney-in-fact of United Surety Insurance Company the corporation described in and which executed the within instrument; that he knows the corporate seal of said corporation; that the seal affixed to the within instrument is such corporate seal, and that he signed the said instrument and affixed the said seal as Attorney-in-Fact by authority of the Board of Directors of said corporation and by authority of this office under the Standing Resolutions thereof. My commission expires October 26, 2029 Notary Public ANDREA HUGhES Molary Pumic,Canmonweaah of Messaehusetts My ConlmisSW Expires October 26,2029 L1C S POWER OF ATTORNEY 171333 KNOW ALL MEN BY THESE PRESENTS:That United Casualty and Surety Insurance Company,a corporation oft he State of Nebraska,and US Casualty and Surety Insurance Company and United Surety Insurance Company,assumed names of United Casualty and Surety Insurance Company(collectively,the Companies),do by these presents make,constitute and appoint: Mark D.Leskanic,Matthew Leskanic,Greg Angel,Colin Warner, Lauren Leskanic its true and lawful Attorneys)-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 JL 00/100 Dollars ( $S,000,000.00 ). This Power of Attorney shall expire without further action on December 310,2026. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Board of Directors of the Companies at a meeting duly called and held on the 1"day of July,1993: Resolved that the President,Treasurer,or Secretary be and they are hereby authorized and empowered to appoint Attorneys-in-Fact of the Company,in Its name and as its ads to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances,contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company. Any such writings so executed by such Attorneys-in-Fact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected Officers of the Company in their own proper persons. That the signature of any officer authorized by Resolutions of this Board and the Company seal may be affixed by facsimile to any power of attorney or special power of attorney or certification of either given for the execution of any bond,undertaking,recognizance or other written obligation in the nature thereof;such signature and seal, when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereunto affixed,this 14th day of January,2025 UNITED CASUALTY AND SURETY INSURANCE COMPANY US Casualty and Surety Insurance Company United Surety Insurance Company - — Corporate Seals R.Kyle ler,Treasurer Commonwealth of Massachusetts County of Suffolk ss: On this 14th day of January,2025 before me,Colleen A.Cochrane,a notary public,personally appeared,R.Kyle Fowler,Treasurer of United Casualty and Surety Insurance Company,US Casualty and Surety Insurance Company and United Surety 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(s),or the entity on behalf of which the person(s)acted,executed the instrument. I certify under PENALTY OF PERJURY under the laws of the Commonwealth of Massachusetts that the foregoing paragraph is true and correct. WITNESS my hand and seal. COLLEEN A.COCHRANE �« (Seal) �. �P"�Conrrmaeanh d A'assaiJuszle My Cammssw E p,*1127142/ otary Public Commis ion Expires:10/27/2028 I,Robert F.Thomas,President of United Casualty and Surety Insurance Company,US Casualty and Surety Insurance Company and United Surety 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 Board of Directors,set out in the Power of Attorney are in full force and effect. In Witness Whereof,I have hereunto set my hand and affixed the seals of said Companies at Boston,Massachusetts this 1 6th day of September 2025 Corporate Seals ■ ■ ■ Robert F.Thomas,President m TO CONFIRM AUTHENTICITY OF THIS BOND OR DOCUMENT EMAIL CONFIRMBOND@UNITEDCASUALTY.COM United Casualty and Surety Insurance Company DBA United Surety Insurance Company DBA US Casualty and Surety Insurance Company Statement of Assets, Liabilities, and Surplus Year Ended December 31 Year Ended 2024 2023 Admitted Assets Cash and Short Term Investments $41,394,126 $36,321,994 Stocks 19,798,138 2,176,755 Bonds 4,936,241 6,738,979 Uncollected Premiums & Agents' Balance 3,880,950 2,272,570 Other Assets 780,356 2,402,610 Total Net Admitted Assets $70,789,811 $49,912,908 Liabilities Funds Held as Collateral $9,973,991 $14,101,531 Unearned Premium 10,494,364 8,098,812 Losses 2,879,260 1,919,898 Other Expenses 549,747 528,056 Taxes, Licenses, and Fees 208,961 147,927 Loss Adjustment Expenses 11190,067 530,475 Payable to Parent or Affiliates 1,766,168 1,001,040 Ceded Reinsurance Payable 1,822,923 1,277,138 Other Liabilities 1,179,840 442,295 Total Liabilities $30,065,321 $28,047,172 Capital and Surplus Paid In Surplus $34,850,639 $17,364,311 Unassigned Surplus 3,378,106 2,005,680 Common Stock 2,600,000 2,600,000 Less: Treasury Stock 104,255 104,255 Total Capital and Surplus $40,724,490 $21,865,736 Total Liabilities and Capital and Surplus $70,789,811 $49,912,908 I, Raymond Kyle Fowler,Treasurer and Secretary of United Casualty and Surety Insurance Company, hereby certify that the above is an exact copy of the financial statements of the Company dated December 31, 2024 and is a true and correct statement of the condition of United Casualty and Surety Insurance Company as of that date. IN TESTIMONY WHEREOF, I have set my hand and affixed the seal of the Company this 71h day of March 2025. R. Kyle Fowler,Treasurer and Secretary CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA } County of RIVERSIDE } On S e , /7 702S before me, BETTY JEAN RUTH / NOTARY PUBLIC ere insert name and nt e o tree o icen f personally appeared Ce✓� Z /y44 G who proved to me on the basis of satisfactory evidence to be the person(X whose name( is/are-subscribed to the within instrument and acknowledged to me that he/e44A4'eq-executed the same in his/1ief44elf authorized capacity("), and that by his/4,�i signaturex) on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. 1 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. 00 BETTY JEAS Ru_.'H WIT S my hand and offi al se 4. "awry Pubiic-Ca'tfor„a f Riverside County Commission;2516148 +��l wy Comm.Expires Apr 28,2029 Notary Pub i cgnature (Notary Public Seal) i INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL T NAL INFORMATION This farm complies with current California statutes regarding notary wording and DESCRIPTION OF THE ATTACHED DOCUMENT ifneeded should be completed and attached to the document.Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California naary ydeption law. (Tit of ltache ovum ) • State and County information must be the State and County where the document signter(s)personally appeared before the notary public for acknowledgment. � _7 G/xL • bate of ntotanzation must be the date that the signer(s)personally appeared which (Title a description of attached document continued) must also he the same date the acknowledgment is completed. • The notarypublic must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public) • Print the name(s)of document signer(s) who personally appear at the time of notarization CAPACITY CLAIMED BY THE SIGNER Indicate the correct singular or plural forms by crossing off incorrect forms(i e. I "she/Owe -is/are)or circling the correct forms.Failure to correctly indicate this ivldual (s) information may lead to rejection of document recording. e"o Corporate Officer The rotary seal impression must be clear and photographically reproducible Impression must not cover tent or Imes. If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment farm Signature of the notar% public must match the signature on file with the office of ❑ Partner(s) the county clerk G Attorney-in-Fact 4 Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document Other 'I? Indicate title or type of attached document,number of pages and date ❑ 0 Indicate the capacity,claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary) 01,n g7:Gaac • Securely attach this document to the signed document with a staple —� CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA } County of RIVERSIDE } On( 17 O!�Sbefore me, BETTY JEAN RUTH / NOTARY PUBLIC ere insert name and ti e of the officer) personally appeared CD G t who proved to me on the basis of satisfactory evidence to be the personol whose name( is/afe.,subscribed to the within instrument and acknowledged to me that he/sheft+r" executed the same in his/fihetkheif•authorized capacity{ies3; and that by his/herM eif signature(, on the instrument the person V. 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. I SS Notary Public•California Rtverside CountyCommission A 2516148 Comm,Expires Apr 28.2029 Notary bft ign Ur (Notary Public Seal) INSTRUCTIONS FOR COMPLETING TEIIS FORM ADDITION A P ONAL INFORMATION 7htrform complies with current California statutes regarding notary wording and. DESCRIPTIONO HE ATTACHED DOCUMENT if needed.should be completed and attached to the document.Acknowledgments from other states may be completed for documents being sent to that state so long t as the wording does not require the Caitfornia notary to violate California notary law. ITi a or description o attached docu nt) • State and County information must be the State and County where the document n� � signets)personally appeared before the notary public for acknowledgment- -0 • Date of twtariration must be the date that the signers)personally appeared which (Title or ption of attach doament continued) must also be the same date the acknowledgment is completed • The notary public must print his or her name as it appears within his or her Number of Pages J Document Date commission followed by a comma and then your title(notary public). • Print the name(s)of document signers)%ho personally appear at the time of notarization CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing oft'incorrect forms(i.e. � kelshe/spe�is late)or circling the correct forms.Failure to correctly indicate this LVIdU81 (S) information may lead to rejection of document recording. ElCorporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or Imes If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact 4 Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document O Indicate title or type of attached document,number of pages and date Other ❑ 0 Indicate the capacity claimed by the signer- If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). ,vww NotaryGlasses cum 800-873-9865 9 Securely attach this document to the signed document with a staple. SURETY BOND PROF ESS IONALS INC YOUR BOND PARTNER PERFORMANCE AND/OR PAYMENT BONDS ATTACHED Attached, please find the Performance and/or Payment Bonds that you've requested. Please review these for accuracy and be certain to sign, seal, and witness as appropriate. PLEASE NOTE that in some instances you will have to fill in the date on the bond and on the power of attorney. This is left blank intentionally as in certain cases the owner/obligee may want to fill such in themselves. We greatly value the relationship we have established so if we can lend our support or assistance at any point in the future, do not hesitate to contact us. If you know anyone who might benefit from our bonding services, please let us know or provide them with our contact information. Thank you! 1661 WORCESTER ROAD,SUITE 207,FRAMINGHAM,MA 01701 TOLL FREE:855-5 SURETY(855-578-7389) 1 781-559-0568 1 FAX:781-559-0569 1 SURETYBONDPROFESSIONALS.COM