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Superior Paving - United Paving BidSECTION 1200 BID DATE: 07/28/2020 The undersigned, as bidder, declares it has received and examined the Contract Document entitled Project No. 2020-04, Washington Street Pavement Rehabilitation, and will contract with the City, on the form of Contract provided herewith, to do everything required for the fulfillment of the contract for said work at the prices and on the terms and conditions herein contained. We have included the following items and agree that they shall form a part of this bid: SECTION TITLE 1200 Bid 1210 Bid Schedule 1220 Bid Guaranty Bond 1230 Certification of Bidder's Experience and Qualifications 1240 Proposed Subcontractors 1250 Non -Collusion Affidavit 1260 DIR Project Vendor Information We acknowledge that the following addenda have been received and have been examined as part of the Contract Documents. Bidders must be on the Plan Holders List with the City of La Quinta in order to receive addenda. Addendum # Date Received Ini 'als Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY. Superior Paving Company Inc dba United Paving Co Name of Bidder (951) 739-9200 Bidder's Telephone Number Bid 1200-1 If our bid is accepted, we agree to sign the contract without qualifications and to furnish the performance and payment bonds and the required evidence of insurance within 10 calendar days after receiving written notice of the award of the contract. We further agree, if our bid is accepted and a Contract for performance of the work is entered into with the City, to so plan work and to prosecute it with such diligence that the work shall be completed within the time stipulated. Superior Paving Company Inc dba United Paving Co Name of Bidder 1880 North Delilah Street Corona CA 92879 Bidder's Address 865828 Contractor's License No. California State of Incorporation ZOLA Signature of Bidder Mark Wiley Printed Name of Signatory RMO Title of Signatory (951) 739-9200 Bidder's Telephone Number lessee@united-paving.com Bidder's Email Address 10/31/2021 Contractor's Expiration Date itn ss cco["ui�eng ynGu�agP�` Title of Witness Bid 1200-2 SECTION 1210 BID SCHEDULE PROJECT NO. 2020-04 WASHINGTON STREET PAVEMENT REHABILITATION City of La Quinta 78-495 Calle Tampico La Quinta, CA 92253 To Whom It May Concern: Pursuant to the Invitation to Bid, and in accordance with the provisions therein stated, the undersigned hereby proposes and agrees that on award by the City under this Bid, to execute a Contract, with necessary bonds, to furnish and install any and all labor, materials, transportation and services for Project No. 2020-04, Washington Street Pavement Rehabilitation, in accordance with the plans and specifications therefore adopted and on file with the City within the time hereinafter set forth and at the prices named in this Bid. It is understood that the basis of award shall be the lowest total price of the Base Bid Area plus All Additive Alternates. Unit prices in each and every case represent the true unit price used in preparing the bid schedule totals (Bid Form). Unit prices listed herein include material, installation and appurtenant work as is necessary to have the item complete and in place meeting the full intent of the plans and specifications. We acknowledge that unbalanced unit prices shall be sufficient cause for the rejection of our bid. Bid Schedule 1210-1 ADDENDUM 01 — JULY 24, 2020 BASE BID — WASHINGTON STREET PAVEMENT REHABILITATION Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Mobilization 1 LS $y309. 5y $ y3o9- 5N 2 Traffic Control 1 LS $y2392 • 20 $y2,39a. 20 3 Dust Control 1 LS $y29g_ 3y $ yj299. 3y 4 2" Grind and Overlay 360,479 SF $ 1.5a $519. b �3.q Continue to Full Depth Asphalt Concrete Grind 5 (3.5"f), Compact Existing 1,275 SF $ 3• M $ 3, U3,1(, Aggregate Base, and 5.5 Asphalt Concrete Overlay to Bottom of Final Lift Remove and Construct 5.5" 6 AC over 6.5" AB, CLQ STD. 321 SF $ �'35 $�27 195 Remove Existing Concrete 7 Sidewalk, Ramps, and 5,105 SF $ F93 $I9SS7.�� Cross -Gutters Remove Existing Curb and 8 Curb & Gutter (Regardless 307 LF $ 1%, q& $5, 513.3� of Height) 9 Crack Seal and Type II 11,157 SF $ �. (Q(� $19,5yy k3 Slurry Seal Construct Curb & Gutter per 10 City of La Quinta Std. Dwg. 201and 202 (Regardless of 307 LF �� g��,j� Height) Construct Sidewalk per City 11 of La Quinta Standard 240 615 SF $.�9 Mod. Construct Concrete Curb 12 Ramps per City of La Quinta 9 EA $3'y 36�1 Standard 250 Mod. Construct Portion of Cross- 13 Gutter per City of La Quinta 735 SF $ ((� $ lqjq03 ' STD 230 Mod. and 231 Mod. 14 Lower and Raise Drainage 1 EAf5q� ya $3��a,5Z Manhole to Grade 15 Striping and All Incidentals 1 LS G&1,31 $ 65,cf61,31 Total Amount of Bid Items 1 — 15 rs7��,337,3� Bid Schedule 1210-2 ADDENDUM 01 - JULY 24, 2020 City may award all or none of the following additive alternates: ADDITIVE ALTERNATE No. 1 — Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Lower Sewer Manhole per 9 EA $2I R11. 35 $ 19, 956• l5 CVWD Standards 2 Raise Sewer Manhole per 9 EA $3115 N U9,57b dy CVWD Standards Total Amount of Bid Items 1 — 2 $Y9, 53) . ,(0 ADDITIVE ALTERNATE No. 2 — Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Lower Water Valve per 19 EA $/519. Gy $ 301013.01 CVWD Standards 2 Raise Water Valve per 19 EA 1 QM. 3b $ Yg20q, 39 CVWD Standards Total Amount of Bid Items 1 — 2 $ ADDITIVE ALTERNATE No. 3 — Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Lower Irrigation Valve per 3 EA $ ��J53. 13 $y5gp,3� CVWD Standards 2 Raise Irrigation Valve per 3 EA $ �3(c�. �� $ CVWD Standards Total Amount of Bid Items 1 — 2 $ ADDITIVE ALTERNATE No. 4 — Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Lower Frontier Manhole with 1 EA $ 7 $ 2j� �,)'� Vehicle Traffic Rated Cap , Total Amount of Bid Items 1 $3 (04s , f Bid Schedule 1210-3 ADDENDUM 01 - JULY 24, 2020 O O kYJ WA 11111 d 4 A 0 F-A d410S 70 Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 2" Grind and Overlay with 504 • SF $ 57 $ /&''Yq Pavement Fabric _31, Replace obliterated striping, pavement markings, and 2 pavement markers in 2" 1 LS $ �(�q,'1 "� $ Grind and Overlay with Pavement Fabric construction area. Total Amount of Bid Items 1 — 2 $ GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES(Figures): $ qyo►123 . -� 5 GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Words): fte kL md(ed - vdy 4WiAs d, o�� huidved �WtnPi wee 40ars G S&0A:d - ve WfS Bid Amount of each of the above Bid Items must be filled in and completed. It is understood that the quantities shown hereon are but estimates and the bidder is responsible to verify quantities prior to submitting a bid. Final payment will be based upon actual work performed, subject to such adjustments and alterations as elsewhere provided herein. . / a Signature of Bidder (Ink) Name of Bidder (Printed or Typed) ,1 N) 949 - 39 U O Tem e e armed - Powio� . Cohn Bidder Telephone Number Bidder Email Address Bid Schedule 1210-4 SECTION 1220 BID GUARANTY BOND The Ohio Casualty PRINCIPAL, and Insurance Company__, as SURETY, are held and firmly bound unto the City in the penal sum of TEN (10) PERCENT OF THE TOTAL AMOUNT OF THE BID of the Principal above named, submitted by said Principal to the City for the work described below, for the payment of which sum in lawful money of the United States, well and truly to be made to the City to which said bid was submitted, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEREAS, the Principal has submitted the above -mentioned bid to the City, for certain construction specifically described as follows, for which bids are to be opened at La Quinta, California. PROJECT NO. 2020-04 WASHINGTON STREET PAVEMENT REHABILITATION NOW, THEREFORE, if the aforesaid Principal is awarded the contract and, within the time and manner required under the specifications, after the prescribed forms are presented to him/her for signature enters into a written contract in the prescribed form, in accordance with the bid, and files two bonds with the City, one to guarantee faithful performance, and the other to guarantee payment for labor and materials as required by law, and provide certificate of insurance coverage required by the Contract Documents, then this obligation shall be null and void; otherwise, it shall be and remain in full force and virtue. IN WITNESS WHEREOF, we have hereunto set our hands on this 22nd day of July 2020. Superior Paving Company, Inc. dba United Paving Co. The Ohio Casualty Insurance Company 90A 0 Title of Sign Signature of Princip 1880 N. Delilah Street, Corona, CA 92879 Address Scott Salandi, Attomey-in-fact Title of Signatory ig ature of Surety 790 The City Drive South, Suite 200, Orange, CA 92868 Address Note: Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On J U L 2 2 2020 personally appeared Scott Salandi before me, Annette Lisa Romero, A Notary Public (insert name and title of the officer) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/anx subscribed to the within instrument and acknowledged to me that he/ssbsesitl ay executed the same in his/he!•xftesk authorized capacity(ies), and that by his/hm*hesk signature(%) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) � ANNETTE L ISA ;ISAROMERO c+r COMM. # 2244076 s NOTARY PUBLIC CALIFORNIA o S{ ORANGE COUNTY ti J� My Comm. expires May. 26, 2D22 t CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County fo1 County of �iui?VSt iJ} On 2� WED Date personally appeared — I before me, &ewa LA" Nidi l i . 1L.dT6>r W W << Here Insert Name and Title of the Officer of Signer{I who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. �• CHELSEA LAUREN BRIMHALL Notary Public - California Riverside County Commission # 2261646 My Comm. Expires Oct 7, 2022 Place Notary Seal and/or Stamp Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and fficial seal. Signature ature of Notary Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document A Title or Type of Document: _ $TG4i'YL+ Document Date: Number of Pages: Signer(s) Other Than Named Above: _ Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer itle(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian of Conservator ❑ Other: Signer is Representing: 02017 National Notary Association Signer's Name: • - _ ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ A .1jorney in Fact ❑ Trustee uardian of Conservator ❑ Other: Z! Signer is Representing: This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty mutuil. SURETY Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8202672-977490 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, David S. Jacobson Scott Salandi: Leonard E. Liminsky all of the city of Irvine state of CA each individually if there be more than one named, its true and lawful allomey-in-fad to make, execute, seal, acknMedge and deliver. for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seats of the Companies have been affixed thereto this 3rd day of December _, 2019 . N N c ..x State of PFN NSYLVAN 1A � County of MONTGOMERY rn Liberty Mutual Insurance Company P4 1NSU/P P4S`f INS& a ttvsu The Ohio Casualty Insurance Company a`- cnRPOfWr -cl yJ °� 4 � y �[aP �oo to West American Insurance Company bfi ct iao u @am 2�1912 0 0 1919�0 � 1991 rye �s4CH°�Aa s� NAMP a +'p �raxAxE da David M. Carey, Assistant Secretary a) On this 3rd day of December , 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance O o , Company, The Ohio Casually Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes U) `m > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. chi w rr N a? 3 IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. C.N p, PA3 O d) ¢�,a�tfiF�r�Cf COMMONWEALTH OF PE NN S Y LVANIA i LOt C� p Notarial Seale do Teresa Paslella, Notary Public 0 d) .OF Upper MadonTwp., Montgomery County By: C Y My Commission Expires March 28, 2021 v� eresa Pastella, Notary Public Member,re Penylvaniah•.:rt: .ai:c" � cNc-ar=e N; rd � I w This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual v - Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: E a ARTICLE IV — OFFICERS: Section 12. Power of Attorney. 0 2 Any officer or other Official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the a President may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety C any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such Z � instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys4- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this day of g, v 1HSU� 'qY INS& 1NSUhi r.`yPc °�°'� s ,� yC�i`lPeen�°'4r 9y VP ion P o ell 4�0 1912 0 1919 1991 0 !yam By: Yd�4cHu4ga y°3� varr8��aao �S, hoxANA orb Renee C. Llewellyn, Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Co_062018 O c� C ca E re O O D7 ev lu 0 as v N O N CM O 0 co SECTION 1230 CERTIFICATION OF BIDDER'S EXPERIENCE AND QUALIFICATIONS The undersigned Bidder certifies that he is, at the time of bidding, and shall be, throughout the period of the contract, licensed under the provisions of Chapter 9, Division 3, of the Business and Professions Code of the State of California, to do the type of work contemplated in the Contract Documents. Bidder shall further certify that it is skilled and regularly engaged in the general class and type of work called for in the Contract Documents. The Bidder represents that it is competent, knowledgeable, and has special skills on the nature, extent, and inherent conditions of the work to be performed. Bidder further acknowledges that there are certain peculiar and inherent conditions existent in the construction of the particular facilities, which may create, during the construction program, unusual or peculiar unsafe conditions hazardous to persons and property. Bidder expressly acknowledges that it is aware of such peculiar risks and that it has the skill and experience to foresee and to adopt protective measures to adequately and safely perform the construction work with respect to such hazards. The Bidder shall list below four (4) projects completed in the last seven (7) years of similar size and complexity that indicate the Bidder's experience as a General Contractor. 1. Project Name: _Bedell & Webster ES Owner: Santa Paula USD Construction Cost: $597,241.25 Construction Time: _120_ Owner's Representative: Owner's Telephone No.: 805-861-8353 Doug Hennings Date of Substantial Completion: _9/24/2019 2. Project Name: Cerritos Parking Lot State RD & Del Amo Owner: _City of Cerritos_ Construction Cost: $_531,529.55 Construction Time: 86 Owner's Representative: _Dario Simoes _ Owner's Telephone No.: 562-860-0311 Date of Substantial Completion: _8/13/2019 Calendar Days Calendar Days Bidders Experience & Qualifications 1230-1 3. 4 Project Name: Ontario International Airport Owner: Ontario International Airport _ Construction Cost: $535,596.00_ Construction Time: 70 Owner's Representative: _James Jensen Owner's Telephone No.: 661-251-7401 Date of Substantial Completion: _3/1/2020 Project Name: Different Locations Victorville, Ca. Owner: _Victor Elementary School District Construction Cost: $_568,868.25_._ Construction Time: _52 Owner's Representative: _Dale Etter _ Owner's Telephone No.: 760-245-1691 Date of Substantial Completion: 7/30/2019_ _ Calendar Days Calendar Days Signed this day of , 2020. Superior Paving Company Inc dba United Paving Co. 865828 1000002563 Name of Bidder Contractor's License No. DIR Reg No. ` 10/31/2021 Signature of Bidder Expiration Date Mark Wiley RMO Printed Name of Bidder Title of Signatory Bidders Experience & Qualifications 1230-2 SECTION 1240 PROPOSED SUBCONTRACTORS Pursuant to California Public Contracting Code, Section 4100 et. seq., the following list gives the name, business address, and portion of work (description of work to be done) for each subcontractor that will be used in the work if the bidder is awarded the Contract. (Additional supporting data may be attached to this page. Each page shall be sequentially numbered and headed "Proposed Subcontractors" and shall be signed.) The Contractor shall perform, with its own organization, Contract work amounting to at least 50 percent of the Contract Price except that any designated "Specialty Items" may be performed by subcontract and the amount of any such "Specialty Items" so performed will be deducted from the Contract Price before computing the amount required to be performed by the Contractor with its own organization. "Specialty Items" will be identified by the Agency in the Bid or in the Special Provisions. Where an entire item is subcontracted, the value of work subcontracted will be based on the Contract Unit Price. Subcontractor/Business Address/Description of Work/% of Work/License No./DIR Reg No. rCojp--.,r►t3arriCades Y11563 siasop, Sf- i4o,Ca•122,oi -iyal, ,co,,4n1 S'l. 787 OY 10000 z9yl .2 C4 �auP. rat P.0.13ox21� 3eaamonf,Ca9zn3 $frifi09 71. 7-7&30b 1000001�7(� top crack- it 32 RaKcko circle Uke i ores -I, Ca. tiz(p3o CracKFi ii 31. %6gU l 0000b u43V We,Ieoh CojohuC4,,om klM Tihdio -blyd 1'idib,cA. 922oi cOhGrefe 11. �s%37q loopD07Xylo yerd[l COAC(efe 5W Supat ✓Idle ip,vers�de :Ca ��?�th014— /I 7 $05 $1 I0000n al t vcr5 i Ed rts half /ZZV) N, 013Ve S - A 44 et'M i Co . AeK Coat 2 -l- G K11;L& 1o99o0 9q/v -,�e -� I Signature of Bidder Superior Paving Company Inc dba United Paving Co. Name of Bidder Proposed Subcontractors 1240-1 SECTION 1250 NON -COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ) ss. County of Riverside ) Mark Wiley , being first duly sworn, deposes and say that he or she is RMO of superior Paving Company Inc dba United Paving Co. , 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 contract, agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Jl /I Signature Superior Paving Company Inc dba United Paving Co. Name of Bidder RMO Title 0'7 Pz81-z ozv Date Non -Collusion Affidavit 1250-1 SECTION 1260 DIR Project Vendor Information Vendor Information: Name: —Superior Paving Company Inc dba United Paving Co. Address: 1880 N. Delilah St. City: —Corona Project Manager: —lessee Sando Phone: 951-739-9200 ST:_CA Zip:_92879 Email: _lessee@United-Paving.com_ CSLB/Certification Number: _865828_Class A C-12 Public Works Registration No.:_1000002563 Classification: Asbestos Boilermaker Bricklayers Carpenter Carpet/Linoleum Cement Masons Drywall Finisher Drywall/Lathers Electricians Elevator Mechanic Glaziers _Iron Workers Laborers Millwrights Operating Eng Painters Pile Drivers Pipe Trades Plasterers Roofer SheetMetal Sound/Com Surveyor Teamster Tile Worker Prevailing Wages and Payroll: The project is subject to prevailing wage rates and enforcement by the Department of Industrial Relations (DIR). Prevailing wage rates can be obtained at: htti)://www.dir.ca.Qov/Public-WorksjPrevailing-Wacie,html. Contractors and subcontractors on most public Works projects are required to submit certified payroll records to the Labor Commissioner using DIR's electronic certified payroll reporting system. For your convenience, the link for reporting certified payroll is: http://www.dir.ca-ciov/Public-Works/Certified-Payroll Reporting.html. A copy of certified payroll, including the employees and/or subcontractors working on with invoices submitted to the City of La Quinta. names and addresses of the job must be included DIR Project Vendor Information 1260-1 SECTION 1330 WORKERS' COMPENSATION INSURANCE CERTIFICATE In accordance with California Labor Code Section 1861, prior to commencement of work on the Contract, the Contractor shall sign and file with the City the following certification: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract." A Signature . e Title 0 1 1 z6 IT,2_0 Date Workers Compensation Insurance Certificate 1330-1