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Jacobsson Engineering Construction, Inc.SECTION 1200 BID DATE 5/9/22 The undersigned, as bidder, declares it has received and examined the Contract Document entitled Project No. 2017-09 Jefferson Street at Avenue 53 Roundabout Street Improvements 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 "�Sa 1 5/5/2022 Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANT . Jacobsson Engineering Construction, Inc. 760-345-8700 Name of Bidder 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. Jacobsson Engineering Construction, Inc. 760-345-8700 Name of Bidder P.O. Box 14430 Palm Desert, CA 92255 Bidder's Address 650389 Contractor's License No. California State of Incorporation C-S�—i�gnature of Bidder Dan Jacobsson Bidder's Telephone Number danjQa jacobssoninc.com Bidder's Email Address 7/31 /22 Contractor's Expiration Date Pxreoc J00N5M04 Witness Estimator Printed Name of Signatory Title of Witness President Title of Signatory Bid 1200-2 ADDENDUM 01 - 5-5-2022 SECTION 1210 BID SCHEDULE PROJECT NO. 2017-09 Jefferson Street at Avenue 53 Roundabout Street Improvements 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 2017-09, Jefferson Street at Avenue 53 Roundabout — Street Improvement Project, 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 - 5-5-2022 BASE BID — Jefferson Street at Avenue 53 Roundabout Unit Price Item Total Item Item Description Est. Unit (In (In No. Qty. Figures) Figures) Dollars Dollars 1. Mobilization 1 LS $154 16110 $ 1541b'O 2. Dust Control 1 LS $ 311500 $ 31 ,SpO Preparation and 3. Maintenance of the 1 LS $ 331 coo $ 3'3l0tx�' SWPPP 4. Traffic Control 1 LS $1371 ami $1%7, oco Clearing and Grubbing 5. (adjacent non irrigated 1 LS $7,1obo $ 7,6000 planter areas Remove interfering existing landscape and 6 hardscape from planter 1 LS $121%00 $ 1�'�dO area and modify existing irrigation to join new irrigation Remove and Modify 7. Existing Irrigation to 35,900 SF $ 0.15 $ S,385 maintain function for areas to remain Remove and salvage 8. existing electric 1 LS $ 2,75n $ 2176-t3 landsca a light Remove and salvage existing light pole, 9. includes the removal 2 EA $ 3ISSIb $ 311-To and of associate pull boxes and wiring 10. Remove existing tree 4 EA $ 11 S06 $ la,0oo Remove and dispose of existing asphalt 11. concrete and road 96,950 SF $ O. V $ 71152f -n section to depth required Remove and dispose of 12. existing concrete cross 1,100 SF $ 6.10o $ 1o,l000 utter and spandrel Bid Schedule 1210-2 ADDENDUM 01 - 5-5-2022 Unit Price Item Total Item Item Description Est. Unit (In (In No. Qty. Figures) Figures) Dollars Dollars Remove and dispose of 13. existing concrete 12,500 ' SF sidewalk, curb ramps, and stamped concrete Remove and dispose of 14. existing concrete 1,300 SF $ 10.00 $ 7, SW drivewa Remove and dispose of 15. existing 6" concrete 1,920 LF $ 13.50 $25,9Lo curb and gutter Remove and dispose of 16. existing 6" concrete 2,045 LF $ 3,cc $ Ib1360 curb Remove and dispose of 17. existing concrete catch 1 EA $112g5 basin Remove and dispose of 18. existing reinforced 20 LF $ 71.Oo $ I142.40 concrete pipe 19 Earthwork, including 1 LS $?-&s-000 $ ZZS,doO import Expose existing 20 headwall, re-establish 2 EA ,100 $ 612,00 grade adjacent area 15', and flush drainage pipe Cold Plane existing 21 asphalt pavement 1.5" 3,170 SF $ l-.3o $ 13,31 thick x 5 wide and overlay 4.5" Asphalt Pavement 22. on 12" Class II 61,115 SF $ S.00 $ 3o5,57S Aggregate Base 4.5" Asphalt Pavement 23. on 6" Class II Aggregate 3,085 SF $13.00 $`i0' 105 Base 24 6" Concrete Curb & Gutter per City of La 2,140 LF $ 31. gp $67,410 Uinta Std. 201 6" Concrete Median 25. Curb per City of La 2,658 LF $ 2.7. 00 $ 71171PAP Uinta Std. 210 26 Concrete U-Channel 5' 111 LF $ IOl $ 118ZI1 wide .00 Bid Schedule 1210-3 ADDENDUM 01 - 5-5-2022 Unit Price Item Total Item Item Description Est. Unit (In (In No. Qty. Figures) Figures) Dollars Dollars 27 Concrete Truck Apron 553 LF $ 4q .00 $ Z1, 097 Wedge Curb Concrete Cross Gutter 28. per City of La Quinta 1,080 SF $ 19.00 $1q,440 Std. 231 Concrete Meandering 29 Sidewalk and Median 241810 SF $ 7.$'o $14%10,073 Cut Through per City of La Quinta Std. 245 Mod Concrete Driveway per 1 EA $1 , SSS $ 11 555 30. City of La Quinta Std. 221 W=14' 4" Thick Colored Stamped Concrete 31. (median hardscape) per 1,730 SF $ Il.00 $ Iq,030 City of La Quinta Std. 720 Concrete Truck Apron 3,187 SF $ 2-1. cc $ %6 POy'1 32. with colored stamped concrete finish Concrete Curb Ramp 33. Case "C" per City of La 8 EA $1 i 4.50 $ 11, 600 Quinta Std. 250 Concrete Curb Ramp 34. Case "F" per City of La 4 EA $3,oyo $ 12.,1(po Quinta Std. 250 Curb Inlet Catch Basin No. 1 per City of La 35. Quinta Std. 300 and 1 EA $ %4000 $ S,bOo Gutter Depression per City of La Quinta Std. 330 Reconstruct existing 36. Catch basin for U- 1 EA $ 3,98Z $ 3,q%2 Channel connection 37 Truncated Domes at 240 SF $ 46-0* $ 11"Or Median Cut-Throu hs Reset existing Street 38. Monument per City of La 2 EA $ 72..a $ 1, 444 Uinta Std. 801 39. 2" Schedule 80 PVC 1,647 LF $ t#4 $ 72 ,gloS Conduit w/ Tracer Wire Bid Schedule 1210-4 ADDENDUM 01 - 5-5-2022 Unit Price Item Total Item Item Description Est. Unit (In (In No. Qty. Figures) Figures) Dollars Dollars 40. No. 6 Pull Box w/ 45 7 EA $ 1 375 $ 9�1e degree 2" conduit sweeps 41. Signing and Striping 1 LS $115,soo $ 11S,S�v includingall incidentals Install City Furnished 42 Street Lighting and 1 LS $131,6700 $ Soo Furnish and Install Electrical System Furnish and Install 3/4" 43. Desert Gold Crushed 11,550 SF $ 1.00 $ 111550 Rock - 2" Depth per ' City Standard 707 Furnish and Install 3/8" Minus Mohave Gold 44. Decomposed Granite - 321246 SF $ I.31 $ 4411- 1.02 3" Depth per City Standard 707 Place back 3/8" Minus Mohave Gold Decomposed Granite - 45. 3" Depth per City 11,950 SF $t %1 $ IV,371. 5a Standard 707 on graded slopes in existing parkway planters Grade and Transition existing 3" stabilized DG 46. trail into proposed 3,000 SF $ 0. SS $ 1171+0 sidewalk where they intersect 10' wide 47 Furnish and Install 3"-8" 9,537 SF $1,.o0 $ 570 2-2Z Arizona River Rock 48 Soil Prep and Fine 53,827 SF $ o.z3 $ 1213$0.21 Grading 49 Furnish and Install 5 Gal 221 EA $ZS•Zo $•Z+o Shrub 50. Furnish and Install 1 Gal 34 EA $ 11.0d $ 37y Shrub 51. Furnish and Install 24" 21 EA $ S710 $ 12 Oi10 Box Tree 52. Furnish and Install Date 3 EA $ 3,`l23 $ ISO, 2" Palm 20' BTH Bid Schedule 1210-5 ADDENDUM 01 - 5-5-2022 Unit Price Item Total Item Item Description Est. Unit (In (In No. Qty. Figures) Figures) Dollars Dollars Furnish and Install 53. Mexican Fan Palm 20' 8 EA $1,400 $ it AOD BTH Furnish and Install 54. Permal-oc Header - 21220 LF $ 11. 7-0 $ 2.9's i Asphalt Edge Furnish and Install 55. Boulders per Plan - 58 EA $ 2.53 $14, 67y "Baja Cresta", 3' Furnish and Install 56. Boulders per Plan - 31 EA $ bi4 $ lit qvq "Baja Cresta", 5' 57 Furnish and Install 1 LS $YB,000 $9E�aoo Irri ation per Plan 58. Stacked Boulder Wall, 105 LF $ 77 $Sloss 24" high max 59. 90-Day Maintenance 1 LS $13,5oe $ 13, Sod Raise Air Vac and place 60. cover on northwest 1 EA $'1giv.7q $ 79&•71 corner per CVWD Standard Plans 61. Temporary Lighting 1 LS $11,ggq .-02- $ �1,449•d'L Construct 6" of Concrete 62. Pavement over 6" of 560 SF $ It*.S7 $ I5,1041.20 Class II Aggregate Base Total Base Bid Items 1-62 1 $2,42.1,70. Bid Schedule 1210-6 ADDENDUM 01 - 5-5-2022 City may award all or none of the following additive alternates: ADDITIVE ALTERNATE NO. 1 — Slurry Seal Item Item Description Est. Unit Unit Item Total No. Qty. Price (in (in figures) figures) Dollars Dollars 63. Mobilization 1 LS $16,24°I•1o3 $66,2119.0 64. Traffic Control 1 LS $21,g49•o2 $21,gg9.o2 Crack Seal and Type II Slurry Seal (Limits 65. North side of Avenue 54 346,864 SF $ 0. 4-2- $145-JW2 00% to South side of Avenue 52, excluding new avement 66. Striping and All 1 LS $ 92,ss6.c� $92,sse.�4 Incidentals Total Amount of Additive Alternate Bid Items 63-66 $21o8,ygo.� ADDITIVE ALTERNATE NO. 2 — CVWD Water Valve Item Item Description Est. Unit Unit Item Total No. Qty. Price (in (in figures) figures) Dollars Dollars 67 Lower Water Valve per 3 EA $ 3Rq . 25- $ 1-1 j97, TS CVWD Standards 68 Raise Water Valve per 3 EA $ it sl .o,} $ 3, 4s3.12- CVWD Standards Total Amount of Additive Alternate Bid Items 67-68 $ 411*00. &7 Bid Schedule 1210-7 ADDENDUM O1 - 5-5-2022 ADDITIVE ALTERNATE NO. 3 - CVWD Sewer Manhole Item Item Description Est. Unit Unit Item Total No. Qty. Price (in (in figures) figures) Dollars Dollars Lower CVWD Sewer 69. Manholes per CVWD 1 EA $ 57q.23 $ 571. Z3 Standards Raise CVWD Sewer 70. Manholes per CVWD 1 EA $ 1 logl,31 $ 1,661.11 Standards Total Amount of Additive Alternate Bid Items 69-70 $ Z, 21oV-54 GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Figures): Z,071 1101.040 GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Words): Two PASU Lion SIX �-4u4DRs,D NlwtzY yEvEtl T►+ouSaW.O naE ►^ LtNQp-Fr, NiNC_TrQlDz1.LAVS NOD 'Six Cx*FTS 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. Signature of Bidder (Ink) Name of Bidder (Printed or Typed) 7(00,315 - Vloo Bidder Telephone Number n L 1 ac..ob5�w+t IIZL: [�+ Bidder Email Address Bid Schedule 1210-8 SECTION 1220 BID GUARANT BOND PRINCIPAL, and The Ohio Casualty Insurance* , as SURET , 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. PR03ECT NO. 2017-09 Jefferson Street at Avenue 53 Roundabout - Street Improvements 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 6th day of May . 2022. Jacobsson Engineering Construction Inc. Pr'651b rErrT Title of Signatory r Signature of Principal P O Box 14430, Palm Desert, CA 92255 The Ohio Casualty Insurance Company Attornev in fact Title of Signatory c CCD L&u rA 12 LA" Signature of Surety Diane M Nielsen -Attorney in Fact 818 West 7th St Los Angeles, CA 90017 Address Address Note Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond * The Ohio Casualty Insurance Company 1220-1 CALIFORNIA ALL-PURPOSE 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 J On �j lg f, ^ Dale before me, Linda Rocha personally appeared Diane M. Nielsen y� a° LINDA f OCHA w Notary Public - California -... , -w�:'► Riverside County w .. Commission' 23 10 332 `µy Comm. Expirts Nuv 20, 2023 Place Notary Seal Above , Notary Public, Insert Name of Notary exactly as it appears on the official seal Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my ha a tcial Se I, Signature C Signatu of otary Public Linda Rocha OPTIONAL Though the information below is not required by law it may prove valuable to persons relying on the document and could prevent fraudulent removal anJ reattachment of the form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s): ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Top of thumb here Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer—Title(s): ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Top of thumb here 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 mutual. SURETY Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8205922-972035 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, Di one NI, Nielsen; Matthew S Costello; Sal C Sandoval all of the city of Faint Desert state of CA each individually if there be more than one named, its true and lawful attorney -in -fact to make, execute, seal, acknowledge 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 seals of the Companies have been affixed thereto this 9th day of July , 2021 . C ca y c`o State of PENNSYLVANIA s rr„ County of MONTGOMERY Liberty Mutual Insurance Company INsr�� 11 INS& N INSful The Ohio Casualty Insurance Company West American Insurance Company 1912 0 1919 0 1991 Y�3�edICHUS` yD 0��brsb� �S 'kniaxh a By $rj # �tti a�yd * }off �1441 * h David M. Carey, Assistant Secretary a) On this 9th day of July 2021 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insu w Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument far the pur G therein contained by sionino on behalf of the corporations by himself as a dulv authorized officer. ca CD r =$ _-a � •rn aj O O � (Q ai Cn a) C C P — o a3 �L > aa)i L OL 2 L) 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. ,p, PAST ' pHw F�{ C°mmomveallh of an - NaLwy Seal 0 ' Teresa Pastella, Notary Public Montgomery County of My commission expires March 28, 2025 By: Commission number 1126044 y LV Member. PennsyNmla AssopMion nrN vviones F1y Pastella, Notary Public 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 Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV — OFFICERS: Section 12. Power of Attorney. 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 President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -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 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 attorney -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 All — 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 allomeys-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 attorneys -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 attorneys -in - 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 6th day of May , 2022 INS41Z INS& � %14slis. `� aHPOR7r yn �, c°V%POR4 VP pflnPOR,�T yn 21 1912 n o 1919 1991 n _444r— By r�,, °aacHu� a y° h�ti<vs a Ys EN AA` ab Renee C. Llewellyn, Seaelary w E �o N w 004 �� ao -a co m0 IV C U m aA LMS-12873 LMIC OCIC WAIC Multi Co 02121 SECTION 1230 CERTIFICATION OF BIDDER'S E PERIENCE 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: Project Phoenix owner: City of Twentynine Palms Construction Cost: $4.8M Construction Time: 15 months Owner's Representative: Kenneth Bailey Owner's Telephone No.: 760-367-6799 Date of Substantial Completion: 3/31 /22 2. Project Name: Dune Palms Road Widening Owner: City of La Quinta Construction Cost: $1.2M Construction Time: 9 months Owner's Representative: Leonard St Sauver Owner's Telephone No.: 760-777-7048 Date of Substantial Completion: 10/31/19 Calendar Days 325 Calendar Days 110 Bidders Experience Qualifications 1230-1 3. Project Name: City of Hope Village Road North Improvements owner: City of Hope Construction Cost: $2.3M Construction Time: 8 months Calendar Days 251 Owner's Representative: Kevin Cruz Owner's Telephone No.: 949-422-7805 Date of Substantial Completion: 1/31/22 4. Project Name: San Manuel Blvd South Owner: San Manuel Band of Mission Indians Construction Cost: $2.2M Construction Time: 12 months Calendar Days 365 Owner's Representative: Angel Lopez Owner's Telephone No.: 702-830-2567 Date of Substantial Completion: 5/31/20 Signed this 9 day of May , 2022. Jacobsson Engineering Construction, Inc. 650389 1000008233 Name of Bidder Contractor's License No. DIR Reg No. 7/31 /22 Signature of Bidder Expiration Date Dan Jacobsson President 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. M^Ticbt pOR.Tlonl of G4RP0Rano4 Pn Iboit to .yAj5*L Wp,C* It z&4%o Asyt4Aur PAu►u c.1 I'M 753 I00C404#21v0 CltOsfi'COWN) W-454 PIAZ SM. 'FowttaN of �►.FsTR►tA� pAr'1'A 1 RWIN D►", CX 4 170h F �L 7S(0.5CA I000OOOVS5' ► WAAK) WA&i-rNr Po ISO* U'1'1 PoRY►oN OF 6A,WP5ur,.pE C-O KVrIA �R S I,A %%MlNTA CA 1%7,47 lj6*j05 .a?E 4 11t�►�alat�01.� °Ib37yN 1 0000c3b�o hKOLlcqQ PO Qox 310030 AsP&raLt Sou-r►4,oNc• �oNtANA► , c0► 92.ssj TovrlofJ of S�uerr.Y sal• ?�yqb� oGOoon(ay5 5MPE0.1oR PA"gul 2,li P60MV0 of- MAtwr'�C's B4.u.y►a T cA gjs4,S si&%jiNE, 1,sTwipr4e, 77630(o l0000b14-1b Signature of Bidder Dan Jacobsson Name of Bidder Proposed Subcontractors 1240-1 SECTION 1250 NON -COLLUSION AFFIDAVIT TO BE E ECUTED B BIDDER AND SUBMITTED WIT BID State of California ss. County of Riverside Dan Jacobsson being first duly sworn, deposes and say that he or she is President of Jacobsson Engineering Construction, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation that the bid is genuine and not collusive or sham that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding that the bidder has not in any manner, directly or indirectly sought by 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. (S�iinature Dan Jacobsson Name of Bidder President Title 05/09/2022 Date Non -Collusion Affidavit 1250-1 SECTION 1260 DIR Project Vendor Information Vendor Information: Name Jacobsson Engineering Construction, Inc. Address P.O. Box 14430 i P 92255 Project Manager Patrick Johnston Phone 760-345-8700 City Palm Desert ST CA Email pjohnston@jacobssoninc.com CSLB Certification Number 650389 Public Works Registration No. 1000008233 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 http www.dir.ca.gov Public -Works Prevailing-Wage.f}tm]. 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.gov Public -Works Certified-Payroll- Reporting.html. A copy of certified payroll, including the names and addresses of employees and/or subcontractors working on the job must be included with invoices submitted to the City of La Quinta. DIR Project Vendor Information 1260-1