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Urban Habitat BidDATE: June 28, 2022 SECTION 1200 BID The undersigned, as bidder, declares it has received and examined the Contract Document entitled Project No. 2016-03G X-Park Landscaping and Irrigation 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 1270 Iran Contracting Act of 2010 1280 Russian Aggression Against Ukraine Sanctions 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 Initials 01 July 1, 2003 Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY. Urban Habitat 760-345-1101 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. Urban Habitat Name of Bidder PO BOX 1177 La Quinta, CA 92253 Bidder's Address 963744 Contractor's License No. California State of Incor or Si ature of Bidder Brett Brennan Printed Name of Signatory President Title of Signatory 760-345-1101 Bidder's Telephone Number brett@myurbanhabitat.com Bidder's Email Address 7/31 /2023 Contractor's Expiration Date Witn ss Estimator Title of Witness Bid 1200-2 CALIFORNIA ADDENDUM NUMBER TO: All Prospective Bidders and Plan Holders FROM: Ubaldo Ayon, Assistant Construction Manager DATE: June 29, 2022 SUBJECT: Project No. 2016-03G X-Park Landscaping and Irrigation Improvements The following shall be considered as incorporated into the project plans and specifications for the above referenced project. Portions of plans and specifications not specifically mentioned in this Addendum remain in force. ■ PROJECT SPECIFICATIONS Section 1210: Section 1210 is replaced: the following is a summary of the chan9es: ■ Bid Item 8: Quantity Updated ■ Bid Item 16: Description and Quantity Updated to Include all Concrete Curbs • Add Bid Item 28: Apply Stained Arrow per Caltrans Standard Plan A24A, Bike Lane Arrow, Three-part application Section 1500: Sheet 1500-2 Section 3.0 Li uidated Damages, replace first sentence of paragra h 1• As Reads It is agreed by the parties to the Contract that time is of the essence; and that in the case all work is not completed before or upon the expiration of the time limit set forth within Section 1300 Contract, Subsection 4, damage will be sustained by the City and it is, therefore, agreed that the Contractor will pay to the City an amount of $1,500 per work day. Is Amended to Read It is agreed by the parties to the Contract that time is of the essence; and that in the case all work is not completed before or upon the expiration of the time limit set forth within Section 1300 Contract; Subsection 4, damage will be sustained by the City and it is, therefore, agreed that the Contractor will pay to the City an amount of $1,500 per calendar day. ta Qaigra CALIFORNIA Section 3000: Sheet 3000-8. Section 4.4, Permits, Licenses and Inspection Fees, add the foliowin sentence to the end of paragraph 1: The Contractor will be required to obtain a no -cost Building and Safety permit from the City of La Quinta. The Contractor will be required to request inspection from Building and Safety for the trash enclosure as outlined in the permit. Section 4000: Sheet 4000-4, Section 3.0, Traffic Control, replace the section: As Reads 3.0 TRAFFIC CONTROL (Base Bid Item 2) Traffic Control shall comply with Section 3000-4.1 these Bid Documents. Traffic Control shall be paid for at the contract lump sum (LS) basis as shown on the Bid Schedule. Monthly payments will be made on a pro-rata basis. No additional traffic control will be paid if the add alternate is selected. Is Amended to Read 3.0 WORKING HOURS, SITE CONTROL, AND TRAFFIC CONTROL (Base Bid Item 2) Traffic Control shall comply with Section 3000-4.1 these Bid Documents. X-Park is an active park with the following hours: June 1 2022 - September 4 2022 Monday & Tuesday: Closed Wednesday -Friday: 2:00pm-10: 00pm Saturdays -Sundays 9:00am-9:00pm September S. 2022 - June _1_, 2023 Monday: Closed Tuesday -Friday: 12: 00pm-9:00pm Saturdays -Sundays 9:00am-9:00pm Contractor may work within the fenced area during the times the X-Park is closed only. The Contractor may work outside the fence, in the parkway, and within the parking lot during regular construction hours as listed in the specifications. Concurrent work is encouraged. Contractor shall clean site of construction debris and properly store equipment by the end of each work day. Contractor shall protect all work and open trenches from the public at all times which may require fencing; in addition, Contractor shall install open trench signs, cones, or other protective devices. The use of caution tape tied to cones is not allowed as a means to close off an area. ta Q�dara CALIFORMA Complying with Working Hours, Site Control, and Traffic Control shall be paid for at the contract lump sum (LS) basis as shown on the Bid Schedule under Traffic Control. Monthly payments will be made on a pro-rata basis. No additional traffic control will be paid if the add alternate is selected. Sheet 4000-9, Section 8.0, Concrete Removal and Construction, Add Sub -Section 8.1, Concrete Staining, after payment clause: 8.1 Concrete Staining Concrete staining shall conform to the manufacturer guidelines and as specified below. Concrete staining shall be performed with a three-part application: 1. Prep stencil area with EZ Etch, by Ameripolish. Contractor shall take care to only apply application within the stencil area. 2. Stain concrete within Stencil with Colorluice E, by Ameripolish. Color shall be Walnut. 3. Seal concrete with X-Link, by Amipolish, with CA-29 Mini Safe Grip Non -Skid Additive mixed in, by Westcoat. Contractor shall take care to only apply application within the stencil area. Contractor shall provide a sample of the three-part application on concrete for the City's approval prior to applying to final location. Contractor may provide sample on concrete designated within the project area to be removed. Sample shall be a minimum of 1'x1'. Apply Stained Arrow per Caltrans Standard Plan A24A, Bike Lane Arrow, Three-part application shall be paid for at the each (EA) contract price and no additional compensation will be allowed. Payment shall include full compensation for furnishing all labor, materials, tools, equipment, sample, and doing all work involved in applying concrete stain as specified and no additional compensation will be allowed therefore. Sheet 4000-12, Section 9.0, Asp.halt..Concrete and Placement of Base Material, Sub - Section 9.5, Measurement and Payment, remove the second paragraph as noted below: The EWitFaet Unit pFiee paid peF Square Feet of Remove and Genstruet 5.5" AG ever 6.5" AIJ 61 Q STIR. 195 c-'Hde C..II -, ✓~' F K L.' If 1 b [ -.te Fjals �-�Vl� . T[jiTT[TfTf,3TTlT.jf 11[fC� Uf1 UVVI, m44411U [al � e95„dLt,1ly UIILI YluLii[y ta Qa�tra CALIFORNIA Sheet 4000-12, Section 10.0, Miscellaneous Metal Items. Add the followincl after second paragraph: Metal fencing shall be constructed to the dimensions, color, and shapes shown on the plans. Metal fencing shall be painted conforming to the provisions in Section 59, 'Structural Steel Coatings", of the State Specifications. Color shall be as shown on the plans to be approved by the City prior to the application. Sheet 4000-21, Section 12.0, Landscape and Trr gation, Sub -Section_ 801-5_.1, Generai, add sentence after first sentence: All mainline shall be 1 1/4" schedule 40 pipe. PROJECT PLANS The following changes are made to the plans: ■ Sheet 3: Stained Concrete Arrow Added to Plan • Sheet 6: Clarification to Existing Sleeve Locations Added to Plan. The Contractor is hereby notified; Addendum No. 1 must be acknowledged and initialed as stipulated under the instructions to Bidders and submitted as part of the Bid. Failure to do so shall result in the City designating said bid as "Non -Responsive." APPROVED: Digitally signed by Ubaldo Ayon Jr DR: cn=Ubaldo Ayon Jr, --City of La �-� Quinta,o Public Works, / email=uayon@laquintaca.gov, -US Date: 2022.06.29 17:07:40 -07'00' Ubaldo Ayon Assistant Construction Manager Attachments: 1. Revised Bid Schedule Dated 6-29-2022 2. Updated Plan Sheets 3. Manufacture Technical Data Sheets END OF ADDENDUM NUMBER 1 ADDENDUM O1 — 6/29/2022 SECTION 1210 BID SCHEDULE PROJECT NO. 2016-03G X-PARK LANDSCAPING AND IRRIGATION 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 Project No. 2016-03G X-Park Landscaping and Irrigation Improvements, 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. 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 — 6/29/2022 BASE BID AREA UNIT PRICE ITEM TOTAL ITEM ITEM DESCRIPTION EST. QTY. UNIT (in figures) (in figures) DOLLARS DOLLARS 1 Mobilization 1 LS $'6LV--) ,p $ (31 0 2 Traffic Control 1 LS $ �'�� $ 13�j �Z tl 3 Dust Control 1 LS $ $1�1 1 1 Demolition and Disposal per 4 Plans (including bollard 1 LS $ a61 $ G1O11. removal) 5 Site Wall per Plans 12 SF $ 1�Z• 0 $ '�-CbS v 6 Clean/Paint Walls per Plan 1 LS $ 65W ,2. $ 65101 7 Concrete for Board Yard per Plans 108 SF $'R •'b\ $ Z I'�CA 8 Sidewalk Construction per 600 S F $ Zy•ZO $ Plans 23.Go 9 Stamped Concrete per Plans 483 SF $ L q 1 $ 5t,0 10 Drainage Concrete Box/Grate EA $ $ per Plans 2,A -71(10 Full Depth Asphalt Concrete 11 Grind (4"f), Compact Existing 8 SF $ $ Aggregate Base, and 4" Asphalt Concrete Overlay �ci 00, t (o Modification of existing fence 12 and furnish and install 1 EA $ $ Pedestrian Gate per Plans to 10 3Q3 _ 13 Trash Enclosure per Plans 1 LS $ 501 $ 5071A y Keystone Block Wall 6" high 14 block, 3-course. Locations to 100 LF $ II'' qoG $ be determined in field Lod Ol -00 Clearing, Grubbing, Weed 15 Abatement, and Soil 1 LS $ $ Preparation (including rock and debris removal) Curb, including mow curb, 16 median type curb, and 1,802 LF $ $ modified median type curb as 2 `Suv 3 �,Lc�` l G designated in the plans. vVuv- 17 3/4" Crushed Rock - Desert 18,036 SF $ $ 6Z Gold 18 6" Minus Baja Cresta Rubble 2,651 SF $ '� "� $ q A A 19 3/8" Crushed Rock - Apache 1,018 SF $ Z� $ 2 2 A0 Brown 14�b Bid Schedule 1210-2 ADDENDUM 01 - 6/29/2022 UNIT PRICE ITEM TOTAL ITEM NO. ITEM DESCRIPTION EST. QTY. UNIT (in figures) (in figures) DOLLARS DOLLARS 20 3/8" Minus Decomposed 36,145 SF $ $ 2 Granite - Desert Gold 3/8" Minus Stabilized 21 Decomposed Granite - Desert 12,615 SF $ 1. Z �o C� Gold • 22 Lawn - Sod 4,215 SF $ ` `? $ 23 Artificial Turf with Heatblock SF $ ZU DC^ $ 4 (7 W J Technology3,590 24 Furnish and Install Boulders 36 EA $ 'Z� ' $ WMI 7 per Plans , , 25 Furnish and Install Landscaping per Plans 1 LS $ 511?ISo .y $ '1 C-1 26 Furnish and Install Irrigation 1 LS $ t� $-1 l °l 1 per Plans • 27 90-Day Maintenance Period 1 LS $ fy. $ I �ls� • D Apply Stained Arrow per 28 Caltrans Standard Plan A24A, 1 EA $ $ Bike Lane Arrow, Three-part 1w.11 application Total Amount of Bid Items 1 - 28 $ GRAND TOTAL BASE BID (Figures): $ J 1-) v ­� �— GRAND TOTAL BASE BID (Words): 'FtVi VVnIft I f v r 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. gnature of Bidder (Ink) Urban Habitat Name of Bidder (Printed or Typed) 760-345-1101 Bidder Telephone Number Brett@myurbanhabitat.com Bidder Email Address Bid Schedule 1210-3 1_1%K_ f SECTION 1220 ¢ID GUARANTY BOND PRINCIPAL, and The Gray Casualty & Surety 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. 2016-03G X-PARK LANDSCAPING AND IRRIGATION IMPROVEMENTS NOW, THEREFORE, if the aforesaid Principal is awarded the contract and. time and manner required under the specifications, afte presented to him/her for signature enters into a written form, in accordance with the bid, and files two bonds with faithful performance, and the other to guarantee paymen required by law, and provide certificate of insurance Contract Documents, then this obligation shall be null and and remain in full force and virtue. t within the r the prescribed forms are contract in the prescribed the City, one to guarantee for labor and materials as coverage required by the void; otherwise, it shall be IN WITNESS WHEREOF, we have hereunto set our hands on this 28th day of .tune , 2022, Urban Habitat The Gray Casualty & Surety Company Brett Brennan, President Title of Signatory Si ure of Principal P_O_ Box 1177, La Quinta, CA 92247 Address Matthew C_ Gaynor, Attoney-in-Fact Title of Signatory Signature of Surety 1225 West Causeway Approach, Mandeville, LA 70471 Address Note: Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 Rancho Mesa Insurance Services 06/28/2022 08:42 3205656016940 THE GRAY INSURANCE COMPANY THE GRAY CASUALTY & SURETY COMPANY GENERAL POWER OF ATTORNEY Bond Number: Bid Bond Principal: Urban Habitat Project: Project No 2016-03G. X-Park Landscaping and Irrigation Improvements KNOW ALL BY THESE PRESENTS, THAT The Gray Insurance Company and The Gray Casualty & Surety Company, corporations duly organized and existing under the laws of Louisiana, and having their principal offices in Metairie, Louisiana, do hereby make, constitute, and appoint: Matthew C. Gaynor, Anne Wright, and Andrew Roberts of Santee, California jointly and severally on behalf of each of the Companies named above its true and lawful Attomey(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its deed, bonds, or other writings obligatory in the nature of a bond, as surety, contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the amount of $15,000,000.00. This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boar& of Directors of both The Gray Insurance Company and The Gray Casualty & Surety Company at meetings duly called and held on the 261h day of June, 2003. "RESOLVED, that the President, Executive Vice President, any Vice President, or the Secretary he and each or any of them hereby is authorized to execute a power of attorney qual&3,ing the attorney named .ire 4he given Pcr"vT of Attorney to execute on behalf of the Company bonds, undertakings, and ail contracts of surely, and that each or any of them is hereby authorized to attest to the execution of such Power of Attorney, and to attach the -seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be binding upon the Company now and in the future when so affixed with regard to any bond, undertaking or contract of surety to which it is attached. IN WITNESS WHEREOF, The Gray Insurance Company and The Gray Casualty & Surety Company have caused their official seals to be hereinto affixed, and these presents to be signed by their authorized officers this 28`h day of October, 2021. �. t.g . ..A SEAL By: State of Louisiana r Michael T. Gray President The Gray Insurance Company 4� 0 Cullen S. Piske President The Gray Casualty & Surety Company 1 SEALS ss: Parish of Jefferson On this 2811 day of October, 2021, before me, a Notary Public, personally appeared Michael T. Gray, President of The Gray Insurance Company, and Cullen S. Piske, President of The Gray Casualty & Surety Company, personally known to me, being duly sworn, acknowledged that they signed the above Power of Attorney and affixed the seals of the companies as officers of, and acknowledged said instrument to be the voluntary act and deed, of their companies. to Yc7 I.+ y Notary Public Leigh Anne Henican Notary Q No.92653 Notary Public, Parish of Orleans State of Louisiana Orleans Parish, Louisians My Commission is for Life ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Diego On _ June 28, 2022 _ before me, Daniel Bondesson, Notary Public (insert name and tifie of the officer) personally appeared Mathew C. Gad' who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature DANIEL BON DEMN r -Notary Public • Cafifomfa = w San Commission C� Conission ion � MOM AA COrxoires Ja1 10, 2026 (Seal) 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 June 28, 2022 before me, Teresa Angulo, Notary Public (insert name and title of the officer) personally appeared Brett Brennan 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. ESAANCAJLO WITNESS m hand and official seal. *my zyiPublic-Calify Notary i'uhllc - Callfonrla Riverside County Commission # 2343248 Comm, Expires Jan 24, 2025 Signature (Seal) SECTION 1230 CERTIFICATION OF BIDDER'5 E}CPERIENCE AND i�L1ALIFICATIONS 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: 2. North LaQuinta Turf Renovation- Rancho Ocotillo Owner: City Of LaQuinta Construction Cost: $ 657317.00 Construction Time: 210 Owner's Representative: Owner's Telephone No.: Ubaldo Ayon 760-777-7000 Calendar Days Date of Substantial Completion: April 2021 Project Name: North LaQuinta Turf Renovation - Highlands Owner: City Of LaQuinta Construction Cost: $ 721040.00 Construction Time: 120 Owner's Representative: Owner's Telephone No.: Ubaldo Ayon 760-777-7000 Date of Substantial Completion: November 2019 Calendar Days Bidders Experience & Qualifications 1230-1 3. Project Name: Henderson Park Turf Conversion owner: City Of Henderson Construction Cost: $ 519447.00 Construction Time: 90 Calendar Days Owner's Representative: —DoUQLGUild Owner's Telephone No.: 702-267-4042 Date of Substantial Completion: ctoher2019 _ 4. Project Name: La Cadena Medians Owner: Citv Of Colton Construction Cost: $ 494709.00 Construction Time: 270 Calendar Days Owner's Representative: Jessica Sutows Owner's Telephone No.: 909-370-5561 Date of Substantial Completion: August 2019 Signed this 28 th day of June , 2022. Urban Habitat 963744 1000003890 Name of Bidder Contractor's License No. DIR Reg No. 7/31 /2023 Si ure of Bidder Expiration Date Brett Brennan 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. A B Fence/1440 Beaumont Ave Ste A2 #324 Beaumont, CA/Gates/3.5%/CSLB 995035/ DIR 1000044449 Pavement Rehab/810 Mandevilla Corona, CA/AC Paving/1.5%/CSLB 1051374/ DIR 1000064823 AFE Sports/2683 Lime Ave Signal Hill,CA/Artificial Turf/100/o/CSLB 747934/ DIR 1000004130 S?i 9ana ur id Urban Habitat Name of Bidder Proposed Subcontractors 1240-1 SECTION 12SO NUN-COLLUSXON AFFIDA IT TO BE EXEC11TE0 BY BIDDER AND S11113MITTED WITH BID State of California ) ss. County of Riverside ) Brett Brennan , being first duly sworn, deposes and say that he or she is President of Urban Habitat , 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. Signature Urban Habitat Name of Bidder President Title June 28, 2022 Date Non -Collusion Affidavit 1250-1 7F CALIFORNIA JURAT This certificate is attached to a document titled/for the purpn>e"'Of containing pages, ayd dated A notarypublic or other o#Frcer 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 —\ '0 T *v d� ) Subscribed and sworn to (or affirmed) before me on this day of - � U n �P_ - — , 20 c3L , by �— proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. TERESAANGULO Notary Public - CaliforniaRiverside County 4bmy Commission # 2343248 Comm. Expires Jan 24, 2025 Signature (Seal) r Optional Information Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this jurat to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document Method of Affiant Identification Protome on the basis of satisfactory evidence: Prove D credible witness{Qs) Notarial event is detailed in notaryjournal on: Page # Entry # Notary contact: Other Affian7Thumbprint(s) Describe: 0 Copyright 2007-2015 Notary Rotary, Inc. PO Box 41400, Des Moines, IA 50311-0507. All Rights Reserved. Item Number 101884. Please contact your Authorized Reseller to purchase copies of this form, SECTION 1260 lOIR Project Vendor Inf rmati n Vendor Information: Name: Urban Habitat Address: PO BOX 1177 City: La Quinta ST: CA Zip: 92253 Project Manager: Estella Candelario Email:_ EstellaCcDmyurbanhabitat.com Phone: 760-496-4450 CSLB/Certification Number: 963744 Public Works Registration No.: DIR 1000003890 Classification: Asbestos Boilermaker Bricklayers Carpenter Carpet/Linoleum Cement Masons X Drywall Finisher Drywall/Lathers Electricians Elevator Mechanic Glaziers Iron Workers Laborers X Millwrights _ Operating Eng X Painters Pile Drivers Pipe Trades Plasterers Roofer SheetMeta l Sound/Com Surveyor Teamster Tile Worker. Prevailing Wages and Payr411; 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.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.govLPublic-Works/Certified-Payroll- Reurtina-htmI. 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 1270 COMPLIANCE WITH IRAN CONTRACTING ACT OF 2010 Pursuant to the Iran Contracting Act of 2010 (Pub. Contract Code, § 2200 et seq.), (a) Contractor shall be ineligible to bid on or submit a proposal for any contract for One Million Dollars ($1,000,000) or more if Contractor engages in investment activities in Iran as defined in Public Contract Code Section 2202.5, and/or if Contractor is identified on the list of persons engaging in investment activities in Iran prepared by the State of California pursuant to Public Contract Code Section 2203 subdivision (b). (b) For bids of One Million Dollars ($1,000,000) or more, Contractor must certify that it is not on the list of ineligible vendors prohibited from doing business with the State of California and shall complete the Iran Contracting Act Certification and submit with their proposal at the time of bid. Contractor shall obtain the Iran Contracting Act Certification in the form approved by the State of California, or upon written request to the City Clerk's Office, a copy of the form will be provided to Contractor. Failure by Contractor to provide the certification required by this Section may deem Contractor's bid non -responsive. (c) Nothing in this Section is intended to prevent the City from exercising its rights pursuant to Public Contract Code section 2203, subdivision (c) or (d), or both, on a case -by -case basis. IRAN CONTRACTING ACT CERTIFICATION Pursuant to the Iran Contract Act of 2010 (Public Contract Code 2200-2208), Vendors/Bidders are ineligible to bid on or submit a proposal for any contract with a public entity for goods or services of one million dollars ($1,000,000) or more if the Vendor/Bidder engages in investment activities in Iran. MUST BE SUBMITTED WITH BID PROPOSAL IF BID AMOUNT IS $1,000,000 OR MORE Prior to bidding on, submitting a proposal, or executing a contract or renewal for a public entity contract for goods or services of $1,000,000 or more, a vendor must either: a) certify it is not on the current list of persons engaged in investment activities in Iran created by the California Department of General Services ("DGS") pursuant to Public Contract Code section 2203(b) and is not a financial institution extending $20,000,000 or more in credit to another person, for 45 days or more, if that other person will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS; or b) demonstrate it has been exempted from the certification requirement for that solicitation or contract pursuant to Public Contract Code section 2203(c) or (d). To comply with this requirement, please insert your vendor or financial institution name and Federal ID Number (if available) and complete one of the options below. Please note: California law establishes penalties for providing false certifications, including civil penalties equal to the greater of $250,000 or twice the amount of the contract for which the false certification was made, contract termination, and three-year ineligibility to bid on contracts. (Pub. Cont. Code § 2205.) OPTION #1- CERTIFICATION I, the official named below, certify I am duly authorized to execute this certification on behalf of the vendor/financial institution identified below, and the vendor/financial institution identified below is not on the current list of persons engaged in investment activities in Iran created by DGS and is not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another person/vendor, for 45 days or more, if that other person/vendor will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS. I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Iran Contracting Act Certification 1270-2 OPTION #2 — EXEMPTION Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a vendor/financial institution engaged in investment activities in Iran, on a case -by -case basis, to be eligible for, or to bid on, submit a proposal for, or enters into or renews, a contract for goods and services. If you have obtained an exemption from the certification requirement under the Iran Contracting Act, please fill out the information below, and attach documentation demonstrating the exemption approval. Vendor Name/Financial Institution (Printed) Federal ID Number (or n/a) By (Authorized Signature) Printed Name and Title of Person Signing � Date Executed Iran Contracting Act Certification 1270-3 SECTION 1280 COMPLIANCE WITH CALIFORNIA EXECUTIVE ORDER N-6-22 RUSSIAN AGGRESSION AGAINST UKRAINE (a) Contractor shall comply with California Governor Executive Order N-6-22 regarding sanctions in response to Russian aggression in the Country of Ukraine, and any implementing guidelines and/or economic sanctions imposed by the United States government in response to Russian actions in Ukraine, as well as any sanctions imposed under California law (collectively "economic sanctions"). Contractor shall comply with all such economic sanctions. By submitting a bid to the City, Contractor agrees to take any and all actions to support the Ukrainian government and people as required by law, including by refraining from new investments in, and financial transactions with, Russian institutions or companies that are headquartered or have their principal place of business in Russia (Russian entities), not transferring technology to Russia or Russian entities, and directly providing support to the government and people of Ukraine. (b) If bidding on a contract for Five Million Dollars ($5,000,000) or more, Contractor shall submit a written report to the City on Contractor's compliance with the economic sanctions, and the steps Contractor has taken in response to Russia's actions in Ukraine, including, but not limited to, desisting from making new investments in, or engaging in financial transactions with, Russian entities, not transferring technology to Russia or Russian entities, and directly providing support to the government and people of Ukraine as required by law. Failure to submit the report required by this Section may deem Contractor's bid non- responsive. Please include a written re art to the City if this section is applicable.