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Ortiz Enterprises, Inc. BidSECTION 1200 BID DATE: 101 VJ W- The undersigned, as bidder, declares it has received and examined the Contract Document entitled City Project No. 2011-05, Federal Project No. BRNBIL (537), Dune Palms Road Bridge 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 Federal Requirements Forms for Federal -Aid Construction Projects (The DBE and subcontractor listings are to be submitted by the 5th calendar day after bid openings all bidders) 1280 Russian Aggression Against Ukraine Sanctions 1290 Iran Contracting Act of 2010 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 # 2 3 4 Date Received 9/16/22 9/20/22 9/21 /22 9/26/22 Initials 1 Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY. Ortiz Enterprises Inc., Name of Bidder (949)753-1414 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. Ortiz Enterprises Inc., Name of Bidder 6 Cushing ste 200 Irvine CA 92618 Bidder's Address 467088 Contractor's License No. California (949) 753-1414 Bidder's Telephone Number estimating@ortizent.com Bidder's Email Address 12/31/22 Contractor's Expiration Date State of Incorporati n Signature of Bidder Witness Patrick A. Ortiz Printed Name of Signatory President Title of Signatory Administrative Assistant Title of Witness Bid 1200-2 Addendum 04 — September 26, 2022 SECTION 1210 BID SCHEDULE City Project No. 2011-05 Federal Project No. BRNBIL (537) DUNE PALMS ROAD BRIDGE IMPROVEMENTS REVISED 09 25 2022 — Addendum #4 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 City Project No. 2011-05, Federal Project No. BRNBIL (537), Dune Palms Road Bridge 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 all Base Bid Areas and 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. Item #2A is predetermined for bidding purposes only and only actual costs incurred for utility inspection from utility companies shall be paid without mark-up. Furthermore, this project has broken down the Base Bid areas according to project funding requirements, therefore several of the same bid items have been split between the Base Bid Areas. The following is a listing of the "duplicate" bid items numbers and their corresponding Base Bid location for Contractor reference. In the Bid Schedule, the "Duplicate" items have been noted with a (D) in the description. Base Bid #1 Duplicate Base Bid Area Des--ri tion Item Number & Item Number #-### Sawcut & Removal AC Pavement 5 2-91 Sawcut & Remove Conc. Slope Protection 7 3-116 Unclassified Excavation (Roadway) 9 2-93 Unclassified Fill (Roadway) 11 2-94 Suitable Backfill Material 12 2-95 Asphalt Concrete (T=4.5") 14 2-97 Class 2 Aggregate Base (T=6.0") 15 2-99 6" AC Dike 17 2-100 6" Curb & Gutter 18 2-101 8" Median Curb 19 2-102 Concrete Sidewalk (W=5.5') 20 2-103 Concrete Driveway Approach 21 2-104 Colored Stamped Concrete Median 22 2-105 Bid Schedule 1210-1 Addendum 04 - September 26, 2022 Concrete Slope Protection 26 3-117 Curb Ramp (Case A) 27 2-106 6' (Tall) Masonry Block Wall 28 2-107 4" Schedule 40 PVC, Landscaping Sleeve 47 2-109 Install Landscaping Plant Material & Irrigation 51 2-111 3/8" Crushed Rock (Apache Brown) 52 2-112 3/4" Crushed Rock (Desert Gold) 53 2-113 6" Minus - Baja Cresta Rubble 54 2-114 3/8" Decomposed Granite - Brimstone 55 2-115 Structure Excavation (Ret Wall) 59 3-134 Structure Backfill (Ret Wall) 60 3-135 Structural Concrete (Ret Wall) 67 3-136 Bar Reinforcing Steel (Ret Wall) 72 3-137 BASE BID AREA - DUNE PALMS ROAD BRIDGE IMPROVEMENTS: BASE BID #1; FEDERAL PARTICIPATING (STA 16+50 - 25+62) Item Item Description Est. Unit Unit Price (in figures) Item Total (in figures) Q y- Dollars Dollars Roadway Approaches 1 Mobilization 1 LS $,� /(jt2,cT00 - $ Z, /00, 0cN 2 Best Management Practices 1 LS $ A 15-&Z - $ AIS,D� 2A Utility Company Inspection 1 LS $ 60,000.0 $ 60,000.00 (Allowance) 3 Traffic Control 1 LS $ 17faov $ 1']j-6vJ - 4 Resident Engineers Trailer 23 MO $ $ �,2,C-V,) 4A Construction Monitoring 1 LS $ aC�,�9c7iD $ 2a,Qc90 '" Camera 5 Sawcut & Remove AC 22,000 SF $ $O $ Pavement (D) 6 Remove Concrete Pavement 41,686 SF $ _ $ 2�, 1t(a _ and Cut Off Wall (Crossing) 7 Sawcut & Remove Conc. Slope 13,160 SF $ �,�0 $ a'7 qS� Protection (D) i 8 Clearing & Grubbing 1 LS $ 1RO ,JVD_ $ 9 Unclassified Excavation 555 CY $ GO $ (Roadway) (D) (F) 10 Unclassified Excavation 3,200 CY $ 30— $ `((O,cloo — (Channel) (F) 11 Unclassified Fill (Roadway) 5,435 CY $ $ (D) (F) Bid Schedule 1210-2 Addendum 04 — September 26, 2022 BASE BID #1; FEDERAL PARTICIPATING (STA 16+50 — 25+62) Est. EstQty Unit Price Item Total Item No. Item Description Unit (in figures) (in figures) Dollars Dollars 12 Suitable Backfill Material 80 CY $ 300— $ ,2L100r-> _ (D) (F) 13 Construct & Remove Bypass 1 LS $ /IaW'c7W— $ 1��Qc�, vUD Road 14 Asphalt Concrete (T=4.5") (D) 24,140 SF $ ?j.ao $ 77,2L(S 15 Class 2Aggregate Base 24,140 SF $ $ (T=6.0-) (D) 16 Crushed Misc. Base 521 CY $ /yo— $ V. c1 Ya r 17 6" AC Dike (D) 135 LF $ / 3 .- $ /, 7%S 18 6" Curb & Gutter (D) 448 LF $ $ q� 8 19 8" Median Curb (D) 581 LF $ /9 $ I D39 20 Co) crete Sidewalk (W=5.5') 4,148 SF $ /(o— $ (06, 369 — 21 Co) crete Driveway Approach 1,034 SF $ 2 (o — $ 2 �o, 22 Colored Stamped Concrete 711 SF $ ((o $ III.3x Median (D) 23 Concrete Cross Gutter 1,215 SF $ 1_57� SU $ 24 8" Concrete Pavement 1,142 SF $ 9 — $ 79 25 Type 1A Retaining Wall 1,829 SF $ �j�p $ 26 Concrete Slope Protection (D) 1,210 CY $ -710 -- $ 27 Curb Ramp (Case A) (D) 1 EA $ 8, fop $ 28 6' (Tall) Masonry Block Wall 300 LF $ /Lab $ �yrcTo� (D) 29 Catch Basin Per LQ Std 300 & 3 EA $ y� Local Depression (Sump)- 30 Catch Basin / Drywell System 1 EA $ ,Cop w/ Local Depression (Sump) 31 Storm Drain Manhole No. 2 1 EA $ Ut1v ' $ ci3OUO — per MH252 32 Reconstruct to Grade SD 7 LF $ ' S� _ $ 0, Sum Manhole F33 24" Storm Drain Outlet w/ 1 EA $ (z OC2� $ Grate Bid Schedule 1210-3 Addendum 04 - September 26, 2022 BASE BID #1; FEDERAL PARTICIPATING (STA 16+50 - 25+62) Unit Price Item Total Item Item Description Est. Unit (in figures) (in figures) Dollars Dollars 34 42" Storm Drain Outlet w/ 1 EA $ )C aao $ %0,CDer"0 Grate 35 Concrete Collar Per M803 3 EA $ 2,,2� $ 36 24" HDPE N-12, WT Joint SD 232 LF $ So $ 3y,8� r Pipe 37 Metal Fencing (Retaining Wall) 438 LF $ ;IO $ III -f $D 38 Metal Gate Assembly 2 EA $ '�A'oa $ `ILI'ac-p-c-, - 39 Chain Link Fence H=6', w/ 1,085 LF $ y� - $ Fabric 40 24' Wide Vehicle Gate w/ Lock 1 EA $ (a1 (0049- $ 41 Temporary Fence (High 700 LF $ S— $ 5,- bw Visibility) 42 Meter Pedestal Per LQ Std 730 1 EA $ �;-dva l $ 5-0" 43 Pipe Gate 26 LF $ - $ / �/� 3C-)b - 44 2" Schedule 80 PVC, City 2,042 LF $ 30. $ ��2ap0 Comm. Conduit 45 Pull Box No. 3.5 (PCC) 6 EA $ 35-10 — $ 02 , I Ov - 46 Signing, Striping & Pavement 1 LS $ 30,5da $ 30,500 Markers 47 4" Schedule 40 PVC, 42 LF $ '3357 $ 31 S7D - Landscaping Sleeve (D) 48 Adjust to Grade Storm Drain 1 EA $ � F0 - $ 1 SO - Manhole 49 4" Thick Decomposed Granite (D) (School Ret. & Pool Wall) 1,430 SF $ '� 7 $ `O, 0/O - 50 Remove Communications 1 EA $ /�,0oz7 $ MH/Vault Landscaping 51 Install Landscaping Plant 4,600 SF $ /p $ y�o,�a - Material & Irrigation (D) 52 3/8" Crushed Rock (Apache 3,490 SF $ 3 $ �� y7p - Brown) (D) 53 3/4" Crushed Rock (Desert 1,130 SF $ $ �6a Gold (❑ r54 6" Minus - Baja Cresta Rubble 465 SF $ $ (D) Ir Bid Schedule 1210-4 Addendum 04 - September 26, 2022 BASE BID #1; FEDERAL PARTICIPATING (STA 16+50 - 25+62) Item Item Description Unit Unit Price (in figures) Item Total (in figures) Qty: Dollars Dollars 55 Not Used 56 90-Day Maintenance Period 1 LS $ 7 7 ,o v - Brid e 57 Structure Excavation (Bridge) 151 CY $ 3*0 $ l(r,, 3cro (F) 58 Structure Backfill (Bridge) (F) 361 CY $ 7s - $ 63 59 Structure Excavation (Ret 204 CY $ q O - $ Wall #3 & 4) (F) (D) 60 Structure Backfill (Ret Wall 288 CY $ 1, 0 - $ 3 y #3 & 4) (F) (D) 61 2 j" Cast -In -Drilled -Hole -Piling 3,076 LF $ /60 - $ y92, /60 ' 62 60" Cast -In -Drilled -Hole -Piling 1,284 LF $ (090- $ 0- ?(oo � , 63 restr s ing Cast -In -Place Prestressing 1 LS $ (2S�r,`to�� $Concr�•Z�C��1J 64 Structural Concrete, Bridge 1,130 CY $ 750 "- $ 0Y 7, Polymer Fiber (4,500 PSI) (F) 65 Structural Concrete (4,500 1,640 CY $q 5- $ PSI) (Bridge) (F) 66 Structural Concrete (4,000 285 CY $ /� S"� $ 57� , 7� - PSI) (Bridge) (F) 66A Structural Concrete (Bridge 152 CY $ �570 _ $ CN Footing) (F) 67 Structural Concrete (Ret 119 CY $ �� 2Qa - $ Wall #3 & 4) (F) (D) 68 Structural Concrete Approach 206 CY $ /� yp� $ ��'/&D - Slab (Type N 30) 69 Minor Concrete (Median Paving, 116 CY $ yC3 � - $ l6� Y� Colored and Stamped) (F) 70 Joint Seal Assembly (MR = 2 181 LF $ �O $ L(S, 2S-D 71 Bar Reinforcing Steel (Bridge) 1,191,536 LB $ $ (F) 72 Bar Reinforcing Steel (Ret Wall #3 & 4) (D) (F) 11,881 LB $ O ) � $ 99 O O 73 Condc)rete Barrier (Type 732 SW 968 LF $ L/0 - $ 3,3 WMo Bid Schedule 1210-5 Addendum 04 - September 26, 2022 BASE BID #1; FEDERAL PARTICIPATING (STA 16+50 - 25+62) INo Item Description Est. Qty, Unit Unit Price (in figures) Dollars Item Total (in figures) Dollars 74 Metal Railing (Bridge) 968 LF $ 3Vs - $ 33J y�o 75 Bridge Lighting & Pull Boxes 1 LS $ $ 76 Miscellaneous Metal - Conduit Support System (Bridge) 1 LS $ �10 ODD - $ ] c?OD - CVWD Sewer Main Relocation 77 Remove Sewer Manhole 3 EA $ $ /7, 7(D 78 Remove Pipe 201 LF _ $ 75 $ 1,5� 07S 79 Reconstruct Sewer Manhole 7.4 LF $ /,, 700 $ 80 48" Sewer Manhole 4 EA $ ,Z� ch30 Y $ 81 12" PVC Sewer Pipe 49 LF $ 500 $ 82 18" PVC Sewer Pipe 166 LF $ C/ SO $ 7 Y, 700 83 Remove Structural Encasement 43 LF $ - 02.?a $ 70 - F84 Remove 36" Steel Sleeve 73 LF $ $ 85 Structural Encasement 50 LF $ 3(aS - $ 86 Sewer Bypass 1 LS $ Spec% $ 5-0,(Doi) - CVWD Water Main Relocation 87 18" CL 350 DIP Watermain w/ Restr. As, Zinc Coated & V Bio Poly Wrapped 670 LF $ /c7o - $ 737,vva 88 Remove Blind Flange 2 EA $ S<<f00 $ 89 Remove Water Main 646 LF $ jZ9 - $ 90 36" Steel Sleeve 24 LF $ /� �� $ Total Amount of Base Bid #1; Bid Items 1 - 90 $ '`6 7,F) /01 r Bid Schedule 1210-6 Addendum 04 — September 26, 2022 BASE BID #2; NON-FEDERAL PARTICIPATING (STA 10+82 — 16+50 & 25+62 — 36+05) Unit Price Item Total Item Item Description Est. Qty Unit (in figures) (in figures) Dollars Dollars Roadway Items 91 Sawcut & Remove AC 16,190 SF $ /. c,60 $ .2 Pavement (D) 92 Clearing & Grubbing 1 LS $ �"Ov�O — $ S0,00 — 93 Unclassified Excavation 275 CY $ (oQ — $ � (p, (Roadway) (D) (F) 94 Unclassified Fill (Roadway) 640 CY $ $ — $ �, l (D) (F) 95 Suitable Backfill Material (D) 51 CY $ 3c70 — $ ( 3c9a (F) 96 Cold Mill AC Pavement (T=0.10') (D) 3,360 SF $ $ o — 3� 97 Asphalt Concrete (T=4.5") (D) 18,540 SF $ CD $ 32$ 98 Asphalt Concrete (T=0.10') 3,360 $(D) PSF 99 Class 2 Aggregate Base 18,540 $ �O $ 3S; 22(0 — (T=6.0") (D) 100 6" AC Dike (D) 351 LF $ 13 — $ y5�. 101 6" Curb & Gutter (D) 347 LF $ , $ 102 8" Median Curb (D) 2,093 LF $ q $ 103 Concrete Sidewalk (W=5.5') 4,909 SF $ $ 104 Concrete Driveway Approach 723 SF $ $ (D) 105 Colored Stamped Concrete 1,360 SF — Median (D) 106 Curb Ramp (Case A) (D) 1 EA $ $�So�' $ 107 6' (Tall) Masonry Block Wall 60 LF $ $ 108 Signing, Striping & Pavement 1 LS $ Oao $ Markers 109 4" Schedule 40 PVC, 46 LF $ $ p �� Landscaping Sleeve (D) 110 Water Service Manifold Reconstruction 1 LS $ 3� _ Bid Schedule 1210-7 Addendum 04 - September 26, 2022 BASE BID #2; NON-FEDERAL PARTICIPATING (STA 10+82 - 16+50 & 25+62 - 36+05) Unit Price Item Total Item Item Description Est.. Qty. Unit (in figures) (in figures) Dollars Dollars Landscaping 111 Install Landscaping Plant 1,630 SF $ jp $ Material & Irrigation (D) 112 3/8" Crushed Rock (Apache 1,235 SF $ 3 — $ 7 OS Brown (D) 113 3/4" Crushed Rock (Desert 395 SF $ $ 90r Gold) (D �` 114 6" Minus - Baja Cresta Rubble 160 SF $ 9 - $ j yya -- 115 Not Used Total Amount of Base Bid #2; Bid Items 91 - 115 $ f 3' BASE BID #3 - CV LINK Item Item Description Est,, Unit Unit Price Item Total No. Qty- (in figures) (in figures) Dollars Dollars CV Link Trail Plan Items 116 Sawcut & Remove Conc. Slope 14,200 SF $ ' �' �O $-f Protection (D) 3� 2 117 Concrete Slope Protection (D) 805 CY $ 710 118 18" Storm Drain Outlet w/ 1 EA $ ��0� $ Ig v�p - Grate 119 18" HDPE N-12, WT Joint SD 58 LF $ jo?� ' $ 7,2s0 Pipe 120 Class 2 Aggregate Base 13' 360 SF $a� j $ 3O, 72$' (T= 4") 121 Concrete Trail (T=6") 13,360 SF $ 7 $ ( :' -52v ` 122 Curb Ramp (Case B, Type 1) 2 EA $ ��CJo $ j 700v — 123 Metal Railing (Trail Retaining 274 LF $ (Q S0 �Op - Walls) 124 Metal Railing (Trail 730 LF $ ��Q' $ j -Y �pD Undercrossing) , 125 Install City Furnished In 18 EA $ 35 ' $ 6 3Qv Pavement Solar Guide Liqht , Bid Schedule 1210-8 Addendum 04 - September 26, 2022 BASE BID #3 - CV LINK Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 126 Thermoplastic Banding 1,588 SF $ �j? .. $ �(o,S, 1/ (Undercrossing) 127 6" Solid White Stripe (Paint) 180 LF $ $ 025-4 - (Tra i I) 128 Paint Bridge Soffit & Exterior 1 LS $ S'�? o� � $ �4, �0D Girder 129 F&I Soffit Panels w/ Electrical 1 LS $ '(0 d0 - Connections 130 3" Schedule 40 PVC, CV Link 990 LF $ ?j0- $ ,2y 7Dd Conduit 131 Pull Box No. 3.5 (PCC) 4 EA $ 70-0 $ �v 132 4" Thick Decomposed Granite 6,400 SF $ j _ $ �z ozo (D) 133 Concrete Wedge Curb 288 LF $ �g ' $ J $Y CV Link Bridge Plan Items 134 Structure Excavation (Ret 368 CY $ Yo_ $ IY,7av- Wall #1 & 2) (F) (D) 135 Structure Backfill (Ret Wall 501 CY $ �/� $ (O 12O, v #1 & 2) (F (D 136 Structural Concrete (Ret 201 CY $ a d0 $ 20v - Wall #1 & 2) (F) (D) 137 Bar Reinforcing Steel (Ret 20,001 LB $ to $ '-1,ZDo�, l� Wall #1 & 2) (D) I Total Amount of Base Bid #3; Bid Items 116 - 137 2 p '? g Ix,/o 0*' BASE BID #4 - UNDERGROUND ELECTRICAL SYSTEM Item No. Item Description Est., Qty. Unit Unit Price (in figures) Dollars Item Total (in figures) Dollars 138 Dry Utility Trenching 900 LF $ SS' - $ 139 Large Vault Per IID Standard 1 EA $ ��(N $ 140 3" Sch. 40 PVC, IID Conduit 30 LF $ S - $ �SO 141 4" Sch. 40 PVC, IID Conduit 100 LF $ $ CTD Bid Schedule 1210-9 Addendum 04 - September 26, 2022 BASE BID #4 - UNDERGROUND ELECTRICAL SYSTEM Item No. Item Description Est. Qty. Unit Unit Price (in figures) Dollars Item Total (in figures) Dollars 142 5" Sch. 40 PVC, IID Conduit 520 LF $ a l , $ lD 9;Z0 — 143 6" Sch. 40 PVC, IID Conduit 4,000 LF $ ag - $ 144 5" Riser for Pole 1 EA $ �f� $ 2� -cm 145 Transformer Pad (Single phase) per IID Standard 1 EA $ �� , Total Amount of Base Bid #4; Bid Items 138 - 145 $ 70 ' The City may choose to Award All Some, or None of the Following Additive Alternates: ADDITIVE ALTERNATE A - ROADWAY (STA 10+82 - 16+50 & 25+62 - 36+05) Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 146 Crack Seal & Type II Slurry 136,650 SF $ Q,?jl $ 9-? S2% S,0 Seal Total Amount of Additive Alternate "A" Bid Item 146 $ L17,$.27. 510 ADDITIVE ALTERNATE B - CVWD SEWER ADJUSTMENTS Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 147 Adjust to Grade Sewer 2 EA $ 7So $ S� Manhole Lid & Frame to Grade 148 Adjust Sewer Cleanout to 1 EA $ S2710 . $ Soa Grade 149 Sewer Cleanout 1 EA $ j, NO ' $ �i�00 150 [Relocate econstruct Sewer Manhole 13 LF $ 3, rJoa 70 - Total Amount of Additive Alternate "B" Bid Items $ 147-150 Bid Schedule 1210-10 Addendum 04 — September 26, 2022 ADDITIVE ALTERNATE C — CVWD WATER ADJUSTMENT Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 151 Adjust to Grade, Water Valve $ —F EA $ Cd� l $ c.1, 000- Can and Lid Total Amount of Additive Alternate "C" Bid Item 151 $ L/ C9[/70 ADDITIVE ALTERNATE D - CVWD WATER RELOCATION Item Item Description No. Est. Qty. Unit Unit Price (in figures) Dollars Item Total (in figures) Dollars 152 Relocate Air Vac Assembly 2 EA $ y, $ 9,Q�7c7 Total Amount of Additive Alternate "D" Bid Item 152 $ 9 �� GRAND TOTAL ALL BASE BIDS AND ALL ADDITIVE ALTERNATES (Figures): ZI,63S7. 1a6a GRAND TOTAL ALL BASE BIDS AND ALLADDITIVEALTERNATES (Words): . -� � C� ; (,l,cvl ,' �4n dral �'`Tr'� F.•ue.�wusa.d Sr u{n f�,,,c..dr.ad 4'; O l Aft a64(c^r > r�- 6 SFxr-V Cam,, ors 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 alteratiopT7sVls"vhFre ftwided herein. Signature of Bidder (Ink) Ortiz Enterprises Inc., Name of Bidder (Printed or Typed) 949 753-1414 Bidder Telephone Number estimating@ortizent.com Bidder Email Address Bid Schedule 1210-11 SECTION 1220 B I D GUARANTY BOND PRINCIPAL, and Berkley 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. 2011-05 Federal Project No. BRNBIL (537) DUNE PALMS ROAD BR I DGE 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 16th day of September , 2022. President Title of Sig patory Signature-0f Principal PatriVsA. Ortiz 6 Cushing, Suite 200., Irvine, CA 92618 Address Attorney -In -Fact Title of Signatory Signature of Sure n G. Kookootsedes 12 Mauchly, Bldg I, Irvine, CA 92618 Address Note: Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 �L.�Y�iY-'s'Lu`�"`--nYj��•`u�'�S'�">3:'�v'i�tir1.4�Gt�`4�tiiLY�.'4.'..'?L.^�'�i�r��'w`ye.�'�'Y�';.�'�`[F�i:'i��SS�'c`�^:�'kiiu3'-i�e��'.��C�Ss�S�is�`ea'`Z'.�.�=Vic.{3�:'7�.a�'..�.:'�=e �e A notary public or other officer completing this certificate verifies onlythe 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 0V C&v\ fre-- Dn ,u-L:4, before me, O \A Date Here Insert Name and Title of the Officer personally appeared ��^U1 �A--oD1oa" 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. '• , UNMEY WINZEN Notary Public • Caiitornia _, r grange County � Commission # 2381340 " my Comm. Expires Nov 2. 2025 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 official seal. Signature Signature of tarp• 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 Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: ©2019 National Notary Association Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: No. BI-8103d POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WILMINGTON, DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. b KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly al organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made, constituted and appointed, and does by these presents make, constitute and appoint: John G. Koohootseeles; or Mark D. ld'alling of Infinity .� Assurance Group d/Wa LAG Insurance Services of Irvine, CA its true and lawful Attorney -in -Fact, to sign its narne as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of .5 Financial Guaranty Insurance, providing that no single obligation shall exceed One Hundred Million and 001100 U.S. Dollars - (u.S.SI00,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. 1A ?This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, o > without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following >> �' resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25, 2010: >; o RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief o Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attomey-in-fact named therein o to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the 3 .° corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such oattorney -in -fact and revoke any power of attorney previously granted; and further e RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, H w or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated; and further n RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney -in -fact named; and a3 further RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any .!2 E power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or s 3 other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as E though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any o ¢ person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have ceased to be such at the time when such instruments shall be issued. w 5- IN WITNESS WHEREOF, the Company has caul d thes presents to be signed and attested by its appropriate officers and its ° corporate seal hereunto affixed tbis�[Iay of �9. o x CZ Attest: Berkley Insurance Company E - (Seal) By By Ira S. Led rnian Jef . after to Executive Vice President & Secretary or Presiden U o E WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE "BERKLEY" SECURITY PAPER. STATE OF CONNECTICUT ) o ) ss: COUNTY OF FAIRFIELD ) 0 y Sworn to before me, a Notary Public in the State of Connecticut, this day of 2019, by Ira S. Lederman and Jeffrey M. Hafter who are sworn to me to be the Executive Vice President/ ecretary, and th • enior Vice President, respectively, of Berkley Insurance Company. MARIA c RUNnRAKEN NOTARY runi IC ch CONNECTITTICUT r �w r I MY COMMISSION APHIL 30,2024PIRE9f4otary Public, State of Connecticut v U CERTIFICATE ~7� I, the undersigned, Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a Q ; true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded 3 and that the authority of the Attorney -in -Fact set forth therein, who executed the bond or undertaking to which this Power of Attorney is attached, is in Bill force and effect as of this date. Given under my }mind and seal of the Company, this ,� r ay of c2�� (Seal) _ Vincent F orte CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of On before me,N0 r4lrL1 Q0 1764,o Date Here Insert Name and Title of tho--bfficer personally appeared PAMc L- A. u �fi2 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. *my CRYSTAL M. PINEDA Notary Public - California Orange CountyCommission M 2340951 U. Comm. Expires Feb 2, 2025 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 official seal. Signature ignature 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 Title or Type of Document: Document Date: Signer(s) Other Than Named Above: — _ _ Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 02019 National Notary Association Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 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. ProjectName: POTRERO BRIDGE ROUTE 60 Owner: City of Beaumont Construction Cost: $ 19154386.16 Construction Time. 1 year Calendar Days Owner's Representative: F.FF HART Owner's Telephone No.: 951 572-3213 Date of Substantial Completion: 1011/19 2. Project Name• ROUTE I-15 TEMECULA Owner: City of Temecula Construction Cost: $ 25751758 Construction Time: 1 year Owner's Representative: Alvin Odviar Owner's Telephone No.: 951.693.3936 Date of Substantial Completion: _5/2/2018 Calendar Days Certification of Bidder's Experience and Qualifications 1230-1 3. ProjectName: RIVERSIDE DR NEAR ZOO DRIVE BRIDGE Owner: City of Los Angeles Construction Cost: $ 12165071 _ Construction Time: 3 years Calendar Days Owner's Representative: je= He nin.le.7 Owner's Telephone No.: 213-485-4970 Date of Substantial Completion: I1/1/19 4. Project Name: NORTH VINEYARD AVE Owner: City of Ontario Construction Cost: $ 26451000 _ Construction Time: One year Calendar Days Owner's Representative: Cind Hacke i.ontario. s Owner's Telephone No.: 909-395-2000 Date of Substantial Completion: 6/15/16 Signed this J' i/ day of r . 0. , 2022. Ortiz Enterpises Inc., Name of Bidder Signatur o Ndder Patrick A. Ortiz Printed Name of Bidder 1 • 1::1, 1000003766 Contractor's License No. DIR Reg No. 12/31 /22 _ Expiration Date President Title of Signatory Certification of Bidder's Experience and 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. Iabd4 Cw . 3 , 1 / P, I P 06vF (D 1p% 4 Let 6,9 r23y(� 1. 19 1 g3 00000 Y2C0d 0-7 Cam. 4 (�v try 5 -, �� s C4 f1773, �' Sip l 7 Sy 30co (000 0 1 ZZ ss — GtO ) Signature of Bidder Ortiz Enterprises Inc., Name of Bidder Proposed Subcontractors 1240-1 SECTION 1240 PROPOSES] 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. o }- S (i 0 0 Cal dU-. , CA 'IZ3 2y 3gv�a & 575�3 I Oct) o & Y Be 9 M — 904) Signature of Bidder Ortiz Enterprises Inc., Name of Bidder Proposed Subcontractors 1240-1 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. 6PCO, h A A a c.a 3o-o 6. kek- si-. B(,ea G¢ 12 z( O .Cr, Xd <6- 0 00 10 �► --904) Signature of Bidder Ortiz Enterprises Inc., Name of Bidder Proposed Subcontractors 1240-1 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. SC,%, CT I J✓ t �r'C r' t' s 7 a r s S LlgZ SfIZ, ! vnooaSr $ - n j /�33 iZ c`lf%�o0 s'3� 7 - Signature of Bidder Ortiz Enterprises Inc., Name of Bidder Proposed Subcontractors 1240-1 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. 1040 y ¢nos r P� A4 --rC: s �0 �c o17� 19 u Ca9 �tLL�. O. SY 7 7., 10 &N70a a t (,5 — Qoz�k� Signature of Bidder Ortiz Enterprises Inc., Name of Bidder proposed Subcontractors 1240-1 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. of 7S3(p L00 00 �s3 -90Z�k� Signature of Bidder Ortiz Enterprises Inc., Name of Bidder proposed Subcontractors 1240-1 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. /o< DOa s3 $�12 (ol S `7 4-lp-Y - 7 -5�i I C,49 f7s- 90�;k� Signature of Bidder Ortiz Enterprises Inc., Name of Bidder Proposed Subcontractors 1240-1 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. r1,414 �-�CA— CO. aGYO 0,900V 71-P - - 904 � Signature of Bidder Ortiz Enterprises Inc., Name of Bidder rend f Gc,,w�� Proposed Subcontractors 1240-1 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 awn 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. 'i Signature of Bidder Ortiz Enterprises Inc., Name of Bidder Proposed Subcontractors 1240-1 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. Signature of Bidder Ortiz Enterprises Inc., Name of Bidder proposed Subcontractors 1240-1 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. Signature of Bidder prtiz Enterprises Inc., Name of Bidder Proposed Subcontractors 1240-1 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. 1 Signature of Bidder Ortiz Enterprises Inc., 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 ) Patrick A. Ortiz being first duly sworn, deposes and say that he or she is President of Ortiz Enterprises 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. f� Signatu Ortiz Enterprises Inc Name of Bidder President Title IV--3-�Zc22, Date Non -Collusion Affidavit 1250-1 CALIFORNIA JURAT GOVERNMENT CODE § 8202 FthAnotary public or other officer completing this certificate verifies only the identity of the individual who signed e document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California Countyof _4301( 43--my CRYSTALM. PINEDA Notary Public - California Orange County. �Commission # 2340951 Comm. Expires Feb 2, 2025 Place Notary Seal and/or Stamp Above Subscribed and sworn to (or affirmed) before me on this . I rh day of W'Ol y , 20t" , by Date Month Year (and (2), ) Name(s) of Signer(s) proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature A • A' gnoture 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 Title or Type of Document:. Y10n Cut1Llsl0Y1 A-MacIV4- Document Date: —1U II 31 yz Number of Pages: Signer(s) Other Than Named Above: 02019 National Notary Association SECTION 1260 SIR Proiect Vendor Information Vendor Information: Name: Ortiz Enterprises Inc., Address: 6 Cushing Ste 200 Zip: 92618 Project Manager: Mike Adams Phone: 949 753 14-1414 Public Works Registration No.: Classification: —City: Irvine mail: madams@ortizent.com CSLB/Certification Number: 1000003766 467088 Asbestos Boilermaker Bricklayers Carpenter X Carpet/Linoleum Cement Masons X Drywall Finisher Drywall/Lathers Electricians ST: CA Elevator Mechanic Glaziers Iron Workers Laborers X Millwrights Operating Eng X Painters Pile Drivers Pipe Trades Plasterers Roofer SheetMetal Sound/Com Surveyor Teamster Tile Worker. Prevailirug 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: htt www.dir.ca. ov Public -Works Prevailin -Wa e.htmi. 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 SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., proposed subcontractor , hereby certifies that he has X I has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS E UAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., proposed subcontractor hereby certifies that he has X f has not participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., proposed subcontractor hereby certifies that he has X has not participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS E UAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., proposed subcontractor hereby certifies that he has- X has not participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., proposed subcontractor hereby certifies that he has X r has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATIO The bidder Ortiz Enterprises Inc., A4,1 is A proposed subcontractor , hereby certifies that he has X I has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not -filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATI®N The bidder Ortiz Enterprises Inc., subcontractor ✓"tC�it�N1`�c55�u�r�5� .�� hereby certifies that he has X has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable proposed filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., proposed subcontractor C-.,pnr'b"4CA041 ��,�. hereby certifies that he has X has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., // proposed subcontractor SG�'l,o� rrs �✓iC . hereby certifies that he has X f has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., proposed subcontractor S Af 17n f : , hereby certifies that he has X has not participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., proposed subcontractor hereby certifies that he has X has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFI+CATION The bidder Ortiz Enterprises Inc., proposed subcontractor (n �� f� 7 c.e— Go . by certifies that he has X has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification SECTION 1270 FEDERAL REQUIREMENTS FORMS FOR FEDERAL -AID CONSTRUCTION PROJECTS EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ortiz Enterprises Inc., proposed subcontractor U/?hereby certifies that he has X , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Federal Requirements Forms for Federal -Aid Construction Projects 1270-1 Equal Employment Opportunity Certification PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has , has not x been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No x If the answer is yes, explain the circumstances in the following space. Federal Requirements Forms for Federal -Aid Construction Projects 1270-2 Public Contract Code Certification Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Federal Requirements Forms for Federal -Aid Construction Projects 1270-3 Public Contract Code Certification DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; ■ has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Federal Requirements Forms for Federal -Aid Construction Projects 1270-4 Debarment and Suspension Certification NON -LOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub -recipients shall certify and disclose accordingly. Federal Requirements Forms for Federal -Aid Construction Projects 1270-5 Non -Lobbying Certification for Federal -Aid Contracts DISCLOSURE OF LOBBYING ACTIVITIES rr)MPI FTF TH1g FnPM Tn nIr,C'l ()SF I nRRYING ACTIVITIES PURUSUANT TO 31 USC 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ® a. contract ® a. bid/offer/application ®a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: © Prime Subawardee Ortiz Enterprises Inc., Tier , if known 6 Cushing Ste 200 Irvine Ca 92618 Congressional District, if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $ ✓�% f❑ actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission ea. cash — d. contingent fee b. in -kind; specify: nature e deferred value f. other, specify _ 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) /j 15. Continuation Sheet(s) attached: Yes No ® �, a & A ! f t6. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than S 10,000 and not more than S 100,000 for each such failure, Federal Use Signature: Print Name: Patrick A. Ortiz ti Title: President Telephone No. 949 753-1414 Standard Form LLL Rev. 09-12-97 Date: Authorized for Local Reproduction Standard Form - LLL Federal Requirements Forms for Federal -Aid Construction Projects 1270-6 Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. Federal Requirements Forms for Federal -Aid Construction Projects 1270-7 Disclosure of Lobbying Activities 10.(a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11.Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12.Check the appropriate box. Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13.Check the appropriate box. Check all boxes that apply. If other, specify nature. 14.Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16.The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503.SF-LLL-Instructions Rev. 06-04-90<<ENDIF>> Federal Requirements Forms for Federal -Aid Construction Projects 1270-8 Disclosure of Lobbying Activities 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 report to the City if this section is al2plicable. SECTION 1290 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. Vendor Name/Financial Institution (Printed) Ortiz_F-44erprises Inc., By Printed Name and Title of Pe(sok Signing Patrick A. Ortiz, President Iran Contracting Act Certification Federal ID Number (or n/a) +L 95-3387686 Date Executed /C'-3- 207 L 1290-2 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 1290-3