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Chrisp Company - BidSECTION 1200 BID DATE: January 9, 2023 The undersigned, as bidder, declares it has received and examined the Contract Document entitled Project No. 2021-04, Citywide Striping Refresh, and will contract with the City, on the form of Contract provided herewith, to do everything required for the fulfillment of the contract for said work at the prices and on the terms and conditions herein contained. We have included the following items and agree that they shall form a part of this bid: SECTION TITLE 1200 Bid 1210 Bid Schedule 1220 Bid Guaranty Bond 1230 Certification of Bidder's Experience and Qualifications 1240 Proposed Subcontractors 1250 Non -Collusion Affidavit 1260 DIR Project Vendor Information 1270 Iran Contracting Act of 2010 1280 Russian Aggression Against Ukraine Sanctions We acknowledge that the following addenda have been received and have been examined as part of the Contract Documents. Bidders must be on the Plan Holders List with the City of La Quinta in order to receive addenda. Addendum # Date Received Initials 1 12/29/2022 OIL 2 1 /06/2023 Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY. Chrisp Company Name of Bidder 909-746-0356 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. Chrisp Company Name of Bidder 2280 S Lilac Ave. Bloomington, CA 92316 Bidder's Address 374600 Contractor's License No. California State of Incorporation J Signature of Bid er David L Morris Printed Name of Signatory Executive Vice President Title of Signatory 909-746-0356 Bidder's Telephone Number coesterblad@chrispco.com Bidder's Email Address 5/31 /2023 Contractor's Expiration Date WitnIiiss �, I Panda Mercedez Oesterblad, Notary Public Title of Witness TESYEREuO vO 2NIC47 � Oj! 11 # —TARP MKIC•CALSfOUTA r s iii;F bwo Coaxrr3 .� Yr w. Exr. J Bid 1200-2 ADDENDUM 2 — 1/6/2023 SECTION 1210 BID SCHEDULE PROJECT NO. 2021-04 CITYWIDE STRIPING REFRESH 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 2021-04, Citywide Striping Refresh, in accordance with the plans and specifications therefore adopted and on file with the City within the time hereinafter set forth and at the prices named in this Bid. It is understood that the basis of award shall be the lowest total price of the Base Bid Area plus all Additive Alternates. Unit prices in each and every case represent the true unit price used in preparing the bid schedule totals (Bid Form). Unit prices listed herein include material, installation and appurtenant work as is necessary to have the item complete and in place meeting the full intent of the plans and specifications. We acknowledge that unbalanced unit prices shall be sufficient cause for the rejection of our bid. Bid Schedule 1210-1 ADDENDUM 2 - 1/6/2023 BASE BID - CITYWIDE STRIPING REFRESH Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Mobilization 1 Dollars $ g bm, cz Dollars 1 LS $ q 1=,60 2 Traffic Control 1 LS $ tUT55-w $ 5PT5 3 Refresh Pavement Striping and 1 LS $ lei, 5 o'cu $ IS7,150O O Markin s, Including All Incidentals Total Amount of Bid Items 1 — 3 $ City may award all or none of the following additive alternates: ADDITIVE ALTERNATE NO. 1 Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) _ Dollars Dollars 1 LS $ 2,600.90 $ 215W. 06 1 Mobilization 2 Traffic Control 1 LS $ 2600.07) s 50- Ouo 3 Proposed Signing and Striping, 1 LS $7%gw-co $ 7S,4CD,Cab Including All Incidentals Total Amount of Additive Alternate Bid Items 1 — 3 $gg,yDO� ADDITIVE ALTERNATE NO. 2 Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 LS $ hO-CD-W 1 Mobilization $ I) CCO1btj 2 Traffic Control 1 LS $ i jljco-Ob $ 1�600-00 3 Paint Median Nose Yellow and 269 EA $ 121j QQ $ 33 ' Install Pavement Markers j 4 Paint Median Taper Yellow and 29 EA $ y 350'bb Install Pavement Markers Total Amount of Additive Alternate Bid Items 1 — 4 $ LlD q`I j ,cu Bid Schedule 1210-2 ADDENDUM 2 - 1/6/2023 ADDITIVE ALTERNATE NO. 3 Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Mobilization 1 LS $ (�J�r�D,O� $1�5Q�,� 2 Traffic Control 1 LS $ (��jj.j $ Refresh Pavement Striping and 3 Markings, Including All 1 LS $r�' 500 $ FJQO (� ' Incidentals at Mobile Home Property Total Amount of Additive Alternate Bid Items 1 — 3 $035CO,col GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Figures): GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Words): Bid Amount of each of the above Bid Items must understood that the quantities shown hereon are responsible to verify quantities prior to submitting upon actual w rk performed, subject to such elsewhere pr vid d herein. be filled in and completed. It is but estimates and the bidder is a bid. Final payment will be base adjustments and alterations as Signature of Bidder (Ink) Name of Bidder (Printed or Typed) Bidder Telephone Number Bidder Email Address Bid Schedule 1210-3 ADDENDUM 2 — 1/6/2023 SCHEDULE OF VALUES A Schedule of Values is required of the two apparent low bidders and shall be submitted within 48 hours of bid opening. Bid is subject to rejection if the Schedule of Values is not submitted within 48 hours of bid opening. The items listed in the Schedule of Values are not intended to reflect all of the various work items required by the Plans and Specifications; rather, the City will use the prices in the Schedule of Values to calculate the value of additions, deductions, and changes in work during construction, including labor, tools, materials, equipment, and incidentals for each indicated item. All pricing blanks shall be filled in completely by the bidder. Listed prices shall represent the true price used in preparing the Bid Schedule. Prices listed herein shall include all tools, materials, installation, and appurtenant work as is necessary to have the item constructed completely and in place, meeting the full requirements and intent of the Plans and Specifications. Unbalanced prices shall be sufficient cause for rejection of the bid. t %' /S� UNIT PRICES ITEM NO. DESCRIPTION � UNIT PRICES UNIT �LF 1• Detail 1 (Yellow Skip) $ 2. Detail 8 (White Skip) $ $ LF LF 3• Detail 11 (White Skip) 4• Detail 12 (White Skip) $ LF 5. Detail 21 (Double Yellow) $ LF 6• Detail 24 (Yellow Edge Line) $ LF 7• Detail 27B (White Edge Line) $ LF 8• Detail 31 (2-Way Double Left) $ LF 9• Detail 37B (8" Lane Drop) $ LF 10. Detail 38A (8" Lane Channel) $ LF 11, Detail 39 (6" Bike Lane) $ LF 12, Detail 39A (Bike Lane Drop) $ LF 13. Detail 40 (White Intersection) $ LF 14. Detail 41 (Yellow Intersection) $ LF 15. 12' WHITE $ LF Bid Schedule 1210-4 ADDENDUM 2 — 1/6/2023 ITEM NO. DESCRIPTION N/A UNIT PRICES UNIT 16. STOP STOP AHEAD $ EA 17. $ EA 18. SIGNAL AHEAD $ EA 19• BIKE LANE $ EA 20• GOLF CART LANE $ EA 21. PED XING $ EA 22. KEEP CLEAR $ EA 23. TYPE III ARROW $ EA 24. TYPE IV ARROW $ EA 25. TYPE VI ARROW $ EA 26 TYPE VII ARROW $ EA 27. PAVEMENT MARKINGS REMOVAL GRIND $ HOUR 28. CERAMIC NON -REFLECTIVE RAISED PAVEMENT MARKERS INSTALLATION $ EA 29. REFLECTIVE RAISED PAVEMENT MARKERS INSTALLATION $ EA 30. RAISED PAVEMENT MARKERS REMOVAL GREEN BACKROUND $ $ EA 31. SF Bid Schedule 1210-5 SECTION 1220 BID GUARANTY BOND PRINCIPAL, and Hartford Fire 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. *Chrisp Company, as PROJECT NO. 2021-04 CITYWIDE STRIPING REFRESH 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 4th day of January . 2023. Chrisp Company Title of Signatory signature of Principal 2280 S. I,.ilac Avenue, Bloomington, CA 92316 Address Hartford Fire Insurance Company Misty R. Hemje, Attorney -In -Fact Title of Signatory V-2 Si nature of Surety Y 2001 N. Main St., Suite 660, Walnut Creek, CA 94596 Address Note* Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 CALIFORNIA NOTARY ACKNOWLEDGEMENT (INDIVIDUAL) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Bernardino On January 4, 2023 before me, Panda Mercedez Oesterblad, Notary Public (insert name and title of the officer), personally appeared David L Morris , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 4 L Signature it s PANDA MERCE0E2 OESTERIB AD Coxv.# 2291164T N (Seal) i xor,u�v rusuc.CAUFO r« . cam, Sm Nammom ea,�+f 10r cowl. Ear. 3 Copyright © 2018 NotaryAcknowledgement.com. All Rights Reserved. ACKNOWLEDGMENT I 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 Contra Costa On 2 before me, Brittany Kavan, Notary Public (insert name and title of the officer) personally appeared Misty R. Hemje who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature J11III IINIINIll lSell IIII III INJIIBeIIIw BRITTANY KAVAN COMM. #2338092 z N ��„ g NOTARY PUBLIC - CALIFORNIA z CONTRA COSTA COUNTY My Commission Expires 12/19/2024 (Seal) ;slit Ill IIIll 111lI1#lllttlt11111111Ir Direct Inquiries/Claims to: THE HARTFORD BOND, T-11 POWER OF ATTORNEY Hartrd Plaza HartfOne ord, Conne tcut06155 Bond.clalmst 1helrantfnrd.com call: 888-266-3488 or fax:860-757.5835 KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: ARTHUR J GALLAGHER & CC INS BRK CA A enc Code: 57-554532 0 Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut 0 Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of the Southeast, a corporation duly organized under the laws of the State of Florida having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the "Companies") do hereby make, constitute and appoint, up to the amount of Unlimited : Virginia L. Black, Brian F. Cooper, Susan Hecker, M. Moody, Maureen O'Connell, Kevin Re, Janet C. Rojo, Betty L. Tolentino, Robert P. Wrixon, K. Zerounian, Gillian Bhaskaran, Susan M. Exline, Misty R. Hemje, Brittany Kavan, Thuyduong Le, Julia Ortega of SAN FRANCISCO, California their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 23, 2016 the Companies have caused these presents to be signed by its Assistant Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. �Tysr�tN.� � A.r�rr y c �r+ ',rw••rrnr�;� w Lp � T .�� St aprn.'4� � s �oa.r . (5 Shelby Wiggins, Assistant Secretary Joelle L. LaPierre, Assistant Vice President STATE OF FLORIDA ss. Lake Mary COUNTY OF SEMINOLE On this 20th day of May, 2021, before me personally came Joelle LaPierre, to me known, who being by me duly sworn, did depose and say: that (s)he resides in Seminole County, State of Florida; that (s)he is the Assistant Vice President of the Companies, the corporations described in and which executed the above instrument; that (s)he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that (s)he signed his/her name thereto by like authority. Jessica Ciccone j, Tt My Commission HH 122290 Expires June 20, 2025 I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Power of Attorney exec! lted by .said Companies, which is still in full force effective as of JanwarY Signed and sealed in -1-ake Mary, Florida. y� �r r � , .:�u.i,u�:.: � ►a� r +' /� _ ,co ' � �.Y ,wfrrow.r� ��r►�ra Ix f ��•+.�r+inA•�� +��ir�71F i- t�7Y = =1 �07fl t 7979 r .� ��atiT� �+A •� r45 V � }' 7wx-.r O.Arf� F s' Keith D. Dozois, Assistant Vice President SECTION 1230 CERTIFICATION OF BIDDER'S EXPERIENCE AND QUALIFICATIONS The undersigned Bidder certifies that he is, at the time of bidding, and shall be, throughout the period of the contract, licensed under the provisions of Chapter 9, Division 3, of the Business and Professions Code of the State of California, to do the type of work contemplated in the Contract Documents. Bidder shall further certify that it is skilled and regularly engaged in the general class and type of work called for in the Contract Documents. The Bidder represents that it is competent, knowledgeable, and has special skills on the nature, extent, and inherent conditions of the work to be performed. Bidder further acknowledges that there are certain peculiar and inherent conditions existent in the construction of the particular facilities, which may create, during the construction program, unusual or peculiar unsafe conditions hazardous to persons and property. Bidder expressly acknowledges that it is aware of such peculiar risks and that it has the skill and experience to foresee and to adopt protective measures to adequately and safely perform the construction work with respect to such hazards. The Bidder shall list below four (4) projects completed in the last seven (7) years of similar size and complexity that indicate the Bidder's experience as a General Contractor. 1. Project Name: Annual Pavement Markings, Thermo and Paint Services Owner: City of Fontana Construction Cost: 8 $167,228.00 (for 2021 only) Construction Time: varies Owner's Representative: Rob Rigby Owner's Telephone No.: 909-350-7634 Calendar Days Date of Substantial Completion: Annual contract from 2007- present 2. Project Name: Street Striping and Pavement Marking Maintenance and Repair Owner: City of Corona Construction Cost: $ $289,399.00 (for 2021 only) Construction Time: varies Owner's Representative: Scot Miller Owner's Telephone No.: 951-817-5708 Calendar Days Date of Substantial Completion: Annual contract from 2014 to present Bidders Experience & Qualifications 1230-1 3. G� Project Name: On Call Street Striping and Markings Owner: City of Oxnard Construction Cost: $ $154,426.00 (for 2021) Construction Time: varies _ Calendar Days Owner's Representative. Eric Ochoa Owner's Telephone No.: 805-797-5071 Date of Substantial Completion: Annual contract since 2017 Project Name: Indio Citywide Slurry seal Owner: City of Indio Construction Cost: $ $572,830.00 Construction Time- 90 _Calendar Days Owner's Representative: PMI - Charlie Hoffman Owner's Telephone No.: 760-625-1802 Date of Substantial Completion: 1/18/2021 Signed this 9th Chrisp Company Name of Bidder Signature of Bid -der David L Morris day of January Printed Name of Bidder 374600 Contractor's License No 5/31 /2023 Expiration Date 2023. 1000000306 Executive Vice President Title of Signatory DIR Reg No. Bidders Experience & Qualifications 1230-2 SECTION 1240 PROPOSED SUBCONTRACTORS Pursuant to California Public Contracting Code, Section 4100 et. seq., the following list gives the name, business address, and portion of work (description of work to be done) for each subcontractor that will be used in the work if the bidder is awarded the Contract. (Additional supporting data may be attached to this page. Each page shall be sequentially numbered and headed "Proposed Subcontractors" and shall be signed.) The Contractor shall perform, with its own organization, Contract work amounting to at least 50 percent of the Contract Price except that any designated "Specialty Items" may be performed by subcontract and the amount of any such "Specialty Items" so performed will be deducted from the Contract Price before computing the amount required to be performed by the Contractor with its own organization. "Specialty Items" will be identified by the Agency in the Bid or in the Special Provisions. Where an entire item is subcontracted, the value of work subcontracted will be based on the Contract Unit Price. Subcontractor/Business Address/Description of Work/% of Work/License No./DIR Reg No. N/A i �6 .& Signature of Bidder Chrisp Company 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 San Bernardino) David L Morris he -0r- sbe is Executive Vice President being first duly sworn, deposes and say that of Chrisp Company the party making the foregoing bid that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly sought by contract, agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Signature Chrisp Company Name of Bidder Executive Vice President Title 1 /09/2023 Date Non -Collusion Affidavit 1250-1 CALIFORNIA JURAT CERTIFICATE A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Bernardino Subscribed and sworn to (or affirmed) before me on this 9th day of January 20 23 , by David L Morris proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. WITNESS MY HAND AND OFFICIAL SEAL. F PANDA ER"D,MERCEDEI OESTERELADCorr+.* 2291041 t! ?+OTARY MIC•CN.IFORNIA +Cam ' L) RSmi FPEARfl1NC COUNTY r Signa re of Nc tary Public .. ..... Hy-SoaTy OPTIONAL INFORMATION The jurat contained within this document is in accordance 7oith California laze. Any affidavit subscribed and s7oorn to before a noMnl shall use the preceding wording or substaltiallil similar urm•ding Imrsumnt to Civil Code sections 7189 arrd 8202. A jurat certificate cannot be affixed to a document sent by mail or otherwise delivered to a notary public, including electronic means, whereby the signer did not personally appear before the notary public, even if the signer is known by the notary public. The seal and signature cannot be affixed to a document without the correct notarial wording. As an additional option an gffuant can produce an affidavit on the same document as the notarial certificate wording to eliminate the use ofadditional documentation. DESCRIPTION OF ATTACHED DOCUMENT .Non Collusion Affidavit (Title of document) Number of Pages 2 (including Jura) Document Date 01 /09/2023 (Additional Information) MMX V. BAN2 510.409 1334 www.BayAreallotary.com CAPACITY CLAIMED BY THE SIGNER Individual Corporate Officer Partner Attorney -In -Fact Trustee Other: SECTION 1260 DIR Project Vendor Information Vendor Information: Name: Chrisp Compan Address: 2280 S Lilac Ave. Zip: 92316 Project Manager: Coda Oesterblad Phone: 909-746-0356 City: Bloomington ST: CA Email: coesterblad@chrispco.com CSLB/Certification Number: 374600 Public Works Registration No.: 1000000306 Classification: Asbestos Boilermaker Bricklayers __Carpenter Carpet/Linoleum Cement Masons Drywall Finisher Drywall/Lathers Electricians Elevator Mechanic Glaziers Iron Workers Laborers X Millwrights Operating Eng Painters Pile Drivers Pipe Trades Plasterers Roofer SheetMetal Sound/Com Surveyor Teamster Tile Worker Prevailing Wages and Payroll: The project is subject to prevailing wage rates and enforcement by the Department of Industrial Relations (DIR). Prevailing wage rates can be obtained at: httl2://www,dir.ca.gov/Public-Works/Prevaiiing-Wage.html. Contractors and subcontractors on most public Works projects are required to submit certified payroll records to the Labor Commissioner using DIR's electronic certified payroll reporting system. For your convenience, the link for reporting certified payroll is: htt www.dir.ca. ov Public -Works Certified -Pa roil - Report i n g. h tm i. 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 Pursuant to the Iran Contracting Act of 2010 (Pub. Contract Code, § 2200 etseq.), (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 1270-1 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) U- _6om Par�r uthori d Signature) — Printed Name an Title of P Signing vl d L�- Mor6_a,_.J(�.6v+' Ve- Vi Federal ID Number (or n/a) OLJ-9_P7nQ[)Ct)k Date jExecut d Iran Contracting Act Certification 1270-2 OPTION #2 — EXEMPTION Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a vendor/financial institution engaged in investment activities in Iran, on a case -by -case basis, to be eligible for, or to bid on, submit a proposal for, or enters into or renews, a contract for goods and services. If you have obtained an exemption from the certification requirement under the Iran Contracting Act, please fill out the information below, and attach documentation demonstrating the exemption approval. Ven or Name/Financial Institution (Printed) Federal ID Number (or n/a) l Nf_A _ By (Authorized Signature) 'Printed Name and Title of Person Signing Date Executed Iran Contracting Act Certification 1270-3 SECTION 1280 COMPLIANCE WITH CALIFORNIA EXECUTIVE ORDER -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 t��grtiQn is ap lica le. 1411 CORPORATION 43650 OgoW Road + Fmmaat Cillforola 94539-5631 • Phmwt (510)456-2840 P.O. Boa 136E r Prvmonl Caul wde 9453E-0136 • FAX: (510)490.2703 i * i a � • ■ ■ R � i � 1� ■� MEETING OF THE BOARD OF DtREC71'ORS OF CHRISM COMPANY A making of the Board of Directors of the Christp Company was held on 8/30/16, during which a resolution was passed authorizing the following individuals) to, by his/herltheir sigr113turc(s), ter7K441 ny and all contracts on behalf of the corporation and, t bythe corporation to such contract: jf(I Robert Chrisp, President Authtori Signature David Morris, l;xccutive Vice President U'U'a e` A—, t zed Si attire Roger Weisbrod, VP of Operations Auth rized Signature 1 i 1 Tammie Allison, Secretary Authorized Signature Certified by and Ctorporale Seal axed hereto by: e�retary and/or Chairman CONTRACi om LIC. 6 374600. A ENGINEERING • C•32 MONWAY IMMtOVEMENTS • C-13 F 31R4CF WIRE, A WOOD SIGNS • MONUMENTS d BARRICADES -STRIPING • PARKINO DUMPERS • FTiM INCI