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Matich Corporation - BidSECTION 1200 BID DATE: July 6, 2023 The undersigned, as bidder, declares it has received and examined the Contract Document entitled Project No. 2022-03, FRED WARING DRIVE PAVEMENT REHABILITATION, and will contract with the City, on the form of Contract provided herewith, to do everything required for the fulfillment of the contract for said work at the prices and on the terms and conditions herein contained. We have included the following items and agree that they shall form a part of this bid: SECTION TITLE 1200 Bid 1210 Bid Schedule 1220 Bid Guaranty Bond 1230 Certification of Bidder's Experience and Qualifications 1240 Proposed Subcontractors 1250 Non -Collusion Affidavit 1260 DIR Project Vendor Information We acknowledge that the following addenda have been received and have been examined as part of the Contract Documents. Bidders must be on the Plan Holders List with the City of La Quinta in order to receive addenda. Addendum # Date Received Initials 1 July 3, 2023 ztl� A Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY. Matich Corporation Name of Bidder 909-382-7400 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. Matich Corporation Name of Bidder 1596 Harry Sheppard Blvd San Bernardino, CA 92408 Bidder's Address 149783 / A & B Contractor's License No. California State of Incorporation s Signature of Bidder Robert M. Matich Printed Name of Signatory President Title of Signatory 909-382-7400 Bidder's Telephone Number rmatich@matichcorp.com Bidder's Email Address November 30, 2023 Contractor's Expiration Date Etne 5 Jacob O. Reade Vice President of Operations Title of Witness Bid 1200-2 taQal�tra (Al IFORNIA - ADDENDUM NUMBER 1 TO: All Prospective Bidders and Plan Holders FROM: Ubaldo Ayon, Assistant Construction Manager DATE: July 3, 2023 SUBJECT: Project No. 2022-03, Fred Waring Drive Pavement Rehabilitation The following shall be considered as incorporated into the project plans and specifications for the above referenced project. Portions of plans and specifications not specifically mentioned in this Addendum remain in force. PROJECT SPECIFICATIONS Section 4000: Sheet 4000-1, Section 3: Traffic Control Section, add the following paragraph after paragraph 4• The Contractor must phase work to only allow vehicles on pulverized material for a maximum of 3 -days per stage. Only one pulverized lane in each direction shall be open at one time. Bicycles shall not be permitted on pulverized material. At no time shall vehicles be permitted to drive on pulverized material over a weekend or City Holiday. Sheet 4000-2, Section 4: dust Control Section, add the following paragraph after Paragraph 1• In addition to general sweeping and maintenance of the site, the Contractor shall sweep sidewalk and other surfaces on a daily basis and as needed after roadway pulverization begins and prior to the base paving. The Contractor is hereby notified; Addendum No. i must be acknowledged and initialed / as stipulated under the instructions to Bidders and submitted as part of the Bid. Failure;QWja to do so shall result in the City designating said bid as "Non -Responsive." '"'! APPROVED: Digitally signed by Ubaldo Ayon Jr Date: 2023.07.03 09:05:36 -07'00' Ubaldo Ayon Assistant Construction Manager END OF ADDENDUM NUMBER 1 ' CONTRACTORS dCa STATE LICENSE BOARD Y ACTIVE LICENSE 'v 149783 E. CORP a.,:,...N—. MATICH CORPORATION Cbnplsgbnl.l A B leohil E.P�.noN.11/30/2023 www.cslb.ca.gov ki+n.cd r.: Corporate Resolution At a meeting of the Board of Directors of MATICH CORPORATION, a California corporation duly called and held on the 15th day of October 2021, a quorum being present the following RESOLUTION was adopted: Resolved, the Corporate Officers for Matich Corporation are: PRESIDENT ROBERT M. MATICH VICE PRESIDENT & TREASURER RANDALL S. VALADEZ VICE PRESIDENT & CORPORATE SECRETEARY RANDALL S. VALADEZ VICE PRESIDENT— ESTIMATING JASON G. JONES VICE PRESIDENT— CONSTRUCTION OPERATIONS JACOB 0. READE FURTHER RESOLVED, that the above listed Corporate Officers are duly authorized to sign document (bids, contracts, etc.) as may be necessary on behalf of MATICH CORPORATION. I, Randall S. Valadez, Secretary of MATICH CORPORATION have compared the foregoing RESOLUTION with original thereof, as it appears in the records of the Board of Directors of said company, and do so certify that the same is true and correct transcript there from, and of the whole said original RESOLUTION. I further certify that said RESOLUTION has not been amended or revoked and is still in full force and effect. IN WITNESS THEREOF, I hereunto set my hand as such Secret7thl`" day of October 2021. Randall S. Valadez, Secretary 1396 HARRY SHEPPARD BLVD, SAN BERNARDINO 92408 • TELEPHONE (909) 382-7400 • FAX (909) 382-0191 www.matichcorp.com SECTION 1210 BID -SCHEDULE PROJECT NO. 2022-03 FRED WARING DRIVE PAVEMENT REHABILITATION City of La Quinta 78-495 Calle Tampico La Quinta, CA 92253 To Whom It May Concern: Pursuant to the Invitation to Bid, and in accordance with the provisions therein stated, the undersigned hereby proposes and agrees that on award by the City under this Bid, to execute a Contract, with necessary bonds, to furnish and install any and all labor, materials, transportation and services for 2022-03, FRED WARING DRIVE PAVEMENT REHABILITATION, in accordance with the plans and specifications therefore adopted and on file with the City within the time hereinafter set forth and at the prices named in this Bid. It is understood that the basis of award shall be the lowest total price of the Base Bid Area plus all Additive Alternates. Unit prices in each and every case represent the true unit price used in preparing the bid schedule totals (Bid Form). Unit prices listed herein include material, installation and appurtenant work as is necessary to have the item complete and in place meeting the full intent of the plans and specifications. We acknowledge that unbalanced unit prices shall be sufficient cause for the rejection of our bid. Bid Schedule 1210-1 BASE BID - FRED WARING DRIVE REHABILITATION Item Item Description Est. Unit Unit Item Total No. Qty. Price (in figures) (in Dollars figures) Dollars 1 Mobilization 1 LS 1��% 111311 2 Traffic Control 1 LS $ 3 Dust Control 1 LS $ $ yG35' �9 4 Earthwork 1 LS $1/7,757 j �1 $L/Z7 5 Pulverize 12" of Road Section 435,000 SF $ Z'� $ - Three Ste Process Construct 5" Asphalt �� 6 Concrete Over Pulverized 435,000 SF $ z Base Sawcut, Remove, and Dispose of Existing Concrete YO 7 Curb Ramp, Includes Curb 620 SF $ Z / $0 037, — and Gutter (Limits 5' beyond BCR to 5' beyond ECR Construct Concrete Curb Ramp per City of La Quinta 8 Std. No. 250, Case A, 1 EA including 5' of sidewalk beyond the BCR to ECR Grade Parkway, Remove, Modify, and Replace 9 Landscape and Irrigation in 1 LS $$,�.� Kind to Furthest Extent Possible to Join proposed / Curb Ram Salvage to City Existing Pull 10 box and Furnish and Install 2 EA $�qq 7T $ new No.6 Pull box 11 Signing & Striping Including 1 LS G $ 3 2 617/` $ 21 All Incidentals Total Amount of Bid Items 1 - 11 $ 7 /Z Bid Schedule 1210-2 City may award all or none of the following additive alternates: ADDITIVE ALTERNATE NO. 1 (Fred Waring) Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Lower Sewer Manhole per 5 EA $�� Z ZS $ CVWD Standards 2 Raise Sewer Manhole per 5 EA $0 ✓ $ CVWD Standards l ✓ Total Amount of Bid Items 1 - 2 ADDITIVE ALTERNATE NO. 2 (Fred Waring) Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Lower Water Valve per 17 EA $ CVWD Standards 2 Raise Water Valve per 17 EA $ �(,'� $ CVWD Standards Total Amount of Bid Items i - 2 $ Bid Schedule 1210-3 a ADDITIVE ALTERNATE NO. 3 WASHINGTON STREET REHABILITATION Item Item Description Est. Uni Unit Price Item Total No. Qty. t (in (in figures) figures) Dollars Dollars 1 Mobilization 1 LS $ l? j`� $ C1, 4 3f6 2 Traffic Control 1 LS $ fZ Z�7_ � $r' 7,06b �� 3 Dust Control 1 LS $ $ 4 2" Grind and Overlay 4,950 SF $ Q� $ 5 Earthwork 1 LS $ 6 Pulverize 12" of Road Section 33,720 SF 3� $ �i $ Ali 22 - Three Step Process — 7 Construct 5" Asphalt Concrete Over Pulverized 33,720 SF Base 8 Signing & Striping Including 1 LS $ S�12'&( ZZ $ / ;Z, 5� All Incidentals i Total Amount of Bid Items i - 8 $ �`�� L13Z Bid Schedule 1210-4 ?l GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Figures): $ �. X12 Z Of 7 GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Words): rul)U N11 G GIOi(1 Vz �d G �A�S •d �,D � l��l � Y C��S . Bid Amount of each of the above Bid Items must be filled in and completed. It is understood that the quantities shown hereon are but estimates and the bidder is responsible to verify quantities prior to submitting a bid. Final payment will be based upon actual work performed, subject to such adjustments and alterations as elsewhere provided herein. Signature of Bidder (Ink) Robert M. Matich, President J Name of Bidder (Printed or Typed) 909-382-7400 Bidder Telephone Number rmatich@matichcorp.com Bidder Email Address Bid Schedule 1210-5 SECTION 1220 BID GUARANTY BOND * PRINCIPAL, and Liberty Mutual 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. * Matich Corporation 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. 2022-03 FRED WARING DRIVE PAVEMENT REHABILITATION NOW, THEREFORE, if the aforesaid Principal is awarded the contract and, within the time and manner required under the specifications, after the prescribed forms are presented to him/her for signature enters into a written contract in the prescribed form, in accordance with the bid, and files two bonds with the City, one to guarantee faithful performance, and the other to guarantee payment for labor and materials as required by law, and provide certificate of insurance coverage required by the Contract Documents, then this obligation shall be null and void; otherwise, it shall be and remain in full force and virtue. IN WITNESS WHEREOF, we have hereunto set our hands on this 21st day of June , 2023. Matich Corporation fl �ly Title of Signatory Signature of Principal Liberty Mutual Insurance Company Attorney -in -Fact Title of Signatory Signa ure of Surety,Leigh WDonough 1596 Harry Sheppard Blvd. 790 The City Drive South, Suite 200 San Bernardino, CA 92408 Orange, CA 92868 Address Address Note: Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA County of SAN BERNARDINO On 6/23/2023 before me, G.M.Bernal Kleespies Notary Public ere insert name and title of me o cer personally appeared ROBERT M MATICH who proved to me on the basis of satisfactory evidence to be the persoro) whose n me(g) 0/are subscribed to the within instrument and acknowledged to me that /she/they executed the same int her/their authorized capacity iib } and that by �i�i Aer/their signature on the instrument the person(', or the entity upon behalf of which the personA 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. G. M. BERNAL KLEESPIES COMM. #2356450 . WITNESS my hand and official sealNotaryPublic- California 5 SAN BERNARDINO COUNTY 6 s� My Comm. Ex . MAY 4, 2025 L Nbfary Public Signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT SECTION 1220 (Title or description of attached document) BID GUARANTY BOND (Title or description of attached document continued) Number of Pages Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other www NotaryClasses.com 800-873-9865 INSTRUCTIONS FOR COMPLETING THIS FORM This farm complies with current California statutes regarding notary wording and, if needed, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk d• Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary) • Securely attach this document to the signed document with a staple. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 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. I State of California County of .- Orange On JUN .Z 12023 before me, _ Le -Kim H. Luu, Notary Public Date Here Insert Name and Title of the Officer personally appeared Leigh McDonough Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) €s/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(€es), 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 1%nature of Notary Public Place Notary Seal Above OPTIONAL Though this section is 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. Number of Pages: ___ Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Corporate Officer -- Title(s): Partner — Limited General Individual x Attorney in Fact Trustee Guardian or Conservator Other: Signer Is Representing: ��.'�.M._--._m'___-____..N...____ Signer's Name: Corporate Officer — Title(s): Partner -- Limited General Individual Attorney In Fact Trustee Guardian or Conservator Other: _ Signer Is Representing: _ 02014 National Notary Association - www.NationalNotary.org - 1 -800 -US NOTARY (1-800-876-6827) Item #5907 _ LE -KIM H, LUU Q COMMISSION # 2316198 3 E Notary Public - California 3 ' ORANGE COUNTY My Comm Expirr:s Dec 17, 2023 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 1%nature of Notary Public Place Notary Seal Above OPTIONAL Though this section is 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. Number of Pages: ___ Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Corporate Officer -- Title(s): Partner — Limited General Individual x Attorney in Fact Trustee Guardian or Conservator Other: Signer Is Representing: ��.'�.M._--._m'___-____..N...____ Signer's Name: Corporate Officer — Title(s): Partner -- Limited General Individual Attorney In Fact Trustee Guardian or Conservator Other: _ Signer Is Representing: _ 02014 National Notary Association - www.NationalNotary.org - 1 -800 -US NOTARY (1-800-876-6827) Item #5907 This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. 5. Liberty Liberty Mutual Insurance Company MutuaL The Ohio Casualty Insurance Company Certificate No: 8209664-977460 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Jeri Apodaca- Kevin Cathcart- Vanessa Copeland. Reece Joel Diasz, Maria Guise, Terah Lane. Eric Lmviq, Kim Luu, Leigh McDonough. Michael D- Parb iao, Lisa Pellerito, Rachelle Rhcatdt, Mark Richirdson- I-kcathcr Sallumik. James Schaller all of the city of Irvine slate of CA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and oil its behalf as surely and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their awn proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 23rd day of March , 2023 . Liberty Mutual Insurance Company P4 ►KsuR� P'11 MIS& a ►tss%?. The Ohio Casualty Insurance Company tia raa`PO"kr 'tn �, °ry GP�eRPORTr yn West American Insurance Company JQ fi �e a °o �m 1912 �+ 0 1919 „ 2 1991 0 A � p°9�cacua L Sp HAUPs'L V!rNnN* s-4 *"A}d� By: navirl M Carav AecieTana Sonrohne State of PENNSYLVANIA County of MONTGOMERY 0:3) On this 23rd day of March , 2023 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance m Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. �o IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year first above written. a) �,►� P�sr � ,pn w4l.. C Commormallh of PannsyNa+aa - Notary Beal Teresa Pastels, Notary Public �Q/� Montgomery County My commission expires March 28, 2025 By v Commisslon nwbar h rh2611A4 SVV4 mflff6 ,Pann¢yNap Ai59mwS W}Nutar. Teresa Pastella, Notary Public Airy l 4? This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV – OFFICERS: Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such 0 instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII – Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation –The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization – By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. �tl YN�y � � 023 IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this day o P� ►NSu. �11 IN,gV+� � ►Nsui? �J LdRpp2q YC y.1 apRPO'�4r �b VP �paPoggr 4, a m m w 1912 0 1919do a 1991 0 "Pa�ya Ys�"°'nx��da By Renee C. L1ewe€lyn, Assistant Secretary LMS -12873 LMIC OCIC WAIC Multi Cc 02/21 Lo SECTION 1230 CERTIFICATION OF BIDDER'S E PERIEN E 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: _Phelan Road Intersection Improvements Owner: San Bernardino County Construction Cost: $ 2,056,154.00 Construction Time: 60 Calendar Days Owner's Representative: Larry White Owner's Telephone No.: (909) 387-7924 Date of Substantial Completion: January 2023 2. Project Name: Street Rehabilitation at Various Locations Owner: City of Banning Construction Cost: $848,796.00 Construction Time: 40 Calendar Days Owner's Representative: Kevin Sin Owner's Telephone No.: (951) 922-3140 Date of Substantial Completion: January 2023 Bidders Experience & Qualifications 1230-1 3. Project Name: 2021 Pavement Rehabilitation owner: City of Palm Springs Construction Cost: $5,7581200.00 Construction Time: 120 Calendar Days Owner's Representative: Vonda Teed Owner's Telephone No.: (760) 232-8253 Date of Substantial Completion: August 2022 4. Project Name: PMP 2021 Street Resurfacing Project Owner: City of Redlands Construction Cost: $ 9,235,780.00 Construction Time: 180 Calendar Days Owner's Representative: Goutam Dobey Owner's Telephone No.: (909) 798-7584 Date of Substantial Completion: July 2022 Signed this 6th day of July , 2023. Matich Corporation Name of Bidder 149783 Contractor's License No Signature of Bidder Robert M. Matich Printed Name of Bidder November 30, 2023 Expiration Date President Title of Signatory 1000004260 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. Gr�i2f�P c6 z-AZ5f21�°JYd�/a7gZ 32ylooZ�a�on�6JP� Mug4azrr P�'Y64,1zy-1j&k oPA 1,-q Signature of Bidder RobertM Matich, President Matich Corporation Name of Bidder poi eleeG -? Z 7 7 -/ 10&)n-6 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 Robert M. Matich , being first duly sworn, deposes and say that he or she is President of Matich Corporation I 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 Robert M. Matich Name of Bidder President Title July 6, 2023 Date Non -Collusion Affidavit 1250-1 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA County of SAN BERNARDINO On 7/05/2023 before me, G.M.Bernal Klees ies Nota Public tH ere insert name ano litle or t e 0 Car] personally appeared ROBERT M MATICH who proved to me on the basis of satisfactory evidence to be the personX whose nameo 0/are subscribed to the wi In instrument and acknowledged to me that &/she/they executed the same in tji /her/their authorized capacity, and that by (91 /her/their signatureA on the instrument the person, or the entity upon behalf of which the persono 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. G. M. BERNAL KLEESPIES {o + COMM. #2356450 WITNESS my hand and official seal. 'Notary Public -California SAN BERNARDINO COUNTY COMM, 5g, MAY 4.2025 Notary Public signature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT SECTION 1250 NON -COLLUSION (Title or description of attached document) AFFIDAVIT TO BE EXECUTED BY BIDDER (Title or description of attached document continued) Number of Pages Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other www.NotaryClasses.com 800-873-9865 INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, if needed, should be completed and attached to the document. Acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public) • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e he/she/tire};- is /are ) or circling the correct forms Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form • Signature of the notary public must match the signature on file with the office of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document Indicate title or type of attached document, number of pages and date. 3 Indicate the capacity claimed by the signer If the claimed capacity is a corporate officer, indicate the title (i e. CEO, CFO, Secretary), • Securely attach this document to the signed document with a staple. SECTION 1260 DIK_P_ EWect Vendor Information Vendor Information: Name: Matich Corporation Address: 1596 Harry Sheppard Blvd. City: San Bernardino ST: CA Zip: 92408 Project Manager: Jacob O. Reade Email: jreade@matichcorp.com Phone: 909-382-7400 _ CSLB/Certification Number: 149783 Public Works Registration No.: 1000004260 Classification: Asbestos Boilermaker Bricklayers Carpenter Carpet/Linoleum Cement Masons V Drywall Finisher Drywall/Lathers Electricians Elevator Mechanic Glaziers Iron Workers Laborers V Millwriahts Operating Eng V Painters Pile Drivers Pipe Trades Plasterers Roofer SheetMetal Sound/Com Surveyor Teamster V Tile Worker Prevailing Wages and Payroll: The project is subject to prevailing wage rates and enforcement by the Department of Industrial Relations (DIR). Prevailing wage rates can be obtained at: http://www.dir.ca.goyIPublic-Works/Prevailing-Wage. html. Contractors and subcontractors on most public Works projects are required to submit certified payroll records to the Labor Commissioner using DIR's electronic certified payroll reporting system. For your convenience, the link for reporting certified payroll is: http://www.dir.ca.gov/Public-Works/Certified-Payroll- A copy of certified payroll, including the employees and/or subcontractors working on with invoices submitted to the City of La Quinta. names and addresses of the job must be included DIR Project Vendor Information 1260-1 Contractor Information Legal Entity Name MATICH CORPORATION Legal Entity Type Corporation Status Active Registration Number 1000004260 Registration effective date 7/1/2022 Registration expiration date 6/30/2025 Mailing Address P 0 BOX 10 HIGHLAND 92346 CA United States of America Physical Address 1596 E HARRY SHEPPARD BLVD SAN BERNARDINO 92408 ... Email Address Trade Name/DBA MATICH CORPORATION License Number(s) CSLB:149783 Legal Entity Information Corporation Number: Federal Employment Identification Number: President Name: Robert Matich Vice President Name: Treasurer Name: Secretary Name: CEO Name: Agent of Service Name: Robert Matich Agent of Service Mailing Address: 1596 Harry Sheppard Blvd. San Bernardino 92408 CA United States of America Workers Compensation Do you lease employees No through Professional Employer Organization (PEO)?: Registration History Effective Date Expiration Date 6/5/2018 6/30/2019 5/8/2017 6/30/2018 6/7/2016 6/30/2017 7/8/2015 6/30/2016 12/22/2014 6/30/2015 7/1/2019 6/30/2022 7/1/2022 6/30/2025 Please provide your current workers compensation insurance information below: PEO PEO PEO PEO InformationName Phone Email Insured by Carrier Policy Holder Name:MATICH CO RPO RATION Insurance Carrier: FEDERAL INSURANCE COMPANYPolicy Number:54303168Inception date:7/1/2021 Expiration Date:6/30/2022 SECTION CUMPAJA 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 pursuant to Public Contract Code on a case-by-case basis. to prevent the City from exercising its rights section 2203, subdivision (c) or (d), or both, 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) Federal ID Number (or n/a) Matich Corporation 95-1810911 By (A ria Si nature z Printed Name and Title of Person Signing Date Executed Robert M. Matich, President July 6, 2023 Iran Contracting Act Certification 1270-2 OPTION #2 — EXEMPTION Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a vendor/financial institution engaged in investment activities in Iran, on a case-by-case basis, to be eligible for, or to bid on, submit a proposal for, or enters into or renews, a contract for goods and services. If you have obtained an exemption from the certification requirement under the Iran Contracting Act, please fill out the information below, and attach documentation demonstrating the exemption approval. Vendor Nam Fi cial Institution (Printed) By (Authorized Signature) Printed Name and Title of Person Signing Federal ID Number (or n/a) Date Executed Iran Contracting Act Certification 1270-3 SECTION 1280 COMPLIANCE WITH CALIFORNIA EXECUTIVE ORDER N-6-22 RUSSIAN AGGRESSION AGAINST UKRAINE (a) Contractor shall comply with California Governor Executive Order N-6-22 regarding sanctions in response to Russian aggression in the Country of Ukraine, and any implementing guidelines and/or economic sanctions imposed by the United States government in response to Russian actions in Ukraine, as well as any sanctions imposed under California law (collectively 'economic sanctions"). Contractor shall comply with all such economic sanctions. By submitting a bid to the City, Contractor agrees to take any and all actions to support the Ukrainian government and people as required by law, including by refraining from new investments in, and financial transactions with, Russian institutions or companies that are headquartered or have their principal place of business in Russia (Russian entities), not transferring technology to Russia or Russian entities, and directly providing support to the government and people of Ukraine. (b) If bidding on a contract for Five Million Dollars ($5,000,000) or more, Contractor shall submit a written report to the City on Contractor's compliance with the economic sanctions, and the steps Contractor has taken in response to Russia's actions in Ukraine, including, but not limited to, desisting from making new investments in, or engaging in financial transactions with, Russian entities, not transferring technology to Russia or Russian entities, and directly providing support to the government and people of Ukraine as required by law. Failure to submit the report required by this Section may deem Contractor's bid non- responsive. Please include a written report to the City if this section is applicable. 17A