All American AsphaltSECTION 1200
BID
DATE' 11 /30/2023
The undersigned, as bidder, declares it has received and examined the Contract
Document entitled Project No. 2023-15, FY22/23 PAVEMENT MANAGEMENT PLAN
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 November 30, 2023
Attached is is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY.
All American Asphalt
Name of Bidder
951-736-7600
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.
All American Asphalt
Name of Bidder
400 E. 6th St., Corona, CA 92879
Bidder's Address
267073
Contractor's License No.
California
State of Incorporation
Signature of Bis er
Edward J. Carlson
Printed Name of Signatory
Vice President
Title of Signatory
951-736-7600
Bidder's Telephone Number
publicworks@allamericanasphalt.com
Bidder's Email Address
1 /31 /24
Contractor's Expiration Date
Witness Michael Farkas
Secretary
Title of Witness
Bid 1200-2
ta GiAra
CALIFORNIA -
ADDENDUM NUMBER 1
TO: All Prospective Bidders and Plan Holders
FROM: Bryan McKinney, P.E., Public Works Director/City Engineer
DATE: November 30, 2023
SUBJECT: Project No. 2023-15, FY22/23 Pavement Management Plan
The following shall be considered as incorporated into the project plans and specifications for the above
referenced project. Portions of plans and specifications not specifically mentioned in this Addendum
remain in force.
■ PROJECT SPECIFICATIONS
Section 1210:
Section 1210 is replaced; the following is a summary of the chances:
• Additive Alternate Schedule 1 has the following changes
o Item 4 Earthwork units has changed from LS to CY
o Item 5 has been added for Remove of Roadway Section
o Item 7 has been added for Grind and Overlay
Section 1340:
Sheet 1340-3, Subsection 2.2 Insurance, Replace paragraph 2 with the foliowina:
As Reads:
Commercial General Liability (at least as broad as ISO CG 0001)
$2, 000, 000 (per occurrence)
$4, 000, 000 (general aggregate)
Must include the following endorsements:
General Liability Additional Insured
General Liability Primary and Noncontributory
Amended to Read:
Commercial General Liability (at least as broad as ISO CG 0001)
$5,000,000 (per occurrence)
$5,000,000 (general aggregate)
Must include the following endorsements:
General Liability Additional Insured
General Liability Primary and Noncontributory
ta Qai�tra
CALIFORNIA -
Section 4000:
Sheet 4000-13 Section 11: Emulsion Aggregate Slurry Seal Re lace paragraph 8 with the
following:
As Reads -
During slurry seal operations, it shall be the Contractor's responsibility to place protective covering
over, or to otherwise avoid slurry seal coating of manholes, utility covers, pavement markers
(reflective and non -reflective), concrete gutters, concrete cross gutters, and drainage facilities,
survey monuments and remove said covering and/or slurry seal coating after slurry sealing has
been completed.
Is Amended to Read:
During slurry seal operations, it shall be the Contractor's responsibility to place protective covering
over, or to otherwise avoid slurry seal coating of manholes, utility covers, concrete gutters,
concrete cross gutters, and drainage facilities, survey monuments and remove said covering
and/or slurry seal coating after slurry sealing has been completed.
Sheet 4000-24, Section 16: Earthwork, Replace the measurement and payment paragraph
with the following:
As Reads -
The contract Lump Sum price paid for Earthwork includes full compensation for furnishing all
labor, materials, tools, equipment, and incidentals and for doing all the work involved in Earthwork,
complete in place, as shown on the plans, as specified in the Standard Specifications for Public
Works Construction and these Special Provisions, and as directed by the Engineer, unless there
is a bid item specifically called out for a more specific item of work.
Is Amended to Read:
Earthwork shall be paid at contract unit price per Cubic Yard (CY) for all earthwork and grading
required to complete the bike lane widening and parkway grading; this item of work includes full
compensation for furnishing all labor, materials, tools, equipment, and incidentals and for doing
all the work involved in Earthwork, complete in place, as shown on the plans, as specified in the
Standard Specifications for Public Works Construction and these Special Provisions, and as
directed by the Engineer, unless there is a bid item specifically called out for a more specific item
of work.
Earthwork will be measured and paid by export material leaving the site and legally
disposed. The shaping of the slopes and preparation of subgrade under the roadway
section is considered as incidental to this and other items of work.
ta Qa�fra
CALIFORNIA -
PROJECT PLANS
Sheets 2-5, 10, and 14 are replaced with the attached. The addendum includes additional notes
and details for the Additive Alternate to construct a bike lane on Monroe in various areas.
The Contractor is hereby notified; Addendum No. 1 must be acknowledged and initialed as
stipulated under the instructions to Bidders and submitted as part of the Bid. Failure to do so
shall result in the City designating said bid as "Non -Responsive."
APPROVED:
Bryan cKinney, P.E.6
Public Works Director/City Engineer
Attachments: 1. Bid Schedule Dated 11/30/2023
2. Revised Plan Sheets 2-5, 10, and 14
END OF ADDENDUM NUMBER 1
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ADDENDUM 01 - 11/30/2023
SECTION 1210
BID SCHEDULE
PROJECT NO. 2023-15
FY22/23 PAVEMENT MANAGEMENT PLAN
City of La Quinta
78-495 Calle Tampico
La Quinta, CA 92253
To Whom It May Concern,
Pursuant to the Invitation to Bid, and in accordance with the provisions therein stated, the
undersigned hereby proposes and agrees that on award by the City under this Bid, to
execute a Contract, with necessary bonds, to furnish and install any and all labor,
materials, transportation and services for Project No. 2023-15, FY22/23 PAVEMENT
MANAGEMENT PLAN in accordance with the plans and specifications therefore
adopted and on file with the City within the time hereinafter set forth and at the prices
named in this Bid. It is understood that the basis of award shall be the lowest total price
of the Base Bid Area plus all Additive Alternates.
Unit prices in each and every case represent the true unit price used in preparing the bid
schedule totals (Bid Form). Unit prices listed herein include material, installation and
appurtenant work as is necessary to have the item complete and in place meeting the full
intent of the plans and specifications. We acknowledge that unbalanced unit prices shall
be sufficient cause for the rejection of our bid.
Bid Schedule 1210-1
ADDENDUM 01 - 11/30/2023
BASE BID — FY22/23 PAVEMENT MANAGEMENT PLAN
Item
Item Description
Est.
Unit
Unit Price
Item Total
No.
Qty.
(in figures)
(in figures)
Dollars
Dollars
1
Mobilization
1
LS
$ ��a� 0 00
$
2
Traffic Control
LS
$ �)'440.
$ �) goo
Sawcut, Remove and Dispose
3
of Existing Concrete Curb; Curb
100
LF
$
$ I �� 9ao
and Gutter
Construct 6" Curb and Gutter
per City of La Quinta Standard
7 9'
'
4
201, 3" Dowel into Adjacent
LF
$
$
Existing Concrete Curb and
% Q.2,b
Gutter
Construct 6" Curb per City of La
5
Quinta Standard 210, 3" Dowel
10
LF
—
$ J-fS
$ / Qso
''
into Adjacent Existing Concrete
Curb
6
Crack Seal and Type I, Latex
33,295
SF
$ .97
$ .2g Q6
Emulsion Aggregate Slurry
7
Crack Seal and Type II, Latex
Emulsion Aggregate Slurry--
1,800,670
SF
$
$
Pavement Repair Type I: 2"
y�
8
Grind and Asphalt Concrete
38,583
SF
$
Overlay
Pavement Repair Type II: Edge
9
Repair AC Showing; Grind AC
90
SF
%
$
(p �3d
$ .,
Shoving 2" Below Adjacent
Surface and 2" Overlav
Pavement Repair Type III:
10
Remove AC (4 1/2"), Compact
332
SF
$
Quid
$
Existing Base, and Variable
Overla 4 1 /2" - 5 1 /2"
11
Signing and Striping, Including
1
LS
$ D
$ �ZS
All Incidentals
mb
W,
Total Amount of Bid Items 1 —11
$
Bid Schedule 1210-2
4td
3g
*C�
ADDENDUM 01 — 11/30/2023
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
1
Mobilization
1
LS
Dollars
$ 16,0 p0
$ 16,, 00O
2
Traffic Control
1
LS
$ �a
$ (C
3
Dust Control
1
LS
$
$ aaJ Do
4
Earthwork
1,300
CY
$ QD
$ It? oaa
5
Remove Roadway Section to
Full Depth Required for
5,400
SF
$ �i. Ii(7
$ .23, 760
Proposed Roadway Width
6
Construct 5" Asphalt Concrete
Pavement Over 6" Aggregate
20,430
SF
$
$ 1 T SV.
Base
and Asphalt Concrete
3,614
SF
Irc
$
$
OverlayGrind
8
Signing and Striping, Including
1
LS
$
p $ //
cow °a
All Incidentals
Total Amount of Bid Items 1 — 8
ADDITIVE ALTERNATE NO. 2
Item
Item Description
Est.
Unit
Unit Price
Item Total
No.
Qty.
(in figures)
(in figures)
Dollars
Dollars
1
Lower Sewer Manhole to Grade
g
EA
$
$ j�
er CVWD Standards
o
2
Raise Sewer Manhole to Grade
g
EA
$ 77�
$
per CVWD Standards
Total Amount of Bid Items 1 — 2 $ c(pb
Bid Schedule 1210-3
I
U/
ADDENDUM 01 - 11/30/2023
GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Figures):
s[1 7's 6, 740.`t
GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Words):
Of) e ` N CO-r\ 5C=
AHn�rec( 021\¢ 40/14rs 'Tn TDrfY^Set.tw Ce V
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)
Michael Farkas, Secretary
Name of Bidder (Printed or Typed)
951-736-7600
Bidder Telephone Number
ublicworks@allamericanasphalt.com
Bidder Email Address
Bid Schedule 1210-4
Bond No. 08597423
Bid Date: 12/04/2023
SECTION 1220
BID GUARANTY BOND
PRINCIPAL, and Fidelity and Deposit Company of Maryland, 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. 2023-15
FY22/23 PAVEMENT MANAGEMENT PLAN
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 28th day of
November 2023.
All American Asphalt
GASLOO - PRE&MW
Title of Signatory-�
Signatu a of Principal
400 East Sixth Street, Corona, CA 92879
Address
Fidelity and Deposit Company of Maryland
Rebecca Haas -Bates, Attorney -in -Fact
Title of Signatory
Signature of Surety
777 S. Figueroa Street, Suite 3900, Los Angeles, CA 90017
Address
Note: Signatures of those executing for the surety must be properly acknowledged.
Bid Guaranty Bond 1220-1
CALIFORNIA ALL-PURPOSE 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 Orange
On 11/28/2023 before me, L. Gomez, Notary Public
Date Here Insert Name and Title of the Officer
personally appeared Rebecca Haas -Bates
Name(*of Signerjrsl
who proved to me on the basis of satisfactory evidence to be the person* whose name(t* is/axe
subscribed to the within instrument and acknowledged to me that toe/she/they( executed the same in
Ns/her/their authorized capacity, and that by hiWher/niw signatures on the instrument the person(},
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.
OMY
L. GOMEZ WITNESS my hand and official seal.
Notary klhlic . California
Orange County
Cornmisslan# 2413682 Signature
Comm. Expires Aug 23, 2026 y
Signature of Lary 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: Bid Bond Document Date: 11/28/2023
Number of Pages: One 1 Signer(s) Other Than Named Above: All American Asphalt
Capacity(ies) Claimed by Signer(s)
Signer's Name: Rebecca Has -Batts
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
1 Individual IVAttorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Fidelity and Deposit Com any of Maryland
Signer's Name:
❑ Corporate Officer — Title(s),
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
D Other:
Signer Is Representing:
02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT 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 truthfulnes.a_ accnracv. or validity of that document.
State of California
County of
Riverside
on November 30, 2023 before me, Kenona Maui, Notgy Public
Date Here Insert name and Title of the Officer
personally appeared Edward J. Carlson
Name(,,) -of Signer(s-
KENON¢NA711RI
90my
Notary Public- California
Riverside CountyCommission'# 2318601
Comm. Expires Jan 10, 2024
Place Notary Seal Above
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'd executed the same in
his/4e4their authorized capacity(ies), and that by his/heF4heir
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 forgoing paragraph is true and correct.
WITNESS my
Signature
seal.
of Notary Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to person relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document Bid Bond — City of La Quinta
Document Date: November 28, 2023 Number of Pages:
Signer(s) Other Than Named Above: Rebecca Haas -Bates, Attorney -in -Fact
Capacity(ies) Claimed by Signer(s)
Signer's Name: Edward J. Carlson Signer's Name:
❑ Individual ❑ Individual
X Corporate Officer — Title(s): Vice President
❑ Partner ❑ ❑ Limited ❑ General
RIGHT THUMBPRINT
❑ Attorney in Fact OF SIGNER
❑ Trustee Top of thumb here
❑ Other:
Signer is Representing:
All American Asphalt
❑ Corporate Officer — Title(s
❑ Partner ❑ ❑ Limited ❑ Geri
❑ Attorney in Fact
❑ Trustee
❑ Other:
Signer is Representing:
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY
AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert
D. Murray, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth
on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and
appoint William SYRKIN, Richard ADAIR, Rebecca HAAS-BATES of Irvine, California, its true and lawful agent and Attorney -in -Fact, to
make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the
execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all
intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN
INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN
CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND
DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons.
The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of
the By -Laws of said Companies, and is now in force.
IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 1 lth day of October, A.D. 2023,
� „,..rrrr µn,.nrrrp Irrhrr� oSEALm USEA s g ySEACO
„„•,.A „ ,x,,,. ATTEST:
ZURICH AMERICAN INSURANCE, COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
By: Robert D. Murray
Vice President
By: Dawn E. Brown
Secretary
State of Maryland
County of Baltimore
On this 1 1 th day of October, A.D. 2023, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Robert D.
Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who
executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of
the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and
the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written.
Genevieve M. Maison
GENEVIEVE M. MAISON
c AaBL% tom'
BALTIMORE COUNTY,
My Commission Expires 14NUARY 27 2025
•h
Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790
EXTRACT FROM BY-LAWS OF THE COMPANIES
"Article V, Section 8, Atooraeys-in-Faei. The Chief Executive Officer, the President, or any Executive Vice President or Vice President
may, by written instrument under the attested corporate seal, appoint attorneys -in -Fact with authority to execute bonds, policies, recognizances,
Stipulations, undertakings, or other like instruments on behalf or the Company, and may authorize any officer or any such attorney -in -fact to
affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time."
CERTIFICATE
I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY
AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power
of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws of the
Companies is still in force.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998.
RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary
and the Seal of the Company may be affixed by facsimile on any Power of Attorney ... Any such Power or any certificate thereof bearing such
facsimile signature and seal shall be valid and binding on the Company."
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May,
1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting
duly called and held on the I Oth day of May, 1990.
RESOLVED: "Thal the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature
of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a
certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect
as though manually affixed.
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies,
this 28th day of November , 2023 .
'' `anu Yqy Ily�'�y
1111M 11l1, ,lt, llllllf
Aiy lN3Uq ,y
c+c:; •W,�s
SEAL ) r+_
! SEAL I v = Y SEAL
51
4 ygaJ.......Z,
_
ti
=•7rY.;.9'7W��'q,. ry �iAS
...111»......S�
M1
lIry
y�`,`
III�I 1000 �,I1111114,A ",
Thomas O. McClellan
Vice President
TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION
OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT
INFORMATION TO:
Zurich Surety Claims
1299 Zurich Way
Schaumburg, IL 60196-1056
re ortsMaim c zurichria.com
800-626-4577
Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790
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: Slurry Seal of Central Area of Sands Section
Owner: City of Manhattan Beach
Construction Cost: $ $730,251.42
Construction Time: 240
Owner's Representative:
Owner's Telephone No.:
Bianca Cardenas
310-802-5357
Date of Substantial Completion: 7/2022
2. Project Name: Neighborhood Slurry Seal Area 3
Owner: City of La Mirada
Construction Cost: $ $799,151.00
Construction Time: 180
Owner's Representative: Priscilla Yi
Owner's Telephone No.: 562-902-2374
Date of Substantial Completion:
12/2022
Calendar Days
Calendar Days
Bidders Experience & Qualifications 1230-1
3
4.
Project Name: Slurry Seal Project 19/20
Owner: City of Dana Point
Construction Cost: $ $1,897,897.00
Construction Time: 395
Owner's Representative: Scott Fisher
Owner's Telephone No.: 949-248-3577
Date of Substantial Completion: 05/2021
Project Name: FY 18/19 Slurry Seal Project
Owner: City of Downey
Construction Cost: $ $313,425.87
Construction Time: 180
Owner's Representative: Desi Gutierrez
Owner's Telephone No.: 562-904-7110
Date of Substantial Completion: 12/2019
Signed this day of
All American Asphalt
Name of Bidder
oo
Signatufe of Ekilder
Edward J. Carlson
Printed Name of Bidder
267073
Calendar Days
Calendar Days
2023.
1000001051
Contractor's License No. DIR Reg No.
01 /31 /2024
Expiration Date
Vice President
Title of Signatory
Bidders Experience & Qualifications 1230-2
2022
PAST WORK REFERENCES
City of Manhattan Beach
1400 Highland Ave.
Manhattan Beach, CA 90266
Contact: Bianca Cardenas (310) 802-5357
brardenas manliattaribeacii. av
RMV Realty, Inc.
28811 Ortega Hwy
San Juan Capistrano, CA 92693
Contact: Kelly Haymes
kha mes ranchomv.com
City of Westlake Village
31200 Oak Crest Dr.
Westlake Village, CA 91361
Contact: Roxanne Hughes (805) 890-8885
rhu hes wilidan.com
City of Burbank
275 E Olive
Burbank, CA 91502
Contact: Artin Megerdichian (818) 238-3942
ame erdichian burbankca. ov
City of Highland
27215 Base Line St.
Highland, CA 9234
Contact: Amanda Perez (909) 864-6861
aperezL@ciofliip,hiancl.org
Slurry Seal of Central Area of Sands Section
Contract Amount: $730,251.42
Start Date:12/2021
End Date: 7/2022
Planning Area 3.1 Street Improvement
Contract Amount: $3,996,996.00
Start Date: 4/2021
End Date-4/2022
Dales Dr. and Parkridge Ave Street Improv.
Amount: $1,025,336.00
Start Date: 5/2022
End Date: 6/2022
Local Residential St. Improv. Project
Contract Amount: $7,761,320.00
Start Date: 1/2022
End Date: 12/2022
Pavement Management Program
Contract Amount: $2,082,099.00
Start Date: 10/2021
End Date: 12/2022
2022
PAST WORK REFERENCES
Toll Bros, Inc.
725 W. Town & Country Road, Ste 200
Orange, CA 92868
Contact: Brandon Haskell (714) 347-1360
bhaskeil@tollbrotliers.com
City of Fullerton
303 W. Commonwealth Ave
Fullerton, CA. 92632
Contact: Nick Esposito (714) 738-6851
Nick-gspQsito@citmoffullerton.com
City of Norco
2870 Clark Ave
Norco, CA 92860
Contact: Chad Blais (951) 270-5678
c bkausC@cu. norco.ca. us
City of Newport Beach
100 Civic Center Drive
Newport Beach, CA. 92660
Contact: Ben Davis (949) 644-3311
bdavi s@newpyrt beac hca.gov
City of Villa Park
17855 Santiago Blvd.
Villa Park, CA 92667
Contact: Hamid Torkamanha (714) 998-1500
hamid@villapark.org
The Metro Heights
Contract Amount: $2,675,250.00
Start Date: 11/2021
End Date: 04/2022
Miscellaneous Rehab FY 21-22
Contract Amount: $704,080.00
Start Date: 06/2022
End Date:12/2022
Corporate Yard Pavement Rehab
Contract Amount: $612,755.33
Start Date: 10/2021
End Date:12/2022
E. Coast Highway & Marguerite Avenue
Pavement Rehabilitation Contract No. 7807-2
Contract Amount: $3,363,056.00
Start Date: 01/2022
End Date:10/2022
FY2021-2022 Slurry Seal Project
Contract Amount: $128,497.60
Start Date: 02/2022
End Date: 12/2022
2022
PAST WORK REFERENCES
City of Norwalk
12700 Norwalk Blvd.
Norwalk, CA 90650
Contact: Damian Rosales (562) 929-5527
jlopez2e norwalkca.1zov
City of Buena Park
6650 Beach Blvd.
Buena Park, CA 90621
Contact: Cesar Ortiz (714) 562-3689
cortix buena ark.com
City of Santa Clarita
23920 Valencia Blvd. #120
Valencia, CA 91355
Contact: Juana Alfaro (661) 255-4942
'afaro santa-clarita.com
Lewis Operating Corp.
1156 N. Mountain Ave.
Upland, CA 91786
Contact: Bill Hanson (909)985-0971
Bill.hanson@lewismc.com
City of La Mirada
15515 Phoebe Avenue
La Mirada, CA 90638
Contact: Priscilla Yi (562) 902-2374
Priscilla.yir cit aflamirada,or.,
Local St. Rehabilitation Project
Contract Amount: $1,041,470.00
Start Date: 01/2021
End Date: 12/2022
Eighth Street Rehab Project
Contract Amount: $510,000.00
Start Date: 1/2021
End Date: 12/2022
Dales Dr. and Parkridge Ave Street Improv.
Amount: $1,025,336.00
Start Date: 5/2022
End Date: 6/2022
Meridian Phase 3 Street Improvements
Contract Amount: $4,947,887.50
Start Date: 11/2021
End Date: 12/2022
Neighborhood Slurry Seal Area 3
Contract Amount: $799,151.00
Start Date: 6/2022
End Date: 12/2022
2021
PAST WORK REFERENCES
City of Anaheim
200 S. Anaheim Boulevard
Anaheim, CA 92805
Contact: Jose Cortez (714) 765-5039
i cortez(i�t) an alie i nn. net
County of Orange
601 North Ross Street
Santa Ana, CA 92701
Contact: Stephen Clayton (714) 995-0206
Steyllcn.clay lon [L ocpw,ocgoyxoni
City of Norwalk
12700 Norwalk Blvd.
Norwalk, CA 90650
Glen W. C. Kau (562) 929-5723
1;a0i' norwalkca.go.y
City of Garden Grove
11222 Acacia Pkwy
Garden Grove, CA 92840
Navin Maru (714) 741-5180
iamartllcr%s�ci�.or�
State College Boulevard Improvement
from Ball Road to SR 91 Freeway
Contract Amount: $484,848.00
Start: 8/2021
Complete: 4/2022
Rossmoor Collectors Grind & Overlay
Contract Amount: $ 2,148,320.90
Start: 4/2021
Complete: 12/2021
Local Streets Rehabilitation
Zone 27 East of Gard — No. 7925.3
Contract Amount: $1,051,330.00
Start: 6/2021
Completed: 12/2021
Arterial STS. Rehabilitation
Contract Amount: $3,185,281.00
Start: 6/2022
Complete: 12/2021
2021
PAST WORK REFERENCES
Colony Commerce
C/O Caprock Partners
1300 Dove Street Suite 200
Newport Beach, CA 92660
Contact: Eric Nutter (949) 428-1400 Ext. 209
etlutlerk moote.eoni
Lennar Homes
25 Enterprise #300
Aliso Viejo, CA 92656
Contact: Diane Hannon (949)349-8000
Diane.hannon, lennar.com
City of Norco
2870 Clark Ave.
Norco, AC 92860
Contact: Todd Shank (951) 270-5603
'rs�cl cif. s lean krcr7 no rc o . c ��. t is
Archibald St. Improvements
Contract Amount: $1,949,000.00
Start: 12/2019
Completed: 12/2021
Merrill & Haven Street Improvement
Contract Amount: $1,481,832.15
Start: 6/2020
Completed: 12/2021
Wayne Makin Park Slurry Seal Project
Contract Amount: $52,725.89
Start: 10/202I
Completed: 12/2021
Los Angeles Department of Water and Power Pine Tree Power Plant Access Road Repair
111 North Hope Street, L-43 Improvements
Los Angeles, Ca 90012 Contract Amount: $810,400.00
Contact: Joelle Morisseau (213) 367-0123 Start: 5/2021
.I ocl le.ni on sseau(i),L AD W i'.coiii Completed: 7/2021
City of Dana Point
33282 Golden Lantern
Dana Point, CA 92629
Contact: Scott Fisher (949) 248-3577
siisherra),DanaPoim.or I
City of Corona
400 South Vicentia
Corona, CA 92852
Contact: Barry Ghaemi (951) 736-2400
bahaciiii'ir)C'oronttcti. ,.ov.
Slurry Seal Project 19/20
Contract Amount: $1,897,897.00
Start: 04/2020
Completed: 05/2021
Street Pavement Maintenance
& Rehabilitation Project No. 2020.01
Contract Amount: $3,471,178.00
Start: 6/2021
Completed: 112022
2020
PAST WORK REFERENCES
City of Ontario
303 East B Street
Ontario, CA 91764
Contact: Ariana Kern (909) 395-2129
akern@ontarioca.gov
City of Loma Linda
25541 Barton Road
Loma Linda, CA 92354
Contact: T. Jarb Thaipejr (909) 799-4400
ithaipeorAlomalinda-ca,ciov
City of Jurupa Valley
8920 Limonite Avenue
Jurupa Valley, CA 92509
Contact: Chase Keys (951) 332-6464
ckeys@ iuruoava IIey, orp
County of Orange
601 N. Ross Street, 4'h Floor
Santa Ana, CA 92701
Contact: Albert Rodriguez
albert.rodri uez ac w.oc ov.com
City of Compton
205 S. Willowbrook Avenue
Compton, CA 90220
Contact: Brittany Duhn (Z & K Consultants)
bduhq_@zandkconsultants.com
City of Huntington Beach
2000 Main Street
Huntington Beach, CA 92648
Contact: Joe Fuentes (714) 536-5259
ifuentesPsurfcity-hb. c Lg
2020 Fall Pavement Rehabilitation Project
Contract Amount: $2,499,333.00
Start Date: 07/2020
End Date: 12/2020
Pavement Rehabilitation — Barton Road
Contract Amount: $768,677.00
Start Date: 04/2020
End Date: 12/2020
Granite Hill Drive Pavement Rehabilitation
Contract Amount: $999,777,00
Start Date: 04/2020
End Date: 10/2020
JOC Pavement Maintenance
Contract Amount: $2,584,747.69
Start Date: 07/2020
End Date: 08/2020
Annual Residential Street Rehabilitation —
Phase 1
Contract Amount: $5,295.068.00
Start Date: 05/2020
End Date: 11/2020
Arterial Rehabilitation of Graham St, Slater
Ave, Newland St and Atlanta Ave
Contract Amount: $5,181,955.00
Start Date: 05/2020
End Date: 11/2020
2019
PAST WORK REFERENCES
City of Simi Valley
2929 Tapo Canyon Rd.
Simi Valley, CA 93063
Contact: Sarah Sheshebor (805)583-6792
ssheshe�7t`i SlrlilV llpl/.prq
County of Ventura
501 Poli Street
Ventura, CA 93001
Contact: Christopher Solis (805) 654-2054
ch ris. so lis [a7ve nt u ra. o rg
City of Stanton
7800 Katella Avenue
Stanton, CA. 90680
Contact: Guillermo Perez (714) 890-4204
erez ci.stanton.ca.us
City of Compton
205 S. Willowbrook Avenue
Compton, CA. 90220
Contact: John Strictland (310) 605-5505
istrictland comptoncity.org
City of San Clemente
910 Celle Negocio
San Clemente, CA. 92673
Contact: Darra Koger (949) 361-3138
ko er❑ san-clernente.or
City of South Gate
8650 California Avenue
South Gate, CA. 90280
Contact: John Rico (323) 563-9594
rico sE te.org
Simi Valley Minor Street Rehabilitation
Contract Amount: $510,124.25
Start Date: 07/2019
End Date: 08/2019
Yerba Buena Area Resurfacing Project
Contract Amount: $3,919,808.95
Start Date: 06/2019
End Date: 12/2019
2019 Citywide Street Resurfacing
Contract Amount: $1,206,869.00
Start Date: 10/2019
End Date: 12/2019
Road Repair Service (Pothole Repair)
Contract Amount: $1.019,100.00
Start Date: 08/2019
End Date: 11/2019
Street Rehabilitation for S. Avenue LA
Esperanza
Contract Amount: $384,055.00
Start Date: 09/2019
End Date: 10/2019
Circle Park Driveway Project
Contract Amount: $268,576.00
Start Date: 06/2019
End Date: 09/2019
2019
PAST WORK REFERENCES
Pardee Homes
1250 Corona Pointe Court, Ste. 600
Corona, CA. 92879
Contact: Nick Lasher (951) 428-4442
nic;k.lasher@pardeehomes.com
City of Fontana
8353 Sierra Avenue
Fontana, CA, 92335
Contact: Kimberly Young (909) 350-7632
kyounq(7fontana arg
DR Horton
2280 Ward low Circle Ste. 100
Corona, CA. 92880
Contact: Keith Alex (951) 830-5872
kalex drhorton.corn
Irvine Community Development Company
550 Newport Center Dr. Ste. 550 B2
Newport Beach, CA. 92660
Contact: Mike Morse (949) 720-2560
mmorse irvinecom an .cam
City of Downey
11111 Brookshire Avenue
Downey, CA. 90241
Contact: Desi Gutierrez, (562) 904-7110
d ug tierr_Odowneyca. orq
Railroad Canyon Widening
Contract Amount: $5,062,746.00
Start Date: 11/2018
End Time: 08/2019
Citrus Avenue Improvements
Contract Amount: $502,730.00
Start Date: 08/2018
End Date: 10/2019
Singlton Road
Contract Amount: $1,684,000.00
Start Date: 07/2018
End Date: 12/2019
Portola Springs PA-6 Enclave 5B Phasel,2
Contract Amount: $2,055,055.00
Start Date: 09/2018
End Date: 12/2019
FY 18/19 Slurry Seal Project
Contract Amount: $313,425,87
Start Date: 06/2019
End Date: 12/2019
2019
PAST WORK REFERENCES
City of Chino
13220 Central Avenue
Chino, CA. 91710
Contact: Dustin Postovoit (909) 334-3415
a ostovoit cit ofchino.or
City of Lancaster
44933 Fern Avenue
Lancaster, CA. 93534
Contact: Greg Wilson (661) 570-8003
Wilson cit oflancasterca_or
City of Colton
650 N. La Cadena Dr.
Colton, CA. 92324
Contact: Victor Ortiz (909) 370-5099
_vortjL@co.Itonca.gov
City of Cathedral City
68700 Ave Lalo Guerrero
Cathedral City, CA. 92234
Contact: John A. Corella (760) 770-0349
icorella@cathedralcity.gov
City of San Clemente
910 Calle Negocio
San Clemente, CA. 92673
Contact: Gary Voborsky (949) 361-6132
voborskyg@san-c(emente. o rq
Slurry Seal Maintenance Work
Contract Amount: $372,805.00
Start Date: 1/2019
End Date: 12/2019
2018 Pavement Management Program
Contract Amount: $2,720,103.65
Start Date: 312019
End Date: 12/2019
FY 18-19 Asphalt Paving Project
Contract Amount: $1.377,700.00
Start Date: 3/2019
End Date: 11/2019
Ortega Road Widening
Contract Amount: $459,998.00
Start Date: 2/2019
End Date: 1212019
Arterial Street Pavement Maintenance
Contract Amount: $1,187,187.00
Start Date: 3/2019
End Date: 7/2019
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.
1ti a R 4 �bcr�c w d k-e Par .Z Rd
Signatur of B' der Edward J. Carlson, Vice President
All American Asphalt
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 RIVERSIDE )
Edward J. Carlson being first duly sworn, deposes and say that he
or she is Vice President of All American Asphalt 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.
Signat a Ed. rd J. Carlson
All American Asphalt
Name of Bidder
Vice President
Title
Date
Non -Collusion Affidavit 1250-1
CALIFORNIA JURAT GOV CODE § 8202
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Riverside
KENONA NAZARI
Notary Public - "California
Riversido County
Commission k 2318601
•tr6RN' 'My Comm. Expires Jan 10, 2024
Place Notary Seal Above
Subscribed and sworn to (or affirmed) before
me on this 30th day of November 2023,
Date Month
By (1) Edward J. Carlson
Name of Signer
Proved to me on the basis of satisfactory evidence
be the person who appeared before me (.) (,)
(2)
(and
Name of Signer
Proved to me on the basis of satisfactory evidence
be the perms who appeared before me.)
Signature
OPTIONAL
Though the information below is not required by law, it may prove
valuable to person relying on the document and could prevent
fraudulent removal and reattachment of this form to another document
Further Description of Any Attached Document
Title or Type of Document Non -Collusion Affidavit
Document Date: 11-30-2023 Number of Pages: 1
Signer(s) Other Than Named Above: None
Signature of Notary Public
Top of thumb here
Top of thumb here
SECTION 1260
DIR Project Vendor Information
Vendor Information:
Name: All American Asphalt
Address: 400 E. 6th St. City: Corona
Project Manager: Brian Anselm
Phone: 951-736-7600
ST: CA Zip: 92879
Email: publicworks@allamericanasphalt.com
CSLB/Certification Number: 267073
Public Works Registration No.: 1000001051
Classification:
Asbestos Boilermaker Bricklayers Carpenter Carpet/Linoleum
Cement Masons x Drywall Finisher Drywall/Lathers Electricians
Elevator Mechanic Glaziers Iron Workers Laborers x Millwrights
Operating Eng x Painters Pile Drivers Pipe Trades Plasterers
Roofer SheetMetal Sound/Com Surveyor Teamster Tile Worker
Prevailing Wages and Payroll:
The project is subject to prevailing wage rates and enforcement by the Department of
Industrial Relations (DIR). Prevailing wage rates can be obtained at:
http://www.dir-ca-gov/Public-Works/Prevailin_q-Wa e.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 roll -Re ortin .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
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 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)
All American Asphalt
j By (Authorized
_ 6
Printed N e ar
CEdward J. Ca
Iran Contracting Act Certification
of Person Signing
Vice President
Federal ID Number (or n/a)
95-2595043
Date Ex cut d
66 �3��ZA)
1270-2
OPTION #2 — EXEMPTION
Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may
permit a vendor/financial institution engaged in investment activities in Iran, on a case -
by -case basis, to be eligible for, or to bid on, submit a proposal for, or enters into or
renews, a contract for goods and services.
If you have obtained an exemption from the certification requirement under the
Iran Contracting Act, please fill out the information below, and attach documentation
demonstrating the exemption approval.
Vendor Name/Financial Institution (Printed) I Federal ID Number (or n/a)
N/A N/A
By (Authorized Signature)
I Printed Name and Title of Person Signing Date Executed
N/A N/A
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 theCit if this section is applicable.
Russian Aggression Against Ukraine Compliance 1280-1