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AOS, Inc. dba Superior RoofingSECTION 1200 BID DATE: // Z02 The undersigned, as bidder, declares it has received and examined the Contract Document entitled Project No. 2023-32, City Hall Roof Repair Project 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 Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY. A65 Sr,c. �hla Su�trior,QOa�'inJc NEeacf Bldde rpan0S �p /9- SZU -oS/ -7 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. A S 3nL dha Super; o r I?,),, o Name of Bidder PO 8o x 2635 &r Marzos 64 gw79 Bidder's Address (P(.092.31 Contractor's License No. CA State of Incorporation Signature of Bidder ey(4, i. S.er "u-s Printed Name of Signatory -P(-,eSId e-r) Title of Signatory '7(oc) -7,45 eisoq Bidder's Telephone Number tf-vav,&-, aoSroo-'. Cow, Bidder's Email Address Contractor's Expiration Date Witness 4&-,:1W)Yfi . Awe - Title of Witness Bid 1200-2 ADDENDUM 01 - 6/10/2024 SECTION 1210 BID SCHEDULE PROJECT NO. 2023-32 CITY HALL ROOF REPAIR PROJECT 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. 2023-32, City Hall Roof Repair Project, in accordance with the plans and specifications therefore adopted and on file with the City within the time hereinafter set forth and at the prices named in this Bid. It is understood that the basis of award shall be the lowest total price of the Base Bid Area. Unit prices in each and every case represent the true unit price used in preparing the bid schedule totals (Bid Form). Unit prices listed herein include material, installation and appurtenant work as is necessary to have the item complete and in place meeting the full intent of the plans and specifications. We acknowledge that unbalanced unit prices shall be sufficient cause for the rejection of our bid. Bid Schedule 1210-1 ADDENDUM 01 - 6/10/2024 BASE BID - CITY HALL ROOF REPAIR PROJECT Item No. Item Description Est. Qty. Unit Unit Price (in figures) Dollars Item Total (in figures) Dollars 1 Mobilization 1 LS $ ppQ $ 3 Oroou r 2 Site Control 1 LS $ ,,,Coo $ aw a, . - 3 Tile Roof Repair 1 LS $ '430, $ �{SS• ' 4 Furnish New Roofing Tiles 200 EA $ can 6 . $ a 5 Remove and Replace Damaged Sheathing 300 SF $ od — m $ l , U� 6 Furnish New Bird Stop Tiles 100 EA $ Total Amount of Bid Items 1 - 6 $ GRAND TOTAL BASE BID (Figures): W Rl Wv r GRAND TOTAL BASE BID (Words): Ck' L� V w () t�--r� S .1 1 }s�y S /� ►1I1���,Jc�r-�L� . 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) Name of Bidder (Printed or Typed) Bidder Telephone Number OVA" co &LS 9-ME. Cow Bidder Email Address Bid Schedule 1210-2 SECTION 1220 BID GUARANTY BOND PRINCIPAL, and RLI Insurance Company , as SURETY, are held and firmly bound unto the City in the penal sum of TEN (10) PERCENT OF THE TOTAL AMOUNT OF THE BID of the Principal above named, submitted by said Principal to the City for the work described below, for the payment of which sum in lawful money of the United States, well and truly to be made to the City to which said bid was submitted, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEREAS, the Principal has submitted the above -mentioned bid to the City, for certain construction specifically described as follows, for which bids are to be opened at La Quinta, California. PROJECT NO. 2023-32 CITY HALL ROOF REPAIR PROJECT 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 7th day of June , 2024. AOS,Inc. dba Superior Roofing President Title of Signatory Signature of Principal Rl,.l'(nsurance Company of Sig Signatu Martha J.'Cohase P. O. Box 2635 9025 North Lind h Drive ^ San Marcos, CA 92079 Peoria, IL 61615 Address Address Note: Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 ,CAS ., -PUR SE ACI W:LEDV i�T 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 truthfiilness, accuracy, or validity of that document. STATE OF CALIFORNIA )ss. COUNTY OF LOS ANGELES On June 7, 2024 before me, Rolando Lopez. Notary Public, personally appeared Martha J. Chase, 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/#hey executed the same in his/her/thek authorized capacity(ies), and that by his/her/fib 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. ROLANDO LOPEZ Sol —(Seal) z NOTARYOACOUNTY u S NZ Rolando Lopez, No Pub7k COMMISSION * 2381870 MY COMM. EXPIRES NOV. 30,202SWC POWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N. Lindbergh Dr. Peoria, IL 61615 Phone: 800-645-2402 Know All Men by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together, the "Company") do hereby make, constitute and appoint: Martha J. Chase in the City of Los Angeles , State of California its true and lawful Agent(s) and Attorney(s) in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five Million Dollars ( $25,000,000.00 ) for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company. RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation, and is now in force, to -wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective Vice President with its corporate seal affixed this 27th day of December . 2022 . `• O0 .. AND OQO •OO�yPOPar�,•y� n - 0 = =6t SEAL; ,D ';Zoe'• • e2 State of Illinois )} County of Peoria SS On this 27th day of December 2022 , before me, a Notary Public, personally appeared Barton W. Davis , who being by me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of the RLI Insurance Company and/or Contractors Bonding and Insurance Company and acknowledged said instrument to be the voluntary act and deed of said corporation. By: Catherine D. Geiger Notary Public ECATHERINE D. GEIGER OFFICIAL SEAL Notary Public - State of Illinois My Commission Expires December 05, 2026 RLI Insurance Company Contractors Bonding and Insurance Company By: � H/ � ai I Barton W. Davis Vice President CERTIFICATE 1, the undersigned officer of RLI Insurance Company and/or Contractors Bonding and Insurance Company, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable; and furthermore, that the Resolution of the Company as set forth in the Power of Attorney, is now in force. In testimony whereof, I have hereunto set my hand and the seal of the RLI Insurance Company and/or Contractors Bondin and Insurance Company this Ztjday of June _, _5Q24 . RLI Insurance Company Contractors Bonding and Insurance Companv By: �f �`1i"""rl Jeffrey DUickv U 11 Corporate Secretary 0464190020212 A0058D l9 A- RNT kL PURPOSE CEKTI I ATE OF ACC W EDMI1NT A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Diego On before me, Hamid Emadian NaeiKi, Notaiy P b1i (Here insert name and title of the offic personally appeared who proved to me on the basis of satisfactory evidence to be the persory(•s') whose namsv) isLat subs r the within instrument and acknowledged to me that he/she/they executed the same in his/her/theft• au h capacity(joe), and that by his/hef/thdr signature on the instrument the personJa'j, t which the personW acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing pat is true and correct. HAMID EMADIAN NAEINI WIT SS a and official seal. = "� Notary Public California < Y San Diego County Commission S 2394143 (Nolan•) Seal) "c •o••'� My Comm. Expires Feb 16, 2026 Signal of otary Public ADDITIONAL L OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of atta ed document) (Title or description of attached document continued) Number of Pages _ Document Date l Z (Additional information) CAPACITY CLAIMED BY THE SIGNER 0 Individual (s) Cam' Colporate OfefifcerQ/��} Ca (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR CO T Ant' acknowledgment completed in California must contain verbiage taaclh as appears above in the notary section or a separate arknorsdedgment form must be Property rompleted and attached to that document. The only evt•eption is if a dortmnent is to be recorded outside of California. In such instances, any alteniative arknowledgrrtew rerbiage as may be printed on such a dormnent so IonS as the verbiage does nor require the notary to do something that is illegal for a nohrn in California (i.e. renthing the authorized ralhrchy of the signer). Please rheck the doctmrertt carefully for proper notarial wording and attach this join if required. • 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 acknowledgmmni is completed. • The notary public must print his or her narne as it appears within hi+ w her commission followed b) 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 form.. by crossing off incorrect forms (i.e. kelshellkey; is late ) 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 roust not cover text a 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. t 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 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: �%tt')gUard OniYer-sl' l S�Vder,4-CeVfer- Owner: V&ncvard Urliderg'i Construction Cost: $ Z12&) 5-&& Construction Time: *® Calendar Days Owner's Representative: SCO4 (at& f man 7riyer Owner's Telephone No.: (Az-&-35/-860) Date of Substantial Completion: 20 2-0 2. Project Name: ►2-041�acirne Owner: 1 Y 4r-rP oy s cT—r-, c Construction Cost: $ Construction Time: Calendar Days Owner's Representative: Daytiel m; ILA(�sl�i - i�� Owner's Telephone No.: / `i v05 Z S 7— Date of Substantial Completion: 5 f Z021 Bidders Experience & Qualifications 1230-1 3. Project Name: oL4- 4-h-e 6-,Jt-n Owner: C"S4-yi,,-W Hc, L.LC Construction Cost: $ 4 gq , 9 1 1 Construction Time: D Calendar Days Owner's Representative: Nr,;S 14,e m , f )- E. U'tle-' Owner's Telephone No.: $ 159- - 9- (ro - 50 /$ Date of Substantial Completion: It /oS IZ-021 4. Project Name: 41 n rn A-WorA au c- Hous nj Owner: Actor -a CAM, I-( /f ousirt� 1'at4nerS Liam Construction Cost: $ ? 400 Construction Time: Calendar Days Owner's Representative: CH ri s So !I i van , t� N 8U) IderS Owner's Telephone No.: S So - gg33 Date of Substantial Completion: A i /26 2 3 Signed this � J day of JuaC-. , 20# Aus j�nc. d) Name of Bidder Signature of Bidder 'IPJav\- 1. Ser tLn() Printed Name of Bidder &bq 7-31 tractor's License No. IOOOOO Zo 33 DIR Reg No. � /-?o /Z-(" Expiration Date I? -e S 1 ct-e-r, ' — Title of Signatory Bidders Experience & Qualifications 1230-2 SECTION 1240 PROPOSED SUBCONTRACTORS Pursuant to California Public Contracting Code, Section 4100 et. seq., the following list gives the name, business address, and portion of work (description of work to be done) for each subcontractor that will be used in the work if the bidder is awarded the Contract. (Additional supporting data may be attached to this page. Each page shall be sequentially numbered and headed "Proposed Subcontractors" and shall be signed.) The Contractor shall perform, with its own organization, Contract work amounting to at least 50 percent of the Contract Price except that any designated "Specialty Items" may be performed by subcontract and the amount of any such "Specialty Items" so performed will be deducted from the Contract Price before computing the amount required to be performed by the Contractor with its own organization. "Specialty Items" will be identified by the Agency in the Bid or in the Special Provisions. Where an entire item is subcontracted, the value of work subcontracted will be based on the Contract Unit Price. Subcontractor/Business Address/Description of Work/% of Work/License No./DIR Reg No. l�f 01 -e_1 Signature of Bidder C—V4A J. 15erpct00S , Pr�s;dP,�•.T- Name of Bidder Proposed Subcontractors 1240-1 SECTION 1250 NON -COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ) ) ss. County of San l) 1 Clo ) cV&V) J. Ser-p_&no s , being first duly sworn, deposes and say that he or she is Precsi ev);- of US Inc• Aba SuMior Roo- ►nn, 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 Gya.n -:1 SeycLnos Name of Bidder '_�)(-e -er k Title Date Non -Collusion Affidavit 1250-1 SECTION 1260 DIR Project Vendor Information Vendor Information: Name: BCDS Zric db4 Suxrror Roofir, Address: ID0 SOK Z&35 City: Saes Marcos ST: CIF Zip:Q2D7`) Project Manager: [—__Vav) SerpQnoS Email: eVCLne o�OSr�o �',Covv� Phone: (9 / q S ZU-O SI "7 CSLB/Certification Number: C0 (09 2 3 Public Works Registration No.: / i 0000 ZC 38 Classification: Asbestos Boilermaker Bricklayers Carpenter Carpet/Linoleum Cement Masons Drywall Finisher Drywall/Lathers Electricians Elevator Mechanic Glaziers Iron Workers Laborers Millwrights Operating Eng Painters Pile Drivers Pipe Trades Plasterers Roofer SheetMetal Sound/Com Surveyor Teamster Tile Worker Prevailing Wanes 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/Prevailing-Waae.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-Reporting.html. A copy of certified payroll, including the names and addresses of employees and/or subcontractors working on the job must be included with invoices submitted to the City of La Quinta. DIR Project Vendor Information 1260-1 SECTION COMPLIANCE WITH IRAN CONTRACTIWw!QiY6RjPmMT 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) S Trc du. Svp-er- or Jeoo 4' hq By (Authorized Signature Federal ID Number (or n/a) 3 3 0 85 3"r i 1 Printed Name and Title of Person S �' ning Date E ec ted , [ _ CVGc r J. '►'�GIYI o S r'reS iC�en -- _—.---.� v i t _ 0_2 T Iran Contracting Act Certification 1270-2 OPTION #2 — EXEMPTION Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a vendor/financial institution engaged in investment activities in Iran, on a case - by -case basis, to be eligible for, or to bid on, submit a proposal for, or enters into or renews, a contract for goods and services. If you have obtained an exemption from the certification requirement under the Iran Contracting Act, please fill out the information below, and attach documentation demonstrating the exemption approval. Vendor Name/Financial Institution (Printed) Federal ID Number (or n/a) By (Authorized Signature) /�— Printed Name and Title of Person Signing Date Executed Iran Contracting Act Certification 1270-3 SECTION 1280 COMPLIANCE WITH CALIFORNIA EXECUTIVE ORDER N-6-22 RUSSIAN AGGRESSION AGAINST UKRAINE (a) Contractor shall comply with California Governor Executive Order N-6-22 regarding sanctions in response to Russian aggression in the Country of Ukraine, and any implementing guidelines and/or economic sanctions imposed by the United States government in response to Russian actions in Ukraine, as well as any sanctions imposed under California law (collectively "economic sanctions"). Contractor shall comply with all such economic sanctions. By submitting a bid to the City, Contractor agrees to take any and all actions to support the Ukrainian government and people as required by law, including by refraining from new investments in, and financial transactions with, Russian institutions or companies that are headquartered or have their principal place of business in Russia (Russian entities), not transferring technology to Russia or Russian entities, and directly providing support to the government and people of Ukraine. (b) If bidding on a contract for Five Million Dollars ($5,000,000) or more, Contractor shall submit a written report to the City on Contractor's compliance with the economic sanctions, and the steps Contractor has taken in response to Russia's actions in Ukraine, including, but not limited to, desisting from making new investments in, or engaging in financial transactions with, Russian entities, not transferring technology to Russia or Russian entities, and directly providing support to the government and people of Ukraine as required by law. Failure to submit the report required by this Section may deem Contractor's bid non -responsive. Please include a written report to the City if this section is applicable. Russian Aggression Against Ukraine Compliance 1280-1