LC Paving & Sealing Inc.
April 2, 2025
LC Paving & Sealing, Inc.
620 Alpine Way
Escondido, CA 92029
SUBJECT: BID BOND RELEASE – PROJECT NO. 2024-05 CITYWIDE MISCELLANEOUS
ADA IMPROVEMENTS
To Whom It May Concern:
Thank you for submitting your proposal for the above referenced project. The La Quinta City
Council, at its regular meeting of April 1, 2025, awarded the contract to the lowest responsive
bidder, CT&T Concrete Paving Inc.
The above-mentioned original Bid Bond, which accompanied your proposal, is enclosed. Your
interest in working with the City of La Quinta is greatly appreciated, and we hope that you will
accept future opportunities to bid on other city projects.
Sincerely,
Olivia Rodriguez, Acting Deputy City Clerk
City Clerk’s Office
Enclosure
c: Great Midwest Insurance Company
File
SECTION 1200
BID
DATE: 1 7 ��
The undersigned, as bidder, declares it has received and examined the Contract
Document entitled Project No. 2024-05 and CDBG Project No. 4.LQ.50-24, Citywide
Miscellaneous ADA Improvements, and will contract with the City, on the form of
Contract provided herewith, to do everything required for the fulfillment of the contract for
said work at the prices and on the terms and conditions herein contained.
We have included the following items and agree that they shall form a part of this bid:
SECTION TITLE
1200 Bid
1210 Bid Schedule
1220 Bid Guaranty Bond
1230 Certification of Bidder's Experience and Qualifications
1240 Proposed Subcontractors
1250 Non -Collusion Affidavit
1260 DIR Project Vendor Information
1270 Iran Contracting Act of 2010
1280 Russian Aggression Against Ukraine Sanctions
1290 B-4 Certification of Bidder Regarding Non -Segregated Facilities (Required for all
Projects)
1290 B-7 Bidder's Certification on Federal Contract Requirements (Required for all
Projects)
1290 B-8 Questionnaire Regarding Bidders (Required for all Projects)
1290 B-9 List of Subcontractors and Suppliers (Required for all Projects)
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 #
#1
Date Received
3/21 /2025
Initi s
/V_
Bid 1200-1
Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY.
LC Paving & Sealing, Inc.
Name of Bidder
760-752-1743
Bidder's Telephone Number
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.
LC Paving & Sealing, Inc.
Name of Bidder
620 Alpine Way Escondido CA 92029
Bidder's Address
621610 A,B, & C-12
Contractor's License No.
CaVonia
State of Incorporation
760-752-1743
Bidder's Telephone Number
Marisa@lcpaving.com
Bidder's Email Address
08/31 /2026
Contractor's Expiration Date
Sign re of Bidder Witness
Jose Salinas
Printed Name of Signatory
President, Vice President, Secretary
Title of Signatory
("qPiA-
Title of Witness
Bid 1200-2
SECTION 1210
BID SCHEDULE
PROJECT NO. 2024-05 AND CDBG PROJECT NO. 4.LQ.50-24
CITYWIDE MISCELLANEOUS ADA IMPROVEMENTS
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. 2024-05 and CDBG Project No.
4.LQ.50-24, Citywide Miscellaneous ADA Improvements, in accordance with the plans
and specifications therefore adopted and on file with the City within the time hereinafter
set forth and at the prices named in this Bid. It is understood that the basis of award shall
be the lowest total price of 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 — CITYWIDE MISC. ADA IMPROVEMENTS — NAVARRO PLAZA
Item
Item Description
Est.
Unit
Unit Price
Item Total
No.
Qty.
(in figures)
(in figures)
Dollars
Dollars
1
Mobilization
1
LS
$ 43,000.00
$ 43,000.00
2
Traffic Control
1
LS
$ 20,000.00
$ 20,000.00
3
Dust Control
1
LS
$ 15,000.00
$ 15,000.00
4
Earthwork
1
EA
$ 15,000.00
$ 15,000.00
5
Sawcut, Remove, and Dispose of
20
LF
$ 110.00
$ 2,200.00
ExistingCurb
6
Sawcut, Remove, and Dispose of
855
SF
$ 5.75
$ 4,916.25
Existing Sidewalk and Ram
7
Construct Sidewalk per City of La
845
SF
$ 17.00
$ 14,365.00
Quinta Std. No. 240 Mod.
Construct Concrete Curb Ramp per
8
City of La Quinta Std. No. 250 Mod.
1
EA
$9,950.00
$
per Plan, Case B (Including Curb
9,950.00
along Ram
Full Depth Grind Asphalt Concrete
9
Pavement (3"), Compact Existing
35
SF
$ 171.00
$ 5,985.00
Base, and Variable Overlay (Y —
4"
Grade Parkway, Remove, Modify,
10
and Replace Landscape,
1
LS
$ 10,400.00
$ 10,400.00
Hardscape, and Irrigation in Kind to
Furthest Extent Possible
11
Signing and Striping, Including All
1
LS
$ 5,600.00
$ 5,600.00
Incidentals
Total Amount of Bid Items 1 — 11
$ 146,416.25
Bid Schedule 1210-2
City may award all or none of the following additive alternates:
ADDITIVE ALTERNATE NO. 1 — AVENIDA LA FONDA SPEED TABLES
Item
Item Description
Est.
Unit
Unit Price
Item Total
No.
Qty.
(in figures)
(in figures)
Dollars
Dollars
1
Mobilization
1
LS
$43,000.00
$ 43,000.00
2
Traffic Control
1
LS
$ 27,500.00
$ 27,500.00
3
Dust Control
1
LS
$ 15,000.00
$ 15,000.00
4
Sawcut, Remove, and Dispose of
90
LF
$ 49.00
$ 4,410.00
Existing Curb; and/or Curb & Gutter
5
Sawcut, Remove, and Dispose of
785
SF
$ 6.00
$ 4,710.00
Existing Ramp and Pavers
6
Construct Sidewalk per City of La
450
SF
$ 19.50
$ 8,775.00
Quinta Std. No. 240 Mod.
Remove and Dispose of Existing
7
Roadway Section to Depth
750
SF
$ 12.50
$ 9,375.00
Required
8
Construct 5.5" Asphalt Concrete
460
SF
$ 32.00
$ 14,720.00
over 6.5" Aggregate Base
Construct Two (2) Concrete Speed
9
Tables (Including All Concrete
1
LS
$ 36,500.00
$36,500.00
Work, Aggregate Base, Grading,
Rebar, and Conduit
Furnish and Install Truncated Dome
10
Concrete Tile per City of La Quinta
75
SF
$112.00
$ 8,400.00
Std. 250 Mod.
Remove, Regrade, and Reset
11
Sidewalk Pavers Per City of La
275
SF
$ 30.00
$ 8,250.00
Quinta Std. 206
Salvage to City Existing Pull Box
12
and Furnish and Install New No. 6
1
EA
$ 1,750.00
$ 1,750.00
Pull Box per Caltrans Std. Plan ES-
8A
Grade Parkway, Remove, Modify,
13
and Replace Landscape,
1
LS
$ 11,500.00
$ 11,500.00
Hardscape, and Irrigation in Kind to
Furthest Extent Possible
14
Signing and Striping, Including All
1
LS
$ 8,000.00
$ 8,000.00
Incidentals
Total Amount of Additive Alternate Bid Items 1 — 14
$ 201,890.00
Bid Schedule 1210-3
GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Figures):
$ 348, 306.25
GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Words):
Three Hundred Forty -Eight Thousand Three Hundred Six Dollars and Twenty Five Cents
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.
Jose Salinas
760-752-1743
L t , VAQ
J Name of
Signature of Bidder (Ink)
`A G
er (Printed or Typed)
Bidder Telephone Number
Marisa@Icpaving.com
Bidder Email Address
Bid Schedule 1210-4
SECTION 1220
BID GUARANTY BOND
PRINCIPAL, and Great Midwest 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. 2024-05 AND CDBG PROJECT NO.4.LQ.50-24
CITYWIDE MISCELLANEOUS ADA IMPROVEMENTS
NOW, THEREFORE, if the aforesaid Principal is awarded the contract and, within the
time and manner required under the specifications, after the prescribed forms are
presented to him/her for signature enters into a written contract in the prescribed form, in
accordance with the bid, and files two bonds with the City, one to guarantee faithful
performance, and the other to guarantee payment for labor and materials as required by
law, and provide certificate of insurance coverage required by the Contract Documents,
then this obligation shall be null and void; otherwise, it shall be and remain in full force
and virtue.
IN WITNESS WHEREOF, we have hereunto set our hands on this 24th day of March
, 2025.
LC Paving & Sealing, Inc.
Title of Sianatory
SigpAture of Principal
620 Alpine Way
_Escondido. CA 92029
Address
Great Midwest Insurance Company
Attorney -in -Fact
Title of Signatory
nature of Surety Lawrence F. McMahon, Attorney -in -Fact
800 Gessner Road, Suite 600
Houston, TX 77024
Address
Note: Signatures of those executing for the surety must be properly acknowledged.
Bid Guaranty Bond 1220-1
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 DIEGO
On 7i�, Z� before me, MARISA HAAS, NOTARY PUBLIC
(insert name and title of the officer)
personally appeared DOSE SALINAS
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal. MARISAANN HAAS
Notary Public • California
San Diego County
COmmissi0n N 2466839
Comm. Expires oct 17, 2027
Signature/II (Seal)
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 Diego
On March 24, 2025
before me,
personally appeared Lawrence F. McMahon
Minna Huovila, Notary Public
(insert name and title of the officer)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
r
Signature
MINNA HUOVILA
,' i�. COMM. #2473536 n
NNOTARY PUBLIC-CALIFORNIA n
U SAN DIEGO COUNTY
My Commission Expires
(Seal) 10
0 DECEMBER 6. 2027
POWER OF ATTORNEY
Great Midwest Insurance Company
KNOW ALL MEN BY THESE PRESENTS, that GREAT MIDWEST INSURANCE COMPANY, a Texas Corporation, with its principal office
in Houston, TX, does hereby constitute and appoint:
Sarah Myers, Janice Martin, Maria Guise, Ryan Warnock, Lawrence F. McMahon, Maria Hallmark
true and lawful Attorney(s)-In-Fact to make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or other
tings obligatory in nature of a bond.
This authority is made under and by the authority of a resolution which was passed by the Board of Directors of GREAT MIDWEST
INSURANCE COMPANY, on the 111 day of October, 2018 as follows:
Resolved, that the President, or any officer, be and hereby is, authorized to appoint and empower any representative of the Company or
er person or persons as Attorney -In -Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of indemnity or other
tings obligatory in nature of a bond not to exceed Ten Million dollars ($10,000,000.00), which the Company might execute through its duly elected
cers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney -In -Fact shall be as binding upon the
mpany as if they had been duly executed and acknowledged by the regularly elected officers of the Company. Any Attorney -In -Fact, so appointed,
y be removed in the Company's sole discretion and the authority so granted may be revoked as specified in the Power of Attorney.
Resolved, that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney granted,
nd the signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such
ower or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed
nd certificate so executed and sealed shall, with respect to any bond of undertaking to which it is attached, continue to be valid and binding on the
ompany.
IN WITNESS THEREOF, GREAT MIDWEST INSURANCE COMPANY, has caused this instrument to be signed by its President, and its
rporate Seal to be affixed this 11th day of February, 2021.
GREAT MIDWEST INSURANCE COMPANY
BY H*- V) Vats L -
Mark W. Haushill
President
ACKNOWLEDGEMENT
On this 11th day of February, 2021, before me, personally came Mark W. Haushill to me known, who being duly sworn, did depose and
that he is the President of GREAT MIDWEST INSURANCE COMPANY, the corporation described in and which executed the above instrument;
he executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation.
CHRIST— INA BISHOP
Notary Public, State
BY
of Texps
Comm. Expires 04-14-2025
11
Christina Bishop
Notary ID 131090488
Notary Public
CERTIFICATE
I, the undersigned, Secretary of GREAT MIDWEST INSURANCE COMPANY, A Texas Insurance Company, DO HEREBY CERTIFY that
the original Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions
as set forth are now in force.
Signed and Sealed at Houston, TX this 24th Day of March 2025
BY
Leslie K. Shaunty
Secretary
"WARNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance of claim
containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a
fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.
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.
Project Name:
Owner:
Construction Cost: $
Construction Time:
Owner's Representative:
Owner's Telephone No.:
Date of Substantial Completion:
2. Project Name:
Owner:
Construction Cost: $
Construction Time:
Owner's Representative:
Owner's Telephone No.:
Date of Substantial Completion:
Calendar Days
Calendar Days
Bidders Experience & Qualifications 1230-1
REFERENCES
CITY OF HEMET
445 E FLORIDA AVENUE
HEMET, CA 92543
*CDBG 2021/22 ACCESSIBLE SIDEWALK
$461,852.50 - APRIL 2023
CITY OF TEMECULA
41000 MAIN STREET
TEMECULA, CA 92590
*CITYWIDE CONCRETE REPAIRS
$272,369.97 - APRIL 2023
CITY OF SAN CLEMENTE
910 CALLE NEGOCIO, STE 100
SAN CLEMENTE, CA 92673
*CALLE DEL CERRO
$792,396.00 - OCTOBER 2023
CITY OF SANTEE
10601 MAGNOLIA AVENUE
SANTEE, CA 92071
*PROSPECT AVE & MESA RD INTERSECTION
*750,927.00 - FEB 2024
CITY OF RIVERSIDE
3900 MAIN STREET
RIVERSIDE, CA 92522
*2023/2024 CDBG STREET IMPROVEMENTS
*1,412,036.00 - JANUARY 2025
DARYL SCHOLES
DScholes@hemetca.gov
951.765.2361
RYAN CASTILLO
ryan.castillo@temeculaca.gov
951.693.3964
MASAKO HENNEQUIN
hennequinM@san-clemente.org
949.361.6133
TAYLOR CARRICO
Tcarrico@cityofsanteeca.gov
619-258-4100
DAVID HATCH
dhatch@riversideca.gov
951-826-5723
CITY OF BRAWLEY JUAN CABRERA
180 S WESTERN AVENUE JCabrera@brawley-ca.gov
BRAWLEY, CA 92227 760-344-5800
*STREET IMPROVEMENTS VARIOUS LOCATIONS
*1,177,956.00 - NOVEMBER 2024
CITY OF POWAY MIGUEL SOLANO
13325 CIVIC CENTER DRIVE msolano@Poway.org
POWAY, CA 92064 858-668-4653
*NEIGHBORHOOD SIDEWALK POWERS ROAD
*$204,898.75 - NOV 2025
3. Project Name:
Owner:
Construction Cost: $
Construction Time:
Owner's Representative:
Owner's Telephone No.:
Date of Substantial Completion:
4. Project Name:
Owner:
Construction Cost: $
Construction Time:
Owner's Representative:
Owner's Telephone No.:
Date of Substantial Completion:
Calendar Days
Calendar Days
Signed this day of I V m c `, V , 2025.
. (. �(A,\)
0G
Name of Bidder
Signa ure of Bidder
V A �
Printed Name of Bidder
UIU l( 0 10,0d69Q5Z I
Contractor's License No. DIR Reg No.
q I ZJ ZB 1-0
Expiration Date
T (,e�l di A
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.
(t787!`ta �tvC—S .�rZ-lov���3i�o��
zqz
Sign re of Bidder
LC Paving & Sealing, Inc.
Name of Bidder
Proposed Subcontractors 1240-1
SECTION 1250
NON -COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED
WITH BID
State of California )
) ss.
County of 5('D - KVy )
Jose Salinas being first duly sworn, deposes and say that he
or she is President of LC Paving & Sealing. Inc. the
party making the foregoing bid that the bid is not made in the interest of, or on behalf of,
any undisclosed person, partnership, company, association, organization, or corporation;
that the bid is genuine and not collusive or sham; that the bidder has not directly or
indirectly induced or solicited any other bidder to put in a false or sham bid, and has not
directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone
else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not
in any manner, directly or indirectly sought by contract, agreement, communication, or
conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any
overhead, profit, or cost element of the bid price, or of that of any other bidder, or to
secure any advantage against the public body awarding the contract of anyone interested
in the proposed contract; that all statements contained in the bid are true; and, further,
that the bidder has not, directly or indirectly, submitted his or her bid price or any
breakdown thereof, or the contents thereof, or divulged information or data relative
thereto, or paid, and will not pay, any fee to any corporation, partnership, company
association, organization, bid depository, or to any member or agent thereof to effectuate
a collusive or sham bid.
Signatvfe
LC Paving & Sealing, Inc.
Name of Bidder
President
Title
r
Date
Non -Collusion Affidavit 1250-1
SECTION 1260
DIR Proiect Vendor Information
Vendor Information:
Name: LC Paving & Sealing, Inc.
Address: 620 Alpine Way City: Escondido ST: CA
Zip: 92029
Project Manager: _� 1(x_ f-tL(� Email:
Phone. 760-752-1743
CSLB/Certification Number: 621610
Public Works Registration No.: 1000004325
Classification:
Asbestos Boilermaker Bricklayers Carpenter X Carpet/Linoleum
Cement Masons X Drywall Finisher Drywall/Lathers Electricians
Elevator Mechanic Glaziers Iron Workers Laborers X Millwrights
Operating Eng X Painters Pile Drivers
Roofer SheetMetal Sound/Com Surveyor
Prevailinq Wages and Payroll:
Pipe Trades Plasterers
Teamster X Tile Worker
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-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-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
Exhibit B-4
Required Bid Form
CERTIFICATION OF BIDDER
REGARDING NONSEGREGATED FACILITIES
Project Name:` 9v� ZDA- Z�
Name of Bidder. LC Paving & Sealing, Inc.
The above named Bidder hereby certifies that:
I do not maintain or provide for my employees any segregated facilities at
any of my establishments, and that I do not permit my employees to perform
their services at any location, under my control, where segregated facilities
are maintained. As used in this certification, the term "segregated facilities"
means any waiting rooms, work areas, rest rooms, wash rooms, restaurants
and other eating areas, time clocks, locker rooms or other dressing areas,
parking lots, drinking fountains, recreation or entertainment areas,
transportation, and housing facilities provided for employees which are
segregated by explicit directive or are in fact segregated on the basis of race,
color, religion, national origin, or because of habits, local customs, or
otherwise.
I further agree to obtain identical certifications from all proposed
subcontractors prior to the award of subcontracts exceeding $10,000.
Signature: a��
Name (Print): Jose Salinas
Title: President
Date:
CDBG Required Bid Form 1290-1
Exhibit B-7
Required Bid Form
BIDDER CERTIFICATION ON
FEDERAL CONTRACT REQUIREMENTS
Project Name:'_W V4 76Y' b� Bid/Solicitation #:
CERTIFICATION:
I hereby certify that I have reviewed and understand the diversified Federal
construction contract related requirements imposed on the Contractor(s) of HUD -
funded construction projects, including but not limited to the following-
1. The subject project is being financed with Community Development Block
Grant funds (24 CFR Part 570); and
2. This project and all related construction contracts are subject to the U.S.
Department of Housing and Urban Development's Federal Labor
Standards Provisions (HUD 4010 — revised 10/2023); and
3. This project is subject to all applicable laws and regulations as listed in the
General Summary of these Special Federal Provisions; and
4. If my bid is $200,000 or more, this project and all related contracts will be
subject to Section 3 requirements (12 U.S.C.1701 u); and
5. If the project is $250,000 or more, this project and all related contracts will
be subject to comply with the requirements of the Build America, Buy
America (BABA) Act (41 USC 8301).
CONTRACTOR'S NAME: LC Paving & Sealing, Inc.
CONTRACTOR'S LICENSE NO.: 621610
ADDRESS: 620 Alpine Way Escondido CA 92029
AUTHORIZED REP
I
7NTATIVE: Jose Salinas
// (Print Name)
SIGNATURE:
DATE:
CDBG Required Bid Form 1290-2
Exhibit B-8
Required Bid Form
QUESTIONNAIRE REGARDING BIDDERS
Bidder has been engaged in the contracting business under the present name of
LC Paving & Sealing, Inc. , since 06/1991 (Date).
Present business address is: 620 Alpine Way Escondido CA 92029
Federal Tax ID: 27-2327769 Amount of Bid $ 348,306.25
California Contractor's License No.: 621610
UEI Number:
Expiration Date: 08/31/2026
or CAGE Code: L1 I t 1 �
Because this project is Federally funded, it is necessary to obtain information
concerning minority and other group participation for statistical purposes. The U.S.
Department of Housing and Urban Development (HUD) uses this information to
determine the degree to which its programs are being utilized by minority business
enterprises and targeted group contractors.
A minority enterprise is defined by the Federal Government as a business that is fifty-
one percent (51 %) or more "minority -owned". Please check applicable box concerning
the ownership of your business:
❑ American Indian or Native Alaskan
❑ Asian or Pacific Islander/Native Hawaiian
❑ Black/African American
0 Hispanic
❑ White
❑ Hasidic Jews
❑ Other
A woman -owned enterprise is defined by the Federal Government as a business that is
fifty -percent (51 %) or more woman -owned. Please check applicable box concerning the
ownership of your business:
❑ Woman/Female owned ® Male owned
A Section 3 Contractor or Subcontractor is a business concern that is more than fifty-
one percent (51 %) owned by a low or very low-income person, or over 75 percent of the
labor hours performed for the business over the prior three-month period are performed
by Section 3 workers. Please check the applicable box concerning the ownership of
your business:
❑ Section 3 Business concern ER Non -Section 3 Business concern
The United States Department of Housing and Urban Development (HUD) is authorized to
solicit the information requested in this form by virtue of Title 12, United States Code,
Section 1701 et seq., and other regulations. It will not be disclosed or released outside of
HUD without your consent, except as required or permitted by law.
CDBG Required Bid Form 1290-3
Exhibit B-9
Required Bid Form
LIST OF SUBCONTRACTORS
SUBCONTRACTOR FED. I.D.# AMOUNT ADDRESS/PHONE NO.
�J-..> s �.1� S�� � , .�.. �3� - 3 2/ � � 3 � _ 7u�� %`-" 4 i8 � r a � �u- •�1v�
SUPPLIERS
NAME OF SUPPLIER ADDRESS/PHONE NO. CONTRACT AMOUNT
Superior Ready Mix 1564 W Mission Rd Escondido CA 92029
Granite Construction Company 35100 Dillon Rd Indio CA 92201
Martin Marrieta 88200 Fargo Canyon Rd Coachella CA 92236
This form is to be completed and submitted with the bid package.
CDBG Required Bid Form 1290-4
SECTION 1270
COMPLIANCE WITH IRAN CONTRACTING ACT OF 2010
Pursuant to the Iran Contracting Act of 2010 (Pub. Contract Code, § 2200 et seq.),
(a) Contractor shall be ineligible to bid on or submit a proposal for any contract for
One Million Dollars ($1,000,000) or more if Contractor engages in investment
activities in Iran as defined in Public Contract Code Section 2202.5, and/or
if Contractor is identified on the list of persons engaging in investment
activities in Iran prepared by the State of California pursuant to Public
Contract Code Section 2203 subdivision (b).
(b) For bids of One Million Dollars ($1,000,000) or more, Contractor must certify
that it is not on the list of ineligible vendors prohibited from doing business with
the State of California and shall complete the Iran Contracting Act Certification
and submit with their proposal at the time of bid. Contractor shall obtain the
Iran Contracting Act Certification in the form approved by the State of California,
or upon written request to the City Clerk's Office, a copy of the form will be
provided to Contractor. Failure by Contractor to provide the certification
required by this Section may deem Contractor's bid non -responsive.
(c) Nothing in this Section is intended to prevent the City from exercising its rights
pursuant to Public Contract Code section 2203, subdivision (c) or (d), or both,
on a case -by -case basis.
Iran Contracting Act Certification 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)
LC Paving & Sealing, Inc.
By (Authoni nature)
Printed Na a and Title of Person Signing
Jose alinas; President
Federal ID Number (or n/a)
27-2327769
DateEx Wed
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)
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.
Russian Aggression Against Ukraine Sanctions Certification 1280-1