CT&T Concrete Paving Inc.SECTION 1200
BID
DATE. 3/25/25
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 # Date Received Initials
3/18/25
Bid 1200-1
Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY
CT&T Concrete Paving Inc.
Name of Bidder
61• . • :111
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.
CT&T Concrete Paving Inc.
Name of Bidder
324 S. Diamond Bar Blvd, PMB 275,
Diamond Bar, CA 91765
Bidder's Address
875627
Contractor's License No.
Bidder's Telephone Number
jose.cttinc@gmail.com
Bidder's Email Address
04/30/2026
Contractor's Expiration Date
California
State of In ration
ignature of Bidder Witness
Jose Carvajal
Printed Name of Signatory
President
Title of Signatory
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
$ ,��3
$ ia, Sao
2
Traffic Control
1
LS
$ 3, a S
$
3
Dust Control
1
LS
$ ti, oS L
$ ti, o S z
4
Earthwork
1
EA
$ 51 3
$ S, - -1 3
5
Sawcut, Remove, and Dispose of
20
LF
$
$
ExistingCurb
Z `� "
6
Sawcut, Remove, and Dispose of
855
SF
$ "1
$ S, Sti L 9S
Existing Sidewalk and Ramp
7
Construct Sidewalk per City of La
845
SF
$ 3.
$ 3, 131. 11
Quinta Std. No. 240 Mod.
Construct Concrete Curb Ramp per
8
City of La Quinta Std. No. 250 Mod.
1
EA
$ �� } (�
$ }�
per Plan, Case B (Including Curb
t
along Ram
Full Depth Grind Asphalt Concrete
9
Pavement (3" ), Compact Existing
35
SF
$
$
Base, and Variable Overlay (Y —
4"
Grade Parkway, Remove, Modify,
10
and Replace Landscape,
1
LS
$ 2 130
$ 2- 3 o g
Hardscape, and Irrigation in Kind to
Furthest Extent Possible
11
Signing and Striping, Including All
1
LS
$ -� �v7
$ =�,
Incidentals
Total Amount of Bid Items 1 —11
$ 5'/7/o'-70
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
$ )2- / LUka
$ I L1 ?�
2
Traffic Control
1
LS
$ �j� �5--�
$ `7 / S S`
3
Dust Control
1
LS
$
$ Z/, !i" a 6
4
Sawcut, Remove, and Dispose of
90
LF
$ . g
$ 21 3 a a.
Existing Curb; and/or Curb & Gutter
5
Sawcut, Remove, and Dispose of
785
SF
$ f)-9(
$ 9 179 3S
Existing Ramp and Pavers
1
6
Construct Sidewalk per City of La
450
SF
$ 1 1 ��,
$ �,3
Quinta Std. No. 240 Mod.
Remove and Dispose of Existing
7
Roadway Section to Depth
750
SF
$ `� • ��
$ 32S
Required
8
Construct 5.5" Asphalt Concrete
460
SF
$ Z 2 • ii b
$ ! b,
over 6.5" Aggregate Base
Construct Two (2) Concrete Speed
9
Tables (Including All Concrete
1
LS
$
$
Work, Aggregate Base, Grading,
Rebar, and Conduit
Furnish and Install Truncated Dome
10
Concrete Tile per City of La Quinta
75
SF
$
$ 215-q
Std. 250 Mod.
Remove, Regrade, and Reset
11
Sidewalk Pavers Per City of La
275
SF
$ q�
$ 2/c.{S-� S`
Quinta Std. 206
Salvage to City Existing Pull Box
12
and Furnish and Install New No. 6
1
EA
$ 3(7 , C)0
$ s� i
Pull Box per Caltrans Std. Plan ES-
8A
Grade Parkway, Remove, Modify,
13
and Replace Landscape,
1
LS
$ 1-1135"0
$ q, 3 Sv
Hardscape, and Irrigation in Kind to
Furthest Extent Possible
14
Signing and Striping, Including All
1
LS
1"+cj
$ �'''`
Incidentals
Total Amount of Additive Alternate Bid Items 1 -14
,;t92- 8�
Bid Schedule 1210-3
GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Figures):
GRAND TOTAL BASE BID PLUS ALL ADDITIVE ALTERNATES (Words):
Ayy-,%a►'LPL wA jl't4k do I lc4 fS li 5 P vc+q y t..e h 117S
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 pe75AXII
d��t to such adjustments and alterations as elsewhere
provided herein.
Signature of Bidder (Ink)
Name of Bidder (Printed or Typed)
qC)<J) c�-2C1— ?->0v ex}_ 10'Z
Bidder Telephone Number
Bidder Email Address
Bid Schedule 1210-4
SECTION 1220
BID GUARANTY BOND
PRINCIPAL, and Contractors Bonding and 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.
CT&T Concrete Paving, Inc. Contractors Bonding and Insurance Company
Jose Carvajal - President / Secreta
Title of Signatory
SignatiAll Principal
324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, CA 91765
Address
Emilie Young, Attorney -in -Fact
Title of Signatory
pn� h
Signature of S r ty
9025 N. Lindbergh Drive, Peoria, IL 61615
Address
Note: Signatures of those executing for the surety must be properly acknowledged.
Bid Guaranty Bond 1220-1
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On, i4a4 Z-I.1,n -z S before me, Daniel A. Butler, A Notary Public
ere !risen name ancl title ot t e o icer
personally appeared -105,c et 1 -
who proved to me on the basis of satisfactory evidence to be the person(s) whose
name(&) is re subscribed to the within instrument and acknowledged to me that
K i he/they executed the same in Is er/their authorized capacity(ies), and that by
Is er/their signature(s) on the instrument the person(s), or the entity upon behalf of
which the person(* 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.
DANIEL A. BUTLER
WITNESS my hand and official seal. ,- r, Commissionit2402807
Notary Public - California
~ Los Angeles County
My Comm. Expires May 2, 2026
Notary Public Signature (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
(Title or description of attached document)
(Title or description of attached document continued)
Number of Pages Document Date
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
❑ Corporate Officer
(Title)
❑ Partner(s)
❑ Attorney -in -Fact
❑ Trustee(s)
❑ Other
www.NotaryClasses.com 800-873-986.5
INSTRUCTIONS FOR COMPLETING THiS FORM
This form complies with current California statutes regarding notary wording and.
rf needed, should be completed and attached to the document. Acknowledgments
from other states mad• be completed for documents being sent to that state so long
as the ivording does not require the California notary to violate California notary
Tmv.
• State and County infonnation must be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title (notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forts (i.e.
fie/she/they- is lave ) or circling the correct forts. Failure to correctly indicate this
information may lead to rejection of document recording.
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bnpression must not cover text or lines. If seal impression smudges, re -scat if a
sufficient area permits, otherwise complete a different acknowledgment farm.
• Signature of the notary_ public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer, if the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary).
• Securely attach this document to the signed document with a staple.
ARIZONA NOTARY ACKNOWLEDGMENT
State of Arizona
County of Maricopa
On this MAR 2 4 2025 before me Danielle Hanson
personally appeared
Emilie Young
[Name of Signer]
[Name of Notary Public]
whose identity was proven
to me on the basis of satisfactory evidence to be the person who he or she claims to be, and
acknowledged that he or she signed the above/attached document.
DANIELLE IRIS HANSON
a e ° Notary Public - Arizona
° Maricopa County
w Commission # 653538
d8 ?o
My Commission Expires
August 11, 2027
(Seal)
[Affix Seal Here]
Witness my hand and official seal.
)"' -e---
Signature of Notary Public
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:
Yung T. Mullick, P. Austin Neff, Irene Luone Emilie Young Danielle Hanson Christine Woolford Alexander R. Holsheimer, Thao
Luu, Joseph P. McGradv, joints or severely
in the City of Mission Viejo , 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 an&or Contractors Bonding and Insurance Company, as applicable, have
caused these presents to be executed by its respective Sr. Vice President with its corporate seal affixed this 27th day of
September , 2024 .
AN D,ysGCC..
•:9{t
4��, m
�Q OORPOAgrF
-`0¢:•"o
y' SEAL
= SEAL
,_
OJ 'r2
State of Illinois "11NO'S
�� L 1 N O�`'.`
SS
County of Peoria
On this 27th day of September 2024 , before me, a Notary
Public, personally appeared Eric Raudins , 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.
/1
By: ( .
`�.
Jill A. Scott Notary Public
1
JILL A SCOrT
Notary Pubic
�- State of Ohio
o My Comm. Expires
y - •sj-»- o Seote^tber 12. 2025
RLI Insurance Company
Contractors ng and ln�nce Company
By: G
Eric Raudins Sr. 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, 1 have hereunto set my hand and the seal of the RLI
Insurance Company and/or Contractors Bonding and Insurance
Company this 24th day of March , 2025 .
RLI Insurance Company
Contractors Bonding and Insurance Company
By: 944nL-A a -�C*-
Jeffrey DUADCorporate Secretary
0456659020212
A0058D19
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:
CDBG ADA Curb Ramps FY24-25
Owner: City of Ontario
Construction Cost: $ 175,000.00
Construction Time: 12/14/24 - 1 /10/25
Owner's Representative:
Owner's Telephone No.:
Daniel Leon
909-395-2632
Date of Substantial Completion: 01 /10/25
Calendar Days
2. Project Name: Citywide Sidewalk Improvements, CIP R-24
Owner: City of Beaumont
Construction Cost: $ 428,355.00
Construction Time: 06/24/24 - 08/16/24 Calendar Days
Owner's Representative: Dustin Christensen
Owner's Telephone No.: 951-572-3192
Date of Substantial Completion: 08/16/24
Bidders Experience & Qualifications 1230-1
3. Project Name: FY 23-24 ADA Curb Ramp Installation - CDBG
Owner: City of Rancho Santa Margarita
Construction Cost: $ 128,199.75
Construction Time: 01 /15/24 - 01 /19/24 Calendar Days
Owner's Representative: Wilson Leung
Owner's Telephone No.: 949-635-1800, ext. 6506
Date of Substantial Completion: 01/19/2024
4. Project Name: FY 22-23 Concrete Improvements Project
Owner: City of Monterey Park
Construction Cost: $ 1,571,233.00
Construction Time: 08/14/23 - 12/1/23 Calendar Days
Owner's Representative: Peter Shiau
Owner's Telephone No.: 626-877-1928
Date of Substantial Completion: 12/1/23
Signed this 24th day of March
CT&T Concrete Paving Inc.
Name of Bidder
re of Bidder
Jose Carvajal
Printed Name of Bidder
, 2025.
875627
1000025154
Contractor's License No. DIR Reg No.
04/30/2026
Expiration Date
President
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.
gnature of Bidder
Jose Carvajal
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 Los Angeles )
Jose Carvajal being first duly sworn, deposes and say that he
or she is President of CT&T Concrete Paving Inc. I the
party making the foregoing bid that the bid is not made in the interest of, or on behalf of,
any undisclosed person, partnership, company, association, organization, or corporation;
that the bid is genuine and not collusive or sham; that the bidder has not directly or
indirectly induced or solicited any other bidder to put in a false or sham bid, and has not
directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone
else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not
in any manner, directly or indirectly sought by contract, agreement, communication, or
conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any
overhead, profit, or cost element of the bid price, or of that of any other bidder, or to
secure any advantage against the public body awarding the contract of anyone interested
in the proposed contract; that all statements contained in the bid are true; and, further,
that the bidder has not, directly or indirectly, submitted his or her bid price or any
breakdown thereof, or the contents thereof, or divulged information or data relative
thereto, or paid, and will not pay, any fee to any corporation, partnership, company
association, organizaaion, bid depository, or to any member or agent thereof to effectuate
a collusive or sharWid.
re
CT&T Concrete Paving Inc.
Name of Bidder
President
Title
03/24/2025
Date
Non -Collusion Affidavit
WKINi
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of _Los Angeles
On,t'.(r Z`d `&1—S before me, Daniel A. Butler, A Notary Public ,
ere insert name an tille ol t e o icer
personally appeared TS e- ef (
who proved to me on the basis of satisfact ry evidence to be the person(-&) whose
name(s-) is re subscribed to the within instrument and acknowledged to me that
iEe she/they executed the same in is er/their authorized capacity(ies), and that by
is er/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. DANIEL A. BUTLER
Commission # 2402807
V Notary Public - California
Los Angeles County
My Comm. Expires May 2, 2026
Nofary Public Signature (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
(Title or description of attached document)
(Title or description of attached document continued)
Number of Pages Document Date
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
❑ Corporate Officer
(Title)
❑ Partner(s)
❑ Attorney -in -Fact
❑ Trustee(s)
❑ Other
www.NotaryClasses.com 800-873-9865
INSTRUCTIONS FOR COMPLETING THIS FORM
This form complies with current California statutes regarding notary wording and,
if needed, should be completed and attached to the document. Aclmowledgments
from other states may be completed for documents being sent to that state so long
as the wording does not require the California notary to violate California notary
lair.
• State and County information must be the State and County where the document
si-ner(s) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title (notary public).
• print the name(s) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
he/she/t13ey- is /are ) or circling the correct forts. Failure to correctly indicate this
information may lead to rejection of document recording.
• "The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re -seal if a
sufficient area permits, otherwise complete a different acknowledgment form.
• Signature of the notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. if the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary).
• Securely attach this document to the signed document with a staple.
SECTION 1260
DIR Project Vendor Information
Vendor Information:
Name: CT&T Concrete Paving Inc.
Address. 324 S. Diamond Bar Blvd, PMB 275
Zip: 91765
Project Manager: Jose Carvajal
City: Diamond Bar ST: CA
Email: jose.cttinc@gmail.com
Phone: 909-629-8000 CSLB/Certification Number. 875627
Public Works Registration No.: 1000025154
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 X 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/Prevailing-Wage.html.
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.htm1.
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: Citywide Miscellaneous ADA Improvements
Name of Bidder: CT&T Concrete Paving 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 1 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 id tigot certifications from all proposed
subcontractors prior to t ubcontracts exceeding $10,000.
Signatur
Name (Print):
Jose Carvajal
Title: President
Date: 03/25/2025
CDBG Required Bid Form 1290-1
BIDDER CERTIFICATION ON
FEDERAL CONTRACT REQUIREMENTS
Citywide Miscellaneous
Project Name: ADA Improvements Bid/Solicitation #:
CERTIFICATION:
2024-05
Exhibit B-7
Required Bid Form
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: CT&T Concrete Paving Inc.
CONTRACTOR'S LICENSE NO.: 875627
ADDRESS. 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, CA 91765
AUTHORIZED REPR /Jose Carvajal
(Print Name)
SIGNATURE:
DATE: 03/25/25
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
CT&T Concrete Paving Inc., since (Date).
Present business address is: 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, CA 91765
Federal Tax ID: 202642225
California Contractor's License No.:
Amount of Bid $
875627
Expiration Date: 04/30/2026
UEI Number: NCEUYHRA56G9 or CAGE Code: 8AG90
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
® 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 IX 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.
� S�" � le I00-cO 013S3 0 %: 1,C0 1�5 w IS- St At--'sh Ci4,-'i'4F-o--t,
NAME OF SUPPLIER ADDRESS/PHONE NO. CONTRACT AMOUNT
This form is to be completed and submitted with the bid package.
CDBG Required Bid Form 1 29d_q
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 No i ti (Printed) I Federal ID Number (or n/a)
CT&T nc. 1202642225
By (A � � a
Anted Name d Title of Person Signing Date Executed
Jose Carvajal, President 03/24/2025
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)
I
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
EXHIBIT B-4
Required Bid Form
CERTIFICATION OF BIDDER
REGARDING NONSEGREGATED FACILITIES
Project Name: Citywide Miscellaneous ADA Improvements
Name of Bidder: City of La Quinta
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 certi 'cations from all proposed subcontractors prior to the
award of subcontracts exceed�,�
Signature-,/oe
Name (Print): Jose Carvajal
Title: President
Date:
03/24/2025
Special Federal Provisions 1550-56
EXHIBIT B-7
Required Bid Form
BIDDER CERTIFICATION ON
FEDERAL CONTRACT REQUIREMENTS
Project Name: Citywide Miscellaneous ADA Improvements Bid/Solicitation #: 2024-05
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); a n d
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.1701u); 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: CT&T Concrete Paving Inc.
CONTRACTOR'S LICENSE NO.:
875627
ADDRESS: 324 S. Diamond Bar Blvd, PM 5, Diamond Bar, CA 91765
4
AUTHORIZED REPRES E/2
Jose Carvajal tint Name)
SIGNATURE:
DATE: 03/24/2025
Special Federal Provisions 1550-57
01
1 4vCsiatra{L
' Y�t� �' bOtWflCf'gb
EXHIBIT B-8
Required Bid Form
QUESTIONNAIRE REGARDING BIDDERS
Bidder has been engaged in the contracting business under the present name of
CT&T Concrete Paving Inc.
since 03/24/25 (Date).
Present business address is: 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, CA 91765
Federal Tax ID: 202642225
California Contractor's License No.: 875627
UEI Number: NCEUYHRA56G9
Amount of Bid $
Expiration Date: 04/30/2026
or CAGE Code: 8AG90
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 the applicable box concerning the
ownership of your business:
❑ American Indian or Native Alaskan
❑ Asian or Pacific Islander/Native Hawaiian
❑ Black/African American
® Hispanic
❑ White
❑ Hasidic Jews
❑ Other
A woman -owned enterprise is defined by the Federal Government as a business that is fifty-one
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 IN 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.
Special Federal Provisions 1550-58
E\HIBI'I' B-9
Required laid Forin
LIST OF SUBCONTRACTORS
SUBCONTRACTOR FED. I.D.# AMOUNT ADDRESS/PHONE NO.
V Cl 2,k"T�3 s� i�, <I -1,9- W ►sr
NAME OF SUPPLIER ADDRESS/PHONE NO. CONTRACT AMOUNT
This form is to be completed and submitted with the bid package.
Special Federal Provisions 1550-59