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Bid - Union Pavement Services, Inc.June 4, 2025 Union Pavement Services, Inc. 2904 Rubidoux Blvd., Ste. A Jurupa Valley, CA 92509 SUBJECT: BID BOND RELEASE – PROJECT NO. 2024-03 FY 24/25 PMP SLURRY SEAL 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 June 3, 2025, awarded the contract to the lowest responsive bidder, Roy Allan Slurry Seal, 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: Western Surety Company File SECTION 1200 BID DATE: 05/22/2025 The undersigned, as bidder, declares it has received and examined the Contract Document entitled Project No. 2024-03, FY24/25 PMP Slurry Seal 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 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. Union Pavement Services, Inc. Name of Bidder (951) 410-4858 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. Union Pavement Services, Inc. Name of Bidder 2904 Rubidoux Blvd., Suite A Jurupa Valley, CA 92509 Bidder's Address 1131864 Contractor's License No. California (951) 410-4858 Bidder's Telephone Number Estimating (a-)_union pavement. com Bidder's Email Address 01 /31 /2027 Contractor's Expiration Date State of Incorporation i Signature of Bidder Witness Doug Ford Melissa Ailshie, Secreta Printed Name of Signatory Title of Witness Vice President Title of Signatory Bid 1200-2 SECTION 1210 BID SCHEDULE PROJECT NO. 2024-03 FY24/25 PMP SLURRY SEAL 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. 2024-03, FY24/25 PMP Slurry Seal 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. 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 - FY24/25 PMP SLURRY SEAL IMPROVEMENTS Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Mobilization 1 LS $21, -50 vo $ 27, 7So- oo 2 Traffic Control 1 LS $ _�;oo.00 $3Ff,sao-�o 3 Crack Seal and Type II, Latex 2,080,510 SF $ o.2-q $YK 322 Emulsion Aggregate Slur Full Depth Grind AC (3 1/2"), 4 Compact Existing Base, and 140 SF $ $ 1, o2s 00 Variable Overlay 3 1 /2"-4 1 /2" 5 Signing and Striping, Including 1 LS s o37,o0 $- $ �� 037, o 0 All Incidentals Total Amount of Bid Items 1 - 5 $1o3 ' (03y. GRAND TOTAL BASE BID PLUS (Figures): $ (0sq, (03y yb GRAND TOTAL BASE BID (Words): S,X IuUr Qj 1 hira-v 7Noyse,id. S; x A od-r,,�-%61r�� 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 upon actual work performed, subject to such adjust d alterations provided herein. will be based as elsewhere Signature of Bidder (Ink) Union Pavement Services, Inc. Name of Bidder (Printed or Typed) (951) 410-4858 Bidder Telephone Number Estimating@unionpavement.com Bidder Email Address Bid Schedule 1210-2 SECTION 1220 BID GUARANTY BOND PRINCIPAL, and Western Surety 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. 2024-03 FY24/25 PMP SLURRY SEAL 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 13th day of May 2025. Union Pavement Services, Inc. QyuS J�OrC4, Viw Title Signatory Signature of Principal Western Surety Company Attorney -in -Fact Title of Signatory Sign tune o , urety Lucy M. Dunham, Attorney -in -Fact 2904 Rubidoux Blvd., Ste. A, Jurupa Valley, CA 92509 910 Pleasant Grove Blvd., Ste. 120-347, Roseville, CA 95678 Address Address Note: Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 :r.�„cr„cc�rcr•.s:e�c.�r.�„�rcr„�c,�c,�e„s.rec�r cx.�e�r�,zr.�,cctic.�rxr,�rcrcc>.�cser„�r-. - _ _ . -. - - - - ,� 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 _.Contra Costa - �/ vim On before me, Date personally appeared Lucy M. Dunham-------- YvonneRoncagliolo, Notary Public ----------------------------------- Here Insert Name and Title of the Officer Name(s) of Signer(s) 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. YVONNE RONCAGLIOLO Notary Public - California San Francisco County r Signature Commission aY 2455415 M Signature of Notary Public y Comm. Expires Aug 24, 2027 Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: __ Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Lucy M Dunham er's Name: ❑ Corporate Officer — Title(s): _ LJ Corp Officer — Title(s): ❑ Partner — ; Limited L_ i General ❑ Partner — ited ❑ Ge ❑ Individual Izl Attorney in Fact L Individual -� in Fact ElTrustee ❑ Guardian or Conservator ❑ Trustee uardian onservator ❑ Other: _ 1-I Other: Signer Is Representing: Signer epresenting: ©2014 National Notary Association • www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907 Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Charles R Shoemaker, Kathleen Earle, Kelly Holtemann, Mark M Munekawa, Nerissa S Bartolome, Yvonne Roncagliolo, Patrick R Diebel, Karen Rhodes, Valerie Takeuchi, Erica Li, Christina Parsons, Zachary V Overbay, Andrew S Holloway, Rossio Polio, Lucy M Dunham, Christopher M Howell, Nathalia P Sholl, Individually of San Francisco, CA, its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalfbonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the Authorizing By -Laws and Resolutions printed at the bottom of this page, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 30th day of December, 2024. rz,oSIET? O' WESTERN SURETY COMPANY OR, .So= ?W: dZiF �f Ate:;•,? Larry Kasten, Vice President State of South Dakota 1 ss County of Minnehaha I On this 30th day of December, 2024, before me personally came Lang Kasten, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. }44444444444444bb44444444} My commission expires i M. BENT `r r �R NOTARY PUBLIC $ i March 2, 2026 ISOUTH DAKOTA�f }44444444444444444444444 } M. Bent, Notary Public CERTIFICATE I, Paula Kolsrud, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Laws and Resolutions of the corporation printed below this certificate are still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this 13th day of May, 2025. ��, Ste" Ty"•a WESTERN SURETY COMPANY `.40lijyt pp�l0 Paula Kolsrud, Assistant Secretary Authorizing By -Laws and Resolutions ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders of the Company. Section 7. 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, and 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. This Power of Attorney is signed by Larry Kasten, Vice President, who has been authorized pursuant to the above Bylaw to execute power of attorneys on behalf of Western Surety Company. This Power of Attorney may be signed by digital signature and sealed by a digital or otherwise electronic -formatted corporate seal under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 27"' day of April, 2022: "RESOLVED: That it is in the best interest of the Company to periodically ratify and confirm any corporate documents signed by digital signatures and to ratify and confirm the use of a digital or otherwise electronic -formatted corporate seal, each to be considered the act and deed of the Company." Go to )4wH.cnasuretv.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity. Forth F4280-6-2023 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Riverside On May 22nd, 2025 before me, Melissa Ailshie, Notary Public Date Here Insert Name and Title of the Officer personally appeared Doug Ford Name($) of Signer() who proved to me on the basis of satisfactory evidence to be the person(t) whose name(t) is/dre subscribed to the within instrument and acknowledged to me that he/she/th(ey executed the same in his/Mr/thleir authorized capacity(i6s), and that by his/h,br/thbir signature(g) on the instrument the person(i), or the entity upon behalf of which the person(8) acted, executed the instrument. MELISSA AILSHIE Notary Public • California Riverside county Commission ax 2400931 ~ �•i .o� '' My Comm. Expires Apr 14. 2026 Place Notary Seal Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature _ Signature of No ry Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Bid Guaranty Bond Document Date: Number of Pages: 1 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ID Corporate Officer — Title(s): L Partner — O Limited i General 7 Individual --I Attorney in Fact ❑ Trustee I , Guardian or Conservator ❑ Other: Signer Is Representing: /13/2025 Signer's Name: -) Corporate Officer — Title(s): U Partner — Limited General I Individual _i Attorney in Fact !Trustee = Guardian or Conservator Other: Signer Is Representing: ©2014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907 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: ***Please see attached Resume, References, Statement of Qualification 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 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 22nd day of May , 2025. Union Pavement Services, Inc. 1131864 2000008321 Name of Bidder Contractor's License No. DIR Reg No. Signature of Bidder Dou!c Ford Printed Name of Bidder CSLB Exp. 01/31/2027 / DIR Exp. 06/30/2025 Expiration Date Vice 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. MD Rubberized Crackfill, LLC - 32 Rancho Circle, Lake Forest, CA 92630 - 20.27% - CSLB 986686 - DIR 1000006438 Onyx Paving Company, Inc. - 2890 E. La Cresta Ave., Anaheim, CA 92806 - 4.41 % - CSLB 630360 - 1000004798 Cat Tracking, Inc. - 17 Commercial Ave., Riverside, CA 92507 - 8.81% CSLB 991122 - DIR 1000011750 Signature of Bidder Union Pavement Services, 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 Riverisde ) Doug Ford being first duly sworn, deposes and say that he or she is Vice President of Union Pavement Services. 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, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Signature Union Pavement Services, Inc. Name of Bidder Doug Ford, Vice President Title 05/22/2025 Date Non -Collusion Affidavit 1250-1 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 _) See Attached Document (Notary to cross out lines 1-6 below) See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Riverside Subscribed and sworn to (or affirmed) before me on this 22nd day of May 2025 by Date Month Year (1) Doug Ford o MELISSAAILSHIE (and (2) ), Notary Public -California � Name(4 of Signer() S Riverside County _ Commission ; 2400831 �• oar'' My Comm. Expires Apr 14, 20 1 proved to me on the basis of satisfactory evidence to be the person($) who appeared before me. Signature Signature of Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Non -Collusion Affidavit Document Date: 05/22/2025 Number of Pages: 1 Signer(s) Other Than Named Above: 02014 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5910 SECTION 1260 DIR Project Vendor Information Vendor Information: Name: Union Pavement Services, Inc. Address:2904 Rubidoux Blvd., Suite A City:Jurupa Valley ST: CA Zip: 92509 Project Manager: Doug Ford Email: Doug.Ford@unionpavement.com Phone: (951) 410-4858 CSLB/Certification Number: 1131864 Public Works Registration No.: 2000008321 Classification: Asbestos Boilermaker Bricklayers Carpenter Carpet/Linoleum Cement Masons Drywall Finisher Drywall/Lathers Electricians Elevator Mechanic Glaziers Iron Workers Laborers X Millwrights_ Operating Eng Painters Pile Drivers Pipe Trades Plasterers Roofer SheetMetal Sound/Com Surveyor Teamster Tile Worker Prevailing Wages and Payroll: The project is subject to prevailing wage rates and enforcement by the Department of Industrial Relations (DIR). Prevailing wage rates can be obtained at: http://www.dir.ca.gov/Public-Works/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 SECTION COMPLIANCE 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 Instituiion. (Printed) Union Pav ervic_ es, Inc. _ By (Au th zed Signlure) y -y Printed Name and Title of Person Signing Doua Ford. Vice President Federal ID Number (or n/a) 88-4223744 Date Executed 05/22/2025 Iran Contracting Act Certification 1270-2 N #2 — EXEMPT Pursuan Public Contract Code sections 2203(c) and (d), a public entity may permit a vendo Apancial institution engaged in investment activities in Iran, on a case - by -case basis, to be Ible for, or to bid on, submit a proposal for, or enters into or renews, a contract for go oftand services. If you have obtained an exemMiw from the certification requirement under the Iran Contracting Act, please fill out the ormation below, and attach documentation demonstrating the exemption approval. Vendor Name/Financial Institution (Printed) \ I Federal ID Number (or n/a) By (Authorized Signature) Printed Name and Title of Person Signing I 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 DOUGLAS M. FORD 2328 Three Bar Ln. Norco, CA 92860 SUMMARY: An experienced professional with 42 years' in the construction industry. EXPERIENCE: July, 2007- September 2023 PAVEMENT COATINGS CO. Jurupa Valley, CA President * Responsible for the management of all supervisors, estimators and divisional financial results within the four company locations. * Manage expansion of growth through the greenfield process into Northern California, then through multiple acquisitions within the state. * Active with industry trade associations. 2012 President, International Slurry Surfacing Association, ISSA. BOD member from 2005 to 2013. California Chip Seal Association, Maintenance Superintendents Association. * Responsible for managing new product development *Reclaimed Asphalt Pavement (RAP); slurry seal, micro surfacing, chip seal, scrub seal and cape seals *Rubberized and fiberized slurry seals *Cool Pavements surfacing May, 1994 — July, 2007 Vice -President *Hands on supervision of crews in the field and mechanics at the shop *Recommend and negotiate all equipment purchases and supervise equipment maintenance *In the absence of the President, signs contract and checks *Interacts with owners of property where jobs are performed, including public and private agencies *Conduct health and safety training for all employees, including Drug Free Program *Maintain CHP records and keep track of BIT program per State of California May, 1991-May, 1994 Crew Foreman *Locate and set up onsite yard for public works and private slurry seal projects. *Oversee crew, materials and equipment on site for 8 man crew. *Track billing quantities and manage onsite budget. *Work on crew as mixer operator, line driver, squeegee and traffic control. July 1990-May 1991 MAYA CONSTRUCTION COMPANY, Irvine, CA. Project Engineer *Scheduled all in house employees and all subcontractors on major road and bridge work *Processed all subcontract and vendor payment for $5,000,000 jobs *Experienced at pricing change orders as Project Engineer for road and bridge construction. *Responsible for daily work reports and quantity updates as Project Engineer for road and bridge construction. August 1986-July 1990 BORDERLAND CONSTRUCTION CO., Tucson, AZ Estimator Assistant 2 Yrs *Quantity Estimating for construction involving Operator/Grade Checker 2 Yrs earthwork, concrete structures, underground utilities and paving. *Assistant Estimator for contract of up to $3,500,000 *Background with AGTEC Earth Analysis and Lotus 123 programs. *Set line and grade for layout of house pads and street designs for private and government work *Operated heavy equipment for large excavations and for preparation and placement of asphaltic cement. May 1983 — August 1986 Labor and Superintendent SUNCOUNTY DEVELOPMENT CO., Tucson AZ. *Scheduling and management skills as site Superintendent for Home Development Company. EDUCATION: August 1983 — May 1986 University of Arizona Civil Engineering Tucson, AZ. 85721 Pima Community College Downtown Campus Estimation with Lotus 123 H www.UnionPavement.com Statement of Qualification Union Pavement Services, Inc. (UPSI) is a new pavement preservation company backed and run by extremely experienced corporations and employees. The Reed Family Companies, formally known as Basic Resources, which is the parent company to UPSI is located in Modesto, California and has been contracting in the state of California for over 80 years. The Reed Family Companies is a part of several successful entities including a paving general contractor and a preservation general contractor, which have been in business for over 50 years. The UPSI field crew is equipped with state-of-the-art equipment. The latest model Macropaver 12-EX are eco-friendly while being the most productive machine on the market. They feature fixed gate design to ensure precise material control and consistent quality application. UPSI comes with reliability. The management of UPSI and its operations are being overseen by Doug Ford, Vice President. Doug has an extensive background in the Southern California pavement preservation market beginning in 1991. He worked in the field on both slurry seal and micro surfacing crews in various capacities including foreman, mixer operator, line driver, squeegee man and traffic control with Pavement Coatings Co. (PCC). In 1994, he became Vice President of PCC where he took on the responsibility of all equipment maintenance, purchasing, project bids, and operations management and continued to work in the field during the busy summer months. In 2007 PCC was acquired by a contractor to expand into the pavement preservation market. In 2007 Doug became President of PCC and continued to hold this position until he retired from the company in 2023 after serving 32 years. During this time, PCC expanded their workforce from 2 slurry seal crews operating in Southern California, into 8 crews and two oil spreading divisions operating throughout California. After 32 years in the pavement preservation market, Doug has developed an extensive knowledge of field application, material knowledge, equipment knowledge and quality control. With 16 years of growing PCC, Doug has developed an extensive knowledge of crew base building, skilled and technical labor training, product development and material management. Doug has also been active in several industry trade associations. He served on the International Slurry Surfacing Association (ISSA) Board of Directors from 2005 through 2015, serving as President of ISSA in 2012. His involvement in the development and application of 100% Recycling Aggregate Products (RAP) slurry seal has made him an industry leader for assistance throughout the United States where he has served as an advisor to several agencies in the implementation of RAP products in their pavement preservation projects. UNION PAVEMENT SERVICES 2904 Rubidoux Blvd, Suite A, Jurupa Valley, CA 92509 P.O. Box 292 Modesto, Ca 95353 1 Phone: (951) 410-4858 www.UnionPavement.com The following is a partial list of agency customers that Doug has worked on or managed within the Southern California market. Southern California Counties: • County of Los Angeles, Orange County, Riverside County, San Diego County, Ventura County, Santa Barbara County, Kern County, and others. Incorporated Cities in the LA and Orange County area- • Arcadia, Monrovia, Duarte, Azusa, Covina, West Covina, Temple City, Monterey Park, La Verne, Claremont, Upland, Chino, Chino Hills, Diamond Bar, Whittier, La Canada Flintridge, Commerce, Pico Rivera, Glendale, Pasadena, San Marino, Compton, South Gate, Norwalk, Downey, Torrance, Redondo Beach, Hermosa Beach, Manhattan Beach, El Segundo, Hawthorne, Lawndale, La Mirada, La Habra, Buena Park, Fullerton, Orange, Standon, Cypress, Cerritos, Lakewood, Signal Hill, Los Alamitos, Westminster, Garden Grove, Fountain Valley, Huntington Beach Seal Beach, Long Beach, Irvine, Costa Mesa, Newport Beach and many others. While the name Union Pavement Services, Inc. is new to the industry, their corporate support, management, and staff come with decades of a prominent level of involvement in the pavement preservation industry. Paired with their high -quality equipment, UPSI are incredibly experienced and qualified to perform any slurry seal, micro surfacing, chip seal or other preservation services using qualified union labor. UNION PAVEMENT SERVICES 2904 Rubidoux Blvd, Suite A, Jurupa Valley, CA 92509 P.O. Box 292 Modesto, Ca 95353 1 Phone: (951) 410-4858 References www.UnionPavement.com Roger Schlierkamp, M.Sc., PE GMU Engineers and Geologists 30336 Esperanza Rancho Santa Margarita, CA 92688 Office: (949) 888-6513 Cell: (949) 300-2158 E-mail: rschlierkamp@gmugeo.com Clarence Su, PE Civil Engineer Los Angeles County Public Works 900 S. Fremont Ave. Alhambra, CA 91803 Office: (626) 458-7927 Cell: (626) 710-3659 E-mail: csu@dpw.lacounty.gov Orland Mott, PE Mott Engineering, Inc. San Diego County Public Works 8580 Ferndale St. San Diego, CA 92126 Cell: (760) 214-4529 E-mail: orland.mott@sdcounty.ca.gov UNION PAVEMENT SERVICES 2904 Rubidoux Blvd, Suite A, Jurupa Valley, CA 92509 P.O. Box 292 Modesto, Ca 95353 1 Phone: (951) 410-4858 The following list were projects completed by Pavement Coatings Co. under Doug Ford as the President and Responsible Managing Officer (RMO) on their California Contractors State License Board. 2021 Dollars Contact Phone Email County of Stanislaus Urban Pavement Preservation - Phase D $1,720,862.00 Marcie Ryan 209-525-4185 ryanm@stancounty.com Town of Los Gatos FY 2020/21 Street Repair and Resurfacing Project #20-811-9901 $3,143,344.00 Suyesh Shrestha 408-395-1437 sshrestha@losgatosca.gov County of Colusa Seal Cracks and Slurry Seal Runway 13-31 Phase 1 $ 151,012.00 Angela Gross 530-458-0437 On..ggr0S6@COUnty0fCIlt0Sa.OIg City of Santa Cruz 2021 Surface Seal Project City Project No. c400810 $ 961,514.40 Ricardo Valdes 831-420-5198 rvaldes@cityofsantacruz.com City of Fremont 2021 Cape and Slurry Seal Project $3,967,998.00 Edward Nakayama 510-4944775 enakayama@fremont.gov City of Victorville 2021 Liberty Village Pavement Rehabilitation Project, Project CC21-103 $1,561.450.00 Celeste Calderon 760-955-5085 cmcalderon@victonnlleca.gov City of El Cerrito 2021 Slurry Seal Project, City Project NO. C3027-22 $ 395,286.97 Ana Bemardes 510-215-4382 abemardes@ci.el-cenito.ca.us City of Clearlake 2021 Avenues Double Chip Seal Project $ 335,046.00 Marisa Hewitt 530-751-0952 mhewitt@cecusa.net Caltrans Ot-OK4304 Replace AC Surface With Precoated Aggregate and Micro Surfacing $1,441,275.00 City of Vacaville 2021 Slurry Seal $2,286,842.00 Amer Rihani 707449-5139 amer.rihani@dtyofvacaville.com City of Redondo Beach Citywide Slurry Seal Project - Phase 2, Job No. 41140 S 720,725.75 Javier Urista 310-318-0661 javier.unsta@redondo.org City of San Diego Slurry Seal Group 2025 $4,032,592.55 Celina Suarez 619-533-6678 csuarez@sandiego.gov County of Yuba 2021 CSA Resurfacing Project $1,099,406.01 Brett Poliquin 530-749-5416 bpoliquin@co.yuba.ca.us City of Roseville On -Call Roadway and Trail Maintenance Services $5,268,494.00 Jason Shykowski 916-774-5348 jhykowski@roseville.ca.us City of San Diego Slurry Seal Group 2121 $3,798,322.90 Celina Suarez 619-533-6678 csuarez@sandiego.gov San Bemardino County CSA 70 Zone G Road Chip Seal Project $ 136,209.00 Rudy Guerro 909-338-1618 rguerrero@sdd.sbcounty.gov Town of San Anselmo 2021 Slurry Seal Project S 446.196.00 Scott Schneider 415-258-4653 sschneider@townofsananselmo.org Placer County 2021 Roadway Surface Treatments $1,989,171.00 Robert Bigney 530-886-2122 BBigney@placer.ca.gov Fresno County Slurry Seals $ 761,503.00 Steven White 559-353-4919 DesignServices@fresnocountyca.gov City of Ukiah Slurry seal of local streets specification NO. 21-03 $ 321,078.00 Seth Strader 707463-5719 sstrader@cityofukiah.com City of San Diego Slurry Seal Group 2024 $4,605,610.28 Celina Suarez 619-533-6678 csuarez@sandiego.gov 2022 Dollars Contact Phone Email County of San Diego Countywide Slurry Seal Treatments FY21-22 $2,537,490.50 Anastasia Bulyche 858-505-6474 anastasia.bulycheva@sdcounty.ca.gov City of Menifee PMP 22-02: Potomac and Meadows Resurfacing Project PMP 22-02 $ 765,613.00 Margarito Comejo 951-723-3716 mcomejo@cityofinenifee.us Town of Los Gatos Street Repair and Resurfacing (Slurry Seal/Rubber Cape Seal) $2,282,624.00 Suyesh Shrestha 408-395-1437 SShrestha@losgatosca.gov City of Lafayette 2022 SURFACE SEAL PROJECT $2,495,851.00 Therese Kam 925-284-1951 tkain@lovelafayette.org Caltrans SLURRY SEAL AND PAINT TRAFFIC STRIPE (RECESSED) 08-1 M0204 $4,013,735.00 City of San Diego Slurry Seal Group 2124 $5,453,874.87 Juan Espindola 619-533-4491 jeespindola@sandiego.gov City of Lakeport 2022 Microsurface Project Bid NO. 22-06 $ 194,530.00 Olivia Group 707-263-3578 Ogrupp@cityo0akeport.com City of Exeter FY-22 Cape Seal & Microsurfacing Project- Project # 22-002 $ 309,227.00 Norm 559-592-3318 pw@exetercityhall.com City of Stockton Local Street Resurfacing Program FY 2021-22 SB1 Project #WT22003C $ 698,275.00 Thinh Phan 209-937-8885 Thinh.Phan@stocktonca.gov City of Novato 2022 Annual Pavement Rehabilitation Contract 2- Pavement Rehabilitation $ 484,878.00 Gosia Woodfin 415-899-8997 gwoodfin@novato.org City of San Rafael 2021-22 Slurry Seal Project, Project No. 11410 $1,029,500.00 April Miller 415-485-3355 April. Miller@cityofsanrafael.org City of Stockton Local Street Rusrufacing Program FY 2021-22 SB1Project No. WT22D03D $ 709.288.00 Thinh Phan 209-937-8885 Thinh.Phan@stocktonca.gov City of Auburn 2022 Surface Treatment Project $ 447.987.00 Mengil Deane 530-823-4211 mdeane@aubum.ca.gov City of Folsom Pavement Resurfacing Project FY 2021-22 $1,063,250.00 Ryan Chance 916-461-6713 rchance@folsom.ca.us City of San Diego Slurry Seal Group 2221 K-22-2086-DBB-3 $4,988,706.98 Ron McMinn 619-533-4618 rmcminn@sandiego.gov City of Mill Valley 2022 Slurry Seal Project -Project # 22-6 $1,409,670.60 Kevin VanKatwyk 415-384-4800 kvankatwyk@cityofmillvalley.org County of San Mateo 2022 Pavement Preservation Project $2,473.490.44 Milton Wong 650-599-1472 MWONG4@SMCGOV.ORG City of Cotati 2023 Pavement Preservation Project No. 1062022-0079 $ 703.543.70 Jonathan Caldwell 707-665-4238 jaldwell@cotaticity.org City of San Diego Slurry Seal Group 2222 $5,342,936.97 Ron McMinn 619-533-4618 rmcminn@sandiego.gov City of San Pablo FY 22-23 Citywide Slurry Seal Project #0602 $1,384,024.20 Jimmy Zhou 510-215-3069 JimmyZ@sanpabloca.gov San Bemadino County County Service Area 70 R-2 Road Chip Seal Project #1552.0003 S 116,990.30 John Abon 909-387-7910 John.Abon@sdd.sbcounty.gov San Bemadino County County Service Area 70 R-40 Road Chip Seal Project #1708.0001 $ 75,498.50 John Abon 909-387-7910 John.Abon@sdd.sbcounty.gov Cityof Padier 2022 ROAD REHAB S 577,839.90 Javier Andrade 559429-4747 javier@am-engr.com City of Lynwood Citywide Slurry Seal - Phase 3 - Project FY 2022-2023 S 745,859.30 Mir Fattahi 310-603-0220 Mfattahi@lynwood.ca.us City of Belvedere 2022 Road Maintenance Project $ 221,605.45 Chris Barry 415435-8903 cbarry@cityofbelvedere.org Town of Loomis Slurry Seal Project No. 22-01 $ 384,175.35 Merrill Buck 916-824-1518 townengineer@loomis.ca.gov City of Cupertino 2022 Pavement Maintenance Phase 2 Project# 2022-107 $1,672,133.50 Jo Anne Johnson 408-777-3245 Joannej@cupertino.org City of San Diego Slurry Seal Group 2223 K-23-2128-DBB-3 $5,128 653.38 Brittany Friedenreich 619-533-3104 bfdedenreic@sandiego.gov City of Ridgecrest Measure V Chip Seal FY22 Street Improvements $1,178,760.00 Mike Bustos 805-279-6870 mbustos@willdan.com 2023 Dollars Contact Phone Email City of Lincoln Road Sealant Project Contract # CIP 615 $ 280,896.65 Edgar Garcia 916.434.2486 Edgar. Garcia@lincolnca.gov City of Coming Jennings Heights Subdivision Maintenance & Rehabilitation Project $ 431,680.00 Robin Kampmann 530.824.7025 rampmann@coming.org City of Sunnyvale Sluny Seal 2023-8 $1,376,491.10 Lisa Vo 408.730.7608 No@sunnyvale.ca.gov City of Lincoln Slurry Seal Re -Stripe Parking Lots Project CIP 608 $ 262,580.90 Edgar Garcia 916.434.2486 Edgar. Garcia@lincolnca.gov City of Mill Valley 2023 Slurry Seal Project $ 998,758.75 Rick Navarro 415.384.4800 dcknavarro@cityofmillvalley.org City of Exeter FY 23 Cape Seal & Microsurfacing Project No. 23-003 $ 398,685.95 Norm 559-592-3318 pw@exetercityhall.com City of Pacifica FY2023-24 Pavement Resurfacing Project $1,568,829.20 Raymund Donguines 650-738-3768 donguinesr@ci.pacifica.ca.us City of Livermore 2021 Slurry Seal Project No. 2021-04 $2,069,232.20 Sni Hawan 925-960-4540 snijhawan@cityoflivennore.net City of Greenfield 2023 Pavement Maintenance Project $1.664,375.50 Douglas Pike 805-331-3553 dpike@msengineers.com Caltrans 06-1 E6204 Tulare Cc Polymer asphaltic emulsion, seal coat, HMA and striping. $3,100,159.00 Caltrans 11-2N1204 San Diego Co Micro -surfacing $2,319,474.50 City of San Diego Slurry Seal Group 2322 $4,871,940.48 Brittany Friedenreich 619-5336-3104 bfdedenreic@sandiego.gov Town of San Anselmo 2023 Slurry Seal Project S 479,343.45 Sean Condry 415-258-4601 scondry@sananselmo.gov City of Hanford FY 23 Double Fiberized Micro Surface Treatment Project $ 451,500.00 Jennifer Minear 559-585-2559 jminear@cityofhanfordca.com Caltrans 07-OW4104 Los Angeles CO Apply slurry seal and install thermoplastic traffic stripe. $2,372,011.25 City of Menifee PMP 23-01 Slurry Seal Project S 409,703.50 Jennifer Chnstoffersen 951-723-1731 jchnstoffersen@cityofinenifee.us City of Riverbank Pavement Restoration 2023 Project $ 691,651.80 1 Laura Graybill 209-863-7155 Igraybill@dverbank.org County of San Diego Countywide Slurry Seal Treatments for FY 2022-2023 RFB 12449 $6,756,318.28 lJohn Shin 858-505-6378 John.Shin@sdcounty.ca.gov SUPREME SWEEPING, INC. 1247 Inspiration Point West Covina, CA 91791 PH: (626) 442-0382 email: supremesweepinginc@yahoo.com A UNION SWEEPING COMPANY MEMBER OF LOCAL 12 $225.00 per hour, 4 Hours min. Portal to Portal Monday — Friday $260.00 per hour, 4 Hours min. Portal to Portal Saturday $295.00 per hour, 4 Hours min. Portal to Portal Sunday *Night work, add $1.00 more to rate for Operator's Wage *Rates are subject to change *All Invoices must be in 30 days, or sooner. If no payment is received, we will not perform any work until payment is made Contact: LUIS LOPEZ (626) 442-0382