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SAVI Construction
SECTION 1200 BID DATE: 01 /05/2026 The undersigned, as bidder, declares it has received and examined the Contract Document entitled Project No. 2025-09, Dune Palms Mobile Estates Pool Abandonment, 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 # NA Date Received Initials Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY. SAVI Construction Inc. Name of Bidder 805 889-3547 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. SAVI Construction Inc. Name of Bidder 6725 Birmingham Dr, Chino, CA 91710 Bidder's Address 1116157 Contractor's License No. California State of Incorporation -?Am4. � Signature of Bidder Ramesh Bachuvala Printed Name of Signatory President Title of Signatory 805 889-3547 Bidder's Telephone Number contactsavi247@gmail.com Bidder's Email Address 04/30/2026 Contractor's Expiration Date Witness Title of Witness Bid 1200-2 SECTION 1210 BID SCHEDULE PROJECT NO. 2025-09 DUNE PALMS MOBILE ESTATES POOL ABANDONMENT 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. 2025-09, Dune Palms Mobile Estate Pool Abandonment, 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 — DUNE PALMS MOBILE ESTATES POOL ABANDONMENT Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Mobilization 1 LS $ 9,500 $ 9,500 2 Site/Traffic Control 1 LS $ 4,500 $ 4,500 3 Dust Control 1 LS $ 2,500 $ 2,500 4 Demolition, Disposal, Clearing, 1 LS $ 34,000 $ 34,000 and Grubbing 5 Furnish and Install Unclassified 315 TON $ 46 $ 14,490 Fill 6 Furnish and Install 12" Crushed 910 SF $ 6.50 $ 5,915 Miscellaneous Base Furnish and Install 3/8" Minus 7 w/ 20% Fines "Desert Gold" 3,410 SF $ 7 $ 23,870 Stabilized Decomposed Granite 3" Thick Furnish and Install 6' HT Steel Fence with Footings per City of 8(F) La Quinta Std. No. 784.1-784.2. 50 LF $ 155 $ 7,750 Style to match existing steel fence. 9 Furnish and Install 6' HT Steel 1 EA $ 4,500 $ 4,500 Single Gate with Footings Total Amount of Bid Items 1 — 9 $107,025 Bid Schedule 1210-2 GRAND TOTAL BASE BID (Figures): $ 107,025 GRAND TOTAL BASE BID (Words): One Hundred Seven Thousand Twenty -Five Dollars Only Bid Amount of each of the above Bid Items must be filled in and completed. It is understood that the quantities shown hereon are but estimates and the bidder is responsible to verify quantities prior to submitting a bid. Final payment will be based upon actual work performed, subject to such adjustments and alterations as elsewhere provided herein. Signature of Bidder (Ink) SAVI Construction Inc. Name of Bidder (Printed or Typed) 805 889-3547 Bidder Telephone Number 805 889-3547 Bidder Email Address Bid Schedule 1210-3 •;.oNSTRUCT�O -. SEAL :Fee. z" •�' •' • CgUFOFN�P; , • SECTION 1220 BID GUARANTY BOND *Developers Surety and Indemnity Company PRINCIPAL, and * , 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. 2025-09 DUNE PALMS MOBILE ESTATES POOL ABANDONMENT 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 5th day of January , 2026. SAVI Construction Inc. President Title of Signatory mgL, � Signature of Principal Developers Surety and Indemnity Company Attorney -in -Fact Title of Signatory Signature of Surety Edward N. Hackett, Attomey-in-Fact 6725 Birmingham Dr., Chino, CA 91710 800 Superior Avenue E., 21st Floor, Cleveland, OH 44114 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 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 LDS HtqftLA On 3-r4 1e.n 20 Lb Date personally appeared before me, °Crnt . C,�' t-t�i�G✓i 'lip Go (�°G Here Insert Name and Title of the Offi r R&rne_s �, 13 A- 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. ��;�==�,, kQJAIAXMI CHIIUKURI: COMM #, 24019927 x Signature Los Angeles County - Signature of Notary Public ✓' \ California Notary Public �( p `. Comm Exp Apr, 25, 2026 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 Docume t J Title or Type of Document: I %30 Document Date: OI Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: IJ Corporate Officer — Title(s): 1-1 Partner — ❑ Limited J General 1-1 Individual C1 Attorney in Fact lJ Trustee ❑ Guardian or Conservator Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): 17 Partner — ❑ Limited I 1 General I] Individual Cl Attorney in Fact * Trustee Cl Guardian or Conservator ❑ Other: Signer Is Representing: ©2015 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 CALIFORNIA 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 Ora n ) On January 5, 2026 before me, C'-"f-P - + 0 o Fc� P�b�i c. There nsert name and title of the o er) personally appeared E8 'U-{4 who proved to me on the basis of satisfactory evidence to be the persons) whose name(4is/,K4 subscribed to the within instrument and acknowledged to me that he/toy executed the same in his/their authorized capacity(+es), and that by hiss signature(s*on the instrument the person(, or the entity upon behalf of which the persons} 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. Signature ~ CARLY P. MATLOCK �� ' . COMM. #2423661 z � z Notary Public - California m o Orange County Comm. Expires Oct. 27, 2026 (Seal) Optional Information Although the information in this section is not required by law it could prevent fraudulent removal and reattachment of this acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document titled/for the purpose of SAVI Construction Inc. Bid Bond containing _I pages, and dated _ January 5, 2026 The signer(s) capacity or authority is/are as: J Individual(s) Attorney -in -Fact ❑ Corporate officer(s) Titles) ❑ Guardian/Conservator ❑ Partner - Limited/General ❑ Trustee(s) ❑ Other: representing: Name(0 of Person(s) or Entity0es) Signer is Representing I Method of Signer Identification Proved to me on the basis of satisfactory evidence: Q form(s) of identification C- credible wimess(es) Notarial event is detailed in notary journa on: Page 4 Entry Notary contact: _Other _ [] Additional Signer(s) [i Signer(s) Thumbprint(s) 11 :r Copyright 2007.2021 Notary Rotary PO Box 41400, Des Moines. Id S0311-0507 All Rights Reserved. Item Number 1C1772. Please rontact your Authorized Reseller to purchase copies of this form POWER OF ATTORNEY FOR COREPOINTE INSURANCE COMPANY DEVELOPERS SURETY AND INDEMNITY COMPANY 59 Maiden Lane, 43rd Floor, New York, NY 10038 (212) 220-7120 KNOW ALL BY 'r1lESE PRESENTS that. except as expressly limited herein. COREPOINTE INSURANCE COMPANY and DEVELOPERS SURETY AND INDEMNITY COMPANY, do hereby make, constitute and appoint: Brendan Hackett and Edward Hackett of Laguna Beach, CA as its true and lawful Attomey-in-Fact. to make. execute, deliver and acknoMedge. for and on behalf ofsaid companies. as sureties. bonds. undertakings and contracts of surety ship giving and granting unto said Attomey-in-Fact full power and authority to do and to perform every act necessary. requisite or proper to be done in connection therewith as each of said company could do, but reserving to each of said company full ponver of substitution and revocation. and all of the acts of said Anomey-i n-Fact, pursuant to these present,. are hereby ratified and confirmed This Power of Attorney is effective .Npyember 14, 2025 This Po%%cr ofAttomey is granted and is signed underand by authority of the tollowing resolutions adopted b� the Board of Directors of COR EPCIINTE INSURANCE COMPANY and DEVELOPERS SURETY AND iN DEMNITY COM PANY (collectively.' -Company") on February 10 2023 RESOLVED, that Sam Zaza, President, Surety Underwriting, James Bell. Vice President, Surety Underwriting, and Craig Dawson, Executive Underwriter, Surety, each an eml2lovee of AmTrust North America. Inc.. an affiliate of the Company (the "Authorized Signors'), are hereby authorized to execute a Power of Attorney, qualifying attorney(s)-in-fact named in the Power of Attorney to execute, on behalf of the Company, bonds, undertakings and contracts of suretyship, or other suretyship obligations, and that the Secretary or any Assistant Secretary of the Company be, and each of them hereby is, authorized to attest the execution of any such Power ofAttorney RESOLVED, that the signature of any one of the Authorized Signors and the Secretary or any Assistant Secretary of the Company, and the seal of the Company must be affixed to any such Power of Attorney, and any such signature or seal may be affixed by facsimile, and such Power of Attorney shall he valid and binding upon the Company when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF, COREPOINTE INSIIRANCECOMPANY and DEVELOPERS SURETY AND INDEMNITY COMPANY have caused these presents to be signed by the Authori7A Signor acid attested by their Secretary or Assistant Secretary this August 7, 2024_ _ i - Printed I -.Tint Sam Z.i., Title President, Surety Underwriting ACKNOWLEDGEMENT: ORo Nsu C 10 �;, o.SEAL:= t) ••�FCAWP��C: j A notary public or other officer completing this certificate verifies only the I identity of the individual who signed the document to which this certificate is jattached, and not the truthfulness, accuracy, or validity of that document. AND J OEtPOR4'. F� �O•� 2 ul 1936 = = 0 :0 STATE OF California COUNTY OF Orange_ On this 1 day of 1 1tNnt3 S ( 20_a , before me, Hoang-Qm en Phu Pham personally appeared Sam Zaza __, who proved to me on the bads of satisfactory evidence to be the person whose name is subscribed to within the instrument and acknowledged tome that they executed the same in their authorized capacity, and that by the signature on the instrument the entities upon behalf which the person acted, executed this 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 }— ■ _ HOANG-QUYEN. P. PI M Notary Public - California Signattue � .�, y1,. —..` Orange County f. Commission # 2432970 r t- • My Comm. Expires Clot 31, 2026 CORPORATE CERTIFICATION The undersigned, the Secretary or Assistant Secretary of COREPOINTE INSURANCE COMPANY and DIEVELOi'ERS SURETY AND INDEMNITY C0110PANY, does hereby certify that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in this Power ofAttorney are in force as of the date of this Certification. This Certification is executed in the City of Cleveland, Ohio, this August 2, 2024. ----DocuSiyned by: i By: - )&i' C& Janie Clark, Assistant Secretary L•---87666D3E22364A8. Docusign Envelope ID 5AB920B9-227B-46CB-BD53-COE3AO5A3E46 Ed 0824 Signed and sealed this Stday of fgnHaA� , 2026 No. 4606-0 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE SAN FRANCISCO Amended Certificate of Authority THIS IS TO CERTIFY that, pursuant to the Insurance Code of the State of California, Developers Surety and Indemnity Company of California, organized under the laws of California, subject to its Articles of Incorporation or other fundamental organizational documents, is hereby authorized to transact within this State, subject to all provisions of this Certificate, the following classes of insurance: Fire, Marine, Surety, Disability, Plate Glass, Liability, Workers' Compensation, Common Carrier Liability, Boiler and Machinery, Burglary, Credit, Sprinkler, Team and Vehicle, Automobile, Aircraft, Legal, and Miscellaneous as such classes are now or may hereafter be defined in the Insurance Laws of the State of California. THIS CERTIFICATE is expressly conditioned upon the holder hereof now and hereafter being in full compliance with all, and not in violation of any, of the applicable laws and lawful requirements made under authority of the laws of the State of California as long as such laws or requirements are in effect and applicable, and as such laws and requirements now are, or may hereafter be changed or amended. IN WITNESS WHEREOF, effective as of the I" day of November, 2017, I have set my hand and caused my official seal to be affixed this 1" day of November, 2017 Dave Jones Insurance Commissioner By Valerie Sarfaty for Joel Laucher Chief Deputy NOTICE: Qualification with the Secretary of State must be accomplished as required by the California Corporations Code promptly after issuance of this Certificate of Authority. Failure to do so will be a violation of Insurance Code section 701 and will be grounds for revoking this Certificate of Authority pursuant to the covenants made in the application therefor and the conditions contained herein. SECTION 1220 BID GUARANTY BOND PRINCIPAL, and , 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. 2025-09 DUNE PALMS MOBILE ESTATES POOL ABANDONMENT 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 day of , 2026. Title of Signatory Signature of Principal Address Title of Signatory Signature of Surety Address Note: Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 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: On call Concrete Maintenance - 3 Year Contract Owner: City of La Quinta Construction Cost: $ $120,000 Construction Time: September 2025 Owner's Representative: Owner's Telephone No.: David Eastlick 760.668.0710 Date of Substantial Completion: September 2025 Calendar Days 2. Project Name: Sidewalk Improvement Program FY24-25 Owner: City of Laguna Niguel, CA Construction Cost: $ $160,000 Construction Time: July 2025 Owner's Representative: Owner's Telephone No.: Angel Fuertes, PE, 949-212-6990 Date of Substantial Completion: July 2025 Calendar Days Bidders Experience & Qualifications 1230-1 3. Project Name: FY 24-25 ADA Ramp Project Owner: City of Aliso Viejo, California Construction Cost: $ $248,800 Construction Time: June 2025 Calendar Days Owner's Representative: Quang Le, P.E. Owner's Telephone No.: 949-425-2531 Date of Substantial Completion: June 2025 4. Project Name: CDBG Curb, Gutter, & Sidewalk Improvement Project, CB2401 Owner: City of Rialto, California Construction Cost: $ $126,000 Construction Time: May 2025 Calendar Days Owner's Representative: Rudy victorio Owner's Telephone No.: 909-820-2532 Date of Substantial Completion: May 2025 Signed this 5th day of January , 2026. SAVI Construction Inc. 1116157 2000001284 Name of Bidder Contractor's License No. DIR Reg No. Signature of Bidder Ramesh Bachuvala Printed Name of Bidder 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. NA Signature of Bidder Ramesh Bachuvala 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 ) Ramesh Bachuvala being first duly sworn, deposes and say that he or she is President of SAVI Construction Inc. the party making the foregoing bid that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly sought by contract, agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. �megb � Signature SAVI Construction Inc. Name of Bidder President Title 01 /05/2026 Date Non -Collusion Affidavit 1250-1 SECTION 1260 DIR Project Vendor Information Vendor Information: Name: SAVI Construction Inc. Address: 6725 Birmingham Dr, City: Project Manager: Ramesh Bachuvala Phone: 805 889-3547 Public Works Registration No.: Classification: Chino ST: CA Zip: 91710 Email: contactsavi247@gmail.com CSLB/Certification Number: 1116157 2000001284 Asbestos Boilermaker Bricklayers Carpenter Carpet/Linoleum_ Cement Masons X Drywall Finisher Drywall/Lathers Electricians Elevator Mechanic Glaziers Iron Workers X Laborers 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.htm]. Contractors and subcontractors on most public Works projects are required to submit certified payroll records to the Labor Commissioner using DIR's electronic certified payroll reporting system. For your convenience, the link for reporting certified payroll is: http://www.dir.ca.gov/Public-Works/Certified-Payroll-Reporting.html. A copy of certified payroll, including the names and addresses of employees and/or subcontractors working on the job must be included with invoices submitted to the City of La Quinta. DIR Project Vendor Information 1260-1 SECTION COMPLIANCE WITH IRAN CONTRACTING ACT OF 2010 Pursuant to the Iran Contracting Act of 2010 (Pub. Contract Code, § 2200 et seq.), (a) Contractor shall be ineligible to bid on or submit a proposal for any contract for One Million Dollars ($1,000,000) or more if Contractor engages in investment activities in Iran as defined in Public Contract Code Section 2202.5, and/or if Contractor is identified on the list of persons engaging in investment activities in Iran prepared by the State of California pursuant to Public Contract Code Section 2203 subdivision (b). (b) For bids of One Million Dollars ($1,000,000) or more, Contractor must certify that it is not on the list of ineligible vendors prohibited from doing business with the State of California and shall complete the Iran Contracting Act Certification and submit with their proposal at the time of bid. Contractor shall obtain the Iran Contracting Act Certification in the form approved by the State of California, or upon written request to the City Clerk's Office, a copy of the form will be provided to Contractor. Failure by Contractor to provide the certification required by this Section may deem Contractor's bid non -responsive. (c) Nothing in this Section is intended to prevent the City from exercising its rights pursuant to Public Contract Code section 2203, subdivision (c) or (d), or both, on a case -by -case basis. Iran Contracting Act Certification 1270-1 IRAN CONTRACTING ACT CERTIFICATION Pursuant to the Iran Contract Act of 2010 (Public Contract Code 2200-2208), Vendors/Bidders are ineligible to bid on or submit a proposal for any contract with a public entity for goods or services of one million dollars ($1,000,000) or more if the Vendor/Bidder engages in investment activities in Iran. MUST BE SUBMITTED WITH BID PROPOSAL IF BID AMOUNT IS $1,000,000 OR MORE Prior to bidding on, submitting a proposal, or executing a contract or renewal for a public entity contract for goods or services of $1,000,000 or more, a vendor must either: a) certify it is not on the current list of persons engaged in investment activities in Iran created by the California Department of General Services ("DGS") pursuant to Public Contract Code section 2203(b) and is not a financial institution extending $20,000,000 or more in credit to another person, for 45 days or more, if that other person will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS; or b) demonstrate it has been exempted from the certification requirement for that solicitation or contract pursuant to Public Contract Code section 2203(c) or (d). To comply with this requirement, please insert your vendor or financial institution name and Federal ID Number (if available) and complete one of the options below. Please note: California law establishes penalties for providing false certifications, including civil penalties equal to the greater of $250,000 or twice the amount of the contract for which the false certification was made, contract termination, and three-year ineligibility to bid on contracts. (Pub. Cont. Code § 2205.) OPTION #1 - CERTIFICATION I, the official named below, certify I am duly authorized to execute this certification on behalf of the vendor/financial institution identified below, and the vendor/financial institution identified below is not on the current list of persons engaged in investment activities in Iran created by DGS and is not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another person/vendor, for 45 days or more, if that other person/vendor will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS. I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Vendor Name/Financial Institution (Printed) Federal ID Number (or n/a) SAVI Construction Inc. 99-1544486 By (Authorized Signature) Printed Name and Title of Person Signing Date Executed Ramesh Bachuvala 01/05/2025 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) Federal ID Number (or n/a) SAVI Construction Inc. 99-1544486 By (Authorized Signature) —U m ab K,� Printed Name and Title of Person Signing Date Executed Ramesh Bachuvala 01/05/2025 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. NOT APPLICABLE Russian Aggression Against Ukraine Compliance 1280-1