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Tri-Star Contracting II, Inc.
SECTION 1200 BID DATE: 1 /7/2026 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 # Date Received I itials 1 1 /2/2026 Attached is a bid guaranty bond as required by Paragraph 1110-15.0, BID GUARANTY. Tri-Star Contracting II, Inc. Name of Bidder 760-251-5454 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. Tri-Star Contracting II, Inc. Name of Bidder 15501 Little Morongo Road Desert Hot Springs, CA 92240 Bidder's Address 909195 Contractor's License No. CA State Incorp on Signatu a of Bidder Jordan Willis Rodriguez Printed Name of Signatory CFO Title of Signatory 760-251-5454 Bidder's Telephone Number 0willis@ri-star.info Bidder's Email Address 1 /31 /2028 Contractor's Expiration Date Witness Secretary 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 $ 5,930.00 $ 5,930.00 2 Site/Traffic Control 1 LS $ 32,282.00 $ 32,282.00 3 Dust Control 1 LS $24,228.00 $ 24,228.00 4 Demolition, Disposal, Clearing, 1 LS $ 35,984.00 $ 35,984.00 and Grubbing 5 Furnish and Install Unclassified 315 TON $ 65.00 $20,475.00 Fill 6 Furnish and Install 12" Crushed 910 SF $8.70 $7,917.00 Miscellaneous Base Furnish and Install 3/8" Minus 7 w/ 20% Fines "Desert Gold" 3,410 SF $ 5.00 $17,050.00 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 $ 345.00 $ 17,250.00 Style to match existing steel fence. 9 Furnish and Install 6' HT Steel 1 EA $ 4,402.00 $ 4,402.00 Sin le Gate with Footings Total Amount of Bid Items 1 — 9 $ 165,518.00 Bid Schedule 1210-2 GRAND TOTAL BASE BID (Figures): $ 165, 518.00 GRAND TOTAL BASE BID (Words): One Hundred Sixty Five Thousand Five Hundred Eighteen Dollars 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) Jordan Willis Rodriguez Name of Bidder (Printed or Typed) 760-251-5454 Bidder Telephone Number jwiIIis@tri-star.info Bidder Email Address Bid Schedule 1210-3 SECTION 1220 BID GUARANTY BOND PRINCIPAL, and Harco National 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. 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 7th day of January „ 2026. TRI-STAR CONTRACTING II, INC. HARCO NATIONAL INSURANCE COMPANY C\ C Title of gnato :�� Signatur of Principal Douglas J. Rothey, Attorney -in -Fact Title of Signatory SignaturtofSu 1550 L,-\ lU MLA -&,A QL R4200 Six Forks Road, Ste 1400, Raleigh, NC 27609 Address ('AG)NvAddress Note: Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 State of Colorado ) ) ss. County of Arapahoe ) On January 7, 2026, before me, a Notary Public in and for said County and State, residing therein, duly commissioned and sworn, personally appeared Douglas J. Rothey. known to me to be Attorney -in -Fact of Harco National Insurance Company the corporation described in and that executed the within and foregoing instrument, and known to me to be the person who executed the said instrument on behalf of the said corporation, and he duly acknowledged to me that such corporation executed the same. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my offici I, the day a d y ar stated in this certificate above. My Commission Expires: December 4, 2028 imberly D ii-A&WcAlLkankfir, ary Public E LY DIANE MCALEXANDERBLIC - STATE OF COLORADO ARY ID 20244044404 SSION EXPIRES DEC 4, 2028 POWER OF ATTORNEY Bond# STATE OF NEW JERSEY STATE OF ILLINOIS sEat County of Essex County of Cook '" .� 190V_ 4 1 +E Michael F. Zurcher Executive Vice President, Harco National Insurance Company and International Fidelity Insurance Company HARCO NATIONAL INSURANCE COMPANY INTERNATIONAL FIDELITY INSURANCE COMPANY Member companies of IAT Insurance Group, Headquartered: 4200 Six Forks Rd, Suite 1400, Raleigh, NC 27609 KNOW ALL MEN BY THESE PRESENTS: That HARCO NATIONAL INSURANCE COMPANY, a corporation organized and existing under the laws of the State of Illinois, and INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation organized and existing under the laws of the State of New Jersey, and having their principal offices located respectively in the cities of Rolling Meadows, Illinois and Newark, New Jersey, do hereby constitute and appoint DOUGLAS J. ROTHEY, WES BUTORAC, ZACH ROTHEY, KIMBERLY MCALEXANDER, KIM PAYTON, ERIK ULIBARRI Denver, CO their true and lawful attorney(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise, and the execution of such instrument(s) in pursuance of these presents, shall be as binding upon the said HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY, as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by their regularly elected officers at their principal offices. This Power of Attorney is executed, and may be revoked, pursuant to and by authority of the By -Laws of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY and is granted under and by authority of the following resolution adopted by the Board of Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting duly held on the 13th day of December, 2018 and by the Board of Directors of HARCO NATIONAL INSURANCE COMPANY at a meeting held on the 13th day of December, 2018. "RESOLVED, that (1) the Chief Executive Officer, President, Executive Vice President, Senior Vice President, Vice President, or Secretary of the Corporation shall have the power to appoint, and to revoke the appointments of, Attorneys -in -Fact or agents with power and authority as defined or limited in their respective powers of attorney, and to execute on behalf of the Corporation and affix the Corporation's seal thereto, bonds, undertakings, recognizances, contracts of indemnity and other written obligations in the nature thereof or related thereto; and (2) any such Officers of the Corporation may appoint and revoke the appointments of joint -control custodians, agents for acceptance of process, and Attorneys -in -fact with authority to execute waivers and consents on behalf of the Corporation; and (3) the signature of any such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation, to be valid and binding upon the Corporation with the same force and effect as though manually affixed." IN WITNESS WHEREOF, HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY have each executed and attested these presents on this 31st day of December, 2024 VRON .cfi z: SEAL c: %0% 1984 4rNoN`'.' A ZV On this 31st day of December, 2024 , before me came the individual who executed the preceding instrument, to me personally known, and, being by me duly sworn, said he is the therein described and authorized officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies; that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of said Companies. P��1Y C IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal, at the City of Newark, G R,� New Jersey the day and year first above written. �OTA/Y,_ �rJBL\G %9TFop N ��Cathy Cruz a Notary Public of New Jersey My Commission Expires April 16, 2029 CERTIFICATION I, the undersigned officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Sections of the By -Laws of said Companies as set forth in said Power of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power cf Attorney has not been revoked and is now in full force and effect. IN TESTIMONY WHEREOF, I have hereunto set my hand on this day, January07, 2026 A00911 Irene Martins, Assistant Secretary 19NRfill0EWA DNIELSEN ACORD CERTIFICATE OF LIABILITY INSURANCE D 118/2 Y 15 218/025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisionsior be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER License # 0757776 CONTACT Diane Nielsen NAME: HONE Ext 760 360-4700 4742 FAX ( ): ( ) (A/C, No):(760) 200-9706 HUB International Insurance Services Inc. 75030 Gerald Ford Drive Suite 201 Palm Desert, CA 92211 E-DmDAR'Ess, diane.nielsen@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:United Specially Insurance Company 12537 INSURED INSURER B : Republic-Vancivard Insurance Company 40479 INSURER C : Benchmark Insurance Company 41394 Tri-Star Contracting ll, Inc. Telar, Inc. 15-501 Little Morongo Road INSURER D : Travelers Property Casualty Company of America 26674 INSURER E: Starstone Specialty Insurance Company 44776 Desert Hot Springs, CA 92240 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICDY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR $5,000 Deductible ATN25911196 6/26/2025 6/26/2026 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED E E Ea occur ence $ 50,000 X MED EXP An one person)$ 5,000 GEN'L PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY F jECT 0 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 B AUTOMOBILE LIABILITY(Fa X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON SV64ED AUTOS ONLY AUTOS ONLY X No Deductible RVA1078785-00 11/23/2025 11/23/2026 SINGLE LIMIT $ 1,000,000 _acCOMBINED BODILY INJURY Per person)$ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LAB X OCCUR CLAIMS -MADE BTN2592989 6/26/2025 6/26/2026 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 X DED RETENTION $ 0 Over GL & WC On $ Ci WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 99WC-00005143-00 10/1/2025 10/1/2026 X PER OTH- TAT TE E E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D E Lease/Rented Pollution 6606072C693 T87499252AEM 1/11/2025 10/27/2025 1/11/2026 10/27/2026 Leased/Rented Limit 500,000 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project - City Project No. 2025-09 - Dune Palms Mobile Estate Pool Abandonment City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE n ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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. 2. Project Name: One Quail Place Owner: City of Palm Desert Construction Cost: $ 128,362.00 Construction Time: 28 Owner's Representative: Brad Chuck Owner's Telephone No.: 760-776-6450 Date of Substantial Completion: 8/22/2025 Project Name: Kalura Patio Improvments Owner: City of Palm Spri Construction Cost: $ 417,655.04 Construction Time: 103 Owner's Representative: Alberto Gradilla Owner's Telephone No.: 760-323-8253 Ex 8718 Date of Substantial Completion: 9/24/2025 Calendar Days Calendar Days Bidders Experience & Qualifications 1230-1 3. Project Name: Indian Ave Wash Owner: City of Desert Hot Springs Construction Cost: $ 4,994,536.09 Construction Time: 185 Calendar Days Owner's Representative: Danny Porras Owner's Telephone No.: 760-329-6411 Date of Substantial Completion: 5/15/2024 4. Project Name: Mission Creek Groundwater Recharge Facility Maintenance Project Owner: Desert Water Agency Construction Cost: $ 335,422.30 Construction Time: 44 Calendar Days Owner's Representative: Maya Lopez Owner's Telephone No.: 760-323-4971 Date of Substantial Completion: 2/2/2025 Signed this 7th day of January , 2026. Tri-Star Contracting II, Inc. 909195 1000004952 Name of Bidder Contractor's License No. DIR Reg No. 1 /31 /2028 Signatur4 of Bidder Jordan Willis Rodriguez Printed Name of Bidder Expiration Date CFO 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. Spartan Concrete & Asphalt Cutting, Inc./PO Box 431 Desert Hot Springs, CA 92240/Saw Cutting/ 1.9%/Lic. 683437/DIR# 1000011594 Signaturi of Bidder Jordan Willis Rodriguez Tri-Star Contracting II, 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 ►� �v�,z�c>�_ ) Jordan Willis Rodriguez being first duly sworn, deposes and say that he or she is of Tri-Star Contracting p, 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 associati , organization, bid depository, or to any member or agent thereof to effectuate a collusir or sham bid. Signatur4 joraan vviins Kociriguez Tri-Star Contracting II, Inc. Name of Bidder CFO Title 1 /7/2026 Date Non -Collusion Affidavit 1250-1 SECTION 1260 DIR Proiect Vendor Information Vendor Information: Name: Tri-Star Contracting II, Inc. Address: 15501 Little Morongo Road City:Desert Hot SpringsST: CA Zip: 92240 Project Manager: Daniel Willis Email: dwillis@tri-star. info Phone: 775-388-2106 CSLB/Certification Number: 909195 Public Works Registration No.: 1000004952 Classification: Asbestos Boilermaker Bricklayers Carpenter Carpet/Linoleum Cement Masons 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. Prevailinq 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 SECTION1 COMPLIANCE WITH IRAN CONTRACTING ACT OF 1 1 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. Vendo Name/Financial Institution (Printed) Tri-S r Con ting II, Inc. By (A orizeq Signahtwj Printed Vame and Title of Person Signing Jordan1Willis Rodriguez/CFO Federal ID Number (or n/a) 20-8168300 Date Executed 1 /7/2026 Iran Contracting Act Certification 1270-2 OPTION #2 — EXEMPTION Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a vendor/financial institution engaged in investment activities in Iran, on a case - by -case basis, to be eligible for, or to bid on, submit a proposal for, or enters into or renews, a contract for goods and services. If you have obtained an exemption from the certification requirement under the Iran Contracting Act, please fill out the information below, and attach documentation demonstrating the exemption approval. Vendor Name/Financial Institution (Printed) Federal ID Number (or n/a) By (Authorized Signature) Printed Name and Title of Person Signing Date Executed Iran Contracting Act Certification 1270-3 SECTION 1280 COMPLIANCE WITH CALIFORNIA EXECUTIVE ORDER N-6-22 RUSSIAN AGGRESSION AGAINST UKRAINE (a) Contractor shall comply with California Governor Executive Order N-6-22 regarding sanctions in response to Russian aggression in the Country of Ukraine, and any implementing guidelines and/or economic sanctions imposed by the United States government in response to Russian actions in Ukraine, as well as any sanctions imposed under California law (collectively "economic sanctions"). Contractor shall comply with all such economic sanctions. By submitting a bid to the City, Contractor agrees to take any and all actions to support the Ukrainian government and people as required by law, including by refraining from new investments in, and financial transactions with, Russian institutions or companies that are headquartered or have their principal place of business in Russia (Russian entities), not transferring technology to Russia or Russian entities, and directly providing support to the government and people of Ukraine. (b) If bidding on a contract for Five Million Dollars ($5,000,000) or more, Contractor shall submit a written report to the City on Contractor's compliance with the economic sanctions, and the steps Contractor has taken in response to Russia's actions in Ukraine, including, but not limited to, desisting from making new investments in, or engaging in financial transactions with, Russian entities, not transferring technology to Russia or Russian entities, and directly providing support to the government and people of Ukraine as required by law. Failure to submit the report required by this Section may deem Contractor's bid non -responsive. Please include a written report to the City if this section is applicable. Russian Aggression Against Ukraine Compliance 1280-1