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Home My WebLink AboutS&H CivilworksSECTION 1200 BID nATF 1 2312 U2,6 The undersigned, as bidder, declares it has received and examined the Contract Document entitled Project No. 2024-06, Citywide Miscellaneous Concrete 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. 5 �- V l u1ZKS CiO�� 2.o�-Ilg Name of Bidder 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. Having examined the bid documents, we certify that we have acquainted with the nature, geographical and exact location of the works; the general conditions of execution; the neighboring buildings and other constraints that might affect the construction methods; the obligation not to obstruct the traffic where requested, or the flow of any water; the physical conditions specific to the construction sites; the climatic conditions; local conditions; means of communication and transport; the possibility of supplying water, electricity and fuel; the availability of labor sufficient in number and quantity; all constraints and obligations resulting from social, tax and customs legislation; and all conditions and circumstances which might influence the execution or price of the works. We certify that we are satisfied with the description of the works and the Project Engineer's explanations and that we understand perfectly the works to be undertaken as specified and implied in the execution 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. 3 a H C,IVILJWKKS cl 0157) 206 - II B I Name of Bidder I9ja I 4ILLTbF> Dt; IV1= Bidder's Address I OoF� y6 Contractor's License No. (2A-LiPOPO I N State of Incorporation Sign`s1it ire of BicTder J E5s C . i -D Printed Name of Signatory eR-e_slp�ll Title of Signatory Bidder's Telephone Number J f5SS5 P SAND l I- C fV I LL,)o[z-K S. Cet-4 Bidder's Email Address Contractor's Expiration Date Witness S Py Title of Witness _,id 1200-2 SECTION 1210 BID SCHEDULE PROJECT NO. 2024-06 CITYWIDE MISCELLANEOUS CONCRETE 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. 2024-06, Citywide Miscellaneous Concrete 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 — CITYWIDE MISCELLANEOUS CONCRETE IMPROVEMENTS Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars 1 Mobilization 1 LS $ LI 50 o $ SOCD 2 Traffic Control 1 LS $ 6 boo $ Sd� 3 Dust Control 1 LS $ 3 �a0 $ 3� Sawcut, Remove, and Dispose 4 of Existing Concrete Curb & 120 LF $ 2 D $ 24 U a Gutter; and/or Rolled Curb Sawcut, Remove, and Dispose 5 of Existing Concrete Sidewalk, Ramp, Driveway, Cross- 840 SF $ S $ Tc zno and Gutter Construct Curb and Gutter per 6 City of La Quinta Std. No. 201, 50 LF $ $ l Cyr 3" Dowel into Adjacent Existing Concrete Curb Construct Type `C' Curb per 7 City of La Quinta Std. No. 203, 40 LF F000 3" Dowel into Adjacent Existing Concrete Curb Construct Curb Transition per 8 City of La Quinta Std. No. 205, 10 LF $ �jD $ Z C)Q:�) 3" Dowel into Adjacent Existing Concrete Curb 9 Construct Driveway per City of 220 SF $ ZS $S_J Tco La Quinta Std. No. 221 Mod. Construct Portion of Cross- 10 Gutter per City of La Quinta Std. No. 230 Mod. and 231 30 SF $ � $ ` Qd Mod. 11 Construct Sidewalk per City of 380 SF $ �� $� La Quinta Std. No. 240 Mod. Construct Concrete Curb Ramp 12 per City of La Quinta Std. No. 1 EA $ Ot 060 $ � �� Wo 250 Mod., Case B (Including Curb and Gutter Along Ram Construct Concrete Curb Ramp 13 per City of La Quinta Std. No. 1 EA $ 4 0 D00 $ to/ 0� 250 Mod., Case E (Including a Curb and Gutter Along Ram Bid Schedule 1210-2 r Item Item Description Est. Unit Unit Price Item Total No. Qty. (in figures) (in figures) Dollars Dollars Sawcut, Remove, and Dispose of Existing Concrete Ramp; 14 Furnish and Install Truncated 40 SF $ So $ 3 LCCD Dome Concrete Tile per City of La Quinta Std. 250 Mod. Full Depth Grind Asphalt Concrete Pavement (4"), 15 Compact Existing Base, and 570 SF $ yo $ Variable Overlay (4" — 5"). 2'x1- 1/2" Header Cut incidental. _ — Grade Parkway, Remove, Modify, and Replace 16 Hardscape, Landscape and 1 LS $ (U Clid , $ ( D C1� Irrigation in Kind to Furthest Extent Possible. 6" Under - sidewalk Drain incidental. Striping and Pavement 17 Markings, Including All 1 LS $ �� $U� Incidentals Total Amount of Bid Items 1 — 17 $ 100, Bid Schedule 1210-3 SECTION 1220 BID GUARANTY BOND PRINCIPAL, and Merchants Bonding Company (Mutual) 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. 2024-06 CITYWIDE MISCELLANEOUS CONCRETE 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 20th day of Ju!y--- 2026. S&H Ciiv!m�ojks ES (00A Tit e of Si orv_ A �' 1. • ��''. Sit,rj9tt)Fe"of PrincI* ..0 a� : va® 1801 Hilltop Dr. r 2412015 Colton, CA 92324 Address Merchants Bonding Company (Mutual) Emily Preciado, Attorney -In -Fact Title of Signatory 6700 Westown Pkwy, Des Moines, IA 50266 Address Note: Signatures of those executing for the surety must be properly acknowledged. Bid Guaranty Bond 1220-1 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On --I 1120 120 Z1, before me, personally appeared Emily Preciado Kassandra De Leon, Notary Public (insert name and title of the officer) who proved to me on the basis of satisfactory evidence to be the person($) whose name() is/*e subscribed to the within instrument and acknowledged to me that Me/she/tt*y executed the same in his/her/thkir authorized capacity(its), and that by his/her/their signature(6) on the instrument the person(s), or the entity upon behalf of which the person(¢) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature 1 \ / (Seal) KASSANDRA DE !EON "f Notary Public - California Orange County > = Commission ; 2559191 Comm. Expires Jul t5. 2030 MERCHANTS BONDING COMPANY. POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa, and MERCHANTS NATIONAL INDEMNITY COMPANY, an assumed name of Merchants National Bonding, Inc., (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Danielle Black; Edith Garibay; Emily Preciado; Kassandra De Leon their true and lawful Attorney(s}in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power-of-Attomey is granted and is signed and sealed by facsimile under and by authority of the By -Laws adopted by the Board of Directors of the Companies. 'The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attomey-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attomey-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 13th day of March , 2026 MERCHANTS BONDING COMPANY (MUTUAL) •NOR G�PMERCHANTS NATIONAL BONDING, INC. j1POgf 9 NFORO��• MERCHANTS NATIONAL INDEMNITY COMPANY p R'' o � ti••.y 2"Z -0 _0_•tip 1933 c: :2`•: : z a :0 :.�'• :•dam,• :d••. � :�y. 'aa; By STATE OF IOWA COUNTY OF DALLAS ss. On this 13th day of March 2026 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL), MERCHANTS NATIONAL BONDING, INC., and MERCHANTS NATIONAL INDEMNITY COMPANY; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies, and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. tipR�A43` Penni Miller o Commission Number 787952 • • My Commission Expires irnHA January 20, 2027 cRt�y� (Expiration of notary's commission Notary Public does not invalidate this instrument) I, Elisabeth Sandersfeld, Secretary of MERCHANTS BONDING COMPANY (MUTUAL), MERCHANTS NATIONAL BONDING, INC., and MERCHANTS NATIONAL INDEMNITY COMPANY do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF - ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 20th day of ,July 2026 - �02p(�POR;hy `ORpOgq B01. : :Npt,p��FOR� u; 1933 c� _ 2003 ,7 ;i'• r Secretary POA 0018 (5/25) No. 2482-8 STATE OF CALIFORNIA DEPARTMENT OF INSURANCE SAN FRANCISCO Amended Certificate of Authority 'I HIS IS TO CER111-Y that, pursuant ro the Insuraruc Code of the Slate vfCalijornia, Merchants Bonding Company (Mutual) oflonu, organi.ed tender the lairs of lower. subject to its Articles of hu•urpuraiion or other lundamenta! organizational docronents, m hereht• authorized to iraitsac•t within IhisSiate, subject to all prortcions opht% C'ertiyicate. the following classes gf insurance. Surety, Liability, and Miscellaneous us such classes are noir or met) hereafter be defined in the Insurance Lairs ofthe:State of California THIS CERTIFICATE is expressly conditioned upon the holder hereof nuw and hereglier being in fill rumpliance with all. and not in violation ujarry, ojtlto applicable lenvs and lot: f rl requiremerus made touter• autlrorih= of the tau:� gfthe .Stare ojC,'a/ifornia ac long as such laws ur reyuirenrents are ire efji c•r cnrd cq phcoble, and as such lmvs and requirements nuts are, or may hereafter be changed or amended IN 1VI1 iNESS WHEREOF, itWlire as of the P day of October 2015, 1 have hereunto set my hand and caused my official .seal ro he crffixecl this P day of October, 2015. Dave Jones Insurw,ee Contntu.rime•e e i 4 l Ri Valerie Sarfaty for Nettie Hoge a'_'hh. f Depart `OTiCE.: Qualification with the Secratarp of Stmc must be accomplished as required by the California Corporations Code protnpth- otter issuance ofthis Certificate of Authority: failure to do so will be a violation of Insurance Code kection 701 and will be grounds for revoking this Certificate of Authority pursuant to the covenants made in the application therefor and the condhinns contained herein. GRAND TOTAL BASE BID (Figures): ^n GRAND TOTAL BASE BID (Words): M16 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. r Signature of Bidder (Ink) 574-�/ GI V1 Lrk-Z2A: 5S Name of Bidder (Printed or Typed) G�1) 2d C-, lI fi Bidder Telephone Number JESEE St�7VD7tC-4vl Bidder Email Address Bid Schedule 1210-4 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: -�S fE - ,� CA FL 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 22 NP �UL Signed this day of , 2026. Sll -Ii �I W U0()�,�s t () D �� O�o� 3 y ��40 Name of Bidder Contractor's License No. DIR Reg No. i 3 6 NSignWture of Bidder Expirati6n Dat e-- C TM Printed Name of Bidder 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. 0-T Z�c� rnJ �� sT-t2-i Plu G, ptZ�^'� b I�-i��r �� Lt c. 1122 O1/z [ o0a0 FW r-;,; Sig ture of Bidder 5"�-+w c l �/1 tWOMz. j 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 , A-v `J � _-t-j -tT-D being first duly sworn, deposes and say that he or she is 0-5, (D-:;- k � of S41 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. Signat S+4 c4yiL Lt)oj2IL:S Name of Bidder Title q 712- Date Non -Collusion Affidavit 1250-1 SECTION 1260 DIR Protect Vendor Information Vendor Information: Name: S ),- k GI V/ L JOW-7s Address: 00 ( 41 ILL'-IY �1� City: (,�oL ZA) ST Y- Zip: g2-52Ll Project Manager: J 0-25 3U17D Email: PhoneC9U'q) -ID j — I /S'/ CSLB/Certification Number: 10 D Public Works Registration No.: 1 oboo 3 4-1q �2 Classification: / P Asbestos Boilermaker Brickla ers Car enter Car et/Linoleum Y P Cement Masons ✓ Drywall Finisher Drywall/Lathers Electricians Elevator Mechanic Glaziers Iron Workers Laborers_zMillwrights Operating Eng /Painters Pile Drivers Pipe Trades Plasterers _ Roofer SheetMetal Sound/Com Prevailing Wages and Payroll: Surveyor Teamster ✓ Tile Worker, The project is subject to prevailing wage rates and enforcement by the Department of Industrial Relations (DIR). Prevailing wage rates can be obtained at: http://www.dir.ca.gov/Public-Works/Prevailing Wage. html. Contractors and subcontractors on most public Works projects are required to submit certified payroll records to the Labor Commissioner using DIR's electronic certified payroll reporting system. For your convenience, the link for reporting certified payroll is: http://www.dir.ca.gov/Public-Works/Certified-Payroll-Reporting.html. A copy of certified payroll, including the names and addresses of employees and/or subcontractors working on the job must be included with invoices submitted to the City of La Quinta. DIR Project Vendor Information 1260-1 • 1 11 _ \ ■ ► Wina _ ME Me, 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. Vendor N me/Financial Institution (Printed) I LI�Ut2�s By nat ) Printe4 Name and Title of Person Signing __J �3S c . 5 zltm IPHFs l - I Federal ID Number (or n/a) y)s--i-6o/�s Dat�E�ecute 0 23 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 S&H CIVILWORKS COMPLETED PROJECT REFERENCES PAST (5) YEARS Project Owner Project Scope of Work Contact Contract Completion Amount Date City of Riverside Street Widening Widening, Concrete Kevin Goodwin $60,000 June 2018 3900 Main Street of Quite lane and asphalt Project Manager Riverside CA 92522 (951) 318-3134 I kgoodwn@riversideca.gov j Thomas Dahlin OMNITrans ATP safe Route Demo, sidewalk, ADA Capital Project $2.1 M December 1700 West 51' St to Transit Project Ramps & Asphalt Manager/Inspector 2018 San Bernardino, CA Paving (951) 358-9322 92411 thomas _dahlin(cDomnitrans.org Thomas Dahlin OMNITrans Corona Avenue Demo, sidewalk, ADA Capital Project $308,000 April 2019 1700 West 511 St ATP safe Route Ramps & Asphalt Manager/Inspector San Bernardino, CA to Transit Project Paving (951) 358-9322 92411 thomas_dahlin((:�omnitrans.org Nathan Toczek City of San Annual Concrete Demo, sidewalk, City Inspector $2.1M April 2019 Bernardino Repair & ADA driveway, ADA Ramps (760) 963-2085 1 201 N "E" Street, san Access Ramp & cross gutter toczek—n-a@_sbcity.org Bernardino CA Project Roadway City of Santa Measure A Cycle Improvement, Ken Young — Barbara 3 Sidewalk Infill concrete, storm Project Manager $1.1 M December 630 Garden Street, Project drainage, retaining (805) 560-7568 2019 Santa Barbara CA walls, Ramps & kyoungPsantabarbaraca.gov Asphalt Paving i County of Riverside Mayberry Avenue Roadway Trai Nguyen — Principal 2950 Washington St, Sidewalk Project Improvement, concrete Inspector $316,000 February Riverside, CA 92504 —Hemet CA sidewalk, cross gutter (951) 961-5363 2020 and ramps trnquyenCd�rivco.orq City of Costa Mesa City Parkway Citywide concrete Cristina Oquendo $3.2M May 2020 77 Fair Drive Maintenance repair curb, gutter, Project Manager Costa Mesa CA Project sidewalk, driveway and (714) 754-5015 ADA Ramps cristina oguendoC@costamesaca ov City of Newport Concrete Demo, Curb, Gutter, Ben Davis PE- 100 Civic Center Replacement Sidewalk, ADA Project Manager $763,500 July 2020 Drive, Newport Project Ramps, Cross gutter & (949) 644-3317 Beach, CA 92660 Asphalt bdavisCnewp_ortbeachca.gov C John Trujillo City of Loma Linda ADA Access Demo, sidewalk, Inspector/Superintendent $113,000 August 2020 26000 Barton Road, Ramp Installation driveway, ADA Ramps 909.253.8884 Loma Linda 92354 Project & cross gutter jtrujillo@lomalinda-ca.gov City of West CDBG Concrete Demo, sidewalk, Mila Solugob $311,000 October 2020 Hollywood Repair Project driveway, ADA Ramps Project Manager Inspector 8300 Santa Monica & cross gutter (323) 848-6338 West Hollywood, CA msoloqub(a)weho.orq L_ 90069 Page 1 of 2 S&H CIVILWORKS COMPLETED PROJECT REFERENCES PAST (5) YEARS Project Owner Project Scope of Work Contact Contract Amount Completion Date City of Perris A Street and Demo, sidewalk, Brad Brophy $298,000 November 1015 S G St, Perris, Nuevo Road driveway, ADA Ramps, Project Manager Inspector 2020 CA 92570 Project cross gutter and (951) 943-6504 asphalt brad@trilakeconsultants.com City of Newport Ben Davis PE — j 100 Civic Center Concrete Repair Street Reconstruction, Project Manager $700K July 2021 Drive, Newport Program Project Concrete Repair (949) 644-33 17 Beach, CA 92660 bdavis(a-)newportbeachca.gov City of Newport Concrete Alley Carpenter PE — Patricia Car p 100 Civic Center and Street Street Reconstruction; Project Manager November Drive, Newport Replacement Concrete, drainage (949) 644-3344 $2.2M 2021 Beach, CA 92660 Project and PCC pavement pcarpenteraenewportbeachca.q ov City of Chino Hills 5 Year On -Call Remove and Jerry Barragan 14000 City Center contract Project reconstruction of curb, Superintendent $225K/Yr On -going Ur, Chino Hills CA 2019-2024 gutter, driveway (909) 573-4355 sidewalk and ramp 1— ba—rra an chinohills.org - City of Corona Oak Avenue Street Reconstruction; Julianna Zaleski 400 S. Vicentia Ave Sidewalk Improvement Concrete and PCC Project Manager (951) 736-2264 $550K April 2022 Corona, CA 92882 Project pavement ul� ianna zaleskiCa�coronaca.gov_ Carver Tract Trai Nguyen —Supervisor County of Riverside Sidewalk Street Reconstruction; Principal Inspector November 2950 Washington St, Improvement Concrete, drainage (951) 96_-(Kq $1.5M 2022 Riverside, CA 92504 Replacement and Asphalt pavement trnguyen�riv_c_q_org Project _ County of Riverside El Toro Street Reconstruction, Steve Wann —Principal i 2950 Washington St, Road/Dexter Concrete, drainage Inspector (951) 961-5946 $1.5M November 2022 Riverside, CA 92504 Road Project and Asphalt pavement swann@rivco.orq City of Orange Annual Concrete Remove and Evan Arnold 300 E Chapman at Various reconstruction of curb, Construction Inspector $1.1M October 2023 Ave, Orange, CA location gutter, driveway (714) 602-0111 92866 sidewalk and ramp Earnold Cit ofOrange.org City of Lake Forest Remove and Nazila Mokarram 100 Civic Center Dr, Phase 13 — CDBG reconstruction of curb, Principal Engineer $104K November Lake Forest CA ADA Ramp gutter, driveway (949) 461-3490 2023 sidewalk and ramp nmokarram@lakeforestca.gov City of Costa Mesa On Call Concrete Citywide concrete Cristina Oquendo $200K May 2025 77 Fair Drive Project repair curb, gutter, Project Manager Costa Mesa CA sidewalk, driveway and (714) 754-5015 ADA Ramps cristinaoquendo costamesaca qov Page 2 of 2 S&H CIVILWORKS COMPLETED PROJECT REFERENCES PAST (5) YEARS I Project Owner Project Scope of Work Contact Contract Completion I Amount Date j City of Santa Ana 25-7527 City Park Concrete curb, gutter, Michelle Cabana 20 Civic Center Plaza Santa Ana, CA ADA Sidewalk Improvement sidewalk and driveway Project Manager 9 714-882-0851 $290K January 2026 92701 Project (CDBG) MCabanas@santa-ana.org City of lake Forest Citywide Park Concrete Park Justin Kirik 100 Civic Center Dr, Concrete Trail Sidewalk Inspector $50K March 2026 Lake Forest, CA Repair Project 949-461-3416 92630 jkirk .lakeforestca.gov John Trujillo City of Loma Linda Construction of Demo, Concrete and Inspector/Superintendent $50K March 2026 26000 Barton Road, Bus Stop Project bus stop 909.253.8884 Loma Linda 92354 jtruiillo@lomalinda-ca.gov Cathedral City Cathedral Concrete curb, gutter, Shawn Maddox $80K June 2026 68385 Kieley Rd, Sidewalk sidewalk and driveway Inspector Cathedral City, CA Improvement (760) 641-8224 92234 Project smaddoxftcathedralcity.gov f City of Yorba Linda 6 Year On -Call Remove and Armando Jaime 4845 Casa Loma contract Project reconstruction of curb, Superintendent $2M On -going Ave. Yorba Linda, 2022-2028 gutter, driveway (714) 814-4687 CA 92886 sidewalk and ramp aL ine orbalindaca.gov Page 3 of 2