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11/10/86 :b c `
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
SHARP INSURANCE & BONDING
303 N. WEST STREET
P.O. BOX 1230 COMPANIES AFFORDING COVERAGE
VISALIA, CA 93291 COMPANY
TEL: (209) 7349246 LETTER A NORTHBROOK PROPERTY & CAS . INS . CO.
LETTER COMPANY B
INSURED REPUBLIC INDEMNITY COMPANY OF
BEAVER CONSTRUCTION COMPANY
P .O. BOX 1746 LETTER c
TULAR E, CA 93275 COMPANY
LETTER
COMP
sti I
LETTER
LE R
A.
V�4'
a. .»r.. -e .....,
THIS IS TO CERTIFY THAT 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
BEISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDI- e
TIONS OF SUCH POLICIES.
CO POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS
LTA TYPE OF INSURANCE POLICY NUMBER DATE(MWDD/YY) DATE(MM/DD/YY) EACH
' OCCURRENCE AGGREGATE
§ GENERAL LIABILITY
BODILY
X COMPREHENSIVE FORM INJURY $ $
X PREMISES/OPERATIONS PROPERTY
X EXPLOSIONU&DCOLLAPSE HAZARD DAMAGE $ $ s-
A X PRODUCTS/COMPLETED OPERATIONS GL 02 67 72 6 5/15/86 5/15/87 ~
y,
CONTRACTUAL COMBINED $1 ,000, $1 ,000,
X INDEPENDENT CONTRACTORS
X BROAD FORM PROPERTY DAMAGE
X PERSONAL INJURY PERSONAL INJURY $1 000 1
AUTOMOBILE LIABILITY BODILY
ANY AUTO INJURY(PER
(PER PERSON)
ALL OWNED AUTOS(PRIV. PASS.) BODILY
CA 02 67 83 2 5/15/86 5/15/87 i�RACMW $
X ALL OWNED AUTOS (PRIV. PASS.
X HIRED AUTOS PROPERTY
X NON-OWNED AUTOS DAMAGE $
GARAGE LIABILITY
BI&PD 1�y
COMBINED `" 000,1 _
EXCESS LIABILITY
ti X UMBRELLA FORM BI&PD 1 ,000 ,000,
COMBINED $ 1$1 A OTHER THAN UMBRELLA FORM �I -0 2 h 9 4 5/15/8 6 5/15/87
Ft.
� sr.4ruroRY �r
WORKERS' CO)APENJSAT;ON
�l 000 E r
B
AND I $1 000-SE,,, OL ICY L; 'Irl ;:
EMPLOYERS' LIABILITY PC 987 324 10/1/86 10/1/87
$1 000,``crSE EACH EMP OYES
OTHER ;
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS FOR ; CONSTRUCTION OF ASSESSMENT DISTRICT 4
SEWAGE COLLECTION FACILITIES AND APPURTENANT WORK It is hereby understood and
a re d tha the Ci y of AT SCA ERO, heir off ' ag n p o ee
m s and trona insure ungeer poiicles QLM� /;526, eCA 26 8 ' & �JEL�2H428 ,
y T n�re-spert to-,.t e,,a ue�men.�one 3o
•._�;� - �,.:� _ ,,.gal ., ....; �... ._; <..: ,t..; „e �=J•,,,:,
F;
CITY OF ATASCADERO SHOULD ANY OF THE ABOVEDESCRIBED POLICIES CANCELLED BEFORE THE EX
r: PIRA r DATE
THE OF, THE ISSUING CO PANY WILL ENDEAVOR TO
P.O. BOX 746 MAIL DAYS IRI
EN NOTICE TO THE CERT ! HOLDER NAMED TO THE
RTAS C AD ERO CA 9 3 4 2 3 LEFT,BUT FAILURE T IL SU OTICE S M N OBLIGATICN OR LIABILITY
OF ANY KIND UPON H COMP N „ IT EN7 R EPJESENES.
4
AUTHORIZED REPRES NT IV
ARP
.w.�.•;X d'4*S^ 'Sri'-' _°' �- .�- _..�: - a� .r"..
ADDENDUM NO. 1
CITY OF ATASCADERO
ASSESSMENT DISTRICT 4 SEWAGE COLLECTION FACILITIES
SEPTEMBER 1986
ITEM NO. 1
On Plan Sheet 37 titled "Lift Station - Mechanical Plan I,
Traffic Way" the wet well lid and slab detail titled "Top Slab
Plan & Section, detail C/M-1" has been changed to reflect an
octagonal wet well lid in place of a square wet well lid. A
replacement Plan Sheet 37 with the change has been provided with
this Addendum. The new wet well lid detail applies to each of
the three wet wells.
ITEM NO. 2
On Plan Sheet 37 titled "Lift Station - Mechanical Plan I ,
Traffic Way" the notes titled "Mechanical And Equipment Schedule,
ITEM FD-1" shall be changed to include "Aluminum Floor Door With
Stainless Steel Fittings, Key Wrench, Slam Lock" and "Bilco KD4
or approved equal." The capacity shall remain 5' - 0" x 5' - 0" .
A replacement Plan Sheet 37 with the change has been provided
with this Addendum. The new wet well floor door note applies to
each of the three wet wells.
ITEM NO. 3
On Page 14 of the Supplementary General Conditions under
paragraph 1 .12, "Insurance," subparagraph B, "Amount of Public
Liability And Property Damage Insurance, delete subparagraphs 1
and 2. The subparagraphs to be deleted are as follows.
1. Public liability insurance in an amount not less than
1,000,000 dollars for injuries, including accidental death,
for any one person, and subject to the same limit for each
person in an amount not less than 5,000,000 dollars on
account of any one accident.
2. Property damage insurance in an amount not less than
1,000,000 dollars.
In the place of the deleted subparagraphs 1 and 2 listed above
insert the following paragraph.
8 q0171
J
1 . Comprehensive general and auto liability insurance not less
than 1,000,000 dollars combined single limit per occurrence
coverage with a 2,000,000 dollar net aggregate. Net
aggregate shall be the amount remaining after deducting
actual claims and claims pending from suits not related to
this project.
ITEM 4
On Page 14 of the Supplementary General Conditions under
paragraph 1.12, "Insurance," subparagraph C, "Builders Risk
Insurance," delete the entire subparagraph C. Builders Risk
Insurance will not be required by the City of Atascadero for this
project.
ITEM 5
On page 9 of "the Supplementary General Conditions delete
paragraph F: "No street closures will be permitted, and adequate
provisions shall be made to provide for traffic on all roads and
streets during the entire construction period, as specified
herein."
Street closures will be allowed and the conditions related to
street closures are located elsewhere in the Specifications.
End Addendum No. 1
2
CALII'ORIC141A 311ELIMINARY 20-DAY NOTICE
(PUBLIC AND PRIVATE WORKI_
IN ACCORDANCE WITH SECTION 337 AND 30e OPIFORNIA CIVIL CODE
YOU ARE HEREBY NOTIFIED THAT. . .
,,
CONSTRUCTION LENDER or ... Hearn Trucking, Inc
(name and address of person or firm—sender)
Reputed Construction Lender, if any lr,, ,tawF 3416 Sequoia Ave.
San Luis Obispo, Ca. 93401
has furnished or will furnish labor,services,equipment or materials of
the following general description:
Labor Involving Trucking of Base
(general description of the labor,services,equipment or materials furnished or to be furnished)
Materials
for the building, structure or other work of improvement located at:
San Jaciento, Atascadero, Assessment
(address or description of job site sufficient for identification)
FOLD HERE District 4 Sewage Collection Facility
The name of the person or firm who contracted for the purchase of such
labor, services,equipment or materials:
Beaver Construction
NOTICE TO PROPERTY OWNER
If bills are not paid in full for the labor, services, equipment, or
materials furnished or to be furnished,a mechanic's lion leading to the
loss,through court foreclosure proceedings,of all or part of your prop-
Owner or PUBLIC AGENCY erty being so improved may be placed against the property even though
you have paid your contractor in full.You may wish to protect yourself
or Reputed Owner (on public work) against this consequence by(1)requiring your contractor to furnish a
(on private work) signed release by the person or firm giving you this notice before
making payment to your contractor or(2)any other method or device
which Is appropriate under the circumstances.
The person or firm giving this notice is required• pursuant to a collec-
tive bargaining agreement,to pay supplemental fringe benefits into an
City of Atascadero express trust fund(described in Civil Code§3111), said fund is iden-
P.O. Box 746 tified as follows: (strike if inapplicable)
Atascadero, Ca. 93423 (name)
Le. (address)
FOLD HERE
(name)
!addms)
Inarrr)
(addms)
ORIGINAL CONTRACTOR or
Reputed Contractor Mailed this date: March 9, 1987
ikmp Sec.
(signature) of)
Beaver Construction , An estimate of the total price of the tabor, services, equipment or
materials furnished or to be furnished is:
P.O. Box 1746 = 1 ,000.00
Tulare, Ca. 93274
L J
DECLARATION OF SERVICE OF CALIFORNIA PRELIMINARY 20-DAY NOTICE
In Accordance With §3097.1(c) and 3098, California Civil Code
Paula Hearn Cardoza declare:
On the 9 day of March 19 87 at 4:00 P mi., Declarant
served the CALIFORNIA PRELIMINARY 20-DAY NOTICE on the interested parties as follows: (Check applicable box.)
0 By placing a true copy thereof enclosed in a sealed envelope with first-class registered or certified postage prepaid in the United States
mail at San Luis Obispo, Ca. addressed as follows:
P.O. Box 1746 P.O. Box 746
Tulare, Ca. 93274 Atascadero, Ca. 93423
0 By delivering a true copy tnereof to the parties listed below:
0 By leaving a true copy thereof at the address or place of business with some person in charge,of the parties whose names and addresses
delivered are listed below: (not to be used on public works)
1 declare under penalty of perjury that the foregoing is true and correct. Executed on March 9 19 87 ,
at San T.iii s 0hi spin California %� L
Declarant
WOLCOTTS FORM 1510,We.7.8/a (price class 4-2P) ; 1981 WOLCOTTS,INC. (PLEASE NOTE REVERSE SIDE)
For your assistance the following complete text of Secti,n 3097,Section 3057.1 and Sectfon 3098 of the Ca Nornia Civil Code are hereafter quoted.Should
you have any doubt as to the usefulness of this form for your purposes you are urged to consult your own attorney.
§ 3097. Preliminary 20-day notice (private work). "Preliminary 20-day Where such notice is required to contain the information set forth in
notice (private work)" means a written notice from a claimant that is given paragraph(6)of subdivision(c),a failure to give such notice,Including such
prior to the recording of a mechanic's lien and orior to the filing of a stop information,that results In the filing of a lien or the delivery of a stop notice
notice, and is required to be given under the following circumstances: by the express trust fund to which such obligation is owing constitutes
(a) Written preliminary notice; parties. Except one under direct contract grounds for the disciplinary action by the Registrar of Contractors against the
with the owner or one performing actual labor for wages,or an express trust subcontractor it the amount due such trust fund is not paid.
fund described in Section 3111, every person who furnishes labor,service, (f) Construction lender; designation or permit application. Every city,
equipment,or material for which a lien otherwise can be claimed under this county, city and county, or other governmental authority Issuing building
title,or for which a notice to withhold can otherwise be given under this title, permits shall,in its application form for a building permit,provide space and
must,as a necessary prerequisite to the validity of any claim of lien,and of a a desfgna''son for the applicant to enter the name,branch,designation,if any,
notice to withhold,cause to be given to the owner or reputed owner,to the and address of the construction lender and shall keep the in
on file
original contractor,or reputed contractor,and to the construction lender,if open for public inspection during the regular business hours of the authority.
any,or to the reputed construction lender,if any,a written preliminary notice If there is no known construction lender,that fact shall be noted in such
as prescribed by this section. designated space. Any failure to indicate the name and address of the con-
(b) Construction lender. Except the contractor, or one performing actual struction lender on such application, however, shall not relieve any person
labor for wages,or an express trust fund described in Section 3111,all per- from the obligation to give to the construction lender the notice required by
sons who have a direct contract with the owner and who furnish labor,ser- this section.
vice,equipment,or material for which a lien otherwise can r claimed under ()) Designation of mortgage, deed of trust or other Instrument securing
this title,or for which a notice to withhold can otherwise be given under this loan. A mortgage,deed of trust,or other instrument securing a loan,any of
title,must,as a necessary prerequisite to the validity of any claim of lien,and the proceeds of which may be used for the purpose of constructing improve-
of a notice to withhold,cause to be given to the construction lender,it any,or ments on real property, shall bear the designation "Construction Trust
to the reputed construction lender, it any, a written preliminary notice as Deed" prominently on its face and shall state all of the following: (1)the
prescribed by this section. name and address of the lender,and the name and address of the owner of
(;)Time; � ntgnt;architect, enoineer or surveyor.The preliminary notice the real property described in the instrument, and (2)a legal description of
referred tom subdivisions(a)and (b)shall be given it,)!iai f 1r,a ._O day:, the P^I prooertv which secures the loan and,it known,the street address of
after the claimant has first furnished labor, service,equipment,or TO
the property.The failure to be so designated or-to slate airy of 1.1%e
to the jobsite, and shall contain the following information: required by this subdivision shall not affect the validity of any such mortgage,
(1)A general description of the labor,service,equipment,or materials fur- deed of trust, or other instrument.
nished,or to be furnished,and it there is a construction lender,he shall be fur- Failure to provide such information on such an instrument when recorded
nished with an estimate of the total price thereof in addition to the foregoing. shall not relieve persons required to give preliminary notice under this section
(2)The name and address of such person furnishing such labor, service, fromy.
The countyrecorderof the county in which such instrument is recorded
equipment, or materials.
(3)The name of the person who contracted for purchase of such labor,ser- of
sshall uch indicate in t sec g esea l i ndtructione official records of the county that
vice, equipment, or materials.
(4)A descriptton of the jobsite sufficient for identification. (k)Trust fund and lender;supplementary fringe benefits.Every contractor
(5)The following statement in boldface type: and subcontractor who is required pursuant to a collective-bargaining agree-
mentto pay supplementary fringe benefits into an express trust lurid described
NOTICE TO PROPERTY OWNER in Section 3111,and who has failed to do so shall cause to be given to such
fund and to the construction lender, if any, or to the reputed construction
If bills are not paid in full for the labor, services,equipment,or materials lender,if any,not later than the date such payment due to such fund became
furnished or to be furnished,a mechanic's lien leading to the loss,through delinquent, a written notice containing:
court foreclosure proceedings,of all or part of your property being so improved (1)The name of the owner and the contractor.
may be placed against the property even though you have paid your contrac- (2)A description of the jobsite sufficient for identification.
for in full.You may wish to protect yourself against this consequence by(1) (3)The identity and address of the express trust fund.
requiring your contractor to furnish a signed release by the person or firm (4)The total number of straight time and overtime hours on each such job,
giving you this notice before making payment to your contractor or(2)any payment for which the contractor or subcontractor is delinquent to the
other method or device which is appropriate under the circumstances. express trust.
(6)It such notice is given by a subcontractor who is required pursuant to a (5)The amount then past due and owing.
collective-bargaining agreement to pay supplemental fringe benefits into an Failure to give such notice shall constitute grounds for disciplinary action
express trust fund described in Section 3111,such notice shall also contain by the
eRegistrar of and address of owner;information to person seeking to
the identity and address of such trust fund or funds. ()
If an invoice for such materials contains the information required by this serve notice. Every written contract entered into between a property owner
section,a copy of such invoice,transmitted in the manner prescribed by this and an original contractor shall provide space for the owner to enter his name
section shall be sufficient notice. and address of residence;and place of business if any.The original contrac-
A certificated architect,registered engineer,or licensed land surveyor who for shall make available the name and address of residence of the owner to
has furnished services for the design of the work of improvement and who any person seeking to serve notice required by this section.
gives a preliminary notice as provided in inis section nut inter than 20 iiap §3097.1 Proof of service of preliminary 20-day notice,proof of serv:"
after the work of improvement has commenced shall be deemed to have com-
plied with subdivisions(a)and(b)with respect to architectural,engineering, 3097 was served in accordance with subdivision(f)of Section 3097 shall be
or surveying services furnished, or to be furnished.
(d)Election not to give preliminary notice;subsequent rights. If labor,ser made as follows:
vice, equipment, or materials have been furnished to a jobsite by a person (a)If served by mail,by the proof of service affidavit described in subdivi-
who elected not to give a preliminary notice as provided in subdivision(a)or sion(c)of this section accompanied either by the return receipt of certified or
(b),such person shall not be precluded from giving a preliminary notice not registered mail,or by a photocopy of the record of delivery and receipt main-
later than 20 days after furnishing other labor, service, equipment, or tained by the post office,showing the date of delivery and to whom delivered,
materials to the same jobsite. Such person shall, however, be entitled to or, in the event of nondelivery, by the returned envelope itself.
claim a lien and a notice to withhold only for such labor,service,equipment, (b)If served by personally delivering the notice to the person to be notified,
or material furnished within 20 days prior to the service of such notice,and at or by leaving it at his address or place of business with some person in
any time thereafter. charge, by the proof of service affidavit described in subdivision (c).
(a)Waiver.Any agreement made or entered into by an owner,whereby the (c)A 'proof of service affidavit'' is an affidavit of the person making the
owner agrees to waive the rights or privileges conferred upon him by this service, showing the time, place and manner of service and facts showing
section shall be void and of no effect. that such service was made in accordance with Section 3097.Such affidavit
(f) Service. The notice required under this section may be served as shall show the name and address of the person upon whom a copy of the pre-
follows: liminary 20-day notice was served,and,if appropriate,the title or capacity in
(1)If the person to be notified resides in this state,by delivering the notice which he was served. I ,
personally, or by leaving it at his address of residence or place of business §3098. Preliminary 20-day notice(public work),stop notice;service;dis-
with some person in charge, or by first-class registered or certified mail, ciplinary action; exemption for express trust fund. ''Preliminary 20-day
postage prepaid,addressed to the person to whom notice is to be given at his notice (public work), stop notice" means a written notice from a claimant
residence or place of business address or at the address shown by the that was given prior to the filing of a stop notice on public work, and is
building permit on file with the authority issuing a building permit for the required to be given under the following circumstances:
work, or at an address recorded pursuant to subdivision (j)of this section. (a)In any case in which the law of this state affords a right to a person fur-
(2)If_the person to be notified does not reside in this state,by any method nishing labor or materials for a public work who has not been paid therefor to
enumerated in paragraph(1)of this subdivision:-If such person cannot be file a stop notice with the public agency concerned, and thereby cause the
served by any of such methods,then notice may be given by first-class cer- withholding of payment from the contractor for the public work,any such
tified or registered mail, addressed to the construction lender or to the person having no direct contractual relationship with the contractor, other
original contractor. than a person who performed actual labor for wages or an express trust fund
described in Section 3111, may file such a notice, but no payment shall be
(T,Whr?n servii'P is made by first-Class c.prtillPfl nr rpoiiztP,red mail.CP..'vlrP, withheld from env such crintractnr,-ritirspant in Priv siirh nnt+raiinrocc curh
is complete at the time of the deposit of such registered or certified mail. person has caused written notice to be given to such contractor, and the
(g) Single notice; additional material, service,labor or equipment. A per- public agency concerned, not later than 20 days after the claimant has first
son required by this section to give notice to the owner and to an original con- furnished labor,services,equipment,or materials to the jobsite,stating with
;Tactor,and to a person to whom a nntir.P to withhold may be given,need give substantial accuracy a general description of labor, service, equipment, or
My one surn nonce to owner,and to the original contractor and to the per- materials turnished or to be furnished,and the name of the party to whom the
son to whom a notice to withhold may be given with respect to all materials, same was furnished. Such notice shall be served by mailing the same by
service, labor,or equipment he furnishes for a work of improvement,which first-class maii, registered mail, or certified mail, postage prepaid, in an
means the entire structure or scheme of improvements as a whole,unless the envelope addressed to the contractor at any place he maintains an office or
same is furnished under contracts with more than one subcontractor, in conducts his business, or his residence, or by personal service. In case of
which event,the notice requirements must be met with respect to materials, any public works constructed by the Department of Public Works or the
services, labor, or equipment furnished to each such contractor. Department of General Services of the state, such notice shall be served by
If a notice contains a general description required by subdivision(a)or(b) mailing in the same manner as above,addressed to the office of the disburs-
of the materials,services,labor,or equipment furnished to the date of notice, ing officer of the department constructing the work, or by personal service
it is not defective because, after such date, the person giving notice fur- upon such officer. When service Is by registered or certified mail,service is
nishes materials,services,labor-,or equipment not within the scope of such complete at the time of the deposit of the registered or certified mail.
general description. (b)Where the contract price to be paid to any subcontractor on a particular
(h)Disciplinary action against contractors and subcontractors. Where the work of improvement exceeds four hundred dollars($400),the failure of that
contract price to be paid to any subcontractor on a particular work of contractor, licensed under Chapter 9 (commencing with Section 7000) of
improvement exceeds four hundred dollars($400),the failure of that contrac- Division 3 of the Business and Professions Code,to give the notice provided
tor, licensed under Chapter 9(commencing with Section 7000)of Division 3 for in this section,constitutes grounds for disciplinary action by,the Registrar
of the Business and Professions Code,to give the notice provided for in this of Contractors.
section, constitutes grounds for disciplinary action by the Registrar of (c) The notice requirements of this section shall not apply to an express
Contractors. trust fund described in Section 3111.
NOTICE OF AWARD
Dated October 30, 19 .86
TO: Beaver Construction
(BIDDER)
ADDRESS: P.O. Box 1746
Tulare, CA 93275
OWNER'S PROJECT NO. N/A
PROJECT _Assessment District 4 Sewage Collection Facilities
OWNER'S CONTRACT NO.
CONTRACT FOR Construction of Assessment District 4 Sewage
Collection Facilities
(Insert name of Contract as it appears in the Bidding Documents)
You are notified that your Bid dated October 15 , 198 6 for the above
Contract has been considered. You are the apparent successful bidder and have been
awarded a contract for Alternate Bid Schecule I
(Indicate total Work.alternates or sections of Work awarded)
The Contract Price of your contract is Nine Hundred Fifty-Seven Thousand Three
Hundred Fifty dollars and 36 cents Dollars ($ 957, 350 . 36 )
Three copies of each of the proposed Contract Documents (except Drawings) accom-
pany this Notice of Award. Three sets of the Drawings will be delivered separately or
otherwise made available to you immediately.
You must comply with the following conditions precedent within fifteen days of the
date of this Notice of Award, that is by November 14 , 198_6._.
1. You must deliver to the OWNER three fully executed counterparts of the Agreement
including all the Contract Documents. This includes the triplicate sets of Drawings.
Each of the Contract Documents must bear your signature on (the cover) (every)
page.
2. You must deliver with the executed Agreement the Contract Security (Bonds) as
specified in the Instructions to Bidders (paragraph 17), General Conditions (para-
graph 5.1) and Supplementary Conditions (paragraph SC-S.1).
a
EJCDC No. 1910-22(1983 Edition)
Prepared by the Engineers'Joint Contract Documents Committee and endorsed by The Associated General Contractors of America.
E-1
3. (List other conditions precedent).
The sentence, "Within ten days after you comply with those conditions,
OWNER will return to you one fully signed counterpart of the Agree—
ment with the Contract Documents attached." shall be deleted. In its
place shall be substituted as follows, "The City Manager may execute
the Agreement included in the contract documents only following receipt
ot the proceeds Irom the sale ot bonds to be au orize y e City
Council.
Failure to comply with these conditions within the time specified will entitle OWNER to
consider your bid abandoned, to annul this Notice of Award and to declare your Bid
Security forfeited.
Within ten days after you comply with those conditions, OWNER will return to you
one fully signed counterpart of the Agreement with the Contract Documents attached.
City of Atascadero
(OWNER)
B �L� ��.J
y
(AUTHORIZED SIGNA rURE)
Director Public Works
(TITLE)
Copy to ENGINEER
(Use Certified Mail,
Return Receipt Requested)
E-2
Article 5 - It is expressly agreed by and between the parties hereto that
the Contract Documents shall consist of the Notice Inviting Bids, Instructions
to Bidders , Contract Proposal and Bid Sheets, Contractor's Licensing Statement,
List of Subcontractors, Bid Bond, Agreement, Performance Bond, Payment Bond,
Worker's Compensation Certificate, Non-Collusion Affidavit, Notice of Award,
Notice to Proceed, Change Order Form, Work Directive Change Form, Standard
General Conditions of the Construction Contract, Supplementary General
Conditions, Technical Specifications (including referenced portions of Standard
Specifications) , Contract Drawings (Plans) , and all Change Orders and Work
Directive Changes authorizing additions, deletions, or modifications, and all
appendices and addenda as prepared prior to the date of opening bids setting
forth any modifications or corrections or interpretations of any of said
documents. In the event of any conflict between the provisions thereof, the
terms of said documents shall control over each other in the following order:
1. Agreement
2. Change Orders and Work Directive Changes
3. Addenda
4. Supplementary General Conditions
5. Notice Inviting Bids
6. Instructions to Bidders
7. Contract Proposal
8. Standard General Conditions of the Construction Contract
9. Technical Specifications
10. Contract Drawings (Plans)
Soils reports and logs of borings are NOT a part of the Contract Documents.
Article 6 - Contractor agrees to commence work pursuant to this Contract
within 10 calendar days from the date specified in the Notice to Proceed, and to
diligently prosecute the same to completion within 270 calendar days from the
date of commencement as specified in the Notice to Proceed.
IN WITNESS WHEREOF, the parties to these present hereunto set their hands on
the date first above written.
CITY OF ATASCADERO
ATTEST: BY - 62A�' 1
Mayor
City Clerk Beaver Construction
Contractor
BY
Approved as to form:
Henry M. Beaver
City Attorney (Typed or Printed Signature)
Owner
Title
LFM 86062-091086 AGREEMENT
JS2-1.35S PAGE C-2
AGREEMENT
FOR CONSTRUCTION OF ASSESSMENT DISTRICT 4
SEWAGE COLLECTION FACILITIES AND APPURTENANT WORK
This agreement, made and entered into this / 8o— day of �eem Istr 1986,
at Atascadero, California, by and between the City of Atascadero, hereinafter
referred to as the "City," and 824V&r C01AS-"r14.t '{7'P-V) hereinafter
referred to as the "Contractor," in accordance with and by virtue of the
provisions of the "Municipal Improvement Act of 1913" (Division 12 of the
Streets and Highways Code of the State of California) and of all Acts
supplementary thereto, incorporated by reference therein, or amendatory thereof.
WHEREAS, the Contractor, as will appear by reference to the records of the
Proceedings of the City, was duly awarded the contract for the Work hereinafter
mentioned.
NOW, THEREFORE, IT IS HEREBY AGREED THAT:
Article i - All applicable provisions of the "Municipal Improvement Act of
1913" and of all acts supplementary thereto, incorporated by reference therein,
or amendatory thereof , are incorporated herein by this reference thereto
and made a part hereof.
Article 2 - Witnesseth, that for and in consideration of the payment and
agreements hereinafter mentioned, to be made and performed by said City, and
under the conditions expressed in the two bonds, bearing even date with these
present, and hereunto annexed, said Contractor agrees with said City, at its own
cost and expense, to do all the work and furnish all materials, except such as
are mentioned in the Contract Documents to be furnished by the City, necessary
to construct and complete in good, workmanlike and substantial manner the
above-described work in accordance with the Contract Documents as listed herein
and are by such reference made a part hereof.
Article 3 - The said City hereby promises and agrees with the said
Contractor to employ, and does hereby employ, the said Contractor to provide the
materials and to do the work according to the terms and conditions herein
contained and referred to, for the price aforesaid, and hereby contracts to pay
the same at the time, in the manner, and upon the conditions above set forth;
and the said parties for themselves, their heirs, executors, and administrators.
Article 4 - The said Contractor agrees to receive and accept the price
stated in the following Bid Sheet as full compensation for furnishing all
materials and for doing all the work contemplated and embraced in this
Agreement; also for all loss or damage arising out of the nature of the work
aforesaid, or from the action of the elements, or from any unforeseen
difficulties or obstructions which may arise or be encountered in the
prosecution of the work until its acceptance by the said City and for all
expenses incurred by or in consequence of the suspension or discontinuance of
the Work; and for well and faithfully completing the Work, and the whole thereof
in the manner and according to the requirements of the Contract Documents
therefor, and the requirements of the Engineer under their terms , to wit :
LFM 86062-091086 AGREEMENT
JS2-1.355 PAGE C-1
WORKER'S COMPENSATION INSURANCE CERTIFICATE
Prior to execution of the Contract Agreement, the Contractor shall execute the
following form as required by Sections 1860 and 1861 of the California Labor
Code:
I am aware of the provisions of Section 3700 of the Labor
Code which require every employer to be insured against
liability for Worker's Compensation or to undertake
self-insurance in accordance with the provisions of said
Code , and I will comply with such provisions before
commencing the performance of the work of this Contract.
Date November 14, 1986 Beaver Construction
Contractor
By; ;)�� /'? .
S nature Henry M. Beaver
Owner
Title
Attest:
By:
Signature
Title
LFM 86062-091086 WORKER'S COMPENSATION CERTIFICATE
JS2-1.29 PAGE C-6
c
C'
ttt
t
State of California
d
ss.
'County of Los Angeles
e Z
e 1
henry F. wright personally known to me, was by me duly sworn, and did depose and say: that
Vicc Pr.esidcnt of
helshe resides in the State of California; that helshe is the duly elected
i
FAIIZNtONT INSURANCE COMPANY, the corporation described in and which executed the above instru- _
mens: that helshe knows the seal of said corporation; that the seal affixed to said instrument is such cor- !
porate seal; that it was so affixed by authority of his/her office under the Bylaws of said corporation, and
'name thereto by like authority.
that helshe signed his/her
Subscribed and sworn to me this 22nd day of
March 1985
OFFICIAI. SLAL
HARRIET LAMBELL Notary Public in and
�yt� NOTARY ➢IWLIC —CALIFORNIA PAL OFFICE. IN for said County nd State. .
➢RINci
LCS ANGELES COUNTY
My Cummission Expires Apr.21, 1988
• 3
CERTIFICATION
I,
Assistant secretary of FAIRMONT
Trude A Tsujimoto the
ted Sections 13.
INSURANCE COMPANY, certify that the foregoing power of attorney and the above quo
and 14. of Article IV of the Bylaws have not been abridged or revoked and are now in full force and effect.
5igned and Sealed at Burbank, California, this 14th day of NOVEMBER 19 86
'��IIwFFµy�4
ATie: sistant tarY
APR. 10 zv=
Y
6: X970 ;� ;
r
"4ti CALIF. .
I�AIRNION'I' INSURANCEC(UMI�ANY
Ilurbank, California
POVVLH OF A71'ORNLY
i
.%I,I, NII:N 111' 1,I11:SE 1>I1171SENI'S: 4
r
That FAIRMONT INSURANCE COMPANY, a California Corporation, docs hereby make, constitute and
appoint Donald P. Sharp,, Bonnie J. Conroy, Linda L. Bram
r
Of: Visalia, California
as its true la++•rul Attorney(s)-in-Fact,with full powcr:uul authority,for and on bchalrorthe Company as surety,to execute
and deliver and al'(ix the seal of the Company Ilie reto,ifa seal is required,bonds,undertakings,rccognizances,consents of
suety or other written obligations in the nature thcrof, as follows:
Any and all bonds, undertakings, recognizances, consents of surety or other written obligations in the nature
thereof,
and to bind FAIRMONT INSURANCE COMPANY thereby, and all of ti-te acts of said Attorney(s)-in-Fact,
pursuant to these presents, are hereby ratified and confirmed.
This appointment is made under and by authority of the following Bylaws of the Company, which Bylaws
are now in full force and effect:
ARTICLE IV. Section 13. ATPORNEYS-IN-FACT AND AGENTS. The chairman of the board, the president, the vice
president,the chief fin.inii,il ofGier,ser the sei n t.vy of thi•icirpirr.rtiun may appoint attornevs-in-fact or agents with power
and authority. as defined or limited in their respective powers of attorney,for and un behalf of the corporation to execute
and deliver, and affix the seal of the Corporation thereto, bonds• undertaking-.,, ncognizances, consents of surety or
other written obligations in the nature thereof and anv of said oficers may remove any such attorney-in-fact or agent
and revoke the power and authority given to him or her.
ARTICLE IV, Section la. ALITI IORITY TO f11Nn. Any bund, undertaking, r•cognirance, consent of surety or written '
obligation in the nature Illcri•of sh,ili bc'vilid nfid hindiII a on the corporation when signed by the chairman of the
board, the president, the vire president, the chief financial of�icer, or the secretary of the corporation and duly attested
and scaled, if a seal is retluired,by the secretary ser assistant secretary,or shall be valid and binding upon the corporation .
when duly executed and sealed, if a seal is required, by a duly authorized attorney-in-fact or agent, pursuant to and
within the limits of the authority granted by his or her power of attorney.
This power of attorney is signed and sealed by facsimile under and by the authority of the following Resolu-
tion adopted by the Board of Directors of FAIRMONT INSURANCE COMPANY at a meeting duly called
and held on the Ord day of October, 1983:
RESOLVED that the signature of any officer authorized by the Bylaws, and the seal of the corporation, may be affixed
by facsimile to any power of attorney or special power of attorney or certification of either given for the execution of
anv bond, undertakeng. recognizance consent of surety or other written obligation in the nature thereof; such signature
and seal, when soused, 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, FAIRMONT INSURANCE COMPANY has caused these presents to be signed
by its proper officer and its corporate seal to be hereunto affixed this 22na day of March of 1985
++r1�l/Nf//14j
"I \SSV R�l,y��;-,,,
•..,• FAIRMONT INSURANCE COMPANY
,` : •%oaf !`
� � l �APR. 10�•' By
:•' 1970Lj
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•',�� 2:1, +' Si�ort flf:llY% l' 1' Y.l�Jllt , V1Presiden
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"off l oltllrr,`
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"EXECUTED IN TRIPLICATE (3) COPIES"
; ORIGINAL BONDNO . FB 010389
a, IPREMIUM: INCLUDED
PAYMNT BOND
For Labor and Materials
KNOW ALL KEN BY THESE PRESENTS,
THAT WE, BEAVER CONSTRUCTION as Principal, and
FAIRMONT INSURANCE COMPANY as Surety, are
firmly bound unto the City of Atascadero, 3J�bum of NINE HUNDRED FIFTY
SEVEN THOUSAND, THREE HUNDRED FIFTY ollars ($ 957 , 350. 36 ) ,
said sum being 100 percent of the estimated amount payable by the City of
Atascadero under the terms of the following described Contract, for which
payment well and truly to be made, we bind ourselves, our heirs, executors and
administrators, successors or assigns, jointly and severally, firmly by these
presents.
THE CONDITION OF THIS OBLIGATION IS SUCH,
z
THAT WHEREAS, the City Council of Atascadero, State of California, by format
action on the 27th day of October 1986, awarded to said
Principal a contract for the
CONSTRUCTION OF ASSESSMENT DISTRICT 4
SEWAGE COLLECTION FACILITIES AND APPURTENANT WORK !
in strict conformity with the Contract Documents, and whereas said Principal is
required under the terms of said Contract to furnish a bond for the payment of
labor and materials of said Contract;
NOW THEREFORE, if the Principal, his/hers or its heirs, executors,
administrators, successors, or assigns, shall fail to pay for any materials,
provisions, provender, or other supplies or equipment used in, upon, for, or
about the performance of the Work contracted to be done, or for any work or
labor thereon of any kind, as required by the provisions of an act of the
legislature of the State of California, entitled: "An Act to secure the payment
of persons employed by the Contractors upon Public Works , and the claims of
persons who furnish materials , supplies, teams , implements or machinery used or
consumed by such Contractors in the performance of such works, and prescribing
the duties of certain public officers with respect thereto," approved May 10,
1919, as amended, and provided that the persons, companies, or corporations so
furnishing said materials, provisions, provender or other supplies, equipment,
appliances or power used in, upon, for, or about the performance of the work
contracted to be executed or performed, or any person) company, or corporation
renting or hiring implements or machinery or power for or contributing to said
work to be done, or any person who performs work or labor upon the same, or any
person who supplies both work and materials therefor, shall have complied with
the provisions of said Act, then Surety will pay the same in or to an amount not
exceeding the amount hereinabove set forth, and also will pay in case suit is
brought upon this Bond such reasonable attorney's fees as shall be fined by the
Court, awarded and taxed as in the above-mentioned Statute provided.
LFM 86062-091086 PAYMENT BOND
JS2-1.38 PAGE C-4
This Bond shall inure to the benefit of any and all persons, companies, and
corporations entitled to file claims under said Act, so as to give a right of
action to them or their assigns in any suit brought upon this Bond.
And the said Surety, for value received, hereby stipulates and agrees that no
change, extension of time, alterations or additions to the terms of the Contract
or to the Work to be performed thereunder shall in any wise affect its
obligations of this Bond, and it does hereby waive notice of any such change,
extension of time, alteration or addition to the terms of the Contract or to the
Work.
IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and
Surety above-named on the 14th day of NOVEMBER 1986.
BEAVER CONSTRUCTION (Seal)
(Seal)
_(Seal)
Principal
FAIRMONT INSURANCE COMPANj5�Seal)
Surety
s
1540 RIVER PARK DR. , STE. 201 ,
AT 0 1EY-IN-FACT Address
DONALD P. SHARP SACRAMENTO, CA 95815
NOTE: Signature of person exeuting for the Surety must be properly acknowledged .
LFM 86062-091086 PAYMENT BOND
JS2-1.38 PAGE C-5
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State of California
ss.
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County of Los Angeles
t
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Henry F. Wright , personally known to me, was by me duly sworn, and did depose and say: that
he/she resides in the State of California; that he/she is the duly elected Vice President of ;
FAIIZNIONT INSURANCE COMPANY, the corporation described in and which executed the above instru-
ment; that he/she knows the seal of said corporation; ,
ration• that the seal affixed to said instrument is such cor-
porate seal; that it was so affixed by authority of his/her office under the Bylaws of said corporation, and
that he/she signed his/her name thereto by like authority.
Subscribed and sworn to me this 22nd day of
March ' 1985
OFFICIAL S:AI
HARRIET LAMSELL Notary Public in and
NOTARY PVCUC—CAItFOttNIA
f� v� rRINCIPAI OFrICF IN for said County and State. -
' LCS ANGELES COUNTY
My currlmission Expires Apr.27,1988
CERTIFICATION
Trude A Tsujimoto the Assistant Secretary of FAIRMONT
I, .
INSURANCE COMPANY, certify that the foregoing power of attorney and the above quoted Sections 13.
and 14. of Article IV of the Bylaws have not been abridged or revoked and arc now in full force and effect.
Signed and Sealed at Burbank, California, this 14th day of NOVEMBER • 19 86
`�,.rfrwrreyr4
Ti e: Assistant tarY
.•
f { &PR. 10 T �
�" 19 .0 f. x
CA' IF
FAIRNICIN'I' INSURANCECOMI3ANY
1
Burbank, California
POJVLI1 OF A'I"I'ORNEY
}�\U«' ,iLI, 111:N 131' '1'lii•:SF P[tIiSENTS: ¢
That FAIRMONT INSURANCE COMPANY, a California Corporation, docs hereby make, constitute and
appoint Donald P. Sharp-, Bonnie J. Conroy, Linda L. Bram
Of: Visalia, California
-is its true lawful Attorney(s)-in-Fact, with full powrrantl authority,forand on behalrol•the Company as surety,to execute
IfIX the til';d of the Company thereto,iI'❑seal is required,bonds,unclertakings,rccognizanccs,consents of
and deliver and a
surety or other written obligations in the nature thcrof', as follows:
Any and all bonds, undertakings, recognizances, consents of surety or other written obligations in the nature
thereof,
and to bind FAIRMONT INSURANCE COMPANY thereby, and all of the acts of said Attorney(s)-in-Fact,
pursuant to these presents, are hereby ratified and confirmed.
This appointment is made under and by authority of the following Bylaws of the Company, which Bylaws
are now in full force and effect:
ARTICLE IV, Section 13. ATi'ORNI:YS•iN-FACT AND AGENTS. The chairman of the board, the president, the vice
president, the chief fio.ir%651 officer,or the s6t retary of thi•corporation may appoint attornevs-in-fact or agents with power
and authority, as defined or limited in their respective powers of attorney,for and on behalf of the corporation to execute
and deliver, and affix the seal of the Corporation thereto, bunds, undertakings, recognisances, consents of surety or
other written obligations in the nature thereof and any of said oficers may remove any such attorney-in-fact or agent
and revoke the power and authority given to him or her.
ARTICLE iV. Section 14. AUTi IORITY TO f11Nn. Any bond, undertaking, recognizance, consent of surety or written '
obligation in tK- nature llic'riof shill be vilid irid hindT: u((++on the corporation when signed by the chairman of the
board, the president• the vice president, the chief financia�ofi'rcer, or the secretary of the corporation and duly attested
and sealed, if a seal is reyired•by the secretary or assistant secretary,or shall be valid and binding upon the corporation .
when duly executed anti scaled, if a seal is required, by a duly authori ed auorncy-inor agent, pursuant to and
within the limits of the authority granted by his or her power of attorney.
This power of attorney is signed and scaled by facsimile under and by the authority of the following Resolu-
tion adopted by the Board of Directors of FAIRMONT INSURANCE COMPANY at a meeting duly Called
and held on the lyd day of October, 1983:
RESOLVED that the signature of any officer authorized by the Bylaws, and the seal of the corporation, may be affixed
by facsimile to any power of attorney or special power of attorney or certification of either given for the execution of
anv bond• undertakinf•, recognizance consent of surety or other written obligation in the nature thereof; such signature
and seal, when so used,being hereby adopted by the corporation as the oril•inal signature of such officer and the original
seal of the corporation, to be valid and binding upon the corporation with tju same force and effect as though manually
affixed.
iN WiTNESS WHEREOF, FAIRMONT INSURANCE COMPANY has caused these presents to be signed
by its proper officer and its corporate seal to be hereunto affixed this 22na day of march of 1985
� ,. •..,, F %�� FAIRMON't INSURANCE COMPANY
13
APR. 10 :a y
I 9910 r�; / l �r
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CALIF
�• ..,..�.,,
I!',A
"EXECUTED IN TRIPLICATE (3) COPIES"
ORIGINAL 4W BOND NO.FB 010389
PREMIUM: $11 ,179 .00
i
I
PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS,
That we, BEAVER CONSTRUCTION as Principal, are firmly
bound unto the City of Atascadero in the sum of $957 ,350 . 36
NINE HUNDRED FIFTY SEVEN THOUSAND, THREE HUNDRED FIFTY AND 36/100
said sum being 100 percent of the amount of the following described contract, to
be paid to the said City, its successors and assigns; for which payment, well
and truly to be made, we bind ourselves , our heirs, executors and
administrators, successors or assigns, jointly and severally, firmly by these
presents .
THE CONDITION OF THIS OBLIGATION IS SUCH,
THAT WHEREAS, the City Council of the City of Atascadero, State of California,
by formal action on the 27th day of October 1986, awarded to
said Principal, a contract for the
CONSTRUCTION OF ASSESSMENT DISTRICT 4
SEWAGE COLLECTION FACILITIES AND APPURTENANT WORK
in strict conformity with the Contract Documents, and whereas, said Principal,
his or her heirs, executors , administrators, successors or assigns shall in all
things stand to and abide by, and well and truly keep and perform the covenants,
conditions, and agreements in the said Contract, and any alteration thereof made
and therein provided, on his/her or their part, to be kept and performed at the
time and in the manner therein specified and in all respects according to their
true intent and meaning, and shall indemnify and save harmless the City of
Atascadero, its officers and agents, as therein stipulated, then this obligation
shall become null and void; otherwise it shall remain in full force and effect.
And the Surety, for value received, hereby stipulates and agrees that no change,
extension of time, alteration or addition to the terms of the Contract or to the
work to be performed thereunder shall in any way affect its obligations on this
bond , and it does hereby waive notice of any change , extension of time,
alteration, or addition in terms of the Contract or to the Work.
IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and
Surety above named, on the 14th day of NOVEMBER , 1986.
BEAVER CONSTRUCTION (Seal)
' (Seal)
(Seal)
Principal
FAIRMONT INSURANCE COMPANYSeal)
Surety
1540 RIVER PARK DR. , STE. 201 ,
A -IN-F CT Addresss 95815
DONALD P. SHARP SACRAMENTO, CA
+ NOTE: Signature of perso executin3 for the Surety must be properly acknowledged
LFM 86062-091086 PERFORMANCE BOND
JS2-1.37 PAGE C-3
MEETING G A
DATE (J 8 11EM
MEMORANDUM
TO: City Council
THROUGH: Mike Shelton , City Manager
FROM: Paul Sensibaugh, Director of Public Works
SUBJECT : Notice of Completion - AD #4
DATE: November 4 , 1987
Recommendation :
Staff recommends that Council accept the attached
Notice of Completion for Sanitary Sewer Assessment District
##4 (Seperado-Cayucos) .
Background:
As of October 22 , 1987 the project is deemed
substantially complete and available for connection . Some
residents of this area have abandoned their on-site systems
and connected to the new lines .
While we do not anticipate problems with the
improvements , the area was video taped prior to the start of
construction to record existing conditions . In addition ,
the work is under warranty for a period of one year from
substantial completion .
Fiscal Impact :
The acceptance of the Notice of Completion starts the
one year warranty period after which the system will be the
maintenance responsibility of the Sanitation District .
NOTICE OF CONTRACT
Commencement/Completion
Date: November 4, 1987
TO: City Manager
FROM: Public Works Department
1. Contract No. dated
for Sanitary Sewer Assessment District #4
-2. Contractor Beaver Construction
P.O. Box 2593
Visalia, CA 93279
3. Work to commence by
Commenced work on January 5, 1987
Contract completed on October 22, 1987 Total days 289
Contract days allowed 267 extensions 22 days Total 289
4. Remarks
Signedr J
cc: Contractor
Finance
JOHN L. WALLACE & ASSOCIATES
CONSULTING CIVIL ENGINEERS
November 4, 1987
Paul Sensibaugh
City of Atascadero
P.O. Box 747
Atascadero, CA 93423
Subject: Assessment District 4 - Substantial Completion
Dear Mr. Sensibaugh:
The Specifications for the Construction of Assessment District 4
Sewage Collection Facilities, Section 11 , "Project Closeout,"
Section 1 .04 "Completion of the Work,`• includes the following.
A. "Completion of the Work", as the term is used in this
Contract, shall mean substantial completion of the Work.
Substantial completion shall exist where there has been no
willful departure from the terms of the Contract, no
omission in essential points, and where the Contract has
been honestly and faithfully performed in its material and
substantial particulars, and the only variance consists of
technical or relatively unimportant omissions or defects,
and the Work can be used or occupied for the purpose for
which it was intended.
B. The date of substantial completion of the Project shall
be the date when the construction is sufficiently completed,
in accordance with the Contract Documents, as modified by
any change orders agreed to by the parties, so that the City
can occupy or utilize the project for the use for which it
was intended and the legislative body of the City has
accepted the Project as evidenced by ex4cution and recording
of a Notice of Completion or Substantial Completion.
We have inspected the Contractor's work and have verified that
the facilities installed under this contract are suitable and
available for the intended use. We recommend that the date of
substantial completion be October 22, 1987.
(Sincerely
Gar R. Sims
1458 HIGUERA STREET•SAN LUIS OBISPO, CALIFORNIA 93401 - (805) 544-4011
r
1 '
NON-COLLUSION AFFIDAVIT
TO BE EXECUTED BY EACH AWAROEE OF A PRINCIPAL CONTRACT
STATE OF CALIFORNIA)
1 Ss
0 �� � , `��� ✓ , being first duly
sworn,deposes and says that he is sb\
4' (sole owner,a partner,president,secretary etc.,)
of &JI
we the party making the foregoing bid;that such bid is not made in the interest of or on behalf of any undisclosed person,
partnership, company association, organization, or corporation; that such bid is genuine and not collusive or sham; that
said 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,nor that
anyone shall refrain from bidding; that said bidder has not in any manner, directly or indirectly,sought by agreement,
"Vice communication, or conference with anyone to fix the bid price of said bidder or of any other bidder,nor to rix any
overhead, profit, or cost element of such bid price,nor of that of any other bidder,nor to secure any advantage against the
public body awarding the contract or anyone interested In the proposed contract;that ail statements contained in such bid
are true; and,further,that said bidder has not directly or indirectly,submitted his bid price or any breakdown thereof,nor
the contents thereof, nor divulged Information or data relative thereto, nor paid and will not pay fee in connection
40 therewith to any corporation,partnership,company,association,organization,bid depository,nor to any member or agent
thereof, nor to any other individual except to such person or persons as have a partnership or other financial interest with
said bidder in his general business.
Signed:
Title
Subscribed and sworn to before me
this ll a y of)W_ Oatl, I9t� *My
LILA W. CARPENTER
—'
NOTARY PUBLIC
S a of Notary TULARE COUNTY,CALIFORNIA
-L1 Commission Expires Nov.5,19M
OWNNotary Public
'+9et1
NON-COLLUSION AFFIDAVIT
Form n e,e,C 7.73 PAGE D-I
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