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2007-027 Brinar Construction
AGREEMENT For The Construction of the SIDEWALK BARRIER REMOVAL PROJECT CITY BID NO. 2007-007 This agreement is made and entered into this )-3 day of a`hvber 2007, at Atascadero, California, by and between the City of Atascadero, hereinafter referred to as"City", and BRINAR CONSTRUCTION hereinafter referred to as "Contractor". 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 1 -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 thereof. Article 2 -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 3 -The said Contractor agrees to receive and accept the price stated in the 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 therefore, and the requirements of the Engineer under their terms, to wit: Article 4- It is expressly agreed by and between the parties hereto that the Contract Documents shall consist of the Notice to Bidders, Proposal, Bid Sheet(s), Contractor's/Subcontractors Certification Concerning State Labor Standards and Prevailing Wages, Contractor's Licensing Statement, List of Subcontractors, Conflict of Interest Statement, Certification of Affirmative Action Program, Equal Employment Opportunity Certification, Public Contract Code Section 10285.1 Statement, Public Contract Code Section 10162 Questionnaire, Public Contract Code Section 10232 Statement, Non- Collusion Affidavit, Debarment and Suspension Certification, Anti-Lobbying Certification for Federal- Aid Contracts, Disclosure of Lobbying Activities, Bid Security Form, Minority/Women's Business Enterprise Certification, Section 3 Project Workforce Breakdown, Section 3 Contractors/ Subcontractors Breakdown,Agreement, Faithful Performance Bond, Labor and Material Bond, Section 3 Assurances, Section 3 Affirmative Action Plan, Maintenance Bond,Worker's Compensation Certificate, Notice of Award, Notice to Proceed, Special Provisions, Project Plans, any addenda and bulletins issued during the bidding period, and all Change Orders amending or extending the work contemplated and which may be required to complete the work in a substantial and acceptable manner. In addition, all Change Orders and Work Directive Changes authorizing additions, deletions, or modifications, and all appendices, bulletins 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. Notice To Bidders 5. Contract Proposal 6. Special Provisions 7. Contract Plans 8. City of Atascadero Standard Specifications and Drawings 9. State of California Department of Transportation Standard Specifications, July 2002, or the latest edition thereof. Article 5-The Contractor agrees to commence work pursuant to this Contract within ten (10)working days from the date specified in the Notice to Proceed, and to diligently prosecute the same to completion within THIRTY(30)Working Days from the date of commencement as specified in the Notice To Proceed. Article 6 - For any withhold of amounts earned by the Contractor(under Paragraph 2), the Contractor may substitute securities as provided in Section 22300 of the Public Contract Code, as amended, which states in part as follows: Provisions shall be included in any invitation for bid and in any contract documents to permit the substitution of securities for any moneys withheld by a public agency to ensure performance under a contract, provided that substitution of securities provisions shall not be required in contracts in which there will be financing provided by the Farmers Home Administration of the United States Department of Agriculture pursuant to the Consolidated Farm and Rural Development Act(7 U.S.C. Sec. 1921 et seq.), and where federal regulations or policies, or both, do not allows the substitution of securities. At the request and expense of the contractor, securities equivalent to the amount withheld shall be deposited with the public agency, or with a state or federally chartered bank in California as the escrow agent, who shall then pay such moneys to the contractor. Upon satisfactory completion of the contract, the securities shall be returned to the contractor. Alternatively, the contractor may request and the owner shall make payment of retentions earned directly to the escrow agent at the expense of the contractor. At the expense of the contractor, the contractor may direct the investment of the payments into securities and the contractor shall receive the interest earned on the investments upon the same terms provided for in this section for securities deposited by the contractor. Upon satisfactory completion of the contract, the contractor shall receive from the escrow agent all securities, interest, and payments received by the escrow agent from the owner, pursuant to the terms of this section. The contractor shall pay to each subcontractor, not later than 20 days of receipt of the payment, the respective amount of interest earned, net of costs attributed to retention withheld from each subcontractor, on the amount of retention withheld to ensure the performance of the contractor. Securities eligible for investment under this section shall include those listed in Section 16430 or bank or savings and loan certificates of deposit, interest bearing demand deposit accounts, standby letters of credit, or any other security mutually agreed to by the contractor and the public agency. The contractor shall be the beneficial owner of any securities substituted for moneys withheld and shall receive any interest thereon. The escrow agreement entered into must be substantially similar to the form included in Public Contract Code Section 22300(e). The contractor shall obtain the written consent of the surety to such agreement. If any provision of this Section shall be declared by a court of law to be illegal or unenforceable, then, notwithstanding, this Section shall remain in full force and effect(exclusive of the illegal or unenforceable provision). IN WITNESS WHEREOF, the parties to these present hereunto set their hands on the date first above written. CITY OF ATASCADERO CONTRACTOR By: 94 By: - 9 EC:wcar CHSVMUA oA r'��. Wade G. McKinney, City Mana er (name of firm or indivi ual) (signature) (printed name) Yr-Si le,,A - (title) Approved as to for City Attorney App a Content : Steven B . Kahn , City Engineer MAINTENANCE BOND BOND NO.: 2208563 Premium Included in Performance KNOW ALL MEN BY THESE PRESENTS: THAT we, Brinar Construction, Inc. as Principal, and Insurance Company of the West a corporation organized and doing business under and by virtue of the laws of the State ofCalifornia and duly licensed to conduct Surety business in the State of California,as Surety,are held and firmly bound unto City of Ataseadero as Obligee,in the sum of Twelve Thousand Nine Hundred Sixty Two 10/100 (S 12,962.10 )Dollars, for which payment,well and truly to be made,we bind ourselves,our heirs,executors and successors,jointly and severally firmly by these presents. THE CONDITION OF THE OBLIGATION IS SUCH THAT: WHEREAS,the above named Principal entered into an agreement or agreements with said Obligee to: 2007-007 Sidewalk Barrier Removal Project WHEREAS,said agreement provided that Principal shall guarantee replacement and repair of improvements as described therein for a period of one year following final acceptance of said improvements; NOW,THEREFORE,if the above Principal shall indemnify the Obligee for all loss that Obligee may sustain by reason of any defective materials or workmanship which become apparent during the period of one year from and after acceptance of the said improvements by Obligee,then this obligation shall be void; otherwise to remain in full force and effect. IN WITNESS WHEREOF,the seal and signature of said Principal is hereto affixed and the corporate seal and the name of the said Surety is hereto affixed and attested by its duly authorized Attorney-in-Fact this 26th day of October 2007 YEAR Brinar Construction, Inc. Insurance Company of the West By. "�/i/�J Principal l , _ � �� B th 1 Myma S ]tl], Attorney-in-Fact ID-1 201(CA)(One Year Term)(REV.3101) _y No. 0002883 ICW GROUP Power of Attorney Insurance Company of the West Explorer Insurance Company Independence Casualty and Surety Company KNOW ALL MEN BY THESE PRESENTS: That Insurance Company of the West,a Corporation duly organized under the laws of the State of California, Explorer Insurance Company,a Corporation duly organized under the laws of the State of California,and Independence Casualty and Surety Company,a Corporation duly organized under the laws of the State of Texas,(collectively referred to as the"Companies"),do hereby appoint MYRNA SMITH,LEONORE WOOLPERT,KERRY POLLOCK their true and lawful Attomey(s)-in-Fact with authority to date,execute,sign,seal,and deliver on behalf of the Companies,fidelity and surety bonds,undertakings,and other similar contracts of suretyship,and any related documents. In witness whereof,the Companies have caused these presents to be executed by its duly authorized officers this 1 st day of November,2005. cI Y ooyPµr,`r `�gURApc� �vmom �ooe►oMr"a�f tum o � 4 Y G INSURANCE COMPANY OF THE WEST w O°SEAL ; y EXPLORER INSURANCE COMPANY 0, �4a�a4J °y� a 6$ INDEPENDENCE CASUALTY AND SURETY COMPANY �'��R°tNfl �, 9 Jeffrey D.Sweeney,Assistant Secretary John L.Hannum,Executive Vice President State of California } ss. County of San Diego On June 5,2006 before me,Mary Cobb,Notary Public,personally appeared John L.Hannum and Jeffrey D.Sweeney,personally known to me to be the persons whose names are subscribed to the within instrument,and acknowledged to me that they executed the same in their authorized capacities,and that by their signatures on the instrument,the entity upon behalf of which the persons acted,executed the instrument. Witness my hand and official seal. MARYGM YO� V �GA '60 Mary Cobb,Notary Public RESOLUTIONS This Power of Attorney is granted and is signed,sealed and notarized with facsimile signatures and seals under authority of the following resolutions adopted by the respective Boards of Directors of each of the Companies: "RESOLVED: That the President,an Executive or Senior Vice President of the Company,together with the Secretary or any Assistant Secretary,are hereby authorized to execute Powers of Attorney appointing the person(s)named as Attomey(s)-in-Fact to date,execute,sign,seal,and deliver on behalf of the Company,fidelity and surety bonds,undertakings,and other similar contracts of suretyship,and any related documents. RESOLVED FURTHER: That the signatures of the officers making the appointment,and the signature of any officer certifying the validity and current status of the appointment,may be facsimile representations of those signatures;and the signature and seal of any notary,and the seal of the Company,may be facsimile representations of those signatures and seals,and such facsimile representations shall have the same force and effect as if manually affixed. The facsimile representations referred to herein may be affixed by stamping,printing,typing,or photocopying." CERTIFICATE I,the undersigned,Assistant Secretary of Insurance Company of the West,Explorer Insurance Company,and Independence Casualty and Surety Company,do hereby certify that the foregoing Power of Attorney is in full force and effect,and has not been revoked,and that the above resolutions were duly adopted by the respective Boards of Directors of the Companies,and are now in full force. IN WITNESS WHEREOF,I have set my hand this 26th day of October , 2007 Jeffrey D.Sweeney,Assistant Secretary To verify the authenticity of this Power of Attorney you may call 1-800-877-1111 and ask for the Surety Division. Please refer to the Power of Attorney Number,the above named individual(s)and details of the bond to which the power is attached. For information or filing claims,please contact Surety Claims,ICW Group, 11455 El Camino Real,San Diego,CA 92130-2045 or call(858)350-2400. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of San Luis Obispo On October 26,2007 before me, Cathi P.Madrigal,Notary Public Data Name and Title of ON—{e.g_'Jwe Doe,"ary Publid) ' personally appeared Mryna Smith Name(s)of Signm(s) ®personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person ,(,6`j whose namg5, is/fir€ subscribed to the within instrument nd THI acknowledged to me that she/the executed CATHI P. MADRIGAL the same in �her/teauthorized COMM. #1614717 capacity(ieef, and that by hWher/th19i'r P�on the instrument NOTARYPUBLIC-CALIFORNIA si SAN LUIS OSISPO COUNTY t the erson or � 9 nature my Comm I:xotesOCT,18.2009 the entity upon behalf of which the person(s1 acted,executed the instrument. WITNkYS my hand and qfficial seal. c Signalurb of Notary Pubic OPTIONAL. Though the information below is not required bylaw,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: Maintenance Bond Document DateOctober26,2007 Number of Pages: 1 Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: Myrna Smith ❑ Individual Top of thumb here ❑ Corporate Officer-Title(s): ❑ Partner-❑ Limited ❑General ® Attorney-in-Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing:Insurance Company of the West 1999 National Notary Association 9350 De Soto Ave.,P.O.Box 2402 Chatsworth,CA 91313-202 www.nationalnotary.org Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827 LABOR AND MATERIAL BOND Bond # 2208563 Premium Tncl uc1Pc1 in Performance KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, the City Council of the City of Atascadero, State of California, by Resolution adopted on the 26th day of October ,2007, has awarded to Brinar Construction, Inc. hereinafter designated as the"Principal", a contract for construction of SIDEWALK BARRIER REMOVAL PROJECT CITY BID NO.2007-007 in strict conformity with the plans and specifications dated September 2007, now on file in the office of the Director of Public Works of the City of Atascadero; and WHEREAS, said Principal is required to furnish a bond in connection with said contract, providing that if said Principal, or any of his or its sub-contractors shall fail to pay for any materials, provisions, provender or any other supplies or teams used in, upon, for or about the performance of the work contracted to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth; NOW,THEREFORE,WE Brinar Construction, Inc. as Principal, hereinafter designated as the"Contractor"and Insurance Company of the west —, as Surety, are held and firmly bound unto the City of Atascadero, in the sum of one Hundred Twenty Nine Thousand Six Hundred Twenty One 00/100 Dollars($ 129,621.00 said sum being one hundred percent of the estimated amount payable by the said City of Atascadero under the terms of the 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, that if the above bounded Contractor, his or its heirs,executors,administrators, successors or assigns, shall fail to pay for any materials, provisions, provender or other supplies or teams 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 claims of persons employed by 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 person,companies or corporations so furnishing said materials, provisions, provender or other supplies,teams, appliances or power used, in upon, for or about the performance of the work contracted to be executed or performed by any person, company or corporation renting or hiring teams or 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 fixed by the Court, awarded and taxed as in the above mentioned Statute provided. This Bond shall insure 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 or the specifications accompanying the same shall in any wise affect its obligations on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the term of the contract or to the Work or to the Specifications. IN WITNESS WHEREOF, this instrument has been duly executed by the Contractor and Surety above-named, on the 26th day of October 2007. Address of Co tract 156 Casa Street, San Luis Obispo, CA 93405 �j (seal) �rk� �t ;v►ctr 1"Y r. e (seal) Address of Surety: 155 E. Shaw Ave, Ste. #316, Fresno, CA 93710-7619 (seal) Myrna Smith, Attorney-in-fact (seal) No. 0002883 ICW GROUP Power of Attorney Insurance Company of the West Explorer Insurance Company Independence Casualty and Surety Company KNOW ALL MEN BY THESE PRESENTS: That Insurance Company of the West,a Corporation duly organized under the laws of the State of California, Explorer Insurance Company,a Corporation duly organized under the laws of the State of California,and Independence Casualty and Surety Company,a Corporation duly organized under the laws of the State of Texas,(collectively referred to as the"Companies"),do hereby appoint MYRNA SMITH,LEONORE WOOLPERT,KERRY POLLOCK their true and lawful Attomey(s)-in-Fact with authority to date,execute,sign,seal,and deliver on behalf of the Companies,fidelity and surety bonds,undertakings,and other similar contracts of suretyship,and any related documents. In witness whereof,the Companies have caused these presents to be executed by its duly authorized officers this 1 st day of November,2005. Y 4��OMPANYD�,r `�SUIZAI`ICI� �J �Om �ooePoMrEn�� i W�u �r� k o INSURANCE COMPANY OF THE WEST O°SEAL $ EXPLORER INSURANCE COMPANY 440M i,A0 �a,�i" `q`�9 ° a � INDEPENDENCE CASUALTY AND SURETY COMPANY �RORNU �y8 Jeffrey D.Sweeney,Assistant Secretary John L.Hannum,Executive Vice President State of California } ss. County of San Diego On June 5,2006 before me,Mary Cobb,Notary Public,personally appeared John L.Hannum and Jeffrey D.Sweeney,personally known to me to be the persons whose names are subscribed to the within instrument,and acknowledged to me that they executed the same in their authorized capacities,and that by their signatures on the instrument,the entity upon behalf of which the persons acted,executed the instrument. Witness my hand and official seal. � M!1 Co�r�nieeian� i�r '` Mary Cobb,Notary Public RESOLUTIONS This Power of Attorney is granted and is signed,sealed and notarized with facsimile signatures and seals under authority of the following resolutions adopted by the respective Boards of Directors of each of the Companies: "RESOLVED: That the President,an Executive or Senior Vice President of the Company,together with the Secretary or any Assistant Secretary,are hereby authorized to execute Powers of Attorney appointing the person(s)named as Attomey(s)-in-Fact to date,execute,sign,seal,and deliver on behalf of the Company,fidelity and surety bonds,undertakings,and other similar contracts of suretyship,and any related documents. RESOLVED FURTHER: That the signatures of the officers making the appointment,and the signature of any officer certifying the validity and current status of the appointment,may be facsimile representations of those signatures;and the signature and seal of any notary,and the seal of the Company,may be facsimile representations of those signatures and seals,and such facsimile representations shall have the same force and effect as if manually affixed. The facsimile representations referred to herein may be affixed by stamping,printing,typing,or photocopying." CERTIFICATE I,the undersigned,Assistant Secretary of Insurance Company of the West,Explorer Insurance Company,and Independence Casualty and Surety Company,do hereby certify that the foregoing Power of Attorney is in full force and effect,and has not been revoked,and that the above resolutions were duly adopted by the respective Boards of Directors of the Companies,and are now in full force. IN WITNESS WHEREOF,I have set my hand this 26th dayof October 2007 Jeffrey D.Sweeney,Assistant Secretary To verify the authenticity of this Power of Attorney you may call 1-800-877-1111 and ask for the Surety Division. Please refer to the Power of Attorney Number,the above named individual(s)and details of the bond to which the power is attached. For information or filing claims,please contact Surety Claims,ICW Group, 11455 El Camino Real,San Diego,CA 92130-2045 or call(858)350-2400. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California SS. County of San Luis Obispo On October 26,2007 before me, Cathi P.Madrigal,Notary Public Data Name and Titre of Officer(e.g.,'Jane Doe,Notary Public') personally appeared Mryna Smith vamds)of s ignor(s) ®personally known to me ❑ proved to me on the basis of satisfactory evidence to be the personwhose name/ ,�.,. CATHI P. MADRIGAL subscribed to the within ins ument nd COMM. #1614717 acknowledged to a that /she/tt executed r NOTARY PUBLIC-CALIFORNIA = the same in V /her/t it authorized Q SAN LUIS OBISPO COUNTY capacity(i , and that by/her/tPefr InN Comm.Expires OCT. 18,2009 signatureQ91 on the instrument the persoq?<or the entity upon behalf of which the personK acted,executed the instrument. WIT hand and official seal. 1Z Signature of Notary Public OPTIONAL Though the information below is not required by taw,it may prove valuable to persons retying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: Payment Bond Document Date October 26,2007 Number of Pages: 2 Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: Myrna Smith ❑ Individual Top of thumb here ❑ Corporate Officer-Title(s): ❑ Partner-❑ Limited ❑General ® Attorney-in-Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing:Insurance Company Of the West 1999 National Notary Association 9350 De Soto Ave.,P.O.Box 2402 Chatsworth,CA 91313-2402 waw.nationalnotary.org Prod.No.5907 Reorder.Call Toll-Free 1-800-876-6827 FAITHFUL PERFORMANCE BOND Bond # 2208563 Premium $2,944.00 KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, the City Council of the City of Atascadero, State of California, by Resolution adopted on the 26th day of October 2004, has awarded to Brinar Construction, Inc. hereinafter designated as the"Principal", a contract for construction of the SIDEWALK BARRIER REMOVAL PROJECT CITY BID NO. 2007-007 in strict conformity with the plans and specifications dated September 2007, now on file in the office of the Director of Public Works of the City of Atascadero; and WHEREAS, said Principal is required under the terms of said Contract to furnish a bond for the faithful performance of said Contract; NOW,THEREFORE,WE Brinar Construction, Inc. as Principal, hereinafter designated as the"Contractor"and Insurance Company of the west as Surety, are held and firmly bound unto the City of Atascadero, in the sum of one Hundred Twenty Nine Thousand Six Hundred Twenty One 00/100************************* Dollars ($ 129,621.00 ),said sum being one hundred percent of the estimated amount payable by the said City of Atascadero under the terms of the 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, that if the above bounded Contractor, his or its 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 as therein provided on his or their part, to be kept and performed at the time and in the manner therein 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 said 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 or the Specifications and Special Provisions accompanying the same 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 to the terms of the Contract or to the work or to the said Specification and Special Provisions. IN WITNESS WHEREOF, this instrument has been duly executed by the Contractor and. Surety above named, on the 26th day of Oct oher 2007. Address of Contract r: 156 Casa street, San Luis Obispo, CA 93405 p (seal) ��'y.v�� Uf`+�•c r `1 C ��ew (seal) Address of Surety: 155 E. Shaw Ave, Ste. #316, Fresno, CA 93710-7619 (seal) Myrna Smith Attorney-in-fact _(seal) No. 0002883 ICW GROUP Power of Attorney Insurance Company of the West Explorer Insurance Company Independence Casualty and Surety Company KNOW ALL MEN BY THESE PRESENTS: That Insurance Company of the West,a Corporation duly organized under the laws of the State of California, Explorer Insurance Company,a Corporation duly organized under the laws of the State of California,and Independence Casualty and Surety Company,a Corporation duly organized under the laws of the State of Texas,(collectively referred to as the"Companies"),do hereby appoint MYRNA SMITH,LEONORE WOOLPERT,KERRY POLLOCK their true and lawful Attomey(s)-in-Fact with authority to date,execute,sign,seal,and deliver on behalf of the Companies,fidelity and surety bonds,undertakings,and other similar contracts of suretyship,and any related documents. In witness whereof,the Companies have caused these presents to be executed by its duly authorized officers this 1st day of November,2005. �pOYPANYafr `�S vRA G INSURANCE COMPANY OF THE WEST 0- SEAL- ; y EXPLORER INSURANCE COMPANY 4k#-1,AO a, 'gyp ,"mob s $ INDEPENDENCE CASUALTY AND SURETY COMPANY \\i, ORpIR Jeffrey D.Sweeney,Assistant Secretary John L.Hannum,Executive Vice President State of California } ss. County of San Diego On June 5,2006 before me,Mary Cobb,Notary Public,personally appeared John L.Hannum and Jeffrey D.Sweeney,personally known to me to be the persons whose names are subscribed to the within instrument,and acknowledged to me that they executed the same in their authorized capacities,and that by their signatures on the instrument,the entity upon behalf of which the persons acted,executed the instrument. Witness my hand and official seal. MI cam., Cm NDTARY PLIC OEG01 r, Mary Cobb,Notary Public RESOLUTIONS This Power of Attorney is granted and is signed,sealed and notarized with facsimile signatures and seals under authority of the following resolutions adopted by the respective Boards of Directors of each of the Companies: "RESOLVED: That the President,an Executive or Senior Vice President of the Company,together with the Secretary or any Assistant Secretary,are hereby authorized to execute Powers of Attorney appointing the person(s)named as Attomey(s)-in-Fact to date,execute,sign,seal,and deliver on behalf of the Company,fidelity and surety bonds,undertakings,and other similar contracts of suretyship,and any related documents. RESOLVED FURTHER: That the signatures of the officers making the appointment,and the signature of any officer certifying the validity and current status of the appointment,may be facsimile representations of those signatures;and the signature and seal of any notary,and the seal of the Company,may be facsimile representations of those signatures and seals,and such facsimile representations shall have the same force and effect as if manually affixed. The facsimile representations referred to herein may be affixed by stamping,printing,typing,or photocopying." CERTIFICATE I,the undersigned,Assistant Secretary of Insurance Company of the West,Explorer Insurance Company,and Independence Casualty and Surety Company,do hereby certify that the foregoing Power of Attorney is in full force and effect,and has not been revoked,and that the above resolutions were duly adopted by the respective Boards of Directors of the Companies,and are now in full force. IN WITNESS WHEREOF,I have set my hand this 26th dayof October 2007 Jeffrey D.Sweeney,Assistant Secretary To verify the authenticity of this Power of Attorney you may call 1-800-877-1111 and ask for the Surety Division. Please refer to the Power of Attorney Number,the above named individual(s)and details of the bond to which the power is attached. For information or filing claims,please contact Surety Claims,ICW Group, 11455 El Camino Real,San Diego,CA 92130-2045 or call(858)350-2400. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of San Luis Obispo on October 26,2007 before me, Cathi P.Madrigal,Notary Public Data Name and Title of Officer(e.g.,'Jane Doe,Notary Public) personally appeared Mryna Smith Mann(s)of sig.*O ®personally known to me ❑ proved to me on the basis of satisfactory evidence to be the personxwhose nameW-1s/VL6' subscribed to the within instrument and acknowledged t9 me that /she/tt 4 executed CATHI P. MADRIGAL the same in Vs/her/t it out orized COMM.#1614717 capacityQ96), and that by s/herltFyrir NOTARY PUBLIC-CALIFORNIA z signature(Von the instrument the personX or SAN LUIS OBISPO COUNTY the entity upon behalf of which the person My Comm.Expires OCT.18,2009 acted,executed the instrument. WIT ESS my hand�d official seal. ynr Signature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: Performance Bond Document Date October 26,2007 Number of Pages: 2 Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: Myrna Smith ❑ Individual Top of thumb here ❑ Corporate Officer-Title(s): ❑ Partner-❑ Limited ❑General ® Attorney-in-Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing:Insurance Company of the West 1999 National Notary Association 9350 Be Soto Ave.,P.O.Box 2402 Chatsworth,CA 91313-2402 www.nabonalnotary.org Prod.No.5907 Reorder Call Toll-Free 1-800-87MB27 B ITEM NUMBER: A-6 DATE: 10/23/07 lig Atascadero City Council Staff Report— Public Works Department 2007 Sidewalk Barrier Removal Project Award (City Bid No. 2007-007) (Project consists of the installation of sidewalks and wheelchair ramps.) RECOMMENDATIONS: Council: 1. Authorize the City Manager to execute a contract with Brinar Construction for$129,621 to construct the Barrier Removal Project; and, 2. Authorize the Public Works Director to file a notice of completion after the project is finished. DISCUSSION: The City has allocated approximately $228,000 for four separate barrier removal projects. The 2007 Sidewalk Barrier Removal Project consists of the installation of sidewalks, wheel chair ramps, and bridge ramp improvements to enhance disabled and handicap access to City sidewalks. The individual projects are located at the following locations: 1. Montecito Avenue handicap ramp and sidewalk. This project consists of extending the existing sidewalk along EI Camino Real to Montecito Avenue. The project will require a retaining wall along the back of sidewalk and a new handicap corner ramp. 2. 9255 EI Camino Real to Principal Avenue. This project consists of extending the sidewalk from 9255 EI Camino Real to Principal Avenue. The sidewalk will be five feet wide with a five foot planting area between the curb and sidewalk. A handicap ramp will be installed at the corner to enhance handicap and pedestrian access. 3. 6925 Atascadero Avenue to Navajoa Road. Two sections of infill sidewalk will be constructed along Atascadero Ave. The project will consist of a five foot wide sidewalk, new curb and gutter and a handicap access ramp at Navajoa Road. 4. Capistrano Bridge access ramps and pedestrian walkway replacement. The Capistrano Bridge pedestrian access ramps will be reconstructed to meet ADA slope requirements and the pedestrian walkway decking will replaced. Hand railing will be constructed to enhance pedestrian ramp safety. r The bids were opened on October 11, 2007, and were reviewed for accuracy and compliance with the City of Atascadero Procurement Policy. The responsible low bidder was Brinar Construction with a bid of $129,621.00. The bid summary is attached to this staff report. FISCAL IMPACT: AVAILABLE REVENUES CDBG Grant Funds $ 228,000 PROJECTED EXPENDITURES Design - actual costs $ 12,814 Staff Support and Other Costs 19,222 Survey and Inspection - 15%of construction 19,443 Construction 129,621 Contingency - 20%of construction 25,924 Total Projected Expenditures $ 207,024 Attachment: Bid summary sheet Attachment 1 Ch v ofAtaseadero Office of'the City Clerk k BID SUAINURY TO: Public Works Department FROM: Victoria Randall,Deputy City Clerk BID NO.: 2007-007 OPENED: Thursday,October ll,2007— 2:00 p.m. PROJECT: Sidewalk Barrier Removal Project Six(6)bids were received and opened today,as follows:. Bidder Total Biel Price 1_ Michael Bray Constriction $132,649.501 2_ California Coastal Ike--elopmcnt $159,556.15 3_ BrinarConstruction $129,621.001 4_ G. Sosa Construction $179,917.00 ;i_ R.Burke Carp_ $2:73,316.0(1 6. .Arthur's Contracting $141,121.00 NOV-9-2007 11:25 FROM:BRINAR CONSTRUCTION 5441159 TO:4617612 P.2 11/t2if 200( 11:44 UtMgbi rbl'L l;1 l Y L11- A I AZ3I;RUG u r Hat tic Forth W.9 Request for Taxpayer Give form do the not Fay.N--Td- ) Identification Number and Certification ` ny'°o oeo-YWo d h Titin y send d toto fife IRS.& t„rnal AwMw as Na C4 a =ffo tax nta0 m _ easirlaa name,Vdl fwW Gam above e 0 Exempt from boom �winaptsats bore— Sole et1001Mlor �"Carporeton L] Psrtnerradp Q oef+srWItOldirg ----------........ ❑ AdefaSS px>frrber,~,and apt,Or suite roe) Requester's n mn rd uldres[oprcr&l e and t,�Goa. /� • ust eaootae m,rebd'o h (opuanao Taxpaymer Iderttificadon Number Enter your TIN 1n the appspprab box The TIN prodded must match the Mama gNan on tine 1 to avoid aoClat eacu►11Y timber backup vnithhokfing For Ir ,vimtals,this is yaw social sacurV number(SW.However,for a resident alien,note proprietor.or disregarded entity.sae the Part 1 ktstructi s On page 3.For ether entities,it is your employer Identification number OaN) H you do not nage a number,sea How fo get a 71N on page S. or Nota.If the account Is In more than one name,see the chart on page s for guidelines on whomN number to eater. OM Cel'ti madon Under penalties of perjury,i ooft that: 1. The number shown on this fom+is my correct taxpayer ktgrttifleation number(or)am wak ft for a number to he issued to mej,and 2. 1 am not subiect to backup wiftotdhg because.(a)I am exempt tram backup wlthhokflng,or lj:r)I have rot been notlflad by tare IMtsmal Revenue Service OAS)terse I am subject to beckup withhotding as a result of a fare to report all interest or dividends,or(c)the IRS has nofted me that 1 am no"or subjeet to backup vrithhotdutg,and 3. 1 am a U.S.person jinctuding a U.S.resident alley Certification Instructions.You must cross alt kern 2 above it you neva been notified by the IRS that you are oun*1 i!►subject to backup withholding becom you have lasted to report a11interest and dividends on your tat return.For nal estate.vansactlens,kern 2 doge not apply. For mortgage interest paid,acquisition or abentlonment of secured property,cancellation of debt,wntributlom to an Individual railroment arrangement QFW,and generally.payments other than intatect and dividends,you are not requr'rad to aign the C Ulloation,but you must provide your coneet 71N.(gee the kt on page 4,) $IJjirt whirs of % Dam lipC� Here L&Person I;. Purpose of Form •An IncAviduat who 15 a dMzm ar,resident of the United A person who I3States. requrred to fire an information Tatum with the iRS,must obtitin your correct ULVuyer identfflcatlon number •A partno ship,corporation,company,or association (nr)to report,for example,Irteorrre paid to you,real estate crested or organised In the United States or under the taws transactions,mortgage Interest you pallk acquisition or of the United States,or abandonment of secured property,cancellation of debt,or s•Any estate(other than a foreign estate)ar trust.See contributions you made to an IRA. Ftegutations sectlons 301.7701-6(a)and r(a)for adrift al U.S. petum Use Form W-9 only If you are a U.S.person information. (mckm ing a resident alien);to provide your correct TIN to the Special Maes for pattrarshos.Partrserships that conduct a person requesting it(the requester)and,when applicable,to trade or businece in the UNtW States are generally required 1.Certify that the 11N you ore giving is convect(or you we to pay a withholding tax on anj foreign partners'attke of waiting for a number to be issued), Income from such btnhtess.Further.in certain cases whore a 2.Certify that you are not subject to bwJwp withholdift,or Form W-9 has not been received.a partnership 12 required to S.Claim exemption from backup withholding if you are a presume that a partner Is a foreign parson,and pay the withholdIn tax.Therefore,It you are a U.S.parson that is a U.S.exempt P®U' partner In a partnership conducting a trade or buWness.In the in 3 above,H applicable.you are also certifying that as a United States,provide Form W-9 to the partnership to U.S.person,your allocable share of any partnership irworne i3stabllsh your U.S,status and:avafd withholding an your from a U.S.trade or business is not subject to the share of pannership Incom& withhold'mg taut on foreign per hers'share of effectively connected Inoornie. The person who gives Form W-9 to the perbwattip for Note.If a requester gives you a form ashes thForm W8 to doses of establishing ft U.S.status and avoiding an request your TIN.you must use the raquesteir's form it it is partnership(Sng co d aliooaWe deosharof net ss In from the substantially slmllor to this Foran W-g, States is In c sfollo tt$a trade or business in tete United States i9 in the following cases: For federal tan purpose%you are considered a person If you ♦The U.S.owner of a die0egadwd entity and nat the ernity, are: CO.No.10231X Form -9 Oiw.11-9005) i~+tiSNESS LI-CENSE C, ; 0 A SC:� 1'f"J CFl l L F 1'EP3i i+ :a't` ♦s. 4�- :j'-7 i l ilrtL w-It Si(`l iw S LICEN)E OITY 0a= ATASCAEIE{�O i.�FFiCi�aL I.�+:.larS'N1�,SS LICEa)�i �`' ; _ -IT" a— r'_ "CIAL E3 1�°p"ST'N C�8 iC'rrTSf P CE�', KEEP FOR YOUR RECORDS N NggFERA�LE' ra s,� a(.'� ��' AM E�0 8 41 i I .qpt jCV8S A���, t3f)1t:i1TtiJ E�xSLLT�R � � � '" `�"`"" r (j�(tQt�►MT(i�tJ(V�L}ER 1� r BUSINESS TAX RECEIPT int f' 'cliVE S l Irg"".,. .S i I F`0" IES L�CE�a r r '` '2"t p� i t1r JSh`�'```SLICEr-,GE.CITY M4,0783'tiit� ��_1N�EEf1E "iG'i ivSL CITY(?s3AtiaL J`,L'ci a ACCT.NO. 14078 d�t L i FFICI ?E34JSS' T 10Ef SE IO:ITY OF A,ASCADERO I , r;XPJRATION LiC:r 3 i 1 OFMEEXIVE)09,rEO "'+ Cl �- DATE PAID 11/5/2007 I11213112007 C. ,> CI tY Ot ATA +5�^070rF1CIAI �BUSINESS Li427 Y OF AT4S0.�1-CITY OF SCt �Flt�t.; � r JS, i. .NS ' TYPE OF BUSINESS' �' Con r OFFICIAL. pl `` ` SF 01, OF ATnaSCAO ` F ° jI 1 CTROJO $50.00 ag, -�F APPOUT $20.00 F U SAL 11 ti L� 1 (T� �$ �r�SCN(Ji C F A Aar Aid£ 30 OFF A ADf =iO ` F �' Art -a ` TOTAL $70.00 ryRCFIO € !0 C ct; INIESS Li: tS- ' `'` FRQaK'N O C z (Sk i7I �' fei S 1 3 �' S-1.. i t 4..1 'a ' x cm 1) ATA CONTACT Or— 1 i t 3 iia at7=.r s tt 3 F j�i C 7i ;TYU 1� A r 43 rks ^3 #tai ^a3 a'a J't iiY.'1.[E- h { BIfSiNESSN(��JE,rr sC� l "Q STPAV911QNjNQ i �t +a 3 f�xa��iS Li; Ei1SI CIT CR q " ;f3ERD OR ' S r' 1!7S a ti LtC sa t tr e� n' C C r 'ATTN it `R4(13 0 a iCt , sSPsESS L f"6 NS° O,�IREYDEF.L� F R F z a" l.' �A�+ .`dr, TAXES CE CIT) t�Y�=^. .�X. 2 FIC i��'Fa �vI.i3� a 6' i F#,i.. .CriY C CCt3'�Sa�. ti1E )f .. BUS BUSINESS TA7(ORD ORDINANCE N ACCORDANCE WITH Or, 0, saT�, ac A > l� Os - CITY OF DRESS:,: r SAN: � QQp3t1 34051$0 �C9N T - t z ars ".j 5 �L a t t Or '1 s arse. O riCa ' ATASCADERO p'ti t IAtlw I34)�it'1 L! P 3E C'i FY C Af,"z�� : `hl .n".s'��i3.�L 0� .NON REFUNDABLE t�r �a_..�c L€�=_d" f t I ��:, '0t=1rita ;sSlidFttLaL . .� .t.17�:I✓€Lr Crt ti, �.�::.'i"1�;::>.`->L.ia.En'�ac a t Y+ G�nCiEF3 C7t EtCI,a! 5 3iP1 SS z is a? C a F. City of, A Office of the City Clerk BID SUMMARY TO: Public Works Department _ J; FROM: Victoria Randall,Deputy City Clerk BID NO.: 2007-007 OPENED: Thursday, October 11,2007 -- 2:00 p.m. PROJECT: Sidewalk Barrier Removal Project Six (6) bids were received and opened today, as follows: Bidder Total Bid Price 1. Michael Bray Construction $132,649.50 2. California Coastal Development $159,556.15 3. Brinar Construction $129,621.00 4. G. Sosa Construction $179,917.00 5. R. Burke Corp. $271,316.00 6. Arthur's Contracting $141,121.00 ,1 Attention is directed to the Federal minimum wage rate requirements in the books entitled "Proposal and Contract." If there is a difference between the minimum w IRt",i9" the Secretary of Labor and the general prevailing wage rates determin %� , `rg py;)f the California Department of Industrial Relations for similar classifications of labor, the Contractor and subcontractors shall pay not less than the higher wage rate. The Department will not accept lower State wage rates not specifically included in the Federal minimum wage determinations. This includes"helper" (or other classifications based on hours of experience)or any other classification not appearing in the Federal wage determinations. Where Federal wage determinations do not contain the State wage rate determination otherwise available for use by the Contractor and subcontractors, the Contractor and subcontractors shall pay not less than the Federal minimum wage rate which most closely approximates the duties of the employees in question. The U.S. Department of Transportation (DOT) provides a toll-free"hotline" service to report bid rigging activities. Bid rigging activities can be reported Mondays through Fridays, between 8:00 a.m. and 5:00 p.m., Eastern Time, Telephone No. 1-800-424-9071. Anyone with knowledge of possible bid rigging, bidder collusion, or other fraudulent activities should use the "hotline" to report these activities. The "hotline" is part of the DOT's continuing effort to identify and investigate highway construction contract fraud and abuse and is operated under the direction of the DOT Inspector General. All information will be treated confidentially and caller anonymity will be respected. The Contractor will be required to maintain and distribute certified payroll records in compliance with Section 1776 of the California Labor Code. Notice is given to all bidders that no more than 50% of the work, as defined by the contract price, may be done by subcontractors. Bidders shall contact the Department of Public Works office the day prior to Bid opening to obtain any addenda information. Submittal of a signed Bid shall be evidence that the Bidder has obtained this information and that the Bid is based on any changes contained therein. Notice is also hereby given that all Bidders may be required to furnish a sworn statement of their financial responsibility, technical ability and experience before award is made to any particular Bidder. Provision is made for security substitution on payment withholds as provided in Public Contract Code Sections 22200 and 22300. Bids are required for the entire work described herein. Before submitting Bids, Contractors shall be licensed in accordance with the Laws of the State of California. Accordingly, the successful Bidder shall possess a Class A General Engineering Contractor's license at the time this contract is awarded. The successful Contractor will be required to furnish three (3) acceptable surety bonds: one for faithful performance, one for labor and materials and the other for maintenance following construction. Each bond is to be executed in a sum equal to one hundred percent (100%) of the contract price except that the Maintenance Bond shall be for ten percent (10%) of the Contract Price and shall remain in effect for one year following acceptance of the project for final payment. The successful Contractor will be required to obtain a business license from the City and pay related fees. Technical questions should be directed to the Office of the Director or Public Works, City of Atascadero, California, telephone (805)461-5000. On the outside of the bid envelope the Bidder shall indicate the following: 1. Name and Address of Bidder 2. Name of project on which Bid is submitted 3. Date and time of Bid opening The right is reserved by the City of Atascadero to reject any or all Bids, to evaluate the Bids submitted, and award the contract to the lowest responsible Bidder. The City further reserves the right to waive any informalities or minor irregularities in the Bid. No Bidder may withdraw his Bid for a period of 60 working days after the date set for the opening thereof. 4 Dated this �i day of ti Cv�, 2007, at Atascadero, California. CITY OF&TASCADERO ✓� -- BY: dl? ( Marcia M. Torgerson, City Clerk RECEIVED OCT 1 j CITY OF ATASCADERO PROPOSAL FORM CITY CLERK'S OFFICE City Clerk City of Atascadero 6907 EI Camino Real Atascadero, California 93422 Gentlemen: The undersigned hereby proposes to perform all work for which a contract may be awarded to the undersigned and to furnish any and all plant, labor, services, material, tools, equipment, supplies, transportation, utilities, and all other items and facilities necessary therefor as provided in the Contract Documents, and to do everything required therein for street improvements within the City of Atascadero as specifically set forth in documents entitled: Contract Documents and Special Provisions for the SIDEWALK BARRIER REMOVAL PROJECT BID NO. 2007-007 together with all appurtenances thereto, all as set forth in the Contract Documents; and further proposes and agrees that, if the undersigned's proposal is accepted, the undersigned will contract in the form and manner stipulated to perform all the work called for in the Contract Documents, and to complete all such work in strict conformity therewith within the time limits set forth therein, and that the undersigned will accept as full payment therefor the price or prices set forth in the Bid Sheet(s) forming a part hereof. A cashier's check, a certified check o Bid Bond, a edted by an admitted surety insurer, properly made pa a to the City of Atascade reI fter designated as the City, for the sum of dollars ($ /*0 n ), which amount is not less than 10 percent of the total amount of the Bid, is attached hereto and is given as a guarantee that the undersigned will execute the agreement and furnish the required bonds and insurance if awarded the Contract and, in case of failure to do so within the time provided, the proceeds of said check shall be forfeited to the City if applicable, or, the Sureties' liability to the City for forfeiture of the face amount of the Bid Bond shall be considered as established. It is understood and agreed that: 1. The undersigned has carefully examined all the Contract Documents which shall comprise those documents specifically referred to in Article 4 of the Agreement Form. 2. The undersigned has, by investigation at the site of the Work and otherwise, satisfied itself as to the nature and location of the Work and has fully informed itself as to all conditions and matters which can in any way affect the Work or the cost thereof. 3. The undersigned fully understands the scope of the Work and has checked carefully all words and figures inserted in its Proposal and further understands that the City will in no way be responsible for any errors or omissions in the preparations of this Proposal. 4. The undersigned understands that no more than 50% of the work, as defined by the contract price, may be done by subcontractors. True copies of subcontracts will be provided to the City Engineer upon his request. 5. The undersigned will execute the Agreement and furnish the required performance and payment bonds and proof of the specified insurance coverage within 10 working days, not including holidays, after notice of acceptance of its Proposal by the City; and further, that this Proposal may not be withdrawn for a period of 60 working days after the date set r The Total Bid Price shall include all work proposed to complete the SIDEWALK BARRIER REMOVAL PROJECT. 7!iFiMTV-es) �5 ��� �� ;�,�� r �Item Itemd Unit Price Total Price No. Description (figures) (figures) ure TS-1 Traffic Control System Is 1 �/ / 06 TS-2 Water Pollution Control Program Is 1 ms's TS-3 Earthwork-Excavate dirt, rock, ac, & yd 226 concrete to sub grade TS-4 New PCC Sidewalk w/base sf 3465 TS-5 Install Handicap Ramp in New ea 3 Sidewalk w/base JJ TS-6 Install Allen Block Gravity Wall sf 350 System w/ Drain & Rock TS-7 Install Driveway Approach w/base sf 272 TS-8 Install PCC Curb&Gutter w/base If 187 j TS-9 Adjust Utility Facilities to Grade ea 2 -- -- TS-10 Replace Sign Post ea 1 � TS-11 Arborist Is 1 /� TS-12 Install Sidewalk Underdrain If 11 /O 1.210 TS-13 Relocate Guy Wire ea 1 TS-14 Remove Tree ea 1 /2CO— lo? � TS-15 Street Trees 25 gal ea 3 TS-16 Irrigation Stubs 1"sch 40 pvc If 90 � TS-17 Planter Area (wood chips over dirt) sf 1340 TS-18 Remove Exist. Facilities on dwg. Is 1 C4.0 --- TS-1 9 TS-19 Install AC sf 125 /.;7— g(o TS-20 Construct Conc. Ramp sf 80 4 TS-21 Construct Conc. Curb If 60 r TS-22 Construct Concrete Abutment If 10 98D TS-23 Install ADA Hand Railing If 96 TS-24 Construct Wood Ramp sf 65 2 p /99� 2, PAGE 3 of 3 TS-25 Replace Wood Bridge Decking sf 200 :2r7 63a,29 �O TS-26 Saw Cut, Remove and Replace AC If 218 /o TS-27 Clear and Grub Is 1 TOTAL BID PRICE: LS=LUMP SUM SY=SQUARE YARDS EA=EACH LF=LINEAR FEET CY=CUBIC ARDS The Contractor shall comply with the requirements of Division 5, Part I, of the State Labor Code, and specifically with Sections 6705 and 6707 thereof. The Contractor shall submit for approval a detailed plan showing the design of shoring, bracing, sloping, or other provisions to be made for worker protection for all areas to be excavated to a depth of five feet or more. If the plan varies from the shoring system standards, the plan shall be prepared by a registered civil or structural engineer. The undersigned further agrees that in case of default in executing and submitting the Contract with required bonds and insurance within ten (10)working days after having received notice that the Contract is ready for signature, the proceeds of the check or bond accompanying this Bid shall become the property of the City. The Contractor to whom the contract is awarded shall submit a statement each month certifying that it is in conformance with the City's Affirmative Action Program. The Contractor to whom the contract is awarded shall submit a copy of their contract with the specified sub-contractors which include the following certifications and assurances. No payment shall be made for work done by sub-contractors without this documentation on file. The following Contractor's/Subcontractors Certification Concerning State Labor Standards and Prevailing Wages, Contractor's Licensing Statement, List of Subcontractors, Conflict of Interest Statement, Certification of Affirmative Action Program, Equal Employment Opportunity Certification, Public Contract Code Section 10285.1 Statement, Public Contract Code Section 10162 Questionnaire, Public Contract Code Section 10232 Statement, Non-Collusion Affidavit, Debarment and Suspension Certification, Anti-Lobbying Certification for Federal-Aid Contracts, Disclosure of Lobbying Activities, Bid Security Form, and Minority/Women's Business Enterprise Certification, Section 3 Project Workforce Breakdown, and Section 3 Contractors/Subcontractors Breakdown shall be filled out, signed, and submitted by each Bidder and shall be part of the Contract Documents. PAGE 3of3 , 7 for the opening of Bids, unless otherwise required by law. If any Bidder shall withdraw its Bid within said period, the Bidder shall be liable under the provisions of the Bid Security, or the Bidder and its Surety shall be liable under the Bid Bond, as the case may be. Also, the undersigned will furnish a Maintenance Bond in the form of ten percent(10%)of the total Bid Price prior to final acceptance of the Work. The Maintenance Bond shall remain in effect for a period of one year following the acceptance of the Work. 6. The undersigned hereby certifies that this Proposal is genuine and not sham or collusive or made in the interest or in behalf of any person not herein named, and the undersigned has not directly or indirectly induced or solicited any other Bidder to put in a sham bid, or any other person or corporation to refrain from bidding; the undersigned has not in any manner sought by collusion to secure for itself an advantage over any other Bidder. 7. In conformance with the current statutory requirements of Section 1860 et. seq. of the Labor Code of the State of California, the undersigned confirms the following as his or her certification: "I am aware of the provisions of Section 3700 of the Labor Code which requires every employer to be insured against liability for worker's compensation or to undertake self insurance in accordance with the provisions before commencing the performance of the work of this Contract." 8. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). By my signature on this proposal I further certify, under penalty of perjury under the laws of the State of California and the United States of America, that the Noncollusion Affidavit required by Title 23 United States Code, Section 112 and Public Contract Code Section 7106; and the Title 49 Code of Federal Regulations, Part 29 Debarment and Suspension Certification are true and correct. Now: In compliance with the Notice to Bidders and all the provisions hereinbefore stipulated; the undersigned with full cognizance thereof, hereby proposes to perform the entire Work for the prices set forth in the attached Bid Sheet(s)upon which award of contract is based. Dated October 10,2007 Bidder:Brinar on ruction Inc. By: (Corporate Seal) Title: Ura--i r1Pnt JTr0AR11r1-r Bidder's Post Office Address: Corporation organized under the laws of the State of: California This Proposal is s bmitted with respect to the changes to the contract included in Addenda Numberls --(Fill in addenda numbers if addenda have been received and insert, in this Proposal, any Engineer's Estimate sheets that were received as part of the addenda) BID SHEET PROJECT: SIDEWALK BARRIER REMOVAL PROJECT CITY OF ATASCADERO BID NO.: 2007-007 BID OPENING: October 11,2007, at 2:00 p.m. NAME OF BIDDER: BRINAR CnNSTRiTCTTnN, TNr BUSINESS ADDRESS: 156 CASA STREET SAN LUIS OBISPO, CA 93405 BUSINESS PHONE: 805-544-1159 FAX NO.: 805-544-1159 RESIDENCE ADDRESS: 1 241 5 RTVP.R ROAD SANTA MARC,ARTTA rA RESIDENCE PHONE: 805-438-3140 TO: CITY COUNCIL CITY OF ATASCADERO The undersigned declares that he has carefully examined the location of the proposed work, that he has examined the Plans and Specifications and read the accompanying instructions to bidders, and hereby proposes to furnish all materials, machinery, tools, labor and services, and do all the work necessary to complete the project in accordance with said Plans, Specifications, and Special Provisions for the unit prices shown. The undersigned declares that he has read and acknowledges the following: Bids are required for the entire work. Incidental items of work shall be incorporated into the most appropriate unit price bid item and no additional compensation shall be made therefor. The amount of the Bid for comparison purposes will be the total of all items. The total of unit basis items will be determined by multiplying the unit price bid by the estimated quantity set forth for the item. The Bidder shall set forth for each item of work, in clearly legible figures, a unit price and a total for the item in the respective spaces provided for this purpose. In the case of the unit basis items,the amount set forth under the"Total'column shall be the multiplication of the unit price bid by the estimated quantity of the item. In case of discrepancy between the unit price and the total set forth for the item, the unr} price shall prevail; provided, however, if the amount set forth as a unit price is ambiguous, uointeiligible, of uncertain for any reason, or is omitted, or in the case of unit basis items, is the same.arnount as the entry in the"Total'column, then the amount set forth in the "Total'column for the itern shall prevail in accordance with the following: 1. As to lump sum items, the amount set forth in the"Total'column shall be the unit price. 2. As to unit basis items, the amount set forth in the"Total'column shall be divided by the estimated quantity for the item and the price thus obtained shall be the unit price. The City reserves the right to reject any and all bids. PAGE 3 of 3 CONTRACTOR'S/SUBCONTRACTOR'S CERTIFICATION CONCERNING STATE LABOR STANDARDS AND PREVAILING WAGES All contractors and subcontractors shall submit the following certification to the City of Atascadero. A. "I am aware of the provisions of Section 1720 et seg. of the California Labor Code which requires that the State prevailing wage rate shall be paid to employees where this rate exceeds the Federal wage rate." B. 'I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers'compensation or to undertake self-insurance in accordance with the provisions of that Code,and I will comply with such provisions before commencing the performance of the work of this contract." C. "It is further agreed that,except as may be provided in Section 1815 of the California Labor Code,the maximum hours a worker is to be employed is limited to eight hours a day and 40 hours a week and the subcontractor shall forfeit, as a penalty,$25 for each worker employed in the execution of the subcontract for each calendar day during which a worker is required or permitted to labor more than eight hours in any calendar day or more than 40 hours in any calendar week." Brinar Construction, Inc. (Contractor/Subcontractor) By Oct. 10, 2007 (Signature) (Date) Frank Brinar; President/Treasurer (Typed Name and Title) PAGE 1 of 1 CONTRACTOR'S LICENSING STATEMENT The undersigned is licensed in accordance with the laws of the State of California providing for the registration of Contractors. The undersigned hereby certifies that they possess at the time of bid a State of California Class A General Engineering Contractor's license. The undersigned further agrees that they will maintain current throughout the term of this contract this Class A General Engineering Contractor's license. Contractor's License Classification and Number: A C-8 427128 Name of Firm or Individual: Business Address: Business Tel: Business Fax: (or) Signature, Title, and Address of members signing on behalf of partnership: Name Title Address Name Title Address Name Title Address (or) Name of Corporation: Brinar Construction, Tnn Business Address: 156 Casa Street, San Luis Obispo, Ca. 93405 Corporation organized under the laws of the State of California Signature of President of Corporation -- Signature of Secretary of Corporation PAGE 1 of 1 LIST OF SUBCONTRACTORS The Bidder shall list the name and address of each subcontractor to whom the Bidder proposes to subcontract portions of the work, as required by the provisions in Section 2-1.054, "Required Listing of Proposed Subcontractors," of the Standard Specifications and Section 2-1.01, "General," of the Special Provisions. PLEASE PRINT LEGIBLY Name under which License No. Mailing Address Specific y Subcontractor and And Description is listed Classification Contact Phone Number of Subcontract A WOCE- Do not list alternative subcontractors for the same work. PAGE 1 of 1 1 { r CONFLICT OF INTEREST STATEMENT Conflict of Interest of Members, Officers, or Employees of Contractors, Members of Local Governing Body, or other Public Officials. In the procurement of supplies, equipment, construction, and services by the CDBG Grantee (City of Atascadero), the conflict of interest provisions in 24 CFR 85.36, OMB Circular A-110, and 24 CFR 570.611, respectively, shall apply. None of the City of Atascadero's officers, members or employees, designees or agents(e.g., subrecipients, consultants), City Councilmembers, or other public officials with duties involving the grant activities may have any interest in any contracts or proceeds for the work done in conjunction with this contract. The Contractor shall include this Conflict of Interest Statement in all subcontracts on the project. The Contractor/Subcontractor understands and will abide by these provisions. Brinar Construction, Inc. (Contractor/Subcontractor) By Ir Oct 10, 2007 ( ignature) (Date) Frank Brinar; President/Treasurer (Typed Name and Title) PAGE 1 of 1 CERTIFICATION OF AFFIRMATIVE ACTION PROGRAM The Bidder hereby certifies that it is in compliance with the Civil Rights Act of 1964, Executive Order No. 11246, the California Fair Employment Practices Act, and any other applicable federal and state laws and regulations relating to equal opportunity employment. NAME OF BIDDER: ADDRESS: 156 Casa Street San T,,; sQhispe-, 41-� A5 SIGNATURE OF BIDDER: (or authorized agent) TITLE: President/Treasurer DATE: Oct 10 2007 ACTION PROGRAM PAGE 1 of 1 1 1 EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION A. Equal Opportunity Clause. During the performance of this contract, the contractor agrees as follows: 1. The contractor will not discriminate against any employee or applicant for employment because of race,color, religion, sex,or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex,or national origin. Such action shall include, but not be limited to,the following: employment, upgrading,demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor,state that all qualified applicants will receive consideration for employment without regard to race,color,religion,sex, or national origin. 3. The contractor will send to each labor union or representative of workers with which the contractor has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers'representatives of the contractor's commitments under this section,and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations,and relevant orders of the Secretary of Labor. 5. The contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor,or pursuant thereto, and will permit access to its books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. 6. In the event of the contractor's noncompliance with the discrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled,terminated,or suspended in whole or in part and the contractor may be declared ineligible for further government contracts or Federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rules, regulations, or orders of the Secretary of Labor, or as otherwise provided by law. 7. The contractor will include the portion of the sentence immediately preceding paragraph (1)and the provisions of paragraphs(1)through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 504 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance; Provided, however,that in the event a contractor becomes involved in,or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency,the contractor may request the United States to enter into such litigation to protect the interests of the United States. The applicant further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in Federally assisted construction work; provided, that if the applicant so participating is a State or local government,the above equal opportunity clause is not applicable to any agency, instrumentality, or subdivision of such government which does not participate in work on or under the contract. The applicant agrees that it will assist and cooperate actively with the administering agency and the Secretary of Labor in obtaining the compliance of contractors and subcontractors with the equal opportunity clause and the rules, regulations, and relevant orders of the Secretary of Labor,that it will furnish the administering agency and the Secretary of Labor such information as they may require for the supervision of such compliance, and that it will otherwise assist the administering agency in the discharge of the agency's primary responsibility for securing compliance. The applicant further agrees that it will refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965,with a contractor debarred from,or who has not demonstrated eligibility for, government contracts and Federally assisted construction contracts, pursuant to the Executive Order and will carry out such sanctions and penalties for violation of the equal opportunity clause as may be imposed upon contractors and subcontractors by the administering agency or the Secretary of Labor pursuant to Part II, Subpart D of the Executive Order. In addition,the applicant agrees that if it fails or refuses to comply with these undertakings,the administering agency may take any or all of the following actions: cancel,terminate,or suspend in whole or in part this grant(contract, loan, insurance, guarantee); refrain from extending any further assistance to the applicant under the program with respect to which the failure or refund occurred until satisfactory assurance of future compliance has been received from such applicant; and refer the case to the Department of Justice for appropriate legal proceedings. B. Federal Equal Employment Opportunity Construction Contract Specifications. 1. As used in these specifications: a. "Covered area"means the geographical area described in the solicitation from which this contract resulted. b. "Director"means Director,Office of Federal Contract Compliance Programs, United States Department of Labor, or any person to whom the Director delegates authority. c. "Employer identification number"means the Federal social security number used on the Employer's Quarterly Federal Tax Return, U.S. Treasury Department Form 941. d. "Minority"includes: (1) Black(all persons having origins in any of the Black African racial groups not of Hispanic origin). (2) Hispanic(all persons of Mexican, Puerto Rican,Cuban,Central or South American or other Spanish culture or origin, regardless of race). (3) Asian and Pacific Islander(all persons having origins in any of the original peoples of the Far East,southeast Asia,the Indian subcontinent or the Pacific Islands). (4) American Indian or Alaskan Native(all persons having origins in any of the original peoples of North America and maintaining identifiable tribal affiliations through membership and participation or community identification). 2. Whenever the contractor, or any subcontractor at any tier, subcontracts a portion of the work involving any construction trade, it shall physically include in each subcontract in excess of$10,000 the provisions of these specifications and the notice which contains the applicable goals for minority and female participation and which is set forth in the solicitations from which this contract resulted. 3. If the contractor is participating (pursuant to 41 CFR 60-4.5)in a Hometown Plan approved by the U. S. Department of Labor in the covered area either individually or through an association, its affirmative action obligations on all work in the plan area(including goals and timetables)shall be in accordance with that plan for those trades which have unions participating in the plan. Contractors must be able to demonstrate their participation in and compliance with the provisions of any such Hometown Plan. Each contractor or subcontractor participating in an approved plan is individually required to comply with its obligations under the EEO clause, and to make a good faith effort to achieve each goal under the plan in each trade in which it has employees. The overall good faith performance by other contractors or subcontractors toward a goal in an approved plan does not excuse any covered contractor's or subcontractor's failure to take good faith efforts to achieve the plan's goals and timetables. 4. The contractor shall implement the specific affirmative action standards provided in paragraphs 7.a. through 7.p. of these specifications. The goals set forth in the solicitation from which this contract resulted are expressed as percentages of the total hours of employment and training of minority and female utilization the contractor should reasonably be able to achieve in each construction trade in which it has employees in the covered area. Covered construction contractors performing construction work in geographical areas where they do not have a Federal or Federally-assisted construction contract shall apply the minority and female goals established for the geographical area where the work is being performed. Goals are published periodically in the Federal Register in notice form and such notices may be obtained from any Office of Federal Contract Compliance Programs or from Federal procurement contracting officers. The contractor is expected to make substantially uniform progress in meeting its goals in each craft during the period specified. 5. Neither the provisions of any collective bargaining agreement, nor the failure by a union with whom the contractor has a collective bargaining agreement,to refer either minorities or women shall excuse the contractor's obligations under these specifications, Executive Order 11246, or the regulations promulgated pursuant thereto. 6. In order for the non-working training hours of apprentices and trainees to be counted in meeting the goals,such apprentices and trainees must be employed by the contractor during the training period, and the contractor must have made a commitment to employ the apprentices and trainees at the completion of their training,subject to the availability of employment opportunities. Trainees must be trained pursuant to training programs approved by the U.S. Department of Labor. 7. The contractor shall take specific affirmative actions to ensure equal employment opportunity. The evaluation of the contractor's compliance with these specifications shall be based upon its effort to achieve maximum results from its actions. The contractor shall document these efforts fully and shall implement affirmative action steps at least as extensive as the following: a. Ensure and maintain a working environment free of harassment, intimidation, and coercion at all sites, and in all facilities at which the contractor's employees are assigned to work. The contractor,where possible,will assign two or more women to each construction project. The contractor shall specifically ensure that all foremen, superintendents,and other on-site supervisory personnel are aware of and carry out the contractor's obligation to maintain such a working environment,with specific attention to minority or female individuals working at such sites or in such facilities. b. Establish and maintain a current list of minority and female recruitment sources, provide written notification to minority and female recruitment sources and to community organizations when the contractor or its unions have employment opportunities available,and maintain a record of the organizations'responses. c. Maintain a current file of the names,addresses and telephone numbers of each minority and female off-the-street applicant and minority or female referral from a union, a recruitment source or community organization and of what action was taken with respect to each such individual. If such individual was sent to the union hiring hall for referral and was not referred back to the contractor by the union or, if referred,not employed by the contractor,this shall be documented in the file with the reason therefore, along with whatever additional actions the contractor may have taken. d. Provide immediate written notification to the Director when the union or unions with which the contractor has a collective bargaining agreement has not referred to the contractor a minority person or woman sent by the contractor or when the contractor has other information that the union referral process has impeded the contractor's efforts to meet its obligations. e. Develop on-the-job training opportunities and/or participate in training programs for the area which expressly include minorities and women, including upgrading programs and apprenticeship and trainee programs relevant to the contractor's employment needs,especially those programs funded or approved by the Department of Labor. The contractor shall provide notice of these programs to the sources compiled under 7.b. above. f. Disseminate the contractor's EEO policy by providing notice of the policy to unions and training programs and requesting their cooperation in assisting the contractor in meeting its EEO obligations; by including it in any policy manual and collective bargaining agreement;by publicizing it in the company newspaper, annual report,etc; by specific review of the policy with all management personnel and with all minority and female employees at least once a year; and by posting the company EEO policy on bulletin boards accessible to all employees at each location where construction work is performed. g. Review at least annually,the company's EEO policy and affirmative action obligations under these specifications with all employees having any responsibility for hiring, assignment, layoff, termination or other employment decisions, including specific review of these items with on-site supervisory personnel such as superintendents,general foremen,etc., prior to the initiation of construction work at any job site. A written record shall be made and maintained identifying the time and place of these meetings, persons attending,subject matter discussed, and disposition of the subject matter. h. Disseminate the contractor's EEO policy externally by including it in any advertising in the news media, specifically including minority and female news media, and providing written notification to and discussing the contractor's EEO policy with other contractors and subcontractors with whom the contractor does or anticipates doing business. i. Direct its recruitment efforts,both oral and written,to minority,female and community organizations,to schools with minority and female students and to minority and female recruitment and training organizations serving the contractor's recruitment area and employment needs. Not later than one month prior to the date for the acceptance of applications for apprenticeship or other training by any recruitment source,the contractor shall send written notification to organizations such as the above, describing the openings, screening procedures, and tests to be used in the selection process. j. Encourage present minority and female employees to recruit other minority persons and women and,where reasonable, provide after-school summer and vacation employment to minority and female youth both on the site and in other areas of a contractor's workforce. k. Validate all tests and other selection requirements where there is an obligation to do so under 41 CFR Part 60.3. I. Conduct at least annually,an inventory and evaluation at least of all minority and female personnel for promotional opportunities and encourage these employees to seek or to prepare for,through appropriate training,etc.,such opportunities. m. Ensure that seniority practices,job classifications,work assignments and other personnel practices, do not have a discriminatory effect by continually monitoring all personnel and employment related activities to ensure that the EEO policy and the contractor's obligations under these specifications are being carried out. n. Ensure that all facilities and company activities are non-segregated except that separate or single-user toilet and necessary changing facilities shall be provided to assure privacy between the sexes. o. Document and maintain a record of all solicitations of offers for subcontracts from minority and female construction contractors and suppliers, including circulation of solicitations to minority and female contractor associations and other business associations. p. Conduct a review, at least annually, of all supervisors'adherence to and performance under the contractor's EEO policies and affirmative action obligations. 8. Contractors are encouraged to participate in voluntary associations which assist in fulfilling one or more of their affirmative action obligations(7.a.through 7.p.). The efforts of a contractor association, joint contractor-union, contractor-community,or other similar group of which the contractor is a member and participant, may be asserted as fulfilling any one or more of its obligations under 7.a. through 7.p.of these specifications provided that the contractor actively participates in the group, makes every effort to assure that the group has a positive impact on the employment of minorities and women in the industry, ensures that the concrete benefits of the program are reflected in the contractor's minority and female workforce participation, makes a good faith effort to meet its individual goals and timetables, and can provide access to documentation which demonstrates the effectiveness of actions taken on behalf of the contractor. The obligation to comply, however, is the contractor's and failure of such a group to fulfill an obligation shall not be a defense for the contractor's noncompliance. 9. A single goal for minorities and a separate single goal for women have been established. The contractor, however, is required to provide equal employment opportunity and to take affirmative action for all minority groups, both male and female,and all women, both minority and non-minority. Consequently,the contractor may be in violation of the Executive Order if a particular group is employed in a substantially disparate manner(for example, even though the contractor has achieved its goals for women generally,the contractor may be in violation of the Executive Order if a specific minority group of women is under-utilized). 10. The contractor shall not use the goals and timetables or affirmative action standards to discriminate against any person because of race,color, religion,sex or national origin. 11. The contractor shall not enter into any subcontract with any person or firm debarred from government contracts pursuant to Executive Order 11246. 12. The contractor shall carry out such sanctions and penalties for violation of these specifications and of the Equal Opportunity Clause, including suspension,termination and cancellation of existing subcontracts as may be imposed or ordered pursuant to Executive Order 11246, as amended,and its implementing regulations, by the Office of Federal Contract Compliance Programs. Any contractor who fails to carry out such sanctions and penalties shall be in violation of these specifications and Executive Order 11246, as amended. 13. The contractor, in fulfilling its obligations under these specifications,shall implement specific affirmative action steps, at least as extensive as those standards prescribed in paragraph 7 of these specifications,so as to achieve maximum results from its efforts to ensure equal employment opportunity. If the contractor fails to comply with the requirements of the Executive Order,the implementing regulations, or these specifications,the Director shall proceed in accordance with 41 CFR 60-4.8. 14. The contractor shall designate a responsible official to monitor all employment related activity to ensure that the company's EEO policy is being carried out, to submit reports relating to the provisions hereof as may be required by the government and to keep records. Records shall at least include for each employee the name, address,telephone number,construction trade,union affiliation, if any, employee identification number when assigned, social security number, race,sex, status(e.g., mechanic, apprentice, trainee, helper, or laborer), dates of changes in status, hours worked per week in the indicated trade, rate of pay, and locations at which the work was performed. Records shall be maintained in an easily understandable and retrievable form; however,to the degree that existing records satisfy this requirement,contractors shall not be required to maintain separate records. 15. Nothing herein provided shall be construed as a limitation upon the application of other laws which establish different standards of compliance or upon the application of requirements for the hiring of local or other area resident(e.g.,those under the Public Works Employment Act of 1977 and the Community Development Block Grant Program). 16. By the submission of this bid,the bidder,offeror, applicant, or subcontractor certifies that he/she does not maintain or provide for his/her employees any segregated facility at any of his/her establishments, and that he/she does not permit employees to perform their services at any location under his/her control where segregated facilities are maintained. He/she certifies further that he/she will not maintain or provide for employees any segregated facilities at any of his/her establishments, and he/she will not permit employees to perform their services at any location under his/her control where segregated facilities are maintained. The bidder,offeror, applicant,or subcontractor agrees that a breach of this certification is a violation of the Equal Opportunity Clause of this contract. As used in this certification,the term"segregated facilities"means any waiting rooms,work areas,rest rooms and wash rooms, restaurants and other eating areas,time clocks, locker rooms,and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas transportation and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, or national origin,habits,local custom,or otherwise. He/she further agrees that(except where he/she has obtained identical certifications from proposed subcontractors for specific time periods)he/she will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding$10,000 which are not exempt from the provisions of the Equal Opportunity Clause;that he/she will retain such certifications in his/her files;and that he/she will forward the following notice to such proposed subcontractors(except where proposed subcontractors have submitted identical certifications for specific time periods). Brina�r Construction, Inc. (Contracor/Subcntra r) By Oct 10, 2007 (Signature) (Date) Frank Brinar; President/Treasurer (Typed Name and Title) PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _, has notx_ been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after"has"or"has not' in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire in conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes, explain the circumstances in the following space. Public Contract Code Section 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappeasable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. SECTION 10232 STATEMENT PAGE 1 of 1 NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY ATASCADERO, DEPARTMENT OF PUBLIC WORKS: In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares 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 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. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: ■ is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; ■ has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; ■ does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. ANTI-LOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The undersigned certifies, by signing and submitting this bid or proposal,to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed $100,000 and that all such sub-recipients shall certify and disclose accordingly. Brinar Construction, Inc. (Contractor/Subcontractor) By oct 10 , 2007 (Signature) (Date) Frank Brinar; President/Treasurer (Typed Name and Title) Approved by OMB 0348-0046 Disclosure of Lobbying Activities Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 See reverse for public burden disclosure 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑ a. contract ❑ a. bid/offer/application ❑ a. initial filing b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For material change only: e. loan guarantee Year quarter f. loan insurance Date of last report 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is ❑ Prime ❑ Subawardee Subawardee, Enter Name and Address of Prime: Tier if Known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including (if individual, last name, first name, Ml): address if different from No. 10a) (last name, first name, Ml): 11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of Signature: lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This Print Name: Frank Rr; nar disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi- Title: President/Treasurer annually and will be available for public inspection.Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and Tel. No.:8 0 5—5 4 4—1 1 59 Date: 10/10/ 0 not more than$100,000 for each such failure. Authorized for Local Reproduction 1=ederl Us+ Oply p n�� �. ...' .... = Standard Form-LLL(Rev.7-97) INSTRUCTIONS FOR COMPLETION OF SF-LLL DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1 st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks"Subawardee,"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Included prefixes, e.g.,"RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last Name, First Name, and Middle Initial (MI). 11. The certifying official shall sign and date the form, print his/her name, title, and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046),Washington, DC 20503 BID SECURITY FORM BID BOND Know All Men By These Presents: That we, Brinar Construction, Inc. ,as principal and, Insurance Company of the West , as surety, are held and firmly bound unto the City of Atascadero, California,a General Law City, hereinafter referred to as"City,"in the sum of Ten Percent of Bid Amount dollars ($ los of Bid ),to be paid to the said Owner,its.successors,and assigns:for which payment,well and truly to be made,we bind ourselves, our heirs, executors, administrators, successors, and assigns,Jointly and severally,firmly by these presents. The Condition of this obligation is such that if the certain proposal of the above bounden to construct roadway improvements in connection with a project entitled SIDEWALK BARRIER REMOVAL PROJECT CITY BID NO.2007-0.07 in the City of Atascadero,County of San Luis Obispo,as specifically set forth in documents entitled the same, all in accordance with the Specifications and Plans on file at the offices of the City of Atascadero,Department of Public Works,6907 EI Camino Real, ,Atascadero, California 93422, is not withdrawn within the period of 60 working days after the date set for the opening of Bids, unless otherwise required by law, and notwithstanding the award of the Contract to another Bidder and that if said proposal is accepted by the City through action of its legally constituted contracting authorities and if the above bounden Brinar Construction, Inc-his heirs,executors,administrators, successors and assigns,shall duly enter into and execute a contract for such construction and shall execute and deliver the required Performance and Payment Bonds and proof of Insurance Coverage within 10 working days (not including holidays)after the date of notification by and from the said City that the said Contract is ready for execution,then this obligation shall become null and void: otherwise it shall be and remain in full force and virtue. 11th October In Witness Whereof,we hereunto set our hands and seals this day of ,2047• Brinar Construction, Inc. jj Insurance Company of the West By: er�l BY• L rna Smith, Att ney-in-Fact (Note: The standard printed bond form of any bonding company acceptable to the City may be used In lieu of the foregoing approved sample bond form provided the security stipulations protecting the City are not in any way reduced by use of the Surety Company's printed standard form.) No. 0002883 ICW GROUP Power of Attorney Insurance Company of the West Explorer Insurance Company Independence Casualty and Surety Company KNOW ALL MEN BY THESE PRESENTS: That Insurance Company of the West,a Corporation duly organized under the laws of the State of California, Explorer Insurance Company,a Corporation duly organized under the laws of the State of California,and Independence Casualty and Surety Company,a Corporation duly organized under the laws of the State of Texas,(collectively referred to as the"Companies"),do hereby appoint MYRNA SMITH,LEONORE WOOLPERT,KERRY POLLOCK their true and lawful Attomey(s)-in-Fact with authority to date,execute,sign,seal,and deliver on behalf of the Companies,fidelity and surety bonds,undertakings,and other similar contracts of suretyship,and any related documents. In witness whereof,the Companies have caused these presents to be executed by its duly authorized officers this 1 st day of November,2005. �oMr�xroo ;�Z6RA c �wTr eNom aaT��'oeraurFe�� ;��o°� �ri�\ INSURANCE COMPANY OF THE WEST OSEAL�Iy I o EXPLORER INSURANCE COMPANY �`j't�r a �`c� INDEPENDENCE CASUALTY AND SURETY COMPANY JI Jeffrey D.Sweeney,Assistant Secretary John L.Hannum,Executive Vice President State of California } ss. County of San Diego On June 5,2006 before me,Mary Cobb,Notary Public,personally appeared John L.Hannum and Jeffrey D.Sweeney,personally known to me to be the persons whose names are subscribed to the within instrument,and acknowledged to me that they executed the same in their authorized capacities,and that by their signatures on the instrument,the entity upon behalf of which the persons acted,executed the instrument. Witness my hand and official seal. hum C06B f COW.4"em"O IiMY PIJMNA 0 OCM N- Mary Cobb,Notary Public RESOLUTIONS This Power of Attorney is granted and is signed,sealed and notarized with facsimile signatures and seals under authority of the following resolutions adopted by the respective Boards of Directors of each of the Companies: "RESOLVED: That the President,an Executive or Senior Vice President of the Company,together with the Secretary or any Assistant Secretary,are hereby authorized to execute Powers of Attorney appointing the person(s)named as Attomey(s)-in-Fact to date,execute,sign,seal,and deliver on behalf of the Company,fidelity and surety bonds,undertakings,and other similar contracts of suretyship,and any related documents. RESOLVED FURTHER: That the signatures of the officers making the appointment,and the signature of any officer certifying the validity and current status of the appointment,may be facsimile representations of those signatures;and the signature and seal of any notary,and the seal of the Company,may be facsimile representations of those signatures and seals,and such facsimile representations shall have the same force and effect as if manually affixed. The facsimile representations referred to herein may be affixed by stamping,printing,typing,or photocopying." CERTIFICATE I,the undersigned,Assistant Secretary of Insurance Company of the West,Explorer Insurance Company,and Independence Casualty and Surety Company,do hereby certify that the foregoing Power of Attorney is in full force and effect,and has not been revoked,and that the above resolutions were duly adopted by the respective Boards of Directors of the Companies,and are now in full force. IN WITNESS WHEREOF,I have set my hand this 11th day of October , 2007 Jeffrey D.Sweeney,Assistant Secretary To verify the authenticity of this Power of Attorney you may call 1-800-877-1111 and ask for the Surety Division. Please refer to the Power of Attorney Number,the above named individual(s)and details of the bond to which the power is attached. For information or filing claims,please contact Surety Claims,ICW Group, 11455 El Camino Real,San Diego,CA 92130-2045 or call(858)350-2400. I , CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of San Luis Obispo On October 11,2007 before me, Cathi P.Madrigal,Notary Public Data Name and Title of Officer(e.g.,'Jane Doe,Notary Public') personally appeared Myrna Smith Names)of signors) ®personally known to me ❑ proved to me on the basis of satisfactory evidence to be the personxwhose name0s/ayz subscribed to the within instrument and tyRf� CATHI P. MADRIGAL acknowledged t me thate/she/t�executed COMM. #1614717 the same in �/herlt it authorized Q NOTARY PUBLIC-CALIFORNIA z capacity(i ), and thhtby jos/her/tt e4r SAN LUIS 081SP0 COUNTY signatureO on the instrument the person( or My Comm.Expires OCT.18,2009 the entity upon behalf of which the person acted,executed the instrument. WIT SS my hand and official seal., Signature ofublic �. OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: Bid bond Document Date October 11,2007 Number of Pages: l Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: Myrna Smith ❑ Individual Top of thumb here ❑ Corporate Officer-Title(s): ❑ Partner-❑ Limited ❑General ® Attorney-in-Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing:Insurance Company of the West 1999 National Notary Association 9350 De Soto Ave.,P.O.Boz 2402 Chatsworth,CA 91313-2402 www.nationalnotary.org Prod.No.5907 Reorder.Call Toll-Free 1-800-876-6827 BID SECURITY FORM BID BOND Know All Men By These Presents: That we, , as principal and as surety, are held and firmly bound unto the City of Atascadero, California, a General Law City, hereinafter referred to as"City," in the sum of dollars ($ ), to be paid to the said Owner, its successors, and assigns; for which payment, well and truly to be made,we bind ourselves, our heirs, executors, administrators, successors, and assigns,jointly and severally, firmly by these presents. The Condition of this obligation is such that if the certain proposal of the above bounden to construct roadway improvements in connection with a project entitled SIDEWALK BARRIER REMOVAL PROJECT CITY BID NO. 2007-007 in the City of Atascadero, County of San Luis Obispo, as specifically set forth in documents entitled the same, all in accordance with the Specifications and Plans on file at the offices of the City of Atascadero, Department of Public Works, 6907 EI Camino Real, ,Atascadero, California 93422, is not withdrawn within the period of 60 working days after the date set for the opening of Bids, unless otherwise required by law, and notwithstanding the award of the Contract to another Bidder and that if said proposal is accepted by the City through action of its legally constituted contracting authorities and if the above bounden his heirs, executors, administrators, successors and assigns, shall duly enter into and execute a contract for such construction and shall execute and deliver the required Performance and Payment Bonds and proof of Insurance Coverage within 10 working days (not including holidays)after the date of notification by and from the said City that the said Contract is ready for execution, then this obligation shall become null and void; otherwise it shall be and remain in full force and virtue. In Witness Whereof,we hereunto set our hands and seals this day of , 2007. (Note: The standard printed bond form of any bonding company acceptable to the City may be used in lieu of the foregoing approved sample bond form provided the security stipulations protecting the City are not in any way reduced by use of the Surety Company's printed standard form.) MINORITY/WOMEN'S BUSINESS ENTERPRISE CERTIFICATION (a) It is the policy of the City of Atascadero to take positive steps to maximize the utilization of minority and women's business enterprises in all contract activity administered by the Community Development Block Grant Program. (b) The contractor will utilize his best efforts to carry out this policy in the award of his subcontracts to the fullest extent consistent with the efficient performance of this contract. As used in this contract,the term "minority or women's business enterprise"means a business,at least 50%of which is owned by minority group members or women or, in the case of publicly-owned businesses, at least 51% of the stock is owned by minority group members or women. For the purpose of this definition, minority group members are Black, Hispanics,Asians, Native Americans,Alaskans or Pacific Islanders. (c) The contractor will submit the following statement as part of his/her sealed bid: I have taken affirmative action to seek out and consider minority and women's business enterprises for the portions of work to be subcontracted. Such actions are fully documented in my records and available upon request. Results are as follows (use additional sheets if necessary): Name and Address of Minority/Women's Firms Dollar Value Contractor Anticipates Utilizing" Category of Work of Participation "Indicate whether business is owned by a minority or a woman. Total Bid: Total Subcontract Amount: Minority/Women's Enterprise Total of Subcontract Amount:: Brinar Construction, Inc. (Cont r r/Subcont ctor) By 10/10/07 (Signature) (Date) Frank Brinar; President/Treasurer (Typed Name and Title) • s ' PROJECT WORK FORCE BREAKDOWN Job Total Number of Positions Number of Number of Positions Category Positions Needed Occupied by Positions not filled with for Project Permanent Employees Occupied Section 3 residents Supervisor Professional Technical Office/Cleric. I Others TRADE: Journeyman Apprentices (f� Trainees Others TRADE: Journeyman (Z-) Apprentices Trainees Others Section 3 Resident: Individual residing within the Section 3 Area Company whose family income does not exceed 80%of the � ;oy-07 median income in the Metropolitan Statistical Area or the county if not within a MSA in which Project the Section 3-covered project is located. See O attached income schedule. roje t mbe NOTE: This document must be submitted by the contractor with the bid documents. erson Completing For Date: / d OBTAINING LISTS OF MINORITY AND WOMEN CONTRACTORS Caltrans is an excellent source of information regarding minority and women contractors. A complete copy of the statewide listing may be obtained by calling the Caltrans Publications Distribution Unit at (916)445-3520. Other sources of information are: 1. State Department of General Services Office of Small and Minority Business, (916)322-5060 2. National Economic Development Association, (916)649-2551 SECTION 3 CONTRACTS/SUBCONTRACTS BREAKDOWN Est. Number of Estimated Dollar Type of Contract Total Total Approx. Contracts to Amount to Sec. 3 Bus.or Prof. Number Dollar Amount Sec.3 Businesses Businesses NOTE: This document is to be submitted by Company the contractor with bid documents. Project DBGMompletting Date Personorm SECTION 3 BUSINESS ELIGIBILITY CERTIFICATION The U.S. Department of Housing and Urban Development(HUD)monitors our hiring practices on Section 3-covered projects. It is important,therefore that the information below be provided. Please be aware that your response,though needed, is voluntary and has no affect on your contracting. Your answers will be treated with confidentiality. Thank you for assisting us. Sincerely, City of Atascadero Public Works Department Business Name: z Address- 1. ddress1. Are 51%of business owners qualified Section 3 Residents? If YES stop, if NO proceed. 2. Are at least 30%of your employees Section 3 Residents(or were they when they stated less three years ago? AZ�2 _If YES then stop, if NO then proceed. 3. Does the business subcontract in excess of 25%of the dollar award of all subcontracted to be awarded to business concerns that meet the qualification set forth in number 1 and 2 above? I � 0_If YES stop, if NO proceed. We currently do not qualify as a Section 3 business certify that the statements made on this sheet are true, complete and correct to be best of my knowledge and belief, and made in good faith. Date: l© O Signature: �r'e- CITY OF ATASCADERO BIDDERS INFORMATION LIST All bidders/proposers are required to provide the following information for all DBE and non-DBE contractors, who provided a proposal, bid, quote, or were contacted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Atascadero will use this information to maintain and update a"Bidder's" List to assist in the overall annual DBE goal setting process. To the extent permitted by law, all information submitted will be held in strict confidence and will not be shared without your consent. PRIME CONTRACTOR: W# &.t�rnoFirm Name �� y 1 � Phone: Business Address:! ( �� �( �a Fax: License No. and Classification: �+� ��" Years in Business: t' Contact Person: TIF'I 0'�J' Is the firm currently certified as a DBE by Caltrans? P�14o ❑Yes, Certification No.: Gro s Annual Receipts for last year: $1 million [--I<$5 million ❑<$10 million ❑<$15 million ❑>$15 million ycl- Type of work/services/materials provided for this job: Contractor ❑ Supplier ❑ Manufacturer ❑ Trucking ❑ Broker 0 Other(Describe) Con ractor Specialty for this job? Roadway Construction (including signing, paving, and concrete) Roadway Painting/Striping ❑ Roadway Lighting and Electrical Signals ❑ Water, Sewer, and Pipeline Construction ❑ Power Line (including conduit construction) ❑ Masonry(including retaining walls and foundations) ❑ Concrete Retaining Walls ❑ Building Construction ❑ Other(describe) CITY OF ATASCADERO BIDDERS INFORMATION LIST (continued) SUBCONTRACTORS/SUPPLIERS/OTHERS: � J r Firm Name -IS Phone: Business Address:?. A? Alis Fax: /W License No. and Classification: Old2ql • Years in Business: Contact Person5PJ t(}-- Is the firm currently certified as a DBE by Caltrans? ❑NoPgYes, Certification No.: w2 Gross Annual Receipts for last year: 0<$1 million 0<$5 million ❑<$10 million 0<$15 million ❑>$15 million Type of work/services/materials provided for this job: ❑ Contractor ❑ Supplier ❑ Manufacturer ❑ Trucking ❑ Broker ❑ Other(Describe) Contractor Specialty for this job? ❑ Roadway Construction (including signing, paving, and concrete) ❑ Roadway Painting/Striping ❑ Roadway Lighting and Electrical Signals ❑ Water, Sewer, and Pipeline Construction ❑ Power Line (including conduit construction) ❑ Masonry(including retaining walls and foundations) ❑ Concrete Retaining Walls ❑ Building Construction Other(describe) n--1L_ This form may be duplicated if necessary to report all bidders(DBEs and non-DBEs) information. . e CITY OF ATASCADERO BIDDERS INFORMATION LIST (continued) SUBCONTRACTORS/SUPPLIERS/OTHERS: Firm Name: 7—&&9/2TPhone: Business Address:qb60f 131/ f 1 C --- Fax: License No. and Classification: Years in Business: Contact Person: Is the firm currently certified as a DBE by Caltrans? []No ❑Yes, Certification No.: Gross Annual Receipts for last year: ❑<$1 million ❑<$5 million ❑410 million ❑<$15 million ❑>$15 million Type of work/services/materials provided for this job: ❑ Contractor ❑ Supplier ❑ Manufacturer ❑Trucking ❑ Broker ❑ Other(Describe) Contractor Specialty for this job? ❑ Roadway Construction (including signing, paving, and concrete) ❑ Roadway Painting/Striping ❑ Roadway Lighting and Electrical Signals ❑ Water, Sewer, and Pipeline Construction ❑ Power Line (including conduit construction) ❑ Masonry(including retaining walls and foundations) ❑ Concrete Retaining Walls ❑ Building Construction Other(describe) This form may be duplicated if necessary to report all bidders(DBEs and non-DBEs) information. Oct Al 2Qt)7 12: 34PM Madrone Landscapes, Inc. 805. 464. 0675 p. 1 u QCT^11-2007 11:08 FROM:02IMAR COWTRUCTIQN 5441159 TO.46,4%75 P.1 CI'T'Y Of ATASCADERO BIDDERS INFORMATION LIST(contMued) SUBCONTRACTORS I SUPPLIERS I OTHERS: Firm Marna: t,3 I &K�LNCd4�: Phone: Business Address: .' t7?j Fax: License No.and Clpeaiticadon:r-21 � 1`�"� Years in Business: ?� ' Confect Person: '^r, Is the firm currently c e tilied me a DBE by Caitrsne7 ONOQYes,CoNication No.: Cxoas Annual Rece1P4 for last year. 0<$1 mmon 45 millon (Q<$10 mOkm [ 415 million [J>$1fi million T of work/ 1 nu�lerials prow&!ed For#his jab: Contrecfi�rN0 ❑3uppl�r ❑Matx�Facturor 0 Trucking 17 Broker Other(Describe) Contractor Specialty for this job? ❑ Roadway Constructton(including signing,pavhg.and corse*) ftoodway PainhnglStriping Ifoadway Lighting and Electrical Signals Wader.Bawler,mW Pipeline Construction Pourer Line(inckidIng conduit conshxAk n) Masonry(Including retaining walls end fowdeltons) Concrete Retaining Wads Bulldxng Construction Other(describe) This farm may be dtWeatad If necessary to n*md all bidders(DBEs sed nor-DBEs) �alor�. ' o h