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HomeMy WebLinkAboutC35000 - Homme-Adams Park Upper Prk Shelter Rplcmnt 927-16Contract No. C35000 CITY OF PALM DESERT STAFF REPORT REQUEST: AWARD CONTRACT NO. C35000 FOR THE CAP HOMME/RALPH ADAMS PARK UPPER PARK SHELTER REPLACEMENT TO T.J. JANCA CONSTRUCTION, INC., IN THE AMOUNT OF $53,716 (PROJECT NO. 927-16) SUBMITTED BY: Mark Greenwood, P.E., Director of Public Works CONTRACTOR: T.J. Janca Construction, Inc. 2328 N. Batavia Street, #105 Orange, CA 92865 DATE: March 10, 2016 CONTENTS: Agreement and Bonds Contractor's Bid Vicinity Map Recommendation By Minute Motion, the City Council: 1. Award Contract No. C35000 for the Cap Homme/Ralph Adams Park Upper Park Shelter Replacement to T.J. Janca Construction, Inc., of Orange, California, in the total amount of $53,716.00 (Project No. 927- 16); 2. Authorize the Director of Finance to set aside an additional 10 percent contingency in the total amount of $5,371.60; and 3. Authorize the Mayor to execute the agreement. Funds are available in Account No. 6100000-2399100, Homme/Adams park Trust Fund. Background The existing palapa in the upper portion of Homme/Adams Park is a traditional style palapa made from wood and palm fronds. Over the years it has been vandalized by park users and damaged by the elements. Staff has made periodic repairs to the structure and refreshed the natural roof material, but the frame and rafters have been damaged beyond any permanent structural repair and replacement is necessary. Staff Report Award Contract No. C35000 for Replacement of Upper Park Shelter at Homme/Adams Park Page 2 of 2 March 10, 2016 On February 4, 2016, the project was advertised for bid and on February 26, 2016, bids were opened and read aloud with the following results: Contractor location PriCa T.J. Janca Construction, Inc. Orange, CA $ 53,716.00 Pacific Tennis Courts, Inc. Moorpark, CA $109,901.00 Fiscal Analvsis There is no fiscal impact beyond the cost of replacing the park shelter. Prepared y: Randy a , Zdscape Supervisor 64pz-� Paul S. Gibson, Director of Finance AppNval: J M. Wohlmuth it Manager Mark r nwood, FE\ Direct r f Public Works CONTRACT NO. C35000 AGREEMENT THIS AGREEMENT is made and entered into this 10T" day of March, 2016, by and between City of Palm Desert, California, hereafter called "CITY" and T.J. Janca Construction, Inc., hereinafter called "CONTRACTOR". WITNESSETH RECITALS: CONTRACTOR has submitted to CITY its Contractor's Bid for the construction of CITY Project, 1. CAP HOMME/RALPH ADAMS PARK UPPER PARK SHELTER REPLACEMENT, Project No. 927-16, Contract No. C35000, in strict accordance with the Contract Documents identified below, CITY has accepted said Bid. 2. CONTRACTOR states that it has re-examined its CONTRACTOR'S Bid and found it to be correct, has ascertained that its Subcontractors are properly licensed and possess the requisite skill and forces, has examined the site and Contract in accordance with the Contract Documents for the money set forth in its Bid to be paid as provided in the Contract Documents. AGREEMENT: IT IS AGREED BY THE PARTIES AS FOLLOWS: 1. Contract Documents: The entire contract consists of the following: (a) The Agreement; (b) The Notice Inviting Bids; (c) The Instruction to Bidders; (d) The Contractor's Bid; (e) The Bidder's Bond; (f) The Performance Bond; (g) The Payment Bond; (h) The General Specifications; (i) The Special Provisions; 0) The Standard Specifications as modified in other portions of the Contract Documents; (k) The Plans; (1) Addenda Nos. 1 & 2; (m) Any Change Orders issued; (n) Any additional or supplemental specifications, notices, instructions and drawings issued in accordance with the provisions of the Contract Documents. All of said Documents presently in existence are by this reference incorporated herein as if here set forth in full and upon the proper issuance of their documents they shall likewise be deemed incorporated. 2. Contractor shall commence the work within ten calendar days after the date of the Notice to Proceed and will do all things necessary to construct the work generally described in Recital No. 1 in accordance with the Contract Documents and will complete said work within 90 Calendar Days from the Notice to Proceed date to the satisfaction of the Engineer. CONTRACT NO. C35000 3. Contractor agrees to indemnify, defend and save CITY and its officers, agents and employees, and the Engineer harmless from: a. Any and all liability, claims, damages, losses or injuries to any person or other entity, including injury to Contractor's employees, and all claims which arise from or are connected with the negligent performance of or failure to perform the work or other obligations of this Agreement, or which are caused or which are claimed to be caused by the negligent or intentional acts or omissions of Contractor, its subcontractors, its agents or employees, and, all expenses of investigating and defending against same, b. Any and all liability, claims, damages, losses or injuries to any and all contractors, subcontractors, material -men, laborers, or any other person, firm or corporation furnishing or supplying work, services, materials or supplies in connection with the performance of the Agreement. C. Attention is directed to the General Specifications - Claims, Liability, and Indemnity Agreement/Hold Harmless sections, which specifications are made part of this Agreement as set forth in Agreement paragraph 1, above. d. Attention is directed to Section 6-9, "Liquidated Damages" of the Standard Specifications and is hereby amended to substitute the "City of Palm Desert" in place of "Agency." Liquidated damages shall be $500.00 per calendar day of delay. 4. Should any litigation or arbitration be commenced between the parties concerning the works of improvements as referenced herein, the prevailing party in any such litigation, being the CITY or the Contractor, should be entitled to a reasonable sum for attorney's fees incurred in any such litigation relating to this Contract. 5. This Agreement shall be binding upon all parties hereto and their respective heirs, executors, administrators, successors, and assigns. 6. Contractor shall be paid in the manner set forth in the Contract Documents the amount of its Bid as accepted by CITY, subject to such additions and deductions as may be made pursuant to the Contact Documents and applicable law. Satisfactory Performance: The prime Contractor agrees to pay each Subcontractor under this prime contract for satisfactory performance of its contract no later than 10 days from the receipt of each payment the prime Contractor receives from City of Palm Desert. Any delay or postponement of payment from the above referenced time frame may occur only for good cause following written approval of the City of Palm Desert. CONTRACT NO. C35000 Release of Retention: The prime Contractor agrees further to release retention payments to each Subcontractor within 30 days after the Subcontractor's work is satisfactorily completed. Any delay or postponement of payment from the above referenced time frame may occur only for good cause following written approval of the City of Palm Desert. 7. Execution of the Agreement by the parties constitutes their agreement to abide by all applicable provisions of the California Labor Code; constitutes contractor's certification that he is aware of the provisions of said Code and will comply with them; and further constitutes Contractor's certification as follows: "I am aware of the provisions of Section 3700 of the California 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 of that Code, and I will comply with such provisions before commencing the performance of the work of this contract." IN WITNESS WHEREOF the parties hereto have executed or caused to be executed by their duly authorized officials, this Agreement which shall be deemed an original on the date first above written. CONTRACTOR: 1--r i Signature to be notarized TITLE: CITY: BY: TITLE: Mavor of Palm Desert, CA APPROVED AS TO CONTENT: MARK GREENWOOD, P.E. DIRECTOR OF PUBLIC WORKS ATTEST BY: TITLE: ATTEST BY: TITLE: City Clerk of Palm Desert. CA APPROVED AS TO FORM: ROBERT W. HARGREAVES CITY ATTORNEY CONTRACT NO. C35000 CONTRACTOR ACKNOWLEDGMENT A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) ) ss. County of ) On , 20 , before me, , a Notary Public, personally appeared , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (seal) CONTRACT NO. C35000 PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS awarded to T.J. Janca Construction, Inc., contract for: That whereas the City of Palm Desert has hereinafter designated as the "Principal", a CAP HOMME/RALPH ADAMS PARK UPPER PARK SHELTER REPLACEMENT PROJECT NO. 927-16 CONTRACT NO. C35000 WHEREAS, said Principal is required under the terms of said contract to furnish a good and sufficient bond for the performance of said contract: NOW THEREFORE, WE, T.J. Janca Construction, Inc., the Principal, and as Surety, are held and firmly bound unto the City of Palm Desert hereinafter called the City, in the penal sum of Fifty-three Thousand Seven Hundred Sixteen and 00/100 Dollars ($53,716.00), being 100% of the contract amount in lawful money of the United States of America for the payment of which sum well and truly to be made, we hereby bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the above bounded Principal, his executors, heirs, administrators, and successors, or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants and agreements in the said contract and any alterations thereof made as therein provided, on his or their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless the City, its officers and agents, as therein stipulated, then this obligation shall become null and void; otherwise, it shall be and remain in full force and virtue. And the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to 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, alterations or additions to the terms of the contract or to the work or the specifications. Should it become necessary for the City to institute a lawsuit or any other legal proceeding to enforce the terms and conditions of this bond, then all costs of said proceeding, including attorneys' fees, shall be awarded to the prevailing party. Page 1 CONTRACT NO. C35000 IN WITNESS WHEREOF, identical counterparts of this instrument, each of which shall for all purposes be deemed an original thereof, have been duly executed by the Principal and Surety above named, on this day of , 20 SURETY M. PRINCIPAL (Signature must be notarized) (Signature must be notarized) INSURANCE COMPANY and/or AGENT Name: Address: City/State/Zip Code: Telephone No.: Page 2 CONTRACT NO. C35000 A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. SURETY ACKNOWLEDGEMENT State of California ) ) ss. County of ) On before me, personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) Page 3 CONTRACT NO. C35000 A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. PRINCIPAL ACKNOWLEDGEMENT State of California ) ) ss. County of ) On before me, , personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) Page 4 CONTRACT NO. C35000 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS: THAT WHEREAS, the City of Palm Desert (sometimes referred to hereinafter as "Obligee") has awarded to T.J. Janca Construction, Inc., (hereinafter designated as the "CONTRACTOR"), an agreement dated March 10, 2016, described as follows: CAP HOMME/RALPH ADAMS PARK UPPER PARK SHELTER REPLACEMENT, Project No. 927-16, Contract No. C35000, (hereinafter referred to as the "Contract"); and WHEREAS, said CONTRACTOR is required to furnish a bond in connection with said Contract, and pursuant to Section 9100 of the California Civil Code; NOW, THEREFORE, we, T.J. Janca Construction, Inc., the undersigned CONTRACTOR, as Principal, and a corporation organized and existing under the laws of the State of , and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the City of Palm Desert and to any and all persons, companies or corporations entitled to file stop payment notices under Section 9100 of the California Civil Code, in the sum of Fifty-three Thousand Seven Hundred Sixteen and 00/100 Dollars ($53,716.00), said sum being not less than one hundred percent (100%) of the total amount payable by the said Obligee under the terms of the said Contract, for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that, if said CONTRACTOR, his or its heirs, executors, administrators, successors or assigns, or Subcontractors, shall fail to pay for any materials, provisions or other supplies, implements, machinery or power used in, upon, for or about the performance of the Public Work contracted to be done, or to pay any person for any work or labor of any kind, or for bestowing skills or other necessary services thereon, or for amounts due under the Unemployment Insurance Code with respect to such work or labor, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of said CONTRACTOR and his or its Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor as required by the provisions of Section 9100 et seq. of the Civil Code, or for any amounts required to be deducted, withheld, and paid over to the Franchise Tax Board or Internal Revenue Service from the wages of employees of the CONTRACTOR or his or its Subcontractors, the Surety or Sureties hereon will pay for the same in an amount not exceeding the sum specified in this bond, otherwise the above obligation shall be void. In addition to the provisions herein above, it is agreed that this bond will inure to the benefit of any and all persons, companies and corporations entitled to serve stop payment notices under Section 9100 of the Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this bond. Page 5 CONTRACT NO. C35000 The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the said Contract or to the work to be performed thereunder or the Specifications accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the Specifications. No final settlement between the Obligee and the CONTRACTOR hereunder shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. CONTRACTOR and Surety agree that if the Obligee is required to engage the services of an attorney in connection with the enforcement of the bond, each shall pay Obligee's reasonable attorney's fees incurred, with or without suit, in addition to the above sum. IN WITNESS WHEREOF, we have hereunto set our hands and seals this day of 20 PRINCIPAUCONTRACTOR: (Typed Name of Principal/Contractor) (Signature) (Signature to be Notarized) (Typed Name and Title) SURETY: (Typed Name of Surety) (Signature of Attorney -in -Fact) (Signature to be Notarized) (Typed Name of Attorney -in -Fact) The rate of premium on this bond is $ per thousand The total amount of premium charged: $ (the above must be filled in by corporate surety) IMPORTANT: Surety companies executing bonds must possess a certificate of authority from the California Insurance Commissioner authorizing them to write surety insurance defined in Section 105 of the California Insurance Code, and if the work or project is financed, in whole or in part, with federal, grant or loan funds, it must also appear on the Treasury Department's most current list (Circular 570 as amended). THIS IS A REQUIRED FORM. Surety Agent or Representative for service process in California if different than Surety Name: Name: Address: Address: City/State/Zip Code: City/State/Zip Code: Telephone No.: Telephone No.: Page 6 CONTRACT NO. C35000 A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. PRINCIPAUCONTRACTOR ACKNOWLEDGEMENT State of California ) ) ss. County of ) On before me, personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) Page 7 CONTRACT NO. C35000 A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. SURETY ACKNOWLEDGEMENT State of California ) ) ss. County of ) On before me, personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) Page 8 CONTRACT NO. C35000 C - CONTRACTOR'S BID CAP HOMME/RALPH ADAMS PARK UPPER PARK SHELTER REPLACEMENT PROJECT NO.927-16 CONTRACT NO. C36000 TO: CITY OF PALM DESERT, "CITY" DATE: February 24, 2016 BIDDER: T.l.lanca Construction, Inc. "CONTRACTOR" The UNDERSIGNED, "CONTRACTOR", having carefully examined the site and the Contract Documents for the construction of, CAP HOMME/RALPH ADAMS PARK UPPER PARK SHELTER REPLACEMENT, Project No, 927-16, Contract No. C35000, hereby proposes to construct the work in accordance with the Contract Documents, including Addenda No(s). +a for the amount stated in this Bid. By submitting this Bid, CONTRACTOR agrees with CITY: That unless withdrawn in person by CONTRACTOR or some person authorized in writing by CONTRACTOR before the time specified in the Notice Inviting Bids for the public opening of bids, this Bid constitutes an Irrevocable offer for 60 calendar days after that date. 2. The CITY has the right to reject any or all Bids and to waive any irregularities or informalities contained In a Bid. 3. That the contract shall be awarded only by the governing body of CITY. Said contract shall only be deemed awarded after the CONTRACTOR'S complete submission of all contract documents, bonds, insurance documentation, and the CITY shall obtain all necessary signatures of the governing body, at which time the contract shall be deemed awarded. 4. To submit to CITY such information as CITY may require to determine the Bidder's financial standing experience and to perform the work. 5. That the accompanying certified or cashier's check or Bid Bond constitutes a guarantee that if awarded the contract, CONTRACTOR will execute the Agreement and deliver the required bonds and certificates of insurance within 10 days after notice of award. If CONTRACTOR fails to execute and deliver said documents, the check or bond is to be charged with the costs of the resultant damages to CITY, including but not limited to publication costs, the difference in money between the amount bid and the amount In excess of the bid which costs CITY to do or cause to be done the work involved, lease and rental costs, additional salaries and overhead, increased Interest and costs of funding the Page C-1 CONTRACT NO. C35000 project, attorney expense, additional engineering and architectural expense and cost of maintaining or construction alternate facilities occasioned by the failure to execute and deliver said documents. It is understood that the quantities shown hereon, except for those quantities marked "Lump Sum", are estimates and the final payment will be based upon the actual work performed, subject to such adjustment and alterations as elsewhere provided herein. Na _` ITEM.bE CRMON n 1 Mobilization 1 Clearing and grubbing and removal 3 l Supply and Install one 12'x12' Steelworx park shelter (no wooden parts), or approved equal Colors and design to match existing steel structure on site. ( 4 Submit calculations and wet stamped drawings by structural engineer. 5 Install footings per approved structural engineer drawings j 8 i Coordinate Inspections with the City's Building & Safety Department and subit paperwork for project acceptance. 7 Install 14'x14' 4-inch thick concrete slab with broom finish. i 8 Perform cleanup as needed. ' $ 53,716.00 The costs of any work shown or required in the Plans and Specifications, but not specifically identified as a Pay Item, are Included In the related Pay Item(s), and no additional compensation shall be due the CONTRACTOR by virtue of CONTRACTOR'S compliance with the Plans and Specifications. TOTAL LUMP SUM BID AMOUNT IN FIGURES $ 53,716.00 TOTAL LUMP SUM BID AMOUNT IN WORDS Fifty -Three Thousand, Seven Hundred, and Sixteen Dollars only IN WITNESS WHEREOF CONTRACTOR exec ted this Bid as of date set forth on B Page C-1: y I�� : Signature (to notarized - see next page) Title: Tim Janca, President Page C-Z CONTRACT NO. C35000 A Notary Public or other officer completing this certificate veril%s only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of Califomia ) ss. County of IC`OLAI-Q- ) Subscribed and sworn to (or affirmed) before mq Dn thi 2�•� day ofT;6ru0.� i'month), Za l w (year), by —I `r+no!H Zk&A , proved to me on the basis of satisfactory levidence to be the person(s) who appeared before me. Signature of Notary Page C-3 (Seal of Notary) uNDA MIACKEY COMMIS9100 # 2044M NWWy PubYC • C4W0nNa MY Carom. EXW" 09111, 2017 CONTRACT NO. C35000 D -- INFORMATION REQUIRED OF BIDDER TO ACCOMPANY BID The bidder is required to supply the following information. Additional sheets may be attached If necessary. (1) Company Name - - -- - -- - - (2) Address 2128 N. Batavia St., #105, Orange, CA 92865 (3) Telephone No. (714) 921-3940 (4) Type of Firm (Individual, Partnership or Corporation) Corporation (5) Corporation organized under the laws of the State of California (6) Contractor's License No. 774195 Exp. Date 01/31/2018 (7) Department of Industrial Relations Contractor Registration number: 1000002326 (8) Email Address for DIR Contact lmackey@protectturf.com (9) List the names and addresses of all owners of the firm or names and titles of all officers of the corporation: Tim Janca, sole Officer/Shareholder,14882 Wildcat Canyon Rd., Silverado, CA 92676 (10) Number of years' experience as a Contractor in construction work 30+years (11) List at least three similar projects completed recently: CoMmot Amount Class of Work Date Completed Name, Address & 1. $28,000 2. $46,500 Metal Shade June, 2015 Shelter 0 Franklin E-S Metal Shade Shelter at Henninger Elem September, 2014 3. Site prep, concrete, $150,335 and Surfacing February 9, 2016 installations Page D-1 Telephone No. of Owner Santa Ana USD 1601 E. Chestnut Ave., Santa Ana 92701 Todd Budcher - (951) 453-0163 Santa Ana USD 1401 E, Chestnut Ave., Santa Ana 92701 Todd Butcher - (951) 453-0163 Alvord USD 10365 Keller Ave., Riverside, CA 9505 (951) 538-2613 - Jeff Windbigler CONTRACT NO. C35000 (11) Pursuant to California Public Contracting Code, Section 4100 et. Seq., the following list gives the name business address, and portion of work (description of work to be done) for each subcontractor that will be used in the work if the bidder is awarded the Contract, (Additional supporting data may be attached to this page. Each page shall be sequentially numbered, and headed "Proposed Contractors" and shall be signed.) The Bidder shall list all subcontractors who will perform work or labor or render service to the prime contractor in excess of one-half of one percent of the prime's bid. Failure to Include the subcontractor's DIR realstratlon number may result In the bid beina re/eWted as nonresponsive. Subcontractor's Name: None License Number: DIR Contractor Registration No. Business Address: Telephone: DIR Email Address Work Description: Percent of Work: Subcontractor's Name: License Number: DIR Contractor Registration No. Business Address: Telephone: DIR Email Address Work Description: Percent of Work: Subcontractor's Name: License Number: DIR Contractor Registration No. Business Address: Telephone: DIR Email Address Work Description: Percent of Work: (12) List the name of the person who inspected the site of the proposed work for your firm Tim Janca (13) A financial statement or other information and references sufficiently comprehensive to permit an appraisal of your current financial condition may be required by the City. (14) Contractor hereby swears under penalty of perjury that the information provided here is true and correct. By: ,! Signature Page D-2 Title: Tim Janca, President Contractor CONTRACT NO. C35000 E— NONCOLLUSION DECLARATION To be Executed by Bidder and Submitted with Bid The undersigned declares: I am the President of T.J. Janca Construction, Inc. , the party making the foregoing bid. The bid Is not made In the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding. 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. All statements contained in the bid are true. 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, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose. Any person executing this declaration on behalf of a bidder that Is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder. declare under penalty of perjury under the laws of the State of California that the foregoing Is true and correct and that this declaration is executed on February 24 , 2016 , at Orange California city State By: Signature Title; Tim Janca, President CONTRACTOR Page E-1 CONTRACT NO. C35000 7c" pa rr NIP,-, Pua!)C WCrk1 12 03 54 02-22-2016 ? i F — Bidder's Bond To Accompany Bid KNOW ALL MEN BY THESE PRESENTS, That we, T.J. Janca Construction, Inc. as principal, and Contractors Bondin, and Insurance Company as surety, are held and Firmly bound unto the City of Palm Desert in the sum of $'Ten Percent of (10% of bid) to be paid to the said City or its certain attorney, its successors and assigns; for which payment, weal 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 # the certain bid of the above bounden principal to perform certain work described as follows: *Amount Bid CAP HOMMEIRALPH ADAMS PARK UPPER PARK SHELTER REPLACEMENT PROJECT NO. 927-16 CONTRACT NO. C35000 The general items of work to be done hereunder consist of removal and replacement of poured in place playground surfacing and dated 2/2`t/ I to is accepted by the City of Palm Desert, and if the above bounden principal T.J. Janca Construction, Inc. shall duly enter into and execute a contract for such construction, and shall execute and deliver the Performance Bond and Payment Bond and insurance certificates as required by said contract, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. Should it become necessary for the City to institute a lawsuit, or any other legal proceeding to enforce the terms and conditions of this bond, then all costs of said proceeding, including attomey's fees, shall be awarded to the prevailing party. IN WITNESS WHEREOF, we hereunto set our Hands and Seals this 23rd day of February 2016. Contractor's Name: T.J. Janca Con truction, Inc. Contractor's Signature: l.t�nn I (Slgnatura to be notarized) Title: �MS t4 �, rti� -- - - ---- Address: 2328 Batavia St., #105 Grange. Ca 92865 Telephone: (714)921-3940 CONTRACT NO. C35000 760;417C58 Pa.r^ Dvscrt P-"p i 14*0?ks Surety's Name: _Contractors Bonding and Insurance Company Surety's Signature: /J r/ (Signal re to be notarized) Title: Vickie Spence, Attorney -In -Fact Address: 111 Pacifica, Suite 350 Irvine, Ca 92618 Telephone: (800)274-2242 16 02-22-1016 4 5 A Notary Public or other officer completing this certificale verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. Contractor Acknowledgment State of California } ) ss. County of Or'Anjt ) On 1Peb►V*-e1 j ZS ,'Lb (to before me, 11;$J , v MD�0-r- y personally appeared -T7''e- ��KGq , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Ware subscribed to the within instrument and acknowledged to me that he/she/they executed the same In his/her/their authorized capacity(ies), and that by histhedtheir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal, Signature v"''` LINDA MACKEY Commieeion f 2044995 Notuy PubHC - C11111 ie Orange County iWMyCoMm.Expjm0ct11I 2017 X LINDA MACKEY Com lion 12044995 y Notary • Conform 0 qe My Comm. Expire 1, 2017 (Seal) OA— Com . s 4995 Notary P lc - Ca, •ante Orange my My Comm. Expires 11 204 CONTRACT NO. C35000 7503417098 Prim : esen PuMic'NO(ks 12 C4 31 02-22-2016 5 5 A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. Surety Acknowledgment State of California ) " ) SEE ATTACHED " County of ) On before me, personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) CONTRACT NO. C35000 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 !trY:rwM__•N-Y�.�,.6.,.�RrM...�l.nJ....-i'tar-1�n...r�.r^q..r.-..14rrr.=v.�..�..-.-u-_...,� ��.b�ry-rNr..r�yV-/V]Rr�r�-rV.R.r A notary public or other officer completing this certificate verifies only the Identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of ORANGE ) On 2/23/16 before me, OLGA S HAPPEL, NOTARY PUBLIC Date Here Insert Name and Title of the Offrcer personally appeared VICKIE SPENCE Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within Instrument and acknowledged to me that he/she/they executed the same In his/her/their authorized capacity(les), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the Instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS mqSign ficial seal. OLGA S HAPPEL m COMM. 0 20S3051 Signature NOTARY PUBUIORANGE � ORNu► rre of Notary Public MY COMM. EXPIRES DEC. 23, 2027. 1 Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: BOND Document Date: 2/23/16 Number of Pages: 3 Signer's) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): O Partner — ❑ Limited O General O Individual O Attomey in Fact O Trustee O Guardian or Conservator O Other: Signer Is Representing: Signer's Name: O Corporate Officer — Title(s): ❑ Partner — O limited D General ❑ Individual ❑ Attorney In Fact O Trustee O Guardian or Conservator O Other. Signer Is Representing: C2014 National Notary Association • www.NabonaiNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 CONTRACT NO. C35000 R L I is SOWER OF ATTORNEY M Surety 9025N.UntibershDr. IPearls,IL61615 Contractors Bonding and Insurance Company Phooe: (tto0)645-2402I Pm- 009)669.2036 Snow A Men by Tbase Presents: That ibis Power of Adormy is not valid or in effect unless attached to the bond which it authorizes, but may be detached by the approving officer if desired. That this Pm"r ofAti mey may be effective and given to either or both of RLI Insurance Company/RLI Indemnity Company and Contractors Bonding and Insurance Company, required for the applicable bond. That RLI Insurance Compeoy/RLI lademnity Company ardor Contractors Bonding and Insurance Company, each Illinois corporations (as applicable), each authorized and licensed to do business in all states and the District of Columbia do hereby mske, constitute and appoint: Julie Durkin, Grace L Reza, Vickie Spence, Olga S. Aguirre, Betty Walker in the City of Irvine . State of California as Attorney in Fact, with full power and authority hereby conferred upon hint/her to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed, all of the following classes of documents to -wit: Indemnity, Surety and Undertakings that may be desired by contract, or may be given in any action or proceeding in any court of law or equity; policies indemnifying employers against lass or damage caused by the misconduct of their employees, official, bail and surety and fidelity hoods. Indemnify in all cases where indwutity may be lawfully given; and with full power and authority to execute consents and waivers to modify or change or extend any bond or document executed for this Company, and to compromise and settle any and all claims or demands made or existing against said Company. RLI Insurance Company/RLI Indemnity Company and Contractors Bonding and Insurance Company, as applicable, have each further cerfifred that the following is a true and exact copy ore, Resolution adopted by the Board of Directors of each such corporation, and now in force, to -wit "Ail bonds, policies, undertakings, Powers of Attorney or other obligations of the Corporation shall be executed in the corporate name of the Corporation by the President. Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who &hall have authority to issue bonds, policies or undertakings in the name of the Corporation. The corporate seal is not necessary for Cite validity of any bonds, politics, undertakings, Powers of Attorney or other obligations of the Corporation. The signature of any such officer and the corporate seal may be printed by facsimile or other electronic image." IN wrimsS WHEREOF, RLI Insurance Company/RLI Indemnity Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents lobe executed by its respective Vice P=tdent with its corporate seal affixed this 23rdday of February 2016 . ATTEST: elbVlo AIM Cherie L. Montgomery jAssistaa Secrets S �+Y rY Statc of JlliaWs j} S5 County of Pia RLI Insurance CompanylRLI Indeannity Company Contractors and Insurance Company Banon W. Davis Vice Preaideal On this 23rc1 day of February 2016 before me, a Notary Public, personally appeand B41wn W. Davis and Chem. Mnntgomer:—, who being by me duly swam, acknowledged that they signed the above Power of Atlomey as Vice Pn_sidenr and As.+slanl Secretary , respectively, of RLI Insurance CompanylM Indemnity Company and Contractors Bonding and Insurance Company, and admwltdged said instrument to be the vol tary act and dad of said corporstion. _LZ�-ett� -OFFICIAL SEAV IN queline K B kler Notary Public sae: @Xt a na A0056115 r ~ { ~ �;4$ 019 ♦ F..M1.•. L� 4. w.4blk .. i x• t� , a '..tt •- •mod - r '1 � •� �aci• � 5 � W • M 1 .r: THRUSH Rp oFPD Homme 1 Adams Park Palapa Date: 2016 VICINITY MAP