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HomeMy WebLinkAboutC34320 - Highway 111 Right Turn to Westbound Fred Waring 659-14Contract No. C34320 CITY OF PALM DESERT PUBLIC WORKS DEPARTMENT STAFF REPORT REQUEST: AWARD CONTRACT NO. C34320 TO GRANITE CONSTRUCTION COMPANY OF INDIO, CA IN THE AMOUNT OF $404,000.00 FOR THE HIGHWAY 111 RIGHT TURN TO WEST BOUND FRED WARING DRIVE (PROJECT NO. 659-14) SUBMITTED BY: Mark Greenwood, P.E., Director of Public Works DATE: June 11, 2015 CONTENTS: Agreement and Bonds Contractors Bid Vicinity Map Recommendation By Minute Motion: 1. Appropriate $80,000.00 from Unobligated Measure "A" funds to Account 2134383-4400100; 2. Award Contract No. C34320 to Granite Construction Company of Indio, CA for the Highway 111 Right Turn to West Bound Fred Waring Drive project in the amount of $404,000.00 (Project No. 659-14); 3. Authorize the Director of Finance to set aside a 10 percent contingency in the amount of $40,400.00; and 4. Authorize the Mayor to execute said Agreement. Funding is available for this project in Measure "A" Account No. 2134383-4400100 for the Right Turn portion of the project and Account No. 2134363-4400100 for the sidewalk improvements in front of MOR furniture. Strategic Plan Objective This project will meet objectives outlined in Envision Palm Desert Forward Together in Tourism & Marketing by improving access to retail developments while mitigating traffic congestion. Background In September 2011, the City of Palm Desert acquired right-of-way from N and D Restaurants, Inc., the owner of the property at the Red Lobster Development. The Staff Report Award Contract No. C34320 for Highway 111 to West Bound Fred Waring Drive Page 2 of 2 June 11, 2015 additional right-of-way was required to construct a dedicated right turn onto westbound Fred Waring Drive from Highway 111 to mitigate traffic congestion. The work will include grading, paving, sidewalk and extensive traffic signal work. In addition to the work at the Highway 111 and Fred Waring Drive intersection, the project will also add sidewalk and ADA compliant driveways at the current location of the MOR furniture store. On May 14, 2015 the original bid for this project was rejected. Staff felt that an item in the traffic signal component was ambiguous and could lead to a substantial change order. On June 1, 2015, the re -bids for the Highway 111 Right Turn to West Bound Fred Waring Drive project were opened and read aloud. Only Granite Construction of Indio submitted a bid. Granite's bid was $404,000.00. The bid was verified and Granite Construction is the lowest responsive bidder. Fiscal Analysis The proposed bid has exceeded the budgeted amount for this project. The allocation of $80,000 of Measure "A" funds will cover the shortfall, contingency and the necessary survey and soils testing services. Prepared By: /6el Montalvo, P.E., Senior Engineer odg-- Paul S. Gibson, Director of Finance Approval: M. Wohlmuth, City Manager AGREEMENT THIS AGREEMENT is made and entered into this 11 th day of June, 2015, by and between City of Palm Desert, California, hereafter called "CITY" and Granite Construction Company hereinafter called "CONTRACTOR". WITNESSETH RECITALS: CONTRACTOR has submitted to CITY its Contractor's Bid for the construction of CITY Project, 1. HIGHWAY 111 RIGHT TURN TO WEST BOUND FRED WARING DRIVE, PROJECT NO. 659-14, CONTRACT NO. C34320, 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) Any Change Orders issued; (m) Any additional or supplemental specifications, notices, instructions and drawings issued in accordance with the provisions of the Contract Documents (n) The Determination of Prevailing Wage Rates for Public Work, (o) Addenda No(s) Q. 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 45 Calendar Days from the Notice to Proceed date to the satisfaction of the Engineer. Contract No. C34320 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 $1,500 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. C34320 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: Granite Construction Company BY: ATTEST BY: Signature to be notarized TITLE: CITY: M TITLE: Mayor of Palm Desert, CA APPROVED AS TO CONTENT: MARK GREENWOOD, P.E. DIRECTOR OF PUBLIC WORKS TITLE: ATTEST BY: TITLE: City Clerk of Palm Desert, CA APPROVED AS TO FORM: DAVID J. ERWIN CITY ATTORNEY 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, Notary Public, personally appeared who proved to me on the basis a 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 C -- CONTRACTOR'S BID HIGHWAY 111 RIGHT TURN TO WEST BOUND FRED WARING DRIVE PROJECT NO.659-14 CONTRACT NO. C34320 TO: CITY OF PALM DESERT, 'CITY" DATE: 06/01/2015 BIDDER; Granite Construction Company "CONTRACTOR" The UNDERSIGNED, "CONTRACTOR", having carefully examined the site and the Contract Documents for the construction of, HIGHWAY 111 RIGHT TURN TO WEST BOUND FRED WARING DRIVE, PROJECT NO. 659-14, CONTRACT NO. C34320, hereby proposes to construct the work in accordance with the Contract Documents, Including Addenda No(s). NONE for the amount stated in this Bid. By submitting this Bid, CONTRACTOR agrees with CITY: 1. 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 project, attorney expense, additional engineering and architectural expense and cost of maintaining or construction attemate 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. 1 Mobilization LS 1 $ oo /�000 $ oa /�ObD 2 Traffic Control LS 1 $ 3 0cv $ 3'f vcr> 3 Clearing and Grubbing LS 1 $ly q SSOCO $W 9 55 vo 4 Remove and Dispose of Tree EA 3 $Soo °^a $ / Seo 5 Remove Base and Surfacing SF 2,600 $ %r a $/3, eoo� 6 Remove Concrete Curb/Curb and Gutter LF 220 $ 00 $ 980 do 7 Remove Concrete SF 2,850 $ $ , o?,s„ 8 Unclassified Excavation (F) CY 350 $ xe o $CIF g2 9 Adjust Water Valve to Grade EA 14 $ 00 ^ $ 10 Adjust Sewer Clean Out to Grade EA 2 $ map— $ 600 &' 11 Adjust Irrigation Boxes, Storm Drain Grate and Valve Covers to Grade EA 7 $lea ~ $S6op 2-0 If 12 Irrigation System Modifications LS 1 soo ,e 13 Aggregate Base CY 70 $ ?oo ep $/yAvo 14 Asphalt Concrete Pavement Surface Course TON 50 $ 300 $ 15 Asphalt Concrete Pavement Base Course TON 80 $ .1715jee $ 16 Concrete Curb and Gutter (Type I) LF 210 $ .74 —*0 $ %S60 Page C-2 17 Concrete Curb (Type II) LF 45 Fri $ 30 o 18 Concrete Sidewalk SF 2,700 $ �, eo $��600 19 Concrete Curb Ramp EA 1 $ $� V-0— 20 Slough Wall LF 230 $ s-/ °� $//730 21 Concrete Driveway SF 1,600 $ od $ 22 Landscaping LS 1 $ 7, soe7soo $ ge 23 Signing and Striping LS 1 $ Fswo$ 24 Traffic Signals (S) and Safety Lighting S LS 1 $ C 60 1 jJ fJQ $/ £ Da TOTAL BID PRICE J$ o �, p uv Page C-3 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 CONTRACTOR by virtue of CONTRACTOR'S compliance with the Plans and Specifications. TOTAL AMOUNT BASE BID IN FIGURES $ 4 Dy' oao ou TOTAL AMOUNT BASE BID IN WORDS f 14uv),k f,- F ( -{ nu5�►� IN WITNESS WHEREOF CONTRACTOR executed this Bid as of date set forth on Page C-1: By: Sign re Joseph P. Richardson Title: Regional Chief Estimator CONTRACTOR Ar 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 -- oe'er, �— ) Subscribed and sworn to (or affirmed) before on this t *r day of -� u ►--j— ��� (month), ol-0 l m 5 (year), by LCA-U 5 proved to me on the basis of satisfact ry evidence to be the person(s) who appeared before me. Signature of Notary ---=<vl� T. SMER Commission / 1955551 Notary Public - California Riverside County @Mg Comm Fx Hes Nov 4.2015 Page C-4 GRANITE CONSTRUCTION COMPANY CERTIFICATE OF SECRETARY RESOLVED, that, effective April 9, 2015 through December 31, 20I5, the individuals named on the attached Exhibit I are authorized to negotiate, execute and/or attest electronic and paper documents and contracts necessary for the conduct of the Company's affairs with respect to the submission and execution of construction project bids, bid proposals, bid addenda and all other bid -related documents prepared and submitted on behalf of the Company not to exceed $25 million, relating to any and all domestic construction projects arising out of the Company's operations. RESOLVED, that, effective April 9, 2015 through December 31, 20I5, the individuals named on the attached Exhibit 2 are authorized to negotiate, execute and attest electronic and paper documents and contracts necessary for the conduct of the Company's affairs with respect to the submission and execution of construction project bids, bid proposals, bid addenda and all other bid -related documents prepared and submitted on behalf of the Company not to exceed $75 million, relating to any and all domestic construction projects arising out of the Company's operations. RESOLVED FURTHER, that the authority provided for herein shall be in accordance with applicable policies, procedures and limits of authority previously approved and the Granite Construction Incorporated Delegation of Authority and Policy then in effect. I, Richard A. Watts, do hereby certify that I am duly qualified as Secretary of GRANITE CONSTRUCTION COMPANY, a California corporation (the "Company"); that the foregoing is a true and correct copy of resolutions duly adopted effective April 9, 2015 by unanimous written consent of the Executive Committee of the Board of Directors, held without a meeting in accordance with the provisions of Article III, Section 9 of the Bylaws of the Company; that the Directors acting were duly and regularly elected; and that the resolution adopted has not been modified or repealed and is still in full force and effect. PN.� E CO '. ¢ r Dated: April 10, 2015 �, c Page I of 21 LKNAUMCOIMUICOO CWWMA 4W Maanp'AA�tWO&SP nQOMAMAWCCEUMEtlfn.4f0A— EXHIBIT 1 AUTHORIZED SIGNERS Granite Construction Company California Group Desert Cities Region AUTHORIZED SIGNERS Brian Caris, Construction Manager Joseph P. Richardson, Regional Chief Estimator Jeff J. Mercer, Construction Manager Ralph M. Pipkin, Project Manager Lon Dillman, Regional Controller Jennifer Francis, Regional Office Manager ATTESTORS Brian Caris, Construction Manager Joseph P. Richardson, Regional Chief Estimator Jeff J. Mercer, Construction Manager Ralph M. Pipkin, Project Manager Carley L. Cechin, Project Manager Lon Dillman, Regional Controller Jennifer Francis, Regional Office Manager Tamara Speer, Project Pursuit Coordinator Carolyn Maness, Estimating Assistant Page 13 of 21 LZHANW.COLMU'CO%PCo,wjLea 1z Mm p%AWmxd lrb k�ari2o17U{nMiCC C[Ai t�YM.I-ylSdm EXHIBIT 2 AUTHORIZED SIGNERS Granite Construction Company California Group AUTHORIZED SIGNERS Jim Radich, VP Coastal Region Michael Tatusko, VP Valley Region Bruce McGowan, VP Central California Region David A. Donnelly, VP San Diego Region Brad J. Williams, VP Desert Cities Region Page 20 of 21 LWtARW.COMLVMU Cmrsrt0MW M1 p%wl idRed&,p— jSAMr4CCC[RT.%b 9"w,4.gjs*= PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS: That whereas the City of Palm Desert has awarded to Granite Construction Company hereinafter designated as the "Principal", a contract for: HIGHWAY 111 RIGHT TURN TO WEST BOUND FRED WARING DRIVE PROJECT NO. 659-14 CONTRACT NO. C34320 WHEREAS, said Principal is required under the terms of said contract to fumish a good and sufficient bond for the performance of said contract: NOW THEREFORE, WE, 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 Four Hundred and Four Thousand Dollars and No Cents ($ 404,000.00), 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 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 PRINCIPAL M (Signature must be notarized) (Signature must be notarized) INSURANCE COMPANY and/or AGENT ADDRESS TELEPHONE NUMBER SURETY ACKNOWLEDGEMENT 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 ) 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 Page 2 PRINCIPAL ACKNOWLEDGEMENT 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 ) ME personally appeared before me, , 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 Page 3 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS: THAT WHEREAS, the City of Palm Desert (sometimes referred to hereinafter as "Obligee") has awarded to Granite Construction Company (hereinafter designated as the "CONTRACTOR"), an agreement dated June 11, 2015 described as follows: HIGHWAY 111 RIGHT TURN TO WEST BOUND FRED WARING DRIVE, PROJECT NO. 659-14, CONTRACT NO. C34320, (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, 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 Four Hundred and Four Thousand Dollars and No Cents ($ 404,000.00), 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. 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 Page 4 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: Granite Construction Company By: (Signature) (Typed Name and Title) (Signature must be notarized) The rate of premium on this bond is $ SURETY: (Typed Name of Surety) 0 (Signature of Attorney -in -Fact) (Typed Name of Attorney -in -Fact) (Signature must be notarized) The total amount of premium charged: $ (the above must be filled in by corporate surety). per thousand. 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. Any claims under this bond may be addressed to: (Name, Address and Telephone No. of Surety) (Name, Address and Telephone No. of agent or representative for service of process in California if different from above) Page 5 SURETY ACKNOWLEDGMENT A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of 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 Page 6 PRINCIPAL ACKNOWLEDGMENT ,A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document." State of California ) County of ) 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 Page 7 tiW" a - -.I Parcels