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HomeMy WebLinkAboutC34700 - 2016 Parking Lot Maintenance Project 750-16Contract No. C34700 CITY OF PALM DESERT PUBLIC WORKS DEPARTMENT STAFF REPORT REQUEST: AWARD CONTRACT NO. C34700 FOR CONSTRUCTION OF THE 2016 PARKING LOT MAINTENANCE PROJECT TO S 2 SEALING AND STRIPING OF PALM DESERT, CALIFORNIA, IN THE AMOUNT OF $64,990 (PROJECT NO. 750-16) SUBMITTED BY: Mark Greenwood, P.E., Director of Public Works CONTRACTOR: S 2 Sealing and Striping P.O. Box 12785 Palm Desert, California 92255 DATE: September 10, 2015 CONTENTS: Contract Agreement and Bonds Contractor's Proposal Location Map Recommendation By Minute Motion: 1. Award Contract No. C34700 for construction of the 2016 Parking Lot Maintenance Project to S 2 Sealing and Striping of Palm Desert, California, in the amount of $64,990 (Project No. 750-16); 2. Authorize the Director of Finance to set aside a 10 percent contingency in the amount of $6,499; and 3. Authorize the Mayor to execute the subject agreement. Funding is available for this project in the New Construction Tax Parking Lot Maintenance Account, and the Presidents Plaza III Parking Lot Improvement Account: 2314313-4332000 and 2824373-4332000, respectively. Background The City maintains parking lots at parks, City -owned facilities, and parking lots with public parking easements. The project this year will seal coat five parking lots: Desert Willow Academy, Desert Willow Overflow Lot, Freedom Park, Magnesia Falls Park, and President's Plaza III. Staff Report Award Contract C34700 to S 2 Sealing and Striping Page 2 of 2 September 10, 2015 A call for bids was advertised, and on August 25, 2015, sealed bids were opened and read aloud. The following is a summary of the bids received: Contractor Location Bid Amount S 2 Sealing and Striping Palm Desert, CA $ 64,990 NPG Perris, CA $104,070 J.RDMMAC Victorville, CA $167,770 Hardy and Harper Santa Ana, CA $177,000 S 2 Sealing and Striping was the lowest responsible bidder. Although there is a large range in the bid prices, the low bid is in line with the engineer's estimate. S 2 is a small local company, so the bid price could be lower due to less travel time and lower overhead than the other bidders. S 2 Sealing and Striping has successfully completed contracts for the City in the past, and Public Works recommends approval of this contract. Fiscal Analysis This is an on -going maintenance activity with no fiscal impact beyond the contract amount. The work in Presidents Plaza III is being paid for with funds collected from the property owners and held by the City for periodic maintenance. Prep ed By: Dep m nt ead: ir - & A ix4m Ryj Gayler roject Administrator Mark Gr ty ood,P.Directorblic Works rJ4 Paul S. Gibson, Director of Finance Approval: Wohlmuth, City Manager Contract No. C34700 AGREEMENT THIS AGREEMENT is made and entered into this 10th day of September, 2015, by and between City of Palm Desert, California, hereafter called "CITY" and S 2 Sealing and Striping hereinafter called "CONTRACTOR". WITNESSETH RFr..ITAI .q- CONTRACTOR has submitted to CITY its Contractor's Bid for the construction of CITY Project, 1. 2016 PARKING LOT MAINTENANCE PROJECT, PROJECT NO. 750-16, CONTRACT NO. C34700, 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. 1. 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 25 Calendar Days from the Notice to Proceed date to the satisfaction of the Engineer. Contract No. C34700 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 $1,000.00 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. C34700 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 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." 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: BY: TITLE: CITY: BY: Signature to be notarized TITLE: Mayor 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: DAVID J. ERWIN CITY ATTORNEY Contract No. C34700 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 Contract No. C34700 PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS: That whereas the City of Palm Desert has awarded to S 2 Sealing and Striping hereinafter designated as the "Principal", a contract for: 2016 PARKING LOT MAINTENANCE PROJECT PROJECT NO. 750-16 CONTRACT NO. C34700 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, S 2 Sealinq and Striping 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 Sixty-four thousand Nine hundred Ninety and no/100 Dollars ($64,990.00), 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. Contract No. C34700 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 AN PRINCIPAL I1-YA (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 Contract No. C34700 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 ) 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 Contract No. C34700 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS: THAT WHEREAS, the City of Palm Desert (sometimes referred to hereinafter as "Obligee") has awarded to S 2 Sealing and Striping (hereinafter designated as the "CONTRACTOR"), an agreement dated September 10, 2015 described as follows: 2016 PARKING LOT MAINTENANCE PROJECT, PROJECT NO. 750-16, CONTRACT NO. C34700, (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, S 2 Sealing and Striping 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 Sixty-four thousand Nine hundred Ninety and no/100 Dollars ($64,990.00), 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. Contract No. C34700 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 CONTRACTOR) At (Signature) (Typed Name and Title) (Signature must be notarized) The rate of premium on this bond is $ SURETY: (Typed Name of Surety) By: (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) Contract No. C34700 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 Contract No. C34700 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 ) m 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 C - CONTRACTOR'S BID 2016 PARKING LOT MAINTENANCE PROJECT PROJECT NO. 750-16 CONTRACT NO. C34700 TO: CITY OF PALM DESERT, "Cll Y" DATE: X 1251 I S BIDDER: "CONTRACTOR" The UNDERSIGNED, "CONTRACTOR", having carefully examined the site and the Contract Documents for the construction of, 2016 PARKING LOT MAINTENANCE PROJECT, PROJECT NO. 750-16, CONTRACT NO. C34700, hereby proposes to construct the work in accordance with the Contract Documents, including Addenda No(s). 1 (� i 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 project, attorney expense, additional engineering and architectural expense and Page C-1 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. �0fiT' 'F"'�` ;Y7"'..,,'r''fW''is Desert Willow Academy $ $ +/- 48,100 square feet LS 1 g2en. �205 1 complete in minimum of two moves m Desert Willow Overflow Lot $ $ +/- 86,100 square feet LS 1 2 complete in minimum of two moves 121O941-0- 12, 054, Freedom Park $ ,,, (2, $ ,. I Zi 8W +/- 93,850 square feet LS 1 do 3 complete in minimum of three moves Magnesia Falls Park $ $ +/- 30,100 square feet LS 1 4 complete on one Saturday J�2 5 a33 =' President's Plaza III $ $ +/- 223,100 square feet LS 1 5 complete in minimum of four moves O 5J (�1`'0 �5, &aO TOTAL BID PRICE $ ��� 9�0 ao Page C-2 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 $ �`� ��0• a' TOTAL AMOUNT BASE BID IN WORDS SA,6g urOuSat�A �l i•1?i L) o U*rs A. 03 Zero IN WITNESS WHEREOF CONTRACTOR executed this Bid as of date set forth on Page C-1: S-4 ���s�.'u� : sna:PN� iN�. By: C::�- ��- Signature Title: 5 «f4`�� CONTRACTOR 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 l Ij�►*q Subscribed and sworn to (or affirmed) before Me on this 2 day of '&u U.S� (month), 09.6 l'Fj (year), by proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature of Notary T. SPEER commission # 195555, Notary Public - California Riverside County Low....M4 Comm. Expires Nov 412015 Page C-3 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 IN (2) Address ??Q . SLx 12785. ?A bi ��s F CA. 9aa 55 (3) Telephone No. lGo . 340. a 7S'7 (4) Type of Firm (Individual, Partnership or Corporation) . (5) Corporation organized under the laws of the State of CA (6) Contractor's License No. 5 / Y gc2o Exp. Date 9150//5- (7) Department of Industrial Relations Contractor Registration number: /OcOo/& i95 (8) Email Address for DI R Contact aS o2 sEALs mn e- C VA~. Go N (9) List the names and addresses of all owners of the firm or names and titles of all officers of the corporation: 7� i?•0. U?c I�� PAIR uCSw OA- 9a.255 e,0. K 1a7 ioP(n �is..:, Gd. 9a�ss (10) Number of years' experience as a Contractor in construction work (11) List at least three similar projects completed recently: Contract Amount Class of Work Date Completed Name, Address & Tele one No. of Owner '6,Dwt, - Ac re of ST�n" L QA eL. (Ail4 %!�O •345.255 2. s(c(/.s 0 PAL►, De5eA� 3' u' 4YN(.L�IC�PJ 76o - -9 -77l Page D-1 State Of ca mia 91i „ CONTRACTORS STATE 1.10ENSE BOARD c:,w.,.�� ACTIVE UCE WENfb- ,...N... 518420 F. CORP S 2 SEALING & STRIPING INC wC32 09/30/2015 w ifi.cslb.ca.gov Registration Payment Success Page 1 of 1 /�J�1. �,1=.1oFolridrnl=aP4i c,1�r 1�nlol�l=:1"+'(oi� ��t`=.iFcPrttc!IFa s•' Division of Labor Standards Enforrement Thank you for your payment. Payment Confirmation Number. KN4397Y2Z3PC1 Registration Number: 1000016195 Contractor Name: S2 SEALING & STRIPING, INC NO77(:E., if paying byACH/EFT, pleess allow up to 7 days for processing. swan to N1 bi works ►fomaoa4a ('upi riehl , 2014 Sorb of California littps://efi ling.d ir.ca.gov/PWCR/ActionServlet?action=navmentComnlete 3/2p/2015 (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 registration number may result in the bid being rejected as non -responsive. Subcontractor's Name: NONE License Number: DIR Contractor Registration No. Business Address: Telephone: Work Description: Percent of Work: Subcontractor's Name: License Number: DIR Contractor Registration No. Business Address: Telephone: Work Description: Percent of Work: Subcontractor's Name: License Number: DIR Contractor Registration No. Business Address: Telephone: Work Description: Percent of Work: (12) List the name of the person who inspected the site of the proposed work for your firm (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 this information provided is true and correct. By: Title: SignatUrel Contractor Page D-2 E — NONCOLLUSION DECLARATION To be Executed by Bidder and Submitted with Bid The undersigned declares: am the S�e�e-,- of S-a s6A'in ; srtiPft� /Nc, the party making the foregoing Od. 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. I 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 A uM . ?6 , 20 IS , at /A/�/� CAA City State By:y-�-L-- Signature Title: Acr� CONTRACTOR Page E-1 F — BIDDER'S BOND To Accompany Bid KNOW ALL MEN BY THESE PRESENTS, e,06WCAS That we, and as firmly bound unto the City of Palm Desert in the sum of $ as principal, surety, are held and (10% of bid) to be paid to the said City or its certain attorney, its successors and assigns; for which payment, well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the certain bid of the above bounden principal to perform certain work described as follows: 2016 PARKING LOT MAINTENANCE PROJECT PROJECT NO. 750-16 CONTRACT NO. C34700 The general items of work to be done hereunder consist of: Mobilization; Crack Sealing; Asphalt Repair; Seal Coat; Striping ; and Traffic Control and dated is accepted by the City of Palm Desert, and if the above bounden principal 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 attorney's fees, shall be awarded to the prevailing party. [Remainder of this page has intentionally been left blank. Signature blocks are contained on the next page] Page F-1 IN WITNESS WHEREOF, We hereunto set our Hands and Seals this day of 20 Contractor's Name: Contractor's Signature: Title: Address: Telephone: Surety's Name: Surety's Signature: _ Title: Address: Telephone: Must be Notarized Must be Notarized Page F-2 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 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 F-3 42ND REMITTER S-2 SEALING & STRIPING INC T:TBAW('800) LAKEW. D,CO8AVE. 1262991 LAKEWOOD, CO 0215 964-3444 82 504/1070 DATE August 25, 2015 PAY TO THE CITY OF PALM DESERT --------- _---- __---- _---------------- ___—_ ORDER OF a C—MI-61-11 �'a R E? OOttRR SIX COMMA FIVE ZERO ZERO PERIOD ZERO MO All I .,.I „.;rr;,,,L,al' CASHIER'S CHECK Notice to Customer. It this check is lost, stolen, or destroyed within 90 days of th date it is issued. we will not pay or reissue a replacement Check without an .d? Indemnity bond or other adequate security. After 90 days, we will pay or reissue a replacement check upon receipt of a properly executed declaration of loss form ------'-' ii0001262991))' 1:1070050471: 21C30200336))' 42ND REMITTER S-2 SEALING & STRIPING INC PAYABLE TO CITY OF PALM DESERT CASHIER'S CHECK RECEIPT T:TBAW ILOOE9WOOD,644--34440802V5 Notice to Customer If this check Is lost, stolen, or destroyed within 90 days of the date it is Issued, we will not pay or reissue a replacement check without an Indemnity bond or other adequate security. After 90 days, we w1!1 pay or reissue a replacement check upon receipt of a properly executed declaration of loss form FIRSTBANK ABA» 1070050,17 AUG 2 520 42"1D , PALP1 DESERT, CA 22 TFEER .2 $6,500.00 nP L AUTHORIZED SIGNAT URE 1262991 82 504/1070 DATE August 25, 2015 AMOUNT $6,5OO.00 NOT NEGOTIABLE 9 President Plaza /// +/- 183,428 Sq Ft 750-16 4417578 Sq Ft loy-WWWOR VICINITY MAP