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American Asphalt South Inc This page is part of your document-DO NOT DISCARD yv;T,44,0 20160382510 aiIIIIIIIIIIIIIIIIIIIIIIIIIIIII P0�06: RecortleNFiled in ficial Records tk,� �� .1�f Recorder's ORlce,Los Angeles Cou�rty, «�� California 04/06/16 AT 04:30PM FEES: 0.00 TAXES: 0.00 OTHER: 0.00 PAID: 0.00 IIIIIII I I VIII II I VIII II IIII I I IIII III I I VIII II I VIII III IIIIIII III IIII II II IIII LEADSHEET 11I1 IIl 111111111111111111111 1101 lUll Oil V11111111111111111111111111111111111111 20160406334008? 00011924106 IIIOIWINII�nnN1111991111111VIIIIIIAI 0074773 SEQ: 01 ,111�s DAR - Counter (UpfFont scan) VIII li uVIII�IIIII��I��I�� IIII IIY 111111111111111111 III�IIIflIII�VIIIIIn�IIVII�IIpIIIIIII�N�IIAIIIAIII�llnlll�lnllnllll - - THIS FORM IS NOT TO BE DUPLICATED RECORDING REQUESTED BY: 1 1111 Rano R€ bo 4AIV1e:rde s r City Clerk 1 IiIIiIiIiif/'//IIll/(/IIiIiIiIIii 6/2016 Naitof Rancho Palos Verdes Street 30940 Hawthorne Blvd. Address Rancho Palos Verdes, CA City CA *20160State 90275 Zip 1. J Space above this line for recorder's use OLCOTTSORMS NC. _ 4 ... v .�_ _ 893 NOTICE OF COMPLETiON Notice pursuant to Civil Code Section 3093,must be filed within 10 days atter completion. (See reverse side for Notice is hereby given that: complete requirements.) 1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the 2. The full name of the owner is City of Rancho Palos Verdes property hereinafter described. SINCE 3. The full address of the owner is 30940 Hawthorne Blvd. , Rancho Palos Verdes, CA 90275- - 0275- 4. The nature of the interest or estate of the owner is: In fee. (If other than Fee,strike in fee'and insert,for example.'purchaser under contract of purchase.'or'Lessee') 5. The full names and full addresses of all persons, if any, who hold title with the undersigned as joint tenants or as tenants in commonr a e. NAMES ADDRESSES 6. The full names and full addresses of the predecessors in interest of the undersigned, if the property was transferred subsequent q t to the commencement of the work or improvements herein referred to: NAMES ADDRESSES 7. A work of improvement on the property hereinafter described was completed on Nov. 6 , 201 FY-12-13 & FY 13-1 4 Residential Streets Rehabilitation Project_ The work done was: 8. The names of the contractor, if any,for such work of improvement was American Asphalt--South, Inc. (If no contractor for work of improvement as a whole.insert-None-) Nov 1 8 201 los Veres 9. The property on which said work of improvement was completed is in the City of Rahnt County of Los Angeles ,State of CA,and is described as follows: Locations (: ViLtisee attached) on Mai ntPnance areas 1 , 58 & 9 10. The street address of said property is • (If no street address has been officially assigned,insert-none'.) C-1 f` RAnr ho ?oO' Ve'rde S • Dated q[ ( . //1/(04.,,,eGlej2 .-- (Signature of Owner or corporate officer of Owner named in paragraph 2.or his agent) VERIFICATION I, the undersigned,say: I am the City Clerk ,the Declarant of the foregoing Notice of,Manager of,Partner of,Owner of.etc.) 9 9 of Completion; I have read said Notice of Completion and know the contents thereof;the same is true to my own knowledge. I declare under enal of perjury that the fo oing is true and correct. p tY R Executed on / ,20 ,� io . • i • .1•S. Verdes, CA .Al , / ' A ..-/ _/' # 1 Neck_ ( I' sig,,, =i?'.• al who is sweanngtti -e at the contents the Notice of Completion are true) Before you use this form, fill in all blanks, and make whatever chanes are appropriate and necessary to your particular transaction. Consult a lawyer if you doubt the form s fitness for your purpose and use. 111 L I Will Wolcotts makes no representation or warranty, express or implied, with respect to the merchantability 11 or fitness of this form for an intended use or purpose. ©2005 WOLCOTTS FORMS,INC. 67775 01116 2 FORM 1114 Rev. 10-05 Area 1 Ashfork PI. Manitowac Dr. Barkstone Dr. Mazur Dr. Basswood Ave. Menominee PI Bayridge Rd. Mesaba Dr. Birchfield Ave. Mossbank Dr. Birchmont Dr. Pembina Rd. Capeswood Dr. Sandbrook Dr. Clint PI. Shadow Wood Dr. Diversey Dr. Shoreview Dr. Eau Claire Dr. Shorewood Rd. Elmbank Rd. Silver Spur Rd. Elkmont Dr. Springcreek Rd. Finescrest Dr. Via Sonoma Flambeau Rd. Waukesha PI. Fond Du Lac Rd. Waupaca Rd. Freeport Rd. Whitefox Dr. Graylog St. Whitehorn Dr. Grayslake Rd. Whitestone Rd. Groveoak PI. Wildbriar Dr. Hawthorne Blvd. (frontage rd.) Woodbrook Dr. Hyte Rd. Woodfern Dr. Indian Peak Rd. Ironwood St. Lightfoot PI. Littlebow Rd. t a t Area 513 Alta Vista Dr. Via La Cresta Avenida Altisima Via Vicente Avenida Anillo Avenida Celestial Avenida Classica Avenida De Calma Avenida Elegante Avenida Esplendida Avenida Magnifica Avenida Refinada Avenida Selecta Avenida Tranquila Calle De Suenos Calle Del Pajarito Calle Entradero Calle La Resolana Calle Qu i eta Calle Viento Camino Pequeno Camino Porvenir Crest Rd. (Lower) Los Verdes Dr. Pacifica Del Mar Paseo De La Luz Vallon Dr. Via Del Cielo 1 • S Area 9 Atford Dr. Goya Dr. Ronsard Rd. Alaflora Dr. Gunter Rd. Santa Rena Dr. Alvesta PI. Highmore Ave. Sparta Dr. Ave. Aprenda Homeworth Dr. Stokowski Dr. Ave. Cuaderno Jaybrook Dr. Summerland St. Ave. Del Mesa Lasita PI Tarrasa Dr. Ave. Estudiante Lunada Circle Toscanini Dr. Ave. Feliciano Mac Arthur St. Trotwood Ave. Bandra PI. Mendon Dr. Trudie Dr. Bayend Dr. Montereina Dr. Upland St. Beecham Dr. Mt. Hood Ct. Valleta Dr. Bernice Dr. Mt. Langley Ct. Van Karajan Dr. Bloomwood Rd. Mt. Lassen Ln. Velez Dr. Caddington Dr. Mt. Palomar PI. Wycliff Ave. Calzada Dr. Mt. Rainier Rd. Circle Verde Dr. Mt. Rose Rd. Crestwood St. Mt. Rushmore Rd. Delasonde Dr. Mt. Sawtooth Dr. Dorado Dr. Mt. Vancouver Ct. Elberon St. Mt. Whitney Way Eldena Dr. Mt. Shasta Dr. Enrose Ave. Noble View Dr. Fairhill Dr. Peninsula Verde Dr. Galerita Dr. Pontevedra Dr. Gaucho Dr. Redondela Dr. General St. Rockinghorse Dr. • 0 CONTRACT CITY OF RANCHO PALOS VERDES CONTRACT FOR FY2012-13 & FY2013-14 RESIDENTIAL STREETS REHABILITATION PROJECT, AREAS 1, 5B, &9 THIS CONTRACT ("Contract") is made and entered this eighteenth day of November, 2014 ("Effective Date"), by and between the CITY OF RANCHO PALOS VERDES, a California municipal corporation ("City") and American Asphalt South, Inc. ("Contractor"). Contractor's license number is 784969. In consideration of the mutual covenants hereinafter set forth,the parties hereto agree as follows: 1. Contract Documents. The Contract Documents consist of this Contract,the Notice Inviting Bids, Instructions to Bidders, Bid (including documentation accompanying the Bid and any post- Bid documentation submitted before the Notice of Award), the Bonds, permits from regulatory agencies with jurisdiction, General Provisions, Special Provisions, Plans, Standard Plans, Standard Specifications, Reference Specifications, Addenda, Change Orders, and Supplemental Agreements. The Contract Documents are attached hereto and incorporated herein by reference. In the event of any conflict between the terms of this Contract and any incorporated documents, the terms of this Contract shall control. 2. Scope of Services. Contractor shall perform the Work in a good and workmanlike manner for the project identified as FY2012-13& FY2013-14 RESIDENTIAL STREET REHABILITATION PROJECT, AREAS 1, 5B, & 9 ("Project"), as described in this Contract and in the Contract Documents. 3. Compensation. In consideration of the services rendered hereunder, City shall pay Contractor a not to exceed amount of two million, four hundred fifty-eight thousand, seven hundred fifteen dollars ($2,458,715) in accordance with the prices as submitted in Contractor's Proposal, attached hereto as Exhibit "B"and incorporated herein by this reference. 4. Incorporation by Reference. All of the following documents are attached hereto and incorporated herein by this reference:Workers' Compensation Certificate of Insurance;Additional Insured Endorsement (Comprehensive General Liability); Additional Insured Endorsement (Automobile Liability); and Additional Insured Endorsement(Excess Liability). 5. Antitrust Claims. In entering into this Contract, Contractor offers and agrees to assign to the City all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the California Business and Professions Code) arising from purchases of goods, services, or materials pursuant to the Contract. This assignment shall be made and become effective at the time the City tenders final payment to Contractor without further acknowledgment by the parties. 6. Prevailing Wages. City and Contractor acknowledge that this Project is a public work to which prevailing wages apply. The provisions of Section 7.A of the General Provisions shall apply and are mandatory for this Project. 7. Workers' Compensation. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861, by signing this Contract, the Contractor certifies as follows: 1 111 "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract." 8. Titles. The titles used in this Contract are for convenience only and shall in no way define, limit or describe the scope or intent of this Contract or any part of it. 9. Authority. Any person executing this Contract on behalf of Contractor warrants and represents that he or she has the authority to execute this Contract on behalf of Contractor and has the authority to bind Contractor to the performance of its obligations hereunder. 10. Entire Agreement. This Contract, including any other documents incorporated herein by specific reference, represents the entire and integrated agreement between City and Contractor. This Contract supersedes all prior oral or written negotiations, representations or agreements. This Contract may not be modified or amended, nor any provision or breach waived, except in a writing signed by both parties which expressly refers to this Contract. 11. Counterparts. This Contract may be executed in counterpart originals, duplicate originals, or both, each of which is deemed to be an original for all purposes. IN WITNESS WHEREOF, the parties hereto have executed the Contract the day and year first above written. CITY OF r CHO PALS VERDES By: Ma, •/ ATTEST: AP' .OVED AS TO FORM: By. By. City Clerk City Atto ey Dated: AMERICAN ASPHALT SOUTH, INC. ("CONTRAA OR" By: Printed Name: j-64( Title: ViCe PreSidert By: Printed Name: Zyle Je Title: Cre Aiej2 0 0 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ,t. 2t':i'\ 7, .,, _•,. _ `t ! .-tee s - _ ...-!.:-7-:-:--!.:2:::::::,: ::-;:-:- ',':-.::: 1.: :-.'Ji i; State of California (':•. ss. !-).: County of SC,n (I.e.rf(1 t��,n h t:i r— 1; of Nac t o c-0 A 6 s fOtl ��l � before me � rl. Date Name and Tine of Officer(e.g.."Jane Doe.Notary Pub(rc) '' . . L1a Spersonally appeared � �� n �:":° ,.:., Name(s)of Signe(s) ►:-. ;.; C.-proved to me on the basis of satisfactory !::= evidence t i'' to be the person(s) whose name(s) i8'lare --`- subscribed to the within instrument and °i` • acknowledged to me that /s.e/they executed i:' the same in hks/bf/their authorized „', :.: capacity(ies), and that by 13411e/their '!, signature(s) on the instrument the person(s), or t:,; the entity upon behalf of which the person(s) k1; JERI MARIE GRANT acted, executed the instrument. ?,i :inti. r ,'�f r.s.".. �'. COMM.#2031882 Z ,,,,:! � � �:r�'`''� WI � hand and •- -al seal. .�` .,.=' -'`'';• '" s- NOTARY PUBLIC-CALIFORNIA s .• • �' :.1 SAN BERNARDINO COUNTY ' -I My Comm.Expires June 34,2017 AillIllr' Si,nature of otary Public >%i: R� OPTINOAL 44 Though the information below is not required by law,it may prove valuable to person• relyin on the document and could prevent ,;,:. fraudulent removal and reattachment of this form to anoth- iocument. t•,;:; .; Description of Attached Document r;:,',. -r Title or Type of Document: 1�•• • Document Date: Number of Pages: '� Signer(s)Other Than Named Above: '�'( ;ice✓ Ohl Ca acct ieClaimed by Signer Signers Name: ='= OFSIGNER _._. -.: ❑ Individual Top of thumb here s-' ❑ Corporate Officer—Title(s): i, ❑ Partner—❑ Limited ❑General -j' 1 ❑ Attorney-in-Fact ❑ Trustee f J, CI Guardian or Conservator (: ❑ Other: rs•1 Signer Is Representing: .i _ 0 1999 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth.CA 91313-2402•www.nationalnoiary.org Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827 Bond No.12113603 Premium: Included in Perfornance Bond PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Rancho Palos Verdes("Public Agency"), State of California, has awarded to American Asphalt South, Inc. _ 14436 Spnfa Ana Avenue, Fontana,CA 92337 ("Principal"} (Name and address of Contractor) a contract(the"Contract")for the Work described as follows: FY2012-13 &FY2013-14 RESIDENTIAL STREETS REHABILITATION PROJECT, AREAS 1, 5B, &9 WHEREAS, under the terms of the Contract, the Principal is required before entering upon the performance of the work, to file a good and sufficient payment Bond with the Public Agency to secure the claims to which reference is made in Title 3(commencing with Section 9000)of Part 6 of Division 4 of the Civil Code. NOW,THEREFORE,we,the undersigned Principal, and The Guarantee Compan of North America USA One Towne Square, Suite 1470,Southfield, MI 48076 (Name and address of Surety) ("Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency and all Contractors, Subcontractors, laborers, material suppliers,and other Persons employed In the performance of the agreement and referred to in Title 3(commencing with Section 9000)of Part 6 of Division 4 of the Civil Code in the penal sum of, Two Million Four Hundred Fifty-Eight Thousand Seven Hundred Fifteen and No/100---____-- Dollars($ 21458.715.00 ),for materials furnished or labor thereon of any kind, or for amounts due under the Unemployment Insurance Act with respect to this work or labor,that the Surety will pay the same in an amount not exceeding the amount hereinabove set forth, and also in case suit is brought upon this Bond, will pay, in addition to the face amount thereof,costs and reasonable expenses and fees, including reasonable attorneys' fees, incurred by Public Agency in successfully enforcing this obligation,to be awarded and fixed by the court,and to be taxed as costs and to be included in the judgment therein rendered. It is hereby expressly stipulated and agreed that this Bond shall inure to the benefit of any and all persons, companies, and corporations entitled to file claims under Title 3 (commencing with Section 9000)of Part 6 of Division 4 of the Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this Bond. Upon expiration of the time within which the California Labor Commissioner may serve a civil wage and penalty assessment against the Principal, any of its Subcontractors, or both the Principal and its Subcontractors pursuant to Labor Code Section 1741,and upon expiration of the time within which a joint labor management committee may commence an action against the Principal,any of its Subcontractors,or both the Principal and its Subcontractors pursuant to Labor Code Section 1771.2, if the condition of this Bond be fully performed, then this obligation shall become null and void, otherwise it shall be and remain in full force and effect. The Surety hereby stipulates and agrees that no change,extension of time,alteration,or addition to the terms of the Contract or the Specifications accompanying the same shall in any manner 3 w ' • affect its obligations on this Bond,and it does hereby waive notice of any such change,extension, alteration,or addition. IN WITNESS WHEREOF,two(2)identical counterparts of this instrument,each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set forth below,the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s) pursuant to authority of its governing body. Dated: December 1, 2014 _ Principal" "Surety" American Asphalt South,Inc. The Guarantee Company of North America USA By: ,/_i'• By: Its ,� c`p4 pee fireddesti. t lizabeth Collodi,Attorney-in-Fact By: .,.. ._ �� .. By: It Its (Seal) (Seal) APPROVED AS TO FORM: RICHARDS,WATSON & GERSHON A Professional Corporation By: Public'Age r /. omey Note: This Bond must be executed in duplicate and dated, a/I signatures must be notarized, and evidence of the authority of any person signing as attorney-in-fact must be attached. IF CONTRACTOR IS A PARTNERSHIP, ALL PARTNERS MUST EXECUTE BOND. DATE OF BOND MUST NOT BE PRIOR TO DATE OF CONTRACT. Surety companies executing Bonds must appear on the Treasury Department's most current list(Circular 570 as amended)and be authorized to transact business in the State where the Project is located. 4 • I CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT !: State of California a != S`- ss. !,. E J-.-. Countyof SCn �,f 0�r Jon n 4_ L, On6.ee ox ) c)014 before me f,� \Met(1 e cG•.d�tA- U6ko.< Date Name and True of Officer(e.g..-Jane Doe.Notary Pubfrc) i':. r'' -� Ci dl Lt1a personally appeared � n :.:: Name(s)of Signe(s) ,•'• rL;J !I•. 3-proved to me on the basis of satisfactory 1!- evidence to be the person(s) whose name(s) ielare subscribed to the within instrument and - acknowledged to me that I /st e/they executed .1.:::.:! the same in lis/ /their authorized i:-. :,-,; capacity(ies), and that by b4/hef/their =',; :f ,i,::: signature(s) on the instrument the person(s), or t the entity upon behalf of which the person(s) i; i JERI MARIE GRANTE,P...eiltyl,-' acted, executed the instrument. �•I j COM 2 31882 ''; z it- • NOTARY PUBLIC-CALIFORNIA C r NE myhand a,• •fficia l seal. i,` �l� SAN BERNARDINO COUNTY My Comm.Expires June 30,20'6 7 -�Qi1n, G�/1,c�� l'-k: ,:: Signature of Notary Public ',..',;.,1OPTIONALr::.! Though the information below is not required by law,it may prove valuable to pe_•• -lying on the document and could prevent ,- fraudulent removal and reattachment of this form to another document. "� Description of Attached Document r Title or Type of Document: ;ifii i,i;ri -_' Document Date: 1 Number of Pages: i.: xs ji Signer(s)Other Than Named Above: r: I - r. Capacity(ies) Claimed by Signer . Signer's Name: ," .i:' 17 IGHTTlutoir,FuNT= .,:7:! .:: ;":'7 OFSIGNER-_:•_.. ::: ,' 0 Individual Top of thumb here ;2.' ❑ Corporate Officer—Title(s): ,-;, 0 Partner—0 Limited ❑General i:t ❑ Attorney-in-Fact ' ; 0 Trustee :,, • 0 Guardian or Conservator ❑ Other: '•t: Signer Is Representing: 'f:=; r r i i.'.'.;..! . _ _ �••. *.i �i _ _ -~� •tel_. �•_�~�/. .\.' a 1999 National Notary Association•9350 De Soto Ave..P.O.Box 2402•Chatsworth.CA 91313-2402•www.nationatnotary.oro Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827 „. i CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Butte On December 1, 2014 before me, Derek Gould, Notary Public (Here insert name and title of the officer) personally appeared Elizabeth Collodi 9 who proved to me on the basis of satisfactory evidence to be the person(s) whose name(e) is/tee subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/henitheir authorized capacity(), and that by /her/ter signature(s)on the instrument the person(), or the entity upon behalf of which the person fa) 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. � 0”`,71, DEREK GOULD WITNESS hand . .. ► ficial se / _ � ,A COMM. 2060914 I • I NOTARY PUBLIC•CALIFORNIA fil Y-1701.-// COUNTY OF BUTTE 4,4 Comm.Expires MAR.13,2018 v (Notary Signature of Notary Public ie I Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must he properly completed and attached to that document. The only exception is if a Payment Bond document is to be recorded outside of California.In such instances,any alternative (Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in American Asphalt South, Inc. California(i.e.certifying the authorized capacity of the signer).Please check the document carefully for proper notarial wording and attach this form if required (Title or description of attached document continued) •State and County information must be the State and County where the document Number of Pages 2 Document Date 12/01/14 signer(s)personallyappeared before the notary public for acknowledgment. •Date of notarization must be the date that the signer(s)personally appeared which The Guarantee Company of North America USA must also be the same date the acknowledgment is completed. (Additional information) •The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title(notary public). •Print the name(s)of document signer(s)who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER •Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. El Individual (s) heishe/ ,is/are-)or circling the correct forms.Failure to correctly indicate this information may lead to rejection of document recording. ❑ Corporate Officer •The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines.If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) •Signature of the notary public must match the signature on file with the office of the county clerk. El Attorney-in-Fact *.-Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. ❑ Other *.-Indicate title or type of attached document,number of pages and date. *.-Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). •Securely attach this document to the signed document 2008 Version CAPA 02.10.07 800-873-9865 www.NotaryClasses.com 411 4111 THE The Guarantee Company of North America USA GUARANTEE"' Southfield,Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS:That THE GUARANTEE COMPANY OF NORTH AMERICA USA,a corporation organized and existing under the laws of the State of Michigan,having its principal office in Southfield,Michigan,does hereby constitute and appoint Barbara Midstokke,Renee Ramsey,Richard W.Pratt,John Hopkins,Elizabeth Collodi,Susan Lee,Barbara Beeny,Nancy Luttenbacher, Phillip O.Watkins,Keith T.Schuler,Melissa D.Diaz,Shawna Johnson,Patricia M.Simas Interwest Insurance Services,Inc. its true and lawful attomey(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof,which are or may be allowed,required or permitted by law,statute,rule,regulation,contract or otherwise. The execution of such instrument(s) in pursuance of these presents,shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply,to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so,and may be revoked,pursuant to and by authority of Article IX,Section 9.03 of the By-Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31st day of December,2003. The President,or any Vice President,acting with any Secretary or Assistant Secretary,shall have power and authority: 1. To appoint Attorney(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof;and 2. To revoke,at any time,any such Attorney-in-fact and revoke the authority given,except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only,it is agreed that the power and authority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee,shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner— Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. Further,this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011,of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking,contracts of indemnity and other writings obligatory in the nature thereof,and such signature and seal when so used shall have the same force and effect as though manually affixed. �r�+T IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and a its corporate seal to be affixed by its authorized officer,this 23rd day of February,2012. 9, 1/4,,T) THE GUARANTEE COMPANY OF NORTH AMERICA USA STATE OF MICHIGAN Stephen C.Ruschak,Sr.Vice President,COO Randall Musselman,Secretary County of Oakland On this 23rd day of February,2012 before me came the individuals who executed the preceding instrument,to me personally known,and being by me duly sworn,said that each is the herein described and authorized officer of The Guarantee Company of North America USA;that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai IN WITNESS WHEREOF,I have hereunto set my hand at The Guarantee Notary Public,State of Michigan Company of North America USA offices the day and year above written. - — County of Oakland • My Commission Expires February 27,2018a T;a412A:,, Acting in Oakland County ttAtkcotJI,Randall Musselman,Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA,which is still in full force and effect. /WU cA IN WITNESS WHEREOF,I have thereunto set my hand and attached the seal of said Company this 1 day of December , 2014 ►A � Randall Musselman,Secretary 110 Bond No.12113603 Premium:$13,294.00 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Rancho Palos Verdes ("Public Agency"), has awarded to American Asphalt South, Inc. 14436 Santa Ana Avenue, Fontana, CA 92337 ("Principal") (Name and address of Contractor) a contract(the"Contract")for the Work described as follows: FY2012-13 &FY2013-14 RESIDENTIAL STREETS REHABIUTATION PROJECT, AREAS 1, 5B, &9 WHEREAS, Principal is required under the terms of the Contract to furnish a Bond for the faithful performance of the Contract. NOW, THEREFORE,we, the undersigned Principal, and The Guarantee Company of North America USA One Towne Square,Suite 1470, Southfield,MI 48076 (Name and address of Surety) ("Surety")a duly admitted surety insurer under the laws of the State of California, as Surety, are held and firmly bound unto the Public Agency in the penal sum of Two Million Four Hundred Fifty- Eight Thousand Seven Hundred Fifteen and No/100--__ _________________________________ Dollars($2,458,715.00 ), this amount being not less than the total Contract Price, in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, successors executors and administrators,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and provisions in the Contract and any alteration thereof made as therein provided, on the Principal's 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 Public Agency, its officers, agents and employees, as therein stipulated, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. As a part of the obligation secured hereby and in addition to the face amount specified therefor, there shall be included costs and reasonable expenses and fees, including reasonable attorneys' fees,incurred by Public Agency in successfully enforcing such obligation,all to be taxed as costs and included in any judgment rendered. The Surety hereby stipulates and agrees that no change, extension of time,alteration or addition to the terms of the Contract or of the Work to be performed thereunder or the Specifications accompanying the same shall in anywise affect its obligations under this Bond,and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the Work or to the Specifications. Surety hereby waives the provisions of California Civil Code 2845 and 2849. The City is the principal beneficiary of this Bond and has all rights of a party hereto. 5 • IN WITNESS WHEREOF,two(2)identical counterparts of this instrument,each of which shall for all purposes be deemed an original hereof, have been duly executed by Principal and Surety, on the date set forth below,the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated: December 1,2014 "Principal" "Surety" American Asphalt South, Inc. The Guarantee Company of North America USA / By: ,fir By: .I _ Its a., ply )'k yid 1t lizabeth Collodi,Attorney-in-Fact By: Z� � By: _ _ fe ", Its (Seal) (Seal) APPROVED AS TO FORM: RICHARDS, WATSON & GERSHON A Professional Corporation By: Publi Agency'ttorney Note: This Bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney-in-fact must be attached. IF CONTRACTOR IS A PARTNERSHIP, ALL PARTNERS MUST EXECUTE BOND. DATE OF BOND MUST NOT BE PRIOR TO DATE OF CONTRACT. Surety companies executing Bonds must appear on the Treasury Department's most current list(Circular 570 as amended)and be authorized to transact business in the State where the Project is located. & • 0 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT t' ?; ,moi .'. -r: ,r'.' .i• ..:.:-.:--:!,_:.::::.f..: - -- _ _. f _•. .tip »._._ .. • . ..._. .. ._._ •/• �! ^ii State of California f•'•. ss- ;::,: County of Sn .ti e �r .3D l beforem Nac t oefA-� K6• I.:, On �L tM � e �� ) � � Date Name and Title of Officer(e.g.."Jane Doe.Notary Pubfic") �' ''J f. 1 1:); -.:, personally appeared3 �v\ c n cl Lc1a �o n e. ,: !..,, ,) Name(s)of Signe(s) 3.proved to me on the basis of satisfactory 1::- evidence to be the person(s) whose name(s) i tare t.i subscribed to the within instrument and t.' acknowledged to me that Ore/sloe/they executed the same in his/14e/their authorized - capacity(ies), and that by b4(/hef/their !i signature(s) on the instrument the person(s), or r ! the entity upon behalf of which the person(s) k JERI MARIE GRANT acted, executed the instrument. '�1 �•(..,.:'� � � OMM #20318 2 -4i';--:-:�.t> . • SS my hand a fficfal seal. ' ,,:...--7,-.0.. ,-- NOTARY PUBLIC-CALIFORNIA C '!' :..i::� ;.„.. SAN BERNARDINO COUNTY My Comm.Expires June 30,2017 C itti Y:ii signof Notary Public ':-: -�i OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. ":; Description of Attached Document _ =! Title or Type of Document: :•.,:-:: Document Date: Number of Pages: Signer(s)Other Than Named Above: `:.-'I t i ` Ca acit ies Claimed bySigner !-I.:' F.i Signer's Name: 13IGHTjHUt11BPRINT .a ='=::OF_SIGNER--:Y ,' ❑ Individual Top of thumb here '31 ❑ Corporate Officer—Title(s): ❑ Partner--❑ Limited ❑General `.)! ❑ Attorney-in-Fact :-' ❑ Trustee ❑ Guardian or Conservator ;-.- i.':.::., ❑ Other: t.' Signer Is Representing: :f _ _._ .; ; ____- -__-____ 7 3 7:.5.:-z_-.--- -_'r._7 -- _-- ___-__r-rte.. _ 7.7_._ __r- _ .f•__ =7 __--�_71.77_ _\_`- t 1999 National Notary Association•93.50 De Solo Ave.,P.O.Box 2402•Chatsworth.CA 91313-2402•www.nalionalnotary.org Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827 • CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Butte On December 1, 2014 before me, Derek Gould, Notary Public (Here insert name and title of the officer) personally appeared Elizabeth Collodi 9 who proved to me on the basis of satisfactory evidence to be the person(e) whose name(s) is/are subscribed to the within instrument and acknowledged to me that ite/she/they executed the same in /herr authorized capacity(), and that by 46/her/ter signature(s)on the instrument the person(-), or the entity upon behalf of which the persons) 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. • "ur-4gragagh66.7611666:::111166666616111(GOULD : COMM.#2060914 WITNEy hang �:n• officla -. . � ��-- � / t , NOTARY PUBLIC•CALIFORNIA co a COUNTY OF BUTTE Comm.Expires MAR.13,2018 v (Notary Seal) I Signature of Notary Public ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must he properly completed and attached to that document. The only exception is if a Performance Bond document is to be recorded outside of California.In such instances,any alternative acknowledgment verbiage as may be printed on such a document so long as the (Title or description of attached document) verbiage does not require the notary to do something that is illegal for a notary in American Asphalt South, Inc. California(i.e.certifying the authorized capacity of the signer).Please check the document carefully for proper notarial wording and attach this form if required (Title or description of attached document continued) State and County information must be the State and County where the document Number of Pages 2 Document Date 12/01/14 •Ssigner(s)personallappeared before the notary public for acknowledgment. •Date of notarization must be the date that the signer(s)personally appeared which The Guarantee Company of North America USA must also be the same date the acknowledgment is completed. (Additional information) •The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title(notary public). •Print the name(s)of document signer(s)who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER •Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. ❑ Individual (s) he/she/ ,is/ate)or circling the correct forms.Failure to correctly indicate this information may lead to rejection of document recording. ❑ Corporate Officer •The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines.If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) •Signature of the notary public must match the signature on file with the office of the county clerk. Ej Attorney-in-Fact *.-Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. ❑ Other *.-Indicate title or type of attached document,number of pages and date. *.-Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). •Securely attach this document to the signed document 2008 Version CAPA 02.10.07 800-873-9865 www.NotaryClasses.com 11111 THE The Guarantee Company of North America USA GUARANTEE Southfield,Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS:That THE GUARANTEE COMPANY OF NORTH AMERICA USA,a corporation organized and existing under the laws of the State of Michigan,having its principal office in Southfield,Michigan,does hereby constitute and appoint Barbara Midstokke,Renee Ramsey,Richard W.Pratt,John Hopkins,Elizabeth Collodi,Susan Lee,Barbara Beeny,Nancy Luttenbacher, Phillip O.Watkins,Keith T.Schuler,Melissa D.Diaz,Shawna Johnson,Patricia M.Simas Interwest Insurance Services, Inc. its true and lawful attorneys)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof,which are or may be allowed,required or permitted by law,statute,rule,regulation,contract or otherwise. The execution of such instrument(s)in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply,to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so,and may be revoked,pursuant to and by authority of Article IX,Section 9.03 of the By-Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31st day of December,2003. The President,or any Vice President,acting with any Secretary or Assistant Secretary,shall have power and authority: 1. To appoint Attorney(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof;and 2. To revoke,at any time,any such Attorney-in-fact and revoke the authority given,except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only,it is agreed that the power and authority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee,shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner— Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. Further,this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011,of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking,contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF,THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and I 301 its corporate seal to be affixed by its authorized officer,this 23rd day of February,2012. THE GUARANTEE COMPANY OF NORTH AMERICA USA 44NA STATE OF MICHIGAN Stephen C.Ruschak,Sr.Vice President,COO Randall Musselman,Secretary County of Oakland On this 23rd day of February,2012 before me came the individuals who executed the preceding instrument,to me personally known,and being by me duly sworn,said that each is the herein described and authorized officer of The Guarantee Company of North America USA;that the seal affixed to said instrument is the Corporate Seal of said Company;that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai IN WITNESS WHEREOF,I have hereunto set my hand at The Guarantee Notary Public,State of Michigan Company of North America USA offices the day and year above written. County of Oakland Jyp0 = My Commission Expires February 27,2018 .„....., a .�.. Acting in Oakland County I,Randall Musselman,Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA,which is still in full force and effect. pore\ IN WITNESS WHEREOF,I have thereunto set my hand and attached the seal of said Company this 1 day of December , 2014 6""0e' Randall Musselman,Secretary 0 0 WORKERS' COMPENSATION CERTIFICATE OF INSURANCE WHEREAS, the City of Rancho Palos Verdes ("City") has required certain insurance to be provided by: NOW THEREFORE, the undersigned insurance company does hereby certify that it has issued the policy or policies described below to the following named insureds and that the same are in force at this time: 1. This certificate is issued to: City of Rancho Palos Verdes City Hall 30940 Hawthorne Boulevard Rancho Palos Verdes, California 90275 2. The insureds under such policy or policies are: 3. Workers' Compensation Policy or Policies in a form approved by the Insurance Commissioner of California covering all operations of the named insureds as follows: Policy Number Effective Date Expiration Date By: Its Authorized Representative 7 4110 0 ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY Name and address of named insured("Named Insured"): Name and address of Insurance Company("Company"): General description of agreement(s),permit(s), license(s), and/or activity(ies)insured: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached(the"Policy") or in any endorsement now or hereafter attached thereto, it is agreed as follows: 1. The City of Rancho Palos Verdes("Public Agency"),its elected officials,officers,attorneys, agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance,and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall be covered as third-party claims,i.e.,in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance(subject to the terms, conditions and exclusions applicable to such insurance) includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained in or executed in conjunction with the written agreement(s) or permit(s) designated above, between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non-renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty (30) Days before the effective date thereof. In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,while acting within the scope of their duties,from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. 8 0 0 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: City Manager City of Rancho Palos Verdes City Hall 30940 Hawthorne Boulevard Rancho Palos Verdes, California 90275 10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY 11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: o Contractual Liability ❑ Explosion Hazard O Owners/Landlords/Tenants ❑ Collapse Hazard ❑ Manufacturers/Contractors ❑ Underground Property Damage ❑ Products/Completed Operations ❑ Pollution Liability ❑ Broad Form Property Damage ❑ Liquor Liability ❑ Extended Bodily Injury 0 ❑ Broad Form Comprehensive 0 General Liability Endorsement ❑ 12. A❑ deductible or❑self-insured retention (check one)of$ applies to all coverage(s)except: if none, so state). The deductible is applicable❑ per claim or❑per occurrence (check one). 13. This is an ❑occurrence or❑claims made policy(check one). 14. This endorsement is effective on at 12:01 a.m.and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company. Executed , 20 Signature of Authorized Representative (Original signature only; no facsimile signature Telephone No.: ( ) or initialed signature accepted) 9 0 • ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY Name and address of named insured("Named Insured"): Name and address of Insurance Company("Company"): General description of agreement(s),permit(s), license(s), and/or activity(ies)insured: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached(the"Policy") or in any endorsement now or hereafter attached thereto, it is agreed as follows: 1. The City of Rancho Palos Verdes("Public Agency"),its elected officials,officers,attorneys,agents, employees, and volunteers are additional insureds (the above named additional insureds are hereafter referred to as the "Additional Insureds") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance, and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall be covered as third-party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance)includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained or executed in conjunction with the written agreement(s)or permit(s)designated above, between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non-renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty(30)Days before the effective date thereto. In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: City Manager City of Rancho Palos Verdes City Hall 30940 Hawthorne Boulevard Rancho Palos Verdes, California 90275 10. Except as stated above and not in conflict with this endorsement, nothing contained herein shall be held to waive, alter or extend any of the limits, agreements, or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY 11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: Any Automobiles a Truckers Coverage i All Owned Automobiles ► Motor Carrier Act Non-owned Automobiles Bus Regulatory Reform Act Hired Automobiles Public Livery Coverage Scheduled Automobiles Garage Coverage 12. A❑ deductible or❑self-insured retention (check one) of$ applies to all coverage(s)except: (if none, so state). The deductible is applicable G per claim or G per occurrence (check one). 13. This is an ❑ occurrence or❑claims made policy(check one). 14. This endorsement is effective on at 12:01 a.m.and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California,that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company. Executed , 20 Signature of Authorized Representative (Original signature only;no facsimile signature Telephone No.: ( ) or initialed signature accepted) ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY Name and address of named insured("Named Insured"): Name and address of Insurance Company("Company"): General description of agreement(s),permit(s), license(s), and/or activity(ies)insured: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached(the"Policy") or in any endorsement now or hereafter attached thereto, it is agreed as follows: 1. The City of Rancho Palos Verdes("Public Agency"),its elected officials,officers,attorneys,agents, employees, and volunteers are additional insureds(the above named additional insureds are hereafter referred to as the "Additional Insureds") under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance,and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought, except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall be covered as third-party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance)includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s) contained in or executed in conjunction with the written agreement(s)or permit(s)designated above, between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation, change in coverage, reduction of limits (except as the result of the payment of claims), or non-renewal except after written notice to Public Agency, by certified mail, return receipt requested, not less than thirty(30)Days before the effective date thereto. In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior, concurrent, or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. I 0 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: City Manager City of Rancho Palos Verdes City Hall 30940 Hawthorne Boulevard Rancho Palos Verdes, California 90275 10. Except as stated above and not in conflict with this endorsement,nothing contained herein shall be held to waive, alter or extend any of the limits, agreements,or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY ❑ Following Form ❑ Umbrella Liability 0 11. Applicable underlying coverages: INSURANCE COMPANY POLICY NO. AMOUNT 12. The following inclusions, exclusions, extensions or specific provisions relate to the above coverages: 13. A o deductible or 0 self-insured retention (check one) of$ applies to all coverage(s)except: (if none, so state). The deductible is applicable o per claim or❑ per occurrence (check one). 14. This is an ❑occurrence or❑ claims made policy(check one). 15. This endorsement is effective on at 12:01 a.m. and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California, that I have the authority to bind the Company to this endorsement and that by my execution hereof, I do so bind the Company. Executed ,20 Signature of Authorized Representative (Original signature only; no facsimile signature Telephone No.: ( ) or initialed signature accepted 111 ii Exhibit"B" PROPOSAL CITY OF RANCHO PALOS VERDES FY2012-13 & FY2013-14 RESIDENTIAL STREETS REHABILITATION PROJECT, AREAS 1, 5B, &9 TO THE HONORABLE MAYOR AND CITY COUNCIL OF THE CITY OF RANCHO PALOS VERDES: The undersigned, as Bidder, declares that: (1) this Pro osal is made without collusion with any other 9 P Person and that the only Persons or parties interested as principals are those named herein; (2) Bidder has carefully examined the Contract Documents and all Addenda as well as the site of the proposed Work; and (3) Bidder has investigated and is satisfied as to the conditions to be encountered, the character, quality and quantities of Work lo be performed and materials to be furnished. Furthermore, the undersigned agrees that submission of this Proposal shall be conclusive evidence that such examination and investigation have been made and agrees, in the event this Contract be awarded to Bidder, to enter into the Contract with the City of Rancho Palos Verdes to perform the proposed Project in accordance with the Contract Documents and all Addenda in the time and manner therein prescribed, and to furnish or provide all materials, labor,tools, equipment, apparatus and other means necessary so to do, except as may otherwise be furnished or provided under the terms of the Contract Documents and Addenda,for the following stated unit prices or lump-sum price as submitted on the Bid herein. The undersigned submits as part of this Proposal a completed copyof the Contractor's Industrial Safety Record. This Safety Record includes all construction Work undertaken in the State by the Bidder and any partnership,joint venture or corporation that any principal of the Bidder participated in as a principal or owner for the last five(5)calendar years and the current calendar year before the date of Bid submittal. Separate information is being submitted for each such partnership,joint venture,or corporate or individual Bidder. The Bidder may attach any additional information or explanation of data which he or she would like to be taken into consideration in evaluating the Safety Record. An explanation of the circumstances surrounding any and all fatalities must be attached. Accompanying this Proposal is cash, a cashier's check, a certified check or a Bidder's Bond in an amount ; equal to at least ten percent(10%)of the total aggregate Bid price hereof based on the quantities shown and the unit prices quoted. The undersigned Bidder further agrees that should he or she be awarded the Contract on the basis hereof and thereafter fails or refuses to enter into the Contract and provide the required evidence of insurance and Bonds within fifteen (15) Days after written notice of the award, the cash, check or Bid Bond shall be forfeited to the City in accordance with Public Contract Code Section 20172, except as otherwise provided in Public Contract Code Section 20174. The undersigned certifies to have a minimum of five (5) consecutive years of current experience in the type of Work related to this Project and that this experience is in actual operation of the firm with permanent employees performing a part of the Work as distinct from a firm operating entirely by subcontracting all phases of the Work. The undersigned also certifies to be properly licensed by the State as a contractor to perform this type of Work and further certifies to have been so licensed for the five (5)years immediately preceding the date of receipt of Bids. The undersigned possesses California Cont$,)t*s4r do 's L' nseNumber Aele Class , which expires on Or/ . Bidder's name: 4&T,' -0 /6/4a/-91),e fir ice' Date:Signature. �� Yke /41/, Signature: "Z..0Ak 3A.ç f' Date: lid,40/, 9 • CITY OF RANCHO PALOS VERDES BID SHEETS FOR FY2012-13 & FY2013-14 RESIDENTIAL STREET REHABILITATION PROJECT, AREAS 1, 5B, & 9 Bidder's Name: %erica4sh 'S is To the Honorable Mayor and Members of the City Council: In compliance with the Notice Inviting Bids, the undersigned hereby agrees to enter into the Contract to furnish all labor, materials, equipment and supplies for the Project in accordance with the Contract Documents, as that term is defined in the Standard Specifications, to the satisfaction and under the direction of the Director of Public Works, at the following prices: ITEM NO. DESCRIPTION UNIT ESTIMATED UNIT PRICES EXTENDED QUANTITY AMOUNT Mobilization(3% Maximum of Total LS 1 WDDO,t,• $ ,gid Price a s:,oz 2 Traffic Control LS 1 $ $ �� • � � r '93 3 Stormwater Best Management LS 1 $ $ Practices /b Oop.0v $10 Ov.00 Remove Existing and Construct 6" 4 PCC Curb and Gutter with AC Slot LF 750 $ 97 $ ?5,,) -0, Pt' Patch Remove Existing and Construct 8" 5 PCC Curb and Gutter with AC Slot LF 10,500 $ 49.0-0 $514,5140,47 Patch 6 Remove Existing and Construct 4" SF 1,500 $ $ 140,a, PCC Sidewalk g IA 7 Remove Existing and Construct 6" SF 2,200 $ $ PCC Driveway �� °��'�d Remove Existing and Construct PCC 8 Curb Access Ramp with 3'x 4' EA 3 $ $ 5 Truncated Dome Surface, Curb & ��• �� • Gutter,and AC Slot Patch Remove Existing and Construct PCC 9 Curb Access Ramp with 3'x 4' EA 2 $ 4/,tL),rx) $ 3 d f.Y> Truncated Dome Surface,Curb Cut at Spandrel, and AC Slot Patch 10 • DESCRIPTION UNIT ESTIMATED UNIT PRICES EXTENDED ITEM NO. QUANTITY AMOUNT Grind and Cap 3"Depth AC 10 Pavement Repair;AC Type C2 PG SF 146,000 $ 3 $93 g,000,a) 64-10 Remove Existing and Construct 6"AC 11 Pavement Repair;AC Type C2 PG SF 3,400 $ 4/Q $ ?5,11,0,‘Z 64-10 12 Crack Routing and Sealing LS 1 $ 13D $ <a) Remove Existing Thermoplastic and 13 Painted Striping and Markings, and LS 1 $ 5$pPD.;'p $ 5 5 av lZ Pavement Markers 14 Adjust Sewer or Storm Drain Manhole EA 20 $ gc .6i �to Grade �� { Asphalt Concrete Pavement Edge Mill 15 SF 56,000 $ O, $ i498O.''and Disposal 16 1.5"AC Type,T e D PG 64-10 TON 1,650 $ ,tri? / 3/)ifrict9,14' Emulsion Aggregate Slurry Seal Type 17 II with 2.5%Latex Rubber Modifier SF 5,800,000 $ 9.i y5 $VI,09,£j) with Carbon Black Additive 18 Traffic Striping, Marking,and Raised LS 1 $ 7>/,i7D."' $7a ba9_ Pavement Markers 19 Painted House Number EA 3,210 $ lj, 00 20 New Traffic Sign EA 125 $ /Ao, oI) $/5,1)00. va 21 Install New City ProvidedEA 10 $ /?,b1S $ ov, 00 "Neighborhood Watch"Sign 22 New Sign Post EA 300 $ )�. v D $ IS'L7, 11 ITEM NO. DESCRIPTION UNIT ESTIMATED UNIT PRICES TENDED QUANTITY AMOUNT 23 Street Name Sign Post Cap EA 30 $ ?y qp $ / 24 New Street Name Sign EA 17 $ 540,OD $ �,5-0.Dv Note: Several items may be adjusted or deleted. Any changes to the quantities for these items shall not classify as a substantial change as stipulated in Section 3-2.2.1 of the Standard Specifications. Therefore, regardless of total actual volume (percentage) compared to estimated quantities, the unit prices provided above by the Bidder shall be applied to the final quantity when payment is calculated for these items. No adjustment in the unit prices will be allowed. The City reserves the right to not use any of the estimated quantities,and if this right is exercised,the Contractor will not be entitled to any additional compensation. Cost of all export of material shall be included in the above unit costs; no additional compensation will be granted for such expenses. The Contract shall be awarded to the lowest responsible Bidder based on the total Bid price. TOTAL BID PRICE IN DIGITS: $ o?/ V5A 715.DO TOTAL BID PRICE IN WORDS: r„...,„ M�J��o- A:fre /�vn ��/� �� ei�ff►J� 'Apv *di 5?-114, ASed ft-1'1W n h,11d. 1ti Signature: Title: Wu iginf Date: J4/!1/'Ia/y Signature: Title: gecre4y Date: /eV/0Y 12 • INFORMATION REQUIRED OF BIDDER Fill out all of the following information. Attach additional sheets if necessary. (1) Bidder's name: %eriLa h *41,Lu/C (2) If the Bidder's name is a fictitious name, who or what is the full name of the registered owner? If the Bidder's name is not a fictitious name,write"N/Au in the response to this question. If you are doing business under a fictitious name, provide a copy of the filed valid Fictitious Business Name Statement. (3) Business address: / 6' 5?V?7 Aree404rli4, a 9J3/7 (4) Telephone:(74 '/9/ Facsimile: 0000402 (5) Type of firm - Individual, Partnership, LLC or Corporation: C69bra00 (6) Corporation organized under the laws of the state of: Cedird;c? (7) California State Contractor's License Number and Class: 28V9I'Y fJ (8) Original Date Issued: Expiration Date: alid/Nd (9) List the name and title of the person(s)who inspected the site of the proposed Work for your firm: 6;./0 - A/OWN ;Aver (10) List the name and title of the person(s) who attended the mandatory pre-bid meeting for this Project, including the mandatory site visit,for your firm, if any: 7/;.? 6-44f0i AZi2kAih4 Aifler (11) Number of years experience the company has as a contractor in construction work: 741 (12) (12) List the names, titles, addresses and telephone numbers of all individuals, firm members, partners, joint venturers, and company or corporate officers having a principal interest in this Proposal: 400PrO0 kfici.07‘ 32,C(/04 Awdeo Stiee- eertr_44._ (13) List all current and prior D.B.A.'s, aliases, and fictitious business names for any principal having interest in this Proposal: /011 13 (14) List the dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in this Proposal: (15) For all arbitrations, lawsuits, settlements and the like (in or out of court) the company or any principal having an interest in this Proposal has been involved with in the past five (5)years: a. List the names, addresses and telephone numbers of contact persons for the parties: Se 41/ached b. Briefly summarize the parties' claims and defenses: See 1d'/acLeci c. State the tribunal(e.g., Superior Court, American Arbitration Association, etc.), the matter number, and the outcome: See ilAdied (16) Has the company or any principal having an interest in this Proposal ever had a contract terminated by the owner or agency? If so, explain. A (17) Has the company or any principal having an interest in this Proposal ever failed to complete a project? If so, explain. (18) Has the company or any principal having an interest in this Proposal ever been terminated for cause, even if it was converted to a "termination of convenience"? If so, explain. (19) List the dates of any voluntary or involuntary bankruptcy judgments against any principal having an interest in this Proposal: 14 0 0 Question 15 American Asphalt South has not been a party to any arbitration, Lawsuit or settlement in or out of court regarding any claims for breach of contract or non-performance of any contract with an owner or public entity. American Asphalt South has been party to lawsuits within the last five (5)years which are entirely unrelated to its ability to perform the work called for by the proposal. They are as follows: 1. County of Orange Superior Court Case# 30-2011-00451172, Garcia, et. al.v KAD Paving Company, et al: a labor dispute by an employee of a subcontractor against the subcontractor KAD Paving Company: case resolved and dismissed. 2. San Diego Superior Court Case #37-2013-00033535, Acosta and Robles v PAL Engineering, Inc.: a labor dispute by an employee of a subcontractor against the subcontractor PAL Engineering, Inc.: case resolved and dismissed. 3. County of San Bernardino Superior Court Case#CIVRS1207245 consolidated with Case #IVDS1300462 and Case#CIVRS13006852, Nunez,et al v American Asphalt South claim by disgruntled former employees of American Asphalt South related to internal labor issues,American Asphalt South denied liability: case resolved and dismissed. 4. Judicial Council Coordination Proceeding No.4768, Los Angeles Superior Court, Roy Allan Slurry Seal, Inc. and Doug Martin Contracting, Inc.v American Asphalt South, Inc. lawsuits by competitors of American Asphalt South attempting to "piggy-back" off the above referenced lawsuit filed by the disgruntled employees which have been dismissed, alleging general interference with prospective economic advantage. Case is ongoing. Question 20 As indicated above, a few former disgruntled employees filed claims regarding internal labor issues which were subsequently resolved and dismissed. Competitors Roy Allan Slurry Seal, Inc. and Doug Martin Contracting, Inc. have filed their own claim based on these employees' prior claims, alleging general interference with economic advantage. The only unresolved action is the lawsuit by comptetitors Roy Allan Slurry Seal and Doug Martin Contracting, which is based on the claims filed by a few former disgruntled employees and which were dismissed. Ao& (20) For projects that the company or any principal having an interest in this Proposal has been involved with in the last five(5)years, did you have any claims or actions: a. By you against the owner? Circle one: Yes 6::.) b. By the owner against you? Circle one: Yes e c. By any outside agency or individual for labor compliance? Circle one: 42) No d. By Subcontractors? Circle one: Yes No • e. Are any of these claims or actions unresolved or outstanding? Circle one: Yes No If your answer is"yes"to any part or parts of question (20), explain. See Ai4cA,d (21) List the last three (3) projects you have worked on or are currently working on for the City of Rancho Palos Verdes: 4* toe )4YeriV tikrictvt s&- -1-Ae ,Wiae. Upon request of the City, the Bidder shall furnish evidence showing a notarized financial statement, financial data, construction experience, or other.additional information. The Bidder certifies under penalty of perjury under the laws of the State that the information provided above is true and correct. Notary Public Company Subscribed and sworn to me Signature: dr, Signature: Title: Teg t/a� bite Ptejk/ew,' This day of , 20_ Date: •17xfo y Title: Signature: Signature: Title: Lyle =',dt f (SEAL) Date: 40,40/0WPI 15 • • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT , •`_1 I.. State of California f;~ SS. r i• • County of 5Cit, (14,2.,r 0�r ��n n T * n p �� (0(L1 before me,, 0'E� Ct(t e c&� 1 U Bk(..c , ..: ,, Dale t Name and Tee of Officer to Q.-Jane Doe.Notary Public") .:: Si-one, r11ersonally appeared N'� ana Z- ,..,k., Name(*)of Signe(s) i-''i� - Eil--proved to me on the basis of satisfactory evidence c;: to be the person(s) whose name(s) ielare . subscribed to the within instrument and acknowledged to me that he/site/they executed ; the same in ties/b f/their authorized ;;, capacity(ies), and that by bislherf/their T'-, signature(s)on the instrument the person(s), or =:f= the entity upon behalf of which the person(s) ,, ,;`; acted, executed the instrument. •.^, 4<<t�=?{,�4,. rJIRIR1EGRA ?c1 y,, *- a N1V- 14., CoMM.#2031882 -- ;;, Z � hand and official se 1 .. .., • Z NOTARY PUBLIC-CALIFORNIA my =,. SAN BERNARDINO COUNTY nricv„, - My Comm.Expires June 30,2017 rM, Signature of Notary Pale i 1; •1 OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document '." Description of Attached Document Title or Type of Document: Document Date: Number of Pages: .� I:-• • Signer(s)Other Than Named Above: �`.i r': '1 r'1 ,• Capacity(ies) Claimed by Signer 1.; • :1 Signer's Name: 7 fGNT-THU11.lBPRIr1T• `:; 1 . --s 0 Individual Top of thumb here 0 Corporate Officer--Title(s): ,:•. ❑ Partner--0 Limited 0 General -'• • 0 Attorney-in-Fact ' O Trustee "l' ❑ Guardian or Conservator t 0 Other: 1' ,, Signer is Representing: ,, C 1999 National Notary Assoc aiion•9350 De Solo Ave.P.O.Boo 2402•Chatsworth CA 91313.2402•www nalionatnotary orp Prod No 9907 Ret.clec Call Toll-Free 1-800.076.8827 REFERENCES For all public agency projects in excess of$1,000,000 you are currently working on or have worked on in the past five (5)years, provide the following information: Project 1 Name/Number c)/ 20/fl//tW5/Orn,' Seal AR101 Project Description 7j1'e .r,L A!ôAhr 4,qsrr ecL/o, (PA('J '1(A%4 ' ?&Y Approximate Construction Dates From: V4 ,?D/y To: SO( .?0* Agency Name: (4 0 ,4 aaYi O Contact Person: 62?y rms Telephone: �9oY39s'1/30 ?d.. �QAddress: S/ if2rr,*0, ?/ dr Original Contract Amount: $ /t58 (5.7,2l Final Contract Amount: $ 09 0,0/ If final amount is different from original amount, please explain(change orders, extra work, etc.) (jig Orders /tiCTItlf;r3 s4 & added /Vic/ Did you file any claims against the Agency? Circle one: Yes 4J!P Did the Agency file any claims against you? Circle one: Yes No If you answered yes to either of the above two questions, please explain and indicate outcome of claims. Project 2 Name/Number 7//245' hed She/4w'iW' S/67 Si / Project Description perf/6441 COCkSit? fn''/, Approximate Construction Dates From: tVF.'e " "5' To: /0/frail le/P Agency Name: 4J' 01( %ICh ��aropy? Contact Person: /Si'�D 4iid Telephone: (7,00-00 X 152 Address: AM am-a#/4- 4/Yp 49Q C'a g//00 Original Contract Amount: $ idg ‘•18. 22 Final Contract Amount: $ dow ?, 16 • • If final amount is different from original amount, please explain (change orders, extra work, etc.) 67012,4i4er +i) under iof 4A1 Did you file any claims against the Agency? Circle one: Yes No } Did the Agency file any claims against you? Circle one: Yes CIP If you answered yes to either of the above two questions, please explain and indicate outcome of claims. Project 3 Name/Number ,V/1 5/dry �� 4ec/ Project Description 75-0. 5/ant/ CrrnkS ,/ fa7e�biN� 9sf Approximate Construction Dates From: /7Q� BY, To: kld. Agency Name: L/?y Di &rad Contact Person: �,° Telephone: 0/4(0-0/1 Address: /(I562?4 A�2' �rhld 9008 Original Contract Amount $ / 04 18O Final Contract Amount: $ 11.vigg ot-e If final amount is different from original amount, please explain (change orders, extra work, etc.) Did you file any claims against the Agency? Circle one: Yes Gi Did the Agency file any claims against you? Circle one: Yes 2• If you answered yes to either of the above two questions, please explain and indicate outcome of claims. 17 410 i' Project 4 Name/Number5/�my SfaJ Rec/ 17.lQ.c l Ye4r W/ á1d Project Description 91 1127$6y, Sôvl5eci,/ Cr!/c4 fet7‘f+.7 Approximate Construction Dates From: /,fr/feW To: 7 'øe Agency Name: LOl/!� in&de Contact Person: /bn,1 Araie Telephone: g:id,,c-..gi(/ / Address: 950 /i44A 4 1127; td 9150 Original Contract Amount: $ ‘,8t161.�� Final Contract Amount: $ �. 2e? If final amount is different from original amount, please explain (change orders, extra work, etc.) koa/ 9a2M111r r,�,prr j/er 40 Seal 4fkaon� Did you file any claims against the Agency? Circle one: Yes 6) Did the Agency file any claims against you? Circle one: Yes (9 If you answered yes to either of the above two questions, please explain and indicate outcome of claims. Project SName/Number 2T,' '%,a'/5,6t' ‘re4f Project Description pi, J.T11I14' Oece,f�tr(fT�►�/� Approximate Construction Dates From: I/'Q5' Ii/ To: dfri//,/, Agency Name: 7 0 7C 4 Contact Person: Ea e C4QO Telephone: ( OL!J '2O- 2ó'5/ Address: giár/4/I14 AidCe, 21,10/ Original Contract Amount: $ b'tJ 997. D/ Final Contract Amount: $ /41 MO If final amount is different from original amount, please explain (change orders, extra work, etc.) (CO a dd:y add' qf 54re, A 'TM/ 18 • Did you file any claims against the Agency? Circle one: Yes 40 Did the Agency file any claims against you? Circle one: Yes m If you answered yes to either of the above two questions, please explain and indicate outcome of claims. Project 6 Name/Number 545*/4) / l‘ t "A O/ 41/3 Project Description .44f ZIf/ Jez,/fniIX / cxicI '.f�j0i� Approximate Construction Dates From: %JaI/ . � To: OcAt6er "tV, Agency Name: 6Y/4 iirit/dc Contact Person: ábd /7QXCvB" Telephone: (�.JIJ 911-807 Address: OM f2flA1y1 ') .71� // 1f/L ', 91..lQy Original Contract Amount: $ it(-0/11-(°° Final Contract Amount: $ Poq.(0./ If final amount is different from original amount, please explain (change orders, extra work, etc.) Chaiii/fei Ukre aCh4 /101 o19;47/ did Did you file any claims against the Agency? Circle one: Yes 05) Did the Agency file any claims against you? Circle one: Yes If you answered yes to either of the above two questions, please explain and indicate outcome of claims. 19 0 0 { RESUME Attach to this Bid the experience resume of the person who will be designated as General Construction Superintendent or on-site Construction Manager for the Contractor. 1 i 20 • EXPERIENCE RESUME PROJECT MANAGER: TIM GRIFFIN EXPERIENCE: ROY ALLAN SLURRY SEAL FROM 1987-1998 WORKING AS A TRAFFIC CONTROL MAN,SQUEEGEEMAN,SHUTTLEMAN,LINE DRIVER& MIXER OPERATOR. CALIFORNIA PAVEMENT MAINTENANCE FROM 1998-2001 WORKING AS A PROJECT SUPERVISOR&OPERATIONS MANAGER. AMERICAN ASPHALT SOUTH FROM 2001-PRESENT WORKING AS A PROJECT SUPERVISOR&PRODUCTION MANAGER. PROJECT MANAGER: JEFF PETTY EXPERIENCE: AMERICAN ASPHALT FROM 1985-PRESENT WORKING AS A TRAFFIC CONTRAL MAN,SQUEEGEEMAN,SHUTTLEMAN, LINE DRIVER,MIXER- OPERATOR,PROJECT SUPERVISOR&PRODUCTION MANAGER. PROJECT MANAGER: LYLE STONE EXPERIENCE: ROY ALLAN SLURRY SEAL FROM 1986-1998 WORKING AS THE ESTIMATOR AND PROJECT MANAGER. CALIFORNIA PAVEMENT MAINTENANCE FROM 1998-1999 WORKING AS THE AREA MANAGER. ASPHALT MAINTENANCE COMPANY FROM 1999-2000 WORKING AS THE AREA MANAGER AND PROJECT SUPERINTENDENT. VALLEY SLURRY SEAL FROM 2000-2001 WORKING AS THE AREA MANAGER. AMERICAN ASPHALT SOUTH FROM 2001-PRESENT WORKING AS THE AREA MANAGER, PROJECT MANAGER AND ESTIMATOR. PROJECT MANAGER: TYLER SKENDER EXPERIENCE: AMERICAN ASPHALT SOUTH, INC. FROM 2008-PRESENT PROJECT SUPERVISOR: JULIO RUIZ EXPERIENCE: AMERICAN ASPHALT SOUTH,INC. FROM 1998 TO 1999 WORKING AS A LINE DRIVER AND SHUTTLEMAN. WORKING FROM 1999 TO PRESENT AS A PROJECT SUPERVISOR. PROJECT SUPERVISOR: DAVID DARR EXPERIENCE: AMERICAN ASPHALT SOUTH, INC. FROM 2008 TO PRESENT PROJECT SUPERVISOR: JOSE SALINAS EXPERIENCE: AMERICAN ASPHALT SOUTH, INC. FROM 1998-2008&2010 TO PRESENT MIXER-OPERATOR: JAIME SALINAS EXPERIENCE: AMERICAN ASPHALT SOUTH, INC. FROM 2004-PRESENT MIXER-OPERATOR: MANNY GONZALES EXPERIENCE: AMERICAN ASPHALT SOUTH, INC. FROM 2001-PRESENT 0 • MIXER-OPERATOR: JULIO TREJO EXPERIENCE: AMERICAN ASPHALT SOUTH, INC. FROM 2007-PRESENT DESIGNATION OF SUBCONTRACTORS [Public Contract Code 4104] List all Subcontractors doing Work in an amount in excess of 0.5% of the Contractor's total Bid or, in the case of Bids or offers for the construction of Streets or highways (including bridges), in excess of 0.5% of the Contractor's total Bid or$10,000, whichever is greater. If all Subcontractors do not fit on this page, attach another page listing all information for all other Subcontractors. Subcontractors Name under which California Contractor's T e of Work Percentage of License Number(s) & Address & Phone Number YP Total Bid (e.g., Subcontractor is Licensed Class es (e.g., Electrical) 10% ) , //At/7 t r m.1 c. / �'n e, A-ve /1€0,P,10,/ J fn,J4 14/?c' i'1 SP24 I4 )72 • 1(1 / A j 7i I-VW iB.s1 n��c"1-e-pf•4-.) al#' B / )424 teke,4/4. 9d.)g7 4 4-5/ :s VA)4-4 Aet Pf",, ,Pr),-,/,17 471- 4-37. ;1_ - 1 ti 411 *The percentage of the total bid shall represent the"portion of the work"for the purposes of Public Contract Code Section 4104(b). 21 CONTRACTOR'S INDUSTRIAL SAFETY RECORD Bidder's Name Affla*170 44,510X/iLle Current Year of 2013 2012 2011 2010 2009 Total Year Record Number of contracts il Jt9 76 /.0 i. ,1 Q7014 Total dollar amount of 11) contracts (in thousands ) Zg � 9Ø' 22o'2• 2o'i,2 2t /YS' jtj1ill of dollars) Number of fatalities 0 0 0 0 0 0 0 Number of lost workday 6 cases 1 0 / //) 6 Number of lost workday cases involving permanent transfer to another job or 0 0 0 0 0 0 0 termination of employment 1110 The above information was compiled from the records that are available to me at this time and I declare under penalty of perjury that the information is tru- and accurate within the limitations of those records. i Signature: f Signature: �� /� Title: ‘7e7q 44/ ke AtriTitle: L e J6' Arlo', Date: /D/f��1/, Date: AXPie /y 22 • Bond No. N/A BID BOND KNOW ALL PERSONS BY THESE PRESENTS that WHEREAS the City of Rancho Palos Verdes("Public Agency"), has issued an Invitation for Bids for the Work described as follows: • FY2012-13& FY2013-14 RESIDENTIAL STREETS REHABILITATION PROJECT, AREAS 1,5B, &9 WHEREASAmerican Asphalt South, Inc.P.O. Box 310036,Fontana CA 92331 • (Name and address of Bidder) ("Principar), desires to submit a Bid to Public Agency for the Work. WHEREAS, Bidders are required under the provisions of the California Public Contract Code to furnish a form of Bidder's security with their Bid. NOW,THEREFORE,we.the undersigned Principal, and The Guarantee Compy of North America USA One Towne S s uare Ste.#1470,Southfield MI 48076 (Name and address of Surely) ("Surety's)a duly admitted surety insurer under the laws of the State of California,as Surety,are held and firmly bound unto the Public Ancy in the penal sum of Ten Percent of the Amount id _ Dollars($_,10%of the Amount Bid ), being not less than ten percent (10%) of the total Bid price, In lawful money of the United States of America,for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors,administrators, successors,and assigns, jointly end severally,firmly by these presents. • THE CONDITION OF THiS OBLIGATION IS SUCH THAT,if the hereby bounded Principal is marded a contract for the Work by the Public Agency and, within the time and In the manner required by the Specifications,enters into the written form of Contract included within those Specifications,furnishes the required Bonds,one to guarantee faithful performance and the other to guarantee payment for labor and materials,and furnishes the required insurance coverage,then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. in case suit Is brought upon this Bond, Surety further agrees to pay all court costs Incurred by the Public Agency in the suit and reasonable attorneys'fees in an amount fixed by the court. Surety hereby waives the provisions of California Civil Coda Section 2845. • 23 0 • IN WITNESS WHEREOF, this instrument has been duly executed by Principal and Surety, on the date set forth below, the name of each corporate patty being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated: October 8,2014 "Principal' "Surety' American Asphalt South,Inc. The Guarantee Company of North America USA By: /' B Ak21 let ' `�, Its Patricia M. Simas,Attorney-In-Fact i By: :�..� ,/:1..�. By: Seer Its (See) (sear) Note: This Bond must be dated,all signatures must be notarized,end evidence of the authority of any person signing as attofiey- ln-fact must be etUsched. 24 0 • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT _ ..lr • State of California 1 SS. • County of SC 1nR.e.ro kr Lien n tc' \ri\a t t c, GckOn 6CQfZ, before tree, ,i; ,r Dale Name and Tale of Office,le g.'Jane Doe.Notary Pubfi 1 i.. r <i, r onali appeared 3€ 1 _ (?&c\ and Lt1Ia Slane,pe s Y PP � . namely)of Sign si 1' • C4--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 Olt/she/they executed r'' the same in tis/beltheir authorized , • capacity(ies), and that by be/het/theiri signalure(s) on .r•: the instrument the person(s), or the entity upon behalf of which the person(s) , ,./; 4101111)%, s,��I , JERI MARIE GRANT acted, executed the instrument. }.l t - G�, COMM.#2031882 ZNIL.;;;;--j?-1l, -,/NOTARY PUBLIC-CALIFORNIAS = y hand and official seal •.;. .. , SAN BERNARDINO COUNTY • , _ My Comm Expires June 30.2017 %Q., , . Signature Signature of Notary Public ",~! OPTIONAL ..�- i Though the intomiation below is not required by law,;t may prove valuable to persons relying on the document and could prevent ,.. fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: ' •, Document Date: Number of Pages: , •, Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer :" • Signer's Name: l-IGHT.TNUNIBMINT .'. .--`OF.S'GNER _ A 7 ;) 0 Individual Top of herb here :•r:' 0 Corporate Officer—Title(s): r:• 0 Partner--0 Limited 0 General • O Attorney-in-Fact • 0 Trustee . ' ' - O Guardian or Conservator (:. 0 Other: Signer is Representing: - Cr 1999 Naronal Notary Association•9350 De Soto Ave..PO Box 2402•Chaiawont,CA 91303.2402•www.naiionalnolary org Prod.No 5907 Reorder Call Toe-Free 1.800.875.6827 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Sacramento on October 8, 2014 before me, Melissa D. Diaz, Notary Public (Here insert name and title of the officer) personally appeared Patricia M. Simas who proved to me on the basis of satisfactory evidence to be the person(e)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in iiis/her/their authorized capacity(ies), and that by his/her/ter 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. r#1,7"!-. x�; I E L l S S A D. BIT/ WITNESS m 1 seal. y .4,A. COMM. # 1947239 a ar: a NOTARY PUBLIC.CAUFORN1As I -} SACRAMENTO CO. m(Notary Seal) EXP, AUG 7. 2015 Signature of Notary Public ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must he properly completed and attached to that document.The only exception is tic' Bid Bond document is to be recorded outside of Caltfornia.in such instances,any alternative (Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in American Asphalt South, Inc. California(i.e.certifying the authorized capacity of the signer).Please check the (Title or description of attached document continued) document carefully for proper notarial wording and attach this form if required Number of Pages 1 Document Date 10/08/14 •State and County information must be the State and County where the document signer(s)personallappeared before the notarypnblic for acknowledgment •Date of notarization must be the date that the signer(s)personally appeared which The Guarantee Company of North America USA must also be the same date the acknowledgment is completed. (Additional information) •The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title(notary public). •Print the name(s)of document signer(s)who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER •Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. O Individual(s) be/she/they,is/are-)or circling the correct forms.Failure to correctly indicate this information may lead to rejection of document recording. ❑ Corporate Officer •The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines.If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) •Signature of the notary public must match the signature on file with the office of the county clerk. MD Attorney-in-Fact *.-Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. ❑ Other *.-Indicate title or type of attached document,number of pages and date. *.-Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). •Securely attach this document to the signed document I 2008 Version CAPA 02.1 0.07 800-873-9865 www.NotaryClasses.com • 110 THE The Guarantee Company of North America USA GUARANTEE- Southfield,Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS:That THE GUARANTEE COMPANY OF NORTH AMERICA USA,a corporation organized and existing under the laws of the State of Michigan,having its principal office in Southfield,Michigan,does hereby constitute and appoint Barbara Midstokke,Renee Ramsey,Richard W.Pratt,John Hopkins,Elizabeth Collodi,Susan Lee,Barbara Beeny,Nancy Luttenbacher, Phillip O.Watkins,Keith T.Schuler,Melissa 0.Diaz,Shawna Johnson,Patricia M.Simas lnterwest Insurance Services,Inc. Its true and lawful attorneys)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof,which are or may be allowed,required or permitted by law,statute,rule,regulation,contract or otherwise. The execution of such instruments)in pursuance of these presents,shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply,to all intents and purposes,as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so,and may be revoked,pursuant to and by authority of Article IX,Section 9.03 of the By-Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31m day of December,2003. The President,or any Vice President,acting with any Secretary or Assistant Secretary,shall have power and authority: 1. To appoint Attorney(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof;and 2. To revoke,at any time,any such Attorney-in-fact and revoke the authority given,except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only,it is agreed that the power and authority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee,shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner— Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. Further,this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the fith day of December 2011,of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond,undertaking,contracts of indemnity and other writings obligatory in the nature thereof,and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF.THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and le(rie) its corporate seal to be affixed by its authorized officer,this 23rd day of February,2012. 4 THE GUARANTEE COMPANY OF NORTH AMERICA USA 44 _41.00/ e9iit4) STATE OF MICHIGAN Stephen C.Ruschak,Sr.Vice President,COO Randall Musselman,Secretary County of Oakland On this 23rd day of February,2012 before me came the individuals who executed the preceding instrument,to me personally known,and being by me duly sworn,said that each is the herein described and authorized officer of The Guarantee Company of North America USA;that the seal affixed to said instrument is the Corporate Seal of said Company;that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai IN WITNESS WHEREOF,I have hereunto set my hand at The Guarantee Notary Public,State of Michigan Company of North America USA offices the day and year above written. County of Oakland My Commission Expires February 27,2018 a, 7--a_odet.L Acting in Oakland County 1,Randall Musselman,Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA,which is still in full force and effect. IN WITNESS WHEREOF,I have thereunto set my hand and attached the seal of said Company this 8th day of October , 2014 \Vre ItIthurt` ' Randall Musselman,Secretary • 110 NONCOLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID [Public Contract Code 7106] The undersigned declares: I am the like Vat/ STrtivi of //WM/ //Si 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 oompany, 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 he reming is true and correct and that this declaration is executed on /s/I//D1y [date], at /144 if [city], (/4rv"q [state]." Signature 0. Signature y‘.. 0k Printed Name: A/5 %ce � Printed Name: Date:• /41/ItVi1 Date: �� ,/,‘f / This form must be notarized. 25 • • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ----:.'-:•-.F1::.,,Ficz:::::-.-1.-ff,:?:...:3::4,s--‘ ,•.(..!•4::::'...,- 7.-',--*---:::if-,:-.e.7/::.--?-•!:-.'::::-,S--.--Y;z_-?t'•-,-.- - -.-x,--'--i'...:.1::-:::::t.,.:,.:'.:,-,!.. ...--. •.......- :-. :7.•:.•:!:•,.....:4,'•_•;.:.::. . :.' k 1. .:: State of California ,., County of Sa.in Reefle,f I..'Nn n 1 SS 14'5 . , 4..' .f.i : • „ ;.. On (kkobe- W7, 00111 before me )tc‘ \II etc t ., g f ca)--V i( okc ,., Dalt Name ancl Tole ol Onclt It 9.'Jane Doe.Notary Pulie) personally appeared r•,, t), 3 e k' •‘2-V\1/4) aria 11 I e Si-o n e_ .0, Hameioa Sire(S) . •.,' • , •, ri: EP–proved to me on the basis of satisfactory .. ..-,. .• .. evidence ...; . t.,..! to be the person(s) whose name(s) idare t.: subscribed to the within instrument and r. acknowledged to me that lie/she/they executed C J,. the same in his/be./their authorized ,-..., capacity(ies), and that by brislhei/lheir 1!--... signature(s)on the instrument the person(s), or t.- •;:.:! the entity upon behalf of which the person(s) 91 J Et,—.. RI MARIE GRANT ..... ...,:,,,I, 4f'•-....-:`4, acted, executed the instrument. r.li rt 2 Z ,a_....,94 NOTARY PUBLIC-CAUFORNIA C a ,- my hand an official se Zi! ' BAN BERNARDINO COUNTY t-,,..-• i •:., ..:). 1 i My Comm.Expires June 30,2017 , . CVILI ., Signaium al No1ary Public r., 1.., r'n -, f-1 1 INIMIMIIMINIMIIIIMINIMIIIMEmmIMMEMM.11=111111■MINNIIIIMIIIIIIM.111.110.......krillomiloNIWINO.Aftrb OPTIONAL Though the information below ts not required by law,it may prove valuable to persons relying on the document and could prevent ,.., fraudulent removal and reattachment of this lorm to another document. -i Description of Attached Document .,-.,. Title or Type of Document: r.. 1 Document Date: Number of Pages: , . ir,` i:31 .i Signer(s)Other Than Named Above: ...ci ,,:..• i.a.j! •, ,.. Capacity(ies) Claimed by Signer te.. r7..., ;.1. j Signer's Name: . A i_GHTTHW.139 HINT. ,4 ... l3F:SIGNEFI .:_:.:.4. .!.. 0 Individual Top Cl thumb here -"' ,• ... !.1" 0 Corporate Officer—Title(s): ,., ("..' 0 Partner—0 Limited 0 General :-.. 0 Attorney-in-Fact ,•.:; 0 Trustee q ..•'), 0 Guardian or Conservator v.• ::: 0 Other: i'. Signer Is Representing: __.] r.r... " , 0 1999 National Noise.),Assoc.edon•9350 De Solo Ave..P.O.Boo 2402-Chatsworth.CA 91313.2402•www.nationainolary org Prod No 5907 Recirclec Call Toll-Free 1•19004176.6827 ACKNOWLEDGMENT OF ADDENDA Bidder's Name: Ay* 40k//,,ca�G The Bidder shall signify receipt of all Addenda here, if any: Addendum Number Date Received Sig.atur- //0M/7 At- If there are more Addenda than there is room in the chart above, attach another page acknowledging receipt of the Addenda. 26 . • ill CITY OF RANCHO PALOS VERDES PUBLIC WORKS DEPARTMENT ADDENDUM NO. 't TO THE CONTRACT DOCUMENTS, SPECIFICATIONS, & STANDARD DRAWINGS FOR THE RESIDENTIAL STREETS REHABILITATION PROJECT FY2012-13 & FY2013-14 AREAS 1, 5B, & 9 PROJECT NO. 004913 & 004914 In accordance with "Addenda"on the first page of the"Instructions to Bidders",the following changes (revisions, additions, and/or deletions)as noted below, are hereby incorporated and made a part of the subject plans, specifications and contract documents for this project. Portions of the Contract, not specifically mentioned in the Addendum, remain in force. All trades affected shall be fully advised of these revisions, deletions, and additions. This Addendum forms a part of the Contract Documents for the above-identified project and modifies the original specifications and Contract Documents. Each bidder shall be responsible for ascertaining, prior to submitting a Bid,that it has received all issued Addenda and shall ACKNOWLEDGE RECEIPT OF THIS ADDENDUM IN THE SPACE PROVIDED BELOW. A bidder's failure to address the requirements of this addendum or failure to acknowledge the receipt of this addendum may result in that Bid being rejected as non-responsive. The subject contract documents are hereby amended as follows: 1. Replace pages TP-16 & TP-17 of the project specifications with the attached pages TP-16A and TP-17A. End of Addendum No. 1 Any questions regarding this Addendum should be directed to the Project Manager,jJjJMelissa Countryman, Associate Engineer, at . • , 5256. /sAl .. - - ` oc1oeaato,soli Michael Throne, Date Director of Public Works 1 ackno led! - receipt of this Addendum No. 1 and accept the aforementioned. 1 -1 .,_ 1/ .,f-1,k 40/f7611, at4t. '7�, ke ` , :idder's Signature y , - Date Please sign above and include this signed addendum in the Bid package. Failure to do so may result in that Bid being rejected as non-responsive. Page 1 of 1 3094011AWTHORtF E3OLLEVARD/RANCHO PALOS VERDES,CA 90275-5391/(310)544-5252/FAx(310)544.5292/WWW PfAIOSvTRDES CoM/RPv 1'Rm 1 ED UM REC't;LED PAPER