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Ruiz Concrete and Paving Inc
RECORDING REOUESTED,BY: City bf Rancho Palos Verdes ' WHEN RECORDED MAIL TO: City Clerk 1211712015 NameCity of Rancho Palos Verd6- 30940 Hawthorne Blvd. Street R 1111111111101 20151ancho Palos Verdes Address C A 59048 City 90275 State Zip l_ J Space above this line for recorder's use OL0 f:TS'FORMS INC. SINCE 1893 NOTICE OFCOMPLETION Notice pursuant to Civil Code Section 3093,must be filed within 10 days after completion. (See reverse side for com let ' Notice is hereby given that: p e requirements.) 1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the property hereinafter described. 2. The full name of the owner is City of Rancho Palos- Verdes 3. The full address of the owner is 30940 Hawthorne Blvd. Rancho Palos verdes, CA 90275 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 common are. NAMES ADDRESSES 6. The full names and full addresses of the predecessors in interest of the undersigned, if the property was transferred s erred subsequent 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 November 9 , 2015 .The work don - - - _ - .. a. e _ _ • • ' • - . . tt•rovements on Mira Catalina e was: 8. The names of the contractor, if any,for such work of improvement was Ruiz Concrete an• aving , Ile. (11 no contractor for worts of improvement as a whole,insert'None') (Date of Contract) 9. The property on which said work of improvement was completed is in the City of Rancho Palos Verdes County of Los Angeles ,State ofC A ,and is described a I Rightof Way follows: City 10. The street address of said property is Starline Drive and Par urs ive • (If no street address has been officially assigned,insert'none'.) (. ."4 yc Act,(OS .fC.A1:1)) Dated ( f ( S /(40/tALAA.2..Q....."----4 (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 Completion; of,Manager of,Partner of,Owner of,etc.) g I have read said Notice of Completion and know the contents thereof;the same is true to my own ena knowledge. I declare under of perjury that the foregoing is true and correct. p �Y Executed on , 7Z -&L / ,20 /57— 20 /57— Cit of Rancho Palos Verdes CA r -.leI_,� ' / ,,,j (Personal signature of the individual who is swearing th.t the contents o/ e Notice of Completion are true) Before you use this form fill in all blanks, and make whatever chanes are appropriate and necessary ' , ming to your particular transaction . Consult a lawyer if you doubt the form s fitness for your purpose and use. l; Il' 4 Wolcotts makes no representation or warranty, express or implied, with respect to the merchantability 7 '' 6777 S 11 or fitness of this form for an intended use or purpose. ©2005 WOLCOTTS FORMS,INC. 01114 2 FORM 1114 Rev. 10-05 DO NOT RECORD THIS PAGE REQUIREMENTS AS TO NOTICE OF COMPLETION Notice of completion must be filed for record WITHIN 10 DAYS after the completion of the work of improvement (to be computed exclusive of the day of completion) as provided in Civil Code Section 3093. The "owner" who must file for record a notice of completion of a building or other work of improvement means the owner (or his successor in interest at the date the notice is filed) on whose behalf the work was done, though his ownership is less than the fee title. For example, if A is the owner in fee, and B, lessee under a lease, causes a building to be constructed, then B, or whoever has succeeded to his interest at the date the notice is filed, must file the notice. If the ownership is in two or more persons as joint tenants or tenants in common, the notice may be signed by any one of the co-owners (in fact, the foregoing form is designed for givingof the notice by only one co-tenant), but the names and addresses of the other co- owners must be stated in paragraph 5 of the form. Note that any Notice of Completion signed by a successor in interest shall recite the names and addresses of his transferor or transferors. In paragraphs 3, 5 and 6, the full address called for should include street number, city, county, and state. As to paragraphs 7 and 8, this form should be used only where the notice of completion covers the work of improvement as a whole. If the notice is to be given only of completion of a particular contract, where the work of improvement is made pursuant to two or more original contracts, then this form must be modified as follows: (1) Strike the words "A work of improvement" from paragraph 7 and insert a general statement of the kind of work done or materials furnished pursuant to such contract (e.g., "The foundation for the improvements"); (2) Insert the name of the contractor under the particular contract in paragraph 8. In paragraph 8 of the notice, insert the name of the contractor for the work of improvement as a whole. No contractor's name need to given if there is no general contractor, e.g. on so- called "owner-builder jobs." In paragraph 9, insert the full, legal description, not merely a street address or tax description. Refer to deed or policy of title insurance. If the space provided for description is not sufficient, a rider may be attached. In paragraph 10, show the street address, if any, assigned to the property by any competent public or governmental authority. A This page is part of your document-DO NOT DISCARD .=�•0Ft,°= 20151590489� � In� III OlD III 101 II 110110 III 101 I il „: 1;4. Reoredfesdiee, LoOsMalelCnty, P00 3� I_ California C4�oaMt's� 12117/16 AT 11:42AM FEES: 0.00 TAXES: 0.00 OTHER: 0.00 PAID: 0.00 IIII II I III III II I VIII I I II I I I II III I I I II II I VIII I I I III II I I)III I IIII LEADSHEET MillII II III VIII II VIII VIII III II II III VIII VIII IIII 201512773240019 00011498426 IIIH 110110 III II IiIIiI 00 l Iii OW279627 SEQ: 02 DAR - Counter (Upfront Scan) Dliii Uli IIIIIIIIIIIAIIIIIIMIII iUIiliIiI H 11111011 lb 1110 I 111111111111111111111111 Mliii liii 1111111 111111 II 1111 - THIS FORM IS NOT TO BE DUPLICATED - .044ar.ument4C(164D , CITY OF RANCHO PALOS VERDES AGREEMENT FOR ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS ON MIRA CATALINA (Community Development Block Grant Project#601561-13) THIS AGREEMENT (the "Agreement") is made and entered this 18th day of August, 2015, by and between the CITY OF RANCHO PALOS VERDES, a California municipal corporation ("City") and Ruiz Concrete and Paving, Inc.("Contractor"). Contractor's license number is 966395. In consideration of the mutual covenants hereinafter set forth, the parties hereto agree as follows: 1. Scope of Services. Contractor shall perform the work and provide all labor, materials, equipment and services in a good and workmanlike manner for the project identified as ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS ON MIRA CATALINA ("Project"), as described in this Agreement and in the Bid Documents (including the Notice Inviting Sealed Bids, the Instructions to Bidders, the General Provisions, the Special Provisions, the Proposal, Appendices I through V, and all addenda as prepared prior to the date of bid opening setting forth any modifications or interpretations of any said documents), which are on file with the Department of Public Works and incorporated herein by this reference, including miscellaneous appurtenant work. All work shall be performed in accordance with the latest edition of the Standard Specifications for Public Works Construction (commonly known as the"Greenbook"), including supplements, prepared and promulgated by the Southern California Chapter of the American Public Works Association and the Associated General Contractors of California (collectively "Standard Specifications"), which is incorporated herein by this reference. In the event of any conflict between the terms of this Agreement and incorporated documents, the terms of this Agreement shall control. 2. Extra Work. Extra work,when ordered in writing by the Director of Public Works and accepted by the Contractor, shall be paid for underwritten work order in accordance with the terms therein provided. Payment for extra work will be made at the unit price or lump sum previously agreed upon in writing between the Contractor and the Director of Public Works. All extra work shall be adjusted daily upon report sheet furnished by the Contractor, prepared by the Director of Public Works, and signed by both parties, and said daily report shall be considered thereafter the true records of extra work done. 3. Effective Date. This Agreement is effective as of the date listed above, and shall remain in full force and effect until Contractor has rendered the services required by this Agreement. 4. Force Majeure. Neither the City nor Contractor shall be responsible for delays in performance under this Agreement due to causes beyond its control, including but not limited to acts of God, acts of the public enemy, acts of the Government, fires, floods or other casualty, epidemics, earthquakes, labor stoppages or slowdowns, freight embargoes, unusually severe weather, and supplier delays due to such causes. Neither economic nor market conditions nor the financial condition of either party shall be considered a cause to excuse delay pursuant to this Section. Each party shall notify the other promptly in writing of each such excusable delay, its cause and its expected delay, and shall upon request update such notice. 5. Compensation. In consideration of the services rendered hereunder, City shall pay Contractor a not to exceed amount of Fifty Eight Thousand eight hundred eighty two dollars and forty-five cents ($58,882.45) in accordance with the prices as submitted in Contractor's Proposal, attached hereto as Exhibit"A" and incorporated herein by this reference. 6. Payments. City shall make payments within thirty (30) days after receipt of undisputed and properly submitted payment requests from Contractor. City shall return to Contractor any payment C- 1 R6876-0010\1817323v2.doc Attachment A request determined not to be a proper payment request as soon as practicable, but not later than seven (7) days, after receipt and shall explain in writing the reasons why the payment request is not proper. A payment shall be made as the City Council of the City prescribes upon estimates approved by the City Council. However, progress payments shall not be made in excess of ninety-five percent(95%) of the percentage of actual work completed plus a like percentage of the value of material delivered on the ground or stored subject to, or under the control of, the City, and unused. The City shall withhold not less than five percent (5%) of the Agreement price until final completion and acceptance of the Project. However, at any time after fifty percent (50%) of the work has been completed, if the City Council of the City finds that satisfactory progress is being made, it may, at its discretion, make any of the remaining progress payments in full for actual work completed. 7. Substitute Security. a. At the written request and expense of Contractor, securities equivalent to any moneys withheld by the City to ensure performance under this Agreement shall be deposited with the City, or with a state or federally chartered bank in the State of California as the escrow agent,that shall then pay those moneys to Contractor. Upon satisfactory completion of the Agreement, the securities shall be returned to Contractor. b. Alternatively, Contractor may request that the City shall make payment of retentions earned directly to the escrow agent at the expense of Contractor. At the expense of Contractor, Contractor may direct the investment of the payments into securities, and Contractor shall receive the interest earned on the investments upon the same terms provided for securities deposited by Contractor. Upon satisfactory completion of the Agreement, Contractor shall receive from the escrow agent all securities, interest, and payments received by the escrow agent from the City, pursuant to the terms of this Section. c. Securities eligible for investment shall include those listed in California Government Code Section 16430, bank or savings and loan certificates of deposit, interest-bearing demand deposit accounts, standby letters of credit, or any other security to which Contractor and the City mutually agree in writing. Contractor shall be the beneficial owner of any securities substituted for moneys withheld and shall receive any interest thereon. d. If Contractor elects to receive interest on moneys withheld in retention by the City, it shall, at the request of any subcontractor performing more than five percent(5%)of Contractor's total bid, make that option available to the subcontractor regarding any moneys withheld in retention by Contractor from the subcontractor. Further mandatory details are provided in Public Contract Code Section 22300(d), which is incorporated herein by this reference. e. The escrow agreement for security deposits in lieu of retention shall be substantially similar to the form provided in Public Contract Code Section 22300(f), which is incorporated herein by this reference. 8. Taxes. Contractor shall calculate payment for all sales, unemployment, old age pension and other taxes imposed by local, Stat- of Cali,. ''a and federal law. These payments are included in the total amounts in Exhibit ` " it A c, 9. Time. Upon receipt of written Notice to Proceed from the City, Contractor shall perform with due diligence the services requested by the City as specified in the Bid Documents. Time is of the essence C-2 R6876-0010\1817323v2.doc Attachment A in this Agreement. 10. Unresolved Disputes. In the event that a dispute arises between the City and Contractor regarding whether the conditions materially differ, involve hazardous waste, or cause a decrease or increase in Contractor's cost of or time required for performance of any part of the work, Contractor shall notify City promptly of its intention to submit a claim. If the dispute arises before performance of the related work, the written notice shall be submitted prior to commencing such work. In any event, the Contractor shall proceed with such work in compliance with the instructions of the City; such compliance shall not be a waiver of the Contractor's rights to make a claim, provided they have notified the City in writing as above stipulated. In the event of any dispute or controversy with the City over any matter whatsoever, Contractor shall not cause any delay or cessation in or of work, but shall proceed with the performance of the work in dispute. This includes disputed time extension requests and prices for changes. The disputed work will be categorized as an "unresolved dispute" and payment, if any, shall be as later determined by mutual agreement or a court of law. Contractor shall keep accurate, detailed records of all disputed work, claims and other disputed matters. Public Contract Code Sections 20104 et seq. and Rancho Palos Verdes Municipal Code chapter 3.24 ("Claims Against the City") shall govern the procedures of the claim process, and these provisions are incorporated herein by this reference. 11. Default and Remedies. a. Default shall consist of any failure by the Contractor to perform under this Agreement or written amendments thereto or any breach of any covenant, agreement, provision or warranty provided by the Contractor as a part of this Agreement. Actions which constitute a default include, but are not limited to: (1) failure to submit to the City reports which are required pursuant to this Agreement or the submission of required reports that are incorrect or incomplete; (2) submission of requests for payment or reimbursement of amounts that are incorrect or incomplete; (3) the failure of Contractor to accept any additional conditions which may be required by law, by executive order, by regulation or by other policy announced by the City, the state or any federal agency; or(4) failure to perform any activity required by this Agreement. b. Upon occurrence of any default, the City shall advise Contractor in writing of the action constituting the default, and specify the actions that must be taken to cure the default. The City may suspend payment under the Agreement. If Contractor does not cure the default within thirty (30) days of receipt of written notice from the City, the City may continue the suspension or, by written notice of termination, may terminate this Agreement. c. Notwithstanding the above, Contractor shall not be relieved of liability to the City for damage sustained by the City by virtue of any default or breach of the Agreement, and the City may deduct the amount of damages from any outstanding payments to Contractor or may withhold payments until such time as the exact amount of the damages is determined. 12. Termination. a. The City may cancel this Agreement at any time with or without cause without penalty upon thirty(30) days'written notice. In the event of termination without fault of Contractor, City shall pay Contractor for all services satisfactorily rendered prior to date of termination, and such payment shall be in full satisfaction of all services rendered hereunder. b. If federal funding for this Agreement is terminated and no other funding is available for continuation of this project, the City will not be obligated to continue funding for the services contained in this Agreement and may terminate the Agreement. C-3 R6876-0010\1817323v2.doc Attachment A c. In the event of termination, all property and finished or unfinished documents, data, studies, surveys, drawings, maps, models, photographs and reports prepared by or purchased with CDBG/HOME funds by the Contractor under this Agreement shall, at the option of the City, become the City's property, and Contractor shall be entitled to receive just and equitable compensation, as determined by the City, for any work satisfactorily completed hereunder. 13. Indemnity. a. Contractor's Duty. To the maximum extent permitted by law, Contractor shall defend, indemnify, and hold harmless the City, its elected officials, officers, employees, volunteers, agents, successors, assigns, and those City agents serving as independent contractors in the role of City officials (collectively "Indemnitees") from and against any and all claims (including, without limitation, claims for bodily injury, death or damage to property), demands, obligations, damages, actions, causes of action, proceedings, suits, losses, bid protests, stop notices, judgments, fines, liens, penalties, liabilities, costs and expenses of every kind and nature whatsoever, in any manner arising out of or incident to any act, failure to act, error or omission of Contractor or any of its officers, agents, servants, employees, subcontractors, materialmen, suppliers or their officers, agents, servants or employees, arising out of the Agreement, including without limitation, the payment of all consequential damages, attorneys' fees, experts' fees, and other related costs and expenses (individually, a "Claim," or collectively, "Claims"). Further, Contractor shall appoint competent defense counsel approved by the City Attorney at Contractor's own cost, expense and risk, to defend any and all such Claims that may be brought or instituted against Indemnitees. Contractor shall pay and satisfy any judgment, award or decree that may be rendered against Indemnitees in any such Claim. Contractor shall reimburse Indemnitees for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. Contractor's obligation to indemnify shall not be restricted to insurance proceeds, if any, received by Contractor or Indemnitees. This indemnity shall apply to all Claims regardless of whether any insurance policies are applicable. b. Bid Protests. In addition to its obligations pursuant to Section 13(a), Contractor shall reimburse the City for all attorneys' fees and costs incurred by City in connection with, arising out of or incident to any bid protest. c. Civil Code Exception. Nothing in Section 13(a) shall be construed to encompass Indemnitees' sole negligence or willful misconduct to the limited extent that the underlying Agreement is subject to Civil Code section 2782(a) or the City's active negligence to the limited extent that the underlying Agreement is subject to Civil Code section 2782(b). d. Nonwaiver of Rights. Indemnitees do not and shall not waive any rights that they may possess against Contractor because the acceptance by City, or the deposit with City, of any insurance policy or certificate required pursuant to this Agreement. This indemnity provision is effective regardless of any prior, concurrent, or subsequent active or passive negligence by Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence. e. Waiver of Right of Subrogation. Contractor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation and contribution against the Indemnitees, while acting within the scope of their duties, from all Claims arising out of or incident to the activities or operations performed by or on behalf of the Contractor regardless of any prior, concurrent or subsequent active or passive negligence by Indemnitees. f. Survival. The provisions of this Section 13 shall survive the termination of this Agreement and are in addition to any other rights or remedies that Indemnitees may have under the law. Payment C-4 R6876-0010\1817323v2.doc Attachment A is not required as a condition precedent to an I ndemnitee's right to recover under this indemnity provision, and an entry of judgment against a Contractor shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. 14. Incorporation by Reference. All of the following documents are attached hereto and incorporated herein by this reference: City of Rancho Palos Verdes Instructions for Execution of Instruments; Insurance Requirements for the City of Rancho Palos Verdes Public Works Contract; Workers' Compensation Certificate of Insurance; Additional Insured Endorsement (Comprehensive General Liability); Additional Insured Endorsement (Automobile Liability); Additional Insured Endorsement (Excess Liability); Non-Segregated Facilities Certification; Equal Employment Opportunity Commitment; U.S. Department of Housing and Urban Development Report of Additional Classification and Rate(HUD Form 4230A); U.S. Department of Labor Employment Standards Administration Wage and Hour Division Payroll; Contracting with Small Business Minority Firms, Women's Business Enterprise and Labor Surplus Area Firms; Federal Equal Employment Opportunity/Affirmative Action Requirements; Past Performance Certification; and Fringe Benefit Payment Certification. 15. Record-Keeping and Reporting. a. Records to be Kept. Records shall be maintained in accordance with the requirements prescribed by the Secretary of Housing and Urban Development ("HUD") or the County of Los Angeles (the"County") with respect to all matters covered by this Agreement. Except as otherwise authorized by HUD, such records shall be maintained for a period of five (5) years after receipt of the final payment under this Agreement. Additionally, pursuant to Government Code Section 8546.7, Contractor shall be subject to State Auditor examination and audit at the request of the City or as part of any audit of the City, for a period of three (3) years after final payment under this Agreement. b. Documentation of Costs. All costs shall be supported by properly executed payrolls, time records, invoices, contracts, vouchers, orders or other accounting documents. All documents pertaining in whole or in part to this Agreement shall be clearly identified and readily accessible. c. Inspection of Records. At any time during normal business hours and as often as City, County, HUD and/or the Comptroller General of the United States may deem necessary, the Contractor shall make available to any of these entities for examination all of its records, with respect to all matters covered by this Agreement, and will permit any of these entities to audit, examine and make excerpts or transcripts from such records, including contracts, invoices, materials, payrolls, records of personnel, conditions of employment and any other data relating to matters covered by this Agreement. 16. Lobbying Certifications. The Los Angeles County Lobbyist Code Chapter 2.160 County Ordinance No. 93-0031 Certification and the Federal Lobbyist Requirements Certification are attached hereto and incorporated herein by this reference. Consultant shall complete and file these Certifications as required by the City or the County. 17. Utilities. The City acknowledges its responsibilities under Government Code section 4215 and incorporates that section herein by this reference. 18. Location of Existing Elements. The methods used and costs involved to locate existing elements, points of connection and all construction methods are the Contractor's sole responsibility. Accuracy of information furnished, as to existing conditions, is not guaranteed by the City. Contractor, at its sole expense, must make all investigations necessary to determine locations of existing elements, which may include,without limitation, contacting U.S.A. Alert and other private underground locating firm(s), utilizing specialized locating equipment and/or hand trenching. C-5 R6876-0010\1817323v2.doc Attachment A 19. Antitrust Claims. Pursuant to Public Contract Code Section 7103.5, 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. Section 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 Agreement. This assignment shall be made and become effective at the time the City tenders final payment to Contractor without further acknowledgment by the parties. 20. Independent Contractor. Contractor is and shall at all times remain, as to the City, a wholly independent contractor. Neither the City nor any of its agents shall have control over the conduct of Contractor or any of the Contractor's employees, except as herein set forth, and Contractor is free to dispose of all portions of its time and activities which it is not obligated to devote to the City in such a manner and to such persons,firms, or corporations at the Contractor wishes except as expressly provided in this Agreement. Contractor shall have no power to incur any debt, obligation, or liability on behalf of the City, bind the City in any manner, or otherwise act on behalf of the City as an agent. Contractor shall not, at any time or in any manner, represent that it or any of its agents, servants or employees, are in any manner agents, servants or employees of City. Contractor agrees to pay all required taxes on amounts paid to Contractor under this Agreement, and to indemnify and hold the City harmless from any and all taxes, assessments, penalties, and interest asserted against the City by reason of the independent contractor relationship created by this Agreement. Contractor shall fully comply with the workers' compensation law regarding Contractor and its employees. Contractor further agrees to indemnify and hold the City harmless from any failure of Contractor to comply with applicable workers' compensation laws. The City shall have the right to offset against the amount of any compensation due to Contractor under this Agreement any amount due to the City from Contractor as a result of its failure to promptly pay to the City any reimbursement or indemnification arising under this Section. 21. Workers' Compensation Insurance. 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, the Contractor hereby certifies as follows: "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 under take 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." 22. Subcontracting. Contractor shall adhere to all provisions of the Subletting and Subcontracting Fair Practices Act, Public Contract Code Section 4100 et seq., which is incorporated herein by this reference. 23. Debarred, Suspended or Ineligible Contractors. Contractor shall not be, and shall ensure all subcontractors are not, debarred, suspended or placed in eligibility status under the provisions of 24 C.F.R. Part 24 throughout the duration of this Agreement. Contractor shall not perform work with debarred subcontractor pursuant to California Labor Code sections 1777.1 or 1777.7. 24. Anti-Discrimination. Contractor shall adhere to all federal discrimination requirements, including Executive Order 11246, as listed in the Federal Discrimination Provisions, which is attached hereto and incorporated herein by this reference. Contractor shall also adhere to the Equal Employment Opportunity Regulations for Federally Assisted Construction Contracts, which is attached hereto and incorporated herein by this reference. Contractor shall ensure equal opportunity to all persons without regard to race, color, gender, sexual orientation, religion, national origin, ancestry, age, marital status, or disability. C-6 R6876-0010\1817323v2.doc Attachment A 25. Conflicts of Interest. a. Contractor agrees not to accept any employment or representation during the term of this Agreement or within twelve (12) months after completion of the work under this Agreement which is or may likely make Contractor"financially interested," as provided in Government Code Section 1090 and 87100, in any decisions made by City on any matter in connection with which Contractor has been retained pursuant to this Agreement. b. No official, officer, employee, or agent of the City or Contractor shall have any financial interest,direct or indirect, in any contract or subcontract,or the proceeds thereof,for work to be performed in connection with the program assisted under this Agreement. Immediate family members of said officials, officers, employees, and agents are similarly barred from having any financial interest in the program. c. No person who exercises, or has exercised any function or responsibilities with respect to CDBG activities, or who is in a position to participate in a decision making process or gain inside information with regards to such activities, may obtain a financial interest or benefit from a CDBG-assisted activity, or have a financial interest in any contract, subcontract, or agreement with respect to a CDBG- assisted activity, or with respect to the proceeds of the CDBG-assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for one year thereafter. d. Contractor shall take appropriate steps to assure compliance with paragraph (b) of this Section and will incorporate the following provision into every subcontract: "Interest of Subcontractor and Employees. The Subcontractor covenants that no person who presently exercises any functions or responsibilities in connection with the Community Development Block Grant Program has any personal financial interest, direct or indirect, in this Contract. Any interest on the part of the Subcontractor or his employees must be disclosed to the Recipient and the City, provided, however, that this paragraph shall be interpreted in such a manner so as not to unreasonably impede the statutory requirement that maximum opportunity be provided for employment of and participation by residents of the area." 26. Third Party Claims. City shall have full authority to compromise or otherwise settle any claim relating to the Agreement at any time. City shall timely notify Contractor of the receipt of any third-party claim relating to the Agreement. City shall be entitled to recover its reasonable costs incurred in providing this notice. 27. Davis-Bacon Act, Copeland Anti-Kickback Act, and Prevailing Wages. City and Contractor acknowledge that this project is a public work to which prevailing wages apply. City and Contractor acknowledge that this is a federally assisted construction contract and that federal labor standards provisions, including prevailing wage requirements of the Davis-Bacon Act ((40 U.S.C. 276 a to a.7) as supplemented by Department of Labor Regulations (29 CFR Part 5)) and related acts, are incorporated by this reference and will be enforced. Contractor understands that in the event of a conflict between the Federal General Wage Decision as established by the United States Department of Labor (available at www.access.gpo.gov/davisbacon/ca.html) and the State General Prevailing Wage Determination as established by the California Department of Industrial Relations (available at http://www.dir.ca.gov/DLSR/PWD/index.htm), the higher of the two will prevail. The rates per diem for each type of worker are on file with the Public Works Director at City Hall at the address listed below, and are available to anyone upon request. The documents titled U.S. Department of Housing and Urban C-7 R6876-001O\1817323v2.d o c Attachment A Development Office of Labor Relations Federal Labor Standards Provisions and Agreement to Comply with California Labor Law Requirements are attached hereto and incorporated herein by this reference. Eight hours of labor constitutes a legal day's work. The Copeland "Anti-Kick Back Act" (18 U.S.C. 876), as supplemented in Department of Labor regulations (29 CFR Part 3), shall apply, and Contractor shall not induce, by any means, any person employed in this Project to give up any part of the compensation to which he or she is otherwise entitled. 28. Contract Work Hours and Safety Standards Act. In employing mechanics or laborers, Contractor shall comply with the Contract Work Hours and Safety Standards Act (40 USC §§ 327 et seq.), as supplemented by Department of Labor Regulations contained in 29 C.F.R. Parts 3, 5 and 5a. Contractor shall not require or permit any laborer or mechanic, in any workweek in which the laborer or mechanic is employed on that work, to work more than forty (40) hours in that workweek, except as provided in the Contract Work Hours and Safety Standards Act. When a violation occurs, Contractor is liable to the affected employee for the employee's unpaid wages and to the City for liquidated damages equal to ten dollars ($10) for each calendar day on which the individual was required or permitted to work in excess of the standard workweek without payment of the overtime wages required by this chapter. 29. Compliance with Laws. Contractor shall comply with all applicable federal, state and local laws, ordinances, codes and regulations in force at the time Contractor performs pursuant to this Agreement, including those governing the funds provided under this Agreement. 30. Bonds. Contractor shall obtain faithful performance and payment bonds, each in an amount that is not less than the total compensation amount of this Agreement, and nothing in this Agreement shall be read to excuse this requirement. The required forms entitled Payment Bond (Labor and Materials) and Performance Bond are attached hereto and incorporated herein by this reference. Contractor shall also obtain a one-year warranty bond in an amount that is not less than the total compensation amount of this Agreement and in a form approved by the City Attorney and shall deliver this bond to the City before the City's acceptance of the project; alternatively,the Contractor shall submit written evidence from the surety of an extension to its performance bond, to be effective for a year after acceptance by the City, and shall submit this extension before the City's acceptance of the Project. 31. Ownership of Documents and Work Product. a. All final documents, plans, specifications, reports, information, data, exhibits, photographs, images, video files and media created or developed by CONSULTANT pursuant to this Agreement ("Written Products") shall be and remain the property of the CITY without restriction or limitation upon its use, duplication or dissemination by the CITY. All Written Products shall be considered "works made for hire," and all Written Products and any and all intellectual property rights arising from their creation, including, but not limited to, all copyrights and other proprietary rights, shall be and remain the property of the CITY without restriction or limitation upon their use, duplication or dissemination by the CITY. CONSULTANT shall not obtain or attempt to obtain copyright protection as to any Written Products. CONSULTANT hereby assigns to the CITY all ownership and any and all intellectual property rights to the Written Products that are not otherwise vested in the CITY pursuant to this paragraph. b. CONSULTANT warrants and represents that it has secured all necessary licenses, consents or approvals to use any instrumentality,thing or component as to which any intellectual property right exists, including computer software, used in the rendering of the services and the production of all Written Products produced under this Agreement, and that the CITY has full legal title to and the right to reproduce the Written Products. CONSULTANT shall defend, indemnify and hold the CITY, and its elected officials, officers, employees, servants, attorneys, designated volunteers, and agents serving as independent contractors in the role of CITY officials, harmless from any loss, claim or liability in any way C-8 R6876-0010\1817323v2.doc Attachment A related to a claim that CITY's use of any of the Written Products is violating federal, state or local laws, or any contractual provisions, or any laws relating to trade names, licenses, franchises, copyrights, patents or other means of protecting intellectual property rights and/or interests in products or inventions. CONSULTANT shall bear all costs arising from the use of patented, copyrighted, trade secret or trademarked documents, materials, equipment, devices or processes in connection with its provision of the services and Written Products produced under this Agreement. In the event the use of any of the Written Products or other deliverables hereunder by the CITY is held to constitute an infringement and the use of any of the same is enjoined, CONSULTANT, at its expense, shall: (a) secure for CITY the right to continue using the Written Products and other deliverables by suspension of any injunction, or by procuring a license or licenses for CITY; or(b) modify the Written Products and other deliverables so that they become non-infringing while remaining in compliance with the requirements of this Agreement. This covenant shall survive the termination of this Agreement. c. Upon termination, abandonment or suspension of the Project, the CONSULTANT shall deliver to the CITY all Written Products and other deliverables related to the Project without additional cost or expense to the CITY. If CONSULTANT prepares a document on a computer, CONSULTANT shall provide CITY with said document both in a printed format and in an electronic format that is acceptable to the CITY. 32. Contractor's Representations. Contractor represents, covenants and agrees that: a) Contractor is licensed, qualified, and capable of furnishing the labor, materials, and expertise necessary to perform the services in accordance with the terms and conditions set forth in this Agreement; b) there are no obligations, commitments, or impediments of any kind that will limit or prevent its full performance under this Agreement; c) there is no litigation pending against Contractor, and Contractor is not the subject of any criminal investigation or proceeding; and d)to Contractor's actual knowledge, neither Contractor nor its personnel have been convicted of a felony. 33. Non-Assignability; Subcontracting. Contractor shall not assign or transfer any interest in this Agreement nor any part thereof, whether by assignment or novation, without the City's prior written consent. Any purported assignment without written consent shall be null, void, and of no effect, and Contractor shall hold harmless, defend and indemnify the City and its officers, officials, employees, agents and representatives with respect to any claim, demand or action arising from or relating to any unauthorized assignment. 34. Applicable Law. The validity, interpretation, and performance of this Agreement shall be controlled by and construed under the laws of the State of California, excluding California's choice of law rules. Venue for any such action relating to this Agreement shall be in the Los Angeles County Superior Court. 35. Titles. The titles used in this Agreement are for convenience only and shall in no way define, limit or describe the scope or intent of this Agreement or any part of it. 36. Authority. The person executing this Agreement on behalf of Contractor warrants and represents that he or she has the authority to execute this Agreement on behalf of Contractor and has the authority to bind Contractor to the performance of its obligations hereunder. 37. Entire Agreement. This Agreement, including any other documents incorporated herein by specific reference, represents the entire and integrated agreement between City and Contractor. This Agreement supersedes all prior oral or written negotiations, representations or agreements. C-9 R6876-0010\1817323v2.doc Attachment A 38. Amendment. The City or Contractor may only modify or amend this Agreement or any provision herein in a writing signed by both parties which expressly refers to this Agreement. The City may, at its discretion, amend this Agreement to conform with federal, state or local governmental guidelines, policies and available funding amount, or for other reasons. If such amendments result in a change in the funding, the scope of services, or schedule of the activities to be undertaken as a part of this Agreement, such modifications will be incorporated only by written amendments signed by both the City and Contractor. 39. Construction. In the event of any asserted ambiguity in, or dispute regarding the interpretation of any matter herein, the interpretation of this Agreement shall not be resolved by any rules of interpretation providing for interpretation against the party who causes the uncertainty to exist or against the party who drafted the Agreement or who drafted that portion of the Agreement. 40. Non-waiver of Terms, Rights and Remedies. Waiver by either party of any one or more of the conditions of performance under this Agreement shall not be a waiver of any other condition of performance under this Agreement. In no event shall the making by the City of any payment to Contractor constitute or be construed as a waiver by the City of any breach of covenant, or any default which may then exist on the part of Contractor, and the making of any such payment by the City shall in no way impair or prejudice any right or remedy available to the City with regard to such breach or default. 41. Notice. Except as otherwise required by law, any notice or other communication authorized or required by this Agreement shall be in writing and shall be deemed received on (a) the day of delivery if delivered by hand or overnight courier service during Contractor's or City's regular business hours or(b) on the third business day following deposit in the United States mail, postage prepaid, to the addresses listed below, or at such other address as one party may notify the other: To CITY: Mr. Michael Throne, Director of Public Works City of Rancho Palos Verdes 30940 Hawthorne Boulevard Rancho Palos Verdes, CA 90275 To CONTRACTOR: The address listed in Exhibit "A." 42. Counterparts. This Agreement may be executed in counterpart originals, duplicate originals, or both, each of which is deemed to be an original for all purposes. 43. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed the within Agreement the day and year first above written. (signatures on next page) C- 10 R6876-0010\1817323v2.doc Attachment A CITY OF RAN HO PAL•XVERDES By: i JA• OF Ma jr, ATTE By: Jrf ! r w- v City Clerk City C• TRACTO' px?Z �, V/N 1 ii. P inted N • C (2,(14* gate: q_ Ljs� By: Printed Name: j/96 j O '/9- (/— L/ Date: C- 11 R6876-0010\1817323v2.doc CA ALL-PURPOSE ACKNOWLEDGEMENT "A Notary Public or other officer completing this certificate verifies only the identity of the individual idual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document." • State of California } County of Los Angeles } On September 8, 2015,before me, C.O. Pallares/Notary Public, personally appeared,Jose Alejandro Ruiz, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the- same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. C.0.PALLARES . Commission# 1971748 // �-- z .P! :-Mx Notary Public-California Signature z '�;�,� Los Angeles County My Comm.Expires Apr 7, 2016 I Attachment A Bond No. 07646295 PAYMENT BOND EXECUTETTTMPLIME (LABOR AND MATERIALS) PREMIUM INCLUDED IN PERFORMANCE BONE WHEREAS the City of Rancho Palos Verdes,e des, California ("Public Agency") awarded RUIZ CONCRETE & PAVING,INC, 1344 TEMP Y } has to_ - _ LE AVENUE, LONG BEACH,CA 90804 (Name and address of Contractor) ("Principal"), a contract (the "Contract herein by described as follo ), which is incorporatedthis ref ws. erence, for the work ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS ON MIRA CATALIN (Community DevelopmentProject#601561 Block Grant A -13j WHEREAS, Principal is required under the entering upon the performanceterms of the Contract and the California Civil Code of the work to file a good and sufficient before Agency to secure the claims to which reference payment bond with the Public Part 6 of Division 4 of the is made in Title 3 (commencingwith Section Civil Code, 9000) of NOW, THEREFORE, We, the undersigned Principal,rrncrpal, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND 777 - - - - S. FIGUEROA ST.,LOS 90017 (Name and address of Surety) ("Surety'')a duly admitted suretyinsurer firmly bound unto under the laws of the State of the Public Agency and all contractors s California, as Surety, are held and other persons employed in the � subcontractor's, laborers, material suppliers, performance of the Contract and referredPp �' and Section 9000) of Part 6 of Division 4 ofCivilto in Title 3 (commencing EIGHT HUNDRED EI the Code in the sum of *FIFTY-EIGHT with EIGHTY-TWO AND 45/100* THOUSAND Dollars ($ 58 882.45 hundred percent(100%) J (the "Penal Sum"), this amount being of the total Contract price, in lawful not less than one materials furnished or labor thereon of money of the United States of Arneri any kind,or for amounts due under the Unemployment , for Act with respect to this work or labor, that Insurance the surety will pay the same in an amount amount hereinabove set forth, and also in case not exceeding the face amount thereof, costs and suit is brought upon this bond, will a in reasonable expenses and fees, including pay, additionto the incurred by the Public Agency in successfully reasonable attorney's court, and to be taxed enforcing this obligation, to be awarded fees, as costs and to be included in the judgment and fixed by the therein rendered. It is hereby expressly stipulated and agreed companies, and corporations9 eed that this bond shall inure to the benefit entitled to file claims under Title of any and all persons, 6 of Division 4 of the Civil Code, so as to �e 3 (commencing with Section 9000)of upon this bond. give a right of action to them or their Part assigns in any suit brought Should the condition of this bond be fully Shout rise it shall be performed, then this obli ation and remain in full force and effect. 9 shall become null and void, C- 14 Rse78-oo1 o 1$17323v2.doc Attachment A The surety hereby stipulates and agrees that terms of the 9 no change, extension of time, alteration, or addition agreement or the specifications accompanying the addition to the obligations on this bond, and it does herebyY 9 same shall in any manner affect its addition. Surety waive nonce of any such change, euctension hereby waives the provisions of Californiaalteration, or a Civil Code sections 2845 and 2849. IN WITNESS WHEREOF, two2 ( ) identical counterparts of this instrument purposes be deemed an original hereof, have been duly . each of which shall for all set forth below, the name of each corporate executed by Principal and Surety, on the date by its hdel party being hereto affixed and these reser fined representative(s) pursuant to authorityof its presents duly signed governing body. Dated: SEPTEMBER 2, 2015 "Principal" "Surety" RUIZ se CRETE & P NG ,, C, FIDELITY AND DEPOSIT AW CANY ifarr/LArk OF MARYLAND Its —1-7;, Are+ 34 AT'DORNEY-IN-FACT Its By: Its (Seel) (Seal) APPROVED AS TO SURETY AND PRINCIP AMOUNT AL APPROVED AS TO FORM: RICHARDS, WATSON &GERSHON A Professional Corporation By: Insurance Administrator By. Public Agency Attorney Note: This bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of the authority of any R8878-001011817323va doC C- 1 5 • ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of Maryland,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by JAMES M. CARROLL, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate, constitute, and appoint Michael A. QUIGLEY, of Laguna Hills, California, its true and lawful agent and Attorney-in-Fact, to make, execute,seal and deliver,for,and on its behalf as surety,and as its act and deed:any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 18th day of June,A.D.2012. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND OILP 04, 4444' �NN~ 4.71:;$2%. 8BAL " n' '03 ot, . me * l ,.ti4t*pp.., / ,ifr( '° •- E - t,<(. ee), 4A'(41------ I BY: Assistant Secretary Vice President Eric D.Barnes James M. Carroll State of Maryland City of Baltimore On this 18th day of June,A.D. 2012,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,JAMES M. CARROLL,Vice President,and ERIC D.BARNES,Assistant Secretary, of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and being by me duly sworn,deposeth and saith,that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. • , ) .1 0 iv Co-1--,-Aci-,-a-(2 43-A-A,-,-,--- ••..,-.....10-..-.. .; Constance A.Dunn,Notary Public My Commission Expires:July 14,2015 POA-F 012-0626C • EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V, Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 2nd day of SEPTEMBER ,20_15. _140 OE�p4o.+-.44:111 . Waft ), ~ wi + •� I �A 1.1 -"'- sZ _.— (SAL .4.400 4.4;dr Geoffrey Delisio,Vice President • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of ORANGE / . On September 2,2015 before me, MEG QUIGLEY, NOTARY PUBLIC , Date Here Insert Name and Title of the Officer personally appeared MICHAEL A. QUIGLEY Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person( whose name(x) is subscribed to the within instrument and acknowledged to me that ,,: .,�. MEG QUIGLEY he/ executed the same in his/ld#tr authorized <<:�r/ �; Commission # 19636ni Z capacity(), and that by his/ signature( on the za :r..v_ �,,, Notary Public California z instrument the person(R), or the entity upon behalf of 'r4. Orange County D ��' Mtile' which the person(s) acted, executed the instrument. My Comm. Expires Jan 10,2016 p (s} I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. '" WITNESS my h. • nd is 'se• a. Signature a1 • Place Notary Seal Above Signa a• otary•••*c OPTIONAL Though the information below is not required by law,it may prove valuable to persons -lying on the •• e and could prevent fraudulent removal and reattachment of this form to an. er document. Description of Attached Document 0 p _ Title.or Type of Document: Document Date: Number of Pages: Signer(s)Other Than Named Above: Capacity(ies)Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual 0 Individual O Corporate Officer--Title(s): 0 Corporate Officer—Title(s): ❑ Partner—❑Limited 0 General RIGHT THUMBPRINT 0 Partner—❑Limited 0 General RIGHT THUMBPRINT O Attorney in Fact OF SIGNER D Attorney in Fact OF SIGNER ❑ Trustee Top of thumb here El Trustee Top of thumb here ❑ Guardian or Conservator ❑Guardian or Conservator ❑ Other: 0 Other: Signer Is Representing: Signer Is Representing: 02007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationalNotary.org Item#5907 Reorder:Call Toll-Free 1-800-876-6827 CA ALL-PURPOSE ACKNOWLEDGEMENT "A Notary Public or other officer completing this certificate verifies only the identity of the individual who o signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. " • State of California } County of Los Angeles } On September 8, 2015,before me, C.O. Pallares/Notary Public, personally appeared, Jose Alejandro Ruiz, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the- same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument theerson(s), or the entityupon behalf of p p which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. r,,amihmil"1"1"646116 "‘"hdli.,-.:; C. 0. PALLARES Commission# 1971748 ;7c- Al- Notary Public-California z z yrs Signature j z � .y Los Angeles County My Cornm. Expires Apr 7,2416 Attachment A Bond No. 07646295 PERFORMANCE BOND PREMIUM $677.00 EXECUTED IN DUPLICATE WHEREAS the City of Rancho Palos Verdes, California ("Public Agency") has awarded to RUIZ CONCRETE & PAVING,INC. 1344 TEMPLE Ate, LONG BEACH, CA 9080 (Name and address of Contractor) ("Principal"), a contract(the"Contract")for the work described as follows: ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS ON MIRA CATALINA (Community Development Block Grant Project#6015 1 61-1 3) 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 FIDELITY AND DEPOSIT COMPANY OF �y�D 777 S. FI � — — . GUII�OA ST.,LOS AIVGELF�S,CA 90017 "Surety" a dulyadmitted (Name and address of Surat') surety insurer under the laws o - _ - . • firmly bound unto the Public � �+�•- reg, l ' ' � .� S � -�d Agency in the penal sum of e . �.•M r►�. fCJND �� Dollars ($58,882.45 0_ America, this amount beingnot less in lawful money of the United States of o than the total Contract price,for the payment of which truly be made,we bind ourselves,our heirs,executors, administrators, sum well and and severally, firmly by these resents, successors, and assigns,jointly P THE CONDITION OF THIS OBLIGATION IS SUCH THAT, ' its heirs, executors, administrators, A , if the hereby bounded Principal, his, her or successors or assigns, shall in all things well and truly keep and perform all the undertakings, 9 stand to and abide by, and terms, covenants, conditions and provisions in the Contract and any alteration thereof made as thereinr performed, all within the timeand inP ovided, on the Principal's part to be kept and the manner therein specif1ed, and in all respects according #rue intent and meaning, and shall indemnifyand hold to their and employees, harmless the Public Agency, officers, agents, p oyees, as therein stipulated, then this obligation shall becomeYitsall be and remain in full force and effect. 9 null and void; otherwise, shall As a part of the obligation secured herebyand in addition on to the face amount specified therefor, there shall be included costs and reasonable expenses and fees, includingreasonable by the Public Agency in successfully enforcingsuch attorneys'fees, incurred any judgment rendered. obligation, all to be taxed as costs and included in The Surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the agreement or to the work to beperformed thereunder the same shall in anywise affect� or the specifications accompanying YW its obligations on this bond, and it does herebywaive h change, extension of time, alteration or addition to the terms notice of any such of the agreement or to the work or to the specifications. Surety hereby waives therovisions of p California Civil Code sections 2845 and 2849. The City is the principal beneficiary of this bond and has all rights of aa p rty hereto. C- 16 R8876,00101 1817323x2.doc Attachment A IN WITNESS WHEREOF, two (2) identical counterparts - purposes be deemed of this instrument, each of which shall for an original hereof, have been duly executed byPrincipalall set forth below, the name of each corporate party and Surety, on the date by its undersigned representative(s) p bung hereto affixed and these presents dulysigned 9 pursuant to authority of its governing body. Dated: SEPTEMBER 2, 2015 "principal" "Surety" RUIZ CONS- & PAVING INC / FIDELITY AND DEPOSIT COMPANY 14lagalirr Af OF MARYLAND By: ose Its - ` A. QUIGLEY ATTORNEY-IN-FACT By: lis By' itS (Seel} (Seal) APPROVED AS TO SURETY AND PRINCIPAL AMOUNT APPROVED AS TO FORM: RICHARDS, WATSON & GERSHON A Professional Corporation By. By: Insurance Administrator Public— — — — - — — Agency Attorney Note: This bond must be executed in duplicate and dated, all si . person signing as attorney-�n_fact must be attached gnatures must be notarized, and evidence of the authority of any 86876-001011817323v2,d00 G- 17 • ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of Maryland,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by JAMES M. CARROLL, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate, constitute, and appoint Michael A. QUIGLEY, of Laguna Hills, California, its true and lawful agent and Attorney-in-Fact, to make, execute,seal and deliver,for,and on its behalf as surety,and as its act and deed:any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 18th day of June,A.D.2012. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND tooth, 'Er p :, .,�•�G�S'�...»...V�~mss• �Iwn � •wi s ` GO"Nth:�C� (EAL o los s 1 ' • :It r 0 .0.3% 19011 1ff10. 7,( /), { Assistant Secretary Vice President Eric D.Barnes James M. Carroll State of Maryland City of Baltimore On this 18th day of June,A.D. 2012,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,JAMES M. CARROLL,Vice President,and ERIC D.BARNES,Assistant Secretary, of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same,and being by me duly sworn,deposeth and saith,that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A.Dunn,Notary Public My Commission Expires:July 14,2015 POA-F 012-0626C ' , f EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter,wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 2nd day of SEPTEMBER ,2015 . w e s �IN� .�... __ _.- BSA . ifr*1) 1-44 7040 414tier 11 r Geoffrey Delisio,Vice President • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT '.\�'.\�.\/.\ \C�'•\�".\�:\�'.\�'.\�.\•.•,.1\�i��\�i�\�i\�/•1:/�li��i:�i��i\1i1��.�i��•\lT��i\,:i\�•\�i\.'.i\ �'•\�i\�i\�i �i\�i\�\%•'�'i'�'• •,'i �'i= State of California County of ORANGE On September 2,2015 before me, MEG QUIGLEY, NOTARY PUBLIC Date Here Insert Name and Title of the Officer • personally appeared MICHAEL A. QUIGLEY Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is subscribed to the within instrument and acknowledged to me that he/stogy executed the same in his/her authorized MEG QUIGLEY capacity(*, and that by his/ esignature(R) on the Commission# 1963669 instrument the person(R), or the entity upon behalf of .� Notary Public•California Z!„�"�" � z which the persons) acted, executed the instrument. Orange County A My Comm.Expires Jan 10,2016 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. - •• WITNESS my h.t • . d ici• se'aI. Signature • \Vk Place Notary Seal Above Signa .1 otary• oil, OPTIONAL Though the information below is not required by law,it may prove valuable to persons rely" g on t = d. -nt and could prevent fraudulent removal and reattachment of this form to another i.ocument• 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(s) Signer's Name: Signer's Name: ❑ Individual 0 Individual O Corporate Officer—Title(s): 0 Corporate Officer—Title(s): ❑ Partner—❑Limited 0 General RIGHT THUMBPRINT ❑Partner—CI Limited ❑General RIGHT THUMBPRINT O Attorney in Fact OF SIGNER ❑Attorney in Fact OF SIGNER ❑ Trustee Top of thumb here El Trustee Top of thumb here ❑ Guardian or Conservator 0 Guardian or Conservator ❑ Other: 0 Other: Signer Is Representing: Signer Is Representing: 02007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationalNotary.org Item 4/5907 Reorder:Call Tot-Free 1-800-876-6827 CA ALL-PURPOSE ACKNOWLEDGEMENT "A Notary Public or other officer completing this certificate verifes only the identity of the individual sdual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document." • State of California } County of Los Angeles } On September 8, 2015, before me, C.O. Pallares/Notary Public, personally appeared, Jose Alejandro Ruiz, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the-same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ..-�-- C. 0. PALLARES • , Commission# 1971748 /2/ilaa./. Notary Public-California Signature Z ;' Los Angeles County gpt11�y Comm. Expires Apr 7,2016 Attachment A AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS 1. Contractor acknowledges that the project as defined in this Agreement between Contractor and the City, to which this Agreement to Comply with California Labor Law Requirements is attached and incorporated by reference, is a"public work"as defined in Division 2, Part 7, Chapter 1 (commencing with Section 1720) of the California Labor Code ("Chapter 1"), and that this Agreement is subject to (a) Chapter 1, including without limitation Labor Code Section 1771 and (b) the rules and regulations established by the Director of Industrial Relations ("DIR") implementing such statutes. Contractor shall perform all work on the project as a public work. Contractor shall comply with and be bound by all the terms, rules and regulations described in 1(a) and 1(b) as though set forth in full herein. 2. California law requires the inclusion of specific Labor Code provisions in certain contracts. The inclusion of such specific provisions below, whether or not required by California law, does not alter the meaning or scope of Section 1 above. 3. Pursuant to Labor Code Section 1773.2, copies of the prevailing rate of per diem wages for each craft, classification, or type of worker needed to perform the Agreement are on file at City Hall and will be made available to any interested party on request. Contractor acknowledges receipt of a copy of the DIR determination of such prevailing rate of per diem wages, and Contractor shall post such rates at each job site covered by this Agreement. 4. Contractor shall comply with and be bound by the provisions of Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall, as a penalty to the City, forfeit two hundred dollars ($200) for each calendar day, or portion thereof, for each worker paid less than the prevailing rates as determined by the DIR for the work or craft in which the worker is employed for any public work done pursuant to this Agreement by Contractor or by any subcontractor. 5. Contractor shall comply with and be bound by the provisions of Labor Code Section 1776, which among other things requires Contractor and each subcontractor to (1) keep accurate payroll records and verify such records in writing under penalty of perjury, as specified in Section 1776, (2) certify and make such payroll records available for inspection as provided by Section 1776, and (3) inform the City of the location of the records. 6. Contractor shall comply with and be bound by the provisions of Labor Code Sections 1777.5, 1777.6 and 1777.7 and California Administrative Code title 8, section 200 et seq. concerning the employment of apprentices on public works projects. Contractor shall be responsible for compliance with these aforementioned Sections for all apprenticeable occupations. Prior to commencing work under this Agreement, Contractor shall provide City with a copy of the information submitted to any applicable apprenticeship program. Within sixty (60) days after concluding work pursuant to this Agreement, Contractor and each of its subcontractors shall submit to the City a verified statement of the journeyman and apprentice hours performed under this Agreement. 7. Contractor acknowledges that eight (8) hours labor constitutes a legal day's work. Contractor shall comply with and be bound by Labor Code Section 1810. Contractor shall comply with and be bound by the provisions of Labor Code Section 1813 concerning penalties for workers who work excess hours. The Contractor shall, as a penalty to the City, forfeit twenty-five dollars ($25) for each worker employed in the performance of this Agreement by the Contractor or by any subcontractor for each calendar day during which such worker is required or permitted to work more than eight (8) hours in any one (1) calendar day and forty (40) hours in any one calendar week in violation of the provisions of Division 2, C- 19 R6876-00101 1817323v2.d o c Attachment A Part 7, Chapter 1, Article 3 of the Labor Code. Pursuant to Labor Code section 1815, work performed by employees of Contractor in excess of eight (8) hours per day, and forty (40) hours during any one (1) week shall be permitted upon public work upon compensation for all hours worked in excess of eight (8) hours per day at not less than one and one-half(1-1/2)times the basic rate of pay. 8. 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, Contractor hereby certifies as follows: "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." 9. For every subcontractor who will perform work on the project, Contractor shall be responsible for such subcontractor's compliance with Chapter 1 and Labor Code Sections 1860 and 3700, and Contractor shall include in the written contract between it and each subcontractor a copy of those statutory provisions and a requirement that each subcontractor shall comply with those statutory provisions. Contractor shall be required to take all actions necessary to enforce such contractual provisions and ensure subcontractor's compliance, including without limitation, conducting a periodic review of the certified payroll records of the subcontractor and upon becoming aware of the failure of the subcontractor to pay his or her workers the specified prevailing rate of wages. Contractor shall diligently take corrective action to halt or rectify any failure. 10. To the maximum extent permitted by law, Contractor shall indemnify, hold harmless and defend (at Contractor's expense with counsel reasonably acceptable to the City) the City, its officials, officers, employees, agents and independent contractors serving in the role of City officials, and volunteers from and against any demand or claim for damages, compensation, fines, penalties or other amounts arising out of or incidental to any acts or omissions listed above by any person or entity (including Contractor, its subcontractors, and each of their officials, officers, employees and agents) in connection with any work undertaken or in connection with the Agreement, including without limitation the payment of all consequential damages, attorneys' fees, and other related costs and expenses. All duties of Contractor under this Section shall survive termination of the Agreement. Date: - r rIf \ Signature 1: Signature 2: doOer C-20 R6876-001011817323v2.doc Attachment A INDEMNIFICATION AND HOLD HARMLESS AGREEMENT AND WAIVER OF SUBROGATION AND CONTRIBUTION Contract/Agreement/License/Permit No. or description: /1/fM c14-r4tlL',4 �� '�� 14-Uf5 � �11(t PaoInc UiL2- 91 Indemnitor(s) (list all name ): To the fullest extent permitted by law, Indemnitor hereby agrees, at its sole cost and expense, to defend, protect, indemnify, and hold harmless the City of Rancho Palos Verdes and its elected officials, officers, attorneys, agents, employees, volunteers, successors, and assigns (collectively"Indemnitees")from and against any and all damages, costs, expenses, liabilities, claims, demands, causes of action, proceedings, expenses,judgments, penalties, liens, and losses of any nature whatsoever, including fees of accountants, attorneys, or other professionals and all costs associated therewith (collectively "Liabilities"), arising or claimed to arise, directly or indirectly, out of, in connection with, resulting from, or related to any act, failure to act, error, or omission of Indemnitor or any of its officers, agents, servants, employees, subcontractors, material persons, suppliers or their officers, agents, servants or employees, arising or claimed to arise, directly or indirectly, out of, in connection with, resulting from, or related to the above-referenced contract, agreement, license, or permit(the "Agreement")or the performance or failure to perform any term, provision, covenant, or condition of the Agreement, including this indemnity provision. This indemnity provision is effective regardless of any prior, concurrent, or subsequent active or passive negligence by Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence. This indemnity provision shall survive the termination of the Agreement and is in addition to any other rights or remedies which Indemnitees may have under the law. Payment is not required as a condition precedent to an Indemnitee's right to recover under this indemnity provision, and an entry of judgment against an Indemnitee shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. Indemnitor shall pay Indemnitees for any attorney's fees and costs incurred in enforcing this indemnification provision. Notwithstanding the foregoing, nothing in this instrument shall be construed to encompass (a) Indemnitees' sole negligence or willful misconduct to the limited extent that the underlying Agreement is subject to Civil Code 2782(a) or (b) the contracting public agency's active negligence to the limited extent that the underlying Agreement is subject to Civil Code 2782(b). This indemnity is effective without reference to the existence or applicability of any insurance coverage which may have been required under the Agreement or any additional insured endorsements which may extend to Indemnitees. Indemnitor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation and contribution against the Indemnitees, while acting within the scope of their duties, from all claims, losses and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor regardless of any prior, concurrent, or subsequent active or passive negligence by the Indemnitees. In the event there is more than one person or entity named in the Agreement as an Indemnitor, then all obligations, liabilities, covenants and conditions under this instrument shall be joint and several. C-21 R6876-00101 1817323v2.doc Attachment A "Indemnitor" Name: . 'io 1- Name: 114-1)° Pi- ) I C By: / I.IAJIIIIIrI/1 By: Its ' Its C-22 R6876-0010\1817323v2.doc Attachment A STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS' LICENSING LAWS [Business & Professions Code 7028.15] [Public Contract Code 20103.5] I, the undersigned, certify that I am aware of the following provisions of California law and that I, or the entity on whose behalf this certification is given, hold a currently valid California contractor's license as set forth below: Business &Professions Code 7028.15: (a) It is a misdemeanor for any person to submit a bid to a public agency in order to engage in the business or act in the capacity of a contractor within this state without having a license therefore, except in any of the following cases: (1) The person is particularly exempted from this chapter. (2) The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now ' 20103.5] of the Public Contract Code. (b) If a person has been previously convicted of the offense described in this section,the court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person performed contracting work, or four thousand five hundred dollars ($4,500), whichever is greater, or imprisonment in the county jail for not less than 10 days nor more than six months, or both. In the event the person performing the contracting work has agreed to furnish materials and labor on an hourly basis, "the price of the contract"for the purposes of this subdivision means the aggregate sum of the cost of materials and labor furnished and the cost of completing the work to be performed. (c) This section shall not apply to a joint venture license, as required by Section 7029.1. However, at the time of making a bid as a joint venture, each person submitting the bid shall be subject to this section with respect to his or her individual licensure. (d) This section shall not affect the right or ability of a licensed architect, land surveyor, or registered professional engineer to form joint ventures with licensed contractor to render services within the scope of their respective practices. (e) Unless one of the foregoing exceptions applies, a bid submitted to a public agency by a contractor who is not licensed in accordance with this chapter shall be considered non- responsive and shall be rejected by the public agency. Unless one of the foregoing exceptions applies, a local public agency shall, before awarding a contract or issuing a purchase order, verify that the contractor was properly licensed when the contractor submitted the bid. Notwithstanding any other provision of law, unless one of the foregoing exceptions applies, the registrar may issue a citation to any public officer or employee of a public entity who knowingly awards a contract or issues a purchase order to a contractor who is not licensed pursuant to this chapter. The amount of civil penalties, appeal, and finality of such citations shall be subject to Sections 7028.7 to 7028.13 inclusive. Any contract awarded to, or any purchase order issued to, a contractor who is not licensed pursuant to this chapter is void. C-29 R6876-0010\1817323v2.doc Attachment A (f) Any compliance or noncompliance with subdivision (e) of this section, as added by Chapter 863 of the Statutes of 1989, shall not invalidate any contract or bid awarded by a public agency during which time that subdivision was in effect. (g) A public employee or officer shall not be subject to a citation pursuant to this section if the public employee, officer, or employing agency made an inquiry to the board for the purposes of verifying the license status of any person or contractor and the board failed to respond to the inquiry within three business days. For purposes of this section, a telephone response by the board shall be deemed sufficient. Public Contract Code 20103.5: In all contracts subject to this part where federal funds are involved, no bid submitted shall be invalidated by the failure of the bidder to be licensed in accordance with the laws of this state. However, at the time the contract is awarded, the contractor shall be properly licensed in accordance with the laws of this state. The first payment for work or material under any contract shall not be made unless and until the Registrar of Contractors verifies to the agency that the records of the Contractor's State License Board indicate that the contractor was properly licensed at the time the contract was awarded. Any bidder or contractor not so licensed shall be subject to all legal penalties imposed by law including, but not limited to, any appropriate disciplinary action by the Contractor's State License Board. The agency shall include a statement to that effect in the standard form of prequalification questionnaire and financial statement. Failure of the bidder to obtain proper and adequate licensing for an award of a contract shall constitute a failure to execute the contract and shall result in the forfeiture of the security of the bidder. 66TrLicense No.. 3 Class: Expiration Date: /C-3/-1,\ Date: --cc Signature: (,, C-30 R6876-0010\181732 3v2.d o c Attachment A FEDERAL LOBBYIST REQUIREMENTS CERTIFICATION Name of Firm: Pal Zj'?1tJt6) Date: 9--t(-( Address: ( ar•evilit ffre tThlt 6eadif a# cie 5'c l State: cA- Zip Code: sgere Phone No.: c&2 . 30 -7C Acting on behalf of the above named firm, as its Authorized Official, I make the following Certification to the Department of Housing and Urban Development (HUD) and the Community Development Commission, County of Los Angeles: 1. No Federal appropriated funds have been paid, by or on behalf of the above named firm to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of and Federal grant, loan or cooperative agreement, and any extension, continuation, renewal, amendment, or modification thereof, and; 2. If any funds other than Federal appropriated funds have paid or will be paid to any person for influencing or attempting to influence an officer or employee or any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with this Federal contract, grant loan, or cooperative agreement, the above named firm shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying", in accordance with its instructions, and: 3. The above name firm shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreement) and that all sub-recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into the transaction imposed by Section 1352 Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Authorized Official: Name: JO' = %� Title: .& O. Signature: Date: 7—q--13-- /- Federal Lobb ng Requirements Cert' ation Form Revised 09/30/05 C-31 R6876-0010\1817323v2.doc Attachment A likCITY OF RANCHO PALOS VERDES Public Works Department (310)544-5252 FORM B— PRE-PROJECT WORKSHEET In the table below,list estimated weight of debris,by material type,that will be generated,recycled,reused,salvaged,disposed,or transformed by this project. You must include the haulers and all recyclers,salvage companies,recycling facilities,mixed use material recovery facilities,landfills,or transformation facilities that will be used for this project. GENERATION DIVERSION DISPOSAL Estimated Estimated Volume Weight Total Tons MATERIAL TYPE cubic yards) (tons) Conversion Tons to be Recycled. Total Tons to -TITER ESTIMATE IN VOLUMEOR Factor Total Tons to Tons to be Reused or Reused.or be Disposed or _ WEIGHT COLUMN ONLY (11,,,V) be Generated Recycled Salvage, Salvaged Transformed :1 Hauler Name of F, `AspnalL) .(` 772.80 , .cC.,, Bulky Items / J 80.00 Cardboard 53.00 Carpet 147.00 Carpet Padding 62.00 Clay Roofing Tile 860.00 Com Roofing Material(not Tile) 731.00 oncret Lit.re y 860.00 '.i(i,s47 Dirt and Sand 929.00 Durable Plastic Items 50.00 EPS Packaging and Insulation 32.00 Fiberglass Insulation 17.00 Flat Glass 1,400.00 Gypsum 467.00 HVAC Ducting 47.00 Major Appliances 145.00 Metals 225.00 Other Aggregates 860.00 Rock and Gravel 999.00 Leaves&Grass 312.50 Trlrrrnings,Branches,&Stumps. 127.00 Trash Bags 35.00 Wood,Lumber,Pallets 169.00 Mixed Debris(if no recycling) 1,100.00 ` 0.00 0.00. 0 00 MIXED DEBRIS PROCESSING-USE ONLY IF DELIVERING TO A MIXED C&D PROCESSING FACILITY Mixed C&G Debris(min 50%diversional 1 I '.1CTO Ci- 1 0.001 1 I 1 i TOTAL GENERATION r 0.001 TOTAL DIVERSION( 0.001 0.00,TOTAL DISPOSAL ITEMIZED BUILDING MATERIAL LIST(E.G.DOORS.WINDOWS.FIXTURES.ETC.) ESTIMATED TOTAL(complete needed columns) ESTIMATED TOTAL PROJECT DIVERSION RATE Item Quantity Size Tons Cu.Yards Appendix I-3 R6876-0010\1817323v2.doc NON-SEGREGATED FACILITIES CERTIFICATION FEDERALLY-ASSISTED CONSTRUCTION PROJECTS The federally-assisted construction contractor certifies that he/she DOES NOT and WILL NOT: 1. Maintain or provide, for his/her employees, any segregated facilities at any of his/her establishments. 2. Permit his/her employees to perform their services at any location, under his/her control, where segregated facilities are maintained. The federally-assisted contractor agrees that a breach of this certification is a violation of the Equal Opportunity Clause in this contract. As used in this certification,the term segregated facilities means any waiting room, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas,transportation,and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race,creed,color,or national origin,because of habit, local custom, or otherwise. The federally-assisted contractor agrees that(except where he/she has obtained identical certifications from proposed subcontractors for specific time periods) he/she will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause, and that he/she will retain such certifications in his/her files. NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. Date: CO---1S— Project Number: ')/() f 4/ Company: pi iz, cii,t7Th pto ( �t,� Address: r3�� l�r�'i- /�i Abil° � Le-vte01- Oedcli 6'4 By: Title: V-P. CERTIFICATION WITH REGARD TO THE PERFORMANCE OF PREVIOUS CONTRACTS OR SUBCONTRACTS SUBJECT TO THE EQUAL OPPORTUNITY CLAUSE AND THE FILING OF REQUIRED REPORTS Thebidder, Cproposed sub-contractor, hereby certifies that he/she as, Dhas not, participated in a previous contract or subcontract subject to the Equal opportunity Clause, as required by Executive Orders 10925, 11114, or 11246, and that he/she Vhas, Chas not, filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filing requirements. Date: orif--(5 Project Number: /S ' — f�Z r �� ContractAward. Awarding Agency:A : ec i/a' 4 Y Contractor Name: 120 Z Cwt G'tZfi) Atli/n9 Total Number of Employees Affiliate Company: - By: Title: . NOTE:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b)(1),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5(Generally only contracts or subcontracts of$10,000 or under are exempt). Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the U.S. Department of the Interior or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. SF-100(EEO-1)must be filed by; (A)All private employers who are: (1) Subject to Title VII of the Civil Rights Act of 1964(as amended)with 100 or more employees. (2) Subject to Title VII who has fewer than 100 employees, if the company is owned or affiliated with another company,or there is centralized ownership,control or management so that the group legally constitutes a single enterprise,and the entire enterprise employs a total of 100 or more employees. (B)All federal contractors(private employers),who: (1) Are not exempt as provided for by 41 CFR 60-1.5 (2) Have 50 or more employees,and a. Are prime contractors or first-tier subcontractors, and have a contract, subcontract, or purchase order amounting to$50,000 or more; or b. Serve as a depository of Government funds in any amount, or c. Is a financial institution,which is an issuing,and paying agent for U.S.Savings Bonds and Notes. CommunityDevelopment Commission al- L. sy County of Los Angeles -:44 -IS.„).9' 4r*-..41 '''Si.IF OW'P� COUNTY LOBBYIST OBBYIST CODE CHAPTER 2.160 COUNTY ORDINANCE NO. 93-0031 CERTIFICATION Name of Firm: 7Ui ? CCiti-Cae-TEP ' Address: C. State: a- Zip Code: 90tV Telephone Number: ( ) 3 7._-3O ,0 Acting on behalf of the above named firm,as its Authorized Official, I make the following Certification to the County of Los Angeles and the Community Development Commission, County of Los Angeles. 1) It is understood that each person/entity/firm who applies for a Community Development Commission contract, and as part of that process, shall certify that they are familiar with the requirements of the Los Angeles County Code,Chapter 2.160(Los Angeles County Ordinance 93-0031)and; 2) That all persons/entities/firms acting on behalf of the above named firm have and will comply with the County Code, and; 3) That any person/entity/firm who seeks a contract with the Community Development Commission shall be disqualified therefrom and denied the contract and,shall be liable in civil action, if any lobbyist, lobbying firm,lobbyist employer or any other person or entity acting on behalf of the named firm fails to comply with the provisions of the County Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into contract with the Los Angeles County and the Community Development Commission,County of Los Angeles. Authorized Official: itaiZ- 0914 v/ 9 ,31, /12t-ti By: `� ,k /? (Contractor/Subcontractor) (Signal e) VP, (Date) (Title) WORKER'S COMPENSATION CERTIFICATION I certify, by signature below, that 1 am aware of the provisions of Section 3700 of the California Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: Ci--1/4 Project Number: 60 I3T'I '-0 Project Name: /Liao\ � �_� ` P� Company Name: )2Uta a'/UC/?-c--7`E � f3rlA3 6, /NC Address: /3c L/ ( i4-'e � (.C`�'r'tGa i3e4 w),90(/ Cl Print Name: —770 vrr 72u 1'z Title: � � P. Signature: frr:271.4 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT HUD FORM 4230A REPORT OF ADDITIONAL CLASSIFICATION AND RATE OMB Approval Number 2501-0011 (Exp 09130/2036) 1. FROM(name and address of requesting agency) 2. PROJECT NAME AND NUMBER 3. LOCATION OF PROJECT(City,County and State) 4. BRIEF DESCRIPTION OF PROJECT 5. CHARACTER OF CONSTRUCTION ❑ Building ❑ Residential ❑ Heavy El Other(specify) ❑ Highway . 6. WAGE DECISION NO.(include modification number.if any) 0 7. WAGE DECISION EFFECTIVE DATE ❑ COPY ATTACHED 8. WORK CLASSIFICATION(S) HOURLY WAGE RATES BASIC WAGE FRINGE BENEFIT(S)(if any) 9. PRIME CONTRACTOR(name,address) 10. SUBCONTRACTOR/EMPLOYER,IF APPLICABLE(name,address) 1 Check All That Apply:] ❑ The work to be performed by the additional classification(s)is not performed by a classification in the applicable wage decision. O The proposed classification is utilized in the area by the construction industry. O The proposed wage rate(s),including any bona fide fringe benefits,bears a reasonable relationship to the wage rates contained in the wage decision. ❑ The interested parties,including the employees or their authorized representatives,agree on the classifications)and wage rate(s). ❑ Supporting documentation attached,including applicable wage decision. LCheck One: ❑ Approved,meets all criteria. DOL confirmation requested. ❑ One or more classifications fail to meet all criteria as explained in agency referral. DOL decision requested. FOR HUD USE ONLY ji ' 17.'4—/..1" LR2000: A lncy -e. --sentati - Date Log in. yped name d signa- e) Log out: Phone Number HUD-4230A(8-03)PREVIOUS EDITION IS OBSOLETE EQUAL EMPLOYMENT OPPORTUNITY COMMITMENT TO: 11'G u /Zwz .- (Name of Labor Union,Workers Representative,etc Act: /311t( ?s-ihple Lb, b44,en-go KY (Add ss) Name of Business Contractor : f(JiZ C' 1 G L?/t ) � Project Name: ,, ' A- C t; ` ;� Project Number: 6/61 A p ryip p.),ue � �I J The Undersigned currently holds a contract with C17R-61/ z•C� /2a(cs Ved ,linvolving funds of the U. S. Government, or a subcontract with a prime contractor holding such contract. You are advised that under the provisions of the above contract or subcontract, and in accordance with Executive Order 11246,the undersigned is obligated not to discriminate against any employee or applicant for employment because of race, color, religion, sex or national origin. This obligation not to discriminate in employment includes, but is not limited to the follow: 1. Hiring, placement, upgrading, transfer or demotion; 2. Recruitment, advertising or solicitation for employment; 3. Treatment during employment; 4. Rates of pay or other forms of compensation; 5. Selection for training, including apprenticeship; and 6. Layoff or termination. This notice is furnished to you pursuant to the provisions of the above contract or subcontract and Executive Order 11246. Copies of this notice will be posted by the undersigned in conspicuous places available to employees or applicants for employment. / /Amer j--0 4-e /u,e 2 J By: / i (Print Name) (Signature) er—q v P • (Date) (Title) Exhibit"A" PROPOSAL CITY OF RANCHO PALOS VERDES ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS ON MIRA CATALINA (Community Development Block Grant Project#601561-13) TO THE DIRECTOR OF PUBLIC WORKS CITY OF RANCHO PALOS VERDES The undersigned, as bidder, declares that: (1) this proposal is made without collusion with any other person, firm or corporation, and that the only persons or parties interested as principals are those named herein; (2) bidder has carefully examined the project plans, specifications, instructions to bidders, proposal, notice to contractors and all other information furnished therefore and the site of the proposed work; (3) bidder has investigated and is satisfied as to the conditions to be encountered, the character, quality and quantities of work to be performed and materials to be furnished. Furthermore, bidder 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 a contract with the CITY OF RANCHO PALOS VERDES, to perform said proposed work in accordance with the plans, if any, and the terms of the specifications, 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 such thereof as may otherwise be furnished or provided under the terms of said specifications, for the following stated unit prices or lump-sum price as submitted on the Schedule attached hereto: The bidder shall submit as part of this proposal a completed copy of the Contractor's Industrial Safety Record. Accompanying this proposal is tt 1:3„..„,i (Insert)"$ckt- ir 1\i `,:cash," "Cashier's Check," "certified check," or"Bid Bond," as the case may be) in t e 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 in the Bid Sheets. The undersigned further agrees that should he/she be awarded the contract on the basis hereof and thereafter, defaults in executing the required contract, with necessary bonds and documents, within ten (10) days, not including Sundays and legal holidays, after having received notice that the contract has been awarded and is ready for signature,the proceeds of the security accompanying his bid shall become the property of the CITY OF RANCHO PALOS VERDES and this proposal and the acceptance thereof may be considered null and void. Licensed in accordance with an act providing for the registration of contractors, California Contractor's License No. `fi d` 'tc , Class 4 , Expiration Date 10/71/ arc . Signature(s)of bidde . If an individual, so tate. If a firm*or o- artnership, state the firm name and give the names of all individual co-partners composing the firm. If a corporation, state legal name of corporation, also names of president, secretary, treasurer, and manager thereof. Two notarized officer's signatures and the corporate seal are required for corporations. Legal Business Name: !ZurL Ct.r cr k eOU; c • Address: t,V i`-1 Tetil I L Au-*.... (.._,.c, 5c''. t 1606` Telephone: (5C:1) ell 1—3c57 P- 1 R6876-001011817323v2.doc Exhibit"A" Contact. j4sSe 4 . Kkkt r Proposals which do not show the number and date of the Bidder's License under the provisions of Chapter 9 of Division 3 of the Business & Professional Code will be rejected. To be submitted with each bid to contract for the ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS ON MIRA CATALINA (Community Development Block Grant Project#601561-13) Bid Date: jjj `� ;2, s' This information must include all construction work undertaken in the State of California by the bidder and partnership joint venture or corporation that any principal of the bidder participated in as a principal or owner for the last five calendar years and the current calendar year prior to the date of bid submittal. Separate information shall be submitted for each particular partnership, joint venture, corporate or individual bidder. The bidder may attach any additional information or explanation of data which bidder would like to be taken into consideration in evaluating the safety record. An explanation must be attached of the circumstances surrounding any and all fatalities. P-2 R6876-001011817323v2.doc Exhi! A" C TY OF RANCHO VERDES PUBLIC WORKS DEPARTMENT' ADDENDUM NO. 1 TO THE CONTRACT DOCUMENTS, SPECIFICATIONS, &STANDARD DRAWINGS FOR THE ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS MIRA CATALINA PROJECT PROJECT#601561-13 In accordance with "Addenda" on page 1-1 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 nonresponsive. The subject contract documents are hereby amended as follows: Item 1 ---The latest Federal Wage Decision was issued, dated June 19, 2015.The attached Federal Wage Decision and CDBG forms shall supersede Appendix IV included in the specifications. Itgrn 2- Reference Specification Page NC-1.The date for submittal of bids is revised. The updated Notice Inviting Bids is attached. BIDS MUST BE RECEIVED BY: 10:00 a.m. Thursday,July 23, 2015. End of Addendum No.1 Any questions regarding this Addendum should be directed to the Project Manager, Nicole Jules, P.E. at(310) 544-5275. (11 ichael Thronea 1 Date Director of Public Works I acknowledge receipt of this Addendum No. 1 and accept the aforementioned. Bidder's Signature •ate Please sign above and include this jijapeci addendum kite Bid package.Failure to do so may result in that Ind being feljectpd as non-respgnlsive. Page 1 of 1 Exhi • 'A" CITY O ., RANCHO Pt Pt.IC WORKS DEPAR[MEN i ADDENDUM NO. 2 TO THE CONTRACT DOCUMENTS, SPECIFICATIONS,&STANDARD DRAWINGS FOR THE ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS IVIIRA CATALINA PROJECT PROJECT#601561-13 In accordance with "Addenda" on page 1-1 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 nonresponsive. The subject contract documents are hereby amended as follows: ttgn1 ---The latest Federal Wage Decision was issued,dated July 10, 2015.The attached Federal Wage Decision shall supersede Appendix IV included in the specifications. End of Addendum No.2 Any questions regarding this Addendum should be directed to the Project Manager, Nicole Jules, RE, at(310) 544-5275. .}-2:12/ 7//37/i- 4-or. Michael Throne Date Director of Public orks I acknowledge receipt of this Addendum No. 2 and accept the aforementioned. Bidder's Signature D.to Please sign above and include this sl ned addendum In the Bid ackra e. Failure to do so may result in that Bide re acted.a ,,non responsive. Page 1 of 1 Exhibit"A" CITY OF RANCHO PALOS VERDES BID SHEET ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS ON MIRA CATALINA (Community Development Block Grant Project#601561-13) c NAME OF COMPANY: ,' Corcc4 t Mut To the Honorable Mayor and Members of the City Council: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby agrees to enter into a contract to furnish all labor, materials, equipment and supplies for the project identified as ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS ON MIRA CATALINA in accordance with the specifications and plans for demolition, construction and installation in the Contract Documents which are on file in the office of the Director of Public Works'of the City of Rancho Palos Verdes to the satisfaction and under the direction of the Director of Public Works at the following prices: Item Descri tion Estimated Unit Unit Extended No. p Quantity Meas. Price Amount 1 TRAFFIC CONTROL/MOBILIZATION/BMPs 1 LS ).-1+92.5 Z,`t2,S, 2 TRAFFIC STRIPING AND MARKINGS 1 LS `i1 (ITCHY SAWCUT AND REMOVE EXISTING PCC CURB AND 3 GUTTER 275 LF 5/7r5.7.,-1 REMOVE EXISTING ASPHALT CONCRETE PAVEMENT 4 AND BASE 670 SF L L 3(Q Zt SAWCUT AND REMOVE PCC CROSS GUTTER AND C„5'(.0 5 SPANDREL 1,030 SF(g)-4//94 Sc*!2 6 RELOCATE EXISTING SIGN WITH NEW POLE 3 EA ;SCD �-SQ 7 REMOVE AND REPLACE WATER METER BOX 1 EA _300 3 CONSTRUCT PCC CURB AND GUTTER TYE A2-8 PER 8 SPPWC STD. PLAN 120-2 280 LF 7SO-S4‘, S 9 CONSTRUCT PCC CURB AND CROSS GUTTER PER 1,030 SF SPPWC STD. PLAN 122-2 Lc 12 ,o I,Lt 10 CONSTRUCT PCC SIDEWALK 4"THICK OVER 3"CMB 620 SF 'VT Scc eh k 11 CONSTRUCT PCC CURB RAMP PER SPPWC STD. PLAN 3 EA 111-4, CASE B,TYPE 1 OVER 3"CMB t X30 -,q(10. 12 CONSTRUCT VARIABLE HEIGHT PCC CURB 20 LF 2 ,'t 91S 13 CONSTRUCT 8" DEEPLIFT ASPHALT CONCRETE 305 SF kis s TOTAL BID PRICE S1-512,` (S rfs TOTAL BID PRICE IN WORDS: �' kuvilrEQ.,1,61-477c7. P-3 R6876-001011817323v2.d o c Exhibit"A" INFORMATION REQUIRED OF BIDDER The bidder is required to supply the following information: (Additional sheets may be attached if necessary.) (1) Address: (if/ A itti- f3 (2) Telephone: CS' �- 431 ©?d (3) Type of firm - Individual, Partnership, or Corporation: Ce>cet.rj/dIA (4) Corporation organized under the laws of the State of Cc4ry (5) Contractor's license number and class: 9439S. (6) DIR Contractor Registration Number: 100000 1S'") 9._s (7) List the names and addresses of all members of the firm or names and titles of all officers of the corporation: A-icio I3. PZ z J r- ° PresjeZt- d(sice ' Vic ereStriej- (8) Number of years experience as a contractor in construction work 1 ' . (9) List at least three similar projects completed as of recent date: Contract Amount Class of Work Date Completed Name,Address of Owner and Telephone No. Quskytfr‘A I '1,O'N C t'Is5s ��tl 22o i`a --c��:,► vtr� A unit-v.x.. 10)9 73 3. 5 �~ F 3aG hie"ca, 3L JD 2. 1� �. �' /' .1 C /A I.1 ' .��. 4f ` t1 . LQ r, t)4 . i Alia sr _ i !1 g•,` '1 . qt.e-Yireet-Tu. 6C21- 905-`11e (10) List the name of the person who inspected the site of the proposed work for your firm: r.1 ._ A,4-1(2_ E-elcntA 6-ok.3dN (11) NOTE: Upon request of the City, the bidder shall furnish evidence showing a notarized financial statement, financial data, construction experience, or other information. P-4 R6876-001011817323v2.doc DESIGNATION OF SUBCONTRACTORS [Public Contract Code Section 4104] List all Subcontractors who will perform Work or labor or render service to the Contractor in or about the construction of the Work or improvement, or a Subcontractor licensed by the State of California who, under subcontract to the Contractor, specially fabricates and installs a portion of the Work or improvement according to detailed drawings contained in the Plans and Specifications, in an amount in excess of one-half percent (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 one-half percent(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. Name under which Subcontractor is CSLB License DIR Contractor Type of Work Percentage of Total Number(s)and Registration Address and Phone Number YP g Licensed Class(es) Number (e.g., Electrical) Bid (e.g., 10%)* and Registered m < x • *The percentage of the total Bid shall represent the "portion of the work"for the purposes of Public Contract Code Section 4104(b). P-7 R6876-0010\1817323v2.doc INDUSTRIAL SAFETY RECORD FORM Bidder's Name .4A;ZCt,ncci 4' kik iiiiti I:. Current Year of 2014 2013 2012 2011 2010 Total Record Number of contracts 1 (.0 f./ - LI LI1 -3 2- e-- Total dollar amount of contracts(in thousands of dollars) I OO .� -al.S (7 2.---7 t 2.33 (erz k S Y C) -7 13(4 Number of fatalities 2( _____P‹ ter' Qc /C?) ' R/ 2r Number of lost workday cases ;01°.. RC Z ;0'.' K(Y' X (Qt Number of lost workday cases D involving permanent transfer �k"' � �/ ___/ to another job or termination ���T (� of employment 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 true and accurate within the limitations of those records. ti Signature: 17,0t7,1- Signature: ,� _" '�' Title: VIke p �-e4e11/: Title: dcs;s+a.,,a�- ��'►�„� ‘ Date: 1/4,/ao,s Date: 'Z"/ .,9ais P-8 R6876-001011817323v2.doc Exhibit"A" Bond No.N/A BID BOND KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the CITY OF RANCHO PAIRS VERDES ("Public Agency"),has issued an invitation for bids for the work described as follows; ADA ACCESS RAMPS AND SIDEWALK IMPROVEMENTS ON MIRA CATALINA (Community Development Block Grant Project#601561-13) WHEREAS RUIZ CONCRETE & PAVING INC. 1344 TEMPLE AVE.,LONG BEACH,CA 90804 (Name and address of Bidder) :("Principal"), 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 _ _ _ _ _ _ FIDELITY AND DEPOSIT COMPANY OF MARYLAND (Name end 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 *'IST PERCENT OF AMOUNT BID* Dollars($ *(10%)* ), 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 and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal is awarded a contract for the work by the Public Agency and.,within the time and In the manner required by the bidding specifications, enters into the written form of contract included with bidding 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 Code 2845, R8670-001011 B1732Sv2.doc Exhibit"A" IN WITNESS WHEREOF, this instrument has 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: JULY 1, 2015 "Principal" "Surety' RUIZ CONCRETE E & PAVING,INC. FIDELITY AND DEPOSIT COMPANY AliOF MARYLAND -,--~--^.► Al By: �j d .r.r/ ; Its i -pr �'� V■ �r/l .,..�. _ w'• �.�ti ATTORNEY-IN-FACT By: AO By: Its Its (Seep (Seal) Not: This bond must be doted,ell signatures must be notarized,and evidence of The authority of any person signing as attorney- in-Fact Oust be attached. P- 10 RI876-001411817323v .doc Exhibit"A" ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by JAMES M. CARROLL, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate, constitute, and appoint Michael A. QUIGLEY, of Laguna Hills, California, its true and lawful agent and Attorney-in-Fact, to make, execute,seal and deliver,for,and on its behalf as surety,and as its act and deed:any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 18th day of June,A.D. 2012. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND ick ( :?.r"., 141. fies.11:40t,Nit UAL '"" ls --.r�. .•. . AAloos /)i) 1 4‹j-c /'✓ r 4( 4-14--- /7"1B Assistant Secretary Vice President Eric D.Barnes James M. Carroll State of Maryland City of Baltimore On this 18th day of June,A.D. 2012,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,JAMES M. CARROLL,Vice President,and ERIC D.BARNES,Assistant Secretary, of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and being by me duly sworn,deposeth and saith, that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument arc the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. ````��`'<���,n,4'o t •)i' , ,1 Cy,,,,,,-X, ,I.r:-/- /-3-,,,,,,,----- \A.,,,I'I ON-, ,:t"i ''1:lii/lt;:' Constance A.Dunn,Notary Public My Commission Expires:July 14,2015 POA-F 012-0626C Exhibit"A" CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of ORANGE On July 1,2015 before me, MEG QUIGLEY, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MICHAEL A- QUIGLEY Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is subscribed to the within instrument and acknowledged to me that n MEG O U G LE Y he/ n c executed the same in h is/be authorized ' Commission# 1963669 ,_ w ;ki..�; capacity(i , and that by hi signature( } on the 4 +cs !e Notary Public -California zinstrument the rson or the entityu on behalf of Z ''.�'' � Orange Count n � ��� � '" -= 9 Y j which the persons)acted, executed the instrument. My Comm.Expires Jan 10,2016 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. , • ' 1 ' WITNESS my 4n• a • o ,,i: seal.i, s Signature .,• Place Notary Seal Above '. . ' OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on th. .. =.1 and could prevent fraudulent removal and reattachment of this form to another ment., Description of Attached Document . IL Title or Type of Document:- Document Date: _ Number of Pages: . Signer(s)Other Than Named Above: Capacity(les)Claimed by Signer(s) Signer's Name: Signer's Name: . ❑ Individual 0 individual ❑ Corporate Officer—Title(s): ❑Corporate Officer—Title(s): ❑ Partner—0 Limited ❑General ElPartner—❑ Limited 0 General FZIGHTTHUf.1BPRl'JT 141311T,itl,,•1:1,1-11=,1 ❑ Attorney in Fact or SIGtIEF El Attorney in Fact OF S!CMER Top of thumb here Top of thumb here ❑ Trustee 0 Trustee ❑ Guardian or Conservator 0 Guardian or Conservator ❑ Other: 0 Other: Signer Is Representing: - Signer Is Representing: 02007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NatbnalNotaryorg Item#5907 Reorder.Call Toll-Free 1-800.876.6827 Exhibit"A" CA ALL-PURPOSE ACKNOWLEDGEMENT "A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. " State of California } County of Los Angeles } • On July 8, 2015,before me, C.O. Pallares/Notary Public, personally appeared Jose Alejandro Ruiz, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 0 ;I,/ ,0? C. 0. PALLARES Signature Commission# 1971748 Notary Public-California � Los Angeles County My Comm. Expires Apr 7,2016 Exhibit"A" NON-COLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID [Public Contract Code § 7106] State of California ) County of ) ss. City of lz. 'V ) The undersigned declares: 1-6'L . I am theJi'ze s� 'e, -of 9_,Azz.,,,„,k , Mt partymaking the foregoing bid. The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine and not collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding. The bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder. All statements contained in the bid are true. The bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose. Any person executing this declaration on behalf of a bidder that is a corporation, partnership,joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and i that this decl M •tion is executed on ***7/%--/ c i s [date], at r,, [city], C /or [state]. 7 , Signature Subscribed and sworn to before me on (we) (Notary Seal) ignature Notary Public P- 11 R6876-001011817323v2.doc Exhibit"A" "A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. " State of California ) County of Los Angeles ) ss. Subscribed and sworn to (or affirmed)before me on this 8th day of July, 2015,by Jose Alejandro Ruiz,proved to me on the basis of satisfactory evidence to be the person(s)who appeared before me. -dee>, C. o. PALLARES Q ��. Commission # 1971748 5,-0.4.1 Signature -�. Notary Public-California Z z,'' �` Los Angeles County " My C amrn. Ex fres Apr 7, 016 pit • Attached to Poder General Exhibit"A" ADDENDA ACKNOWLEDGMENT FORM � r Bidder's Name: (2c CPACIA Po'i J The Bidder shall signify receipt of all Addenda here, if any: Addendum Number Date Received Signature If there are more Addenda than there is room in the chart above, attach another page acknowledging receipt of the Addenda. P- 12 R6876-001011817323v2.doc ....a-a-4p Ac"C�!@'�` DATE(INM/DDIYY,rY) CERTIFICATE OF LiABILITY INSURANCE 9/2/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pcllcy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ....... .�.. PRODUCER ME: Horace Williams Southland Insurance Brokers PHONE . (951)789-9901 A JAIC,No): (951)534-5500 artaellaillis 19069 Van Buren Blvd. #114-M484 _.service@south.andins.cola INS RER(S)AFFORDING COVERAGE NAIC S Riverside CA 92508 INSURER A:TOSCO Insurance Co. INSURED INSURER B:TOruS Special ty Insurance Co. rr •�p.r..rr�w rwrr W.wrM�Wry run'Ruiz Concrete And Paving I '"'. INSURER C 1344 Temple Ave. INSURER D: INSURER E: Long Beach CA 90804 INSURER F: - . COVERAGES CERTIFICATE NUMBER:CL157200609 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VIMICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN TYPE OF INSURANCE T. I.' LE POLICY E F OLI XP t TRINA SAID POLICY NUMBER (M IC�tY1�Y'�_,IAMIDDJYYYY)._...._�_._......_.,.,.... LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - bAMAGE TO RENTEM X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 50,000 A ......_1 CLAIMS-MADE a OCCUR X 'Z WPAI6/30/2015 6/30/2016 O3I2S1D3 MED EXP(Any one person) $ 5,000 PERSONAL&ADS!INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP1OP AGG $ 2 1000,000 PRO- - X POLICY ; mg LOC $ AUTOMOBILE LIABILITY (Ea accident) _$ 1,000,000 BODILY INJURY(Per person) $ A ANY AUTO ,�,... .- -- X /kit LL gr NED X SCHEDULED X WPA1Q3128103 6/30/2015 6/30/2016 BODILY INJURY(Per accident) $ x NON-C:W1.wYIMV NED -PROPERTY E X HIRED AUTOS AUTOS (Per accident) $ Uninsured motorist combined $ 1 000 000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 B X EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ 4,000,000 DED El RETENTION'. 10,000 87251J 6/30/2015 6/30/2016 151ALT $ WORKERS COMPENSATION TONY LIMITS f)TH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE Ej N/A E.L.EACH ACCIDENT $ OFFICER/MEIvMBER EXCLUDED? (Mandatory In NIH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under -DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional( marks Schedule,If more space is required) The City of Rancho Palos Verdes, CDC, HA and County and each of their elected and appointed officers, officials, representatives, employees and agents are named Additional Insured. 30 Day Notice of Cancellation RE:Mira Catalina CDBG ADA Ramps. Project. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OR THE ABOVE DESCRIBED POLIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rancho cho Falas VerdesACCORDANCE WITHTHE POLICY PROVISIONS. 30940 Hawthorne Blvd. Palos Verdes 0 AUTHORIZED REPRESENTATIVE Arda Williams/HORACE '' .'+L...• geigc, ACORD 25(2010/05) 01988.2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD POLICY NUMBER: WPA10312810 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or C2r_ganization(s):, Locationndcri tion Of Completed Operations tions blanket as required by written contract. The City of Rancho Palos Verdes,CDC,HA and County Primary Insurance applies: It is agreed that such and each of their elected and appointed officers,officials, insurance as is afforded by this policy for the benefit of representatives,employees and agents the Additional Insured shown shall be primary insur- ance, and any other insurance maintained by the Addi- tional Insured(s) shall be excess and noncontributory as respects any claim, loss or liability allegedly arising out of the operations of the named insured, provided however that this insurance will not apply to any claim loss or liability which is determined to be solely the result uf the Additional Insured's negligence or solely the Additional Insured's responsibility. This insurance also does not apply to any structure with an intended occupancy of a private residence, not including apartments. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section Il — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or 'property damage"caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard". POLICY NUMBER: WPA1031281-03 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL I - OWNERS LESSEES OR CONTRACTORS - LED EPERSON R H � ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABIUTY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s)Of Covered Operations .�._ Blanket as required by written contract. The City of Rancho Palos Verdes,CDC,HA and County Primary Insurance applies: It is agreed that such and each of their elected and appointed officers,officials, Insurance as is afforded by this policy for the bene- representatives,employees and agents fit of the Additional Insured shown shall be primary Insurance, and any other insurance maintained by the Additional insured( ) shall be excess and non- contributory as respects any claim, loss or liability allegedly arising out of the operations of the named insured, provided however that this insurance will not apply to any claim loss or liability which is de- termined to be solely the result of the Addriional Insured's negligence or solely the Additional In- sured's responsibility. Information r uired to com Tete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -. Who Is An Insured is amended to P. With respect to the. insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage "personal personal and advertising Injury" "property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or equip- '''. Your acts or omissions;or ment furnished in connection with such work, 2. The acts or omissions of those acting on your on the project (other than service, maintenance behalf; or repairs) to be performed by or on beI alf of in theperformance of your ongoing operations for the additional insureds} at the location of the covered operations has been completed;or the additional insureds) at the iocatlon(s) desig- nated above. 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. POLICY NUMBER: WPA1031281-03 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: The City of Rancho Palos Verdes,CDC,HA and County and each of their elected and appointed officers,officials, representatives,employees and agents information re Scheckile, if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- uompleLed uptliatiuris hatanl". This waiver applius only to the person or organization shown in the Schedule above. WPA1031821-03 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM TRUCKERS COVERAGE FORM SCHEDULE Name of Person or Organization: The City of Rancho Palos Verdes,CDC,HA and County and each of their elected and appointed officers,officials, representatives,employees and agents Description of Operations or Services Location: Mira Catalina CDBG ADA Ramps Project Description of Covered"Autos": Per Schedule on file with company (If no entry appears in the Schedule above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The WHO IS AN INSURED provision under LIABILITY COVERAGE is changed to include as an"insured' the person or organization shown in the Schedule, but only with respect to liability arising out of; 1. Your operations or services performed for that person or organization at the location shown in the Schedule; or 2. The ownership, maintenance or use of the covered"autos"described in the Schedule. A person's or organization's status as an additional insured under this endorsement ends when: 1. Your operations or services performed for that person or organization are completed: or 2. That person's or organization's interest in the described ibauto"ends. CA990009 1004 Includes copyrighted material of Insurance Services Office, Inc., Page I of 1 with its permission. 44r` DATE(MM/DD/YYYY) CERTIFICATE OF' LIABILITY INSURANCE 09/0212015 _ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the paiic l les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Daniel NAME: Capital Provider Insurance Services draNifo.Ext); (818)676-0016 FAX _, C,No): (818)2745600 20121 Ventura Blvd.,Suite#307 _ADDRESS: Daniellitopisgroup,com Woodland Hills,CA 91364 — INSURER(s)AFFORDING COVERAGE NAIC X Phone (818)676-0016 _ — Fax �( 18)676-0015 INSURER A: W _�_�___` INSURED INSURER B: Ruiz Concrete and Paving Inc INSURER C: 1344 Temple Ave INSURER D: State Compensation Insurance Fund INSURER E: -- Long Beach,CSA0 90804 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AD1LSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IELSB,NyD POLICY NU ABER (MM/DD/YYYY)_(MMIDP/YYYYj LIMITS — GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED ❑ COMMERCIAL GENERAL LIABILITY PREMISES(Ea occLt„r ►nce) _$ ❑ ❑ CLAIMS-MADE ❑ OCCUR MED EXP(Any one person $ ❑ PERSONAL&ADW INJURY $ �. ❑❑ GENERAL AGGREGATE $ .._ GEN'L AGGREGATE## LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG_$ El POLICY ED f ED LOG _ r ._.�._._... $ —. COMBINED SINGLE UMIT AU'ra1�401 LIABILITY COMBINED accident) $ L❑ ANY AUTO i BODILY INJURY(Per person) $ 0 ALL OWNED 0 SCHEDULED BODILY INJURY(Per accident) $ ❑ HIRED AUTOS ❑ AU°TSINNED CROP ER DAMAGE ❑ ❑ _ $ ❑ UMBRELLA LIAB El OCCUR EACH OCCURRENCE $ .� ❑ EXCEW LIAB ❑CLAIMS-MADE AGGREGATE $ El DED t;J RETENTION$ $ WORKERS COMPENSATIONi _ PER OTH- AND EMPLOYERS'LIABILITY ATJIE - ❑ W- AND ANY PROPRI.ETOR/PARTNER/EXECUTIV r EL EACH ACCIDENT $ 1,000,000.00 D OFFICER/MEMBER EXCLUDED? NIA 9129720-15 04/011`2015 04101/2016 _ _..._ (Mandatory in PSI) E.L.DISEASE-EA EMPLOYE $ 1,000,000.00 If yes,describe under E.L.DISEASE-POLICY UMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS b __{ elow DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Insurance CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Rancho Palos Verdes THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City Hall ACCORDANCE WITH THE POLICY PROVISIONS. 30940 Hawthorne Boulevard AUTHORIZED REPRESENTATIVE Rancho Palos Verdes,CA 90275.5391 ...�. _..._,...�... ..._._. ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101)QF The ACORD name and logo are registered marks of ACORD r• Department of Consumer Affairs ,tx- :;1 Contractors State Liceni*Eloardn License Application Status Detail zisDISCLAIMER: The license application status information shown below represents information taken from the CSLB application data base at the time of your inquiry. • The applicant cannot contract until the contractor's license has been issued. Due to workload, application status may not reflect pending updates which are being reviewed for subsequent database updating. We are currently working on original license applications received on 09/19/11 Application#: 20110102969 Extract Date: 10/5/2011 RUIZ CONCRETE & PAVING INC dba: RUIZ ENGINEERING Business Information: 1344 TEMPLE AVENUE LONG BEACH, CA 90804 Entity: Corporation Application Type: Original Application Application is pending DATE DESCRIPTION 09/09/2011 APPLICATION RECEIVED 09/14/2011 PRINTED ACKNLDGMNT LTTR TO APPLCNT Application Status: 09/16/2011 APPLICATION REJECTED 09/30/2011 APPLICATION POSTED 09/30/2011 WAIVER BOND AND FEE LETTER SENT 09/30/2011 NEED WORKERS COMP CERT OR EXEMPTION 09/30/2011 REJECT RETURNED CLASS DESCRIPTION Classifications: A GENERAL ENGINEERING CONTRACTOR DATE SURETY INSURANCE COMPANY BOND# AMOUNT Contractor Bonding Information: AMERICAN CONTRACTORS INDEMNITY 09/22/2011 COMPANY 100176005 12500 Click for a Personnel List Conditions of Use I Privacy Policy Copyright©2010 State of California ommwam .., Department of Consumer Affairs Y aA --::, ., �C� Contractors State License oard License Application Status Detail (Personnel List) Contractor Application#: 20110102969 Contractor Name: RUIZ CONCRETE & PAVING INC TYPE NAME POSITION CLASSIFICATION Name RUIZ JOSE ALEJANDRO JR RMO A-GENERAL ENGINEERING CONTRACTOR Name RUIZ ALDO BELARMINO JRY. CEO/PRESIDENT None Name RUIZ JOSE ACOMIAS OFFICER None Conditions of Use I Privacy Policy Copyright©2010 State of California • ti , Bond No.07646295 WARRANTY BOND WHEREAS the City of Rancho Palos Verdes ("City"), has awarded to RUIZ CONCRETE E & PAVING,INC. 1344 TEMPLE AVE.,LONG BEACH,CA 90804 (Name and address of Contractor) ("Principal"), a contract (the "Contract"), which is incorporated herein by this reference, for the work described as follows: "ADA ACCESS RAMPS AND SIDEWALK IMP. ON MIRA CATALINA, PROJECT #601561-13" WHEREAS, Principal is required under the terms of the Contract to file a good and sufficient warranty bond with the City before final completion of the work and its acceptance by the City. NOW, THEREFORE, we, the undersigned Principal, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND 777 S. FIGUEROA ST.,LOS ANGELES,CA 90017 (Name and address of Surety) ("Surety") a duly admitted surety insurer under the laws of the State of California, as Sure re held and firmly bound unto the City in the penal sum of*SIXTY-FOUR THOUSAND SIX HUNDRED 20/100, a Dollars ($ 64,611 .20 ) 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 and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT: WHEREAS, the above named Principal completed work for the referenced contract and has agreed to guarantee the work, labor, and materials furnished for said work, and said work has been accepted by the City as having been built in accordance with the approved plans and specifications, for a period of one (1) year. NOW THEREFORE, the above named Principal has made specific guarantees to the City concerning the work, labor and materials furnished for the above referenced contract. The Principal, his, her or its heirs, executors, administrators, successors or assigns shall remedy,without cost to the City,any defects caused by defective materials or workmanship.And Principal shall indemnify,defend and hold harmless the City, its officers, agents, and employees for any and all claims, demands, causes of action, damages, injuries, liabilities, losses, costs or expenses, including attorneys' fees and costs of defense, which arise out of, pertain to, or relate to such defects or to the Principal's actions or inactions in remedying such defects. If the Principal complies with these guarantees for a period of one (1) year from the date of the City's final acceptance, then this obligation shall be null and void. If City notifies Surety during the one(1)year period that Principal has not met its guarantee, then Surety shall indemnify City for losses. The City shall give written notice to the Principal during the one (1) year period for any defect of the guaranteed work which 01203.0001/276956.1 • becomes apparent. This obligation shall remain in full force and effect until any defect identified in the written notice are repaired by the Principal and accepted in writing by the City. In case suit is brought upon this bond, Surety further agrees to pay, in addition to the Penal Sum, all costs and reasonable expenses and fees, including reasonable attorneys' fees, incurred by the City in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered. FURTHER, Surety hereby waives the provisions of California Civil Code sections 2845 and 2849. The City is the principal beneficiary of this bond and has all rights of a party hereto. The Surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the agreement or to the work to be performed thereunder or the specifications accompanying the same shall in anywise affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the agreement or to the work or to the specifications. 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 7, 2015 01203.0001/276956.1 "Principal" "Surety" RUIZ CONCRETE & PAVING,INC. FIDELITY AND DEPOSIT COMPANY OF MARYLAND By ' _ik4 By: Its - ATTORNEY—IN—FACT By: By: Its Its (Seal) (Seal) APPROVED AS TO SURETY AND APPROVED AS TO FORM: PRINCIPAL AMOUNT By: By: Insurance Administrator City Attorney 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 01203.0001/276956.1 I ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of Maryland,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by JAMES M. CARROLL, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate, constitute, and appoint Michael A. QUIGLEY, of Laguna Hills, California, its true and lawful agent and Attorney-in-Fact, to make, execute,seal and deliver,for,and on its behalf as surety,and as its act and deed:any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 18th day of June,A.D.2012. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND bt:0 OE'a f 4,• L tiA ow. 110 Siril***:°."%i.. 3' SEAL ) W = :ii — ink 141, , MO 4 4 tin\ ''1„?~.'.......-f'P* .. (X,JA,...,,fr(6- 1.1--- /OA: , 44 (-41---- Assistant Secretary Vice President Eric D.Barnes James M. Carroll State of Maryland City of Baltimore On this 18th day of June,A.D. 2012,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,JAMES M. CARROLL,Vice President,and ERIC D.BARNES,Assistant Secretary, of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn,deposeth and saith,that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. ````\\`,;11,►,)1,% coi,„tx„a 4_9_,,,,— ., 11.1\,.'��-; ''''11),tI"\ Constance A.Dunn,Notary Public My Commission Expires:July 14,2015 POA-F 012-0626C EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company,whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this i1day of DECEMBER ,2015 .00:214.4N smut* •— nnis BaAL 41111:# Geoffrey Delisio,Vice President •• I , CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of ORANGE / • On December 7,2015 before me, MEG QUIGLEY, NOTARY PUBLIC , Date Here Insert Name and Title of the Officer • personally appeared MICHAEL A. QUIGLEY Name(s)of Signer(s) • who proved to me on the basis of satisfactory evidence to be the person(x) whose name(s) iskos subscribed to the within instrument and acknowledged to me that he/sbailkowexecuted the same in his/Id#ir authorized •�-7,2 � MEG QUIGLEY Ca aci and that hi si nature on the ,';Q=/,�� ' °; Commission # 1963669 p ty( a), by g `� " Notary Public California- Z instrument the person(p), or the entity upon behalf of � .� Orange Countyn which the person(s) acted, executed the instrument. . My Comm. Expires Jan 10,2016 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS -o = ', of4ici=I seal. I r / Signature : 1 / Place Notary Seal Above 4,11' ' re of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to s: '•ns . on a document and could prevent fraudulent removal and reattachment of this for, -anon': •. me ' Description of Attached Document il . Title or Type of Document: Document Date: Number of Pages: . Signer(s)Other Than Named Above: Capacity(les)Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual 0 Individual ❑ Corporate Officer—Title(s): 0 Corporate Officer—Title(s): ❑ Partner—❑Limited 0 General RIGHT THUMBPRINT 0 Partner—❑Limited 0 General RIGIiTTHUMDPRINT ❑ Attorney in Fact OF SIGNER 0 Attorney in Fact OF SIGNER ❑ Trustee Top of thumb here p Trustee Top of thumb here ❑ Guardian or Conservator 0 Guardian or Conservator ❑ Other: 0 Other: Signer Is Representing: • Signer Is Representing: •'_ -• �//!/�!/� i-\�.���.��/'���'..\��i\�'• /:. • moi, ••/�..'• 'i..` �/,�./i../..T,. �\ ,• /': '.`� .�� , ':'. �`.�,.../� .. �/ •i. . •/ ©2007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth.CA 91313-2402•www NationalNotary org Item#5907 Reorder:Call Toil-Free 1-800-876-8827 • CA ALL-PURPOSE ACKNOWLEDGEMENT A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. " State of California } County of Los Angeles } On December 9, 2015, before me, C.O. Pallares/Notary Public, personally appeared, Jose Alejandro Ruiz, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. - C. 0. PALLARES tT fes.:may♦ Commission # 1971748 • ' Notary Public - California z z -74k ,�.,,, Los Angeles County Signature `'`'� My Comm. Expires Apr 7, 2016