RPVCCA_SR_2010_09_07_12_Traffic_Signal_Upgrade_To_Crenshaw_BlvdCrrvOF
REVIEWED:
Project Manager:
TO:
FROM:
DATE:
SUBJECT:
MEMORANDUM
HONORABLE MAYOR &CITY COUNCIL MEM~~t!JV
RAY HOLLAND,DIRECTOR OF PUBLIC WORtef
SEPTEMBER 7,2010
CONSTRUCTION CONTRACT FOR CRENSHAW BLVD
AT CRESTRIDGE RD TRAFFIC SIGNAL UPGRAGE
PROJECT (FEDERAL PROJECT NO.HSIPL-5413(008)}
CAROLYN LEHR,CITY MANAGER d2-
Nicole Jules,Senior Engineer """Y\t(f
RECOMMENDATIONS:
1.Approve the project construction plans and specifications.
2.Award and authorize the Mayor and City Clerk to execute a construction contract
to Lincoln Pacific Builders in the amount of $137,200 for the Crenshaw,Blvd at
Crestridge Rd Traffic Signal Upgrade Project and authorize an additional 10%or
$13,720 for possible extra work and contingencies;thereby approving a
$150,920 construction budget.
BACKGROUND/DISCUSSION
In 2006,the City applied for federal grant funds to upgrade the traffic signal equipment
at the intersection of Crenshaw Boulevard and Crestridge Road.This location was the
subject of two major collisions that precipitated the need to improve safety.As a result,
the City was awarded $252,450 in Federal Highway Safety Improvement Program
Grant funds to construct protected left-turn phases for all movements at the
intersection.
The project improvements will include upgrading the traffic signal poles,vehicle
indicators,pedestrian indicators,ADA accessible ramps and striping.
ANALYSIS
The project was advertised and sealed bids were received and opened on August 9,
2010.Lincoln Pacific Company submitted the lowest responsive bid out of the eight
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bids received.The following table summarizes the bids received:
BID SUMMARY
Construction Companies Bid Amount
Lincoln Pacific Builders $137,200
California Professional Engineering Inc.$142,991
Christopher R.Morales,Inc.$149,978
Freeway Electric,Inc.$154,451
Steinv &Company,Inc.$155,000
Terno Inc.$156,683
C.T.&F,Inc.$166,830
Republic ITS $172,100
Staff has verified Lincoln Pacific's references and found their past performance on jobs
of similar size and scope to be satisfactory.Lincoln Pacific's bid documents,bonds,and
DBE documents are in order and their contractor's license is current.
This project will be the first project for Lincoln Pacific in Rancho Palos Verdes.
However,based on their references,they have successfully completed similar projects
in South Gate,Glendale and Pasadena within the last 5 months ..
ALTERNATIVE
An alternative recommendation is to reject all construction bids and re-advertise the
construction project.
CONCLUSION
Adopting staff's recommendation will award a construction contract to Lincoln Pacific
Builder's.Construction is expected to begin at the beginning of October 2010 and be
completed by January 2011.
FISCAL IMPACT
The recommended action will result in a total project expenditure of $150,920.Funding
for the project is included in the Roadway Infrastructure Program of the FY 10-11
Budget.
The City Attorney has reviewed and approved the standard construction contract and
project specifications.
Attachments:Contract Agreement
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CITY OF RANCHO PALOS VERDES
CONTRACT FOR:
CRENSHAW BOULEVARD AT CRESTRIDGE ROAD
TRAFFIC SIGNAL UPGRADE
FEDERAL PROJECT NO.HSIPL-5413(008)
THIS AGREEMENT ("Agreement")is made and entered this 7th day of September,2010,by and
between the CITY OF RANCHO PALOS VERDES,hereinafter referred to as "City,"and Lincoln Pacific
Builders hereinafter referred to as "Contractor."
WITNESSETH:
WHEREAS,Contractor and Contractor's Surety are providing the bonds attached hereto and incorporated
by this reference,and
WHEREAS,City desires to contract with Contractor to perform the services detailed in this contract,
including the Proposal,and
WHEREAS,Contractor has represented that it is fully qualified to assume and discharge such
responsibility;
NOW,THEREFORE,the parties hereto do agree as follows:
1.Scope of Services.City hereby employs Contractor to perform the work and provide the services and
materials for the project identified as:CRENSHAW BOULEVARD AT CRESTRIDGE ROAD
TRAFFIC SIGNAL UPGRADE,FEDERAL PROJECT NO.HSIPL-5413(008),as described in the
Plans and Specifications,attached hereto and incorporated herein by this reference,including
miscellaneous appurtenant work.Such work shall be performed in a good and workmanlike manner,
under the terms as stated herein and in these Plans and Specifications,and in accordance with the
latest edition of the Joint Cooperative Committee,Southern California Chapters of the American
Public Works Association and the Associated General Contractors of America,document entitled
"Standard Specifications,"which is incorporated herein by this reference.In the event of any conflict
between the terms of this Agreement and any of the above-referenced documents,the terms of this
Agreement shall be controlling.
2.Compensation.In consideration of the services rendered hereunder,Contractor shall be paid
according to the prices as submitted on the Bid Sheet of the Proposal,attached hereto and
incorporated herein as a part of these Plans and Specifications,and in accordance with the Special
Provisions within the Plans and Specifications.
3.Time.Time is of the essence in the performance of all services under this Agreement.
4.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;Payment Bond
(Labor and Materials);Performance Bond;Workers'Compensation Certificate of Insurance;
Additional Insured Endorsement (Comprehensive General Liability);Additional Insured
Endorsement (Automobile Liability);and Additional Insured Endorsement (Excess Liability).
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5.Audit.The City shall have the option of inspecting and/or auditing all records and other written
materials used by Contractor in preparing its billings to the City as a condition precedent to any
payment to Contractor.Contractor will promptly furnish documents requested by the City.
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.
6.Debarment.Contractor is aware of California Labor Code Sections 1777.1 and 1777.7,which prohibit
Contractor or any subcontractors who have been found by the Labor Commissioner or the Director of
Industrial Relations to be in violation of certain provisions of the Labor Code,from bidding on,being
awarded,or performing work as a contractor or subcontractor on a public works project for specified
periods of time.Contractor is also aware of all federal provisions regarding certification,debarment,
suspension,ineligibility and voluntary exclusion,as explained in pages F-17,F-18 and F-23 of the
Federal Requirements section of the Plans and Specifications.Contractor understands that in the
event of a conflict between these federal and state provisions,the more stringent of the two will
prevail.
7.Location of Existing Elements.Pursuant to Government Code Sections 4216 to 4216.9,the methods
used and costs involved to locate existing elements,points of connection and all construction
methods are Contractor's sole responsibility.Accuracy of information furnished,as to existing
conditions,is not guaranteed.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 frrm(s),and/or utilizing potholes,specialized locating
equipment and/or hand trenching.
8.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.Sec.15)or under the Cartwright Act (Chapter 2 (commencing with
Section 16700)of Part 2 of Division 7 of the California Business and Professions Code)arising from
purchases of goods,services,or materials pursuant to the Agreement.This assignment shall be made
and become effective at the time the City tenders fmal payment to Contractor without further
acknowledgment by the parties.
9.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 or subcontractors,except as set forth herein and in
any documents specifically incorporated into his Agreement,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 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 subcontractors,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 fees due to
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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.
10.Termination.This Agreement may be canceled by City at any time with or without cause and 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.
11.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 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."
12.Prevailing Wages.Contractor acknowledges the provisions of the State Labor Code requiring every
employer to be insured against liability for workers'compensation,or to undertake self-insurance in
accordance with the provisions of that code and certifies compliance with such provisions.
Contractor further acknowledges the provisions of the State Labor Code requiring every employer to
pay at least the minimum prevailing rate of per diem wages for each craft,classification,or type of
workman needed to execute this contract.The document titled "Agreement to Comply with
California Labor Law Requirements"is attached hereto and incorporated herein by this reference.
Contractor further acknowledges that this is a federally assisted construction contract and that federal
labor standards provisions,including prevailing wage requirements of the Davis-Bacon and Related
Acts,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 (~!Vailable 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/DLSRlPWD/index.htm).the higher of the two will prevaiL
13.Federal Requirements.The Federal Requirements section of the Plans and Specifications, including
the cover page and pages F-1 through F-38,is attached and incorporated as a portion of those Plans
and Specifications,and thus all required federal contract provisions are integrated into this
Agreement.Additionally,all of the following documents are attached hereto and incorporated herein
by this reference:Contracting with Small Business Minority Firms,Women's Business Enterprise
and Labor Surplus Area Firms;Form WH 347 -Payroll (for Contractor's Optional Use);and Federal
Non-Discrimination Provisions.Contractor will adhere to all federally-required contract provisions.
Contractor understands that in the event of a conflict between any federal and state provisions
regarding the same issue,the more stringent of the two will prevaiL
14.Force Majeure.Neither party shall be considered in default of any of its obligations under this
Agreement when a failure of performance shall be due to an uncontrollable force.The term
"uncontrollable force"shall mean flood,earthquake,storm,fire,lightning,epidemic,war,riot,civil
disturbance or disobedience,federal, state,or municipal action,statute,ordinance,or regulation,
embargoes of the United States Government or any other government,which by exercise of due
diligence such party could not reasonably have been expected to avoid and by exercise of due
diligence has been unable to overcome.Either party rendered unable to fulfill any of its obligations
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under this Agreement by reason of an uncontrollable force shall give written notice within five (5)
business days of such fact to the other party and shall exercise due diligence to remove such inability
with all reasonable dispatch.
15.Governing Law and Venue.Should either party to this Agreement bring legal action against the
other,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 oflaw rules.Venue
for any such action relating to this Agreement shall be in the Los Angeles County Superior Court.
16.Attorneys'Fees.If any legal action or other proceeding,including action for declaratory relief,is
brought for the enforcement of this Agreement or because of an alleged dispute,breach,default or
misrepresentation in connection with this Agreement,the prevailing party shall be entitled to recover
reasonable attorneys'fees,experts'fees,and other costs,in addition to any other relief to which the
party may be entitled.
17.Third-Party Claim.Pursuant to Public Contract Code Section 9201,the City has full authority to
compromise or otherwise settle any claim relating to this Agreement at any time.The City shall
timely notify Contractor of the receipt of any third-party claim relating to the Agreement.The City
shall be entitled to recover its reasonable costs incurred in providing the notification required by
Public Contract Code Section 9201 (b).
18.Authority to Execute this Agreement.The person or persons 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
under this Agreement.
19.Titles.The titles used in this Agreement are for convenience only and shall in no way defme,limit or
describe the scope or intent of this Agreement or any part of it.
20.Entire Agreement.This Agreement, including any other documents incorporated herein by reference,
represents the entire integrated agreement between the City and Contractor and supersedes all prior or
contemporaneous negotiations,representations,agreements,understandings and statements,written
or oral.This Agreement may only be modified or amended,or provisions or breach may be waived,
by written agreement signed by both parties.
21.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 that portion of the Agreement.
22.Non-waiver of Terms,Rights and Remedies.Waiver by either party of anyone 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.
23.Severability.Whenever possible,each provision of this Agreement shall be interpreted in such a
manner as to be valid under applicable law.If any term or portion of this Agreement is determined by
a court of competent jurisdiction to be invalid,void,illegal,or unenforceable,the remaining
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City Clerk
provisions of this Agreement shall nevertheless continue in full force and effect and shall in no way
be affected,impaired or invalidated.
IN WITNESS WHEREOF,the parties hereto have executed the within Agreement the day and year fIrst
above written.
CITY OF RANCHO PALOS VERDES
By:_
Mayor
ATTEST:
By:_
CONTRACTOR:
By:_
Printed Name Date
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CITY OF RANCHO PALOS VERDES
INSTRUCTIONS FOR EXECUTION OF INSTRUMENTS
TillS IS INSTRUCTION ONLY -IT IS NOT TO BE SIGNED OR USED IN CONJUNCTION WITH
THE AGREEMENT OR ANY OTHER FORMS THAT MUST BE TURNED INTO THE CITY OF
RANCHO PALOS VERDES -IT IS SIMPLY A FORMAT TO USE WHEN FILLING OUT
DOCUMENTS.
1.By an Individual.The individual must sign the instrument,and if he/she is doing business under
a fictitious name,the fictitious name must be set forth.The signature must be acknowledged
before a Notary Public,using the proper form of acknowledgment.
2.By a Partnership.The name of the partnership must be set forth followed by the signatures of
less than all of the partners will be acceptable only if submitted with evidence of authority to act
on behalf of the partnership.The signatures must be acknowledged before a Notary Public,using
the proper form of acknowledgment.
3.By a Corporation.The name of the corporation must be set forth,followed by the signatures of
the President or Vice President and Secretary or Assistant Secretary.The signatures must be
acknowledged before a Notary Public,using in substance the following form of acknowledgment.
4.By a Surety.The name of the surety must be set forth,followed by an authorized signature.The
signatures must be acknowledged before a Notary Public,using the proper form of
acknowledgment.
STATEOF .)
)SS.
COUNTY OF .)
On 20 __,before me,
personally appeared ,
who proved to me on the basis of satisfactory 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 hislher/their authorized
capacity(ies),and that by hislher/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 signature and seal.
(seal)
Notary Public
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INSURANCE REQUIREMENTS FOR CITY OF RANCHO PALOS VERDES
PUBLIC WORKS CONTRACT
The Contractor shall at all time during the term of this Agreement carry,maintain,and keep in full force
and effect,with an insurance company admitted to do business in California and approved by the City (1)
a policy or policies of broad-form comprehensive general liability insurance with minimum limits of
$5,000,000.00 combined single limit coverage against any injury,death,lose,or damage as a result of
wrongful or negligent acts by the Contractor,its officers,employees,agents,and independent contractors
in performance of services under this Agreement;(2)property damage insurance with a minimum limit of
$1,000,000.00;(3)automotive liability insurance with a minimum combined single limits coverage of
$5,000,000.00;and (4)workers'compensation insurance with a minimum limit of $1,000,000.00 or the
amount required by law,whichever is greater.The City,its officers,employees,attorneys,and volunteers
shall be named as additional insured on the policy(ies)as to comprehensive general liability,property
damage,and workers'compensation coverages.
1.Acceptable insurance coverage shall be placed with carriers admitted to write insurance
in California,or carriers with a rating of,or equivalent to,A:VII by A.M.Best &
Company.Any deviation from this rule shall require specific approval,in writing,from
the City.
2.All insurance policies shall provide that the insurance coverage shall not be non-renewed,
canceled,reduced,or otherwise modified (except through addition of additional insured
to the policy)by the insurance carrier without the insurance carrier giving the City thirty
(30)days prior written notice thereof.The Contractor agrees that it will not cancel,
reduce or otherwise modify said insurance coverage.
3.The Contractor agrees that if it does not keep the aforesaid insurance in full force and
effect,and such insurance is available at a reasonable cost,the City may take out the
necessary insurance and pay the premium thereon,and the repayment thereof shall be
deemed an obligation of the Contractor and the cost of such insurance may be deducted,
at the option of the City,from payments due the Contractor.
4.The Contractor shall submit to the City (1)insurance certificates indicating compliance
with the minimum workers'compensation insurance requirements above,and (2)
insurance policy endorsements above,not less than one (1)day prior to beginning of
performance under this Agreement..Endorsements must be executed on the City's
appropriate standard forms entitled "Additional Insured Endorsement,"copies of which
are attached hereto.
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Bond No._
PAYMENT BOND
(LABOR AND MATERIALS)
KNOW ALL PERSONS BY THESE PRESENTS that:
WHEREAS the _
("Public Agency"),has awarded to _
(Name and address o/Contractor)
("Principal"),a contract (the "Contract")for the work described as follows:CRENSHAW
BOULEVARD AT CRESTRIDGE ROAD TRAFFIC SIGNAL UPGRADE,FEDERAL PROJECT NO.
HSIPL-5413(o08)
WHEREAS,Principal is required under the tenns of the Contract and the California Civil Code to secure
the payment of claims of laborers,mechanics, materialmen,and other persons as provided by law.
NOW,THEREFORE,we,the undersigned Principal,and _
(Name and address o/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 _
Dollars ($),this amount being not less than one hundred
percent (100%)of the total contract price,in lawful money of the United States of America,for the
payment of which sum well and truly to be made,we bind ourselves,our heirs,executors,administrators,
successors,and assigns,jointly and severally,fmnly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal,his,her
or its heirs,executors,administrators,successors or assigns,or subcontractors shall fail to pay any of the
persons named in Section 3181 of the California Civil Code,or any amounts due under the
Unemployment Insurance Code with respect to work or labor perfonned under the Contract,or for any
amounts required to be deducted,withheld,and paid over to the Employment Development Department
from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the
Unemployment Insurance Code,with respect to work or labor perfonned under the Contract,the Surety
will pay for the same in an amount not exceeding the penal sum specified in this bond;otherwise,this
obligation shall become null and void.
This bond shall inure to the benefit of any of the persons named in Section 3181 of the California Civil
Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond.In
case suit is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys'
fees in an amount fixed by the court.
Further,the Surety,for value received,hereby stipulates and agrees that no change,extension of time,
alteration,addition or modification to the tenns of the Contract,or of the work to be perfonned
thereunder,or the specifications for the same,shall in any way affect its obligations under this bond,and
it does hereby waive notice of any such change,extension of time,alteration,addition,or modification to
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the tenns of the Contract or to the work or to the specifications thereunder.Surety hereby waives the
provisions of California Civil Code I 2845 and 2849.
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:_
"Principal"
By:_
Its
By:_
Its
(Seal)
APPROVED AS TO SURETY AND
PRINCIPAL AMOUNT
By:_
Insurance Administrator
"Surety"
By:_
Its
By:_
Its
(Seal)
APPROVED AS TO FORM:
RICHARDS,WATSON &GERSHON
A Professional Corporation
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
person signing as attorney-in-fact must be attached.
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BondNo._
PERFORMANCE BOND
KNOW ALL PERSONS BY THESE PRESENTS that:
WHEREAS the _
("Public Agency"),has awarded to _
(Name and address a/Contractor)
("Principal"),a contract (the "Contract")for the work described as follows:CRENSHAW
BOULEVARD AT CRESTRIDGE ROAD TRAFFIC SIGNAL UPGRADE,FEDERAL PROJECT NO.
HSIPL-5413(008)
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 _
(Name and address a/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 _
Dollars ($),this amount being not less than the total contract price,in
lawful money of the United States of America,for the payment of which sum well and truly to be made,
we bind ourselves,our heirs,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,his,her
or its heirs,executors,administrators,successors or assigns,shall in all things stand to and abide by,and
well and truly keep and perform all the undertakings,terms,covenants,conditions and agreements in the
Contract and any alteration thereof made as therein provided,on the Principal's part to be kept and
performed,all within the time and in the manner therein specified,and in all respects according to their
true intent and meaning,and shall indemnify and hold harmless the Public Agency,its officers,agents,
and others as therein provided,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 and reasonable
attorneys'fees in an amount fixed by the court.
FURTHER,the Surety,for value received,hereby stipulates and agrees that no change,extension oftime,
alteration,addition or modification to the terms of the Contract,or of the work to be performed
thereunder,or the specifications for the same,shall in any way affect its obligations under this bond,and
it does hereby waive notice of any such change,extension of time,alteration,addition,or modification to
the terms of the Contract or to the work or to the specifications thereunder.Surety hereby waives the
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provisions of California Civil Code '2845 and 2849.The City is the principal beneficiary of this bond
and has all rights of a party hereto.
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:_
"Principal"
By:_
Its
By:_
Its
(Seal)
APPROVED AS TO SURETY AND
PRINCIPAL AMOUNT
By:_
Insurance Administrator
"Surety"
Its
Its
(Seal)
APPROVED AS TO FORM:
RICHARDS,WATSON &GERSHON
A Professional Corporation
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
person signing as attorney-in-fact must be attached
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WORKERS'COMPENSATION
CERTIFICATE OF INSURANCE
WHEREAS,the City of Rancho Palos Verdes has required certain insurance to be provided by:
NOW THEREFORE,the undersigned insurance company does hereby certify that it has issued the policy
or policies described below to the following named insureds and that the same are in force at this time:
1.This certificate is issued to:
City of Rancho Palos Verdes
City Hall
30940 Hawthorne Boulevard
Rancho Palos Verdes,California 90275
2.The insureds under such policy or policies are:
3.Workers'Compensation Policy or Policies in a form approved by the Insurance Commissioner of
California covering all operations of the named insureds as follows:
Policy Number Effective Date Expiration Date
4.Said policy or policies shall not be canceled,nor shall there be any reduction in coverage or limits
of liability,unless and until thirty days'written notice thereof has been served upon the City Clerk
of the City of Rancho Palos Verdes
By:_
Its Authorized Representative
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AGREEMENT TO COMPLY WITH
CALIFORNIA LABOR LAW REQUIREMENTS
[Labor Code 1720,1773.8,1775,1776,1777.5,1813,1860,1861,3700]
The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the following
provisions of California law:
1.Contractor acknowledges that this contract is subject to the provisions of Division 2,Part 7,Chapter 1
(commencing with Section 1720)of the California Labor Code relating to public works and the awarding
public agency ("Agency")and agrees to be bound by all the provisions thereof as though set forth in full
herein.
2.Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires
the payment of travel and subsistence payments to each worker needed to execute the work to the extent
required by law.
3.Contractor agrees to comply with the provisions of California 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 Agency,forfeit not more than fifty dollars ($50)
for each calendar day,or portion thereof,for each worker paid less than the prevailing rates as determined
by the Director of Industrial Relations for the work or craft in which the worker is employed for any public
work done under the contract by Contractor or by any subcontractor.
4.Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require
Contractor and each subcontractor to (1)keep accurate payroll records,(2)certify and make such payroll
records available for inspection as provided by Section 1776,and (3)inform the Agency of the location of
the records.The Contractor is responsible for compliance with Section 1776 by itself and all of its
subcontractors.
5.Contractor agrees to comply with the provisions of California Labor Code Section 1777.5 concerning the
employment of apprentices on public works projects,and further agrees that Contractor is responsible for
compliance with Section 1777.5 by itself and all of its subcontractors.
6.Contractor agrees to comply with the provisions of California Labor Code Section 1813 concerning
penalties for workers who work excess hours.The Contractor shall,as a penalty to the Agency,forfeit
twenty-five dollars ($25)for each worker employed in the execution of the contract by the Contractor or by
any subcontractor for each calendar day during which such worker is required or permitted to work more
than 8 hours in anyone calendar day and 40 hours in anyone calendar week in violation of the provisions
of Division 2,Part 7,Chapter 1,Article 3 of the California Labor Code.
7.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."
Date _
R6876-0001 \1254820vl.doc
Signature _
C-13
12-15
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
AND WAIVER OF SUBROGATION AND CONTRIBUTION
ContractJAgreementJLicense/Permit No.or description:_
Indemnitor(s)(list all names):
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,materialmen,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 ofjudgment 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 C9de 2782(b).
This indemnity is effective without reference to the existence or applicability of any insurance coverages 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.
"Indemnitor"
Name-----------------
By:_
Its
R6876-0001 \1254820vl.doc
C-14
Name _
By:_
Its
12-16
ADDITIONAL INSURED ENDORSEMENT
COMPREHENSIVE GENERAL LIABILITY
Name and address ofnamed insured ("Named Insured''):
Name and address ofInsurance Company ("Company''):
General description ofagreement(s),permit(s),licensers),and/or activity(ies)insured:
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached
(the "Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows:
1.The _
("Public Agency"),its elected officials,officers,attorneys,agents,employees,and volunteers are
additional insureds (the above named additional insureds are hereafter referred to as the "Additional
Insureds")under the Policy in relation to those activities described generally above with regard to
operations performed by or on behalf of the Named Insured.The Additional Insureds have no liability for
the payment of any premiums or assessments under the Policy.
2.The insurance coverages afforded the Additional Insureds under the Policy shall be
primary insurance,and no other insurance maintained by the Additional Insureds shall be called upon to
contribute with the insurance coverages provided by the Policy.
3.Each insurance coverage under the Policy shall apply separately to each Additional
Insured against whom claim is made or suit is brought except with respect to the limits of the Company's
liability.
4.Nothing in this contract of insurance shall be construed to preclude coverage of a claim
by one insured under the policy against another insured under the policy.All such claiills shall be
covered as third-party claims,i.e.,in the same manner as if separate policies had been issued to each
insured.Nothing contained in this provision shall operate to increase or replicate the Company's limits of
liability as provided under the policy.
5.The insurance afforded by the Policy for contractual liability insurance (subject to the
terms,conditions and exclusions applicable to such insurance)includes liability assumed by the Named
Insured under the indemnification and/or hold harmless provision(s)contained in or executed in
conjunction with the written agreement(s)or permit(s)designated above,between the Named Insured and
the Additional Insureds.
6.The policy to which this endorsement is attached shall not be subject to cancellation,
change in coverage,reduction of limits (except as the result of the payment of claims),or non-renewal
except after written notice to Public Agency,by certified mail,return receipt requested,not less than
thirty (30)days prior to the effective date thereof.In the event of Company's failure to comply with this
notice provision,the policy as initially drafted will continue in full force and effect until compliance with
this notice requirement.
7.Company hereby waives all rights of subrogation and contribution against the Additional
Insureds,while acting within the scope of their duties,from all claims,losses and liabilities arising out of
or incident to the perils insured against in relation to those activities described generally above with
C-15
R6876-0001 \1254820vl.doc
12-17
regard to operations performed by or on behalf of the Named Insured regardless of any prior,concurrent,
or subsequent active or passive negligence by the Additional Insureds.
8.It is hereby agreed that the laws of the State of California shall apply to and govern the
validity,construction,interpretation,and enforcement of this contract of insurance.
9.This endorsement and all notices given hereunder shall be sent to Public Agency at:
10.Except as stated above and not in conflict with this endorsement,nothing contained
herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to
which this endorsement is attached.
TYPE OF COVERAGES TO WHICH
THIS ENDORSEMENT ATTACHES
POLICY PERIOD
FROM/TO
LIMITS OF
LIABILITY
11.Scheduled items or locations are to be identified on an attached sheet.The following
inclusions relate to the above coverages.Includes:
°Contractual Liability
DOwners/Landlords/Tenants
°Manufacturers/Contractors
°Products/Completed Operations
°Broad Form Property Damage
°Extended Bodily Injury
°Broad Form Comprehensive
General Liability Endorsement
°Explosion Hazard
°Collapse Hazard
°Underground Property Damage
°Pollution Liability
°Liquor Liability
0 _
0 _
D ~_
12.A °deductible or °self-insured retention (check one)of $_
applies to all coverage(s)except:_
(ifnone,so state).The deductible is applicable °per claim or °per occurrence (check one).
13.This is an °occurrence or °claims made policy (check one).
14.This endorsement is effective on at 12:01 a.m.and forms a
part of Policy Number _
I,(print name),hereby
declare under penalty of peIjury under the laws of the State of California,that I have the authority to bind
the Company to this endorsement and that by my execution hereof,I do so bind the Company.
Executed ,20 _
Signature of Authorized Representative
Telephone No.:( )__
R6876-000 I\1254820v I.doc
C-16
(Original signature only;no facsimile signature
or initialed signature accepted)
12-18
ADDITIONAL INSURED ENDORSEMENT -AUTOMOBILE LIABILITY
Name and address ofnamed insured ("Named Insured"):_
Name and address ofInsurance Company ("Company''):_
General description ofagreement(s),permit(s),license(s),and/or activity(ies)insured:
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached
(the "Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows:
1.The _
("Public Agency"),its elected officials,officers,attorneys,agents,employees,and volunteers are
additional insureds (the above named additional insureds are hereafter referred to as the "Additional
Insureds")under the Policy in relation to those activities described generally above with regard to
operations performed by or on behalf of the Named Insured.The Additional Insureds have no liability for
the payment of any premiums or assessments under the Policy.
2.The insurance coverages afforded the Additional Insureds under the Policy shall be
primary insurance,and no other insurance maintained by the Additional Insureds shall be called upon to
contribute with the insurance coverages provided by the Policy.
3.Each insurance coverage under the Policy shall apply separately to each Additional
Insured against whom claim is made or suit is brought except with respect to the limits of the Company's
liability.
4.Nothing in this contract of insurance shall be construed to preclude coverage of a claim
by one insured under the policy against another insured under the policy.All such claims shall be
covered as third-party claims,i.e.,in the same manner as if separate policies had been issued to each
insured.Nothing contained in this provision shall operate to increase or replicate the Company's limits of
liability as provided under the policy.
5.The insurance afforded by the Policy for contractual liability insurance (subject to the
terms,conditions and exclusions applicable to such insurance)includes liability assumed by the Named
Insured under the indemnification and/or hold harmless provision(s)contained or executed in conjunction
with the written agreement(s)or permit(s)designated above,between the Named Insured and the
Additional Insureds.
6.The policy to which this endorsement is attached shall not be subject to cancellation,
change in coverage,reduction of limits (except as the result of the payment of claims),or non-renewal
except after written notice to Public Agency,by certified mail,return receipt requested,not less than
thirty (30)days prior to the effective date thereto.In the event of Company's failure to comply with this
notice provision,the policy as initially drafted will continue in full force and effect until compliance with
this notice requirement.
7.Company hereby waives all rights of subrogation and contribution against the Additional
Insureds,while acting within the scope of their duties,from all claims,losses and liabilities arising out of
or incident to the perils insured against in relation to those activities described generally above with
regard to operations performed by or on behalf of the Named Insured regardless of any prior,concurrent,
or subsequent active or passive negligence by the Additional Insureds.
C-17
R6876-0001 \1254820vl.doc
12-19
8.It is hereby agreed that the laws of the State of California shall apply to and govern the
validity,construction,interpretation,and enforcement of this contract of insurance.
9.This endorsement and all notices given hereunder shall be sent to Public Agency at:
City Manager
City of Rancho Palos Verdes
30940 Hawthorne Boulevard
Rancho Palos Verdes,California 90275
10.Except as stated above and not in conflict with this endorsement,nothing contained
herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to
which this endorsement is attached.
TYPE OF COVERAGES TO WHICH
THIS ENDORSEMENT ATTACHES
POLICY PERIOD
FROM/TO
LIMITS OF
LIABILITY
11.Scheduled items or locations are to be identified on an attached sheet.The following
inclusions relate to the above coverages.Includes:
I Any Automobiles
I All Owned Automobiles
I Non-owned Automobiles
I Hired Automobiles
I Scheduled Automobiles
I Garage Coverage
I Truckers Coverage
I Motor Carrier Act
I Bus Regulatory Reform Act
I Public Livery Coverage
I
I
12.A 0 deductible or 0 self-insured retention (check one)of $_
applies to all coverage(s)except:(ifnone,so state).The deductible is applicable
G per claim or G per occurrence (check one).
13.This is an 0 occurrence or 0 claims made policy (check one).
14.
Number
This endorsement is effective on at 12:01 a.m.and forms a part of Policy
I,(print name),hereby
declare under penalty of perjury under the laws of the State of California,that I have the authority to bind
the Company to this endorsement and that by my execution hereof,I do so bind the Company.
Executed ,20 _
Telephone No.:( )__
R6876-0001 \1254820v I.doc
C-18
Signature of Authorized Representative
(Original signature only;no facsimile signature
or initialed signature accepted)
12-20
ADDITIONAL INSURED ENDORSEMENT
EXCESS LIABILITY
Name and address o/named insured ("Named Insured''):
Name and address o/Insurance Company ("Company''):
General description 0/agreement(s),permit(s),license(s),and/or activity(ies)insured:
Notwithstanding any inconsistent statement in the policy to which this endorsement is attached
(the "Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows:
1.The _
("Public Agency"),its elected officials,officers,attorneys,agents,employees,and volunteers are
additional insureds (the above named additional insureds are hereafter referred to as the "Additional
Insureds")under the Policy in relation to those activities described generally above with regard to
operations performed by or on behalf of the Named Insured.The Additional Insureds have no liability for
the payment of any premiums or assessments under the Policy.
2.The insurance coverages afforded the Additional Insureds under the Policy shall be
primary insurance,and no other insurance maintained by the Additional Insureds shall be called upon to
contribute with the insurance coverages provided by the Policy.
3.Each insurance coverage under the Policy shall apply separately to each Additional
Insured against whom claim is made or suit is brought,except with respect to the limits of the Company's
liability.
4.Nothing in this contract of insurance shall be construed to preclude coverage of a claim
by one insured under the policy against another insured under the policy.All such claims shall be
covered as third-party claims,i.e.,in the same manner as if separate policies had been issued to each
insured.Nothing contained in this provision shall operate to increase or replicate the Company's limits of
liability as provided under the policy.
5.The insurance afforded by the Policy for contractual liability insurance (subject to the
terms,conditions and exclusions applicable to such insurance)includes liability assumed by the Named
Insured under the indemnification and/or hold harmless provision(s)contained in or executed in
conjunction with the written agreement(s)or permit(s)designated above,between the Named Insured and
the Additional Insureds.
6.The policy to which this endorsement is attached shall not be subject to cancellation,
change in coverage,reduction of limits (except as the result of the payment of claims),or non-renewal
except after written notice to Public Agency,by certified mail,return receipt requested,not less than
thirty (30)days prior to the effective date thereto.In the event of Company's failure to comply with this
notice provision,the policy as initially drafted will continue in full force and effect until compliance with
this notice requirement.
7.Company hereby waives all rights of subrogation and contribution against the Additional
Insureds,while acting within the scope of their duties,from all claims,losses and liabilities arising out of
or incident to the perils insured against in relation to those activities described generally above with
regard to operations performed by or on behalf of the Named Insured regardless of any prior,concurrent,
or subsequent active or passive negligence by the Additional Insureds.
C-19
R6876-0001 \1254820vl.doc
12-21
8.It is hereby agreed that the laws of the State of California shall apply to and govern the
validity,construction,interpretation,and enforcement of this contract of insurance.
9.This endorsement and all notices given hereunder shall be sent to Public Agency at:
City Manager
City of Rancho Palos Verdes
30940 Hawthorne Boulevard
Rancho Palos Verdes,California 90275
10.Except as stated above and not in conflict with this endorsement,nothing contained
herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to
which this endorsement is attached.
TYPE OF COVERAGES TO WHICH
THIS ENDORSEMENT ATTACHES
POLICY PERIOD
FROMITO
LIMITS OF
LIABILITY
°Following Form
°Umbrella Liability
0 _
11.Applicable underlying coverages:
INSURANCE COMPANY POLICY NO.AMOUNT
12.The following inclusions,exclusions,extensions or specific provisions relate to the above
coverages:
13.A °deductible or °self-insured retention (check one)of $_
applies to all coverage(s)except:_
(if none,so state).The deductible is applicable °per claim or °per occurrence (check one).
14.This is an °occurrence or °claims made policy (check one).
15.This endorsement is effective on at 12:01 a.m.and forms a part of Policy
Number _
I,(print name),hereby
declare under penalty of perjury under the laws of the State of California,that I have the authority to bind
the Company to this endorsement and that by my execution hereof,I do so bind the Company.
C-20
R6876-0001 \1254820vl.doc
12-22
Executed __,20__
Telephone No.:(.)_
R6876-000l \1254820vl.doc
C-21
Signature of Authorized Representative
(Original signature only;no facsimile signature
or initialed signature accepted)
12-23
CONTRACTING WITH SMALL BUSINESS
MINORITY FIRMS,WOMEN'S BUSINESS ENTERPRISE
AND LABOR SURPLUS AREA FIRMS
1.It is national policy to award a fair share of contracts to Small Business and Minority Firms.
Accordingly,affirmative steps must be taken to assure that Small Business and Minority
Firms are utilized,when possible,as sources of supplies,equipment,construction and
services.Affirmative steps include the following:
a.Including qualified Small Business and Minority Firms on solicitation lists.
b.Assuring that Small Business and Minority Firms are solicited whenever they are
potential sources.
c.When economically feasible,dividing total requirements into smaller tasks or
quantities so as to permit maximum Small Business and Minority Firm participation.
d.Where the requirement permits,establishing delivery schedules which will encourage
participation by Small Business and Minority Firms.
e.Using the services and assistance of the Small Business Administration and the
Minority Business Development Agency of the Department of Commerce,as required.
f.If any subcontracts are to be let,requiring the prime contractor to take the affirmative
steps in 1a through 1e above.
2.Grantees shall take similar appropriate affirmative action in support of Women's Business
Enterprises.
3.Grantees are encouraged to procure goods and services from Labor Surplus Areas.
12-24
u.s.Department of Labor
Employment Standards Administration
Wage and Hour Division
PAYROLL
(For Contractor's Optional Use;See Instructions at www.dol.gov/esalwhd/formslwh347instr.htm)
Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.
5IIHa
u.s.Wage and Hour Dl.1sion
Rev.Dec.2008
NAME OF CONTRACTOR 0 OR SUBCONTRACTOR 0 ADDRESS I OMS No.:1215-0149
Expires:12/31/2011
PAYROLL NO.I FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO.
(1)(2)(3)(4)DAY AND DATE (5)(6)(7)(9)
(8)
DEDUCTIONS
NET
NAME AND INDIVIDUAL IDENTIFYING NUMBER "-GROSS WITH-WAGES
(e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY 0 WORK TOTAL RATE AMOUNT HOLDING TOTAL PAIDciNUMBER)OF WORKER z CLASSIFICATION HOURS WORKED EACH DAY HOURS OF PAY EARNED FICA TAX OTHER DEDUCTIONS FOR WEEK
0 1/s
0 /s
0 /s
0 /s
0 /s
0 /s
0 /s
0 1/s
While completion of Form WH-347 is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.§§3.3,5.5(a).The Copeland Act
(40 U.S.C.§3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee during the preceding week."U.S.Department of Labor (DOL)regulations at
29 C.F.R.§5.5(a)(3)(II)reqUire contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed "Statement of Compliance"indicating that the payrolls are correct and complete and that each laborer
or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits.
Public Burden Statement
We estimate that is wili take an average of 55 minutes to complete this collection,inclUding time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reVieWing the collection of information.If you have
any comments regarding these estimates or any other aspect of this collection,Including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room S3502,200 Constilution Avenue,N.W.
Washington,D.C.20210
(over)
1
2
-
2
5
(1)That I payor supervise the payment of the persons employed by
in addition to the basic hourly wage rates paid to each laborer or mechanic listed in
the above referenced payroll,payments of fringe benefits as listed in the contract
have been or will be made to appropriate programs for the benefit of such
employees,except as noted in section 4{c)below.
Date _
I,~:_:__-_:_:::_:__~____:=__:_:_--------------::::c-:-:-----
(Name of Signatory Party)(Title)
do hereby state:
-----------"""'7..__-.---.-;::;-.----.-..,.--.--------------on the
(Contractor or SUbcontractor)
____________-,-;that during the payroll period commencing on the
(Building or Work)
____day of ' 'and ending the day of , ,
all persons employed on said project have been paid the full weekly wages eamed,that no rebates have
been or will be made either directly or indirectly to or on behalf of said
__________---::::--:---:-_--:::-:-_-:----:--:-from the full
(Contractor or Subcontractor)
weekly wages earned by any person and that no deductions have been made either directly or indirectly
from the full wages earned by any person,other than permissible deductions as defined in Regulations,Part
3 (29 C.F.R.Subtitle A),issued by the Secretary of Labor under the Copeland Act,as amended (48 Stat.948,
63 Start.108,72 Stat.967;76 Stat.357;40 U.S.C.§3145),and described below:
(2)That any payrolls otherwise under this contract required to be submitted for the above period are
correct and complete;that the wage rates for laborers or mechanics contained therein are not less than the
applicable wage rates contained in any wage determination incorporated into the contract;that the
classifications set forth therein for each laborer or mechanic conform with the work he performed.
(3)That any apprentices employed in the above period are duly registered in a bona fide
apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of
Apprenticeship and Training,United States Department of Labor,or if no such recognized agency exists in a
State,are registered with the Bureau of Apprenticeship and Training,United States Department of Labor.
(4)That:
(a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS,FUNDS,OR PROGRAMS
D
(b)WHERE FRINGE BENEFITS ARE PAID IN CASH
D -Each laborer or mechanic listed in the above referenced payroll has been paid,
as indicated on the payroll,an amount not less than the sum of the applicable
basic hourly wage rate plus the amount of the required fringe benefits as listed
in the contract,except as noted in section 4{c)below.
(c)EXCEPTIONS
EXCEPTION (CRAFT)EXPLANATION
REMARKS:
NAME AND TITLE SIGNATURE
THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR
SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION.SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE
31 OF THE UNITED STATES CODE.
1
2
-
2
6
FEDERAL NON-DISCRIMINATION PROVISIONS
Contractors shall comply with all relevant requirements of the following federal laws and regulations dealing with
discrimination in federally assisted programs:
A.Titles VI and VII of the Civil Rights Act of 1964 (42 U.S.C.20000d),as amended by the Equal
Employment Opportunity Act of 1972,which provide that no person shall,on the ground of race,color,
national origin,or sex,be excluded from employment or participation in,be denied the benefits of,or be
subjected to discrimination under any program or activity receiving federal financial assistance.
B.Section 109 of Title I ofthe Housing and Community Development Act of 1974,as amended
(42 U.S.C.5309)and regulations at CFR 570.602 which provide that no person shall on the grounds of
race,color,national origin,or sex,be excluded from participation in,be denied the benefits of,be denied
employment in,or be subjected to discrimination under any CDBGIHOME program or activity.
C.Section 504 of the Rehabilitation Act of 1973,as amended,(29 U.S.C.794)which provides that no
otherwise qualified handicapped individual shall,solely by reason of his/her handicap,be excluded from the
participation in,be denied the benefits of,be denied employment in,or be discriminated against under any
program or activity receiving federal assistance,and Section 503 of the Rehabilitation Act of 1973,
which provides for affirmative action to employ and advance qualified disabled people
D.Age Discrimination Act of 1975,as amended (42 U.S.C.6101)which provides that no person shall,on
the basis of age,be excluded from participation in,be denied the benefits of,or be subjected to discrimination
under any program or activity receiving federal assistance.
E.Americans with Disabilities Act of 1990,as amended,(42 U.S.C.12101)and regulations at 28
CFR Part 35 and 29 CFR Title 1630,which provides prohibits discrimination based on disability,and
Architectural Barriers Act of 1968,which requires buildings assigned for public use to be designed,
constructed and altered so as to be accessible to and usable by persons with physical disabilities.
F.Executive Order 11246,as amended by Executive Order 12086,and regulations in 41 CFR 60,
which provides that no person shall be discriminated against on the basis of race,color,religion,sex,or national
origin in all phases of employment during the performance of federally-assisted construction contracts and
subcontracts.Contractors and subcontractors shall take affirmative action to ensure fair treatment in
employment,including recruitment,training,promotion,demotion,transfer,layoff,termination,and pay.
1.The Contractor will not discriminate against any employee or applicant for employment because of race,
color,religion,sex,or national origin.The Contractor will take affirmative action to ensure that applicants
are employed,and that employees are treated during employment,without regard to their race,color,
religion,sex,or national origin.Such action shall include,but not be limited to the following:Employment,
upgrading,demotion,or transfer;recruitment or recruitment advertising;layoff or termination;rates of pay
of other forms of compensation;and selection for training,including apprenticeship.The Contractor agrees
to post in conspicuous places,available to employees and applicants for employment,notices to be
provided by the contracting officer setting forth the provisions in this nondiscrimination clause.
2.The Contractor will,in all solicitations or advertisement for employees placed by or on behalf of the
Contractor,state that all qualified applicants will receive consideration for employment without regard to
race,color,religion,sex or national origin.
3.The Contractor will send to each labor union or representative of workers with which he has a collective
bargaining agreement or other contract or understanding,a notice,to be provided by the agency contracting
officer,advertising the labor union or worker's representative ofthe Contractor's commitments under
section 202 of Executive Order 11246 of September 24,1965,and shall post copies of the notice in
conspicuous places available to employees and applicants for employment.
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4.The Contractor will comply with all provisions of Executive Order No.11246 of September 24,1965,and
of the rules,regulations,and relevant orders of the Secretary of Labor.
5.The Contractor will furnish all information and reports required by Executive Order No.11246 of
September 24,1965,and by the rules,regulations,and orders of the Secretary of Labor,or pursuant thereto,
and will permit access to his books,records,and accounts by the contracting agency and the Secretary of
Labor for purposes of investigation to ascertain compliance with such rules,regulations and orders.
6.In the event of the Contractor's noncompliance with the nondiscrimination clauses of this contract or with
any of such rules,regulations,and orders,this contract may be canceled,terminated,or suspended in whole
or in part and the Contractor may be declared ineligible for further Government contracts in accordance
with procedures authorized in Executive Order 11246 of September 24,1965,or by rule,regulation,or
order of the Secretary of Labor,or as otherwise provided by law.
7.The Contractor will include the provisions of paragraphs (1)through (7)in every subcontract or purchase
order unless exempted by rules,regulations or orders of the Secretary of Labor issued pursuant to Section
204 of Executive Order No.11246 of September 24,1965,so that such provisions will be binding upon
each subcontractor or vendor.The Contractor will take such action with respect to any subcontractor or
purchase order as the contracting agency,and may direct the subcontractor or vendor as a means of
enforcing such provisions including sanctions for noncompliance.Provided,however,that in the event the
contract becomes involved in,or threatened with,litigation with a subcontractor or vendor as a result of
such direction by the contracting agency,the Contractor may request the United States to enter into such
litigation to protect the interest of the United States.
2
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