Loading...
HomeMy WebLinkAboutR. Burke CorporationBID FORMS All bid forms must be completed and submitted with your bid. Failure to submit these forms and required bid bond is cause to reject the bid as nonresponsive. Staple all bid forms together. THE UNDERSIGNED, agrees that they have carefully examined- 1. the location of the proposed work 2. the plans and specifications 3. read the accompanying instructions to bidders and propose to furnish all: 4. materials 5. labor to complete all the required work satisfactorily in compliance with 6. plans 7. specifications 8. special provisions for the prices set forth in the bid item list: BID ITEM LIST FOR 2022 PEDESTRIAN CROSSING IMPROVEMENTS, Specification No. 1000069 Item Item Unit of Estimated Item Price Total No. SS(1) Description Measure Quantity in figures) in figures) 1 7,12 Traffic Control Plan and LS 1 --_ :3120,000.00 Implementation 2 15 Regrade Brick Pavers to LS 1 -_- $4,000.00 Finished Sidewalk Grade 3 15,73 Remove Concrete & Cobble SF 110 '$35.00 $3,850.00 Median - South St 4 15,19 Roadway Excavation - South St CY 2 '$3,000.00 $6,000.00 Median 5 39 Class 2 Aggregate Base - South CY 4 $800.00 $3,200.00 St Median 6 39 Hot Mixed Asphalt Paveout - TON 3 $1,500.00 $4,500.00 South St Median 7 15 Remove and Dispose of Existing EA 1 — :$1,600.00 Bench 8 15,73 Concrete Curb — South Street LF 10 440.00 $4,400.00 Median Concrete Cross Gutter Concrete Curb and Gutter SF 9 15,73 400 $138.00 '$55,200.00 10 9 15, LF 40 '$120.00 :$4,800.00 73 Allowance Concrete Sidewalk Allowance 11 973 ' SF 250 '$28.00 $7,000.00 12 15,73 Bike Ramp - King St & Meadow LS 1 _ '$4,500.00 Park (L1) 13 15,73 Curb Ramp 1 - Broad St & Islay 1 -- '$31,000.00 St SE Corner (1-2)LS BID FORMS A BID FORMS Item No. SS(1) 14 15,73 15 15,73 16 15,73 17 15,73 18 15,73 19 15 20(S) 21(S) 82,86 82,86 22(S) 82,86 23(S) 82,86 84 24 25 84 26 84 27 84 28 84 29 84 30 84 31 84 32 84 33 84 34 84 35 84 36 84 37 84 38 84 39 84 40 84 Item Unit of Estimated Item Prices Total Description Measure Quantity in fi ures in fi un Curb Ramp 2 - Broad St & Islay LS 1 _.,_ '$25,000.00 St SW Corner L2 Curb Ramp 3 - Broad St & Islay LS 1 $30,000.00 St NW Corner (L2) Curb Ramp 1 - Johnson Ave & LS 1 ___ $30,000.00 Sydney St SW Corner (L4) LS Curb Ramp 2 - Johnson Ave & 1 ___ $30,000.00 Sydney St SE Corner (L4) Remove and Replace ADA EA 2 $1,500.00 $3,000.00 Tactile Pad - King St & South St Relocate Water Meter EA 1 .__ $7,000.00 RRFB System - Broad St & Islay LS 1 _ :$35,000.00 St(L2) RRFB System - Kings St & LS 1 __ '$45,000.00 South St (L3) RRFB System - Johnson Ave & LS 1 ___ :$43,000.00 Sydney St L4 RRFB System - Osos St & Islay $35,000.00 St (L10) LS 1 --- Remove Thermoplastic Traffic LS 1 _ $40,000.00 Stripe & Markings Thermoplastic - 12" White LF 56 '$8.00 $448.00 Thermoplastic —White Hi-Vis LF 170 '$36.00 $6,120.00 Crosswalk Thermoplastic — Detail 39 LF 149 1$12.00 $1,788.00 Thermoplastic — Detail 39A LF 232 '$9.00 '$2,088.00 Thermoplastic — Pavement '$38.00 $5,396.00 Markings/Legends (Arrows, SF 142 Words, Symbols, etc.) Traffic Paint —12" Yellow LF 142 $12.00 $1,704.00 Diagonal Traffic Paint — 4" White LF 223 $3.00 $669.00 Channelizing Lines Traffic Paint - Yellow Hi-Vis LF 75 $30.00 ' 2,250.00 Crosswalk Traffic Paint - Detail 25 LF 410 '$4.00 $1,640.00 Traffic Paint - Detail 29 LF 712 `$4.50 $3,204.00 Traffic Paint - Detail 32 LF 3,823 $1.50 $5,734.50 Traffic Paint - Detail 38 LF 50 $3.00 '$150.00 Traffic Paint - Detail 39 LF 3207 $1.00 33,207.00 Traffic Paint - Detail 39A LF 619 $2.00 $1,238.00 Traffic Paint - Bike Buffer LF 6,564 $3.50 '$22,974.00 Traffic Paint — Pavement l� $4.00 $4,936.00 Markings/Legends (Arrows, SF 1,234 Words, Symbols, etc.) BID FORMS B BID FORMS Item No. SS(1) Item Description Unit of Measure Estimated Quantity Item Price in figures) Total in figures) 41 84 Red Curb Paint LF SF _ SF 220 1,298 '$3.00 $660.00 42 84 Green Bike Lane Marking SealMaster Safe Ride $22.00 '$28,556.00 43 84 Green Bike Lane Marking (Traffic Paint 4,743 '$5.00 '$23,715.00 44 82 Roadside Punch Post (12') EA 19 $280.00 $5S320.000 45 82 Roadside Punch Post (16') EA 11 $400.00 $4,400.00 46 82 S1-1 Crosswalk Sign EA 6 '$420.00 :$2,520.00 47 48 82 82 W11-2 Crosswalk Sign EA 14 $360.00 :$5,040.00 W16-7P Downward Diagonal Arrow Sign R1-5 Yield Here to Pedestrians Sign EA 20 '$225.00 '$4,500.00 49 82 EA 10 $360.00 $3,600.00 50 82 Relocate Existing Sign EA 6 $250.00 $1,500.00 51 82 Traffic Logix Rubber Flex Curb EA 40 $500.00 '$20,000.00 52 82 Flex Post White Pexco FG300 EA 10 $250.00 '$2,500.00 53 5 Relocate City Benchmark EA 2 $3,000.00 Bid Total $6,000.00 $744,907.50 Company Name: R. Burke Corporation (1) refers to section in the Standard Specifications, with modifications in the Special Provisions, that describe required work. (S) indicates specialty items of work per section 5-1.13A of the Standard Specifications. BID FORMS C BID FORMS LIST OF SUBCONTRACTORS Pursuant to Section 4100 of the Public Contracts Code and section 2-1.33C of the standard specifications, the Bidder is required to furnish the following information for each Subcontractor performing more than 1/2 percent (0.5%) of the total base bid. Do not list alternative subcontractors for the same work. Subcontracting must not total more than fifty percent (50%) of the submitted bid except as allowed in section 5-1.13 of the standard specifications. For Streets & Highways projects, subcontractors performing less than ten thousand dollars ($10,000) worth of work need not be mentioned. Subcontractors required to pay prevailing wage, must be registered with the Department of Industrial Relations pursuant to Labor Code section 1725.5 to be listed. NOTE: If there are no subcontractors, write "NONE" and submit with bid. DIR Public % of Works Address and Phone Specific Total Name Under Which Registration Number of Office, Mill or Description of Base Subcontractor is Licensed License Number Number Shop subcontract Bid Lee Wilson Electric #851738 1000007719 P.O. Box 25 RRFB System Super Seal & Stripe Arroyo Grande, CA 93421 805-489-4216 #396627 1000000752 P.O. Box 755 Traffic Markings Fillmore, CA 93016 805-524-7345 Attach additional sheets as needed. BID FORMS D BID FORMS PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In compliance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder, or any subcontractor to be engaged by the bidder, has , has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. NOTE: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In compliance -with Public Contract Code Section 10162, the Bidder must complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes, attach a letter explaining the circumstances PUBLIC CONTRACT CODE SECTION 10232 STATEMENT In compliance with Public Contract Code Section 10232, you hereby state under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against you within the immediately preceding two-year period because of your failure to comply with an order of a federal court which orders you to comply with an order of the National Labor Relations Board. LABOR CODE SECTION 1725.5 STATEMENTS The bidder has delinquent liability to an employee or the state for any assessment of back wages or related damages, interest, fines, or penalties pursuant to any final judgment, order, or determination by a court or any federal, state, or local administrative agency, including a confirmed arbitration award. Any judgment, order, or determination that is under appeal is excluded, provided that the contractor has secured the payment of any amount eventually found due through a bond or other appropriate means. BID FORMS E BID FORMS Yes No The bidder is currently debarred under Section 1777.1 or under any other federal or state law providing for the debarment of contractors from public works. Yes No NOTE: The above Statements and Questionnaire are part of the Bid. Signing this Bid on the signature portion constitute signature of this Statement and Questionnaire. Bidders- are cautioned that making a false certification may subject the certifier to criminal prosecution. BID FORMS F BID FORMS NON -COLLUSION DECLARATION I, Robert E. Burke declare that I am President of R. Burke Corporation the party making the foregoing bid that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone refrained from bidding; that 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, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that 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, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Executed on 01/26 , 2023 , in San Luis Obispo I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. (SEAL) Robert E.-Burke, Pfesident (signature and Title of Declarant) Subscribed and sworn to before me this 26th day of January 2023 SEE ATTACHED FOR NOTARY CERTIFICATE Notary Public Company Name: R. Burke Corporation BID FORMS G CALIFORNIA JURAT CERTIFICATE 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 San Luis Obispo Subscribed and sworn to (or affirmed) before me on this 26th day of Jam 2023 by Robe1-t E. B�i1rkQ proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. HELENA ELAINE QUINTANAR COMM. # 2426177 • NOTARY PUBLIC • CALIPORNIAj WITNESS MY HAND AND OFFICIAL SEAL. SANLUISOBISPOCOUNTY Comm. Ex . NOV, if, 2026 Signature of Notary Public (Notary Seal) OPTIONAL INFORMATION The jurat contained within this document is in accordance with California law. Any affidavit subscribed and sworn to before a notanj shall use the preceding wording or substantially similar wording pursuant to Civil Code sections 1189 and 8202. A jural certificate cannot be affixed to a document sent by mail or otherivise delivered to a notary public, including electronic means, whereby the signer did not personally appear before the notary public, even if the signer is known by the notarypublic. The seal and signature cannot be affixed to a document without the correct notarial wording. As an additional option an affrant can produce an affidavit on the same document as the notarial cer•lifrcate wording to eliminate the use of additional documentation. DESCRIPTION OF ATTACHED DOCUMENT Non-Collusi-on Declaration _ (Title of document) Number of Pages 2 (Including jurat) Document Date 01/26/2023 (Additional Information) CAPACITY CLAIMED BY THE SIGNER Individual _ ✓ Corporate Officer Partner Attorney -In -Fact Trustee Other: BID FORMS Bidder Acknowledgements By signing below, the bidder acknowledges and confirms that this bid is based on the information contained in all contract documents, including the notice to bidders, plans, specifications, special provisions, and addendum number(s) (Note: You are responsible to verify the number of addenda prior to the bid opening.) The undersigned further agrees that in case of default in executing the required contract, with necessary bonds, within eight days, (not including Saturdays, Sundays, and legal holidays), after having received a mailed notice that the contract is ready for signature, the proceeds of the check or bond accompanying his bid will become the property of the City of San Luis Obispo. Licensed in accordance with an act providing for the registration of contractors, License N0.264193 Expiration Date 01 /31 /2024 . The above statement is made under penalty of perjury, and any bid not containing this information "will be considered non -responsive and will be rejected" by the City. Signature of Bidder Robert E. Burke, President (Print Name and'i'itle of Bidder) DIR— Public Works Registration No: 1000007955 Business Name (DBA): R. Burke Corporation — Owner/Legal Name: Robert E. Burke _ Indicate One: ❑Sole -proprietor ❑ Partnership Corporation List Partners/Corporate Officers: Robert E. Burke, President Name Title Joanne Burke, Vice -President / Secretary - Name Title Kathy Burke, Treasurer Name Title Business Address P.O. Box 957 Street Address P.O. Box 957 Mailing Address P.O. Box 957 City, State, Zip Code San Luis Obispo, CA 93406 Phone Number 805-543-8568 Fax Number 805-543_2521- Email Address rbc _,rburkecorporation.com — Date 01 /26/2023 BID FORMS H BID FORMS Qualifications Failure to furnish complete reference information ON THIS FORM, as specified in this project's Notice to Bidders and indicated below, is cause to reject the bid. Additional information may be attached but is not a substitute for this form. Reference Number 1 Customer Name & Contact Individual City of San Luis Obispo, Brian Rodriguez Telephone & Email 805-781-7225 brodri uez slocit .com Project Name (Site Address): 2021 Downtown Pavement Improvements, Spec # 1000167 Is this similar to the project being bid Describe the services provided and how this project is similar to and did this project include flashing that which is being bid: beaco installation? Curb Ramps Yes No ❑ Flashing Beacon Installation Was�th}'� contract for a public agency? Traffic Paint ` Yes � No ❑ Date project completed: 03/2022 Reference Number 2 Customer Name & Contact Individual SUB TO - Lee Wilson Electric, Kalli Osborne Telephone & Email 805-489-4216, kalli@leewilsonelectric.com Project Name (Site Address): 91609 BroadNVoodbridge Pedestrian Hybrid Beacon (City of San Luis Obispo Project) Is this similar to the project being bid Describe the services provided and how this project is similar to and did this project include curb ramp that which is being bid: installs 'on? Curb Ramps Yes No ❑ Truncated Domes Install Median Install Was this contract for a public agent Yes No ❑ Date project completed: 08/2021 Reference Number 3 Customer Name & Contact Individual City of Lompoc, Danny Lara Telephone & Email 805-315-7864, D Lara@ci.lompoc.ca.us Project Name (Site Address): ADA Curb Ramp and Parkin Lot - Beattie Park Is this similar to the project being bid Describe the services provided and how this project is similar to and did this project involve curb ramp that which is being bid: installs ion? ADA Curb Ramp Yes No ❑ A.C. Paving Was this contract for a public agency Markings & Signs Yes No ❑ 1 Date project completed: 07/2022 BID FORMS I BID FORMS ATTACH BIDDER'S BOND TO ACCOMPANY BID Know all men by these presents: That we R. Burke Corporation , AS PRINCIPAL, and THE OHIO CASUALTY INSURANCE COMPANY AS SURETY, are held and firmly bound unto the City of San Luis Obispo in the sum of: TEN PERCENT OF AMOUNT BID Dollars ( 10% OF BID) to be paid to said City or its certain attorney, its successors and assigns; for which payment, well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors or assigns, jointly and severally, firmly by these presents: THE CONDITION OF THIS OBLIGATION IS SUCH, that if the certain bid of the above bounden PRINCIPAL to construct 2022 PEDESTRIAN CROSSING IMPROVEMENTS, SPEC NO. 1000069 (insert name of street and limits to be improved or project) dated JANUARY 26TH, 2023 is accepted by the City of San Luis Obispo, and if the above bounden PRINCIPAL , his heirs, executors, administrators, successors, and assigns shall duly enter into and execute a contract for such construction and shall execute and deliver the two bonds described within ten (10) days (not Including Saturdays, Sundays, or legal holidays) after the above bounden, PRINCIPAL has received notice by and from the said City of San Luis Obispo that said contract is ready for execution, then this obligation shall become null and void; otherwise, it shall be and remain in full force and virtue. IN WITNESS WHEREOF, we hereunto set our hands and seals this 23 day of ,IAN. 2023 Bidder Principal: R. BURKE CORPORATION Signature Date Title:Robert E. Burke, President Surety: THE OHIO CASUALTY INSURANCE COMPANY z - BRITTON CHRISTIANSEN, ATTORNEY -in -FACT Bidders signature is not required to be notarized. Surety's signature must be notariz-ed. Equivalent form may be substituted (Rev. 6.30-14) BID FORMS J This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. (n N N c _ Co iiE5cc am > CD U — Liberty mutuR SURETY Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8201903-969577 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Britton Chnstianscn; Myrna Smith; 1111hpili L. Vega; Kevin E. Vega all of the city of Covina state of California each individually if there be more than one named, its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 15th day of August , 2019 . Liberty Mutual Insurance Company 4 %HsuR 4qY INS %NSU'q The Ohio Casualty Insurance Company UP�oR0"+r9tc West American Insurance Company 1912 1919 1991 �9 r y (�$ %s w ❑ d ❑ rd�8.� ctu9�b tl H+�ASPs�a r��w*µTN�a By �k David M. Carey, Assistant Secretary State of PENNSYLVANIA County of MONTGOMERY On this 15th day of August , 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. Q'9P lr�sr _ COMMONWEALTH OF PENNSYLVANIA �>s�"l': F' C :4 r� Notarial Seal?Q%� "- (ir Teresa Paslella, Notary Public Upper Marian Twp ,Montgomery County By: My Commission Expires March 28, 2021 al Teresa Pastella, Notary Public ��RS»• Crl�` f`(oril6pt, NgpnS]MAfdp ASSCt191hn Nnt�dml This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mu Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV— OFFICERS: Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or President may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as su any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of attorney, s have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, s instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE All — Execution of Contracts: Section 5 Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 23RD day of JANUARY , 2023 . P4 INSui P01 INS& N 1NSU,pq LQRPOR�r� 1 n 912 ❑ 1919 � � 1991 � s w ❑ a ❑ By: ej'PACµVg$.dbi~ y�3�lA NPS� ,�0� 'rg M'c,AN¢ da'� Renee C. Llewellyn, Assistant 5eoretary - = E- 3w �E c a `0C) 6 -D (D M 0M O N O L 01 v� i7y� O N E (V � OM C °0 00 U r LMS-12873 LMIC OCIC WAIC Multi Co 062018 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 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 JAN 2 3 2023 before me, Kevin Vega, Notary Public Date Here Insert Name and Title of the Officer personally appeared Britton Christiansen, Attorney -in -Fact Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the personK whose nameN is/arm subscribed to the within instrument and acknowledged to me that he/sloe/RT6y executed the same in his/hvWtheir authorized capacity(te4 and that by his/he;/It e signatureN on the instrument the person(*S�, or the entity upon behalf of which the personN acted, executed the instrument. =r KEVIN EDWARD VEGA Notary Public - California Los Angeles County > Commission # 2326181 My Comm. Expires Apr 29, 2024 Place Notary Seal Above 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 ofjk,a! a Signature Si ature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Mi ©2014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907