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HomeMy WebLinkAboutJob 2. Papich Construction Company, Inc. North ChorroBID FORMS —ADDENDUM NO. 1 BID FORMS — ADDENDUM NO. 1 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: materials labor to complete all the required work satisfactorily in compliance with plans specifications special provisions for the prices set forth in the bid item list: BID ITEM LIST FOR NORTH CHORRO NEIGHBORHOOD GREENWAY, SPECIFICATION NO. 1000036 Item Item Unit of Estimated Item Price Total No. SS Description p Measure Quantity y (in figures) (in fi ures) 1 7 9, TRAFFIC CONTROL PLAN AND LS 1 flt g1wK,2� 12 IMPLEMENTATION 213-94 2 5,9 CONSTRUCTION SURVEY LS 1 -7 O&V 3 5, 9, 7 COMPLY WITH CALTRANS ENCROACHMENT PERMIT LS 1 COMPLY WITH GRANT DEED AND 4 5, 9,7 RIGHT OF WAY AGREEMENT - LS 1 000 W, 000 BIKE PATH 5 9, 15, CLEARING, GRUBBING, AND LIMB LS 1 -Ny 3F, 000 17 REMOVAL 000 6 9 15, 26,39 CHORRO STREET RECONSTRUCTION SQFT 10000 p 000 9, 15, 7 26, CLASS I BIKE PATH (OPTION 2) SQFT 6600 �jU.2� �RR►7 73.90 9, 15, 8 26, MINOR CONCRETE (SIDEWALK) SQFT 1700 73,90 9, 15, 9 26, 39, MINOR CONCRETE (CURB AND GUTTER) LF 2355 73,90 1"l BID FORMS —ADDENDUM NO. 1 A low ;v BID FORMS - ADDENDUM NO. 1 9, 15, 10 26, MINOR CONCRETE (CROSS LF 250 39, GUTTER) ^� lw r''7 VUZ �r 73,90 9, 15, 11 26, MINOR CONCRETE (DRIVEWAY SQFT 800 39, RAMPS) 30 eZ4,000 73.90 12 9, 73, 90 MINOR CONCRETE (1.25' CONCRETE BIKE MEDIAN) LF 1600 ��,1� UU�000 13 9, 73, MINOR CONCRETE (3' CONCRETE LF 1650 fig, 90 BIKE MEDIAN) 14 9, 15, , MINOR CONCRETE (SIDEWALK EA 1 73 UNDERDRAIN) 9, 15' 20, MINOR CONCRETE (ENERGY 15 , DISSIPATION STRUCTURE AND COBBLE)I EA 1 73, 9, 15' 26, STRUCTURE CONCRETE (CURB & 16 GUTTER RETAINING WALL - LF 17251 N RGp 73, 90 BROAD ST - STA 21+40 TO 23+12) 9, 15, 26, STRUCTURE CONCRETE 17 51 (RETAINING WALL - BIKE PATH - STA 1+00 TO 2+80) LF 180 Voo 73,60 9, 15, 26, STRUCTURE CONCRETE 18 51 (LANDSCAPE HIGH CURB - LF 123 73.90 CHORRO/101) 9, 15, 19 26, STRUCTURE CONCRETE (CMU EA 1 51, PILASTER - BIKE PATH) 3q1 000 73.90 20 9,37 TYPE II SLURRY SEAL SQYD 30,440 21 9, 15, BIKE LANE AND EXISTING CURB LS 1 �SIODp 37 RAMP EDGE GRIND I I(���QQO 22 9, 12 TEMPORARY STRIPING AND PAVEMENT MARKINGS LS 1 19V IODO 23 9, 15, MINOR HOT MIX ASPHALT (CASE SQFT 2,330 0- (/a 1r1x 39 1 - 10" THICK) 24 9,39EA MINOR HOT MIX ASPHALT (SPEED 7 0 0 73 HUMP -TYPE 2) r i 25 9, 15 ADJUST STORMDRAIN MANHOLE TO GRADE EA 6 Zi 16i00" 26 9, 15 ADJUST SANITARY SEWER MANHOLE TO GRADE EA 3 Z,toa ?,evo 27 9, 15 ADJUST COMMUNICATION VAULT/MANHOLE/BOX TO GRADE EA 36 2, 2 $1,000 28 9,15 ADJUST GRADE WATER VALVE TO EA 12 It, 000 1,l j pO BID FORMS -ADDENDUM NO. 1 0 BID FORMS - ADDENDUM NO. 1 29 9, 15 ADJUST WATER METER TO GRADE EA 11 I rto _��)l (q qv 30 9764, 18" HDPE STORM DRAIN PIPE LF 63 D l3,V� 31 9, 15, MINOR CONCRETE (STORMDRAIN EA 1 2 39,77 CATCH BASIN) 1f000 000 32 9 15 MINOR CONCRETE (STORMDRAIN �` 2 39,77 MANHOLE) 4,70 V rp0 33 9 64, 6" PERFORATED UNDERDRAIN LF 62 77 PIPE .30 j70 34 9, 15, MINOR CONCRETE (12" MIDSTATE EA 3 5, 77 STORMDRAIN CATCH BASIN) OW 000 35 9 15, MINOR CONCRETE (24" MIDSTATE EA 1 -1tOOv 77 STORMDRAIN CATCH BASIN) 1, 000 REMOVE AND REPLACE 36 9, 64, STORMDRAIN INLET GRATE AND EA 17 77 INSTALL FILTEREXX STORMEXX O 600 FILTER 37 9,82 12' PUNCH POST EA 45 $j 38 9,82 14' PUNCH POST EA 3 aCJ 39 9,82 1 R1-1 SIGN 18" EA 2 y0a L 00 40 9,82 R1-1 SIGN 30" EA 4 p 0 41 9,82 R1-2 SIGN 25" EA 1 1.6y -ZoD 42 9,82 R1-3P PLAQUE EA 4 taso 00 43 9,82 R4-11 SIGN EA 7 .12., 44 9,82 R5-3 SIGN EA 2 300 uCD 45 9,82 1 R7-9 SIGN EA 18 7 4f 46 9,82 R10-15 (MODIFIED) "YIELD TO EA 5 BIKE" SIGN 3� 1 47 9,82 R81 (CA) SIGN EA 3 72 5V 1,060 48 9,82 R81A (CA) SIGN EA 2 12,00 ► w 49 9,82 R81B (CA) SIGN EA 5 -2,00 1,000 50 9,82 W1-1 SIGN EA 2 ?VV30 _7DO 51 9,82 W1-2L SIGN EA 2 3l5T '100 52 9,82 W44P SIGN EA 1 . 6a 53 9,82 W11-2 SIGN EA 8 ;5 D -2�gpO 54 9,82 W16-7P SIGN EA 8 ?,o0 2,*0a 55 9,82 W84 (CA) SIGN EA 3 1 56 9.82 GREENWAY ARROW PLAQUE EA 8 A00 OOD 57 9,82 GREENWAY SIGN EA 19 0500 , 58 9, 82 PEXCO CITY POST MODEL EAC, 36" WHITE WITH 2 GREY WRAPS EA 23 59 9,82 72" WHEEL STOP EA 8 400 '3 2,00 6" YELLOW TACTILE GUIDE STRIP, 60 9,82 VANGUARD ADA SYSTEMS OR LF 82 ��D0 APPROVED EQUAL BID FORMS -ADDENDUM NO. 1 BID FORMS -ADDENDUM NO. 1 61 9, 82 EXISTING /RELOCATED SIGN EA EA 16 tolv �L,Ltap 62 9,84 CURB PAINT LF 200 LAP I 200 63 9,84 PREFORMED THERMOPLASTIC SHEETS (BROAD/MURRAY) SQFT 120 01(p I ),5" 64 9, 84 ZICLA ZEBRA CYCLE TRACK LANE SEPARATORS EA 48 (5v 65 9,84 4" YELLOW STRIPING LF 1,300 2 414 ?, 979 66 9,84 DETAIL 1 LF 2,750 1,Kv 67 9,84 DETAIL 8 LF 50 l' ov �S 68 9,84 DETAIL 22 LF 2,450 2. sv 69 9,84 DETAIL 39 LF 3,750 q 70 9,84 BIKE BUFFER LF 1,360 10 13,wo 71 9.84 BIKE BUFFER AT DRIVEWAY SQFT 1,140 10 72 9,84 HI-VIS CROSSWALK EA 35 ;500 11 73 9,84 STOP BAR LF 465 ;3 1,.3q7 74 9,84 STOP LEGEND EA 32 17,4 q, pad 75 9,84 STOP LEGEND (1/2 SCALE) EA 7 5to- �5 q-3te 76 9,84 BIKE / PED DIRECTIONAL SYMBOL EA 2 U00 j y00 77 9,84 TYPE II ARROW EA 1 ( 16P 78 9,84 TYPE IV ARROW EA 1 79 9,84 HUMP LEGEND EA 12 Soo D 80 9,84 PED LEGEND EA 2 wo Lmy 81 9,84 XING LEGEND EA 4 200 p0 82 9,84 SLOW LEGEND EA 2 1?100 83 9,84 SCHOOL LEGEND EA 4 SAP 1 000 84 9,84 TURNING BIKE BOX EA 3 LA00 I.} ?m 85 9,84 BIKE SYMBOL & ARROW EA 23 00 14. (100 86 9,84 GREENBACK CHEVRON EA 25 lit (/ 87 9,84 GREENBACK SHARROW EA 2 1, D 88 9,84 GREENWAY SYMBOL EA 22 yip 89 9,84 CASEN BIKE LANE MARKINGS LF 118 15D 90 9,84 GREEN BIKE LANE MARKINGS (CASE 2) LF 286 (�,0 91 9,84 GREEN BIKE LANE MARKINGS (CASE 3) LF 364 15D 92 9,84 GREEN SEALMASTER COLOR SAFE PAVEMENT MARKING SQFT 5,640 -1' p� gd19,16 93 9,84 YIELD LINE EA 5 jcj D 'j'fD 94 9, 84, 87 RELOCATE RRFB SOLAR CROSSWALK (RAMONA) LS 1 21� 95 9, 84, 87 RRFB SOLAR CROSSWALK (CHORRO/MILL) LS 1 BID FORMS - ADDENDUM NO. 1 0 BID FORMS - ADDENDUM NO. 1 FOOTHILL TO RAMONA BIKE PATH 96 9,86 LIGHTING / CHORRO LIGHTING / LS 1 -1 CHORRO PG&E SERVICE 97 9, 20 BENCHES (BIKE PATH & CHORRO/MOUNTAIN VIEW) EA 3p00 FOOD 98 9,20 TRASH CONTAINER (BIKE PATH) EA 2 3,6vo 7 ODz' 99 9,20 METAL PICKET FENCING (BIKE PATH) LF 136� q<</ 100 9,20 CHAINLINK FENCE (CHORRO /101) LF 297 L4 Igi0N 101 9,20 CHAINLINK GATES (CHORRO /101) EA 6 gaQ J51*0 102 9,20 SOIL PREPARATION (NON- BIORETENTION & TREE PITS) CY 130 10 (q r)Un 103 9,20 BIORETENTION SOIL MIX CY 90 7.7 104 9,20 CLASS II DRAIN ROCK TON 200 )a 7,s,, 000 105 9,20 ENERGY DISSIPATOR ROCK TON 5o 2 2fiijD 106 9,20 IRRIGATION LS 1 M ) luq.400 107 9,20 TREE WATERING BAGS (NON- �' 35 IRRIGATED TREES) Rke 3V31tp 108 9,20 PLANTING (SHRUBS - ALL AREAS) SQFT 10,672 109 9,20 PLANTING (TREES - ALL AREAS) EA 63 Ip 110 9,20 GREENWAY PLANTERS/SOIL/PLANTS EA 285 �1 `� 11$ S 111 9,20 MULCH (BIORETENTION AREAS) CY 9 112 9,20 MULCH (CONVENTIONAL PLANTING AREAS & TREES) CY 96 113 9, 20 GREENWAY PLANTERS MAINT/WATERING (1-YR) LS 1 12#�� �Z,D 114 9, 20 ESTABLISHMENT/MAINTENANCE ALL TREES & PLANTS (1 YR) LS 1 �,�, (JDd La ODd 115 9,20 HAND WATER NON -IRRIGATED EA 35 D I4,V TREES (1-YR) 116 9,20 HAND WATER NON -IRRIGATED LS 1 UNDERSTORY PLANTINGS 0-YR) 117 9, 73 CURB RAMP ALMOND -MISSION (E) LS 1 L4 I C-4.17 iQD0 1,00 118 9, 73 CURB RAMP BROAD -MISSION (E) LS 1 gZiOo C-4.16 A000 119 9, 73 CURB RAMP BROAD -MISSION (N) LS 1 0 000 ( C-4.15 . 06D 120 9,73 CURB RAMP CENTER-CHORRO LS 1 49, ODD (NE) C-4.26 KOO 121 9,73 CURB RAMP CENTER-CHORRO (NW) C-4.25 LS 1 1"i 09 i"Apo 122 9,73 CURB RAMP CENTER-CHORRO LS 1 40,00 l 000 (SE) C-4.27 123 9,73 CURB RAMP CENTER-CHORRO LS 1 L0,000 41,00D (SW) C-4.28 124 9, 73 CURB RAMP CERRO ROMAULDO- LS 1 9100 FERRINI (NW) C-4.4 t BID FORMS -ADDENDUM NO. 1 BID FORMS - ADDENDUM NO. 1 125 9, 73 CURB RAMP CERRO ROMAULDO- LS 1 NQ �O�dpG FERRINI (SE) C-4.3 pp0 126 9, 73 CURB RAMP FELTON-FERRINI LS 1 ��� 0D0 (NW) C-4.2 3�1.dD0 127 9,73 CURB RAMP FELTON-FERRINI (SW) C-4.1 LS 1 19, ODD D00 128 9,73 CURB RAMP LINCOLN-CHORRO (NE) C-4.35 LS 1 41,000 Lm,000 129 9,73 CURB RAMP LINCOLN-CHORRO LS 1 r70100 (NW) C-4.34 SU,ODd 130 9,73 CURB RAMP LINCOLN-CHORRO LS 1 D (SE) C-4.36 131 9,73 CURB RAMP LINCOLN-CHORRO LS 1 (SW) C-4.37 132 9, 73 CURB RAMP MEINEKE-BROAD (N) LS 1 C-4 8 133 9, 73 CURB RAMP MEINEKE-BROAD (S) LS 1 qI 0I1000 C-4.9 ,,Do 134 9,73 CURB RAMP MEINEKE C-4.10 LS 1 Iu,ObQ alop0 135 9, 73 CURB RAMP MILL-CHORRO (NW) C-4.46 LS 1 Ln. DDO 0,060 136 9, 73 CURB RAMP MILL-CHORRO (NE) C-4.49 LS 1 -1 � ODD - ,ODD 137 9,73 CURB RAMP MILL-CHORRO (SE) LS 1 Ro A 0 C-4.48 v ov Ao 138 9, 73 CURB RAMP MILL-CHORRO (SW) LS 1 �( Cj ��) C-4.47 000 DOD 139 9,73 CURB RAMP MISSION-CHORRO LS 1 of gZlO pp (NE) C-4.20 140 9, 73 CURB RAMP MISSION-CHORRO (NW) C-4.19 LS 1 q, l 000 LK000 141 9,73 CURB RAMP MISSION-CHORRO (SE) C-4.21 LS 1 L100DO NO,Dad 142 9,73 CURB RAMP MISSION-CHORRO LS 1 6?, ODD (SW) C-4.22 00 143 9,73 CURB RAMP MISSION BULBOUT C-4.18 LS 1 1 Qf ODD I 000 144 9,73 CURB RAMP MOUNTAIN VIEW- CHORRO (NE) C-4.30 LS 1 0,000 R,006 145 9,73 CURB RAMP MOUNTAIN VIEW- CHORRO (NW) C-4.29 LS 1 Lrr ,000 4 0d 146 9,73 CURB RAMP MOUNTAIN VIEW- CHORRO (SE) C-4.31 LS 1 wwo ow 147 9,73 CURB RAMP MOUNTAIN VIEW- CHORRO (SW) C-4.33 LS 1 ",000 ��7,(o 148 9, 73 CURB RAMP MURRAY-BROAD (E) LS 1 g56,wo KS wo C-4.12 149 9, 73 CURB RAMP MURRAY-BROAD (N) LS 1 471000 41, C-4.11 00 150 9,73 CURB RAMP MURRAY-BROAD (S) LS 1 LIO 40, D60 C-4.13 ,OUd BID FORMS -ADDENDUM NO BID FORMS - ADDENDUM NO. 1 151 9, 73 CURB RAMP MURRAY-BROAD (W) C-4.14 LS 1 3�( 6pD DDD 152 9,73 CURB RAMP PEACH-CHORRO LS 1 15 goo 91000 (SE) C-4.43 (, 153 9,73 CURB RAMP PEACH-CHORRO LS 1 Diu 154,00� (NW) C-4.45 154 9,73 CURB RAMP PEACH-CHORRO LS 1 ��. qq (SW) C-4.44 �U ow 155 9, 73 CURB RAMP PEACH-CHORRO (NE) C-4.42 LS 1 fj DDD� Ol,� 156 9,73 CURC 4 6B RAMP RAMONA-BROAD (E) LS 1 40, Dd� 40, 0DJ 157 9,73 CURB RAMP RAMONA-BROAD (W) C-4.7 LS 1 $uvo cm, bto 158 9,73 CURB RAMP RAMONA CROSSING C-4.5 LS 1 Q1, Dbp Kopp 159 9,73 CURB RAMP VENABLE-CHORRO (NE) C-4.23 LS 1 44,0D 160 9,73 CURB RAMP WALNUT-CHORRO LS 1 (SE) C-4.40 110. 0 00, 161 9, 73 CURB RAMP WALNUT-CHORRO (SE) C-4.24 LS 1 44 iold)2 A00 162 9, 73 CURB RAMP WALNUT-CHORRO LS 1 (N) C-4.38 'q(,�, 163 9,19 ROUGH GRADING CUT (BIKE PATH) CY 300 164 9,19 ROUGH GRADING CUT (STORM WATER MITIGATION AREAS) CY 200 I 3I,Ot� 165 9,77 REMOVE EXISTING MANHOLE EA 1 AND INSTALL (N) SEWER MANHOLE 166 9,77 INSTALL COATING ON (N) SEWER EA 1 N MANHOLE q �qn, 167 9,77 REMOVE EXISTING CLEANOUT EA 1 AND INSTALL (N) SEWER glODD 410DO CLEANOUT 168 9,77 REMOVE EXISTING 12" CMP AND LF 45 INSTALL (N) 12" PVC 1-49 llj j�o STORMDRAIN 169 9,77 ABANDON EXISTING SEWERLINE LF 275 AND INSTALL (N) 6" HDPE IcQ SEWERLINE , 170 9,77 CONNECT TO EXISTING SDMH EA 1 161o giew PER ENG. STD. 3540 171 9,77 CONNECT EXISTING SEWER EA 4 qI obo 2�j wo LATERAL TO SEWER MAIN 172 9,77 RE -GRADE SEWER LATERAL LF 10 BEYOND 6 FEET I I,Svti 173 9,77 REMOVE EXISTING CONCRETE LS 1 ODD OUTLET STRUCTURE �?, 01)0 $ 174 9,77 INSTALL (N) CATCH BASIN EA 1 ?�U 175 9,73 REMOVE AND REPLACE SQFT 60 SIDEWALK 1W �J,ODIU BID FORMS - ADDENDUM NO. 1 G BID FORMS - ADDENDUM NO. 1 176 9, 77 BYPASS PUMPING LS 1 1 �0r OW 30 a 177 9,77 POTHOLING LS 1 p_ Dot) -zatw Bid Total (or Base Bid) Is tjQ Company Name: Panich Construction Comnanv. Inc. (1) refers to section in the Standard Specifications, with modifications in the Special Provisions, that describe required work. Contractor shall provide a schedule of values for all LS items before or at the pre -construction meeting. BID FORMS —ADDENDUM NO. 1 H 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. Name Under Which Subcontractor is Llcensed License Number DIR Public Works Registration Number Address and Phone Specific Number of Office, Mill or Description of Shop Subcontract % of Total Base Bid 6AM, � -l1L[0� rono0r�s '►�I v� v�v Po�fi`��l n►13 n010A�6 1(7D OD 1040/- p0 1. k h (ti0 �l o -�y�v►rlmryuw,�vl ,Ic. �w, CA .fig �o a5t ����� (- �lu� �1�C1- 0 UDOO�it�i t�,{p � SiY� x� '✓1 0."1 D cT� CqQou� 37duoo 1000000)vo 2��0�. lac �fi� i`n 4.1 loor�vf �i - V - Attach additional sheets as needed. BID FORMS H 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 Works Name Under Which Registration Subcontractor is Licensed License Number Number 14 kl i, f tivn 92�1-7y I DDoOoDi-ilq 44kt-Irl`& Id rITu.v7 1gq4g_ i "k,t,J�9K 10 d a D00o qS Attach additional sheets as needed. BID FORMS H Address and Phone Number of Office, Mill or Shop PO -�v/ 20 Po -�Ox 310a3(o 1�nAXo,�Y+- a23?�r Specific Description of Subcontract -(Pdri NW J % of Total Base Bid -1.3q 2.4-7 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 1726.5 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 BID FORMS I BID FORMS 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. 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 J BID FORMS NON -COLLUSION DECLARATION Jason Papi am President Of Papich Construction Companv. Inc. , declare that 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 0,�, , 20 23 , in Arroyo Grande, CA I declare under penalty of perjury under the lams of the State of California that the foregoing is true and correct. (Signature and Title of Declarant) Subscribed and sworn to before me this day of .20 Notary Public Company Name: Papich Construction Company, Inc. BID FORMS K 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 18th day of January , 20 23 , by Jason Papich proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. ALEX JOSEPH IVERSEN Notary Public • California San Luis Obispo County t Corn misslon a 2310260 my Comm. Explfes Nov 19. 2023 (Seal) Signature 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) J�- (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 No.76705s Expiration Date 07/31/2024 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.x:�ty. Signature of Bidder Jason Papich, President (Print Name and Title of Bidder) DIR— Public Works Registration No: 1000004169 Business Name (DBA): Papich Construction Company, Inc. Owner/Legal Name: Papich Construction Company, Inc. Indicate One: ❑Sole -proprietor ❑ Partnership L(Corporation List Partners/Corporate Officers: Jason Papich, President Name Title April Papich, CEO Name Title V. Gregory Saragas, CFO/Treasurer/Secretary Name Title Business Address 398 Sunrise Terrace Street Address same as above Mailing Address same as above City, State, Zip Code Arroyo Grande, CA 93420 Phone Number 805-473-3016 Fax Number 805-473-2217 Email Address ipapich(iDpapichconstruction.com Date 01/18/2023 BID FORMS L 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 Paso Robles, Kristine Farravanti Telephone & Email 805-237-3861 kferravanti(aprcity.com Project Name (Site Address): Zones 4D & 4G Pavement Rehabilitation Project DPW 20-14 Did this project include curb ramp Describe the services provided and how this project is similar to construction? that which is being bid: Yes d No ❑ Removal and replacement of PCC curb ramps, digout repairs, placement of slurry seal, placement of hot mix aspahlt, and rubberized hot mix asphalt, Was this contract for a public agency? lowering and adjusting of utility covers, and installation of striping and Yes R( No ❑ signage Date project completed: 05/2022 Reference Number 2 Customer Name & Contact Individual City of Atascadero, Ryan Hays P.E., Telephone & Email 805-470-3456 rhayes@atascadero.org Project Name (Site Address): San Anselmo West Pavement Rehabilitation, from El Camino Real to Monterey Road Did this project include curb ramp Describe the services provided and how this project is similar to construction? that which is being bid: Yes E� No ❑ Pavement rehabilitation, inlcuding full reconstruction, and mill and overlay, 2 ADA ramp replacement, striping, markings Was this contract for a public agency? Yes Rf No ❑ Date project completed: 05/2022 Reference Number 3 Customer Name & Contact Individual City of San Luis Obispo, Hai Nguyen Telephone & Email 805-781-7108 hnguyenAsiocity.org Project Name (Site Address): South Broad Street 1m rovements Did this project include roadway Describe the services provided and how this project is similar to maintenance by slurry sealing? that which is being bid: Yes ❑ No u( Milling out to a depth of 6" and placing 6" of HMA in 2 lifts. Protection and/or adjustment of existing utility covers, upgrading of select utility frames Was this contract for a public agency? and covers, striping and markings, traffic control, and ADA ramp Yes i� No ❑ improvements Date project completed: 10/2019 BID FORMS M BID FORMS ATTACH BIDDER'S BOND TO ACCOMPANY BID Know all men by these presents: That we PARCH CONSTRUCTION COMPANY, INC , AS PRINCIPAL, and NATIONWIDE MUTUAL 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% J 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 NORTH CHORRO NEIGHBORHOOD GREENWAY dated JANUARY 26TH, 2023 (insert name of street and limits to be improved or project) is accepted by the City of San Luis Obispo, and if the above bounden PRINCIPAL I 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 12TH day of JAN. , 20 23 Bidder Principal: PARCH CONSTRUCTION COMPANY, INC. Signatj Date Title: ` )'kS i cv)T Surety: NATIONWIDE MUTUAL INSURANCE COMPANY KEVIN VEGA, ATTORNEY -in -FACT Bidder's signature is not required to be notarized, Surety's signature rrrW beorotarized. Equivalent form may be substituted (Rev. 6-30-14) BID FORMS N 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 01 /12/2023 Date personally appeared before me, PHILIP VEGA, NOTARY PUBLIC Here Insert Name and Title of the Officer KEVIN VEGA, ATTORNEY -in -FACT Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the personjq whose names) is/anti; subscribed to the within instrument and acknowledged to me that he/sie/dray executed the same in his/her their authorized capacity(lesL and that by his/her•/their.signature(% on the instrument the personNs , or the entity upon behalf of which the personN acted, executed the instrument. VEGA ' Notarybllc • Callfornia Los Angeles County CORlMISslOn rf 2327592 My Comm. Expires May 31. 2024 r 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 official seal. Signature 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: Document Date: Number of Pages: 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: ©2014 National Notary Association - www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 Power of Attorney KNOW ALL MEN BY THESE PRESENTS THAT: Nationwide Mutual Insurance Company, an Ohio corporation hereinafter referred to severally as the "Company" and collectively as "the Companies" does hereby make, constitute and appoint: PHILIP E VEGA, MYRNA F SMITH, KEVIN VEGA, BRITTON CHRISTIANSEN each in their individual capacity, its true and lawful attorney -in -fact, with full power and authority to sign, seal, and execute on its behalf any and all bonds and undertakings, and other obligatory instruments of similar nature, in penalties not exceeding the sum of UNLIMITED and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company; and all acts of said Attorney pursuant to the authority given are hereby ratified and confirmed. This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company: "RESOLVED, that the president, or any vice president be, and each hereby Is, authorized and empowered to appoint attomeys-in-fact of the Company, and to authorize them to execute and deliver on behalf of the Company any and all bonds, forms, applications, memorandums, undertakings, recognizances, transfers, contracts of indemnity, policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other writings obligatory In nature that the business of the Company may require; and to modify or revoke, with or without cause, any such appointment or authority; provided, however, that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any of said documents on behalf of the Company." "RESOLVED FURTHER, that such attorneys -In -fact shall have full power and authority to execute and deliver any and all such documents and to bind the Company subject to the terms and limitations of the power of attorney issued to them, and to affix the seal of the Company thereto; provided, however, that said seal shall not be necessary for the validity of any such documents," This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company. Execution of Instruments. Any vice president, any assistant secretary or any assistant treasurer shall have the power and authority to signor attest all approved documents. instruments, contracts, or other papers in connection with the operation of the business of the company in addition to the chairman of the board, the chief executive officer, president, treasurer or secretary; provided, however, the signature of any of them may be printed, engraved, or stamped on any approved document, contract, instrument, or other papers of the Company. IN WITNESS WHEREOF, the Company has caused this instrument to be sealed and duly attested by the signature of its officer the 20th day of August, 2021. Antonio C. Albanese, Vice President of Nationwide Mutual Insurance Company ACKNOWLEDGMENT �►�r o►tKwty�, STATE OF NEW YORK COUNTY OF NEW YORK: ss On this 20th day of August, 2021, before me came the above -named officer for the Company TT aforesaid, to me personally known to be the officer described in and who executed the preceding SEAL instrument, and he acknowledged the execution of the same, and being by me duly sworn, deposes and says, that he is the officer of the Company aforesaid, that the seal affixed �a�(eniovs aA� hereto is the corporate seal of said Company, and the said corporate seal and his signature were ��� duly affixed and subscribed to said instrument by the authority and direction of said Company. Stephanie Rubino Notary Public, Slate off New New York York � No. 02MC6270117 Ouallfied In New York County No40 Pubk Commission E>< 'res October 14 202a MY Commlaslon Explros CERTIFICATE OctuDer 19, 2oz+ I, Laura B. Guy, Assistant Secretary of the Company, do hereby certify that the foregoing is a full, true and correct copy of the original power of attorney issued by the Company; that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same has not been revoked or amended in any manner; that said Antonio C. Albanese was on the date of the execution of the foregoing power of attorney the duly elected officer of the Company, and the corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board of directors; and the foregoing power of attorney is still In full force and effect. IN WITNESS WHEREOF, I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate seal of said Company this 12ih day of January 2023 Assistant Secretary BDJ 1(08-21)00 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Luis Obispo On January 18, 2023 before me, Alex Joseph Iversen, Notary Public (insert name and title of the officer) personally appeared Jason Papich who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) ALEX n I aJOSEN NSoatnryLu1111biNpo County Commission s 2310260 My � Comm. Eaves No. 19. 2C23