BID PACKAGE FOR CONSTRUCTION ON COUNTY ROAD IN INYO COUNTY RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT BRLO-5948(001)

Transcription

1 BID PACKAGE FOR CONSTRUCTION ON COUNTY ROAD IN INYO COUNTY RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT BRLO-5948(001) On Riverside Road at the Bishop Creek Canal, approximately 1.3 miles west of the intersection of Five Bridges Road and U.S. 6, near Bishop, California FOR USE IN CONNECTION WITH FEDERALLY FUNDED LOCAL ASSISTANCE CONSTRUCTION PROJECTS ADMINISTERED UNDER THE STANDARD PLANS AND STANDARD SPECIFICATIONS, DATED MAY 2006, OF THE CALIFORNIA DEPARTMENT OF TRANSPORTATION, AND GENERAL PREVAILING WAGE RATES AND LABOR SURCHARGE AND EQUIPMENT RENTAL RATES IN EFFECT ON THE DATE THE WORK IS ACCOMPLISHED PROJECT NO. BRLO-5948(001) Inyo County Public Works Department

2 RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT PROJECT NO. BRLO-5948(001) TABLE OF CONTENTS NOTICE INVITING BIDS BID PROPOSAL FORMS Bid Proposal Form Bid Item List Designation of Subcontractors Public Contract Code Section Statement Public Contract Code Section Questionnaire Public Contract Code Section Statement Contractor s Labor Code Certification Equal Employment Opportunity Certification Non-Collusion Affidavit Debarment and Suspension Certification Non-Lobbying Certification for Federal Aid Contracts Disclosure of Lobbying Activities Instructions for Completion of Form SF-LLL, Disclosure of Lobbying Activities Local Agency Bidder DBE - Information DBE Information Good Faith Efforts Bidder s List Cashier's or Certified Check Form Bid Bond CONTRACT AND BONDS Contract Faithful Performance Bond Labor and Materials Bond

3 NOTICE INVITING BIDS FOR RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT On Riverside Road at the Bishop Creek Canal, approximately 1.3 miles west of the intersection of Five Bridges Road and U.S. 6, near Bishop, California PROJECT NO. BRLO-5948(001) JULY 2010

4 COUNTY OF INYO ROAD DEPARTMENT NOTICE INVITING BIDS PROJECT NO. BRLO-5948(001) The Inyo County Road Department is soliciting bids for: RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT The project location is briefly described below: On Riverside Road at the Bishop Creek Canal, approximately 1.3 miles west of the intersection of Five Bridges Road and U.S. 6, near Bishop, California Bid packages, which include the notice inviting bids, bid proposal forms, contract and bond forms, special provisions, and plans may be obtained only from the Inyo County Public Works Department, 168 North Edwards Street, P.O. Drawer Q, Independence, CA 93526, telephone (760) The bid packages are also available for inspection at the department offices during regular business hours. There will be a non-refundable charge of $ for hard copies of the plans and specifications. Checks are to be made out to Inyo County Public Works Department. Bid packages are also available at no charge at the County of Inyo website at Bidders who obtain bid packages over the Internet are responsible for notifying the county that they are plan holders. Bidders who do not notify the county that they are plan holders may not be notified of any addenda that are issued. If the county issues any addenda to the bid package that are not acknowledged by the bidder, the bid proposal may be rejected. Bids must be delivered in a sealed envelope clearly marked thereon with the bidder's name and address, the word BID, and the project title - RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT To be considered, bids must be received by the assistant clerk to the Inyo County Board of Supervisors, 224 N. Edwards Street (mailing address: P.O. Box N), Independence, CA at or before 3:00 P.M., on August 18, 2010 at which time they will be publicly opened and read. No oral, telegraphic, telephonic, or fax proposals or modifications will be accepted. General Work Description: The scope of work for the project generally consists of the placement and maintenance of construction area signs and road closure signs; the preparation and implementation of a storm water pollution prevention plan; setting up a canal water diversion system; removing the existing bridge superstructure, foundations, and central pier; constructing reinforced concrete footings, abutments, and wingwalls, installing a prefabricated prestressed voided slab bridge deck; installing rip-rap in the canal; importing fill for embankment construction to raise the profile of 3 canal access roads and approximately 500 linear feet of Riverside Road; installing 6 of Class 2 base on top of the fill; installing Riverside Road Bridge Replacement Project Notice Inviting Bids Page 1

5 4 of hot mix asphalt on the Class 2 base material on Riverside Road; installing shoulder backing on Riverside Road; and painting centerline striping. Bids shall conform to and be responsive to the contract documents, which include the notice inviting bids, bid proposal forms, contract and bond forms, Department of Transportation Standard Specifications, dated May, 2006, Department of Transportation Standard Plans, dated May, 2006, special provisions, project plans, and current edition of the Manual of Uniform Traffic Control Devices, and any other documents incorporated therein by reference. Bids are required for the entire work described in the contract documents. Each bid must be submitted on the bid proposal forms furnished as part of the bid package. Additional documents pertaining to the project include: Foothill Resources, Ltd. Historic Property Survey Report for the Riverside Road Bridge Replacement Project, Bishop, Inyo County, California. February Kleinfelder West, Inc. Foundation Report, Riverside Road Bridge Replacement Over Bishop Creek Canal, Bridge No. 48C-0029, Bishop, California. March 29, (Included in Quincy, 2010b.) Quincy Engineering, Inc. 2010a. Bishop Creek Canal Bridge, Bridge Design Calculations. January b. Project Report, Bishop Creek Canal Bridge on Riverside Road, Bridge No. 48C July 15, RMT, Inc. 2005a. Jurisdictional Delineation Report (Wetland Delineation), Riverside Bridge Replacement. August b. Natural Environment Study (Minimal Impacts) Riverside Bridge Replacement Project. August c. Project Description for Riverside Bridge Replacement. August These documents are available for review at the Inyo County Public Works Department. GENERAL REQUESTS FOR INFORMATION, SUCH AS HOW TO ORDER BID PACKAGES OR SOILS REPORTS, OR INFORMATION SUCH AS THE ENGINEER S ESTIMATE, PLAN HOLDERS LIST, BID RESULTS OR SUMMARIES, SUBCONTRACTOR LISTS, OR SIMILAR INFORMATION SHOULD BE DIRECTED TO THE RECEPTIONIST AT THE INYO COUNTY PUBLIC WORKS DEPARTMENT AT Technical questions related to engineering, site conditions, materials, construction methods, or testing should be directed to Lynn Flanigan of the Public Works Department at lflanigan@inyocounty.us. All Requests for Information (RFI) must be submitted by 5:00 p.m. on August 10, Submit RFIs by fax ( Attn: Lynn Flanigan) or by to lflanigan@inyocounty.us. The county will not respond to any RFIs submitted after that time. Riverside Road Bridge Replacement Project Notice Inviting Bids Page 2

6 No prebid meeting has been scheduled for this project. Bidders are encouraged but are not required to visit the project site. Each bid must be accompanied by a cashier's check, a certified check, or a bidder's bond from an admitted corporate surety on the form provided in the bid package, in an amount not less than 10% of the amount of the bid, and made payable to the County of Inyo. If the notice inviting bids and bid proposal forms require or permit each bid to include additive item prices, the amount of the bid bond or check must be not less than 10% of the amount of the bid plus all of the additive bid items. The check or bidder s bond shall be given as security that the bidder will enter into the contract with the county and furnish the required labor and materials payment bond, faithful performance bond, certificates of insurance, or other required documents, if the bid is accepted. The check or bond will be forfeited to the county if the bidder fails to timely enter into said contract or furnish the required bonds, certificates of insurance, or other required documents. The check or bidder s bond may be retained by the county for sixty (60) days or until the contract is fully executed by the successful bidder and the county, whichever occurs first. The successful bidder shall be required to furnish a faithful performance bond and a labor and materials payment bond on the forms provided in the bid package in the amount of 100% of the maximum contract amount. BUY AMERICA This project is subject to the "Buy America" provisions of the Surface Transportation Assistance Act of 1982 (Section 165), and the Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA) Sections1041(a) and 1048(a), and the regulations adopted pursuant hereto. DISADVANTAGED BUSINESS ENTERPRISE This project is subject to Title 49 CFR 26. The project has a Underutilized Disadvantaged Business Enterprise contract goal of 3.33 percent. The contractor, sub-recipient of subcontractor shall not discriminate on the basis of race, color, nation origin, or sex in the performance of the contract. The contract is subject to, and incorporates by reference, the provisions of Public Contract Code Section 22300, pursuant to which the contractor is permitted to substitute securities for earned retentions or have them placed in escrow at the contractor's expense. The contract is also subject to the State Contract nondiscrimination and compliance requirements pursuant to Government Code Section 12990, et seq. Pursuant to Section 1773 of the Labor Code, to which this contract is subject, the prevailing wage per diem rates in Inyo County have been determined by the Director of the State Department of Industrial Relations. These wage rates appear in the Department of Transportation publication entitled General Prevailing Wage Rates in effect at the time the project is advertised. Future effective wage rates, which have been predetermined and are on file with the State Department of Industrial Relations, are referenced, Riverside Road Bridge Replacement Project Notice Inviting Bids Page 3

7

8 BID PROPOSAL FORMS FOR RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT On Riverside Road at the Bishop Creek Canal, approximately 1.3 miles west of the intersection of Five Bridges Road and U.S. 6, near Bishop, California PROJECT NO. BRLO-5948(001) ENCLOSURES: JULY 2010 BID PROPOSAL FORMS Bid Proposal Form Bid Item List Designation of Subcontractors Public Contract Code Section Statement Equal Employment Opportunity Certification Certification Regarding Equal Employment Opportunity Public Contract Code Section Statement Public Contract Code Section Questionnaire Public Contract Code Section Statement Non-Collusion Affidavit Debarment and Suspension Certification Contractor s Labor Code Certification Non-Lobbying Certification for Federal Aid Contracts Disclosure of Lobbying Activities Instructions for Completion of Form SF-LLL, Disclosure of Lobbying Activities Exhibit 15-G1 - Local Agency Bidder UDBE Commitment Exhibit 15-G2 - Local Agency Bidder DBE Information Exhibit 17-O - Disadvantaged Business Enterprises (DBE) Certification Status Change Exhibit 17-F - Final Report Utilization of Disadvantaged Businesses Enterprise (DBE), First Tier Subcontractors Exhibit 12-G - Bidder s List of Subcontractors (DBE and Non-DBE) Exhibit 15-H - UDBE Information Good Faith Efforts Cashier's or Certified Check Form Bid Bond

9 BID PROPOSAL FORM To: COUNTY OF INYO Road Department 168 N. Edwards Street Independence, California (Herein called the "Owner") From: (Herein called the "Contractor"). FOR: RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT PROJECT NO. BRLO-5948(001) (Herein called Project ) Bids will be opened at 3:00 p.m. on August 18, 2010 at the assistant clerk to the Inyo County Board of Supervisor's office, 224 N. Edwards Street, Independence, CA This bid includes all costs for all labor, materials, tools, taxes, insurance, transportation, and other related functions to perform all work as required by, and in accordance with, the contract documents for the Riverside Road Bridge Replacement Project. The bidder must submit a total bid for all of the items included in the bid schedule. In submitting this bid, it is understood that: 1. The notice inviting bids; these bid proposal forms; the contract and bond forms; the special provisions; the Department of Transportation Standard Plans, dated May, 2006; the Department of Transportation Standard Specifications, dated May, 2006; the current edition of the Manual of Uniform Traffic Control Devices, and the project plans; including any documents incorporated therein, are to be considered complementary and are incorporated herein by reference and made a part hereof with like force and effect as if all of said documents were set forth in full herein. All of said documents, which include these bid proposal forms, are referred to collectively as the contract documents and shall constitute the contract between the parties that will come into full force and effect upon acceptance, approval, and execution by the Inyo County Board of Supervisors. 2. The contract for the Riverside Road Bridge Replacement Project requires the contractor to perform a complete and finished asphalt concrete resurfacing of the roadway and additional associated work. Anything necessary to complete this work properly and in accordance with the law and lawful governmental regulations, shall be performed by the contractor, whether set out specifically in the contract documents or not. 3. The bidder, if its or his/her bid is accepted, will furnish the required bonds and certificates of insurance and other required documents as described in the contract documents. In submitting this bid, the bidder has familiarized itself or himself/herself with the bid package which includes the notice inviting bids; the bid proposal forms; the contract and bond forms; the special provisions; the Page 1

10 Department of Transportation Standard Plans, dated May, 2006; Department of Transportation Standard Specifications, dated May 2006; the current edition of the Manual of Uniform Traffic Control Devices, and the project plans. Bidder further agrees in submitting this bid to perform all the work in accordance with the contract documents within 90 working days as required in Section 4, "Beginning of Work, Time of Completion and Liquidated Damages," of the special provisions. The undersigned has/have checked carefully the following figures and understand(s) that the County of Inyo will not be responsible for any errors or omissions on the part of the undersigned in making this bid. Attached as a part of this bid is a bid bond from an admitted corporate surety on the form provided in the bid package ( ), or a certified or cashier's check ( ), in an amount not less than 10% of the amount of the bid submitted, either of which it is agreed, pursuant to the notice inviting bids and the bid proposal forms, shall be forfeited to or retained by the County of Inyo if the undersigned fails to execute the contract, or furnish the required bonds, certificates of insurance, and other required documents within ten (10) calendar days after receiving the contract documents. Also attached as a part of this bid is the bid proposal form; bid item list; designation of subcontractors; Certification Regarding Equal Employment Opportunity; Public Contract Code Section Statement; Public Contract Code Section Questionnaire; Public Contract Code Section Statement; noncollusion affidavit; Contractor's Labor Code Certification; and either (a) cashier's or certified check form, or (b) bid bond form. These documents have been completed and signed as required on the forms provided in the bid package. The bidder's signature on this proposal constitutes an endorsement and execution of each and every certification and declaration that is contained in these documents, and bidder s promise to perform and abide by the terms of these documents. The meanings of words used in these bid proposal forms are the same as set forth in Section , Definitions and Terms, of the special provisions relating to this project. ACCEPTANCE: The owner reserves the right to reject this bid. However, this bid shall remain open and shall not be withdrawn for a period of sixty (60) calendar days from the date set for its opening. If written notice of the acceptance of this bid is mailed or delivered to the undersigned within sixty (60) calendar days after the date set for its opening, or at any other time thereafter before it is withdrawn, the undersigned will execute and deliver the contract, bonds, certificates of insurance, and other required documents, to the owner within eight (8) working days, not including Saturdays, Sundays, and legal holidays, after receipt of the notification of acceptance of this bid (notification of award of contract). The bidder shall set forth for each unit basis item of work an item price and a total for the item; and for each lump sum item, a total for the item; all in clearly legible figures in the respective spaces provided for this purpose. In the case of unit basis items, the amount set forth under the "Total" column shall be the extension of the item price bid on the basis of the estimated quantity for the item. The amount of the bid for comparison purposes will be the total of all items listed in the base bid schedule. In case of discrepancy between the item unit price and the total set forth for a unit basis item, the item price shall prevail, except as provided in (a) or (b), as follows: (a) If the amount set forth as an item price is unreadable or otherwise unclear, or is omitted, or is the same amount as the entry in the item "Total" column, then the amount set forth in the "Total" column for the item shall prevail and shall be divided by the estimated quantity for the item and the unit price thus obtained shall be the item price. Page 2

11 (b) (Decimal Errors) If the product of the entered item price and the estimated item quantity is exactly off by a factor of ten, one hundred, etc., or one-tenth, or one-hundredth, etc., from the entered item total, the discrepancy will be resolved by using the entered item price or item total, whichever most closely approximates percentage-wise the item price or item total in the engineer s estimate. The undersigned, as bidder, declares that the only persons or parties interested in this proposal as principals are those named herein; that this proposal is made without collusion with any other person, firm, or corporation; that he/she has carefully examined the location of the proposed work, the contract and bond forms, and the plans therein referred to; and he/she proposes, and agrees if this proposal is accepted, that he/she will contract with the County of Inyo, on the contract form provided in the bid package, to provide all necessary machinery, tools, apparatus and other means of construction, and to do all the work and furnish all the materials specified in the contract, in the manner and time therein prescribed, and according to the requirements of the engineer as therein set forth; and that he/she will take in full payment therefor the following item prices: Page 3

12 BIDDER S COMPANY NAME BID ITEM LIST RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT PROJECT NO. BRLO-5948(001) ABBREVIATIONS: LS = LUMP SUM SF = SQUARE FEET CY = CUBIC YARD LF = LINEAR FEET HMA = HOT MIX ASPHALT SY = SQUARE YARD EA = EACH LN-MI = LANE MILE TN = TON ITEM NO. SPECIAL PROVISION SECTION DESCRIPTION UNIT MEAS. EST. QUAN ITEM PRICE TOTAL DOLLARS & WATER POLLUTION CONTROL LS LUMP SUM $ $ TEMPORARY CANAL DIVERSION SYSTEM LS LUMP SUM $ $ TEMPORARY FIBER ROLL LF 1710 $ $ TEMPORARY SILT FENCE LF 1710 $ $ TEMPORARY CONCRETE WASHOUT FACILITY EA 2 $ $ CONSTRUCTION AREA SIGNS LS LUMP SUM $ $ TYPE III BARRICADE EA 18 $ $ TEMPORARY RAILING (TYPE K) LF 120 $ $ REMOVE FENCE (TYPE BW) LF 120 $ $ PREPARE CONCRETE BRIDGE DECK SURFACE SQFT 1488 $ $ BRIDGE REMOVAL LS LUMP SUM $ $ Page 4

13 BID ITEM LIST RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT PROJECT NO. BRLO-5948(001) (CONTINUED) DEVELOP WATER SUPPLY LS LUMP SUM $ $ ROADWAY EXCAVATION CY 380 $ $ 14 (F) STRUCTURE EXCAVATION (TYPE D) CY 285 $ $ 15 (F) STRUCTURE BACKFILL (BRIDGE) CY 128 $ $ IMPORTED BORROW CY 260 $ $ IMPORTED MATERIAL (SHOULDER BACKING) CY 8 $ $ DUFF SQFT 3790 $ $ EROSION CONTROL (PUNCHED STRAW) SQFT 3790 $ $ CLASS 2 AGGREGATE BASE CY 400 $ $ HOT MIX ASPHALT (TYPE A) TON 360 $ $ 22 (F) STRUCTURAL CONCRETE, BRIDGE FOOTING CY 53 $ $ 23 (F) STRUCTURAL CONCRETE, BRIDGE CY 83 $ $ (F) denotes final pay item Page 5

14 BID ITEM LIST RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT PROJECT NO. BRLO-5948(001) (CONTINUED) 24 (F) STRUCTURAL CONCRETE, APPROACH SLAB (TYPE EQ) FURNISH PRECAST PRESTRESSED CONCRETE DECK UNIT (SLAB TYPE) (40'- 50') ERECT PRECAST PRESTRESSED CONCRETE DECK UNIT CY 20 $ $ SQFT 1488 $ $ EA 8 $ $ 27 (F) FURNISH POLYESTER CONCRETE OVERLAY CF 337 $ $ 28 (F) PLACE POLYESTER CONCRETE OVERLAY SQFT 1346 $ $ JOINT SEAL (MR 1") LF 87 $ $ 30 (F) BAR REINFORCING STEEL (EPOXY COATED) (BRIDGE) LB $ $ FURNISH SINGLE SHEET ALUMINUM SIGN (0.080"- UNFRAMED) SQFT 36 $ $ ROADSIDE SIGN - ONE POST EA 4 $ $ ROCK SLOPE PROTECTION (LIGHT, METHOD B) CY 110 $ $ ROCK SLOPE PROTECTION FABRIC SQYD 335 $ $ FENCE (TYPE BW, 4-STRAND, METAL POST) LF 120 $ $ (F) denotes final pay item Page 6

15 BID ITEM LIST RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT PROJECT NO. BRLO-5948(001) (CONTINUED) DELINEATOR (CLASS 1) EA 14 $ $ OBJECT MARKER (TYPE P) EA 4 $ $ TRANSITION RAILING (TYPE WB) EA 1 $ $ ALTERNATIVE FLARED TERMINAL SYSTEM EA 1 $ $ CRASH CUSHION (QUADGUARD) EA CONCRETE BARRIER (TYPE 736) LF PAINT TRAFFIC STRIPE (2- COAT) LF MOBILIZATION LS LUMP SUM (F) denotes final pay item TOTAL BID (IN NUMBERS) TOTAL BID (IN WORDS ) REVIEWED AND CHECKED BY: (For County Use) Page 7

16 TIME OF COMPLETION: The undersigned further specifically agrees to complete all the work within ninety (90) working days as required by Section 4 of the Special Provisions. BID SECURITY: The required ten percent (10%) Bid Security for this bid is attached in the form of: (Note: Check and complete one of the following items) ( ) Bid bond issued by, an admitted corporate surety on the form provided in the bid package. ( ) Certified/cashier's check No. issued by ADDENDA: The undersigned acknowledges receipt of the following addenda and has provided for all addenda changes in this bid. (Fill in addendum numbers and dates addenda have been received. If none have been received, enter "NONE".) WARNING: IF ADDENDA HAVE BEEN ISSUED BY THE COUNTY AND NOT NOTED ABOVE AS BEING RECEIVED BY THE BIDDER, THIS PROPOSAL MAY BE REJECTED. Page 8

17 BIDDER'S BUSINESS INFORMATION: IMPORTANT NOTICE: If bidder or other interested person is a corporation, state legal name of corporation and names of the president, secretary treasurer, and manager thereof; if a copartnership or joint venture, state the true name of the firm or joint venture and the names, current addresses, and telephone numbers of all individual co-partners or joint venturers composing the partnership or joint venture; if bidder or other interested person is an individual, state first and last names in full. A. Individual ( ), Partnership ( ), Joint Venture ( ): Corporation ( ): Personal Name: Business Name: Address: Zip Code Telephone: ( ) Federal Identification No. Contractor's License No., State of, Type License Expiration Date (The above address will be used to send notice of acceptance or requests for additional information) THE UNDERSIGNED HEREBY DECLARES, UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA, THAT THE STATEMENTS MADE IN THIS BID PROPOSAL FORM, INCLUDING ALL OF THE ATTACHED STATEMENTS, DESIGNATIONS, CERTIFICATES, AND AFFIDAVITS, ARE TRUE AND CORRECT, AND THAT THEY ARE THE INDIVIDUAL, MANAGING PARTNER, OR CORPORATE OFFICER, DULY AUTHORIZED BY LAW TO MAKE THIS BID ON BEHALF OF CONTRACTOR, AND BY SIGNING BELOW DO MAKE THIS BID ON BEHALF OF CONTRACTOR ACCORDING TO ALL OF THE TERMS AND CONDITIONS SET FORTH OR REFERENCED HEREIN. (Signature of Authorized Person) (Title) (Printed Name) (Date) Page 9

18 DESIGNATION OF SUBCONTRACTORS In compliance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et. seq. of the Public Contract Code of the State of California), the undersigned bidder has set forth below the full name, and the location of the place of business of each subcontractor who will perform work or labor or render service to the prime contractor in or about the construction of the work or improvement, or a subcontractor licensed by the State of California who, under subcontract to the prime contractor, specifically fabricates and installs a portion of the work or improvement according to detailed drawings contained in the plans and specifications to which the attached bid is responsive, and the portion of the work which will be done by each subcontractor for each subcontract in excess of one-half of one percent of the prime contractor's total bid, or $10,000.00, whichever is greater. The bidder understands that if he fails to specify a subcontractor for any portion of the work to be performed under the contract in excess of one-half of one percent of his bid, or $10,000.00, whichever is greater, he shall be deemed to have agreed to perform such portion himself, and that he shall not be permitted to sublet or subcontract that portion of the work except in cases of public emergency or necessity, and then only after a finding, reduced to writing as a public record of the awarding authority, setting forth the facts constituting the emergency or necessity. If no subcontractors are to be employed on the project, enter the word "NONE". (Use additional pages if necessary) BID ITEM NO. DESCRIPTION OF WORK % OF TOTAL CONTRACT SUBCONTRACTOR S NAME, ADDRESS, AND PHONE NO. LICENSE TYPE (Signature of Authorized Person) (Printed Name) (Title) (Date) Page 10

19 PUBLIC CONTRACT CODE SECTION STATEMENT RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT In accordance with Public Contract Code Section (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has (CHECK ONE), 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 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 proposal. Signing this proposal on the signature portion thereof shall also constitute signature of this statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 11

20 PUBLIC CONTRACT CODE SECTION QUESTIONNAIRE RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT In accordance with Public Contract Code Section 10162, the bidder shall 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, explain the circumstances in the following space. By bidder's signature on the proposal, bidder certifies, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements in accordance with Public Contract Code Section are true and correct. Page 12

21 PUBLIC CONTRACT CODE SECTION STATEMENT RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT In accordance with Public Contract Code Section 10232, the contractor hereby states, under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the contractor within the immediately preceding two year period because of the contractor's failure to comply with an order of a federal court which orders the contractor to comply with an order of the National Labor Relations Board. By bidder's signature on the bid proposal form, bidder certifies, under penalty of perjury under the laws of the State of California, that the foregoing statements in accordance with Public Contract Code Section are true and correct. (Name and Title of Signer) Signature Date Company Name Business Address Page 13

22 CONTRACTOR'S LABOR CODE CERTIFICATION (Labor Code Section 3700 et seq.) RIVERSIDE ROAD BRIDGE REPLACEMENT PROJECT I am aware of the provisions of Section 3700 and following of the labor code which requires every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. (Name and Title of Signer) Signature Date Company Name Business Address Page 14

23 (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder, proposed subcontractor, hereby certifies that he has, has not, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President s Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR (b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR (b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Recipient, contractor and its subcontractors shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement. The contractor shall include the nondiscrimination and compliance provisions of this clause in all subcontracts to perform work under the contract. Page 15

24 Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares 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 shall refrain 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. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 16

25 DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; Does not have a proposed debarment pending; and Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 17

26 NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (l) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 18

27 DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a. initial b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier, if known Congressional District, if known Congressional District, if known 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable 8. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No. 10a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $ actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission a. cash d. contingent fee b. in-kind; specify: nature e deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes No 16. Information requested through this form is authorized by Title 31 U.S.C. Section This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: Standard Form LLL Rev Signature: Print Name: Title: Telephone No.: Date: Authorized for Local Reproduction Standard Form - LLL Page 19

28 INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE " 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (Ml). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and Page 20

29 completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project ( ), Washington, D.C SF-LLL-Instructions Rev «ENDIF» Page 21

30 Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY: LOCATION: PROJECT DESCRIPTION: TOTAL CONTRACT AMOUNT: $ BID DATE: BIDDER'S NAME: CONTRACT UDBE GOAL: CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS TO BE PROVIDED Cert. No. of UDBE AND EXPIRATION DATE NAME OF UDBEs DOLLAR AMOUNT (Must be certified on the date bids UDBE are opened - include UDBE address and phone number) For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Contract Award Date: Total Claimed Participation $ % Local Agency certifies that all information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code) Telephone Number: For Caltrans Review: Signature of Bidder Date (Area Code) Tel. No. Person to Contact (Please Type or Print) Print Name Signature Date Caltrans District Local Assistance Engineer Local Agency Bidder - UDBE Commitment (Rev 3/09) Distribution: (1) Copy Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. Failure to send a copy to the DLAE within 15 days of award may result in de-obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance Page 22

31 INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) ALL BIDDERS: PLEASE NOTE: It is the bidder s responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian-Pacific American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian-Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder s Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No s) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime s and subcontractors certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 23