APPENDIX D BID FORM. Any Alteration or Addition to the Bid Form May Invalidate the Bid TO: THE MAYOR AND COUNCIL MEMBERS OF THE CITY OF BEVERLY HILLS

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1 BID NO APPENDIX D BID FORM NOTE: Any Alteration or Addition to the Bid Form May Invalidate the Bid TO: THE MAYOR AND COUNCIL MEMBERS OF THE CITY OF BEVERLY HILLS The undersigned, having carefully examined the site conditions and the Contract Documents for PARKING FACILITIES WATERPROOFING PROJECT, HEREBY PROPOSES AND AGREES to commence the Work per the Agreement; to furnish all labor, materials, equipment, transportation, service, sales taxes, and other costs necessary to complete the Work in 180 calendar days from the date of Notice To Proceed, in strict conformity with the Contract Documents, at prices indicated below N. REXFORD DR PARKING STRUCTURE BID: Three Hundred Eighty Six Thousand One Hundred Dollars and 00/ CAMDEN DR. PARKING STRUCTURE BID: One Hundred Twenty Eight Thousand Three Hundred Dollars and 00/ N. CRESCENT DR. PARKING STRUCTURE BID: Three Hundred Fifty One Thousand One Hundred Dollars and 00/ N. CRESCENT DR. PARKING STRUCTURE BID: Forty Eight Thousand Two Hundred dollars and 00/ N BEDFORD DR. PARKING STRUCTURE BID: Three Hundred Fifty Four Thousand Two Hundred Dollars and 00/ BRIGHTON WAY PARKING STRUCTURE BID: One Hundred Sixty Seven Thousand Eight Hundred Dollars and 00/1 00 PROJECT: PARKING FACILITIES WATERPROOFING PROJECT APPENDIX A - E PAGE 9012

2 BID NO S. BEVERLY DR. PARKING STRUCTURE BID: One Hundred Sixty Two Thousand Dollars and 00/1 00 _Dollars $ 162, N. BEVERLY DR. PARKING STRUCTURE BID: One Hundred Ninety Seven Thousand Eight Hundred dollars and 00/100 Dollars $ 197, N. BEVERLY DR. PARKING STRUCTURE BID: Thirty Four Thousand Three Hundred dollars and 00/ UNIT PRICES Bidder agrees to perform additional work based on the unit prices listed below for quantities not listed in base bid. 2.1 UNIT PRICE NO. 1: Unit Price per lineal foot for additional crack repair. ~ Ninety Dollars and 00/1 00 $90.00 Dollars (in words- printed) Dollars (in figures) 2.2 UNIT PRICE NO. 2: Unit Price per lineal foot for additional Ureathane crack injection repair. ~ Ninety Dollars and 00/1 00 $90.00 Dollars (in words- printed) Dollars (in figures) 2.3 UNIT PRICE NO. 3: Unit Price per lineal foot for additional concrete repair. $ One Hundred and five dollars and 00/1 00 Dollars (in words.. printed) $ Dollars (in figures) 3.0 BID ALTERNATES Bidder agrees to provide an add/deduct for any or all of the Alternate items listed herein as part of the overall Work. These Alternates are shown on the Drawings, but not necessarily indicated as Alternates, and described in respective specification section. The Bidder shall guarantee the bid price(s) for the Alternative for 90 days. Prior to, that date, the City shall inform the Bidder of the City s decision to either proceed or not to proceed with either or both of the Alternatives. If the City decides to proceed with the Alternates, then the Bidder shall complete the Work as specified. A Change Order shall be executed for the alternate amount. The Bidder shall be entitled to an increase in the Contract Time, as specified in these documents. 3.1 ALTERNATE No.1: Provide a cost for Heavy Duty Traffic Deck Coating at 440 N. Camden Dr. Roof Level approximately 22,000 square feet For Bidding Purposes. One Hundred Fourteen Thousand Five Hundred dollars and 00/1 00 $114, Dollars (in words- printed) Dollars (in figures) D PROJECT: PARKING FACILfl1ES WATERPROOFING PROJECT APPENDIX A- E PAGE 10 OF 12

3 BID NO SUBCONTRACTORS: Each bid shall have listed on the form provided herewith the name and location of the place of business of each subcontractor (and the subcontractors State Contractors License Number) who will perform work or labor or render service to the bidder in or about the construction of the work or improvement1 or subcontractor licensed by the State of California who under subcontract to the bidder, will specially fabricate and install portions of the work or improvement according to detailed drawings contained in the plans and specifications in an amount in excess of 112 of 1 percent of the bidders total bid. Each bid shall also have listed on the form the portion of work which will be done by each such subcontractor. The bidder shall list only one subcontractor for each such portion of work which will be done by each subcontractor as defiuied by (he bidder In his bid. NOTICE: Penalties for violations of the Subletting and Subcontracting Fair Practices Act will be enforced by the Owner for failure to list subcontractors as provided by that act Subcontractor s name, mailing address and telephone number and State Contractor s License Number. Description of work to be subcontracted. Eberhard Sika Samafll Roofing at Elevator Raymer Street and stairways Van Nuys, CA (818) License No Blazon Industries P.O. Box 2222 Monrovia, CA (626) License No Deck coating removal and concrete surface preparation Respectively submitted, PROJECT~ PARKING FACILITIES WATERPROOFING PROJECT APPENDIX A - E PAGE 11 OF 12

4 BID NO SECTION 6: SIGNATURE PAGE AND LEGAL STATUS 6. Signature Page and Legal Status. The undersigned certifies that he is an official legally authorized to bind his firm and to enter into a contract should the City accept this proposal. Bid proposal by Western Waterproofing Company, INC. (Name of Firm) Legal status of bidder: Please check the appropriate box A. Corporation x; State of Incorporation Missouri B. Partnership_; List Names C. DBA State full name DBA D. Other _; Explain Signature of Bidder ~. ~ ~ ~.A Title Branch Manager (Au orized Signatur:~ Signature of Bidder Title Reaional Manager Address 720 E. City Anaheim Zip Telephone #( ) Signed this day of Bidder acknowledges receipt of the following Addenda: ADDENDUM NO. BIDDER S INITIALS z ~ct1 City Of Beverly Parking Facilities Waterproofing Project PAGE 12

5 BID NO NON-COLLUSION AFFIDAVIT (TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID) 4(1/ g p. State of California ) -~ ~ JANET~A i. CUEVAS COMM. # ~ ) Notary Public-California ~ I ORANGECOUNTy County of Los Angeles ) My Comm. Expires Feb 9,2016, Kristopher Houger, being first duly sworn, deposes and says that he or she is Branch Manager of Western Waterproofing Co. 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 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. (a A~.~La ~ NAME 4 Branch Manager TITLE ~ H2-o~3 DATE City Of Beverly Parking Facilities Waterproofing Project PAGE 14

6 BID NO STATEMENT ACKNOWLEDGING OBLIGATION TO COMPLY WITH CALIFORNIA LABOR LAW [Labor Code 1720, , 1775, 1776, , 1813, 1860, 1861, 3700] I, the undersigned Contractor, certify that I am aware of and will fully comply with the following provisions of California law: Contractor acknowledges that this contract is subject to the provisions of Division 2, Part 7, Chapter 1 (commencing with Section 1720) of the California Labor Code relating to public works and the awarding public agency ( Agency ) and agrees to he hound hy all provisions thereof as though set forth in full herein. Contractor agrees to comply with the provisions of California Labor Code Section which require the payment of travel and subsistence payments to each worker needed to execute the work, to the extent required by law. Contractor agrees to comply with the provisions of California Labor Code Section 1774 and 1775 concerning the payment of prevailing wages to workers and the penalties for failure to do so. Contractor shall, as a penalty to the Agency, forfeit not more than fifty dollars ($50) for each calendar day or portion thereof, for each worker paid less than the prevailing rates, as determined by the Director of Industrial Relations, for the work or craft in which the worker is employed for any public work done under the contract by Contractor or any subcontractor. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (1) keep accurate payroll records, (2) certify and make those payroll records available for inspection as provided by Section 1776, and (3) inform the Agency of the location of the records. Contractor is responsible for compliance with Section 1776, by itself and all of its subcontractors. Contractor agrees to comply with the provisions of California Labor Code Section concerning the employment of apprentices on public works projects, and Contractor further agrees that Contractor is responsible for compliance with Section and for the compliance of all of its subcontractors. Contractor agrees to comply with the provisions of California Labor Code Section 1813 concerning penalties for workers who work excess hours. Contractor shall, as a penalty to the Agency, forfeit twenty-five dollars ($25) for each worker employed in the execution of the contract by Contractor or by any subcontractor for each calendar day during which such worker was required or permitted to work more than 8 hours in any one calendar day or 40 hours in any one calendar week in violation of the provisions of Division 2, Part 7, Chapter 1, Article 3 of the California Labor Code. California Labor Code Sections 1860 and 3700, provide that every Contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861, Contractor hereby certifies as follows: I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker s compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: c~(9 2~.O fl Signature: ~L~A~A ~ City Of Beverly Parking Facilities Waterproofing Project PAGE 15

7 BID NO BID BOND WHEREAS, Western Waterproofing Company INC.,hereinafter Principal, has submitted a bid to the City of Beverly Hills (hereinafter, City ) for the PARKING FACILITIES WATERPROOFING PROJECT; AND WHEREAS, said Principal is required to furnish a bond in connection with said bid, to ensure that the Principal will enter into a contract with the City; NOW, THEREFORE, we, the Principal and Western Surety Company, 333 S. Wabash Avenue, 41st Floor, Chicago. IL as Surety, are held firmly bound unto the City in the sum of Three Million Two Hundred Thousand and 00/1 00 Dollars ($ 3,200, ), this amount being not less than ten percent (10%) of the Bid Sum, for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if said Principal is awarded a Contract by said City and, within the time and in the manner required in the Contract Documents for said project, enters into the written form of Agreement bound with said Contract Documents and furnishes the required bonds and insurance, and performs all other obligations prerequisite to signing the Agreement, then this obligation shall be null and void, otherwise it shall remain in full force and effect. In the event suit is brought upon this bond by said City and judgment is recovered, said Surety shall pay all costs incurred by said City in such suit, including a reasonable attorney s fee to be fixed by the Court. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original thereof, have been duly executed by the Principal and Surety named herein, on the 14th day of August 2013, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative pursuant to authority of its governing body. Principal Western Waterproofing Company, Inc. By Timothy F. Diehi Treasurer Surety Western Surety Company By Gary L. Ri, ttorney ri-fact City Of Beverly Parking Facilities Waterproofing Project PAGE 16

8 estern Surety Company POWER OF ATTORNEY APPOINTING INDWIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint James P Cittadino, Gregory L Stanley, Michael T Reedy, Theresa A Hunziker, Gary L Riek, Donna J Thone, Jennifer E Ruemker, Joel Karsten, Cindy Rohr, Karen Speckhals, Individually of Saint Louis, MO, ito true end lawful Attornoy(o) in Fact with full power end authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 29th day of April, WESTERN SURETY COMPANY aul T. Bruflat, Vice President State of South Dakota County of Minnehaha On this 29th day of April, 2013, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires June23,2015 CERTIFICATE J. Mohr, Notary Public I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove Set forth is still in force, and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this 14th day of August, 2013 WESTERN SURETY COMPANY Form F A, I L. Nelson, Assistant Secretary

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