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BID TABULATION County of San Bernardino Real Estate Services - Project Management Division y^ouNTY 285 N. Arrowhead Ave. San Bernardino, CA 92415-0184 (909) 387-5000 www.sbcounty.gov/ae Project; Calico Ghost Town Camping Cabin Improvements Project Location: 36600 Ghost Town Road, Yermo Project Mgr: Jeffrey Banks Project No: 6X56 Construction Estimate: $330,000.00 Bid Date: May 19, 2016 Bid Time; 3:00 PM BIDDER t BASE BID SUB_TOTAL TOTAL NOTES rV •' Three Peaks Corp. PO Box 101 1025 Calimesa Blvd., #6 Calimesa, CA 92320 X X X $ 386,567.00 $ 386,567.00 $ 386,567.00 Callison Construction 7840 Luane Trail Coiton, CA 92324 X XX $ 405,664.00 $ 405,664.00 $ 405,664.00 Torga Electrical 3224 North D Street San Bernardino, CA 92405 X X X $ 434,345.00 $ 434,345.00 $ 434,345.00 Golden Land Building, Inc. PO Box 549 Apple Valley, CA 92307 XXX $ 452,000.00 $ 452,000.00 $ 452,000.00 VIncor Construction, Inc. 2707 Saturn Street Brea, CA 92821 X XX $ 456,000.00 $ 456,000.00 $ 456,000.00 Trinity Construction Company PO Box 246 Blue Jay, CA 92317 XXX $ 469,138.00 $ 469,138.00 $ 469,138.00 Jergensen Construction 9320 Daisy Road Oak Hills, CA 92344 XXX $ 604,000.00 $ 604,000.00 $ 604,000.00 Daike & Sons Construction, Inc. 4585 Allstate Drive Riverside. CA 92501-1701 XXX $ 620,680.00 $ 620,680.00 $ 620,680.00 BID RESULTS ARE TENTATIVE UNTIL ALL INFORMATION HAS BEEN VERIFIED. RESULTS WILL BE POSTED TO THE WEBSITE WITHIN THREE (3) BUSINESS DAYWWW.SBCOUNTY.GOV/AE

BID TABULATION County of San Bernardino Arrowhead CA

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Page 1: BID TABULATION County of San Bernardino Arrowhead CA

BID TABULATION

County of San BernardinoReal Estate Services - Project Management Divisiony^ouNTY 285 N. Arrowhead Ave. • San Bernardino, CA 92415-0184(909) 387-5000 ■ www.sbcounty.gov/ae

Project; Calico Ghost Town Camping CabinImprovements Project

Location: 36600 Ghost Town Road, Yermo

Project Mgr: Jeffrey Banks

Project No: 6X56

Construction Estimate: $330,000.00

Bid Date: May 19, 2016

Bid Time; 3:00 PM

BIDDER

tBASE BID SUB_TOTAL TOTAL NOTES

rV •'

Three Peaks Corp.

PO Box 101

1025 Calimesa Blvd., #6

Calimesa, CA 92320 X X X $ 386,567.00 $ 386,567.00 $ 386,567.00Callison Construction

7840 Luane Trail

Coiton, CA 92324 X X X $ 405,664.00 $ 405,664.00 $ 405,664.00Torga Electrical3224 North D Street

San Bernardino, CA 92405 X X X $ 434,345.00 $ 434,345.00 $ 434,345.00Golden Land Building, Inc.

PO Box 549

Apple Valley, CA 92307 X X X $ 452,000.00 $ 452,000.00 $ 452,000.00VIncor Construction, Inc.

2707 Saturn Street

Brea, CA 92821 X X X $ 456,000.00 $ 456,000.00 $ 456,000.00Trinity Construction CompanyPO Box 246

Blue Jay, CA 92317 X X X $ 469,138.00 $ 469,138.00 $ 469,138.00Jergensen Construction9320 Daisy RoadOak Hills, CA 92344 X X X $ 604,000.00 $ 604,000.00 $ 604,000.00Daike & Sons Construction, Inc.

4585 Allstate Drive

Riverside. CA 92501-1701 X X X $ 620,680.00 $ 620,680.00 $ 620,680.00

BID RESULTS ARE TENTATIVE UNTIL ALL INFORMATION HAS BEEN VERIFIED. RESULTS WILL BE POSTED TO THE WEBSITE WITHIN THREE(3) BUSINESS DAYWWW.SBCOUNTY.GOV/AE

Page 2: BID TABULATION County of San Bernardino Arrowhead CA

Project No. 6X56

BID PROPOSAL

PROJECT; Calico Ghost Town Camping Cabins Improvement Project

LOCATION: 36600 Ghost Town Road, Yermo

OWNER: County of San Bernardino

BID OPENING: May 19, 2016, at 3:00 p.m.

BIDDER: Thrcg- ?oqKs

County of San BernardinoReal Estate Services Department - Project Management Division385 North Arrowhead Avenue, Third FloorSan Bernardino, CA 92415-0184www.sbcounty.gov/ae

In compliance with your Invitation for bids, the undersigned has carefully examined theproject Bid Documents, Including the drawings and specifications, for the scope of workwhich includes, but is not limited to, improvements to existing camping cabins, site workpreparation and construction of four new camping cabins in Yermo, California, and fullyunderstands the scope and meaning of the Bid Documents.

The undersigned hereby agrees to furnish all materials, labor, tools, equipment,apparatus, facilities, and transportation necessary to complete all work in strict conformitywith the drawings and specifications, and to execute the contract to the satisfaction of theReal Estate Services Department - Project Management Division, at the following cost(s):

In case of discrepancy between the written bid set forth and the numerical bid set forth,the written bid shall prevail. In the case of a discrepancy between the written bid ornumerical bid set forth on the bid proposal, and the numerical bid set forth in the eProsystem, the information on the bid proposal shall prevail.

BASE BID

For the furnishing of the labor, materials, and equipment necessary to complete all workdesignated in the Plans and Specifications.

The LUMP SUM of Dollars

OP J

Project 6X56 Bid Proposal ^ 1 of7

Page 3: BID TABULATION County of San Bernardino Arrowhead CA

The above-mentioned BASE BID includes applicable California state sales tax, bonds,insurance and all other costs required to perform all the work described in the projectdrawings and specifications.

The lowest bid shall be the lowest bid price on the BASE BID. A responsible andresponsive bidder who submitted the lowest bid shall be awarded the contract, if it isawarded.

BID DEPOSIT (BID BOND)

There is enclosed herewith, a certified check or surety bond in the amount of ten percent(10%) of the BASE BID, or, more specifically, /dVq A-vuDollars ($ c#- ), made payable to the County of SanBernardino. The undersigned agrees that in the event of the failure by the undersigned toexecute the necessary contract and furnish the required contract bonds and insurance,the certified check or surety bond and the money payable thereon shall be, and remain,the property of the County of San Bernardino. If the bid is accompanied by a certified orcashier's check, the check shall be deposited by the Real Estate Services Department -Project Management Division, and a County warrant for the full amount shall be issued tothe undersigned approximately one month after Contract Award.

If the bid is submitted through the County of San Bernardino Electronic ProcurementNetwork (ePro) then scan the bid security (bid bond) and submit the scanned copy withyour bid submittal in ePro, additionally, mail or submit the original bid security, in aseparate sealed envelope labeled "Bid Bond" with the title of the work and the name ofthe bidder clearly marked on the outside, to: Real Estate Services Department - ProjectManagement Division, 385 North Arrowhead Avenue, 3"^ Floor, San Bernardino,California, 92415-0184. Any mailed or submitted bid security must be received on orbefore the time set for the opening of the bids.

TIME OF COMPLETION

The undersigned agrees to complete the work within 56 calendar days from the datestipulated in the Notice to Proceed.

LIQUIDATED DAMAGES

Pursuant to the provisions of Government Code Section 53069.85 and in the event thatall the Work called for in this Contract is not completed within the number of calendardays set forth. Contractor shall forfeit and pay to the County the sum of $200.00 per dayfor each calendar day the work remains incomplete, to be deducted from any paymentsdue or to become due to the Contractor. (Reference General Conditions and SpecialConditions)

Project 6X56 Bid Proposal 2 of 7

Page 4: BID TABULATION County of San Bernardino Arrowhead CA

REJECTION OF BIDS

The undersigned agrees that the County reserves the right to reject any or all bids, andreserves the right to waive informalities in a bid or bids, not affected by law, if to do soseems to best serve the public interest.

VALIDITY OF BIDS

The undersigned agrees that this bid will remain valid for sixty (60) days after thescheduled bid opening.

STATE LICENSES

The undersigned hereby certifies that he/she is currently the holder of a StateContractor's Class A or B License. The undersigned hereby certifies that he is currentlythe holder of a valid license as a contractor in the State of California and that the licenseis the correct class of license for the work described in the project drawings andspecifications. The undersigned also certifies that all subcontractor(s) listed under theDesignation of Subcontractors section of the Bid Proposal are currently the holder of validcontractor's license(s) in the State of California and the license is the correct class oflicense for the work to be performed by the subcontractor(s).

INSURANCE

The undersigned agrees to furnish certified copies of all insurance policies andendorsements: all certificates of comprehensive, general and auto liability insurance;Workers' Compensation insurance; and such other insurance that will protect him fromclaims for damages and personal injury, including death, which may arise from operationsunder the contract, whether such operation be by the undersigned or by anysubcontractor of the undersigned, or anyone directly or indirectly employed by theundersigned or any subcontractor of the undersigned in accordance with Section 11.2 ofthe General Conditions. The undersigned agrees to provide the Real Estate ServicesDepartment - Project Management Division with Certificates of Insuranceevidencing the required insurance coverage at the time Contractor executes thecontract with the County. All policies (excluding Workers' Compensation) shall namethe County of San Bernardino and its officers, employees, agents and volunteers asadditional insureds. All coverages shall be subject to approval by the County foradequacy of protection.

BONDS

If this Bid is successful, the undersigned agrees to execute the required StandardContract and will furnish a payment bond in an amount equal to one hundred percent(100%) of the contract price and a Faithful Performance Bond in an amount equal to onehundred percent (100%) of the contract price. These bonds shall be secured from a

Project 6X56 Bid Proposal 3 of 7

Page 5: BID TABULATION County of San Bernardino Arrowhead CA

surety company or companies satisfactory to the County within ten (10) calendar days ofthe contract award and shall be on County approved bond forms. Bonds shall remain infull force and effect for a period of one year following the date of filing of Notice ofCompletion.

FORMER COUNTY OFFICIALS

Contractor agrees to provide or has already provided information on former County ofSan Bernardino administrative officials (as defined below) who are employed by orrepresent Contractor. The information provided includes a list of former countyadministrative officials who terminated county employment within the last five years andwho are now officers, principals, partners, associates or members of the business. Theinformation also includes the employment with or representation of contractor. Forpurposes of this provision, "county administrative official" is defined as a member of theBoard of Supervisors or such officer's staff, Chief Executive Officer or member of suchofficer's staff, county department or group head, assistant department or group head, orany employee in the Exempt Group, Management Unit or Safety Management Unit.

INACCURACIES OR MISREPRESENTATIONS

If during the course of the bid proposal process or in the administration of a resultingContract, the County determines that the contractor has made a material misstatementor misrepresentation or that materially inaccurate information has been provided to theCounty, the contractor may be terminated from the bid proposal process, or in the eventa Contract has been awarded, the Contract may be immediately terminated. If aContract is terminated according to this provision, the County is entitled to pursue anyavailable legal remedies.

VISITING THE SITES

The undersigned has visited the site, and is familiar with the local conditions of the worksite.

DESIGNATION OF SUBCONTRACTORS

In compliance with the provisions of Sections 4100-4108 of the Public Contract Code ofthe State of California, and any amendments thereof, the undersigned shall set forthbelow the name, location of the place of business and the California contractor licensenumber of each subcontractor who will perform work (meaning the total amount of thesubcontractor's contract amount including all labor, materials, supplies and services) inexcess of one-half of one percent (1/2 of 1%) of the total bid; and, the general category orthe portion of the work to be performed by each subcontractor.

If the undersigned fails to specify a subcontractor for any work to be performed under thecontract, the undersigned agrees to perform the work and shall not be permitted to

Project 6X56 Bid Proposal 4 of 7

Page 6: BID TABULATION County of San Bernardino Arrowhead CA

subcontract that work except in cases of public emergency, and then only after writtenfinding as public record by the Board of Supervisors.

The undersigned certifies that all subcontractor(s) listed below are currently the holder ofvalid contractor's license(s) in the State of California and the license(s) is the correct classof license for the work to be performed by the subcontractor(s).

The undersigned certifies that it and all subcontractor(s) listed below have registered withthe Department of Industrial Relations pursuant to Labor Code section 1725.5 (applicablefor all bids submitted on or after March 1, 2015). The undersigned agrees that nocontractor or subcontractor may be awarded a contract for public work or perform work ona public works project unless registered with the Department of Industrial Relationspursuant to Labor Code section 1725.5 (applicable for all contracts awarded on or afterApril 1, 2015). The undersigned acknowledges that the project is subject to compliancemonitoring and enforcement by the Department of Industrial Relations.

As required by Labor Code 1771.1(a) "A contractor or subcontractor shall not bequalified to bid on, be listed in a bid proposal, subject to the requirements of Section4104 of the Public Contract Code, or engage in the performance of any contract forpublic work, as defined in this chapter, unless currently registered and qualified toperform public work pursuant to Section 1725.5. It is not a violation of this section for anunregistered contractor to submit a bid that is authorized by Section 7029.1 of theBusiness and Professions Code or by Section 10164 or 20103.5 of the Public ContractCode, provided the contractor is registered to perform public work pursuant to Section1725.5 at the time the contract is awarded."

Where a hearing is required for a decision on the substitution of subcontractors, pursuantto the provisions of Chapter 4, Part 1, Division 2, of the Public Contract Code,(commencing with Section 4100) by the awarding authority, or a duly appointed hearingofficer, the Clerk of the Board of Supervisors shall prepare and certify a statement ofcosts incurred by the County for investigation, and to conduct the hearing, including thecosts of any hearing officer and shorthand reporter appointed. For the purposes of ahearing for the substitution of subcontractors (pursuant to the Public Contract Codecommencing with Section 4100) the awarding authority shall be the Director of the RealEstate Services Department, or his/her designee.

The statement of costs shall be sent to the undersigned, who shall reimburse the Countyfor all costs. If not paid separately, such reimbursement shall be deducted from moniesdue and owing to the undersigned prior to acceptance of the project.

Project 6X56 Bid Proposal 5 of 7

Page 7: BID TABULATION County of San Bernardino Arrowhead CA

CONTRACTOR NAME: "Rnree PeciKs QorfSubcontractor Portion of Work Location of CA Cont. Lie. No. DIR Reg. No.

(Description of work Businessto be performed)

ADDENDA

This bid includes Addendum No. dated

Addendum No. dated

Bidder must acknowledge all addendums above, regardless of any acknowledgement ofaddendums in ePro.

AFFIDAVIT

The undersigned has submitted with the bid proposal a non-collusion declaration, signedunder penalty of perjury, for the principal contractor. The undersigned agrees to furnishthe County non-collusion declarations for subcontractors signed under penalty of perjury,and states that this Is a genuine proposal and is neither collusive nor made in the interestof any other person, and has not induced anyone to submit a sham bid or refrain frombidding.

Project 6X56 Bid Proposal 6 of 7

Page 8: BID TABULATION County of San Bernardino Arrowhead CA

The undersigned acknowledges it has registered with the ePro system prior to thedate and time to receive sealed bids or It will be disqualified.

The undersigned declares: that the only person or parties interested in this proposal asprincipals are those named herein; that this bid is made without any connection with anyother person or persons making a bid for the same work, except for another division ofthe undersigned which may submit an independent bid; that the bid is in all respects fairand without collusion or fraud; that the undersigned has read the Advertisement for Bidsand the Instructions to Bidders and agrees to all the stipulations contained therein; thatthe undersigned has examined the form of contract (including the specifications,drawings, and other documents incorporated therein by reference); that in the event thisbid as submitted, including the incorporated bidding documents, be accepted by theCounty, the undersigned shall execute a contract to perform the work as outlined herein.

If undersigned is a corporation, proposal must be signed by an authorized officer of thecorporation.

If the bid proposal is submitted through ePro the undersigned acknowledges that itselectronic signature is legally binding.

Check One: ( ) Sole Proprietor( ) Partnership(^)^orporation( ) Other

Name of Bidder: Three Realms CoyfAddKss: POBOXIOI rrilimestf q qzaaq

Phone:

Contractor's License No.: Primary Class: A,15

Expiration Date of Contractor's License _ 12.31. n

Contractor's DIR Registration #_ 10Q0DDgl4O

Social Security No. or Federal Employer ID No.:

I declare under penalty of perjury the above is true and correct.

Authorized Signature: Title: dPrint Name: FnK Sirrimons Date: 51^.11^

Project 6X56 Bid Proposal 7 of 7

Page 9: BID TABULATION County of San Bernardino Arrowhead CA

NONCOLLUSION DECLARATION

TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID

The undersigned declares:

I am the _ pTesidev^-V of Thyee. Coyf the party makingthe foregoing bid.

The bid is not made in the interest of, or on behalf of, any undisclosed person,partnership, company, association, organization or corporation. The bid is genuine andnot collusive or sham. The bidder has not directly or indirectly induced or solicited anyother bidder to put in a false or sham bid. The bidder has not directly or indirectlycolluded, conspired, connived, or agreed with any bidder or anyone else to put in asham bid, or to refrain from bidding. The bidder has not in any manner, directly orindirectly, sought by agreement, communication, or conference with anyone to fix thebid price of the bidder or of any other bidder, or to fix any overhead, profit, or costelement of the bid price, or of that of any other bidder. All statements contained in thebid are true. The bidder has not, directly or indirectly, submitted his or her bid price orany breakdown thereof, or the contents thereof, or divulged information or data relativethereto, to any corporation, partnership, company, association, organization, biddepository, or to any member or agent thereof, to effectuate a collusion or sham bid,and has not paid, and will not pay, any person or entity for such purpose.

Any person executing this declaration on behalf of a bidder that is a corporation,partnership, joint venture, limited liability company, limited liability partnership, or anyother entity, hereby represents that he or she has full power to execute, and doesexecute, this declaration on behalf of the bidder.

I declare under penalty of perjury under the laws of the State of California that theforegoing is true and correct and that this declaration is executed onMdu [date], at Cfllimesq [city],Ciahftl^mirJ [state].

Signed:

Title: _

Page 10: BID TABULATION County of San Bernardino Arrowhead CA

ACKNOWLEDGMENT

A notary public or other officer completing thiscertificate verifies only the identity of the individualwho signed the document to which this certificate Isattached, and not the truthfulness, accuracy, orvalidity of that document.

State of California

County of Riverside ,

On May 19, 2015 before me, Stacy L Holt, Notary Public(insert name and title of the officer)

personally appeared Erik Simmonswho proved to me on the basis of satisfactory evidence to be the person^ whose nam|«}^Etre^bscribed to the within instrument and acknowle^ed to me th^rH^^fehe/they executed the^me in(msAier/their authorized capacity^i^, and that by^^i^hef/their signature(^ on the instrument thepersonl^ or the entity upon behalf of which the p§fson{^ acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoingparagraph is true and correct.

WITNESS my hand and official seal.STACY L. HOLT

Commltsion # 2120287Notary PuWic - California

RivaniOa County s

Page 11: BID TABULATION County of San Bernardino Arrowhead CA

Document - 2010Conforms with The American Institute of Architects AIA Document 310

Bid BondCONTRACTOR:

(Xanie, legal slaltis and addrexx)SURETY:

(Name, legal xfaliix andprincipal place ofbivdnexs)

Three Peaks Corp.

1025 Calimesa Blvd., #6

Caiimesa, OA 92320

OWNER:

(Name, legal stalas and address)

Developers Surety and Indemnity Company

P.O. 80x 19725

Irvine, OA 92623

County of San Bernardino Real Estate Services Department, Project Management Division

385 North Arrowhead Ave., 3rd Floor

San Bernardino, OA 92415-0184

BOND AMOUNT: $ 10% Ten Percent of Amount Bid

This document has Importantlegal consequences. Consultationwith an attorney is encouragedwith respect to Its completion ormodification.

Any singular reference toContractor, Surety, Owner orother party shall be consideredplural where applicable.

PROJECT:

(Name, location or address and Project imniber, if any)

Calico Ghost Town Camping Cabin Improvements Project, Yermo, California, Project No. 6X56

The Contractor and Surct>' arc bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety' bindllicinselvcs. their Iicirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of thisBond arc such that if tlic Owner accepts the bid of the Contractor within the time specincd in (he bid documents, or within such time periodas may be agreed to by tlic Owner and Contractor, and tiic Contractor citiicr (1) enters into a contract witli the Owner in accordance withtlie terms of such bid, and gives sucli bond or bonds as may be specified in tlic bidding or Contract Documents, witii a surety admitted intlie jurisdiction of the Project and otherwise acceptable to (he Owner, for the faitiiful performance of such Contract and for the promptpayment of labor and material funiisiied in the prosecution thereof; or (2) pays to the Owner the ditYcrencc, not to exceed the amount oftills Bond, between the amount specified in said bid and such larger amount for which the Owner may In good faith contract with anotherparly to perform tiie work covered by said bid, tiieii tills obligullon sliali be null and void, otherwise to remain in lull force and elVect. TheSurety hereby waive.s any notice of an agreement between the Owner and Contractor to extend the lime in which the Owner may accept thebid. Waiver of notice by liie Surely sliall not apply to any extension exceeding sixty (60) days in the aggregate beyond the lime foracceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain liie Surety's consent for an extension beyondsixty (60) days.

If this Bond is issued in connection with a subcontractor's bid to a Contractor, the tcnn Contractor in this Bond shall be deemed to beSubcontractor and the term Owner shall be deemed to be Contractor.

When this Btnid lius been furnished to conmiy with a slutiilory or other legal requirement in the location 4iftlie Project, any provision Intin's Bond conilictiM wilii said statutoryj^egul requirement shall be deemed deleted herelVom and provisions conlbmiing to suchslatulor)' or otherf^al requirement shaU^ deemed incorporated herein. When .so funiisiied, (he intent is that this Bond sliall be construedOS a statutory bo/^and luiws a cominn/law bond.Siancd and scafofl ti 16th ay of M3yi 2016

(Withess)

era

Three Peaks Corp.(Principal) (Seal)

By:

(Title)

Developers Surety and Indemnity Company(Siiix't)') (Seal)

(Witness)

(TiileH,awredce F. McMahon Attorney-in-Fact

S-0054/AS 8/10

Page 12: BID TABULATION County of San Bernardino Arrowhead CA

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT cmi Code § 1189A 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 Diego }On MAY 16 2016 before me, Janice R. Martin , Notary Public,

Date insert Name of Notary exactly as it appears on the ofTiciai seal

personally appeared Lawrence F. McMahonName(s] of Slgner{s)

JANICE R. MARTIN HCOMM. #1986564 n

NOTARY PUBLIC-CALIFORNIA WSAN DIEGO COUNTY 2My Commission Expires •

Place Notary Seal Above

who proved to me on the basis of satisfactory evidence tobe the person(#i) whose name(J$lf subscribed to thewithin instrument and acknowledged to me thatexecuted the same in authorized capacity(/l;^i^il,and that by his/WiJ^//IM^signature(A(,J on the instrument theperson(^, or the entity upon behalf of which the personl)%5acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws ofthe State of California that the foregoing paragraph is trueand correct.

Witness mv hand and official seal.

SignatureSignature Public Janice . Martin

OPTIONAL

Though the information below is not required by law, it may prove valuable to persons relying on the documentand could prevent fraudulent removal and reattachment of the form to another 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 Slgner(s)

Signer's Name:

□ Individual□ Corporate Officer—Title(s):□ Partner □ Limited □ General21 Attorney in Fact□ Trustee□ Guardian or Conservator□ Other:

Signer is Representing:

RIGHTTHUMBPRINT

OF SIGNER

Top of thumb here

Signer's Name:□ Individual□ Corporate Officer —Tltle(s):□ Partner □ Limited □ General□ Attorney in Fact□ Trustee□ Guardian or Conservator□ Other:

Signer is Representing;

RIGHTTHUMBPRINTOF SIGNER

Top of thumb here

Page 13: BID TABULATION County of San Bernardino Arrowhead CA

POWER OF ATTORNEY FOR

DEVELOPERS SURETY AND INDEMNITY COMPANY

INDEMNITY COMPANY OF CALIFORNIA

PO Box 19725, IRVINE, CA92623 (949) 263-3300

KNOW BY THESE PRESENTS that except as expressly Imited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CAUFORNIA, do eachhereby make, constitute and ai^nt

•"Lawrence F. Mo Mahon, Sarah Myers, Maria Guise, James Baldassare Jr., jointly or severally'**

as Oier true and lawful Altomey(s)-in-Facl, to make, execute, deliver and acknowledge, for ̂ on behalf of said corporations, as sureties, bonds, undertakings and contracts of suretyship giving and granting unto said Aaomey(s)-in-Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in conner^on therewith as each ofsaid coqxirations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Attorney(s)-in-Fact, pursuant to these presents,are hereby ratified and confirmed.

This Power of Attorney is granted and is signed by facsimile under ̂ d by authcmty of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETYAND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January 1st. 2008.

RESOLVED, that a combination of any two of the Chaimian of the Board, the President, Executive Vice-Presldent Senior Vice-Presldent or any Vice President of thecorporations be, and that each of them her^y is, authorized to execute ffris Power of Attorney, qualifying the attorney(s) named in the Powerof Attorney to execute, on behalf of thecorporations, bonds, undertakings and contracts of suretyship: and that the Secretary or any Assistant ̂ retary of eith^ of the corporations be. and each of th^ hereby is, authorizedto attest the execution of any such Power of Attorney;

RESOLVED, FURTHER, that the signatures of such officers may be affixed to any such Power ofAttorney or to any c&tificate relating thereto by facsimile, and any suchPower of Attomey or certificate bearing such facsimile signatures sh^l be valid and binding up<xi the corporab'ons when so affixed and in the future with respect to ̂ y bwid, undertakingor contract of suretyship to which it is attacfied.

IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be Signed byffieir respective officers and attested by their respective Secretary or Assistant Secretary this December 1,2014.

By:Daniel Young, Senior Vice-Presldent

Mark J. Lansdon, Vice-Pfesident

State of California

County of Orange

15/ OCT.sSi 10\o}. 1936

JOs

^?0f)

OCT

1967

On December 1,2014 before me.

Date

Lucille Raymond. Notary Public

Here Insert Name and Tile of the Officer

personally appeared. Daniel Young and Mark J. Lansdon

Name(s) Signer(s)

LUCILLE RAYMOND |Commission # 2M1945 |Notary ̂ tHic • Cillfomla |

Cranoe County |My Comm. Expires Oct 13.20181

Place Notary Seal Above

who proved to me on the basis of satisfactory evid^ce to be the person(s) whose n3me(s) is/are subscribed tothe within instrument and acknowledged to me that he/she/they executed ̂ e same in his/herAheir authorizedcapacity(ie5), and that by his/her/their signature(s) on the inslnjment the persai(s), or the entity upon behalf ofwhldi the pe(son(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of ffie State of Califomia that the foregoing paragraph istrue and correct,

WITNESS my hand and official seal.

Signature

CERTIFICATE

Raymond, Notary Public

The undersigned, as Secretary or Assistant Seaetary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA, does herebycertify that the foregdng Power of Attomey remains in hjll force and has not been revoked and, furthemiore, that the provisions of the resdutions of (he respective Boards of Directors ofsaid corporations set fodh in the Power of Attomey are in force as of the date of this Certificate.

ThisCertlficateisexecutedintheCityoflrvine.Califomia,fills 16th d3yofMay2016

Cassie J. Berrisforjr/ssistanl Secretary

ID-1380(Rev.12/14)

Page 14: BID TABULATION County of San Bernardino Arrowhead CA

Project No. 6X56

BID PROPOSAL

PROJECT: Calico Ghost Town Camping Cabins Improvement Project

LOCATION: 36600 Ghost Town Road, Yermo

OWNER: County of San Bernardino

BID OPENING: May 19, 2016, at 3:00 p.m.

BIDDER:

County of San BernardinoReal Estate Services Department - Project Management Division385 North Arrowhead Avenue, Third FloorSan Bernardino, CA 92415-0184www.sbcounty.gov/ae

In compliance with your invitation for bids, the undersigned has carefully examined theproject Bid Documents, including the drawings and specifications, for the scope of workwhich includes, but is not limited to, improvements to existing camping cabins, site workpreparation and construction of four new camping cabins in Yermo, California, and fullyunderstands the scope and meaning of the Bid Documents.

The undersigned hereby agrees to furnish all materials, labor, tools, equipment,apparatus, facilities, and transportation necessary to complete all work in strict conformitywith the drawings and specifications, and to execute the contract to the satisfaction of theReal Estate Services Department - Project Management Division, at the following cost(s):

In case of discrepancy between the written bid set forth and the numerical bid set forth,the written bid shall prevail. In the case of a discrepancy between the written bid ornumerical bid set forth on the bid proposal, and the numerical bid set forth in the eProsystem, the information on the bid proposal shall prevail.

BASE BID

For the furnishing of the labor, materials, and equipment necessary to complete all workdesignated in the Plans and Specifications. _

The LUMP SUM of Dollars

($ ^ )

Project 6X56 Bid Proposal 1 of7

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The above-mentioned BASE BID includes applicable California state sales tax, bonds,insurance and all other costs required to perform all the work described in the projectdrawings and specifications.

The lowest bid shall be the lowest bid price on the BASE BID. A responsible andresponsive bidder who submitted the lowest bid shall be awarded the contract, if it Isawarded.

BID DEPOSIT (BID BOND)

There is enclosed herewith, a certified check or surety bond in the amount of ten percent(10%) of the BASE BID, or, more specifically,Dollars {%/0% ̂ 0^/^ ), made payable to the County of SanBernardino. The undersigned agrees that in the event of the failure by the undersigned toexecute the necessary contract and furnish the required contract bonds and insurance,the certified check or surety bond and the money payable thereon shall be, and remain,the property of the County of San Bernardino. If the bid is accompanied by a certified orcashier's check, the check shall be deposited by the Real Estate Services Department -Project Management Division, and a County warrant for the full amount shall be issued tothe undersigned approximately one month after Contract Award.

If the bid is submitted through the County of San Bernardino Electronic ProcurementNetwork (ePro) then scan the bid security (bid bond) and submit the scanned copy withyour bid submittal in ePro, additionally, mail or submit the original bid security, in aseparate sealed envelope labeled "Bid Bond" with the title of the work and the name ofthe bidder clearly marked on the outside, to: Real Estate Services Department - ProjectManagement Division, 385 North Arrowhead Avenue, 3^ Floor, San Bernardino,California, 92415-0184. Any mailed or submitted bid security must be received on orbefore the time set for the opening of the bids.

TIME OF COMPLETION

The undersigned agrees to complete the work within 56 calendar days from the datestipulated in the Notice to Proceed.

LIQUIDATED DAMAGES

Pursuant to the provisions of Government Code Section 53069.85 and in the event thatall the Work called for in this Contract is not completed within the number of calendardays set forth, Contractor shall forfeit and pay to the County the sum of $200.00 per dayfor each calendar day the work remains incomplete, to be deducted from any paymentsdue or to become due to the Contractor. (Reference General Conditions and SpecialConditions)

Project 6X56 Bid Proposal 2 of 7

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REJECTION OF BIDS

The undersigned agrees that the County reserves the right to reject any or all bids, andreserves the right to waive informalities in a bid or bids, not affected by law, if to do soseems to best serve the public interest.

VALIDITY OF BIDS

The undersigned agrees that this bid will remain valid for sixty (60) days after thescheduled bid opening.

STATE LICENSES

The undersigned hereby certifies that he/she is currently the holder of a StateContractor's Class A or B License. The undersigned hereby certifies that he is currentlythe holder of a valid license as a contractor in the State of California and that the license

is the correct class of license for the work described in the project drawings andspecifications. The undersigned also certifies that all subcontractor(s) listed under theDesignation of Subcontractors section of the Bid Proposal are currently the holder of validcontractor's license(s) in the State of California and the license is the correct class oflicense for the work to be performed by the subcontractor(s).

INSURANCE

The undersigned agrees to furnish certified copies of all insurance policies andendorsements: all certificates of comprehensive, general and auto liability insurance;Workers' Compensation insurance; and such other insurance that will protect him fromclaims for damages and personal injury, including death, which may arise from operationsunder the contract, whether such operation be by the undersigned or by anysubcontractor of the undersigned, or anyone directly or indirectly employed by theundersigned or any subcontractor of the undersigned in accordance with Section 11.2 ofthe General Conditions. The undersigned agrees to provide the Real Estate ServicesDepartment - Project Management Division with Certificates of Insuranceevidencing the required insurance coverage at the time Contractor executes thecontract with the County. All policies (excluding Workers' Compensation) shall namethe County of San Bernardino and its officers, employees, agents and volunteers asadditional insureds. All coverages shall be subject to approval by the County foradequacy of protection.

BONDS

If this Bid is successful, the undersigned agrees to execute the required StandardContract and will furnish a payment bond in an amount equal to one hundred percent(100%) of the contract price and a Faithful Performance Bond in an amount equal to onehundred percent (100%) of the contract price. These bonds shall be secured from a

Project 6X56 Bid Proposal 3 of 7

Page 17: BID TABULATION County of San Bernardino Arrowhead CA

surety company or companies satisfactory to the County within ten (10) calendar days ofthe contract award and shall be on County approved bond forms. Bonds shall remain infull force and effect for a period of one year following the date of filing of Notice ofCompletion.

FORMER COUNTY OFFICIALS

Contractor agrees to provide or has already provided information on former County ofSan Bernardino administrative officials (as defined below) who are employed by orrepresent Contractor. The information provided includes a list of former countyadministrative officials who terminated county employment within the last five years andwho are now officers, principals, partners, associates or members of the business. Theinformation also Includes the employment with or representation of contractor. Forpurposes of this provision, "county administrative official" is defined as a member of theBoard of Supervisors or such officer's staff, Chief Executive Officer or member of suchofficer's staff, county department or group head, assistant department or group head, orany employee in the Exempt Group, Management Unit or Safety Management Unit.

INACCURACIES OR MISREPRESENTATIONS

If during the course of the bid proposal process or in the administration of a resultingContract, the County determines that the contractor has made a material misstatementor misrepresentation or that materially inaccurate information has been provided to theCounty, the contractor may be terminated from the bid proposal process, or in the eventa Contract has been awarded, the Contract may be immediately terminated. If aContract is terminated according to this provision, the County is entitled to pursue anyavailable legal remedies.

VISITING THE SITES

The undersigned has visited the site, and is familiar with the local conditions of the worksite.

DESIGNATION OF SUBCONTRACTORS

In compliance with the provisions of Sections 4100-4108 of the Public Contract Code ofthe State of California, and any amendments thereof, the undersigned shall set forthbelow the name, location of the place of business and the California contractor licensenumber of each subcontractor who will perform work (meaning the total amount of thesubcontractor's contract amount including all labor, materials, supplies and services) inexcess of one-half of one percent (1/2 of 1%) of the total bid; and, the genera! category orthe portion of the work to be performed by each subcontractor.

If the undersigned fails to specify a subcontractor for any work to be performed under thecontract, the undersigned agrees to perform the work and shall not be permitted to

Project 6X56 Bid Proposal 4 of 7

Page 18: BID TABULATION County of San Bernardino Arrowhead CA

subcontract that work except in cases of public emergency, and then only after writtenfinding as public record by the Board of Supervisors.

The undersigned certifies that all subcontractor(s) listed below are currently the holder ofvalid contractor's license(s) in the State of California and the license(s) is the correct classof license for the work to be performed by the subcontractor(s).

The undersigned certifies that it and all subcontractor(s) listed below have registered withthe Department of Industrial Relations pursuant to Labor Code section 1725.5 (applicablefor all bids submitted on or after March 1, 2015). The undersigned agrees that nocontractor or subcontractor may be awarded a contract for public work or perform work ona public works project unless registered with the Department of Industrial Relationspursuant to Labor Code section 1725.5 (applicable for all contracts awarded on or afterApril 1, 2015). The undersigned acknowledges that the project is subject to compliancemonitoring and enforcement by the Department of Industrial Relations.

As required by Labor Code 1771.1(a) "A contractor or subcontractor shall not bequalified to bid on, be listed in a bid proposal, subject to the requirements of Section4104 of the Public Contract Code, or engage in the performance of any contract forpublic work, as defined in this chapter, unless currently registered and qualified toperform public work pursuant to Section 1725.5. It is not a violation of this section for anunregistered contractor to submit a bid that is authorized by Section 7029.1 of theBusiness and Professions Code or by Section 10164 or 20103.5 of the Public ContractCode, provided the contractor is registered to perform public work pursuant to Section1725.5 at the time the contract is awarded."

Where a hearing is required for a decision on the substitution of subcontractors, pursuantto the provisions of Chapter 4, Part 1, Division 2, of the Public Contract Code,(commencing with Section 4100) by the awarding authority, or a duly appointed hearingofficer, the Clerk of the Board of Supervisors shall prepare and certify a statement ofcosts incurred by the County for investigation, and to conduct the hearing, including thecosts of any hearing officer and shorthand reporter appointed. For the purposes of ahearing for the substitution of subcontractors (pursuant to the Public Contract Codecommencing with Section 4100) the awarding authority shall be the Director of the RealEstate Services Department, or his/her designee.

The statement of costs shall be sent to the undersigned, who shall reimburse the Countyfor ail costs. If not paid separately, such reimbursement shall be deducted from moniesdue and owing to the undersigned prior to acceptance of the project.

Project 6X56 Bid Proposal 5 of 7

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CONTRACTOR NAME:

Subcontractor Portion of Work Location of CA Cont. Lie. No. DIR Rea. No.

(Description of work Businessto be performed)

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ADDENDA

This bid includes Addendum No.

Addendum No.

dated

dated

Bidder must acknowledge all addendums above, regardless of any acknowledgement ofaddendums in ePro.

AFFIDAVIT

The undersigned has submitted with the bid proposal a non-collusion declaration, signedunder penalty of perjury, for the principal contractor. The undersigned agrees to furnishthe County non-collusion declarations for subcontractors signed under penalty of perjury,and states that this is a genuine proposal and is neither collusive nor made in the interestof any other person, and has not induced anyone to submit a sham bid or refrain frombidding.

Project 6X56 Bid Proposal 6 of 7

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The undersigned acknowledges it has registered with the ePro system prior to thedate and time to receive sealed bids or It will be disqualified.

The undersigned declares: that the only person or parties interested in this proposal asprincipals are those named herein; that this bid is made without any connection with anyother person or persons making a bid for the same work, except for another division ofthe undersigned which may submit an independent bid; that the bid is in all respects fairand without collusion or fraud; that the undersigned has read the Advertisement for Bidsand the Instructions to Bidders and agrees to all the stipulations contained therein; thatthe undersigned has examined the form of contract (including the specifications,drawings, and other documents incorporated therein by reference); that In the event thisbid as submitted, including the incorporated bidding documents, be accepted by theCounty, the undersigned shall execute a contract to perform the work as outlined herein.

If undersigned is a corporation, proposal must be signed by an authorized officer of thecorporation.

if the bid proposal is submitted through ePro the undersigned acknowledges that itselectronic signature is legally binding.

Check One: Sole Proprietor{ ) Partnership( ) Corporation( ) Other

Name of Bidder:

Address:

Phone:

Contractor's License No.: Primary Class: ^

Expiration Date of Contractor's License ^

Contractor's DIR Registration#

Social Security No. or Federal Employer ID No.: ^703^^ 7

I declare under penalty of perjury the above is true and correct.

Authorized Signature: ^ —

Print Name: Date:

Project 6X56 Bid Proposal 7 of 7

Page 21: BID TABULATION County of San Bernardino Arrowhead CA

NONCOLLUSION DECLARATION

TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID

The undersigned declares:

1 am the of , the party makingthe foregoing bid.

The bid is not made in the interest of, or on behalf of, any undisclosed person,partnership, company, association, organization or corporation. The bid is genuine andnot collusive or sham. The bidder has not directly or indirectly induced or solicited anyother bidder to put in a false or sham bid. The bidder has not directly or indirectlycolluded, conspired, connived, or agreed with any bidder or anyone else to put in asham bid, or to refrain from bidding. The bidder has not in any manner, directly orindirectly, sought by agreement, communication, or conference with anyone to fix thebid price of the bidder or of any other bidder, or to fix any overhead, profit, or costelement of the bid price, or of that of any other bidder. All statements contained in thebid are true. The bidder has not, directly or indirectly, submitted his or her bid price orany breakdown thereof, or the contents thereof, or divulged information or data relativethereto, to any corporation, partnership, company, association, organization, biddepository, or to any member or agent thereof, to effectuate a collusion or sham bid,and has not paid, and will not pay. any person or entity for such purpose.

Any person executing this declaration on behalf of a bidder that is a corporation,partnership, joint venture, limited liability company, limited liability partnership, or anyother entity, hereby represents that he or she has full power to execute, and doesexecute, this declaration on behalf of the bidder.

I declare under penalty of perjury under the laws of the State of California that theforegoing is .true and correct and that this declaration is executed on

'5^//'} //(^ [date], at [city],[state].

Signed: _

Title: —'

Page 22: BID TABULATION County of San Bernardino Arrowhead CA

riAmTrust Surety

At I ArnTrust Financial Company

Developers Surety and Indemnity CompanyIndemnity Company of CaliforniaCorePointe Insurance Company

17771 Cowan Suite 100 • Irvine. California 92614 • (949) 263-3300www AmTrust Surely com

BID BONDBOND NO. n/a

KNOW ALL MEN BY THESE PRESENTS.

That we Callison Construction

as Principal, and Developers Surety and Indemnity Company a corporation

authorized to transact a general surety business in the State of. California

as Surety, are held and firmly bound unto County of San Bernardino

in the full and just sum of Ten Percent of Total Amount Bid

(hereinafter called the Obligee)

DoHars, (S 10% of bid amount ) for the payment whereof in lawful money of the United States, we bind ourselves, our

heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents.

WHEREAS, the said PRINCIPAL has submitted the accompanying bid for

Project 6X56 - Calico Ghost Town Camping Cabins Improvement Project

NOW. THEREFORE, if the said contract be timely awarded to the Principal and the Principal shall, within suchtime as may be specified, enter into the contract in writing, then this obligation shall be void; otherwise to remain in fullforce and effect.

Signed and Sealed this. 17th day of May 2016

Callison Construction

Bill Callison, OwnerlD-1235 (General Bid Bond) (REV 7/15)

Principal

Developers Surety and Indemnity CompanySurely

^lle L. T^ominen, Attomey-m Faa

Page 23: BID TABULATION County of San Bernardino Arrowhead CA

POWER OF ATTORNEY FOR

DEVELOPERS SURETY AND INDEMNITY COMPANY

INDEMNITY COMPANY OF CALIFORNIA

PO Box 19725, IRVINE, CA 92623 (949) 263-3300

KNOW ALL BY THESE PRESENTS that except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, do eachheretiy make, constitute and appoint:

"*Susan C. Monteon, Janelle L, Tuominen, jointly or severally*"

as their true and lawful Attomey(s)-in-Fact, to make, execute, deliver and acknowledge, for and on beh^ of said corporations, as sureties, bonds, undertakings and contracts of suretyship giving and granting unto said Attomey{s)-in-Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each ofsaid corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Attomey(s)-in-Fact, pursuant to tfiese presents,are hereby ratified and confirmed.

This Power of Attomey is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respecbve Boards of Directors of DEVELOPERS SURETYAND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January Isl, 2008,

RESOLVED, that a combination of any two of the Chairman of die Board, the President, Execubve Vice-President, Senior Vice-President or any Vice President of ttiecorporations be, and that each of them hereby is, authorized to execute this Power of Attomey, qualifying the attomey(s) named in the Power of Attorney to execute, on behalf of thecorporations, bonds, undertakings and contracts of suretyship, and ttiat the Secretary or any Assistant Secretary of either of the corporations be, and each of them hereby is, auttiorizedto attest the execution of any such Power of Attorney;

RESOLVED. FURTHER, that the signatures of such officers may be affixed to any such Power of Attomey or to aiy certificate relating thereto by facsimile, and any suchPower of Attorney or certificate bearing such facsimile signabires shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond, undertakingor contract of suretyship to which it is attached.

IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused friese presents to be signed bytheir respective officers and attested by their respective Secretary or Assistant Secretary this November 21, 2013.

r

By:Daniel Young, Senior Vice-Presid^t

Mark J. Lansdon. Vice-President

State trf California

County of Orange

On November 21.2013 before me.

"""t,.

:s UJ I

\ a\ 19 3 6

OCT. •'il10 ir>5

OCT

1967

Antonio Alvarado, Notary Public

Date Here Insert Name and Title of the Officer

personally appeared. Daniel Young and Mark J. Lansdon

Name(s) of Signer(s)

ANTONK) ALVARADOCOMM. #2033556

NOTARY PUeUC CAUFORNVkjORANGECOUNTY

My oonwi. eiipires Aug. 9,2017

Place Notary Seal Above

who proved to me on the basis of safisfactory evidence to be the person(s) whose name(s) is/are subscribed tothe within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorizedcapacityfies), and that by his/herftheir signature{s) on the instrument person(s). or the entity upon behalf ofwhich the persQn(s) acted, executed the instrument,

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph istrue and correct.

WITNESS my hand and official seal.

Signature

CERTIFICATE

Antonio Alvarado, Notary Public

The undersigned, as Secretary or Assistant Secretary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA, does herebycertify that the foregoing Power of Attomey remains in full force and has not been revoked and. furthennore, that the provisions of the resolutions of the resper^rve Boards of Directors ofsaid corporations set forth in the Power of Attomey are in force as of the date of this Certificate.

This Certificate is executed in the City of Irvine. California, this 17th day of f4ay 2016 •

ByCassie J, Berrisfair^ssistant Secretary U

ID-l380{Rev,11/13)

Page 24: BID TABULATION County of San Bernardino Arrowhead CA

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT

A notary public or other officer completing this certificate verifies only the identity of the individual who signed thedocument to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

STATE OF CALIFORNIA

County of Riverside

On May 17, 2016Date

personally appeared J

}before me, Susan C. Monteon . Notary Public.

insert Name of Notary exacdy as it appears on the officiai seal

anelle L. TuominenName(s) of Signer(s}

SU^N C. MONTCON ECOMM. #2033248 mNotaiy PuMc.<Mtroa)ia Sriverside COUNTY 7

who proved to me on the basis of satisfactory evidence tobe the person(s) whose name(s) is/are subscribed to thewithin instrument and acknowledged to me that he/she/theyexecuted the same in his/her/their authorized capacity(ies),and that by his/her/their signature(s) on the instrument theperson(s), or the entity upon behalf of which the person(s)acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws ofthe State of California that the foregoing paragraph is trueand correct.

Witness my hand and official seal.

SignaturePlace Notary Seal Above signature of Notary Public Susan C. Monteon

OPTIONAL

Though the information below is not required by law, it may prove valuable to persons relying on the documentand could prevent fraudulent removal and reattachment of the form to another 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:

□ Individual□ Corporate Officer—Title{s):□ Partner □Limited □ General□ Attorney in Fact□ Trustee□ Guardian or Conservator

□ Other;

Signer is Representing:

RIGHT THUMBPRINTOF SIGNER

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Signer's Name:□ Individual□ Corporate Officer—Title(s):□ Partner □ Limited □ General□ Attorney in Fact□ Trustee□ Guardian or Conservator

□ Other:

Signer is Representing:

RIGHT THUMBPRINTOF SIGNER

Top of thumb here