~Libert}: ~ Mutucil. The Ohio Casualty Insurance Company

BID OR PROPOSAL BOND

KNOW ALL MEN BY THESE PRESENTS, That we,

Bockman and Woody Electric Company Inc.

of Stockton, California

(hereinafter called the Principal) as Principal, and The Ohio Casualty Insurance Company , with its

principal office in the City of Fairfield, Ohio (hereinafter called the Surety), as Surety, are held and firmly bound unto

City of Stockton

of San Joaquin County

(hereinafter called the Obligee) in the penal sum of

Ten Percent of Bid-------------------------------------------------------------------------------------------------------------------------------

Dollars$ 10% of Bid------- lawful money of the United States, for the payment of which sum well and truly to be made,

we bind ourselves, our heirs, executors, administrators, successors, and assigns.

THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas, the Principal has submitted the accompanying bid dated March 14, 2013 for

Traffic Signal Controller Upgrade and Retiming. Project No. 10-12, Federal Project No., CML-5008(098)

Traffic signal contoller upgrade at 20 existing signalized locations on March Lane, Harding Way and Wilson Way;

upgrade seven traffic signal cabinets

NOW, THEREFORE, if the Obligee shall make any award according to the terms of said bid and the Principal shall enter into a contract with said Obligee in accordance with the terms of said bid and give bond for the faithful performance thereof within the time specified; or if no time is specified within thirty days after the date of said award; or if the Principal shall, in the case of failure so to do, indemnify the Obligee against any loss the Obligee may suffer directly arising by reason of such failure, not exceeding the penalty of this bond, then this obligation shall be null and void: otherwise to remain in full force and virtue.

Signed, sealed and dated: March 8, 2013 --------------------------------------------

Bockman and Woody Electric Company Inc.

(Principal)

The Ohio Casualty Insurance Company

(Attorney-in-Fact)

S-137-Rev.

~ Q. Q) "C· ~~~~ s::Q) cu~ .cs:: ..r~ ·- cu "C::~ ~Cl UQ)

.... ::l o­._cu Q)> =­Q)cu _::l

-"C s::·-culll 0~ -:. ... Q)0 0~ s::cu _ ... Q)­t:nt/1 cua> c:n'-1::~ 0.5 E -... ~ ocu ....... "C>­::u . cu s:: ' > Q) t ......... o'-z~

THIS POWER OF ATTORNEY IS NOT VALID UNLESS IJ IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they ha\'e no authority to bind the Company except in the manner and to the extent herein stated.

American Fire and Casualty Company The Ohio Casualty Insurance Company

Liberty Mutual Insurance Company West American Insurance Company

POWER OF ATTORNEY

Certificate No. 5863312

KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire & Casualty Company and The Ohio Casua~y Insurance Company are corporations duly organized under the laws of the State of New Hampshire , that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth , does hereby name, constitute and appoint, George P. Dohrmann; Gregory R. Dohrmann; Melissa K. Knight; Florence T. Unger

all of the city of Stockton , state of CA each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons.

STATE OF WASHINGTON COUNTY OF KING

55

American Fire and Casualty Company The Ohio Casualty Insurance Company Liberty Mutual Insurance Company West American Insurance Company

By:~ Gregory:oave;;pont Secretary

On this~ day of December , 2012 , before me personally appeared Gregory W. Davenport, who acknowledged himself to be the Assistant Secretary of American Fire and Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.

IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Seattle, Washington, on the day and year first above written.

/''''~f}~lfi;~···.\ - By: ~~~~~~·~~G------------------­

KD Riley , NOiAPUblic

.<<d~::~;~;;l~(Y-This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:

ARTICLE IV-OFFICERS- Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.

ARTICLE XIII -Execution of Contracts- SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary.

Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes Gregory W. Davenport, Assistant Secretary to appoint such attorneys-in-fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations.

Authorization -By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed.

I, David M. Carey, the undersigned, Assistant Secretary, of American Fire and Casualty Company, The Ohio Casua~y Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked.

IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of sa id Companies th is .8..th_ day of March ,2o_u_ .

By: ----<-.:~c;_;__:_· ~~""------David M. Carey,'Assistant Secretary

LM5_12873_09201 2 13 of 100

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ~~~~~~~~~~'®.'%~'%~%'%~~~;g;,g;.'@>~'@:>~~%'®~'@;.'§%'?iR;:g:<;;~~~

STATE OF CALIFORNIA

County of San Joaquin }

On March 8 2013 before me, Cheryl M. Ward, Notary Public Date

personally appeared Gregory R. Dohrmann

@ CHERYL M. WARD

Commission # 1952858 i Notary Public - California ~ San Joaquin County

My Comm. Expires Sap 18 2015

Place Notary Seal Above

Here Insert Name and Title of the Officer

Name(s) of Signer(s)

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

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

Witness my h

-------------------------------------------------------- OPTIONAL ----------------------------------------------------Though the information below is not required by law, it may prove valuable to persons relying on the document

and could prevent fraudulent removal and reattachment of this form to another document.

Description of Attached Document

Title or Type of Document: Bockmon & Woody Electric Company, Inc. - Bid Bond

Document Date: _,_,M'-"a""'r~ch'-'--"'8.L.-'=.20"'-1'-'3"----------------- Number of Pages:_1:...._ ______ _

Signer(s) Other Than Named Above: ______________ _ ___________ _

Capacity(ies) Claimed by Signer(s)

Signer's Name: Gregory R. Dohrmann 0 Individual 0 Corporate Officer - Title(s): ________ _

0 Partner - 0 Limited 0 General M Attorney in Fact 0 Trustee 0 Guardian or Conservator

0 Other: --------

Signer Is Representing: The Ohio Casualty Insurance Co .

RIGHTTHUMBPRINT OF SIGNER

Top of thumb here

Signer's Name: ____________ _ _

0 Individual 0 Corporate Officer - Title(s):,__ _______ _ 0 Partner - 0 Limited 0 General 0 Attorney in Fact 0 Trustee 0 Guardian or Conservator

0 Other: --------

Signer Is Representing:

RIGHT THUMBPRINT OF SIGNER

Top of thumb here

.:.-'GZ:~~~~~~'®.m~'@.~~~~'§(>~'@>~'§%~;g;(;~~~iR~~~·§K;'Q<;.'{; © 2007 National Notary Association • 9350 De Solo Ave .. P.O. Box 2402 • Chatsworth, CA 91313·2402 • www. NationaiNotary.org Item #5907 Reorder: Call Toii·Free 1·800·876·6827

S:\ciTYOF STOCKTON

PUBLIC WORKS DEPARTMENT

NOTICE TO CONTRACTORS

Official bid documents including plans and specifications for the following project are now available*:

TRAFFIC SIGNAL CONTROLLER UPGRADE AND RETIMING PROJECT N0.10-12

FEDERAL PROJECT NO. CML-5008(098) (FEDERAL AID CONTRACT)

Project Description: Traffic signal controller upgrade at 20 existing signalized locations on March lane, Harding Way, and Wilson Way; upgrade seven traffic signal cabinets.

Engineer's Estimate: Below $500,000

License Required: Class "A" o8

Mandatory Job Walk: None

Mandatory Pre-Bid Meeting: February 28, 2013, 9:00a.m.

Bid Opening Date:

Funding Source:

City Hall Council Chambers 425 N. ElDorado Street Stockton, CA 95202

Thursday, March 14, 2013, 2 p.m., City Hall

Federal Funds

*Note: Official bid documents including plans and specifications may be obtained from the City of Stockton web site at http://www .stocktongov .com/services/businesslbidflash.

All bids submitted for this project must conform with the requirements of the official bid documents, including plans and specifications.

If you would like additional information regarding this project, please contact, Dennis Yep, Project Engineer, at (209) 937-8825 or email at dennis.yep@stocktongov .com

TRAFFIC SIGNAL CONTROLLER UPGRADE/RETIMING PROJECT NO. 10-12

FEDERAL PROJECT NO. CML-5008(098) FEDERAL AID CONTRACT

BIDDERS CHECKLIST CITY OF STOCKTON

Did you complete and properly sign: V ---=-V_This Bidders Checklist and all forms provided in the following Bid for Public Work

section?

/ List of Subcontractors? v-

Lcheck list of Debarred Subcontractors (Labor Code Section 1777.1 )? http://www.dir.ca.gov/DLSE/Debar.html

L sign and notarize by jurat certificate the Non-Collusion Affidavit form (Exhibit

. / 12-E, Attachment D)? V ___{_Equal Employment Opportunity Certification (Exhibit 12-E, Attachment C)? 1/

ertification of Attempts to Recruit Minority and Women Employees (EE0-1 B)?V

itle VI Violation Self-Certification? v ublic Contract Code (Section 1 0285.1, Section 10162, Section 1 0232)? /

\L' Debarment and Suspension Certification (Exhibit 12-E, Attachment E)?V

, /Non-lobbying Certification for Federal-Aid Contracts (Exhibit 12-E,.v

' /'ttachment F)?~ ___.V_ DDisclosure of Lobbying Activities (SF-LLL) (Exhibit 12-E, Attachment G)?/

Include DBE Forms:

V' DBE Certification Statement (DBE-1A)~ (All Bidders: Due with Bid.)

V Company Workforce Report (DBE-1 B)v' (All Bidders: Due with Bid.)

V Bidders List of Subcontractors (Exhibit 12-G) (All Bidders: Due with Bid.)''-/

__ Bidder DBE Commitment (Construction Contracts - Exhibit 15-G} (1st, 2nd, & 3rd lowest bidders: Due to City within 4 business days.)

__ DBE Information- Good Faith Efforts (Exhibit 15-H) (1st, 2nd, & 3rd lowest bidders: Due to City within 4 business days.)

__ Final Report-Utilization of Disadvantaged Business Enterprises (DBE) (Exhibit 17-F) (Due at End of Project)

__ Disadvantaged Business Enterprises (DBE) Certification Status Change (Exhibit 17-0) (Due at End of Project)

General:

_L_Read and understand U.S. Department of Transportation Federal Highway Administration FHWA-1273, Required Contract Provisions Federal-Aid Construction Contracts? http://www. fhwa .dot.gov/programadmin/contracts/1273/1273. pdf

~ Advise all subcontractors of prevailing wage rate requirements.

7 Check http://www.wdol.gov/dba.aspx#3 website for any revisions to the applicable federal wage rates up to ten days prior to bid opening date. Federal wage rates will be physically included as part of the final contract documents.

_L Construction & Demolition Recycling Plan forms: See Instructions to Bidders: SECTION 24: CONSTRUCTION & DEMOLITION DEBRIS for directions and

/ locations of forms . ..Y_Include your 10% bidder's security (bidder's bond, certified or cashier's check).

_L_Review all Questions/Answers/Clarifications on the City web site at / http://www.stocktongov.com/business/bidflash.cfm prior to submitting your bid.

---"V_Submit company name and contact information to Nancy Arbios at

/ (209) 937-8114 or email at nancy.arbios@stocktongov.com

V Attend Job Walk, if mandatory None

=zAttend Mandatory Pre-Bid Meeting: Februrary 28,2013,9:00 a.m., City Hall Council Chambers- 425 N. ElDorado Street, Stockton, CA 95202

~Submit one (1) Original of all bid documents.

V ___ IDeliver the sealed bid proposal to City Hall, City Clerks Office (1st floor), 425 N. ElDorado Street, Stockton, CA 95202 not later than Thursday, March 14.2013. 2:00p.m. Sealed bid shall be marked "BID" and indicate project name, number, and bid opening date. Please note that some overnight delivery services do not deliver directly to the City Clerk's Office. This could result in the bid arriving in the City Clerk's Office after the bid opening deadline and therefore not being accepted.

NOTE: Bids are invalid which are unsigned or not accompanied by 1 0% bid deposit or a bidder's bond, signed by both the bidder and the surety. If erasures or interlineations appear on your bid form, they must be initialed by the person preparing the bid.

BOCKMON & WOODY ELECTRIC CO., INC

FIRM

209-464-4878 209-465-5314

CONTACT PHONE AND FAX NUMBER

GARY E. WOODY

1528 EL PINAL DRIVE, STOCKTON, CA 95205

ADDRESS GARY®BOCKMONWOODY.COM

E-MAIL ADDRESS

PRESIDENT

TITLE OR AGENCY

3- I 3 ~ Z..~ I ~ DATE

BID FOR PUBLIC WORK

CITY OF STOCKTON

Stockton, CA ------", ..... )~--' ~-=--- · 20_13_

TO THE HONORABLE CITY COUNCIL OF THE CITY OF STOCKTON:

Pursuant to your Notice Inviting Sealed Bids, I, we, or either of us:

coRPORATioN - 'ST~ o-F c.b-.uFoe_N\~ (State whether individual, firm, corporation, association, or co-partnership)

hereby offer (and hereby promise and agree in case this bid is accepted) to furnish all

labor, material , equipment and supplies necessary to complete the work mentioned in

said Notice Inviting Sealed Bids in strict accordance with the plans and specifications for

said work to be done and labor, materials, and equipment and supplies to be furnished ,

which plans and specifications are on file in the office of the City Clerk of the City of

Stockton and made part hereof by reference, the same as if herein fully set out, at the

following rates and prices, to-wit:

TRAFFIC SIGNAL CONTROLLER UPGRADE AND RETIMING PROJECT NO. 10-12

FEDERAL PROJECT NO. CML-5008(098)

BIDDING SCHEDULE

Each bidder shall bid each item, including all alternate bid(s). Failure to bid an

item shall be just cause for considering the bid as non-responsive. Line item

costs should include all Contractor's overhead and profit and indirect costs.

Bids not presented on City forms shall be cause for considering the bid as non­

responsive.

Item Description Unit Quantity ·Unit price Total Price Upgrade existing traffic signal controller to LS 2

1q,$'" Eagle 2070N with Sepac 3.4 and replace 30J,1l~ 1 the existing cabinet with the Type 'P' TS2

Traffic Signal Cabinet at locations 1 and 13, reusing the existing foundation. Upgrade existing traffic signal controller to 10

1, ?;CDC: 73tf:JJ~ 2 Eagle 2070N with Sepac 3.4 at locations 2, LS )

3, 4, 5, 7, 8. 9. 15, 16, and 18.

Upgrade existing traffic signal controller to LS 1 Eagle 2070N controller with Sepac 3.4.

44J~1f 4~21P Install Type 'P' TS2 Traffic Signal Controller 3 Cabinet on a raised foundation above the

existing foundation at the intersection of March Lane and College Square (location 6).

Upgrade existing traffic signal controller to a LS 1 Siemens M50 controller. Install Type 'M' TS1 Traffic Signal Cabinet, set the new ~ oD

4 cabinet adjacent to the existing cabinet on a 4~,~~. 4ttJ~1~ new foundation at the intersection of Harding Way and Center Street (location 10).

Upgrade existing traffic signal controller to a LS 1 Siemens M50 controller with Sepac 3.4. Install Type 'M ' TS1 Traffic Signal Cabinet,

l.j 4>,3"Af!; L{& ?:>1CJ cQ 5 set the new cabinet adjacent to the existing

cabinet on a new foundation, install a Type Ill AF new service, at the intersection of Harding Way and El Dorado Street (location 11 ).

Item Description Unit Quantity Unit price Total Price Upgrade existing traffic signal controller to a LS 1 Siemens M50 controller with Sepac 3.4. Install Type 'M' TS1 Traffic Signal Cabinet,

6 set the new cabinet adjacent to the existing lf~,~ L}~ 1~(j)o0 cabinet on a new foundation, install Type Ill AF new service, at the intersection of Harding Way and San Joaquin Street (location 12).

Upgrade existing traffic signal controller to a LS 1 Eagle 2070N controller with Sepac 3.4.

~~(!fbi t-t~Lf3r 7 Install Type 'P' TS2 Traffic Signal Controller Cabinet on a raised foundation above the existing foundation at the intersection of Wilson Way and Harding Way (location 14). Upgrade existing traffic signal controller to LS 3

~qS.~ 1 lP,4BSoO 8 Siemens M50 controller with Sepac 3.4 at locations 17, 19, and 20. ' Removal and re-installing of fiber optic LS 1 0

3D/JJf 9 cable at locations 6, 10, 11, 12, and 14 ?)J,CIJJ (AT&T fixed fee, the total is $30,000)

BOCKMON & WOODY ELECTRIC CO. , INC. BIDDER'S NAME __________ _

The undersigned agrees that if this bid is accepted, he/she will contract with the City of Stockton in the form of contract attached hereto to perform all of the work in accordance with the contract and the drawings, specifications, and other documents incorporated therein; that he/she will take in full payment therefor, and for all other obligations assumed under the contract, the prices set forth in the following bid schedule except as otherwise provided in the specifications; and that he/she will execute such contract and furnish the required contract bonds in the manner and within the time provided in the bidding requirements and conditions. The undersigned further agrees that he/she has carefully examined the site of the work and the bid documents and any addenda thereto, and is fully informed of the nature and location of the work, the quantities of the work, and the conditions to be encountered in performing the work; that the only parties interested in this bid as principals are those named herein and that this bid is made without collusion with any other party; and that this bid is submitted in all respects in accordance with the bidding requirements and conditions and all other requirements of the bid documents.

A bid guaranty accompanies this bid in the form of (check one of the following):

D Cash, or D Cashier's check, or D Certified check payable to City of Stockton, or ~ Bidder's bond in favor of the City

For any amount not less than ten percent (1 0%) of the aggregate of the bid.

Also accompanying this bid are the following attachments, properly executed and signed:

1. List of Subcontractors to be Used in the Work 2. Non-Collusion Affidavit.

THE CITY RESERVES THE RIGHT TO REJECT ANY AND ALL BIDS.

BOCKMON & WOODY ELECTRIC CO., INC. 209-464 - 4878 68-0203806

(Firm Name) (Phone) (Tax 1.0. No.)

1528 EL PINAL DRIVE STOCKTON CA 95205

(Address) (City) (State)

BOCKMON & WOODY ELECTRIC CO., INC . 588308 C-10 02/28/2014

(Contractor) (Lie. No. & Classification) (Expiration Date)

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT •

DANIELLE M. DIXON

Place Notary Seal Above

who proved to me on the basis of satisfactory evidence to be the person{afwhose nameEsris.lafe-subscribed to the within instrument and acknowledged to me that he/J>hQ/they executed the same in his.li:lerttheir authorized capacity~ and that by his/herftl•eil signature~) on the instrument the person{$};- or the entity upon behalf of which the person{-st-acted, executed the instrument.

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

WITNESS my h

OPTIONAL-------------------------Though the information below is not required by Jaw, it may prove valuable to persons relying on the document

and could prevent fraudulent removal and reattachment of this form to another document.

Description of Attached Document

TitleorTypeofDocument: _£,,d (")Y~ ~ Document Date: j!V)atf!IA ~~ ct:J.f??.~ Number of Pages: I-/ _______ _

Signer(s) Other Than Named Above: () 0 crtrr VJ §) J:>)[_S

Capacity(ies) Claimed by Signer(s)

Signer's Name: ~ b, ~ Signer's Name: ______________ _

2~~ividual ~ ~ 0 Individual ~orporate Officer - Title(s): ~1?-tk}JtL 0 Corporate Officer - Title(s): ________ _ 0 Partner- 0 Limited 0 General 0 Partner- 0 Limited 0 General 0 Attorney in Fact 0 Trustee 0 Guardian or Conservator 0 Other: ________ _

Signer Is Representing: ___ _

RIGHTTHUMBPRINT OF SIGNER

Top o~thomb here 0 Attorney in Fact 0 Trustee 0 Guardian or Conservator 0 Other: _________ _

Signer Is Representing: ____ _

RIGHTTHUMBPRINT OF SIGNER

Top of thumb here

• ©2007 National Notary Association • 9350 De Solo Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotary.org Item #5907 Reorder: Call Toll-Free 1-800-876-6827

By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Section 10162, 10232, and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). By my signature on this proposal I further certify, under penalty of perjury under the laws of the State of California and the United States of America, that the non-collusion affidavit required by Title 23 United State code, Section 112 and Public Contract Code Section 71 06; and the Title 49 Code of Federal Regulations, Part 29 Debarment and Suspension Certification are true and correct.

THE REPRESENTATIONS MADE HEREIN ARE MADE UNDER PENALTY OF PERJURY

BIDDER SIGN HERE

(Title)

NOTE: CONTRACTOR'S LICENSING LAW--In accordance with California Public Contract Code 201 03.5 when federal funds are involved in local agency contracts, no bid shall be invalidated by the failure of the bidder to be licensed in California at the time of bid opening. However, at the time of award the selected contractor shall be properly licensed in accordance with the laws of the State.

LIST OF SUBCONTRACTORS

GENERAL CONTRACTOR: BOCKMON & WOODY ELECTRIC CO., INC.

----------------------------------------PROJECT: TRAFFIC SIGNAL CONTROLLER UPGRADE AND RETIMING PROJECT 10-12

PLEASE LIST BELOW All SUBCONTRACTORS CONTRIBUTING TO THIS WORK

Each bidder shall give the name, business address, description of the work, and the dollar amount to be PAID the subcontractor, for each subcontractor that will be used on the project, if the Bidder is awarded the contract. Only subcontractors with work in excess of one-half of one percent (0.5%) or $10,000 (whichever is greater) of the Bidder's total bid need to be listed. All work in excess of one-half of one percent (0.5%) or $10,000 (whichever is greater) of the Bidder's total bid, for which a subcontractor is not listed on this form, shall be performed by the Bidder's own organization. Additional numbered pages listing proposed subcontractors may be attached to this page. Each page shall be headed "Proposed Subcontractors" and shall be signed by the Bidder.

(MUST PRINT LEGIBLY OR TYPE)

BUSINESS ADDRESS NAME (CITY) TYPE OF WORK

~ctf6 Lcrr61 -t G"rt)rtfVlN_ i?D-Bo~ t{){)CYc;k: 7 {o~C)e:; SWL~,0\4S2Dtp

BIDDER SIGN HERE

AMOUN"(_J'\

4W~ I

Local Assistance Procedures Manual PS&E Checklist Instructions

ATTACHMENT D NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and

Public Contract Code Section 7106)

To thee I COUNTY of 3 f 0 c_)< ton DEPARTMENT OF PUBLIC WORKS.

EXHIBIT 12-E Attachment D

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, fmther, 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 pmt of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit.

OB 12-04

Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution.

Page 12-29 June 29, 2012

CALIFORNIA JURAT WITH AFFIANT STATEMENT

D See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary)

2

3

State of California _

Coun1y o&w 1!mt1JM J/v

• M

Place Notary Seal Above

Signature of Document Signer No. 2 (if any)

Subscribed and sworn to (or affirmed} before me on this

{ 3 day of uVlcuc d.A ' '20 r 3 by Date Month (v-rrf A J:r

(1) ~.~§"...:., ~ proved to me on the basis of satisfactory evidence to be the person who appeared before me (.) (,)

(and

(2} _______ ------,. ______ _ Name of Signer

OPTIONAL------------------------Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent

fraudulent removal and reattachment of this form to another document.

Further Description of Any Attached Document

Title or Type of Document:~~ 1) lJ'DIJ\.(!g)\ Uri\)'() ~ Document Date: ~'h1Yr!JA ( 'Q) &Q( 0 Number of Pages: _1 __ _

Signer(s) Other Than Named Above: \C)\) D\kQ)r "J,Qbe.>(b

RIGHTTHUMBPRINT OFSIGNER#1

Top of thumb here

RIGHT THUMBPRINT OFSIGNER#2

Top of thumb here

• © 2007 National Notary Association • 9350 De Solo Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotary.org Item #591 0 Reorder: Call Toll-Free 1-800-876-6827

LcK:al Asmta.nce Proced1ll'el Manual PS&E Clteeklist Instructions

EXHIBIT 12-E Attaebmeat c

(THE BIDDER'S EXECU110N ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXEC uri ON OF THOSE CERTIFICATIONS WHICH ARE .A PART

OF THIS PROPOSAL)

AITACHMENT C EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION

BOCKMON & WOODY ELECTRIC CO., INC. The bidder proposed

subcontractor ~6 (~ ~ '4%· , hereby certifies that he has~ bas not__, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required

by Executive Orders 10925, 11114, or 11246, and~ where required, he has filed with the Joint Rq>m:ting

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 60-1.7(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 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt)

Currently, Standard Form 100 (EE0-1) 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 IqlOds should note that 41 CFR 60-1.7(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 ofLabor.

OB 12-04 PageU-27

June29,2012

Certification of Attempts to Recruit Minority and Women Employees

(FORM EE0-1 B)

To ensure compliance with City of Stockton's Equal Employment Opportunity Plan, it is the City's policy that all contractors bidding on federal-aid projects complete and return the following information:

I, ""GA-:-R-:Y~E_. :-w_o_o_D_Y:-::-:-:-:------, representing BOCKMON & WOODY ELECTRIC CO. , I~C (PrinUType Company Official Name) (PrinUType Company Name)

am knowledgeable of the City of Stockton's Equal Employment Opportunity goals and I have thoroughly reviewed and complied with provisions of City of Stockton bid requirements and I certify that:

DYes [::]No When recruiting for vacancies this firm conducts mailings to specific outreach agencies and interest groups concerned with minority and women employment.

~Yes 0No This company has an Equal Employment Opportunity policy and all employees and applicants for employment receive equal consideration and treatment.

~Yes 0No This company understands the legal and moral commitment of complying with federai and state legislation promoting equal employment opportunities and is committed to promoting equal opportunity in its work force.

The City of Stockton reserves the right to require add itional information from the bidding contractor at any time .

.-:/it!: o~ Official Date

GARY E. WOODY PRESIDENT

Print/Type Name of Company Official Title

..

TITLE VI VIOLATION SELF-CERTIFICATION

We, the undersigned, self-certify that pursuant to Federal Code of Regulations (CFR),

23 CFR 200.9, 633 and 49 CFR 21.7, we do not have any unresolved violations under

Title VI of the Civil Rights Act of 1964 and related statutes, including Americans with

Disabilities Act (ADA). In addition, we acknowledge that an unresolved Title VI violation

will disqualify us for consideration as a bidder for the subject project.

CONTRACTOR: BOCKMON & WOODY ELECTRIC CO. , INC.

TITLE

DATE: S"" l 3- ;lo f3

PUBLIC CONTRACT CODE

Public Contract Code Section 10285.1 Statement

In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985),

the bidder hereby declares under penalty of perjury under the laws of the State of

California that the bidder has_, has not ~been convicted within the preceding

three years of any offenses referred to in that section, including any charge of fraud,

bribery, collusion, conspiracy, or any other act in violation of any state or Federal

antitrust law in connection with the bidding upon, award of, or performance of, any

public works contract, as defined in Public Contract Code Section 11 01, with any public

entity, as defined in Public Contract Code Section 1100, includ ing the Regents of the

University of California or the Trustees of the California State University. The term

"bidder" is understood to include any partner, member, officer, director, responsible

managing officer, or responsible managing employee thereof, as referred to in Section

10285.1.

Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the 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.

Public Contract Code Section 10162 Questionnaire

In conformance 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, state, or local government project because

of a violation of law or a safety regulation?

Yes No xx --

If the answer is yes, explain the circumstances in the following space.

Public Contract Code 10232 Statement

In conformance 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.

Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution.

Local Assistance Procedures Manual PS&E Chectllst l:utru.ctions

ATfACHMENT E DEBARMENT AND SUSPENSION CERTIFICATION

TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29

EXIDBIT U-:1: Altachmellt E

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 ineligt"bility 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 bad a civil judgment rendered against it by a court of compc1llnt

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.

{11/fr

Exceptions will not necessarily result in denial of award, but will be considered in determining bidder resporun"bility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action.

Notes: Providing false .infonnation 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.

OBll-04 PageU-31

June 29, 2012

Loeal Asaistanee Procedures Manual PS&E Checklist lastruetions

EXIDBIT 11-E Atbldunent F

AITACIIMENT F NONLOBBYING CERTIFI.CATION FOR FEDERAL-AID COl'f.fltACfS

The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that:

(1) 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 contmct, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreemmt, 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 Fonn-ll.L, "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 sub recipients shall certify and disclose accordingly.

OB12-04 Page 12-33

Jnne29,20U

Low Assistaace Procedures Manual PS&E Cbeddist lllstructions

UBIBITU-:K Attadallllent G

AITACIIMENT G DiscLosURE OF LoBBYING AcriVITIFS COMPLETE THlS FORM TO DlSCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352

1. Type of Federal Action: l. Status of Federal Action: 3. Report Type:

D a. oonlmct D a. bidlotlttlapplication D a initial b. grant b. initial award b. material change c. coopc::mtive agreement c. post-award dloan. e. loan gunraotce f. loan insurance

4. Name and Addras of Reporting Entity S. If Reportiug Entity ia No. 4 is awardee, Enter Name and Address of rime:

0 Prime 0 Subawanlee Tier , ifknown

NO LOBBYING N/A Congreuiolllll DUtrlc:t, if known

6. Federal Department/Agency:

8. Federal Adfoo Nlllllber, if known:

18. a. Name and Address of Lobby Entity (If individual, last name, first name, Ml)

Congressional n· trict, ifknown

Namr/Desaiption:

9.

• ladMduals Perfcmning Senices fmcluding address if different from No. lOa) (last twne, first name, Ml)

·on Shect(s) if necessary)

11. Amouat of Payment (check all that apply

$ 0 actual

tz. Fonn of Payment (dlec:k all that a

Ba.cash b. in-kind; specify: re ____ _

13. Type of Payment (check an that appiJ)

a. retainer

b. one-time fee c. commissioo

d contingent fee e dcfi:rred

Value _____ _ f. other, specify _ ________ _

14. SerWies Perfonned or to be performed and Date(s) of Senice, lnclud~Ja: r member(s) contacted, for Payment Indicated in Item 11:

(attach Continuation Sheet(s) ifnecessaty)

Yes 0 No 0 cd through this foon is authorized by Title

1352. This disclosure of lobbying reliance tbe ticc above when his traosaction was made

ocen This disclosure is ~a~.uiredpursuant to 31 U.S.C. 52. This infunnation will be IqJOrtal to Congn:ss

ly and will be available fur public inspection. Any who liuls to file the required disclomre shall be subject

to a civil pe8lllty of not less than SlO,OOO and not more than $100,000 for c.;b such faJ.lure. TelephoneNo.: 209-464-4878

Federal Use Ollly: Authorized fur Local Reproduction Slaodard Form - U.L

Standard Form LLL Rev. 09-12-97

OB 12-04 Page J.l-35

June 29, 2012

DBE Certification Statement (FORM DBE-1A)

The Respondent to a City of Stockton Competitive Bid or Request for Proposal hereby certifies:

1. That it shall demonstrate compliance with the requirements established in the City of Stockton's DBE Program.

2. That it fully understands that the provisions contained in the City's DBE Program shall be considered a part of its contractual agreement with the City in the event of award of contract

3. That it is in compliance with all Executive Orders and all Federal, State and local laws regarding fair employment practices and nondiscrimination in employment. Stockton Municipal Code Chapter 3. 72 (Non-discrimination and Affirmative Action Programs for Performance of City Contracts) shall apply.

4. That it will continue to make good faith efforts to hire women and minorities of those races and in those trades that are substantially under-represented in the

pan workforce.

GARY E. WOODY

Print/Type Name of Company Official

Company Name BOCKMON & WOODY ELECTRIC CO. , INC.

AddreSS 1528 EL PINAL DRIVE STOCKTON, CA 95205

3- 13- 2()t 5 Date

PRESIDENT

Title

Telephone ( 209 ) 464-4878 County_sAN __ J_oA_Q_u_I_N ________ --:--_

ProjectName\rq,yl/'L S,~t-.:)f\1.... ~~ OPb~/~ET\~tNb. ~\0-\1..

DYes ~No

If yes:

Is your company a certified Disadvantaged Business Enterprise?

Certifying Agency-------------Certification Number ____________ _

Qualify as DBE? 0 Yes (iJ No

************************furoffloeuseon~*************************

Verified by ___________ Date--------

Company Name:

Project Name:

Company Workforce Report (FORM DBE-1 B)

BOCKMON & WOODY ELECTRIC CO., INC.

TRAFFIC SIGNAL CONTROLLER UPGRADE AND RETIMING PROJECT NO. 10-12

(Indicate the current ethnic make-up of your permanent office and field personnel.)

JOB CATEGORIES TOTAL LAnNOt AFRICAN ASIAN IIA11VE ASIAN SUB-EIIPLOYEES HISPANIC AIIERICAN PACIFIC ~ COIITIIIEICT MIRE

ISL

M F II F II F II F II F II F • F

1. Officials & Managers 4 4

2. Professionals 3 3

3. Clerical & Office 3 1 2

4. Field Supervisor

5. Skilled - Specific Trade ELECTRICIANS 29 9 20 a.

b. LABORERS 1 1

OPERATING ENGINEER 1 1 c.

6. Unskilled - Specific Trade

a. SHOP MEN 4 1 3

b.

c.

7. TOTAL -Items 1-6 42 3 11 1 31 2

TABLE A: For Official Use Only

(A) (B) (C) (D) (E) (F) (G) Female Hispanic African Asian Native Asian Sub- While Oilier

American Pacific lsi. American continent

Organization Personnel%

Total Personnel

Note: All firms doing business with the City of Stockton must provide the workforce ethnicity information requested on this form. Failure to do so will result in bid or RFP rejection for non-responsiveness.

II

01HER

F

Tolal (A-G)

EXHIBIT 12-G

Bidder's List of Subcontractors (DBE and Non-DBE) Part 1

Obtain most current form from the Caltrans website:

(http://www.dot.ca.gov/hg/LocaiPrograms/lam/forms/lapmforms.htm)

Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non-DBE)

BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON·DBE)· PART I The bidder shall list all subcontractors (both DBE and non-DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms.

Firm Name/ Phone/ Address/ Fax

City, State, ZIP

r-&6 Gms-(eutr -4-~a, Phone

2ll q ~04 s 1<2b Addlrm

\o?f\6 }

?D-~~ Fax

5fbiirz~c w ~ SZOP zoq~~51BZ-Name Phone

Address

Fax

City State ZiP

Name Phone

Address

Fax

City State ZiP

Name Phone

Address

Fax

City State ZIP

Distribution: I) Original· Local Agency File

LPP 06-06

Annual Gross Description of Portion of Work to be Performed

Receipts U<$1 million ~\LEIB ··-·-----·---~< $5million

0 < $10million

0<$15million

0>$15million

U<$1 million

0 < $5million

D < $10million

0 < $15 million

0>$15 million

U<$1 million

0 < $5 million

0 < $10 million

0<$15million

0> $15 million

U<$1 million

U<$5million

0<$10million

0<$15 million

0> $15 million

d~ *,\J!CHO l ;.r Onh I( uhfil't.l UBf ?)

YES NO

If YES list DBE #:

Age of Firm (Y rs.)

YES NO

If YES list DBE #:

Age of Firm (Yrs.)

YES

NO If YES list DBE #:

Age of Firm (Yrs.)

YES NO

If YES list DBE #:

Age of Firm (Yrs.)

Page 12-111 November 14,2006

EXHIBIT 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non-ODE)

BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON·DBE)· PART II The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49. Section 26 of the Code of Federal Re2ulations. Photocoov this form for additional fi ..........

Firm Name/ Address/

City, State, ZIP Name

Address

CityStateZJP

Name

Address

City State ZIP

Name

Address

City State ZIP

Name

Address

City State ZIP

D18trlbutlon: I) Original- Local Agency File

Page 12-112 November 14, 2006

Phone/ Annual Fax Gross

Receipts Phone 0 < $1 million

0 < $5 million

0 < $10million

Fax 0 < $15 million

0> $15 million

Phone U < $1 million

0 <$5million

0 < $10million

Fax 0 < $15million

0 > $15 million

Phone 0<$1 million

0 <$5million

0 < $10million

Fax 0 <$15million

0> $15 million

Phone 0 <$1 million

0 < $5 million

Q < $10million

Fax O < $15 million

0 >$1Smillion

Description of Portion of Work to be Performed

··--· ···---·· -. -· ····- ·-··· . - . -·

··---·

-----···---· . --·· .... . --- . .... ... -

··---------- -----···-·- ···-- ···-· .... ····- ···--·· ·-- ····--· ----· ·----- ---·-··----

-- --·- ... --- ... --- .. --- ... -- .... - ...... -- .. - -·· .. . ··- .... -- .. --- .... -.. --· ..... -· .

··---···----- ···--··----- ---- ·-·-· .. ··-- .. --. ---·····--· ·---· ···-·· ---·····--·

··--· ------- ·--·. -···· .. .. .. --- ..

----- ···---- ····- ..

··--·- ··-----.- ·-

-----------· ·- . -·· ... . .. ··-· . . ·- .....

----------.--- ·-·- --- ····- ·----·· ... -.

----·-·· ---· ·- --- --·· ·- ... . ---···· -··-

··--- ·-----. -- . ··-·· -- ----- - ---- ....

----- ------- ----· --.

----- ------ .. -. ---·-- . - ........... -· ··-. ---·· . . ..

L1u .• I ~~:sau:y 1 ~~ Uul (Certified DBE?)

YES NO

If YES list DBE #:

Age ofFirm(Yrs.)

YES NO

If YES list DBE #:

Age of Firm (Yrs.)

YES

NO If YES list DBE #:

Age of Finn (Yrs.)

YES

NO If YES list DBE #:

Age of Firm (Yrs.)

LPP 06-06

CITY OF STOCKTON Public Wor1ts Department • Solid Waste & Recycling Division • 22 E. Weber Avenue ~ Room 301 ~ Stockton, CA 95202

Construction I Demolition Recycling Plan

Permit#: Date: 3-\ L\., \ 3 Job Site Address: VQ.rlCXb low'flof'!S Zip Code: _____ _

'¢1 Company D Owner

Mailing Address: Y () · C,OK Name: 't3oU4f\ON ~ "{'inoty &-)ec.i-Y\c.-C_n ,r~~ I D f 5 Contact Phone#: 1c:A 4(Q 1-t.\@18

City and ZIP: 5fDC1JON q5 2 D / Project Size: sqft

Type of project: "')d_ Construction D Demo D Roofing D AC D Plumbing ~ Electrical

Describe the project:11 o f{tc Dig na I tbn-/r oIler u pg (a de. -1 rc+trrJJn q

1. How do you plan to dispose of the debris that you will generate with your project?

D I will hire a city permitted hauler: D Cal Waste(369-3712) D Waste Management (946-5721) (Go directly to 3 if using a permitted hauler)

D Allied Waste (466-5192)

~ I will self hau_l debris _to: \<.e_~\cx:>.,'-\ ~ . ~..- P\v;:\ ( ) (See Resource L•st for locations) -::::;) • l... 4 Save your receipts!

2. What materials will be generated by your project?

D Asphalt

D Bricks I rocks

D Cardboard

~ Concrete I Cement

D Dirt I Clean Fill

D Drywall/ sheetrock

D Glass I Windows

D Lumber I Wood

D Metals

D Mixed construction materials

D Roofing materials D composite

D Salvaged items (fixtures, furniture)

D Other (please specify):--------

3. As the owner of, or agent for this permit application, I understand that by signing this form,

the permit applicant is responsible for the debris generated under this project, and will comply

with the city's recycling and reporting requirements, even if the work is performed by a

subcontractor or third party.

Failure to comply may result in fines and I or citations!

Date

~t-ee. 1tle (owner, contractor, agent, etc.)

C&D Package 2010 Please call {209) 937-7579 for assistance Revised 2-2010

CITY OF STOCKTON - - --- -PUBLIC WORKS DEPARTMENT

22 East Weber Avenue, Room 301• Stockton, CA 95202-2317 • 209 / 937-8411 • Fax 209/937-8277 www.stocktongov.com

LETTER OF CLARIFICATION NO. 1

TRAFFIC SIGNAL CONTROLLER UPGRADE AND RETIMING CITY PROJECT NO. 10-12

FEDERAL PROJECT NO. CML-5008(098)

TO ALL PROSPECTIVE BIDDERS DATE: February 28, 2013

Letter of Clarification No. 1 for the above project consists of the following:

1. This acknowledgement form (see important notice at the end of this document).

BID OPENING TIME:

2. The bid opening time was incorrectly posted as 9:00 a.m. on the City's website, BidFiash. The correct bid opening time is 2:00 p.m. on Thursday, March 14, 2013, as is listed on all bid documents.

Stockton

Letter of Clarification No. 1 Traffic Signal Controller Upgrade and Retiming February 28, 2013 Page2

DISADVANTAGED BUSINESS ENTERPRISES (DBE) INSTRUCTIONS TO BIDDERS:

3. Replace Disadvantaged Business Enterprises (DBE) Instructions to Bidders (revised 2/13/13).

~ Gt!!:!t1. DIRECTOR / PUBLIC WORKS DEPARTMENT

GAM:TG:DY:nla

Attachment

NOTICE: THIS FORM MUST BE SIGNED AND RETURNED WITH YOUR BID. FAILURE TO SO INCLUDE OR ACKNOWLEDGE A CLARIFICATION MAY RESULT IN THE BID BEING REJECTED AS NOT RESPONSIVE.

CONTRACTOR: ~D~\D~ ~ \bloo.Di G.£'crtH-~)r~c......... SIGNATURE OF ¥ ~

BIDDER: ~u , DATE: 3 · I 3 ,.. d-.~ / S

:·ODMA\GRPWISE\COS.PW.PW_Library:204039.1

Local Asmtaace Proadures Manaal EXHIBIT 15-G Local Agency Bidder DBE Commitmellt (Coastruction Contracts)

ExHIBIT 15-G LocAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCI10N CONTRACI'S)

NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM

LOCAL AGENCY: Q_ \:f'l Df ~(X__T()~ LOCATION: \lox iav~ k:D(alJc.r.b1 StcCJ:::..rOr-.J Cf\

PROJECTDESCRJP'I10N~ 1\fiYl c St~.\ CD!\7\nl W Clllgrad.c.--< 9eh "''ri\ ~cc.-t \D~ 1'2.

TOTALOONTRACfAMOUNT:$ 1..\~\ I \l£, .00 BIDDATE: 3- )\.-\--13 BIDDER'SNAME:RDL~ ~ %ti).j< \1\E:ftZtL.-[[11 ~Q._.-CONTRACf DBE GOAL: ) . DC) 1 D

PlNTRACT m:M OF WORK AND DESCRIPTION pBECERTNO. ~OFEACH DBE DOlLAR AMOUNT rrEMNO. Plt SERVICES TO BE ~EXPIRATION {Must be catified on the dllll: bids DBE

SUBCONTRACfED OR MATERIALS DATE ~opened - include DBE address IO BE PROVIDED (or CIOIIlraCted if the ~ pbone numbet) bidder is a DBE)

·"' 'tr[y_AG- 2-=JW~ ~2~4- I k'M~ f.b-n?'('-1"&o_ lftx.:U ~ tt:h' ~ In Y.lf::.6 J 1.-<--.1. .... ~ """''"' ffi qqa, ZcPi 4/Q~~6/eD

For Local Agency to Complete: s yacooo Tolal Claimed DBE Local Agency Coollact Number: Participatioo

Federal-&d Project Number: I.\ \ %

Federal Share:

Conlillct Award Date:

JjtfAI/{; !t/!JzJ~ Local Agency certifies that all DBE certifications have been verified and Signature Qtnidcb /?/ infonnatioo is complete and accurate.

3· Jy . ) 3 20C'f q(ocf C/87 8 Date (Area Code) Tel No.

6/tE-kf. £:. \JIJ D~ Print Name Signature Date Local Agatcy Represeolative Person to act ( ype « Print)

(Area Code) TelqJhonc Number: Local AtpJCy Bidde£ DBE Cmwitmml (Comlmdion COIIII3ds) (Rev 612Ml9)

Distribution: (l) Copy- Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) witbin 30 days of COIIUal:t executioo. Failure to send a copy to the DLAE within 30 days of cootract execution may result in de-obligation of fimds for this ~ (2) Copy -Include in award package to Caltrans Dislrict Local Assistance (3) Original- Local agency files

Page lS-1 OB 12-04 June 19, lOll

Unified Certit'ication Program

Back To Query Form

Page 1 of I

Search Returned ll. Records Tuo Nov JO 10:01:19 PST 2010

\lU~ry Criteria Firm ID: 29435

Finn Type: DBE

Firm JD Firm/OBA Name Address Une1 Address Line2 City State Zip Code1 Zlp Code2 Maillng Address LiM1 Mailing Address Line2 Mailing City Mailing State Mailing Zip CodQ1 Mailing Zip Code2 Certification Type EM all Area Code Phone Number Fax Area Code Fax Phone Number Agoncy Name Counties r:listrlcts

18E NAICS

ACDSENAICS

Work Codes

Licenses Gender Ethnlclty Firm Type

29435 RODGERS CONST. & ENGINEERING CO ., INC PO BOX 581l5

STOCKTON CA 95206 666G

DBE rcenda@pacbell.net ( 209) 454-5780 ( 209) 1!6'1-5782 DEPARTMENT OP TRANSPORTATION 10;~4;34;38;39;46; 50;67; 03; 04; 06; 1 0; 237310; 237990;

C1601 CLEARING & GRUBBING; C1901 ROADWAY EXCAVATION; C1910 GRADING; CZ201 FINISHING ROADWAY; C3910 PAVING ASPHALT (ASPHALT CONCRETE); C3940 PLACE ASPHALT CONCRETE DIKE & MISC; C4040 CLEAN & SEAl. PAVEMENT JOINTS -ROUT & SEAL CRACKS; C47.01 GROOVE & GRIND PAVEMENT; C9961 BUILDING MOVER; A General EnglneGrlng Contractor; F NATlVE AMERICAN DBE

.. ...,.,.. ............ - .. ,-.... ,. ,,R':'J.'WI'\""'·l•••I H-f,l'l ...., INM..-.,o•""""'~-..... •W•..,•Ioi-W .... Uf"""" ... "'''_,_,_.....,_,,.,..,.,,, .... _._.,~ ..... ,'"',.,._.ll' JII, ....... ":I..,,._, '""""'li'.,'T»P"',..._.,, .. ,0,'J\I'f,.,_!";T''"~': ' '<:~,..,!"....,./'T"

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