THE AMERICAN INSTITUTE OF ARCHITECTS - …...THE AMERICAN INSTITUTE OF ARCHITECTS AlA Document A31 0 Bid Bond KNOW ALL MEN BY THESE PRESENTS, that we The Fishel company 1366 Dublin

THE AMERICAN INSTITUTE OF ARCHITECTS

AlA Document A31 0

Bid Bond

KNOW ALL MEN BY THESE PRESENTS, that we The Fishel company 1366 Dublin Road, Columbus, OH 43215 (Here insert full name ,and address or legal tiUe of Contractor) as Principal, hereinafter called the Principal, and Western Surety Company 333 S. Wabash Avenue, 41st Floor, Chicago, IL 60604 (Here Insert full name ,and address or legal tiUe of Surety)

a corporation duly organized under the laws of the State ofSDas Surety, hereinafter called the Surety, are held and firmly bound unto City of Stockton

425 N. El Dorado Street, Stockton. CA 95202 (Here insert full name ,and address or legal title of OWner)

as Obligee, hereinafter called the Obligee, in the sum of ~ 1 . v \W~ ....,,~(. ~ ~~ \nurorc::.o ~~~-&'" dol\a~ an E.c~h+'f- "51 X Ct.n-\5· Dollars ( $ 2qr l2J.o, 8Co ),

for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

WHEREAS, the Principal has submitted a bid for Fiber Optic Network Expansion -Weston Ranch and SJRTD Office. Project No. 10-05 Federal Project No. CML-5008(096)

(Here insert full name, address and description of project) NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in €aid bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid then this obligation shall be null and void, otherwise to remain in full force and effect.

Signed and sealed this 14day of March, 2013

The Fishel Company (Seal)

PaJI R Riewe (Tille) Vice president and CFO Western Surety Company

<-~~ Thomas A. Gillies (

1 e) Attorney-In-Fact

AlA DOCUMENT A310 BID BOND AlA® FEBRUARY 1970 ED THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE .• N.W. WASHINGTON, D.C. 20006

Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT

Know All Men 8y These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organilCd and existing corporation

having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby

make, constitute and appoint

Michael W Haughn, Patricia .J Fleming, Barry C Fonarow, Brian F Haughn, Chad Michael Dougherty, Thomas A Gillies Jr~ Individually

of Dublin, OH, its true and lawful Attomcy(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds,

undertakings and other obligatory instruments of similar nature

- In Unlimited Amounts -

and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and alii he acts of said

Attorney, pursuant to the authority hereby given, are hereby ratified and conflrmed.

This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof, duly adopted, as indicated, by

the shareholders of the corporation.

In Witness Whereof, WESTERN SURETY COMPANY has caused these prcsent.s to be signed by its Vice President and its corporate seal to be

hereto affixed on this Jrd day of October, 2012.

State of South Dakota County of Minnehaha

WESTERN SURETY COMPANY

~'"· VluP"'""'

On this Jrd day of October, 2012, before me personally came Paul T. BruOat, to me known, who, being by me duly sworn, did depose and say: that he

resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed

the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed

pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges

same to be the act and deed of said corporation.

My commission expires

June 23,2015

·fit~~~".... . . .....,.,... .... J J.MOHR ~ f ~NOTARY PUBLIC SEAL ~~SOUTH DAKOTA f ,, . . ···~~~"""" ....

CERTIFICATE {j.W ~ J.Mohr, NotaryPublie

I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in

force, and further certify that the By-Law of the corporation printed on t11e reverse-hereof is still in force. In testimony whereof I have hereunto subscribed

my name and affixed the seal of the said corporation this 14th dny of March 2013

WES TERN SURETY COMPANY

Fonn F4280· 7·20 t 2

WESTERN SURETY COMPANY Sloo Fallt, South Dakota

Statement of Net Admlned Asset• and Liabilities December 31, lOll

Bonds Stocks

Cash Nld aOOrt·t=l iDVC3tmcnb UllllOUcc:ted p!UIIiwm aal agcr# baWlccs

Fu.odJ held by or deposited with reinsured complllles

Net deferred tax asset

lnvestiOOU income due and eocrued Otht1'Wdl TotalASJCU

l!ABO.ITmS AND SURPLUS

Losxs

Loss ldjustmcnt expeme Contingenlllld olhcr commissions payable

Otbtrellpcme

T"-es, llccnlca IUid feet Fedelll and foreiplocomc taxes payable Unearned premiums

Olber I!JbUities Tocal L!Jbllities

Swplus Account

Capital paid up

Oross paid in and contributed ~~~rplus Special Surplu.s UIIUiitlJICd funds

Surplus as regads po~eybolden Tocal Ueblllties IDd c.pital

4,000,000 176,43S,2J2

7,321,616 7011727,7SS

$ I .~03,423,937 22,726,363

66,8S2,340 34,.207,619 13,980,081 23,802,839

17,647,115 2.489,406

$ 1,~87,129,780

s 296,352,421 82,551,462 5,246,025

28,831,919

1,921,642 $,637.067

247,814,064

29J861347 697,645.147

$ 889,484,633 $ 1,.?87,11917&0

I, Amy M. Smith, Assistant Vice Pn:sideol of Wes~t:m Swe~y Cotnpell)' ba'Cby certify tt.t the lbovc is an 8C:CU11tc rep~ or tbe finlnclal .--of tbe ComplnY claled December 31, lOll, as lillld w1lh the vlrious tmuraooe DeplrtmeiU and is alnlo llldcorrcct.catcmem of tho conditionofWcalcm s-ty Co~ u of that clalc.

Mx commission mjua;

:•••••••••••o••••••••••••••• : "OFFICIAl SEAL" : : KATHLEEN M. SCHROEDER: : NOIBry Publlo, State Of IllinOis ! t.~.c:::~~!~i~~.~~!~!~.:

By my signature on this proposal I certify, under penalty of pe~ury under the taws of the State of California, that the foregoing questionnaire and statements of PubRc Contract Code Section 10162, 10232, and 10285.1 are true and correct arid that the bidder has C()mplied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, TrtJe 2 of the California Administrative Code). By my signature on this proposal I further certify, under penalty of-pe~ury 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 7106; and the Title 49 Code of Federal Regulations, Part 29 Debarment and Suspension Certification are true and correct

THE REPRESENTATIONS PERJURY

VJ/Jf ~ l~ (SigtJatum) 7

MADE HEREIN ARE MADE UNDER PENALTY OF

BIDDER SIGN HERE VICE PRESIDENT

(Title)

NOTE: CONTRACTOR'S LICENSING LAW-In accordance with California Public Contract Code 20103.5 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.

J

FIBER OPTIC NETWORK EXPANSIONWESTON RANCH & SJRTD OFFICE

FEDERAL AID CONTRACT BIDDERS CHECKLIST CITY OF STOCKTON

Did you complete and properly sign: x This Bidders Checklist and all forms provided in the following Bid for Public Work

section?

x List of Subcontractors?

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

x Sign and notarize by jurat certificate the Non-Collusion Affidavit form {Exhibit

12-E, Attachment D)?

x Equal Employment Opportunity Certification {Exhibit 12-E, Attachment C)?

x Certification of Attempts to Recruit Minority and Women Employees {EE0-1 B)?

x Title VI Violation Self-Certification?

x Public Contract Code {Section 10285.1, Section 10162, Section 1 0232)?

x Debarment and Suspension Certification (Exhibit 12-E, Attachment E)?

x Non-lobbying Certification for Federal-Aid Contracts (Exhibit 12-E,

Attachment F)?

x Disclosure of Lobbying Activities {SF-LLL) (Exhibit 12-E, Attachment G)?

Include DBE Forms: x DBE Certification Statement (DBE-1A) (All Bidders: Due with Bid.)

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

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

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

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

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

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

General: x 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/wogramadminlcontracts/1273/1273.pdf

x Advise all subcontractors of prevailing wage rate requirements.

x 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.

x Construction & Demolition Recycling Plan forms: See Instructions to Bidders: SECTION 24: CONSTRUCTION & DEMOLITION DEBRIS for directions and locations of forms.

x Include your 10% bidder's security (bidder's bond, certified or cashier's check).

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

X Submit company name and contact information to Nancy Arbios at

(209) 937-8114 or email at [email protected]

x Attend Job Walk, if mandatory None

x Attend Mandatory Pre-Bid Meeting: Februrarv 28,2013, 9:00a.m., City Hall Council Chambers- 425 N. El Dorado Street, Stockton, CA 95202

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

x Deliver 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 10% 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.

THE FISHEL COMPANY

FIRM

602.233.0658 (PHONE) 602.233.2930 (FAX)

CONTACT PHONE AND FAX NUMBER

BILL PAULEY

PRINT~ NAME ( ~ ()

I :J ,}j ~ avJ~~4 -SI_G_N-AT.....;U::...R._E. (

t 8 t 9 S. 27TH AVE. PHOENIX, AZ 85009

ADDRESS

WMY [email protected]

E-MAIL ADDRESS

VICE PRESIDENT

TITLE OR AGENCY

3.13.13

DATE

BID FOR PUBLIC WORK

CITY OF STOCKTON

tockton, CA MARCH 14 , 20..!L_

TO THE HONORABLE CITY COUNCIL OF THE CITY OF STOCKTON:

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

THE FISHEL COMPANY INCORPORATED UNDER THE LAWS OF OHIO

(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:

FIBER OPTIC NETWORK EXPANSION WESTON RANCH AND SJRTD OFFICE

PROJECT NO. 10-05 FEDERAL PROJECT NO. CML-5008(096)

BIDDING SCHED ULE

Each bidder shall bid each item, including all alternate bld(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 Weston Ranch Fiber Oetlc Network

Expansion

1 Furnish and Install 2 1/2" Sch 80 PVC LF

Conduit (open trench) 150 $43.36 $6,504.00

2 Furnish and lnstall 2 1/2" HOPE LF

(Boring) 4,690 $21 .52 $100,928.80

3 Furnish and Install #6 Pull Box with EA

Extension 12 $1 ,225.37 $14,704.44

Install the City furnished 24-Strand 4 Dielectric Loose Tube 8.3/125 Micron LF

33,500 $1 .09 $36,515.00 SM Fiber (OSP) Furnish and lnstaii12-Strand Dielectric

5 Loose Tube 8.3/125 Micron SM Fiber LF 6.000 $1 .93 $11 ,580.00

{OSP)

6 Furnish and Install Fiber Cable Warning

EA Label 120 $10.48 $1 ,257.60

7 Furnish and Install Mule Tape with LF

Detectable Trace Wire 37,500 $0.19 $7,125.00

8 Furnish and Install SC Type Anaerobic EA Fiber Connectors 250 $48.16 $12,040.00

9 Furnish and Install 72-Splice Closure EA

Fiber (SCF) with Tray 14 $778.09 $10,893.26

10 Furnish and lnstaii12-Fiber Buffer Fan- EA Out Kit-24" Breakout 19 $88.95 $1 ,690.05

11 Furnish and Install Single Fusion Splice EA

Sleeves (Pack of 50 Sleeves) 8 $177.89 $1,423.12

12 Furnish and Install 96-Fiber Closet EA

Connector Housing 1 $2,178.74 $2,178.78

13 Furnish and lnstaii12-Port Panel SC EA

Duplex SM Loaded 24 $149.55 $3,589.20

14 Furnish and Install 12-Fiber Wall Mount EA

Enclosure 18 $510.03 $9,180.54

RTD Office Fiber Oetlc Network Expansion

Install the City furnished 1250 ft 24-15 Strand Dielectric Loose Tube 8.3/125 LF

1,250 $1 .95 $2,437.50 Micron SM Fiber (OSP)

16 Furnish and install 48-Fiber Closet EA Connector Housing 1 $1 ,624.64 $1 ,624.64

Item Description Unit Quantity Unit price Total Price

17 Furnish and install 12-Fiber Wall Mount EA

Enclosure 2 $837.51 $1 ,675.02

18 Furnish and install 12-Port Panel SC EA Duplex SM Loaded 2 $617.12 $1,234.24

19 Furnish and install 12-Fiber Buffer Fan- EA Out Kit-24" Breakout 4 $290.30 $1161.20

20 -Furnish and install SC Type Anaerobic EA Fiber Connector 52 $63.69 $3,311.88

21 Furnish and install Video Multiplexer

EA 2 $6,806.72 $13,613.44

22 Furnish and install Mule Tape with LF

Detectable Trace Wire 1,500 $0.72 $1 080.00

General 23 Mobilization LS 1 $7,181.90 $7,181.90

24 Traffic Control LS 1 $16,659.97 $16,659.97

25 Landscape/Sidewalk/Roadway Repair LS 1 $19,295.78 $19,295.78

26 Clearing and Grubbing LS 1 $2,383.28 $2,383.28

TOTAL BID $291,268.60

BIDDER'S NAME. __ T_HE_F_Is_HE_L_c_oMP_ANY ____ _

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 wor1< 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 tt}e time provided in the bidding requirements and conditions. The undersigned further agrees that he/she has carefully examined the site of the wor1< 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):

0 Cash, or D Cashier's check, or D Certified check payable to City of Stockton, or liJ 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.

THE FISHEL COMPANY 602.233 .0658 31-436011 5

(Firm Name) (Phone) (Tax I.D. No.)

1366 OUBUN RD. COLUMBUS OHIO, 43215

(Address) (City) (State)

THE FISHEL COMPANY 678942 A C-7 B C-10 10/31113

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

LIST OF SUBCONTRACTORS

GENERAL CONTRACTOR: THE FISHEL COMPANY -----------------------------------------PROJECT: FffiER OPTIC NETWORK EXPANSION-WESTON RANCH & SJRTD OFFICE PROJECT# 10-05

FEDERAL PROJECT NO. CML-5008 (096)

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}

McKuln Pipeline 320 Hunters Lana Hollister, CA 95023

Micom 6150 Quail Valley Ct Riverside California 95027

AZCO 2250 Stewart St #9 Stockton, CA 95205

/JiJj) tJ~ (SIGNATURE OF BID·~r&J=-t-R-) ---

TYPE OF WORK

Directional Bore

Fiber Splicing

Material Supplier

BIDDER SIGN HERE

AMOUNT

$86,000.00

$72,000.00

$22,000.00

UL::St. acoarmenrs Page 1 or L

---Senrc~

Home l.obor Law Y/orl!~lace Safely Work• rs' Cornp Selr ln!lurancu Appwnli<.flhlp Olr1lctor's Orfiet> Bo4rds

DLSE debarments

The lollowlr1g COf\ltactors are o..rrenlly b~rred from bidding on. or ac.atpbng or po<lorm11g any pubhc WO!i<s

contracts, erlhef as a contt3Cior or aubCOntr&Cior, lor tile penod satlort/l belOW

Note· As pel1 of your due diligence, \'.1! suggest that you also chec:t.

Debarments made bY !he Ory,slon of Apprenlleelhro Standards IOASl

Con!Cac;tOr status at the CO!ltractors State LiCense Board ICSLBl

The Federal debarment list atth8 E><ctuded Parties IJst System

For a list of past DLSE debarment! of public works contractors. please contoct.

Susart Nakagamo Speer at Assistant lo tile Labor Commissioner 455 Golden Gate Ave., 9th Fir. San Francisc:l. CA 94102 415-703·4810 SNskagama@dir ca gov

Revised 6/15112

Name of contnctor

Wallcretn lndustriH, Inc.; Garit David Wallace and Amber Anderson, Individuals 400 Kansas, Redlands. CA 92373

CSLB/1834220 Decision ~

fEI Ente'l'ri .. a, Inc Gabr1al Fedlda, IndiVIdual S7o49 VeniCe Blvd • los Angeles, CA 90019

CSLB#659252 OecWon s. Jeffrey Alan Molt end Michelle Mott, Individuals Oda Integrity Landscape 3756 Independence Avenue Sanger, CA 93637 CSLB#774222 O&dsion c;_

Jansen Drywall & Stucco Jaffrey E. Jonson 3714lynda Place National City, CA 91950-3121 CSB#664168 Exp 2118/11 (exp~ed) OeCl.!son ;,'

All West Construction, Inc. Donald Kent Russell 495 N Marks Ave Fresno. CA 93706 CSB I 592321 Exp. 413/12 (suspended) Qeclslon j.

Country Builders, Inc. Woldon Offill, Individually 5915 Graham Ct. Livermore, CA 94550 CSB II 699574 Exp. t 1130112 (octllle) Oeclsloo .: Addendum •'

Sutter Foam & Coating, Inc. 909 A. George Washll)gton Yuba City, CA 95993 CSB II 732014 Exp 1131109 (Inactive)

David Alvin Trexler, an Individual 909 A. George Washington

http://www.dir.ca.gov/dlse/debar.html

Period of debarment

7/29/12 through 7/28/15

0/14112 111rough 0/1311G

3128/12 through 3/28115

3131/11 through J/30/\l

3131/11 through 3/30113

3/111\lhrough 2/20114

711110 throogh 6/30/13

7/1110 through 8/30/13

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Kenneth A. Trexler, an Individual 711/10 through 6/30113 2603 Lago lane Marysville. CA !15901 Decision '" . . ... . ···- .. Soo Dong Kim, an individual. 4119110 lhmugh 4/18113 dba Soo Kim Electric Company 16224 Ridgeview l aue la Mirada. CA 90638 CSB # 568103 Exp. B/1109!inactive)

Hyo Nam Jung, an Individual, dba Lucid Electric

<1119110 through 4118113

18621 Well Street flowland Haighls, CA 91748 cse ~; 9 t4692 Exp. 4/3110 Decision '·

Southwost Grading, dba Southwest Gnadlng Servlcos, Inc.,

3/18/10 through 3/17/13

22031 Waite Street V\lildOmar, CA 92595

David Walter Cholowlnskl, an IndiVIdual 22031 Weite Street VIIi lao mar. A 92595 29970 Technology Drive, Ste. 205 Murrieta, CA 92563 CSB 11840416 Exp. 6/30/10 DeciSion .;

S.J. Cimino Electric, Inc., a California corporation, 3267 Dutton Ave. '

10/15109 through 10114112

Sanla Rosa , CA 95404 Salvatore Joseph Cimino, RMO, CEO ana President of S.J. Cimino Electric, Inc. and sole owner of S.J. Cimino Eloctrlc, an Individual 5825 Heights Rd. Santa Rosa, CA 95401 CSB #343802 Exp. 2/28110 CSB 11294141 Exp. 9/30113 (Inactive) Decision .<:

Cedar Development Corporation Serghon Gabrtel Alram, Individually

815109 through 8/4112

12477 Feather Dr Mira Lama. CA 91752 CSB # 639898 Exp. 6/30/10 (suspended) Decision ..ic

All Floors Commercial and Residential Flooring, Inc:. 5/14109 through 5113/12 Salvador Elias Perea, Individually 750 E. McGiincy Lane, 11103 Campbell, CA 95008 CSB #430969 Exp. 7131/09 Decision v

1-AMD Cqnstructlon. Inc, Alberto Mordokl, Individually Mirella Mordokl, Ind ividually 5300 BeaCh Blvd .. Su~e 11().416 Buena Park, CA 90621 CSB #767533, revo~ed DeCISIOn ~<

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PageL ot '1.

!VON-COLLUSION No. I AFFIDA VTT FOR INI>IVIUUAL BlDOEit STATE OF CALIFORNJA,, ____________ --.tss.

Councyof ____________________________________ --J

(innrt)

:----------------------------------'bcil\;fu•;hlulyS\\un.do..~und~: fuuun behalf of any person not Mlrk!d hercrn: th!1l suid 11idderhas nntcolhxkd. conspn\!d. oonnivcduragru:d, diAA11yorinJio:ctly with. \lrinduccdtli'SOiicitcd am' other bid or p!:r.illn. itrm or oorporotion to put in-u sham bid, or that such other pcr:IOn. finn nr corporafion shall or sh<luld rctmin lrurn bidding; nnd lms not in :my manner sought fly cnllusionto s.-'CUrc to themsclvt:s any oovantnge over or ug-.U n~1 thc City. ur any I>Crson intcrcst.:d in suid improvement. or over any other Oiddo:r.

(Signntlll\: Ind ividual Bidder)

Subscrilx:\1 and s"'um to (ur ailimll'tl) befc1re rne nnthi~ ___ _ day of __ ,_,._ , __________ ~21). ______ _

hy ___ • prov.:d tn me on the basis of satisfactory evidence to be the persun(sl whu appc::m:t.l before me.

<;cuJ

Sigmuuro __ __

No.2 AFPIOA VIT FOR CORPORATION BIDDER STATE OF Cl..biFQII:NlA..___.A..:;.R.;;.;IZ;.;O;..;.N..:;.A'------------J)ss.

County of Maricopa ) (insert)

--------------lltl-l P_•_lll_•v _______ lx:ing first duly swum. dcpos.:s and ~ays: Thutth.:y are the VicePrasldont of TheFislleiCCft'4lony a

corporot ion, which corporation is lhe party making the forcgoin.g bid. !hat such bid is genuine and not sham or collusive, or mode in clio~ inLCrest 0 7 behalf of amy person not named herein: that sald Uilklcr hns not colluded. coat~plrcd. connived or agreed. directly or indiree1ly with. or ind;:~:cd " 'solicited any other bid or person, linn or corporation to put in a shum bid. or th:U ~ud1 other person. finn or corporation shall or soould refrain from bidding: and h~ not in uny manner sought by collusion to secure to th<.:msc:lvcs any advantage over or a!li17· 3'. he City. ur, MV pcrso inrcrested in snin impro,cmcnt, or ewer :my other Bidder. {

()u.. (Sign.11urc Curporotioo lliddcr\

Seal

Signature~ (VI... ~ON\

No.3 AFFIDA VlT FOR FlRM, ASSOCIATION, OR CO-PARTNERSIUP STATE OF CALIFORNIA, ss.

Councyof ______________ ~--------------------J (in.wrt)

c-Jch IJ;:ing tir~1. duly sw<Jrn. depos.: and sny: lllut they arc o member of the linn. association or co·partn~r.;hip.

dcsignat<:d as "'ho is the party making a he fon:gomg hid; thaJ lhe uti!Cf' partn.:r. or parmers, dft: . , ,_,_wu ~tlcll bid i) gcnujne und 001 sham oru1llusive, vr made in th.: interest or behalf of any pcr.>M 1101 named h.:rcin; that snid Bidder has 110t colluded oon.~pin:d. connived or :tgret'd. directly or inJ ir.x:tl) with. or indua:d or o;olicitcd any tlthcr hicl ur rcrson, linn ur corpor.uion shall or should n:llain from proposing; and has 1101 in any manner sought by collusion w ~ tn themselves any n.dvantagc over or aguin51Lhe City. or any pcrlilm interested in said improvement. or nvcr M )' Clthcr Bidder.

(Sigcuuurc)

(Sigmuurc)

Subscribed wul sworn to (11r nmrmcd) h.: fore me on thas day or ...... 20 ----:-hy --· _ .. . pro•ed to me con tho: ba~ts nf o;atlsfacc~ ev1dcnc:x 10 he lhe po:rsun(s) who appcan:d bcfure me.

O.:cal __ ···-·--- _ -··--------

'itgT18hH"C ------------------- -----

I • I~· '{ .. ·; . .J· ' ..

Equal Employment Opportunity Certification

(Form EE0-1A)

The bidder, The Fishel Company , proposed subcontractor. McKuin Pipeline

hereby certifies that he has~. has not_, participated in a previous contract or subcontract subject to the

equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required,

he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a

Federal Government contracting or administering agency, or the former President's Committee on Equal

Employment Opportunity, all reports due under the applicable filing 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 $1 0,000 or under are exempt.)

Currently, Standard Form 100 (EE0-1) is the only report required by the Executive Orders or the implementing regulations.

Proposed prime contractors and subcontractors, who have participated in a previous contract or subcontract subject to the Executive Orders, and have not filed the required reports should note that 41 CFR 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 of Labor.


(Form EE0-1A)

The bidder, The Fishel Company . proposed subcontractor, Micom --------------------hereby certifies that he has~. has not~, participated in a previous contract or subcontract subject to the

equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that. where required,

he has filed with the Joint Reporting Committee. the Director of the Office of Federal Contract Compliance, a

Federal Government contracting or administering agency, or the fanner President's Committee on Equal

Employment Opportunity , all reports due under the applicable filing 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 dause. 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 Fonn 100 (EE0-1) is the only report required by the Executive Orders or the implementing regulations.

Proposed prime contractors and subcontractors, who have participated in a previous contract or subcontract subject to the Executive Orders, and have not filed the required reports should note that 41 CFR 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 of Labor.


(Form EE0-1A)

The bidder, The Fishel Company proposed subcontractor,_AZ_c_o_s_u..:..p:-.pl.:...y _____ _

hereby certifies that he has~. has not_, participated in a previous contract or subcontract subject to the

equal opportunity clauses, as required by Executive Orders 10925, 11114. or 11246, and that, where required,

he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a

Federal Government contracting or administering agency, or the former President's Committee on Equal

Employment Opportunity, all reports due under the applicable filing 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 the implementing regulations.

Proposed prime contractors and subcontractors, who have participated in a previous contract or subcontract subject to the Executive Orders, and have not filed the required reports should note that 41 CFR 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 of Labor.

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, BILL PAULEY , representing THE F'ISHEL COMPANY (PrinVType Company Official Name) (PrinVType 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:

[X]Yes 0No When recruiting for vacancies this firm conducts mailings to specific outreach agencies and interest groups concerned with minority and women employment.

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

[X]Yes 0No This company understands the legal and moral commitment of complying with federal 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 additional information from the bidding contractor at any time.

3/13/13

Date

BILL PAULEY VICE 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: THE FISHEL COMPANY

BY:

VICE PRESIDENT

TITLE

DI-'\TE: 3/13/13

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 1101 , with any public

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

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

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

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

10285.1.

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

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

Public Contract Code 1 0232 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 Contractors 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.

DEBARMENT AND SUSPENSION CERTIFICATION

TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29

The bidder. under penalty of perjury. certifies that. except as noted below. he/she or any other person associated

therewith in the capacity of owner. partner. director, officer, manager:

is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any

Federal agency;

has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency

within the past 3 years;

does not have a proposed debarment pending; and

has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent

jurisdiction in any matter involving fraud or official misconduct within the past 3 years.

If there are any exceptions to this certification, insert the exceptions in the following space.

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

Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification.

NON-LOBBYlNG CERTIFICATION FOR FEDERAL-AID CONTRACTS

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

(I) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned. to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance 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.

NONE DISCLOSURE OF LOBBYING ACTIVITIES

COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S. C. 1352

1. Type of Federal 2. Status of Federal 3. Report Type: Action: Action:

D a. contract D a. bid/offer/application D a. initial b. grant b. initial award b. material change

••

c. cooperative agreement c. post-award d. loan e loan guarantee I. loan insurance

Name and Address of Reporting Entity

0 Prime 0 Subawardee Tier_. if known

Congressional District, if known

6. Federal Department/Agency:

8. Federal Action Number, if known:

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

For Material Change Only: year_ _ quarter _ _ _ date of last report __ _

5. If Reporting Entity In No. 4 Is Subawardee, Enter Name and Address of Prime:

Congressional Dis trict, if known

7. Federal Program Name/Description:

CFDA Number, if applicable-------

9. Award Amount, If known:

b. Individuals Performing Services (inclUding Address if different from No. 10a) (last name. first name, Ml)

(attach Continuation Sheet(s) if necessary)

11. Amount of Payment (chec:J( all that apply) 13. Type of Payment (check all that apply)

S 0 Actual 0 planned a. retainer

12.. Form of Payment (check all that apply):

B a. cash b. in-kind; specify: nature ____ _

value ___ _ _

b. one-lime fee c. commission

d. contingent fee e deferred

f. other, specify - --------

14. Brief Description of Services Performed or to be perfonned and Date(s) of Service, Including offieer(s), employee{ a), or member(s ) contacted, for Payment Indicated In Item 11:

(attach Continuation Sheet(s) if necessary)

15. Contlnuatlon Sheet(s) attached: Yes 0 No 0 16. Information requested lhrough 1t11s fom1 is aulhoflzed by

Title 31 u.s.c. Section 1352. This disdosure of lobbying reliance was placed by the ller above when hit transaction was made Of entered Into. This diSClosure Is required pursuanllo 31 U.S .C. 1352. This lnfonnalion Will be reported to Congress semiannually and wiU be available 101 public inspe<:tion. lvry peiSOO \1M fails to file the required disclosure shan be subject to a civil penalty of not less than $10.000 and not mot'e !han StOO.OOO lor each such laJiute.

Federal Use Only:

Signature: _ __,_N!!./!..!A,__ ________ _ _

Print Name: _______________________ __

nue: ______________________________ __

Telephone No.: - - ----- Date. ____ _

Authonzed for Local Reptoducnon Standard Form - LLL

Sll!NU~rd Form LLL Rev 09-12-97

INSTRUCTIONS FOR COMPLETION OF SF-l.LL, DISCLOSURE OF lOBBYING ACTIVITIES

This disclosure form shall be completed by the reporting entity. 'Nhethef subawardee or prime Federal recipient. at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S. C. section 1352 The filing of a form is required for St.ICh payment or agreement to make payment to lobbying entity for innuenclng or auempting to influence an officer oc employee of any agency, a Member or Congress an officer or employee of Congress or an employee of a Member of Congress in coonectiol1 with a covered Federal action. Attach a continuation stteet tor additional infonnatioo if the space on the form Is inadequate. Complete all items that apply for bOth the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional Information.

1. Identify the type of covered Federal action for 'Nhich lobbying activity is andfoc has beeo secured to in"uence, the outoome of a oovered Federal action.

2. Identify the status of the oovered Federal action. 3. Identify the appropriate classification of this report. If this is a f'ollow.{jp report caused by a material change

to the information preo.llously reported, enter the year and quarter in v.fllch the change oocurred. Enter the date of the last. previously submitted report by this reporting entity for this oovered Federal action.

4. Enter the full name, address, city, state end zip oode of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tlef. SubaWards indllde but are not limited to suboontracts. subgrants and contract awards under grants.

5. If the organization filing the report ln Item 4 checks "Subawardee" then enter the full name. address. city, state and zip oode of the prime Federal recipient Include Congressional District, if known.

6. Enter the name of the Federal agency mak.ing the award or loan commitment Include at least one organization level below agency name, if krloYKt. Foc example, Depattment of Transportation, United States Coast Guard.

7. Enter the Federal program name or description for the oovered Federal action fltem 1 ). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements. loans and loan commitments.

8. Enter the most appropriate Federal identifying number available for the Federal action Identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number. the application/proposal control numbec' assigned by the Federal agency). lndude pre11xes, e.g., "RFP·OE·90-001."

9. Foc a oovered Federal action 'htlere there has been an award or loan commitment by the Federal agency. enter the Federal amount of the award/loan oommitments for the prime entity identified in item 4 or 5.

10. (a) Enter the fUll name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to Influenced the covered Federal action. {b) Enter the full names of the individual(s) performing sef'lloes and include full address If diffefef1t from 10 (a). Enter Last Name, Arst Name and Middle Initial (Ml).

11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (Item 1 0). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If thiS is a material change report, enter the rumutative amount of payment made oc planned to be made.

12. Check the appropriate box(es). Check all boxes that apply. tr payment Is made through an In-kind oontribUtlon, specify the nature and value of the ln-ktnd payment

13. Check the appropriate tlox(es). Check ali bOxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the seNices that the lobbyist has perfooned oc YAII be e)(peded

to perform and the date(s) of any ,services rendered Include aH preparatory and related adivity not just time spent in actual contact with Federal ol\'icials. Identify the Federal oflioer(s) or employee(s) contaded or the ofllcer(s) employee(s) or Member(s) of Congress that were conlsded.

15. Check ~thef or not a continuation sheet(s) is attaclled. 16. The certifying offiCial shall sign and date the form. plint hlslher name, title, and telephone number.

Public reporting burdSfl for thiS collection of Information Is estimated to average 30 minutes per response, includlng time for revieWing instrudion, searching existing data sources. galheflng and rna!ntainiog the dais needed, and completing and revietMng the oo!ledion d inblnatioo. Send comments regarding the tuden estimate oc any otner aspect of this collectlon at lnfon~. inducing suggesliooa tot redUcing this bortlen, to the Office of Management and Budget. PapetWOft\ Reduction Pmjed {0348-0046), washington. D.C. 20503. Sf·lll· IMINefona Rev. 0&-04-

90«ENOII'•

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

compan}J;workfor/j·

f 1.. v 3/13/13

BILL PAULEY Pr1nt!Type l~ame of Company Official

Company Name THE FISHEL COMPANY

Address 1819 S. 27TH AVE. PHOENIX, AZ 85009

Telephone ( 602 ) ..:::23::..::3:....-0::..::6;.;;..58;;__ ___ County MARICOPA

Date

VICE PRESIDENT Title

Project Name FIBER OPTIC NETWORK EXPANSION - WESTON RANCH & SJRTO OFFICE PROffiCT#l0-05

FEDERAL PROJECT NO.CML-5008(096)

DYes [XI No Is your company a certified Disadvantaged Business Enterprise?

If yes:

Certifying Agency-------------Certification Number ___________ _

Qualify as DBE? 0 Yes ~ No

• • • • ~ • • • • • • • • "' • • • • • • • • • • for office use only • • • • • • • • • • • • • • • * • • • • • • • • •

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

Company Name:

Company Workforce Report (FORM DBE-1 B)

!be fjshel Company

Project Name: Fiber Optic Network Expansion- Weston Ranch & SJRTD Office Project No. 10-05 Federal Project NO. CML-5008(096)

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

' TOTAL LATINO/ AI'AICAit ASWI NATIVE ASWISUS. JOB CATEGORIES EMPlOYEES HI$PANIC AIIIEIIICAH PACifiC AIIIEIUCAit COitTlHEHT WHin OTHf.lt ISL I

M c • .. F • .. F .. F .. F .. F • Ill F • II f. . 1. Officials & Managers

3Gf 2.. D 0 } 0 0 0 0 0 b () 38 z_ 0 C)

2. Professionals ~.., 5 3 0 \ \ 0 0 0 0 0 0 22- s 0 0

3. Clerical & omce (o 5U, 3 lb 0 I (.) 0 0 0 0 0 3 45 0

4. Field Supervisor ~lo't I? LD 2.. 1- t 0 0 0 0 ' t

0 lllP lL.. 0

5. Skilled- Specific Trade

a. 'T~chf'\\ ~\ O.V'\":'--. IS ~ t 0 0 l 0 I 0 C> 0 0 lc..l z. ~ b . '::n\es 0 2. C:> C> C> C> 0 0 0 0 C) 0 e,:) 2... 0

c. ~a.~Nl.~ rz.q 0 3tf D 1 0 0 0 t.. 0 z.. 0 S'/ D 0

6. Unskilled - Speciflc Trade

a. l.a.00ce6· ~e\ce.fS "'-''( I tt:, 0 14 0 l () K? D 0 0 q(D l 0

b. C-ro..C~ t.u:x-~~t""-:, 'loa ~ 9l I z.~ l \ 0 1 0 s b ~ z. 0

c.

7. TOTAL - Items 1-6

TABLE A : For Official Use Only . . . .

(A) (8) (C) (0) (E) (F) (G) F.male Hleptnlc Afrtcan Milln N111voe MillnSu~ wtllte au-

Amer1Un P•clftc t•L Americ:•n continent

Organization Personnel •t.

Total Personnel

Nota: All firms doing business with the City of Stockton must provide the workforce ethnicity information requested on th1s form. Failure to do so wtll result in btd or RFP rejection for non-responsiveness.

• UDBE Group Member

0

0

0

0 C)

0 C)

Total (A-G)

EXHIBIT 12-G

Bidder's list of Subcontractors (DBE and Non-DB E) 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 1

The bidder shaU 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 ~mos.

Firm Name/ Phone/ Address/ Fax

City, State, ZIP Name Phone

McKuin Pipeline 831-636-7680

Address 320 Hunters Lane Fax

City State ZIP Hollister, CA 95023

813-636-7531

Name Phone Micom 951-867-3100

Address Quail Valley Ct

Fax

City Stare ZIP Riverside, CA 95207

951-867-3111

Name Phone

AZCO Supply 209-943-2452

Address

2250 (', St#9 Fax

City Stare ZIP Stockton, CA 95205 209-943-0437

Name Phone

I Address

Fax

City State ZIP

Distribution: I) Original - Local Agency File

LPP 06-06

Annual Gross Description of Portion of Work to be Perfonned

Receipts U < $1 million

~ < $5 million

0< $10 million ''Horine:

0< $15 million

0> $15 million

U < $1 million

1iJ < $5 million Fiber Splicing

0 < $10 million

0 < $15 million

0> $15 million

U< $1 million

0<$5 million Material Supplier (MBE #8BNOOOSO) ~< $10 million

0< $15million

0> $15 million

U<$1 million

0<$5 million

0< $10 million

0< $15million

0> $15 million

t~ tr ~:. I .....i.~:~: -~ 1..!...:..:;:_11~ j I 1,.' ~~~ >.lii.dt;,L, Jtrtl- !r

YES

wr.<@ --'ES list DB£#:

'Age of Firm (Yrs.) IOYEARS

YES @

If YES list DB£#:

Age of Firm (Yrs.) 8YEARS

YES 00)

If YES list DB£#:

Age of Firm (Yrs.) 22 YEARS

YES NO

(f YES list DB£#:

Age of Firm ( Y rs.)

Page 12-111 November 14, 2006

I

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

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

· · · 9. Section 26 of the Code of Federal Re!!ularions. Photocoov this form for additional fi ---- ·-. - .......... Firm Name/

Address/ City, State, ZIP

Name

Address

Ciry State ZiP

Name

Address

CiryStateZlP

Name

Address

Ciry State ZIP

Name

Address

Ciry State ZIP

Distribution: I) Original- Local Agency File

Page 12-112 November 14, 2006

Phone/ Fax

Phone

Fax

Phone

Fax

Phone

Fax

Phone

Fax

Annual Gross Description of Portion of Work to be Performed

Receipts U<$1 million

~------0< $5 million

O<SIOmillion

0 < Sl5 million

0> SIS million -

U<$1 million

O<SS million

0< SIO million

0< SIS million

0> $15 million - --- -- -

U < $1 million

0 < SS million

0 < SIO million

0< SIS million

0> $15 million

O <SI million

O<S5 million

0 < $10 million

O<SI5 million - -O> SIS million

··--

~&.=.~ .......... J 1t >i--l ~_JJ~.-? n ~ .-~•lvil 1hU"·,

YES NO

If YES list DB£#:

Age of Finn (Yrs.)

YES NO

If YES list DB£#:

..... t\gc of £-inn (Yrs.)

YES

NO If YES list DB£#:

Age Clf Finn CYrs.)

YES

NO -If YES list DB£#:

Age uf Finn (Yn>.)

LPP 06-06

SUPPLIER C-LEARINGHOUSE CERTIFICATE OF ELIGIBILITY

CERTIFICATE EXPIRATION DATE: 03-16-2014

The Supplier Clearinghouse for the Utility Supplier Diversity Program of the California Public Utilities Commission hereby certifies that it has audited and verified the eligibility of:

Azco Supply, Inc. of Stockton, California as a MBE

pursuant to Commission General Order 156, and the terms and conditions stipulated in the Verification Application Package. This Certificate shall be valid only with the Clearinghouse seal affixed hereto.

Eligibility must be maintained at all times, and renewed within 30 days of any changes in ownership or control. Failure to comply may result ·in a denial of eligibility. The Clearinghouse may reconsider certincation if it is determined that such status was obtained by false, misleading or incorrect information. Decertification may occur if any verification criterion under which eligibility was awarded later becomes invalid due to Commission ruling. The Clearinghouse may request additional information or conduct on- site visits during the term of verification to verify eligibility.

This certification is valid only for the period that the above named firm remains eligible as determined by the Clearinghouse. Utility companies may direct inquiries concerning this Ce1tificate to the Clearinghouse at 800-359-7998 in Los Angeles.

EXHIBIT 15-G

Local Agency Bidder DBE Commitment (Construction Contracts)

Obtain most current form for the New Race Conscious DBE Program from the Caltrans website:


Local Assistance Procedures Manual EXHIBIT 15-G Local Agency Bidder DBE Commitment (Construction Contracts)

EXHIBIT 15-G L OCAL AGENCY BIDDER DBE C OMMITMENT (CONSTRUCTION CONTRACTS)

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

LOCAL AGENCY: LOCATION:

PROJECT DESCRIPTION:

TOTAL CONTRACT AMOUNT:$

BID DATE:

BIDDER'S NAME:

CONTRACT DBE GOAL:

CONTRACT ITEM OF WORK AND DESCRIPTION pBE CERT NO. NAME OF EACH DBE [I:>OLLAR AMOUNT ITEM NO. OR SERVICES TO BE ~D EXPIRATION (Must be cenified on the date bids DBE

SUBCONTRACTED OR MATERIALS DATE pre opened - include DBE nddress TO BE PROVlDED (or contmcled if the ~nd phone number) pidder is a DBE)

For L ocal Agen cy t o C omplete: Total Claimed DBE $

Local Agency Contract Number: Panicipation

Federal-aid Project Number: %

Federal Share:

Contract Award Date:

Local Agency cenifies that all DBE cenificntions have been verified and Signature of Bidder information is complete and accurate.

Date (Area Code) Tel. No.

Print Name Signature Date Local Agency Representative Person to Contact (Please Type or Print)

(Area Code) Telephone Number: tocnl Agency Bidder DBE Commitmem (Construction Commcts) (Rev 6/26/09)

Distribution: (I) Copy- Fax or scan a copy to the Cal trans District Local Assistance Engineer (Dl.AE) within 30 days of contract el(ecution. Failure to send a copy to the DLAE within 30 days of contract execution may result in de-obligation of fund~ for tllis projccL (2) Copy -Include in award package to CaltranS District Local Assistance (3) Original - Local agency Iiles

Puge 15·1 OB 12-04 June 29, 2012

EXHIBIT 1 5-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment (Construction Contracts)

INSTRUCTIONS -LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS)

ALL BIDDERS:

PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive

The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal.

T he form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Material s to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work perfonned by its own forces, if a DBE. T he DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime' s and subcontractors' certification numbers. The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number).

lMPORTANT: ldemify aU DBE firms participating in the project regardless of tier. Names of the First-Tier DBE Subcontractors and the ir respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid.

There is a column for the DBE patticipation dollar amount. Enter the Total Cla imed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Spec ial Provisions. (If I 00% of itetn is not to be performed or furnished by the DBE, describe exact portion of tirne to be performed or furnished by the DBE.) See Section "D isadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firms.

Exhibit 15-G must be s igned and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact.

Local agencies should complete the Local Agency Contract Award, Federal-aid Project Number, Federal Share, Contract Award Date fie lds and verify that all information is complete and accurate before signing and filing.

Page 15-2 June 29, 2012 OB 12-04

EXHIBIT 15-H

DBE Information- Good Faith Efforts


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

Local Assistance Procedures Manual Exhibit 15-H DBE lnfonnation - Good Faith Effort

EXHIBIT 15-H DBE INFORMATION-GoOD FAITH EFFORTS

DBE INFORMATION - GOOD FAITH EFFORTS

Federal-aid Project No. _C:=.M~L~-5~0!..!:::0~8U:C0~9~6),_ _______ Bid Opening Date _.3!.f..._/!..:l4~/~1 3!__ ____ _

The City of Stockton established a Disadvantaged Business Enterprise (DBE) goal of I %for this project. The information provided herein shows that a good faith effott was made.

Lowest, second Lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the fo llowing information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the ad ministering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error.

Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made.

The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions:

A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication):

Publications Dates of Advertisement

B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.):

Names of DBEs Solicited

OB 12-04

Date of Initial Solicitation

Follow Up Methods and Dates

Page 15· 1 June 29, 2012

Exhibit 15-H Local Assistance Procedures Manual DBE Information -Good Faith Effort

C. The items of work which the bidder made available to DBE firms including, where appropriate, any breaking down of the contract work items (including those items normally petformed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demm1strate that sufficient work to facilitate DBE pru.ticipation was made available to DBE firms.

Items of Work Bidder Normally Breakdown of Performs Item Items

(YIN)

Amount ($)

Percentage Of

Contract

D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is uot a DBE:

Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs:

Names, addresses and phone numbers of firms selected for the work above:

E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance. and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs:

Page 15-2 June 29, 2012 OB 12-04

Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort

F. Effmts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate:

G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Intemet page download, etc.):

Name of Agency/Organization Method/Date of Contact Results

H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary):

NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY.

OB 12-04 Page 15-3

June 29, 2012

EXHIBIT 17 -F

Final Report-Utilization of Disadvantaged Business Enterprises (DBE) First Tier Subcontractors


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

Local Assistance Procedures Manual EXIDBJT 17 -F Final Report-Utilization of Disadvantaged Business Enterprises (DBE), First-Tier Subcontractors

STAlE OF CAliFORNIA· DEPARTMENT OF TRANSPORTATION

FINAL REPORT-UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES ADA Notice

(DBE), FIRST-TIER SUBCONTRACTORS For 11\divtduals with sens01y disabilities, !his dorumenrls available in aJtemate formats. For information call (916) 654-6410 or roo (916) 654·3860 or wrile Records and Forms Management, 1120 N Street, M$-89, Sacramento, CA 95814

CEM-2402F (REV 0212008)

CONTRACT NUMBER I COUNTY I ROUTE POST MILES FEDERAL AID PROJECT NO. 1 ADMINISTERING AGENCY I PRIME CONTRACTOR BUSINESS ADDRESS The Rshel Company 1366 W Dublin Ad, Columbus, OH 43215

DESCRIPTION OF CONTRACT PAYMENTS ITE WORK PERFORMED COMPANY NAME AND DBECERT. M AND MATERIAL BUSINESS ADDRESS NUMBER NON-DBE DBE

DATE WORK

NO. PROVIDED COMPLETE

$ $

$ $ $ s $ $ $ $ $ $ $ $

$ $ $ s $ $

s $ $ $

ORIGINAL COMMITMENT

$ TOTAL $ $ DBE

Ust all First-Tier Subcontractors, DisadVantaged Business E.nterprisas (OBEs) regardless of tier, whether or not the firms were originally listed for goal credit. If actual OBE utilization (or Item of wori<) was different than that approved at time of award, provide comments on back of form. Ust actual amount pald lo each entity.

CONTRACTOR REPRESENTATIVE'S SIGNATURE

RESIDENT ENGINEER'S SIGNATURE

Copy Distribution-C:lltl1ln.' cuntr.lcb:

Copy Di:.tribulion-U!c-JI A£Cncy contr.U:I,;

LPP09-02

I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT

BUSINESS PHONE NUMBER

TO THE BEST OF MY INFORMATION AND BEUEF, THE ABOVE INFORMATION IS COMPLETE AND COR.RECT

Onglrwl • Di"ritt Conslruction

Orlglnul - Oo>lnCt IAcol A>sis1ance Ett;ttoeer f•ubmitlt'd witlllhe Repon Of~iture

BUSINESS PHONE NUMBER

Cop)· Buoini!SS Enterprise Progrum

Cop)- Di>trict Local Assislllllce Engineet·

Copy- ConlroiCIOr

Copy· Local Agency nle

I CONTRACT COMPLETION DATE

ESTIMATED CONTRACT AMOUNT $ N/A

DATE OF FINAL PAYMENT

DATE

DATE

Copy Rcsidetll Engineer

Page 17-21 July 1, 2012

EXHIBIT 17-F Local Assistance Procedures Manual Final Report-Utilization of Disadvantaged Business Enterprises (DBE), First-Tier Subcontractors

FINAL REPORT - UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (OBE), FlRST-TIBR SUBCONTRACTORS CEM 2402(F) (Rev. 02/2008)

The form requires spec ific information regarding the construction project: Contract Number, County, Route, Post Miles, Federal-aid Project No., the Administering Agency, the Contract Completion Date and the Estimated Contract Amount. It requires the prime contractor name and business address. The focus of the form is to describe who did what by contract item number and descriptions, asking for specific dollar values of item work compleled broken down by subcontractors who performed the work both DBE and non-DBE work forces. DBE prime contractors are required to show the date of work performed by their own forces along with tbe corresponding dollar value of work.

The form has a column to enter the Contract Item No. (or Item No's) and description of work performed or materials provided, as well as a column for the subcontractor name and business address. For those firms who are DBE, there is a column to enter their DBE Ce1tification Number. The DBE should prov ide their certification number to the contractor and notify the contractor in writing with the date of the decertification if their status should change during the course of the project.

The form has six columns for the dollar value to be entered for the item work performed by the subcontractor.

The Non-DBE column is used to enter the dollar value of work performed for firms who are not certified OBE.

The decision of wh ich column to be used for entering the DBE dollar value is based on what program(s) status the finn is certified. This program status is determined by the California Unified Certification Program by ethnicity, gender, ownership, and control issues at time of certification. To confirm the certification status and program status, access the Department of Transportation Civil Rights web site at: llllp://www.dot.ca.gov/hq/bep or by calling (9 16) 324-1700 or the toll free number at (888) 810-6346.

Based on this DBE Program status, the following table depicts which column to be used:

Column to be used ram status shows DBE on! with no other roorams listed DBE

If a contractor pe1forming work as a OBE on the project becomes decertified and still performs work after their decertification date, enter the total dollar value performed by this contractor under the appropriate DBE identification column.

lf a contractor performing work as a non-DBE on the project becomes certified as a DBE, enter the dollar value of aU work performed after certification as a DBE under the appropriate identification column.

Enter the total of each of the six columns in Form CEM-2402(F).

Any changes to DBE certification must also be submitted on Forrn-CEM 2403(F).

Enter the Date Work Completed as well as the Date of Final Payment (the date when the prime contractor made the "final pay ment'' to the subcontractor for the pmtion of work listed as being completed).

The contractor and the resident engineer sign and date the form indicating that the information provided is complete and correcl.

Page 17-22 July l, 2012 LPP 09-02

EXHIBIT 17-0

Disadvantaged Business Enterprises (DBE) Certification Status Change

Obtain most current form from the Caltrans website:


Local Assistance Procedures ManuaJ EXHIBIT 17-0 Disadvantaged Business Enterprist>s (DBE) Certification Status Change

EXHIBIT 17-0 DISADV Al'lTAGED B USINESS ENTERPRISES (DB E) CERTIFICATION STATUS CHANGE STATE OF CALJFORN£A- DEPARTMENT OF TRANSPORTATION CP-CEM-2403(F) (New. I 0199)

CONTRACT NUMBER I COUNTY I ROUTE POST MLLES I ADMINISTERING AGENCY CONTRACT COMPLETION DATE

PRIME CONTRACTOR The Fishel Company

BUSINESS ADDRESS 1366 W. Dublin Rd, Columbus OH 43215

ESTLMA TED CONTRACT AMOUNT N/A

Prime Contractor: List all DBEs wilh changes in certification status (certijied/decenijud) while in your employ, wlte1her or not jinns were originally listed for good crediJ. Attach DBE certification/Decertification leuer in acoordonce wilh tlu Speciol Provisio11s

CERTIFICATION/ CONTRACT SUBCONTRACT NAME AND BUSINESS CERTIFICATION NUMBER AMOUNT PAID WHILE DECERTIFICATION ITEM NO. BUSINESS ADDRESS PHONE CERTIFIED

s

$

$

$

s

s

s

$

$

CommentS:

I CERTIFYTHATTRE ABOVE INFORMATION IS COMPLETE AND CORRECT CONTRACTOR REPRESENTATIVE SIGNATURE I TITLE I BUSINESS PHONE NUMBER

TO THE BEST OF MY KNOWLEDGE THE ABOVE INFORMATION IS COMPLETE AND CORRECT - · -...

.... ___ ____ - ~ ·-~ . .-- -· ---. . .. ... -- -

Distribution Original copy -DLAE Copy -I) Business Enterprise Program 2) Prime ContaclOT 3) Local Agency 4) Resident Engineer

LPP 11-05

DATE Lcuer attached

DATE

Page 17-43 December 12,2011

EXHIBIT 17-0 Local Assistance Procedures Manual Disadvantaged Business Enterprises (DBE) Certification Status Change

Form CP-CEM 2403(F) (New I 0/99) DISADVANTAGED BUSINESS ENTERPRISES (DBE) CHANGE IN CERTIFICATION STATUS REPORT

The top of the form requires specific information regarding the construction project Contract Number, County, Route, Post Miles, the Administering Agency, the Contract Completion Date, and the Estimated Contract Amount. It requires the Prime Contractor's name and Business Address. The focus of the form is to substantiate and verify the actual DBE dollar amount paid to contractors on federally funded projects that had a changed in Certification status during the course of the completion of the contract. The two situations that are being addressed by CP-CEM 2403(F) are, if a firm certified as a DBE and doing work on the contract during the course of the project becomes Decertified, and if a non-DBE firm doing work on the contract during the course of the project becomes Certified as a DBE.

The form has a column to enter the Contract Item No (or Item Nos.) as well as a column for the Subcontractor' s Name, Business Address, Business Phone, and contractor's Certification Number.

The column entitled Amount Paid While Certified will be used to enter the actual dollar value of the work performed by those contractors who meet the conditions as outlined above during the time period they are Certified as a DBE. This column on the CP-CEM-2403(F) should only reflect the dollar value of work performed while the firm was Certified as a DBE.

The column called Certification/Decertification Date (Letter attached) will reflect either the date of the Decertification Letter sent out by the Civil Rights Program or the date of the Certification Certificate mailed out by the Civil Rights Program. There is a box to check that support documentation is attached to the CP-CEM-2403 (F) form,

T here is a Comments section for any additional information that may need to be provided regarding any of the above transactions.

The CEM-2403(F) has an area at the bottom where the Contractor and the Resident Engineer sign and date that the information provided is complete and correct,

There is a Comments section for any additional information that may need to be provided regarding any of the above transactions.

The CEM-2403(F) has an area at the bottom where the Contractor and the Resident Engineer sign and date that the information provided is complete and COITect.

Page 17-44 July 21, 2006 LPP06-03

~~ CITYOF i/iif;l STOCKTON

PUBLIC WORKS DEPARTMENT

NOTICE TO CONTRACTORS

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

FIBER OPTIC NETWORK EXPANSION- WESTON RANCH & SJRTD OFFICE PROJECT N0.10-05

FEDERAL PROJECT NO. CML-5008(096)

Project Description:

Engineer's Estimate:

License Required:

Mandatory Job Walk:

(FEDERAL AID CONTRACT)

Furnish, install, and terminate fiber optic cables, conduits, and accessories in Weston Ranch area and at San Joaquin Regional Transit (SJRTD) office.

Below $500,000

Class "A". "C-7" or "C-10"

None

Mandatory Pre-Bid Meeting: February 28, 2013, 9:00 a.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/business/bidflash.

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

FIBER OPTIC NETWORK EXPANSION -WESTON RANCH & SJRTD OFFICE

FEDERAL AID CONTRACT BIDDERS CHECKLIST CITY OF STOCKTON

Did you complete and properly sign: __ This Bidders Checklist and all forms provided in the following Bid for Public Work

section?

_ _ List of Subcontractors?

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

__ Sign and notarize by jurat certificate the Non-Collusion Affidavit form (Exhibit

12-E, Attachment D)?

__ Equal Employment Opportunity Certification (Exhibit 12-E, Attachment C)?

__ Certification of Attempts to Recruit Minority and Women Employees (EE0-1 B)?

__ Title VI Violation Self-Certification?

__ Public Contract Code (Section 10285.1 , Section 10162, Section 10232)?

__ Debarment and Suspension Certification (Exhibit 12-E, Attachment E)?

__ Non-lobbying Certification for Federal-Aid Contracts (Exhibit 12-E,

Attachment F)?

__ Disclosure of Lobbying Activities (SF-LLL) (Exhibit 12-E, Attachment G)?

Include DBE Forms: __ DBE Certification Statement (DBE-1A) (All Bidders: Due with Bid.)

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

__ 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: __ 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.

__ 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.

__ Construction & Demolition Recycling Plan forms: See Instructions to Bidders: SECTION 24: CONSTRUCTION & DEMOLITION DEBRIS for directions and locations of forms.

__ Include your 10% bidder's security (bidder's bond, certified or cashier's check).

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

__ Submit company name and contact information to Nancy Arbios at

(209) 937-8114 or email at [email protected]

__ .Attend Job Walk, if mandatory None

__ .Attend 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.

__ Deliver 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, 2:00 p.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 10% 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.

FIRM ADDRESS

CONTACT PHONE AND FAX NUMBER E-MAIL ADDRESS

PRINTED NAME TITLE OR AGENCY

SIGNATURE DATE

BID FOR PUBLIC WORK

CITY OF STOCKTON

Stockton, CA _____ , 20

TO THE HONORABLE CITY COUNCIL OF THE CITY OF STOCKTON:

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

(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:

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) :

0 Cash, or 0 Cashier's check, or 0 Certified check payable to City of Stockton, or 0 Bidder's bond in favor of the City

For any amount not less than ten percent (10%) 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.

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

(Address) (City) (State)

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

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

(Signature)

BIDDER SIGN HERE

(Title)

NOTE: CONTRACTOR'S LICENSING LAW--In accordance with California Public Contract Code 20103.5 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: __________________________________ _

PROJECT: ---------------------------------------------------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 tota l 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.

NAME

(MUST PRINT LEGIBLY OR TYPE)

BUSINESS ADDRESS (CITY) TYPE OF WORK

BIDDER SIGN HERE

(SIGNATURE OF BIDDER)

AMOUNT

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, ~~-..,,-----=-:::--:--:-:-:-----:----- , representing (PrfnVType Company Official Name) (PrinVType 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 0No When recruiting for vacancies this firm conducts mailings to specific outreach agencies and interest groups concerned with minority and women employment.

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

DYes 0No This company understands the legal and moral commitment of complying with federal 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 additional information from the bidding contractor at any time.

Signature of Company Official Date

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:

BY:

TITLE

DATE: ________ _

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 1101, with any public

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

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

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

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

10285.1.

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