HomeMy WebLinkAboutDiamond Bar CDBG Area 3 Curb Ramps - CT&T Proposal DocsEXPERIENCE STATEMENT
To be responsive, the bidder must list below a minimum of three public
agencies for which bidder has performed similar work within the past three
years. Only projects in excess of $200,000 each qualify as similar for
this project.
1 . Project Title Citywide Sidewalk Improvement Project CDBG
Contract Amount $388,900.00
Type of Work Removal and replacement of PCC Sidewalk & Sidewalk Grinding at various locations
Client
City of Pasadena
Agency Project Manager Teddy Luong
Date Completed 04/20/2023
Phone 626-744-3711
Subcontracted 0
2. Project Title Redondela Drive Area ADA Improvements
Contract Amount $242,088.00
Type of Work Removal and Replacement of ADA Curb Ramps
Client City of Rancho Palos Verdes
Agency Project Manager Anthony Flores
Date Completed 04/06/2023
3. Project Title ADA Curb Ramp Improvements
Phone 562-547-8555
Subcontracted 0
Contract Amount $651,300.00
Type of Work Removal and replacement of ADA Curb Ramps
Client City of Moreno Valley
Agency Project Manager Quang Nguyen Phone 951-413-3159
Date Completed 08/30/2022 o Subcontracted 0
NOTE: If requested by the City, the bidder shall furnish a certified
financial statement, references, and of r information sufficiently
comprehensive to permit an appraisal o urrent financial condition.
Bidder's Signature
10
Each bidder shall possess a valid Contractor's License
issued by the Contractor's State License Board at the time
his/her bid is submitted. The class of license shall be
applicable to the work specified in the contract. Each
bidder shall also have no less than three (3) years of
experience in the magnitude and character of the work bid.
Bidder Qualifications called for to be submitted at time
of bid include, but are not necessarily limited to:
1. The Contractor shall have been in business under the
same name and California Contractors License for a minimum
of three (3) continuous years prior to the bid opening
date for this Project. The license used to satisfy this
requirement shall be of same type required by the contract.
2. License classification shall be as required by the
contract specifications.
3. The Contractor shall have three (3) years of experience
in the construction of ADA compliant curb ramps and CDBG
work.
4. The Contractor shall perform at least 500 of contract
with its own forces.
16. LISTING SUBCONTRACTORS: Each bidder shall submit a list of the
proposed subcontractors on this project as required by the
Subletting and Subcontracting Fair Practices Act (Government
Code Section 4100 and following). Forms for this purpose are
furnished with the contract documents. The name and location
of business of any subcontractor who will perform work exceeding
1/2 of 10 of the prime contractor's total bid or ten thousand
dollars ($10,000.00), whichever is greater, must be submitted
with the bid. Any other information regarding the foregoing
subcontractors that is required by City to be submitted may be
submitted with the bid, or may be submitted to City up to 24
hours after the deadline established herein for receipt of bids.
The additional information must be submitted by the bidder to
the same address and in the same form applicable to the initial
submission of bid.
17. WORKER'S COMPENSATION: In accordance with the provisions of
Section 3700 of the Labor Code, the Contractor shall secure the
payment of compensation to his employees. The Contractor shall
sign and file with the City the following certificate prior to
performing the work under this contract: "I am aware of the
provisions of Section 3700 of the Labor Code which require
11
compensation or to undertake self insurance in accordance with
the provisions of that code, and I will comply with such
provisions before commencing the performance of the work of
this contract." The form of such certificate is included as
part of the contract documents.
18. BID DEPOSIT RETURN: Deposits of three or more low bidders, the
number being at the discretion of the City, will be held for
ninety (90) days or until posting by the successful bidder of
the Bonds required and return of executed copies of the
Agreement, whichever first occurs, at which time the deposits
will be returned after consideration of the bids.
19. EXECUTION OF CONTRACT: The bidder to whom award is made shall
execute a written contract with the City on the agreement form
provided, and shall secure all insurance and bonds as herein
provided within ten (10) days from the date of written notice
of the award. Failure or refusal to enter into a contract as
herein provided, or to conform to any of the stipulated
requirements in connection therewith shall be just cause for
the annulment of the award and the forfeiture of the proposal
guarantee.
If the successful bidder refuses or fails to execute the
Contract, the City may award the Contract to the next lowest
responsible bidder or re -advertise. On the failure or refusal
of the lowest responsible bidder or next lowest responsible
bidder to execute the Contract, such bidder's guarantees shall
be likewise forfeited to the City.
20. "OR EQUAL": Pursuant to Division 5, Chapter 4, Article 4
(commencing at #4380) Government Code, all specifications shall
be deemed to include the words "or equal", provided however
that permissible exceptions hereto shall be specifically noted
in the specifications.
21. EMPLOYMENT OF APPRENTICES: Attention is directed to
Sections 1777.5, 1777.6 and 1777.7 of the California Labor Code
and Title 8, California Administrative Code, Section 200 seq.
to ensure compliance and complete understanding of the law
regarding apprentices. The Contractor and any subcontractor
under him shall comply with the requirements of said sections
in the employment of apprentices; however, the Contractor shall
have full responsibility for compliance with said Labor Code
section, for all apprenticeable occupations, regardless of any
other contractual or employment relationships alleged to exist.
In addition to the above State Labor Code Requirements regarding
the employment of apprentices and trainees, the Contractor and
12
all subcontractors shall comply with Section 5 a. 3, Title 29
of the Code of Federal Regulations (29CFR).
22. EVIDENCE OF RESPONSIBILITY: Upon the request of the City, a
bidder whose bid is under consideration for the award of the
Contract shall submit promptly to the City satisfactory
evidence showing the bidder's financial resources, his
construction experience, and his organization and plant
facilities available for the performance of the contract.
23. WAGE RATES: The Contractor and/or subcontractor shall pay wages
as indicated in the "Notice Inviting Sealed Bids" section of
these specifications. The Contractor shall forfeit as penalty
to the City of Diamond Bar, two hundred dollars ($200.00) for
laborers, workmen, or mechanics employed for each calendar day,
or portion thereof, if such laborer, workman or mechanic
employed is paid less than the general prevailing rate of wages
herein referred to and stipulated for any work done under the
proposed contract, by him, or by any subcontractor under him,
in violation of the provisions of Labor Code, and in particular,
Sections 1770 to 1781 inclusive. Copies of all collective
bargaining agreements relating to the work as set forth in the
aforementioned Labor Code are on file with the Department of
Industrial Relations, Division of Labor Statistics and
Research.
24. PERMITS, FEES AND LICENSES: The Contractor shall possess a
valid business license prior to the issuance of the first
payment made under this Contract. Any work required within
Caltrans right-of-way will require a separate permit to be
obtained by the Contractor.
25. TIME OF COMPLETION AND LIQUIDATED DAMAGES: Bidder must agree
to commence work on or before the date of written "Notice to
Proceed" of the City and to fully complete the project within
thirty (30) working days thereafter. Bidder must agree also to
pay as liquidated damages, the sum of seven hundred and fifty
dollars ($750.00) for each calendar day thereafter.
26. CLAIMS FILING AND PROCESSING: The City and Bidder agree to
attempt to orally resolve any disputes which may give rise to
a claim (hereafter, "Claim") that falls within the definition
of Public Contract Code section 9204 (hereafter, "Section
9204"). If these efforts are unsuccessful, the City and Bidder
shall process the Claim in accordance with Section 9204. In
summary, if the Bidder decides to submit a Claim to the City,
it shall be sent by registered or certified mail, return receipt
requested, together with reasonable documentation to support
the Claim. A Claim may include a Claim by a subcontractor or
13
a lower tier subcontractor meeting the requirements of Section
9204(d)(5). Within 45 days of receipt of the Claim, or any
extension thereof agreed upon by the City and the Bidder, the
City will conduct a reasonable review of the Claim and provide
the Bidder with a written statement identifying what portion of
the Claim is disputed and what portion is undisputed. Payment
of any undisputed portion of the Claim shall be made within 60
days after the City issues its written statement. If the City
does not provide a written statement within the time specified,
the Claim shall be deemed rejected.
If the Bidder disputes the City's written statement or if the
Claim is deemed rejected, the Bidder may demand in writing by
registered or certified mail to the City, return receipt
requested, an informal conference to meet and confer in an
effort to settle the disputed portion of any Claim. Within 30
days of receipt of such written demand, the City shall schedule
a meet and confer conference.
If any portion of the Claim remains in dispute after the
conference, the City shall, within 10 City business days of the
conclusion of the conference, provide the Bidder with a written
statement identifying any portion that remains in dispute and
any portion that is undisputed. Payment of any undisputed
portion shall be made within 60 days after the City issues its
written statement. Any remaining disputed portion shall be
submitted to nonbinding mediation in accordance with Section
9204 (c) (2) (B) , unless the Bidder and City waive the mediation
upon mutual written agreement.
27. CONFLICT OF INTEREST: In the procurement of supplies,
equipment, construction and services by sub -recipients, the
conflict of interest provision including, but not limited to,
2 CFR part 200, Subpart B, 200.112, 24 CFR Part 570.611 and 24
CFR part 85, Section 85.36 (b), respectively, shall apply. No
employee, officer or agent of the sub -recipient shall
participate in selection or in award of administration of a
contract supported by Federal funds if a conflict of interest,
real or apparent, would be involved.
14
a lower tier subcontractor meeting the requirements of Section
9204(d)(5). Within 45 days of receipt of the Claim, or any
extension thereof agreed upon by the City and the Bidder, the
City will conduct a reasonable review of the Claim and provide
the Bidder with a written statement identifying what portion of
the Claim is disputed and what portion is undisputed. Payment
of any undisputed portion of the Claim shall be made within 60
days after the City issues its written statement. If the City
does not provide a written statement within the time specified,
the Claim shall be deemed rejected.
If the Bidder disputes the City's written statement or if the
Claim is deemed rejected, the Bidder may demand in writing by
registered or certified mail to the City, return receipt
requested, an informal conference to meet and confer in an
effort to settle the disputed portion of any Claim. Within 30
days of receipt of such written demand, the City shall schedule
a meet and confer conference.
If any portion of the Claim remains in dispute after the
conference, the City shall, within 10 City business days of the
conclusion of the conference, provide the Bidder with a written
statement identifying any portion that remains in dispute and
any portion that is undisputed. Payment of any undisputed
portion shall be made within 60 days after the City issues its
written statement. Any remaining disputed portion shall be
submitted to nonbinding mediation in accordance with Section
9204 (c) (2) (B) , unless the Bidder and City waive the mediation
upon mutual written agreement.
27. CONFLICT OF INTEREST: In the procurement of supplies,
equipment, construction and services by sub -recipients, the
conflict of interest provision including, but not limited to,
2 CFR part 200, Subpart B, 200.112, 24 CFR Part 570.611 and 24
CFR part 85, Section 85.36 (b), respectively, shall apply. No
employee, officer or agent of the sub -recipient shall
participate in selection or in award of administration of a
contract supported by Federal funds if a conflict of interest,
real or apparent, would be involved.
14
BIDDER'S PROPOSAL
CITY OF DIAMOND BAR
AREA 3 RESIDENTIAL NEIGHBORHOOD
ADA CURB RAMP IMPROVEMENT PROJECT
CDBG PROJECT NO. 602474-22
CIP PROJECT NO. SI23104
Date June 9th 2023
To the City Council of the City of Diamond Bar:
The Undersigned hereby declares:
(a) That the only persons or parties interested in this proposal as
principals are the following:
CT&T Concrete Paving Inc.
Jose Carvajal, President & Secretary
Jackie Carvajal, Treasurer
(If the bidder is a corporation, give the name of the corporation
and the name of its president, secretary, treasurer, and manager.
If a co -partnership, give the name, under which the co -partnership
does business, and the names and addresses of all co-partners. If
an individual, state the name under which the contract is to be
drawn.)
(b) That this proposal is made without collusion with any person, firm
or corporation.
(c) That he has carefully examined the location of the proposed work
and has familiarized himself with all of the physical and climatic
conditions, and makes this bid solely upon his own knowledge.
(d) That by submitting this Bidder's Proposal, he acknowledges receipt
and knowledge of the contents of those communications sent by the
City of Diamond Bar to him at the address furnished by him to the
City of Diamond Bar when this proposal form was obtained.
(e) That he has carefully examined the specifications, both general
and detail, and the drawings attached hereto, and communications
sent to him as aforesaid, and makes this proposal in accordance
therewith.
is
(f) That, if this bid is accepted he will enter into a written contract
for the performance of the proposed work with the City of Diamond
Bar.
(g) That he proposes to enter into such Contract and to accept in full
payment for the work actually done thereunder the prices shown in
the attached schedule. It is understood and agreed that the
quantities set forth are estimates and that the unit prices will
apply to the actual quantities whatever they may be.
Accompanying this proposal is a certified or cashier's check or
bidder's bond, payable to the order of the City of Diamond Bar in
the sum of
Ten Percent of Total Bid Amount
DOLLARS ($ 10% of Total Bid Amt )
Said bidder's bond has been duly executed by the undersigned bidder and
by a financially sound surety company authorized to transact business
in this state.
It is understood and agreed that should the bidder fail within ten
(10) days after award of contract to enter into the contract and furnish
acceptable surety bonds, then the proceeds of said check, or bidder's
bond, shall become the property of the City of Diamond Bar; but if this
Contract is entered into and said bonds are furnished, or if the bid is
not accepted then said check shall be returned to the undersigned, or
the bidder will be released from the bidder's bond.
324 S. Diamond Bar Blvd, PMB 275
Address of Bidder
Diamond Bar, CA 91765
City
Zip Code
909-629-8000
Tele Bidder
Signat `re of Bidder
16
BID SCHEDULE
CITY OF DIAMOND BAR
CONTRACT DOCUMENTS AND SPECIFICATIONS
AREA 3 RESIDENTIAL NEIGHBORHOOD
ADA CURB RAMP IMPROVEMENT PROJECT
CDBG PROJECT NO. 602474-22
CIP PROJECT NO. SI23104
ITEM
EST.
DESCRIPTION
UNIT
NO.
QUANT.
UNIT
WRITTEN IN WORDS
PRICE
AMOUNT
1
1
LS
CONSTRUCTION STAKING AND
C5100 0
P510 0
MONUMENT PRESERVATION.
REMOVE EXISTING
IMPROVEMENTS AND CONSTRUCT
CURB RAMP PER SPPWC STD.
7,�oo
'
IZ��LlO�
2
16
EA
PLAN NO. 111-5, INCLUDING
MOBILIZATION, TRAFFIC
CONTROL, AND PUBLIC
SAFETY.
REMOVE EXISTING CURB AND
3
47
LF
GUTTER AND RECONSTRUCT PER
3,7 b0
SPPWC STD. PLAN 120-3.
REMOVE EXISTING CROSS
4
75
SF
GUTTER AND RECONSTRUCT PER
�D
?J� 000
SPPWC STD. PLAN 122-3.
THERMOPLASTIC TRAFFIC
5
1
LS
STRIPING, PAVEMENT
MARKINGS, AND CURB
O
MARKINGS.
MANDATORY BID SCHEDULE ITEMS:
TOTAL AMOUNT BID (IN FIGURES) --> 2 01o, 99L� -
TOTAL AMOUNT BID,
SCHEDULE (WRITTEN IN
WORDS):
Two
HynoWed I--
� � T i s v s a va,
IV ram.¢., fi vn dpec awC
Dv lla-rs a a
Bid Schedule Note: Bid Price indicated refers to all items illustrated
on the plans and details, and delineated within the specifications
installed and completely in place with all applicable portions of the
construction documents and include all costs connected with such items
including, but to necessarily limited to, materials, transportation,
17
taxes, insurance, labor, overhead, and profit, for General Contractor
and Subcontractors.
All work called for on the construction documents are to provide a
completed project with all systems operating properly and ready for
use.
Award will be based on the items of Bid Schedule. Therefore, Contractor
shall completely fill out Bid Schedule.
Accompanying this proposal is Bidder's Bond
(Insert "$ cash",
"cashier's check", "certified check", or "bidder's bond" as
the case may be) in the amount equal to at least ten percent
(100) of the total bid.
The undersigned further agrees that in case of default in
executing the required contract, with necessary bond, within
ten (10) days, not including Sundays and legal holidays, after
having received notice that the Contract has been awarded and
ready for signature, the proceeds of the security
accompanying his bid shall become the property of the City of
Diamond Bar, and this proposal and the acceptance thereof may
be considered null and void.
CT&T Concrete Paving Inc.
NAME OF BIDDER (PRINT)
324 S. Diamond Bar Blvd, PMB 275
ADDRESS
Diamond Bar, CA
CITY
875627, Class A, C-8, C-12
06/08/2023
TURE DATE
91765 909-629-8000
ZIP CODE TELEPHONE
STATE CONTRACTOR LICENSE NO. AND CLASSIFICATION
I declare under penalty of Perjury of the laws of the State of California
that the representations made herein are true and correct in accordance
with the requirements of California Business and Professional Code
Section 7028.15.
m
CONTRACTOR SIGNATURE OR AUTHORIZED OFF
19
LIST OF SUBCONTRACTORS *
BID OPENING DATE 06/09/2023
Area 3 Residential Neighborhood ADA Curb Ramp
PROJECT Improvement Protect PROJECT NO. CIP S123104
LOCATION Various Locations, Diamond Bar, CA
CLIENT City of Diamond Bar
CONTRACTOR CT&T Concrete Paving Inc.
Name Under
Which
Subcontractor
is
Licensed
License
No.
Address
of
Office, Mail,
or
Shop
Percent
of
Total
Contract
Specific
Description
of
Subcontract
5 i1 V ir1
L5411
6,14 N. E-Ckho+f -
`. ZY
O V O VA , CA W 3 609
Maii vn-ze4-a
Prey -vat,
EZ- L'kf-
5fir� p f vl co
21 Y10
7 ? 7 1 0ra-
24 X
s ► ��
UVX4 U
PA yet
[� vtv-k Paf K-, C4
A a,r A,,- "vii
* In compliance with the provisions of the Public Contract Code
Section 4104, the undersigned bidder herewith sets forth the name,
location of the place of business, and California contractor
20
license of each Subcontractor - who will perform work or labor or
render service to the Prime Contractor, specially fabricates and
installs a portion of the work or improvement necessary to complete
construction contained in the plans and specifications, in an
amount in excess of one-half (1/2) of one percent (10) of the
General Contractor's total base bid amount or, in the case of bids
or offers for the construction of streets or highways, including
bridges in excess of one-half of 1 percent (0.5o)of the Prime
Contractor's total base bid or ten thousand ($10,000.00),
whichever is greater, and the portion of the work which will be
done by each Subcontractor.
21
DECLARATION OF ELIGIBILITY TO CONTRACT
[Labor Code Section 1777.1; Public Contract Code Section 6109]
The undersigned, a duly authorized representative of the contractor,
certifies and declares that:
1. The contractor is aware of Sections 1777.1 and 1777.7 of the
California Labor Code, which prohibit a contractor or
subcontractor who has been found by the Labor Commissioner or the
Director of Industrial Relations to be in violation of certain
provisions of the Labor Code, from bidding on, being awarded, or
performing work as a subcontractor on a public works project for
specified periods of time.
2. The contractor is not ineligible to bid on, be awarded or perform
work as a subcontractor on a public works project by virtue of the
foregoing provisions of Sections 1777.1 or 1777.7 of the California
Labor Code or another provision of law.
3. The contractor is aware of California Public Contract Code Section
6109, which states:
(a) A public entity, as defined in Section 1100 [of the
Public Contract Code], may not permit a contractor or
subcontractor who is ineligible to bid or work on, or be
awarded, a public works project pursuant to Section 1777.1 or
1777.7 of the Labor Code to bid on, be awarded, or perform
work as a subcontractor on, a public works project. Every
public works project shall contain a provision prohibiting a
contractor from performing work on a public works project
with a subcontractor who is ineligible to perform work on the
public works project pursuant to Section 1777.1 or 1777.7 of
the Labor Code.
(b) Any contract on a public works project entered into
between a contractor and a debarred subcontractor is void as
a matter of law. A debarred subcontractor may not receive
any public money for performing work as a subcontractor on a
public works contract, and any public money that may have
been paid to a debarred subcontractor by a contractor on the
project shall be returned to the awarding body. The
contractor shall be responsible for the payment of wages to
workers of a debarred subcontractor who has been allowed to
work on the project.
4. The contractor has investigated the eligibility of each and every
subcontractor the contractor intends to use on this public works
22
project, and determined that none of them is ineligible to perform
work as a subcontractor on a public works project by virtue of the
foregoing provisions of the Public Contract Code Sections 1777.1
or 1777.7 of the Labor Code, or any other provision of law.
I declare under
California that
of June 8th
penalty of perjury under the laws of the State of
the foregoing is true and correct. Executed this day
2023, at Pomona,CA (place of execution).
Sig ature
Name: Jose Carvajal
Title: President
Name of Contractor:
CT&T Concrete Paving Inc.
23
BIDDER'S VIOLATION OF LAW/SAFETY QUESTIONNAIRE
In accordance with Government Code Section 14310.5 and in conformance
with Public Contract Code Section 10162, the Bidder shall complete,
under penalty of perjury, the following questionnaire:
QUESTIONNAIRE
Has the Bidder, any officer, principal or employee of the Bidder who
has a proprietary interest in the business of the Bidder, ever been
disqualified, removed, or otherwise prevented from bidding on or
completing a federal, state or local government project because of
violation of law or a safety regulation?
YES
NO X
If the answer is yes, explain the circumstances in the following space:
STATEMENT
In conformance with Public Contract Code Section 10232, the Contractor,
hereby states under penalty of perjury, that no more than on 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.
24
CONTRACTOR'S INDUSTRIAL SAFETY RECORD
Project Identification CIPS123104
Area 3 Residential Neighborhood ADA Curb Ramp Improvement Project
Bid Date 06/09/2023
This information must include all construction work undertaken in the
State of California by the bidder and any partnership, joint venture or
corporation that any principal of the bidder participated in as a
principal or owner for the last three calendar years and the current
calendar year prior to the date of bid submittal. Separate information
shall be submitted for each particular partnership, joint venture,
corporation or individual bidder. The bidder may attach any additional
information or explanation of data, which he would like, taken into
consideration in evaluating the safety record. An explanation must be
attached of the cirmimSfan(-P.q C11Y'l"ni1nrainrr anw >nrq nll -Fmi-nl;+-;,
ITEM
3 CALENDAR YEARS
CURRENT
PRIOR TO CURRENT YEAR
YEAR
2020
2021
2022
TOTAL
No. of Contracts
20
15
16
51
8
Total dollar amount of
contracts in 1,000's
6331820
8573122
8610644
23515586
2162900
No. of lost workday
0
1
1
2
0
cases
No. of lost work day
cases
0
0
0
0
0
involving permanent
transfer to
another job or
termination of
employment
No. of lost workdays
0
6
1
7
0
*The information required for this item is the same as required for
columns 3 to 6, Code 10, Occupational Injuries, Summary - Occupational
Injuries and Illnesses, OSHA No. 102.
The above information was compiled
to me at this time and I declare
information is true and accurate
records.
CT&T Concrete Paving Inc
Name of Bidder (Print
324 S. Diamond Bar Blvd, PMB 275
Address
Diamond Bar, CA 91765
City Zip Code
from the records that are available
under penalty of perjury that the
within the imitations of these
Si2lhature
875627 (A, C-8, C-12)
State Contractor's Lic. No. & Class
909-629-8000
Telephone
25
AFFIDAVIT FOR CO -PARTNERSHIP FIRM
STATE OF CALIFORNIA )
)SS
COUNTY OF LOS ANGELES )
being
sworn, deposes and says:
first duly
That he is a member of the co -partnership firm designated as
which is the party making the foregoing proposal or bid; that such bid
is genuine and not collusive or sham; that said bidder has not colluded,
conspired, connived or agreed, directly or indirectly, with any other
bidder or person to put in a sham bid or that such other person shall
refrain from bidding; and has not in any manner sought by collusion to
secure any advantage against the City of Diamond Bar or any person
interested in the proposed contract, for himself or for any other
person.
That he has been and is duly vested with authority to make and sign
instruments for the co -partnership by
who constitute the other members of the co -partnership.
Signature
Subscribed and sworn
to before me this
day of
20
Signature of Officer Administering Oath
(Notary Public)
26
AFFIDAVIT FOR CORPORATION BIDDER
STATE OF CALIFORNIA )
)SS
COUNTY OF LOS ANGELES )
Jose Carvajal
duly sworn, deposes and says:
That he is President
of, CT&T Concrete Paving Inc.
being first
a corporation which is the party making the foregoing proposal or bid;
that such bid is genuine and not collusive or sham; that said bidder
has not colluded, conspired, connived or agreed, directly or indirectly,
with any other bidder or person to put in a sham bid or that such other
person shall refrain from bidding; and has not in any manner sought by
collusion to secure any advantage against the City of Diamond Bar or
any person interested in the proposed contract, for himself or for any
other person.
Subscribed and sworn
to before me this
day of 7u
r
20 2 _!-,'
Signature of Officer Administering Oath
(Notary Public)
A notary public or other officer completing this
certificate verifies only the identity of the indi-
vidual who signed the document to which this
certificate is attached, and not the truthfulness,
accuracy, or validity of that document.
DANIELA. BUTLER
< Commission # 2402607
Notary Public - California �
~aa / Los Angeles County
My Comm. Expres May 2, 2026
27
AFFIDAVIT FOR INDIVIDUAL BIDDER
STATE OF CALIFORNIA )
)SS
COUNTY OF LOS ANGELES )
duly sworn, deposes and says:
, being first
That he is the party making the foregoing proposal or bid; that
such bid is genuine and not collusive or sham; that said bidder has not
colluded, conspired, connived or agreed, directly or indirectly, with
any other bidder or person to put in a sham bid or that such other
person shall refrain from bidding; and has not in any manner sought by
collusion to secure any advantage against the City of Diamond Bar or
any person interested in the proposed contract, for himself or for any
other person.
Subscribed and sworn
to before me this
day of
Signature
20
Signature of Officer Administering Oath
(Notary Public)
W
AFFIDAVIT FOR JOINT VENTURE
STATE OF CALIFORNIA )
)SS
COUNTY OF LOS ANGELES )
duly sworn, deposes and says:
That he
of,
, being first
one of the parties submitting the foregoing bid as a joint venture and
that he has been and is duly vested with the authority to make and sign
instruments for and on behalf of the parties making said bid who are:
that such bid is genuine and not collusive or sham; that said bidder
has not colluded, conspired, connived or agreed, directly or indirectly,
with any other bidder or person to put in a sham bid or that such other
person shall refrain from bidding; and has not in any manner sought by
collusion to secure any advantage against the City of Diamond Bar or
any person interested in the proposed contract, for himself or for any
other person.
Subscribed and sworn
to before me this
day of
Signature
20
Signature of Officer Administering Oath
(Notary Public)
BOND No.
29
BID BOND
KNOW ALL PERSONS BY THESE PRESENTS that,
WHEREAS the City of Diamond Bar ("City"), has issued an invitation
for bids for the work described as follows:
AREA 3 RESIDENTIAL NEIGHBORHOOD
ADA CURB RAMP IMPROVEMENT PROJECT
CDBG PROJECT NO. 602474-22
CIP PROJECT NO. SI23104
WHEREAS
CT&T Concrete Paving, Inc., 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, CA 91765
(Name and address of Bidder)
("Principal"), desires to submit a bid to Public Agency for the work.
WHEREAS, bidders are required under the provisions of the California
Public Contract Code to furnish a form of bidder's security with their
bid.
NOW, THEREFORE, we, the undersigned Principal, and
Contractors Bonding and Insurance Company, 9025 N. Lindbergh Drive, Peoria, IL 61615
(Name and address of Surety)
("Surety") a duly admitted surety insurer under the laws of the State
of California, as Surety, are held and firmly bound unto Public Agency
in the penal sum of
Ten Percent of Total Bid Amount
Dollars ($ 10% of Bid Amount ) , being not less than ten percent (10 0 ) of the
total bid price, in lawful money of the United States of America, for
the payment of which sum well and truly to be made, we bind ourselves,
our heirs, executors, administrators, successors, and assigns, jointly
and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded
Principal is awarded a contract for the work by City and within the
time and in the manner required by the bidding specifications, entered
into the written form of contract included with bidding specifications,
furnishes the required bonds, one to guarantee faithful performance and
the other to guarantee payment for labor and materials, and furnishes
the required insurance coverages, then this obligation shall become
null and void; otherwise, it shall be and remain in full force and
effect.
34
In case suit is brought upon this bond, Surety further agrees to pay
all court costs incurred by City in the suit and reasonable attorneys'
fees in an amount fixed by the court. Surety hereby waives the
provisions of California Civil Code § 2845.
IN WITNESS WHEREOF, each of which shall for all purposes be deemed an
original hereof, have been duly executed by Principal and Surety, on
the date set forth below, the name of each corporate party being hereto
affixed and these presents duly signed by its undersigned
representative(s) pursuant to authority of its governing body.
Dated: June 5, 2023
"Principal"
CT&T Concrete Paving, Inc.
By:
s reSV-77me- Nev-1
M
Its
"Surety"
Contractors Bonding and Insurance Company
By: Emilie George
9
I t Aj orney-in-Fact
By:
Its
Note: This bond must be dated, all signatures must be notarized, and
evidence of the authority of any person signing as attorney -in -
fact must be attached.
(Seal) (Seal)
35
A notary public or other officer completiing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On before me, Daniel A. Butler, A Notary Public
(Here insert name ancl title or the officer)
personally appeared J Ose-
who proved to me on the basis of satin actory evidence to be the person(S-) whose
name(-&) Is re subscribed to the within instrument and acknowledged to me that
she/they executed the same in Is er/their authorized capacity(ies), and that by
Is er/their signature(s) on the instrument the person(s), or the entity upon behalf of
which the person(a) acted, executed the instrument.
certify under PENALTY OF PERJURY bander the laws of the State of California that
the foregoing paragraph is true and correct.
WITNESS my hand and official seal
Notary Public Signature (Notary Public Seal)
DESCRIPTION OF THE ATTACHED DOCUMENT
(Title or description of attached document)
(Title or description of attached document continued)
Number of Pages Document Date
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
❑ Corporate Officer
(Title)
❑ Partner(s)
❑ Attorney -in -Fact
❑ Trustee(s)
❑ Other
www.NoliaryCla,sses.com 800-873-9865
'* DANIEL A. BUTLER
Commission # 2402W7
� "'-� ^ , •° Notary Public -California �
Los Angeles County
My Comm. Expires May 2, 2026
INSTRUCTIONS FOR COMPLETING THIS FORM
T his Jorm complies with current California statutes regarding notary wording and,
if needed should be completed and attached to the document. Acknowledgments
from other states may be completed for documents being sent to that state so long
as the wording does not require the Calilornia notary to violate California notary
law.
• State and County infomlation must be the State and County where the document
signer(s) personally appeared before the notary public fir acknowledgment.
• L)ate of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
commission followed by a commna and then your title (notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural fornis by crossing off inCtrect forms (i.e.
he/she/they-is 'ra+e) or circling the correct forms. Failure to correctly indicate this
information may lead to rejection of document recording.
• "rile notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re -seal if a
sufficient area permits, otherwise complete it different acknowledgment form.
• Signature of the notary public must match the signature on file with the office of
the county clerk,
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached document. number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary).
• Securely attach this document to the signed document with a staple.
ARIZONA NOTARY ACKNOWLEDGMENT
State of Arizona
County of Maricopa
On this JUG! 0 5 2023 , before me Danielle Hanson
personally appeared
Emilie George
[Name of Signer)
[Name of Notary Public]
whose identity was proven
to me on the basis of satisfactory evidence to be the person who he or she claims to be, and
acknowledged that he or she signed the above/attached document.
Witness my hand and official seal.
DANIELLE IRIS HANSON
NOTARY PUBLIC - ARIZONA
MARICOPA COUNTY
COMMISSION # 566523
MY COMMISSION EXPIRES
(a AUGUST 11, 2023
(Seal)
[Affix Seal Here]
Signature of Notary Public
POWER OF ATTORNEY
RLI Insurance Company
Contractors Bonding and Insurance Company
9025 N. Lindbergh Dr. Peoria, IL 61615
Phone: 800-645-2402
Know All Men by These Presents:
That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the
approving officer if desired.
That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and
together, the "Company") do hereby make, constitute and appoint:
Yuniz T. Mullick, James W. Moilanen P. Austin Neff Irene Luonp Emilie George Danielle Hanson Christine Woolford Alexander R
Holsheimer. tomtly or severally
in the City of Mission Viejo , State of California its true and lawful Agent(s) and Attorney(s) in Fact, with
full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all
bonds and undertakings in an amount not to exceed Twenty Five Million Dollars
( $25,000,000.00 ) for any single obligation.
The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been
executed and acknowledged by the regularly elected officers of the Company.
RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the
following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation, and is now in force, to -wit:
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of
the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board
of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint
Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate
seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The
signature of any such officer and the corporate seal may be printed by facsimile."
IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have
caused these presents to be executed by its respective Vice President with its corporate seal affixed this 15th day of
February_, 2023_.
\NC+AND 4j,SG i, "I", N CE Cpo.
pr 'ppvoRq •9vys ��'c' �O'
�y .GcpRPORAIr
TF Sys
y .',; _
SEAL �- SEAL
OJ r?
State of Illinois l ;�L1NO;5, '' '' << 1 N 0%50°11
SS �
}
County of Peoria JJJ
On this 15th day of February 2023 before me, a Notary Public,
personally appeared Barton W. Davis , who being by me duly sworn,
acknowledged that he signed the above Power of Attorney as the aforesaid
officer of the RLI Insurance Company and/or Contractors Bonding and
Insurance Company and acknowledged said instrument to be the voluntary
act and deed of said corporation.
By:
Catherine D. Geiger Notary Public
QCATHERINE D. GEIGER
OFFICIAL SEAL
Notary Public - State of Illinois
My Commission Expires
December 05, 2026
RLI Insurance Company
Contractors Bonding and Insurance Company
By: "6- � /I/-�'
Barton W. Davis Vice President
CERTIFICATE
I, the undersigned officer of RLI Insurance Company and/or
Contractors Bonding and Insurance Company, do hereby certify
that the attached Power of Attorney is in full force and effect and is
irrevocable; and furthermore, that the Resolution of the Company as
set forth in the Power of Attorney, is now in force. In testimony
whereof, I have hereunto set my hand and the seal of the RLI
Insurance Company and/or Contractors Bonding and Insurance
Company this 5th day of June , 2023 .
RLI Insurance Company
Contractors Bonding and Insurance Company
By: 4k!!"A IJ jeL<
Jeffrey is Corporate Secretary
0456659020212
A0058D 19
CERTIFICATION OF NON-DISCRIMINATION AND AFFIRMATIVE ACTION
As suppliers of goods or services to the City of Diamond Bar, the firm
listed below certifies that it does not discriminate in its employment
with regards to race, religion, sex, or national origin; that it is in
compliance with all federal, state, and local directives and executive
orders regarding non-discrimination in employment; and that it will
pursue an affirmative course of action as required by the affirmative
action guidelines.
We agree specifically:
1. To establish or observe employment policies which affirmatively
promote opportunities for minority persons at all job levels.
2. To communicate this policy to all persons concerned including all
company employees, outside recruiting services, especially those
serving minority communities, and to the minority communities at
large.
3. To take affirmative steps to hire minority employees within the
company.
FIRM CT&T Concrete Paving Inc.
TITLE OF OFFICER 5IGU,�NG President
SIGNATURE
DATE 06/09/2023
Please include any additional information available regarding equal
opportunity employment programs now in effect within your company:
36
CERTIFICATION WITH REGARD TO THE PERFORMANCE OF
PREVIOUS CONTRACTS OR SUBCONTRACTS SUBJECT TO THE
EQUAL OPPORTUNITY CLAUSE AND THE FILING OF REQUIRED REPORTS
The bidder X , proposed subcontractor , hereby certifies that
he has X , has not , participated in a previous contract or
subcontract subject to the Equal Opportunity Clause, as required by
Executive Orders 10925, 11114, or 11246, and that he has , has notX
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.
CT&T Concr
(COMPANY)
President
(TITLE)
DATE: June 9th 2 0 23
ing Inc.
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 (EEO-1) is the only report required by the
Executive Orders or their implementing regulations.
Proposed prime contractors and subcontractors who have participated in
a previous contract or subcontract subject to the Executive Orders and
have not filed the required reports should note that 41 CFR 60-1.7 (b)
(1) prevents the award of contracts and subcontracts unless such
contractor submits a report covering the delinquent period of such other
period specified by the Federal Highway Administration or by the
Director, Office of Federal Contract Compliance, U.S. Department of
Labor.
37
NON -COLLUSION DECLARATION
(TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID)
The undersigned declares:
I am the
the
President
foregoing bid.
of CT&T Concrete PavingInc., the party making
The bid is not made in the interest of, or on behalf of, any undisclosed
person, partnership, company, association, organization, or
corporation. The bid is genuine and not collusive or sham. The bidder
has not directly or indirectly induced or solicited any other bidder to
put in a false or sham bid. The bidder has not directly or indirectly
colluded, conspired, connived, or agreed with any bidder or anyone else
to put in a sham bid, or to refrain from bidding. 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.
All statements contained in the bid are true. 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, to any corporation, partnership, company,
association, organization, bid depository, or to any member or agent
thereof, to effectuate a collusive or sham bid, and has not paid, and
will not pay, any person or entity for such purpose. Any person
executing this declaration on behalf of a bidder that is a corporation,
partnership, joint venture, limited liability company, limited
liability partnership, or any other entity, hereby represents that he
or she has full power to execute, and does execute, this declaration on
behalf of the bidder.
I declare under penalty of perjury under the laws of the State of
California that the foregoing is true and correct and that this
declaration is executed on June 8th, 2023 [date] , at
Pomona [city] , CA [state] .
CT&T Concrete Paving Inc.
Business Name
Signature ofBidder(must be notarized)
324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, CA 91765
Business Address
Attach Notary Acknowledgement Form to this form when submitting
W.
w--
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of Los Angeles
On �1t,c e Z6 2 3 before me, Daniel A. Butler, A Notary Public
(-iere insert nit e o the officer
personally appeared C' I
r
who proved to me on the basis of satisfactory evidence to be the person(--) whose
name(-s-) is re subscribed to the within instrument and acknowledged to me that
the/they executed the same in IS er/their authorized capacity(ies), and that by
Is er/their signature(s) on the instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Notary Public Signature (Notary Public Seal)
PTION OF THE ATTACHED DOCUMENT
(Title or description of attached document)
(Title or description of attached document continued)
Number of Pages Document Date
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
❑ Corporate Officer
(Title)
❑ Partner(s)
❑ Attorney -in -Fact
❑ Trustee(s)
❑ Other
wvw.NotaryClasses.corn 800-873-9865
DAN
: IELA. BUTLER 4- N Commission # 2402807
Notary Public - California C
Q Los Angeles County
My Comm. Expires May 2, 2026
INSTRUCTIONS FOR COMPLETING THIS FORM
T his form complies with current California statutes regarding notary wording and,
if needed, should be completed and attached to the document. Acknowledgments
from other states may be completed for documents being sent to that state so long
as the wording does not require the California notary to violate California notary
law.
• State and County information must be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
urns( also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title (notary public).
• Print the nante(s) of document signers) who personally appear at. the time of
notarization.
• Indicate the correct singular or plural forms by crOssing off incorrect forms (i.e.
#e/she/t}xy� is/ewe) or circling the correct foams. Failure to correctly indicate this
information may lead to rejection of document recording.
• 'file notary seal impression must be clear and photographically reproducible.
hupression must not cover text or lines. If seal impression smudges, re -seal if a
Sufficient area permits, otherwise complete it different acknowledgment form.
• Signature of the notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary),
• Securely attach this document to the signed document with a staple.
NOTICE TO BIDDERS
COMMUNITY DEVELOPMENT BLOCK GRANT
(CDBG)
COMPLIANCE DOCUMENTS FOR CONSTRUCTION CONTRACTS of LESS Than $200,000
A Bidder is required to familiarize itself with the information provided on the following pages. Failure to
comply with and/or meet the requirements may result in a bid being determined incomplete or non-
responsive.
A bidder is required to submit the following Compliance forms with its Bid Proposal:
1: County Lobbying Certification
1 _I 2: Request for Additional Classification and Rate
L l 3: Contractor's List of Proposed Subcontractors
4: Worker's Compensation Certification
._. 5: Non -Segregated Facilities Certification
6: Past Performance Certification
f.._ 7: Notice of Equal Employment Opportunity Commitment
C. 8: Non Collusion Declaration
!. 9: Federal Lobbying Certification
COUNTY LOBBYIST CODE CHAPTER 2.160
COUNTY ORDINANCE NO. 93-0031
CERTIFICATION
Name of Firm: CT&T Concrete Paving Inc.
Address: 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, CA
State: CA
Zip Code: 91765
Telephone Number: ( 909 ) 629-8000
Acting on behalf of the above named firm, as its Authorized Official, I make the following Certification to the
Los Angeles County Development Authority (LACDA).
1) It is understood that each person/entity/firm who applies for a Los Angeles County
Development Authority contract, and as part of that process, shall certify that they are familiar
with the requirements of the Los Angeles County Code, Chapter 2.160 (Los Angeles County
Ordinance 93-0031) and;
2) That all persons/entities/firms acting on behalf of the above named firm have and will comply
with the County Code, and;
3) That any person/entity/firm who seeks a contract with the Los Angeles County Development
Authority shall be disqualified therefrom and denied the contract and, shall be liable in civil
action, if any lobbyist, lobbying firm, lobbyist employer or any other person or entity acting on
behalf of the named firm fails to comply with the provisions of the County Code.
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 contract with
Los Angeles County and the Los Angeles County Development Authority.
Authorized Official:
CT&T Concrete Paving Inc.
(Contractor/Subcontractor)
06/09/2023
(Date)
By:
(Signature)
President
(Title)
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
HUD FORM 4230A
REPORT OF ADDITIONAL CLASSIFICATION AND RATE
OMB Approval Number2501-0011
(Exp. 8/31 /2022)
1. FROM (name and address of requesting agency)
2. PROJECT NAME AND NUMBER
N/A
3. LOCATION OF PROJECT (City, County and State)
4. BRIEF DESCRIPTION OF PROJECT
5. CHARACTER OF CONSTRUCTION
❑ Building ❑ Residential
❑ Heavy ❑ Other (specify)
❑ Highway
6. WAGE DECISION NO. (include modification number, if any) DATE of WAGE DECISION:
7. WAGE DECISION EFFECTIVE
DATE (LOCK -IN):
❑ COPY ATTACHED
8. WORK CLASSIFICATION(S)
HOURLY WAGE RATES
BASIC WAGE FRINGE BENEFIT(S) (if any)
9. PRIME CONTRACTOR (name, address)
9a.
10. SUBCONTRACTOR/EMPLOYER, IF APPLICABLE
( V 4- T (UVl LYl'/tt� VnVIn6t 1 t`lG•
(name, address)
27J�Ng Gn
❑ Agree
vI
❑ Disagree
9b. SIGNATURE
DATE
I_Check All_ at Appfyj
❑ The work to be performed by the additional classifications) is not performed by a classification in the applicable wage decision.
e
e
The proposed classification is utilized in the area by the construction industry.
The proposed wage rate(s), including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in
the wage decision.
The interested parties, including the employees or their authorized representatives, agree on the classification(s) and wage rate(s).
Supporting documentation attached, including applicable wage decision.
Check One:
❑ Approved, meets all criteria. DOL confirmation requested.
❑ One or more classifications fail to meet all criteria. DOL decision requested.
FOR HUD USE ONLY
LR2000:
Agency Representative Date
(Typed name and signature) Log in:
Log out:
Phone Number
HUD-4230A (8-19) PREVIOUS EDITION IS OBSOLETE
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WORKER'S COMPENSATION CERTIFICATION
I certify, by my signature below, that I am aware of the provisions of Section 3700 of the
California Labor Code. §3700 requires every employer be insured against liability for
worker's compensation or to undertake self-insurance in accordance with the provisions of
that code. I further certify that I will comply with such provisions before commencing the
performance of the work of this contract.
Date: 06/09/2023 Project Number: CIP S123104 / CDBG 602474-22
Project Name: Area 3 Residential Neighborhood ADA Curb Ramp Improvement Project
Company Name: CT&T Concrete Paving Inc.
Address: 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, CA 91765
Print Name: Jose Carvajal
Title: President
Signe
Certification of Understanding and Authorization
This certification is required when a Payroll Officer is not listed on the business license
(03130117)
Contractor Name: CT&T Concrete Paving Inc.
Project Name: Area 3 Residential Neighborhood ADA Curb Ramp Improvement Project CDBG Project Number: 602474-22
Project Location: Various Locations, Diamond Bar, CA
Local Contracting Agency (LCA): City of Diamond Bar
Labor Standards Officer (LSO):
Telephone:
The contractor certifies, by signature below, that the designated payroll officer has received a copy of the federal wage decision
assigned to this project as identified below;
► CA 2023022 Modification Number 4 Dated 03/17/2023
The payroll officer acknowledges, by signature below, that she/he have also received, read, and understands the following
provision and publication;
► Federal Labor Standards Provisions (HUD-4010 form), and
► Contractor's Guide to Prevailing Wage Requirements for Federally -Assisted Construction Projects.
Further, the person designated as the Payroll Officer understands the labor standards reporting requirements
applicable to the above listed project, and she/he is hereby authorized to sign the Statement of Compliance
form that will accompany each weekly payroll report for this project on behalf of the contractor.
CT&T Concrete Paving Inc.
Contractor's Business Name
Jose Carvajal
Print Name of Owner or Principal listed on the business license
President
Title
Jackie Carvajal
Print Name of Payroll Officer
875627
License Number
Sign ure of Owner or Principal listed on the business license
06/08/2023
uate
(V;'0Z1J - 0
!_/ Signature of Payroll,lOfficer
NON -SEGREGATED FACILITIES CERTIFICATION
Federally Assisted Construction Projects
The federally assisted construction contractor certifies that he/she DOES NOT and WILL NOT:
1. Maintain or provide, for his/her employees, any segregated facilities at any of his/her
establishments.
2. Permit his/her employees to perform their services at any location, under his/her
control, where segregated facilities are maintained.
The federally assisted contractor agrees that a breach of this certification is a violation of the Equal
Opportunity Clause in this contract. As used in this certification, the term segregated facilities means any
waiting room, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks,
locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or
entertainment areas, transportation, and housing facilities provided for employees which are segregated
by explicit directive or are in fact segregated on the basis of race, creed, color, or national origin, because
of habit, local custom, or otherwise.
The federally -assisted contractor agrees that (except where he/she has obtained identical certifications
from proposed subcontractors for specific time periods) he/she will obtain identical certifications from
proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt
from the provisions of the Equal Opportunity Clause, and that he/she will retain such certifications in
his/her files.
NOTE: The penalty for making false statements in offers are prescribed in 18 U.S.C. 1001.
Date: 06/09/2023 Project Number: CIP S123104 / CDBG 602474-22
Company: CT&T Concrete Paving Inc.
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Address: 324 ZDiamd Bad, PMB 275, Diamond Bar, CA
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Title: "President
PAST PERFORMANCE CERTIFICATION
With regard to performance of previous contracts or subcontracts subject to the Equal Opportunity Clause and filing of required reports
The E]bidder, ❑proposed sub -contractor, hereby certifies that he/she ®has, ❑has not, participated
in a previous contract or subcontract subject to the Equal Opportunity Clause, as required by
Executive Orders 10925, 11114, or 11246, and that he/she ❑has, ®has not, filed with the Joint
Reporting Committee, the Director of the Office of Federal Contract Compliance (OFCCP), 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.
Date: 06/09/2023 Project Number: CDBG 602474-22 ContractAward: $ 2001"Ltp
Awarding Agency: City of Diamond Bar
Contractor Name: CT&T Concrete Paving Inc.
Affiliate C
Title: President
Total Number of Employees 42
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).
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 U.S. Department of the Interior or by the Director, Office of Federal Contract Compliance, U.S.
Department of Labor.
SF-100 (EEO-1) must be filed by, -
(A) All private employers who are:
(1) Subject to Title VII of the Civil Rights Act of 1964 (as amended) with 100 or more employees.
(2) Subject to Title VII who has fewer than 100 employees, if the company is owned or affiliated with
another company, or there is centralized ownership, control or management so that the group legally
constitutes a single enterprise, and the entire enterprise employs a total of 100 or more employees.
(B) All federal contractors (private employers), who:
(1) Are not exempt as provided for by 41 CFR 60-1.5
(2) Have 50 or more employees, and
a. Are prime contractors or first -tier subcontractors, and have a contract, subcontract, or purchase
order amounting to $50,000 or more; or
b. Serve as a depository of Government funds in any amount, or
c. Is a financial institution, which is an issuing, and paying agent for U.S. Savings Bonds and Notes.
TO- The Laborer's Training School
(Name of Labor Union, Workers Representative, etc.
1385 Sierra Madre Ave, Azusa, CA 91702
(Address)
Name of Business (Contractor): CT&T Concrete Paving Inc.
Area 3 Residential Neighborhood ADA Curb Ramp
Project Name: Improvement Project Project Number: CIP S123104 / CDBG 602474-22
The Undersigned currently holds a contract with City of Diamond Bar , involving
funds of the U. S. Government, or a subcontract with a prime contractor holding such contract.
You are advised that under the provisions of the above contract or subcontract, and in accordance
with Executive Order 11246, the undersigned is obligated not to discriminate against any employee
or applicant for employment because of race, color, religion, sex or national origin. This obligation
not to discriminate in employment includes, but is not limited to the follow.-
1 . Hiring, placement, upgrading, transfer or demotion;
2. Recruitment, advertising or solicitation for employment;
3. Treatment during employment;
4. Rates of pay or other forms of compensation;
5. Selection for training, including apprenticeship; and
6. Layoff or termination.
This notice is furnished to you pursuant to the provisions of the above contract or subcontract and
Executive Order 11246. Copies of this notice will be posted by the undersigned in conspicuous
places available to employees or applicants for employment.
Jose Carvajal
i('riu( N.unc)
06/09/2023
(Dille)
By:
(Sicnnfwcl
President
California Public Contract Code requires every bid on every public works contract of a public to include a
declaration under penalty of perjury under the laws of the State of California, in the following form:
NONCOLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID
The undersigned declares:
President CT&T Concrete Paving Inc.
I am the ____ of ____, the party making the foregoing bid.
The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership,
company, association, organization, or corporation. The bid is genuine and not collusive or sham.
The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or
sham bid. The bidder has not directly or indirectly colluded, conspired, connived, or agreed with
any bidder or anyone else to put in a sham bid, or to refrain from bidding. 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. All statements contained in the bid
are true. 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, to any
corporation, partnership, company, association, organization, bid depository, or to any member
or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any
person or entity for such purpose.
Any person executing this declaration on behalf of a bidder that is a corporation, partnership,
joint venture, limited liability company, limited liability partnership, or any other entity, hereby
represents that he or she has full power to execute, and does execute, this declaration on behalf
of the bidder.
I declare under penalty of perjury under the laws of the State of California that the foregoing is
true and correct and that this declaration is executed on ___[date], at ___[city], ___[state]."
06/08/2023 Pomona, CA
FEDERAL LOBBYIST CERTIFICATION
Name of Firm: CT&T Concrete Paving Inc.
Address: 324 S. Diamond Bar Blvd, PMB 275, Diamond Bar, CA
State: CA Zip Code: 91765
Telephone Number: ( 909 ) 629-8000
Acting on behalf of the above named firm as its Authorized Official, I make the following Certification to the U. S.
Department of Housing and Urban Development and the Los Angeles County Development Authority (LACDA).
1) No Federal appropriated funds have been paid by or on behalf of the above named firm to any
person for influencing or attempting to influence an officer or employee of any agency, a Member
of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of and Federal grant, loan or
cooperative agreement, and any extension, continuation, renewal, amendment, or modification
thereof, and;
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 or any 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 above named
firm shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying", in
accordance with its instructions, and;
3) The above name firm shall require that the language of this certification be included in the award
documents for all sub -awards at all tiers (including subcontracts, sub -grants, and contracts under
grants, loans, and cooperative agreement) and that all sub -recipients shall certify and disclose
accordingly.
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 the 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.
Authorized Official:
CT&T Concrete Paving Inc.
(Contractor/Subcontractor)
06/09/2023
(Date)
By.
(Signature)
President
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Form
wM1V
Request for Taxpayer
(Rev. October2018)
Identification Number and Certification
Give Form to the
requester. Do not
Department of the Treasury
Internal Revenue Service
► Go to wwwJrs.gov/FormW9 for instructions and the latest information.
send to the IRS.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
MT Concrete Paving Inc.
2 Business name/disregarded entity name, if different from above
0
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
following seven boxes.
4 Exemptions (codes apply only to
o
certain entities, not individuals; see
o
[:1Individual/sole proprietor or ElC Corporation ❑✓ S Corporation ElPartnership ❑ Trust/estate
instructions on page 3):
ai
single -member LLC
Exempt payee code (if any)
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❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ►
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rn
Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check
LLC if the LLC is classified as a single -member LLC that is disregarded from the owner the
Exemption from FATCA reporting
n
unless owner of the LLC is
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
code (if any)
w
is disregarded from the owner should check the
9 appropriate box for the tax classification of its owner.
U
Ol
CL
❑ Other (see instructions) ►
(Applies to accounts maintained outside the U.S.)
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5 Address number, street, and apt. or suite no. See instructions.
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Requester's name and address (optional)
Cn
324
List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding. For individuals, this is generally your social security number (S. However, for a — m
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter. F-
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign Signature of '\
►
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number ([TIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)