HomeMy WebLinkAboutCCF_000022EXPERIENCE 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
five years. Only projects in excess of $200,000 each qualify as similar
for this project.
1. Project Title Garey High School - Reroofing Project
Contract Amount $3,892,308.00
Type of Work Reroof entire High School Campus
Client Pomona Unified School District
Agency Project Manager Daren McCullough Phone 909-208-4490
Date Completed December2021 % Subcontracted 6%
2. Project Title South Lake Middle School - Reroofing Project
Contract Amount $932,502.00
Type of Work Reroof entire Middle School Campus
Client Irvine Unified School District
Agency Project Manager Joe Garcia Phone 949-343-6069
Date Completed August2022 % Subcontracted 5%
3. Project Title Monterey Hills School - Reroofing Project
Contract Amount $968,818.00
Type of Work Reroof entire Elementary School Campus
Client South Pasadena USD
Agency Project Manager Alfredo Perez Phone 562-659-1224
Date Completed August2021 % Subcontracted 7%
NOTE: If requested by the City, the bidder shall furnish a certified
financial statement, references, and other information sufficiently
comprehensive to permit an appraisal of his�jc�.k-r�ent financial condition.
Bidder's Si nature
g
DECLARATION OF ELIGIBILITY TO CONTRACT
[Labor Code Section 1777.1; Public Contract Code Section 61091
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 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 penalty of perjury under the laws of the State of
California that the foregoing is true and correct. Executed this
day of January 4, 2024 201_, at Arcadia, CA (place of
execution).
&P
Sig ature
Name: Glenn P. Hiller
Title: President
Name of Contractor:
Commercial Roofing Systems, Inc.
BI DDER S VI CLATI CN CF LAW SAFETY CQUESTI CNNAI RE
I n accordance wi t h Gover nment Code Sect i on 14310.5 and in
conf or rrance wi t h Publ i c Cont r act Code Sect i on 10162, t he Bi dder
shall con-pl et e, under penal t y of perj ury, t he f of I owi ng
quest i onnai re:
C UESTI CNNAI RE
Has t he Bi dder , any of f i cer , pr i nci pal or enpl oyee of t he Bi dder
who has a pr opr i et ar y i nt er est i n t he busi ness of t he Bi dder , ever
been di squal i f i ed, r ermved, or of her wi se pr event ed f r om bi ddi ng on
or corrpl et i ng a f eder al , st at a or I ocal gover nn-ent pr of ect because
of vi of at i on of law or a safety r egul at i on?
YES NO V
I f t he answer i s yes, expl ai n t he ci r currst ances i n t he f of I owi ng
space:
STATEMENT
I n conf or Trance wi t h Publ i c Cont r act Code Sect i on 10232, t he
Cont r act or , her eby st at es under penal t y of perj ur y, t hat no rmr e
than on final unappeal abl e f i ndi ng of cont errpt of court by a
federal cour t has been i ssued agai nst the Contractor wi t hi n the
i mredi at el y pr ecedi ng t wv- year per i od because of t he Cont r act or' s
f ai I ure t o conpl y wi t h an order of a f eder al court whi ch orders
t he Cont r act or to conpl y with an order of t he Nat i onal Labor
Rel at i ons Board.
NOTE: The above St at event and Quest i onnai re are part of t he
Proposal. Si qni nq t hi s Proposal on the signature
portion thereof shall also constitute signature of this
St at errent and Quest i onnai r e.
Bi dder s are caut i oned that naki nq a f al se cer t i f i cat i on
rray subi ect t he cer t i f i er t o cr i rri nal pr osecut i on.
CONTRACTOR'S INDUSTRIAL SAFETY RECORD
Project Identificatio
City Hall Re-Roof/Rehabilitation Project
Bid Date January 10 2024
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 five 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 circumstances surrounding any and all fatalities.
ITEM
5 CALENDAR YEARS
CURRENT
YEAR
PRIOR TO CURRENT YEAR
2018
2019
2020
2021
2022
TOTAL
2023
No. of Contracts
53
69
72
83
70
347
64
Total dollar amount of
contracts (in 1,000's)
$11,802
$17,779
$21,389
$22,142
$19,026
$92,138
$16,949
No. of lost workday cases
0
0
1
1
0
2
0
No. of lost work day
cases
involving permanent
0
0
0
0
0
0
0
transfer to
another job or
termination of
employment
No. of lost workdays
0
0
36
42
0
78
0
*The i of or mat i on required for this item is the sane as required for
col urms 3 to 6, Code 10, Occupational I nj ur i es, Surrrrar y - Occupational
I nj ur i es and I I I nesses, CBHA No. 102.
The above i of or rrat i on was corrpi I ed f r om t he r ecor ds t hat ar a avai I abl e
t o rre at t hi s t i rre and I decl are under penal t y of per j ur y that t he
i of or "t i on is true and accurate wi t hi n the I i ni t at i ons of these records.
Glenn P. Hiller
Narre of Bi dder ( Pr i nt
11735 Goldring Rd.
Address
Q ass
Arcadia, CA 91006
Si at ur e I ;
591222
St at a Cont r act or' s Li c. No. &
626-359-5354
Q t y Zi p Code Telephone
Liberty The Ohio Casualty Insurance Company
mutuil-
BID OR PROPOSAL BOND
KNOW ALL MEN BY THESE PRESENTS, That we,
Commercial Roofing Systems, Inc.
(hereinafter called the Principal) as Principal, and The Ohio Casualty Insurance Company , with its
principal office in the City of Hamilton, Ohio (hereinafter called the Surety), as Surety, are held and firmly bound unto
City of Diamond Bar
(hereinafter called the Obligee) in the penal sum of
Ten Percent of Bid Dollars $ 10% of Bid
lawful money of the United States, for the payment of which sum well and truly to he made, we bind
ourselves, our heirs, executors, administrators, successors, and assigns.
THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas, the Principal has submitted the
accompanying bid dated January 25, 2024 for
City Hall Re-Roof/Rehabilitation Proiect
NOW, THEREFORE, if the Obligee shall make any award according to the terms of said bid and the Principal shall enter
into a contract with said Obligee in accordance with the terms of said bid and give bond for the faithful performance
thereof within the time specified; or if no time is specified within thirty days after the date of said award; or if the Principal
shall, in the case of failure so to do, indemnify the Obligee against any, loss the Obligee may suffer directly arising by
reason of such failure, not exceeding the penalty of this bond, then this obligation shall be null and void: otherwise to
remain in full force and virtue.
Signed, sealed and dated: January 23, 2024
Commercial Roofing Systems, Inc.
(Principal) Q
By: 'P' oe J
enr► p Hiller
Attorney in Fact
S-137474--v.
ACKNOWLEDGMENT
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 -44r\ua0. 23 202N before me, Natasha Renee Rodriguez Notary Public
(Insert name and title of the officer)
personally appeared OyAy, ? N, I ler , who proved to me on the basis of satisfactory
evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and
that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the
person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
NATASHARENEERODRIGUEZ
W
Notary Pubiic • California
Z
Los Angeles County
Commission ; 2410425
My Comm, Expires Aug 7, 2026
(Notary Seal)
ACKNOWLEDGMENT
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 Los Angeles
County of
JAN 2 3 2024
On
before me,
A. Bisordi, Notary Public
(insert name and title of the officer)
personally appeared David Noddle
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature /-' " \� �,(Seal)
A. BISORDI
NOTARYLOS ANGELES OUNTYN�
COMMISSION # 2448114
MY COMM. EXPIRES MAY 28, 2027
r�r
This Power of Attorney limits the acts of those named herein, and they have no authority to
bind the Company except in the manner and to the extent herein stated.
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
West American Insurance Company
SURETY
POWER OF ATTORNEY
Certificate No: 8206727-974861
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Angela
all of the city of Tarzana state of CA each individually if there be more tnan one namee, Its [rue dnu IdW tll1 dmn I IVY-n I w 1
execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 1 Oth day of June , 2021
Liberty Mutual Insurance Company
%HSU ZY INS& a %HSU p4 The Ohio Casualty Insurance Company
�JQGavo��(� yJP4oaPOR�reoy \oP�OttOk, �c, West American Insurance Company
1912 0 0 1919 0 2 1991 0
d;-1 104cHU5 �•aa yO� HAMP`P.♦,sO `(s��N01AN>'�,da By: �.
David M. Carey, Assistant Secretary
m
o m State of PENNSYLVANIA
ss
County of MONTGOMERY
On this loth day of June , 2021 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance
m Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes
therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
(D
3 IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written.
Ca Pa
0 a)�yP SrF Commonwealth of Pennsylvania - Notary Seal
` �Q oNWF'gcl �f Teresa Pastella, Notary Public
do = Y Montgomery County
0.2 CP My commission expires March 28. 2025 By:
C tp P Commisslon number 1126044
Member, Pennsylvania Association of Notaries Teresa Pastella, Notary Public
� yAgy t
W
C This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
o •� Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
ARTICLE IV — OFFICERS: Section 12. Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the
President may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety
any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall
have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such
instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the
provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE XIII — Execution of Contracts: Section 5. Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings,
bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in-
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked. JAN 2 3 2024
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this day of
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