HomeMy WebLinkAboutBRNB4220021A8A4_015580BIDDER'S PROPOSAL
CITY OF DIAMOND BAR
STEEP CANYON ROAD EROSION CONTROL AND SEDIMENTATION PREVENTION AT
CLEAR CREEK CANYON DRIVE PROJECT
CITY PROJECT NO. PW 24401
Date 6/4 20 24
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:
Monick J Lopez President/Secretary/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.
(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.
12
1293492A
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
DOLLARS ($ ).
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.
2324 S. Vineyard Ave Ste K 909-218-5700
Address of Bidder Telephone of Bidder
Ontario, Ca 91761 %W A
City Zip Code Signature of Bid
13
2934911
BID SCHEDULE
CITY OF DIAMOND BAR
CONTRACT DOCUMENTS AND SPECIFICATIONS
STEEP CANYON ROAD EROSION CONTROL AND SEDIMENTATION PREVENTION AT
CLEAR CREEK CANYON DRIVE PROJECT
CITY PROJECT NO. PW 24401
ITEM
ESTIMATED
DESCRIPTION
UNIT
NO.
QUANTITY
UNIT
WRITTEN IN WORDS
PRICE
AMOUNT
General
Mobilization, Demobilization, Clearing and
1
1
LS
Grubbing, and Miscellaneous Items of
Work (Not to Exceed 5% of Total
$00
41
`�bo
`I!
Construction Cost
Construction Surveying/Staking,
p00
S,
l000
2
1
LS
Monument Preservation, Reset Disturbed
!
Monuments
3
1
LS
Sheeting, Shoring, and Bracing
100
Ieo
Work Area Traffic Control and Public
a
4
1
LS
Notification (Includes Fencing and
131 0°°
'jj0
Secu rit
5
1
LS
Implementation of Erosion Control
�r000
000
Measures
6
1
LS
Implementation of Temporary Drainage
000
Provisions and Dewatering
Drainage Improvements
Construct Detention Basin Complete-in-
7
1
LS
Place (Includes French Drain, ABS Drain
��F2/boo
52/
Pipe, Structures, Rip Rap Blanket, and
A urtenances
Construct
(D/po0
8
1
LS
StandardPlan No. 5113, PPWCe2021
MOO"'
Edition
9
1
LS
Construct Curb Drain per Standard Plan
%1 215P
/ Zj7t>
No. 150-4, SPPWC, 2021 Edition
Street Improvements
14
1293492.1
Demo Existing Sidewalk and Reconstruct
10
60
SF
Joint to Joint per Standard Plan No. 113-
5�
00
2, SPPWC, 2021 Edition
!
Construct Curb and Gutter — Mountable
V
11
10
LF
per Case B2-6(150), Standard Plan No.
20
2 /Oo
121-3, SPPWC, 2021 Edition
12
56
SF
Construct 4" Broom Finish PCC
°
Z113pO
avem nt over 6" Class II Base
Pavement
13
54
SF
Construct 4" Grooved Finished PCC
s
2
pavement over 6" Class I I Base
Construct 3-1/2" O.D. Cast -in -Place
14
2
EA
Removable Pipe bollard, Galvanized
Finish
15
0.68
TON
Construct 3/4" Crushed Rock Granular
r yo
) 62
Backing
MANDATORY BID SCHEDULE ITEMS:
TOTAL AMOUNT BID (IN FIGURES)❑
TOTAL AMOUNT BID, SCHEDULE (WRITTEN IN WORDS): M l 5 r X
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, 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 I cash", "cashier's check", "certified check", or
"bidder's bond" as the case may be) in the amount equal to at least ten percent
(10%) 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
15
1293492.1
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.
Monick J Lopez of Kormex Construction, Inc. 4/24/24
NAME OF BIDDER (PRINT) SIGNATURE DATE
2324 S. Vineyard Ave Ste K
ADDRESS
Ontario CA 91761 909-218-5700
CITY ZIP CODE TELEPHONE
1073142 A
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)correct)K accordance with the requirements of California Business
and Professional Code Section 7,628.15.
Monick J Lopez
OFFICER
IG
1293492,1
LIST OF SUBCONTRACTORS *
BID OPENING DATE4/24/24
PROJECT: STEEP CANYON ROAD EROSION CONTROL AND SEDIMENTATION CONTROL
PROJECT NO. PW 24401
LOCATION: CLEAR CREEK CANYON DRIVE
CLIENT: CITY OF DIAMOND BAR
CONTRACTOR Kormex Construction, Inc.
Name Under Which
Subcontractor is
Licensed
License
No.
&
DIR No.
Address
of
Place of Business
Percent
of
Total
Contract
Specific Description
of
Subcontract
pa
P AIJO o��r
��.�
Do�D�gti°�
qo6 a
o�
y o
g� a���1.�6
�6ou+'05
3
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
n
1293492.1
California contractor 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 (1 %) 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 (0.5%)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.
18
1293492,1
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:
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 J,;04
1 - Z+ 202�, at OM--i u Cam
(place of execution).
1293492.1
19
Signature w l
Name: Monick Lopez
Title: President
Name of Contractor:
Kormex Construction, Inc.
20
12934921
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 xxxx
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.
122730_ 1
CONTRACTOR'S INDUSTRIAL SAFETY RECORD
Project Identification: STEEP CANYON ROAD EROSION AND SEDIMENTATION
PREVENTION AT CLEAR CREEK CANYON DRIVE- PROJECT NO. PW 24401
Bid Date:4/25/24
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
PRIOR TO CURRENT YEAR
YEAR
2018
2019
2020
2021
2022
TOTA
L
No. of Contracts
0
0
0
ig
21
39
6
Total dollar amount
of
$2.6 M
$3.1 M
5.7 M
$1.8 M
contracts in 1,000's
No. of lost workday
cases
0
0
0
0
No. of lost work day
cases
involving permanent
0
0
0
0
transfer to
another job or
termination of
employment
No. of lost workdays
"The information required for this item is the same as required for columns 3 to 6, Code 10,
Occupational Injuries, Summary - Occupational Injuries and Illnesses, OSHA No. 102.
The above information was compiled from the records that are available to me at this time and I
declare under penalty of perjury that the information is true and accurate within the limitations of
these records.
Kormex Construction, Inc
Name of Bidder (Print
2324 S. Vineyard Ave Ste K
Address
Ontario, Ca 91761
Signature
1073142 A/C27
State Contractor's Lic. No. & Class
909-218-5700
City Zip Code Telephone
22
1293492A
BOND No, 192
:• M
KNOW ALL PERSONS BY THESE PRESENTS that,
WHEREAS the City of Diamond Bar ("City"), has issued an invitation for bids for the work
described as follows:
ect #PW 24401 - STEEP CANYON ROAD EROSION CONTROL AND SEDIMENTATION
PREVENTION AT CLEAR CREEK CANYON DRIVE PROJECT
VVHEREAS Kormex Construction, Inc.
Suite
CA 91761
(Name and address of Bidder)
("Principal'), desires to submit a bid to Public Agency for the work.
WHEREAS, bidders are required under the provisions of the California Public Contract Code to .
furnish a form of bidder's security with their bid.
NOW, THEREFORE, we, the undersigned Principal,
Merchants Bonding Company (Mutual)
PO Box 14498, Des Moines IA 50306
(Name and address of Surety)
("Surety") a duly admitted surety insurer under the laws of the State of California, as Surety, are
held and firmly bound unto Public Agency in the penal sum of TEN PERCENT OF THE AMOUNT
OF THE BID
Dollars($ to%'*'* ), being not less than ten percent (10%) 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.
31
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 24th, 2024
"Principal"
Kormex Construction, Inc.
2324 Vineyard Ave Suite K Ontario, CA 91761
BY,4vyut,K�A�w
Its Monick o resident
By:
Its
"Surety"
Merchants Bonding Company (Mutual)
PO Box 14498, Des Moines, IA 50306
By: ��-
Its Les M. Mantle - Attorney `Mi'F
By: -
Its
-Note- TNs.,bond must be dated, all signatures must be notarized, and evidence of the authority
cif any person signing as attorney -in -fact must be attached.
(Seal)
(Seal)
CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189
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 Orange
on June 24th, 2024 before me, Noreen Mantle - Notary Public
Dote Here Insert Name and Title of the Officer
personally appeared Monick J. Lopez
Nome(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity
upon behalf of which the person(s) acted, executed the instrument.
NOlm O
COW. #2450448 n
t) ON �MNOMKrU11C-CIVpNA
i
COMM AN" 11, WV
Place Notary Seal and/or Stamp Above
I certify under PENALTY OF PERJURY under the
laws of the State of Califomia that the foregoing
paragraph is true and correct.
WIXNESS my hand and official seal.
Signature
i,�%161A
Ynaturfwl.ry Public
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Monick J. LopeZ
X Corporate Officer - Title(s): President
❑ Partner — D Limited ❑ General
❑ Individual ❑ Attorney in Fact
o Trustee ❑ Guardian or conservator
❑ Other:
'.2019 National Notary Association
Number of Pay
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual
Cl Trustee
❑ Other:
Signer is Representing:
❑ Attorney in Fact
in Guardian or Conservator
CALIFORNIA ACKNOWLEDGMENT
CIVIL CODE 51189
A notary public or other officer comple�thisificate verifies only the identity of the individual who signed the document
to which this certificate is attached, athfulness, accuracy, or validity of that document
State of California
County of Orange
On June 24th, 2024
Date
personally appeared
before me, _Mary Martignoni - Notary Public
Here Insert Name and Title of the Offrcer
Les M. Mantle
Names) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person%whose name(1t) is/aWsubscribed
to the within Instrument and acknowledged to me that he %{)tey executed the same in hishye JAWr
authorized capacity("; and that by his[x4flfgCirsignatureQg-on the Instrument the person, or the entity
upon behalf of which the person acted, executed the instrument.
MARY MARTIGNONI
o 1, ; 9'"'�q COMM. # 2463366
3 NOTARY PUBLIC CALIF RNIA s'
/I<<, „• ORANGE COUNTY
'dy cOmm expires Sept 15 20J7 I�
Place Notary Seal and/or Stamp Above
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.
Signatur j XL a I
signu Notary Public
OPTIONAL
Completing this Information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimedby S�ignerts)
SigI
Signer's Name: Les V Mantle
❑ Corporate Officer — Title(s):
❑ Partner— ❑ Limited ❑ General
❑ Individual 10 Attorney In Fact
❑ Trustee o Guardian or Conservator
❑ Other.
Staner Is Reoresentina:
02018 National Notary Association
Number of Pages:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer is Representing:
MERCHANT k
BONDING COMPANY -
POWER OF ATTORNEY
Know Ad Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC..
both being corporations of the State of Iowa, tlWa Merchants National Indemnity Company (in California only) (herein collectively called the
'Companies] do hereby make, constitute and appoint, individually,
Les M Mande
their true and lawful Attomey(s)tin-Fact, to sign its name as surery(ies) and to execute, seal and acknowledge any and all bonds, undertakings,
contracts and other written instruments in the nature thereof, on behalf of the Companies In their business of guaranteeing the fidelity of
persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions
or proceedings allowed by law.
This Powerof-Attomey Is granted and is signed and sealed by facsimile under and by authority of the folkwing By -Laws adopted by the Board
of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of
Merchants National Bonding, Inc., on October 16, 2015.
'The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Yce President shall have power and
authority to appoint AtomeWn-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto,
bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof.'
'The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney
or Certification thereof authorizing the execution and delivery of any bond, undertaking• recognizance, or other suretyship obligations of the
Company, and such signature and seal when so used shall have the same force and effect as though manually fixed'
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority, hereby given to the
Atomeyan"Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction
contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department
of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of
Its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it Is agreed that the power and authority hereby given
to the Abomeymin-Fact cannot be modified or revoked unless prior written personal notice of such Intent has been given to the Commissioner -
Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or mvocation.
In Witness 1Nhereof. the Companies have caused this Instrument to be signed and sealed this 3rd day of February , 2024 -
.•••'"""""••. jkG Co MERCHANTS BONDING COMPANY (MUTUAL)
. SONq • •% 0 .. .(� •.• MERCHANTS NATIONAL BONDING, INC.
�P........... C B . �M... �� .e
�� GopPOqpZ : �o�oAPOgq�ly�t drola MERCHANTS NATIONAL INDEMNITY COMPANY
:S j2e •z: �t�i�I/!�
2003 ;;A; : y: 1933 By !! /
is •• . •.:
STATE OFIOWA •�Jy�•...._ �7�5 dk,.'President
•••• ........
• •• •• COUNTY OF DALLAS ss. ••••••••••• •
On this 3rd day of February 2024 , before me appeared Larry Taylor, to me personally known, who being by me duty mom
did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the
seats affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf
of the Companies by authority of their respective Boards of Directors.
�PROAA<s Penn[ Miller ,
_ Commission Number 787952
• • My Commission Expires t• --
iWVA January 20, 2027 \ \ 1 Note b �
I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby
certify that the above and foregoing Is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which Is still in full
force and effect and has not been amended or revoked.
In Witrhess Whereof, I have hereunto set my hand and affaed the seal of the Companies an this 24th day of .June 202.4
- why+p�� R9l�...'z:
�y
- =;2:2 _o_ 0:0�
•r-c= -o- of
���
°v' 2003
1933 :/c:
Secretary
J•. �.
POA 0018 (1 P24) •''•••:.....•`
••
AFFIDAVIT FOR CORPORATION BIDDER
STATE OF CALIFORNIA )
)SS
COUNTY OF Orange )
Monick J. Lopez being first duly sworn, deposes and says:
That he / she is President
of, Kormex Construction. Inc
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.
By: N \A \ A.e
Signature nick . Lopez
Subscribed and sworn
to before me this
24th day of June , 2o24
00
Signature of Officer Administering Oath
(Notary Public)
SEE ATTACHED Acknowledgment
1_'Ot;97.1
CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189
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 Orange
on June 24th, 2024 _ before me, Noreen Mantle - Notary Public
Date Here Insert Nome and Title of the Officer
personally appeared - Monick J. Lopez
Nome(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity
upon behalf of which the person(s) acted, executed the Instrument.
COMM.2
r) rgtMY1YM6•CAttIONM
D OMIIOE COIIMtY �
Place Notary Sea/ and/or Stamp Above
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.
✓!ram i� X I/i',LZ:=Z
notur4W1175tory Public
:�.
OPTIONAL
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Fraudulent reattachment of this form to on unintended document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signers)
Signer's Name: Monick J. Lopez
X Corporate Officer - Title(s): PreSident
Number of Pages:
Signer's Name:
❑ Corporate Officer - Title(s):
❑ Partner - ❑ Limited ❑ General ❑ Partner - ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact ❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator ❑ Trustee ❑ Guardian or Conservator
❑ Other: ❑ Other:
Signer is Representing: Signer is Representing:
Kormex Construction. Inc.
-2019 National Notary Association
NON -COLLUSION AFFIDAVIT
TO: THE CITY OF DIAMOND BAR:
STATE OF CALIFORNIA )
)SS
COUNTY OF Orange )
Monick J. Lopez , being first duly
sworn, deposes and says that he or she is President
of Kormex Construction, Inc.
, the party making the foregoing bid, that the bid is not made in the
interest of or on behalf of, any undisclosed person, partnership, company association,
organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder
has not directly or indirectly induced or solicited another bidder to put in a false or sham bid, and
has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone
else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any
manner, directly or indirectly, sought by agreement, communication, or conference with anyone
to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element
of the bid price, or of that of any other bidder, or to secure any advantage against the public
body awarding the contact or anyone interested in the proposed contract; that all statements
contained in the bid are true; and further, that the bidder has not, directly or indirectly, submitted
his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or
data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company
association, organization, bid depository, or to any member or agent thereof to effectuate a
collusive or sham bid.
By: L
Signature of i ei Monick J. Loper
STATE OF CALIFORNIA )
)SS
COUNTY OF Orange )
Subscribed and sworn to before me thisz4thday of June .2024.
is in and for the County of
Orange , State of California
SEE ATTACHED Acknowledgment
129344'.1
CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189
Fry public or other officer completing this certificate verifies only the identityofthe individual who signed the document
ch this certificate Is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Orange
on June Nth, 2024 before me, Noreen Mantle -Notary Public
Date Here insert Name and Title of the Officer
personally appeared Monick J. Lopez
Names) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument the persori or the entity
upon behalf of which the person(s) acted, executed the instrument.
MWU
COMM. #2456M 0
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NOgll►N�li•QM/OIIxi� ,�
O Illiftlift MiRr 1. =1
Signatu e
Place Notary Seal and/or Stamp Above ignatu o tory Public
OPTIONAL —
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: MOnick J. Lopez_
)Q Corporate Officer — Title(s): PreSident
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer is
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.
Number of Pages:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer is Representing:
Firm V
"-;2019 National Notary Association