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HomeMy WebLinkAboutSI251 & SI254 Bid docsForm W_9 (Rev.O art Department of me Treasury he Treasury Intemal Revenue Service mequest for Taxpayer Identification Number and Certification ► Go to www.irs.gov/FormW9 for Instructions and the latest information. Give Form to the requester. Do not send to the IRS. (es shown on your Income tax return). Name is required on this line; do not leave this line blank. CONTRCATING, INC. name/dlsregarded entity, name, If different from above cli Fleas a PwpSeven bo box for federal tax classification of the arson whose name Is entered on line 1. Check only one of the ng seven boxes.certain 4 Exemptions (codes apply only to 2. entities, not Individuals; seec proprietor or C Corporation ❑ S Corporation ❑ Partnership ❑ Trustlestate instructions on a e 3oividuaysole page ) C single -member LLC o ❑ Limited liability company. Enter the tax classification (C=C corporation, Exempt payee code (if any) `o w S=S corporation, P=Partnership)► Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check LLC H the LLC is classified as a single -member LLC that is disregarded Exemption from FATCA reporting a `E from the owner unless the owner of the LLC is another LLC that is net disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that is disregarded from the owner should code (if any) check the appropriate box for the tax classification of its owner. aZ❑ Delerlsu"lnst, Cons)► to5 (Appllu roaccwnh m•inlen,eyauhHe Ma U.S.) Address (number, street, and apt. or suite no.) See InsWctions. is Requester's name and (optionap TexceVer Identification Nrrrul•n. matt Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this Is generally your social security number (SSN). However, for a 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. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. 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. Cinr. Here 1 U.S Parson ► Data Ili, dy- od 207-s� 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/F0nnW9. 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) EXPERIENCE 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 $2,500,000 each qualify as similar for this project. 1. Project Title Residential And Collector Streets(Area 2 & Golden Springs Road Contract Amount 3,087,262 Type of work Concrete, Cold Mill, AC Repairs,AC Overlay, Chip Seal, Slurry Seal, M/H, Striping Client City of Diamond Bar Agency Project Manager Chris Malpica Phone 909-839-7042 Date Completed 10/2023 % Subcontracted 37 2. Project Title Residential An Collector Streets(Area 1 & Golden Springs Road) Contract Amount 2,635,516 Type of work Concrete, Cold Mill, AC Repairs, AC Overlay Chip Seal, Slurry Seal, M/H, Striping, Loops Client City of Diamond Bar Agency Project Manager Chris Malpica Phone 909-839-7042 Date Completed 10/2022 % Subcontracted 49 3. Project Title Casa Blanca Neighborhood Resurfacing Contract Amount 2,299,550 Type of work Concrete, ARAM, ARHM Overlay, M/H, Striping Client City of Menifee Agency Project Manager Don Sharp Phone 951-672-6777 Date Completed 1/2024 % Subcontracted 37 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 current financial condition. Bidder's Signature C L A, Jr Ezekiel A Copp, President 10 Copp Contracting, Inc. 04/08/2025 NAME OF BIDDER (PRINT) SIGNATURE DATE 6751 Stanton Ave ADDRESS Buena Park, CA 90621 714-522-7754 CITY ZIP CODE TELEPHONE 384209 A STATE CONTRACTOR LICENSE N0. AND CLASSIFICATION 1000004241 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. SIGNATURE OR AUTHORIZED OFF 22 A Copp, President VOil+l�c2pp Contractor's Ucense No. 884208 A P.O. Box 457 Buena Park, CA, 90821-W7 714 522.7754 Fax 714 622,2074 MEETING OF THE BOARD OF DIRECTORS OF COPP CONTRACTING, INC. A meeting of the Board of Directors of Copp Contracting, Inc., was held on January 6, 2014, during which a resolution was passed authorizing the following indididual(s)tosby hie/her signaturs(s)antar into any and all contracts on behalf of the corporation and, thereby, bind the corporation to such contracts 1 � sc ec • � �a,ia�r� ERLINDA COPP - SEC- . Att:eist s (Seal) DENNIS ?A, COPP-,V' CH-P *3. 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. 24 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 25 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 April 8th , 2025, at Buena Park, California (place of execution) . Signature Name: Ezekiel A Copp Title: President Name of Contractor: Copp Contracting, Inc. BIDDER'S VIOLATION OF LAW/SAFETY QUESTIONNAIRE In accordance with Government Code Section 14310.5 and in conformance with Public Contract Code Section 1O162, 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: -- - - -4- wuesuonnaire are art of the Proposal. Signing this Proposal on the signature ion thereof shall also constitute signature of this 'StatementandQuestionnaire. niaders are cautioned that makin a false cer subject the certifier to criminal prosecution. 2' tion CONTRACTOR'S INDUSTRIAL SAFETY RECORD Project Identification Area4Residential&Collector e a i ion Project No. SI251 & SI254 ree s Bid Date Apri108 2025 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 _ ITEM 3CALENDAR YEARS CURRENT PRIOR TO CURRENT YEAR YEAR 2022 2023 2024 TOTAL 2025 No. of Contracts 7 5 7 19 3 Total dollar amount of contracts in 1000's 6.8 9.6 7.5 23.9 1.2 No. of lost workday cases 0 0 0 0 No. of lost work day cases 0 0 0 0 0 involving permanent transfer to another job or termination of employment No. of lost workda s lo 0 0 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 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. Copp Contracting, Inc Name of Bidder (Print 6751 Stanton Ave Address Buena Park, CA 90621 City Zip Code Irv— Sig'ffatur e` 384209 A State Contractor's Lic. No. & Class 714-522-7754 Telephone W] AFFIDAVIT FOR CO -PARTNERSHIP FIRM STATE OF CALIFORNIA J )SS COUNTY OF LOS ANGELES ) N/A sworn, deposes and says: being 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) 29 AFFIDAVIT FOR CORPORATION BIDDER STATE OF CALIFORNIA ) )SS COUNTY OF LOS ANGELES ) Ezekiel A Copp .Uu y sworn, aeposes and says: That he is President of, 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 Si ature Ezekiel A Copp, President 20 See Attached Signature of Officer Administering Oath (Notary Public) 30 CALIFORNIA JURAT WITH AFFIANT STATIMENT GOVERNMENT CODE § 8202 VSee Attached Document (Notary to cross out lines 1-6 below) I I See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) 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 Subscribed and swom to (or affirmed) before me County of Orange on this 8th day of April 20_ by Date Month Year (1) Ezekiel A Copp ----------- (and (2)-------- — ------------------------- - YOLANDALUJAN Notary public - California } Orange County Commission 12434977 - 0-0m-1y Comm. Expires Jan 17, 2027 Seal Place Notary Seat Above Name(s) of Signers) Proved to me on the basis of satisfactory evidence to be the Person(s) who appeared before me. Signature S#gnatu o Notary Public OPTIONAL Though this section is 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: Affidavit For Corporation Bidder Document Date: Number of Pages: _ Signer(s) Other Than Named Above: 02014 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #i5910 AFFIDAVIT FOR INDIVIDUAL BIDDER STATE OF CALIFORNIA ) )SS COUNTY OF LOS ANGELES ) N/A 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) 31 AFFIDAVIT FOR JOINT VENTURE STATE OF CALIFORNIA ) )SS COUNTY OF LOS ANGELES ) N/A y 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. 32 FAITHFUL PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that, WHEREAS the City of Diamond Bar ("City"), has awarded to (Name and address of Contractor) ("Principal"), a contract (the "Contract") for the work described as follows: WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW, THEREFORE, we, the undersigned Principal, and (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 City in the penal sum of Dollars ($ ), this amount being not less than the total contract 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, his, her, or its, heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and covenants, conditions and agreements in the Contract and any alteration thereof made as therein provided, on the Principal's part to be kept and performed, all within the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and hold harmless City, its officers, agents, and others as therein provided, then this obligation shall become null and void; otherwise, it shall be and remain in full force and effect. 33 In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys, fees in an amount fixed by the court. FURTHER, the Surety, for value received hereby stipulates and agrees that no change, extension of time, alteration, addition or modification to the terms of the Contract, or of the work to be performed thereunder, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. The City is the principal beneficiary of this bond and has rights of a party hereto. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, 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: "Principal" By:_ Its By:_ Its "Surety" By: _ Its 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) APPROVED AS TO SURETY AND PRINCIPAL AMOUNT Insurance Administrator 34 BOND No. PAYMENT BOND (LABOR AND MATERIAL) KNOW ALL PERSONS BY THESE PRESENTS that, WHEREAS the City of Diamond Bar ("City"), has awarded to (Name and address of Contractor) ("Principal"), a contract (the "Contract") for the work described as follows: WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW, THEREFORE, we, the undersigned Principal, and (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 City in the penal sum of Dollars($ ) this amount being not less than one hundred (1000) of the total contract 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 CONDITIONS OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal, his, her or its heirs, executors, administrators, successors, or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code, or any amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code, with respect to work or labor performed under the Contract, the Surety will pay for the same in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall become null and void. This bond shall insure to the benefit of any of their persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In case suit is brought upon this bond, Surety further agrees to 35 pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition, or modification to the terms of the Contract or of the work to be performed thereunder, or the specifications for the same, shall in any way affect its obligations under this bond, and it does hereby waive notice of any such change, extension of time, alteration, addition, or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, 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 "Principal" By: Its By: Its Notary "Surety" By: Its 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) APPROVED AS TO SURETY AND PRINCIPAL AMOUNT By: Insurance Administrator 36 BOND No. WARM. .\. 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 4 RESIDENTIAL & COLLECTOR STREETS REHABILITATION AND ARTERIAL STREET REHABILITATION (BREA CAYON CUTOFF ROAD FROM 57 FREEWAY SOUTH OFF RAMP TO NORTH CITY LIMITS AND LEMON AVENUE FROM GOLDEN SPRINGS DRIVE TO NORTHERN CITY LIMITS) PROJECT NO. SI251 & SI254. WHEREAS Copp Contracting, Inc. - 6751 Stanton Avenue, Buena Park, CA 90621 (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 Dr 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 the total amount of the bid Dollars($10% ), 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. 37 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: March26,2025 "Principal" Copp Contracting, Inc. By: G 4. [ Z It�S President, zekiel Copp By: �.. C Its Secretary, Er nda Copp "Surety" Contractors Bonding and Insurance Company By: t s Attorney -in -Fact, Ryan Butteffas 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) 38 (Seal) CAUFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verities 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 April 08, 2025 before me, Yolanda Lujan - Notary Public Date Here Insert Name and Title of the Officer personally appeared Ezekiel A Copp and Erlinda Copp ----------------- Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(les), 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. UJAN ' Y range C unty Notary Public - [atllornia Orange County € Commission Y 2434977 My Comm. Expires Jan 17, 2027 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 Public Place Notary Seal Above OPTIONAL Though this section is 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: Bid Bond Number of Pages: Document Date: 03/26/2025 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: 1-I Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual CJ Attomey in Fact CI Trustee _ Guardian or Conservator 1 I Other: Signer Is Representing: Signer's Name: Corporate Officer — Title(s): ❑ Partner — ❑ Limited D General ❑ Individual f I Attorney in Fact ❑ Trustee C I Guardian or Conservator Other: Signer Is Representing: 02014 National Notary Association • www.NationalNotary.org • 1-8M-US NOTARY (1-800-876-6827) Item #5907 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 '�uvuva'� XY•-. .4Y•.—�'nY - eriY. : e.'_!'Y'-.ASI Y..'drc 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 e g Oran OnMAR 8 6 2025 before me, Date personally appeared Adelaide C. Hunter, Notary Public Here Insert Name and Title of the Officer Butterfas Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/herRheir 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. ADELAIDE C. HUNTER Notary Public • California -� Orange County Si nature.T11M�0 Commission I2508i52 9 "* My Comm. Expires Jan 23, 2029 Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is 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: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(es) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: ©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 POWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N. Lindbergh Dr. Peoria, IL 61615 Phone: 800-645-2402 Know AM 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: Linda D. Coats. Matthew w J Coats, Summer Reyes Ryan Butterfas iointly or severally in the City of Lamina Hills State of California its true and lawful Agent(s) and Attomey(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 Tw > ty Five Million ( S25.000-000.00 ) for any single obligation. Dollars 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 farther certified that the fol]owing 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 Sr Vice President with its corporate seal affixed this 19th day of March 2024 . pro .' OpPOq�r •, �• r�ri :SEAL lit State of Illinois „`. LNG .,.......�' 11 N o County of Peoria SS ,� On this I th9 day of March . 2024 , before me, a Notary Public, personally appeared Eric Raudins who being by me duly swom, 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; «E���,9 . 9 /{111111 Jill A. Scott Notary Public ruusoon notary Palk _ StaU of ohW 1 is' i Mr CNmm. Expires Se=.e b r 22, 2025 RLI Insurance Company Contractors Bonding and In nce Company By: Erse Raudms Sr. Vice President CERTIFICATE 1, 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 Comppany and/or Contractors Bonding and Insurance Company this Z6th day of March , CO25 RLI Insurance Company Contractors Bonding and Insurance Company Jeffrey DLYickv V v Corporate Secretary a25e04020212 A005RDI9 CERTIFICATION OF NON-DISCRIMINATION AND AFFIRMATIVE ACTION As suppliers of goods or services to the listed below certifies that it does not with regards to race, religion, sex, or compliance with all federal, state, and orders regarding non-discrimination in pursue an affirmative course of action action guidelines. We agree specifically: City of Diamond Bar, the firm discriminate in its employment national origin; that it is in local directives and executive employment; and that it will is required by the affirmative 1. To establish or observe employment policies which affirmatively promote opportunities for minority persons at ail 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 Copp Contracting Inc TITLE OF OFFICER SIGNING President, Ezekiel A Copp - SIGNATURE ! ' j ,cE_ rT-- DATE April 8 2025 Please include any additional information available regarding equal opportunity employment programs now in effect within your company: Copp Contracting Inc. has been an equal employment opportunity employer since 1979. 39 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 X , has not , 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. DATE: April08 Copp Contracting,Inc. (COMPANY) BY: President Ezekiel A Copp (TITLE) 2025 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. 40 NON -COLLUSION DECLARATION (TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID) The undersigned declares: I am the President of Copp Contracting, Inc. , 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 California that declaration is Buena Park penalty of perjury the foregoing is executed on Copp Contracting, Inc. Business Name under the laws true and correct April 08, 2025 [city] , California [state] . 6751 Stanton Ave., Buena Park, CA 90621 Business Address of the State of and that this _ [date], at G i 'en' - (7�� Signatureof Bidder (must be notarized) Attach Notary Acknowledgement Form to this form when submitting CILLIRORNIA ALL-PUR"M 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 April 08, 2025 before me, Yolanda Lujan - Notary Public Date Here Insert Name and Title of the Officer Personally appeared Ezekiel A Copp -------------------------- --------- ------------------------------------Names) of Signer(s)------------ --- wno 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. YOLANDA LUJAN in Notary Public - California Orange County is Corn lssion d 2434977 My Comm. Expires Jan 17, 2027 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 /, ignature f Not ry Public Place Notary Seat Above OPTIONAL Though this section is 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: Non -collusion Declaration Document Date: 04/08/2025 Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: CI Corporate Officer — Title(s): O Partner — Cl Limited CI General IJ Individual ❑ Attorney in Fact L_I Trustee Guardian or Conservator L Other: signer Is Representing: Signer's Name: IJ Corporate Officer — Title(s): _ 77 Partner — ❑ Limited LJ General ❑ Individual i 1 Attorney in Fact Trustee i I Guardian or Conservator J Other: Signer Is Representing: 02014 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY (1-800-876-6827) Item tt5907 0