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11-0301_PETERSON-CHASE GEN ENG CONST., INC_Addendum Number 1
Addendum Dumber I Dated: January 11, 2011 PROJECT: Del Obispo Street Widening.from Alipaz Street to Paseo Adeianto This addendum is issued by approval of the City Engineer as.authorized below. Please note that the issuance of this addendum does not alter the bid opening date and time, which are set for January 31, 2011, at 2 pm at the City Clerk's Office. In case of questions, please contact Nisha Patel, Associate Engineer, at 949/443-6350. Authorized: Nasser Abbaszadeh, PE, City Engineer date Please sign and arch a copy of this addendum to your bid to. ensure your receipt of the latest project information. Con actor authorized sig ory Date E'_11/11I LCJ11 1Lr 13 747*777St�1 �ru rits✓ u...uw v..i i i r-„+w.. r. cs cr Addendum Number I Dated: January 11, 2011 PROJECT. Del Obispo Street Widening from Alipaz Street to Paseo Adelanto This addendum Is issued by approval of the City Engineer as.authorized below, Please note that the issuance of this addendum does not alter the bid opening date and time, which are set for January 39, 2091, at 2 pm at the City Cleric's Office. 1n case of questions, please contact Nisha; Patel, Associate Engineer, at 949/443-6350, kuthorized: Nasser Abbaszadeh, PE, City Engineer Date Please sign and attach a copy of this addendum to your bid to ensure your receipt of the latest project information. . r 6Con actor authorized sig ory Date BID PROPOSAL For the: IMPROVEMENT PLANS FOR DEL OBISPO STREET WIDENING; FROM ALIPAZ STREET TO PASEO ADELANTO (CIP 07107) STPL 5372 (011) PETERSON-CHASE GENERAL ENGINEERING From: CONSTRUCTION INC. Contractor, License No. & Classification To the Members of the City Council City of San Juan Capistrano Gentlemen: The undersigned, as bidder, declares that he has carefully examined'the location of the proposed work as described, examined the Plans, Specifications, Special Provisions, and the Standard Specifications for Public WorksConstruction,2006 Edition,and the State of California Department „ of Trans ortation Standard Specification sMa 2006 Edition, including all Supplements theref6r, read the Instructions to Bidders,and is familiar with all proposal requirements,and hereby proposed and agrees, if the proposal is accepted, to complete the said construction in accordance with the Contract Documents, as defined in Section.1-2 of the Standard Specifications, in the time stated herein, for the unit price or lump sum given on the following pages of this proposal, for a Base Proposal of Bid Items 1 through 80 (excluding Bid Item 25A) amounting to a total of. dxla,- �ur/ly�X ce06s 556,'1 46Words Figures Said amount to include and cover all taxes,the furnishing of all materials,the performing of all the labor requisite or proper and the providing of all necessary machinery, tools, apparatus and.other means of construction;also,the performance and completion of all the work in the manner set forth, described and shown in the Specifications or the drawings for the work. Or for an Alternate Proposal of Bid Items I through 80(including Bid Item 25A)amounting to a total of: o ��4!' a u/- fix $ 3 �4?, S4? Words re'XfV . Figures Said amount to include and cover all taxes,the furnishing of all materials,the performing of all the labor requisite or proper and the providing of all necessary machinery,tools, apparatus, and other means of construction;also,the performance and completion of all the work in the manner set forth, described and shown in the Specifications or the drawings for the work. If the contract is awarded,the undersigned agrees to enter into a contract with the City of San Juan Capistrano and to commence work within fifteen (15) calendar days from the date of execution thereof, and to diligently prosecute the work to completion before the expiration of three hundred QOO) calendar days, and one hundred twenly (120) calendar days thereafter for the landscape maintenance and plant establishment. All bids are to be computed on the basis of the given 3 Estimated Quantities of Work,as indicated in this proposal,times the unit prices as submitted by the bidders. In case of discrepancy between words and figures, the words shall"Prevail. In case of discrepancy between unit prices and the extension thereof,the unit price shall prevail and bids will be computed as indicated above and compared on the basis of corrected totals,given'solely as a basis for comparison of bids. It is understood that the City does.not expressly,nor by implication, agree that the actual amount of work will correspond therewith,but reserves the right to increase or decrease the amount of any item or portion of the work or to omit portions of the work as may be deemed expedient by the Engineer. It is also understood by Bidder that the City of San Juan Capistrano has the right to reject this proposal or to award a contract to the undersigned at the prices stipulated. If the proposal is rejected, then any check or cashier's check shall be returned to the undersigned within thirty(30)days. No bid bonds will be returned. If the proposal is accepted and the undersigned fails to enter into a contract within fifteen(15) days after the agreement is delivered to him for signature,or within such further time as may be granted by the Members of the City Council,then said check shall be cashed or said bond declared forfeit and an amount equal to the difference between the lowest bid and the next lowest bid who will execute a contract shall be paid into the treasury of the City of San .Tuan Capistrano as liquidated damages for the failure of the undersigned to comply with the terms of this proposal. Accompanying this proposal is A IalZPER 1.s SOA(b (Insert "$ /041/0 cash,"cashier's check,certified check or bidder's bond on the forms from pages BB-I and BB-2 of these Contract Documents,as the case may be), in an amount equal to at least ten percent (10%) of the highest total bid. The following is the name and place of business of the surety company which will furnish the required bonds as surety if the work is awarded to the undersigned: SVCS• X6'1 Licensed in accordance with an act providing for the registration of contractors -- License No. &;15-076 and Classification A ,C1 C 3 2f 1R, Signature of Bidder- 4 (If an individual, so state. if a firm or co-partnership, state the firm name and give the names of all individual co-partners composing the firm: President, Secretary,Treasurer,and Manager thereof.) PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION INC. Dated: I -3t T I1 !-ta ZGtS•Ed AV 19W Iirytn Cfi q26 1 Business Address Dated. 252`0410 Telephone Number Further,the undersigned bidder certifies that he has thoroughly checked the figures set forth in this proposal, that they are correct to the best of his knowledge and that they constitute his proposal for the work called out herein. Dated: / -3/-2.a!/ natur of Bidder Dated: I-3!Zoll 2-52- ®4 4/ Telephone Number 5 SCHEDULE OF WORK ITEMS IMPROVEMENT PLANS FOR DEL OBISPO STREET WIDENING FROM ALIPAZ STREET TO PASEO ADETANTO CIP 07.107 STPL 5372 (011 The undersigned declares that he has carefully examined the location of the proposed work, that he has examined the project plans and specifications and read the accompanying instructions to bidders, and hereby proposes to do all the work in accordance with the said construction documents for the amounts set forth below: ITEM DESCRIPTION UNIT ESTIMATED UNIT E TENDED NO. ! UANTITY PRICES AMOUNT GENERA.I. 1, Mobilization. L.S. i Lump sum Lump sum $ .� Progress schedule. (Critical path 2. method). L.S. Lump sum Lump sum $ 3 5-OD. Storm water pollution control/BMP/ 3' Diversion and control of water. L.S. Lump sum Lump sum Prepare and implement construction 4' phasing and traffic control plan. L.S. Lump sum Lump sum Regulatory permit compliance and 5' implementation. L.S. Lump sum Lump sum Off-street storage of equipment and 6' materials. L.S. Luxnp�sum Lump sum 5-000---- 7. - ,,-- 7. Project survey. L.S. Lump sum Lump sum $ 18 ®GO 8. Utility potholing. L.S. Lump sum Lump sum 5000- - STREET IMPROVEMENTS 9. Clearing and grubbing. L.S. Lump sum Lump sum $ 20 CrQ- l0. Remove asphalt paving and base. S.F. 9,510 $ 2 , ..-- $ Iq ®20.. 11. Remove concrete. curb and gutter. L.F. 540 $ 7• $ 8® 12. Salvage plaque. L.S. Lump sum Lump sum 13. Remove concrete sidewalk. S.F. 2,240 $ Z,40 $ g 28a — 14. Remove concrete driveway. S.F. 250 $ 2> as $ 6 ITEM DESCRIPTION UNIT ESTIMATED UNIT EXTENDED NO. QUANTITY PRICES AMOUNT 15. Remove tree. EA. 20 $ $ /p4QJ - 16. Remove chain link fence and gate. L.F. 510 $ �• .-- $ (�� -� 17. Reset survey monument. EA. 1 $ S�Y1. 18. Construct concrete curb, type A-8. L.F. 495 ' $ l� _ '" $ 9 y�S• — 19. Construct concrete sidewalk. S.F. 2,420 $ 20. Construct concrete driveway. S.F. 350 $ �. $ -- 2L Construct concrete curb and gutter L.F type G8. 650 $ • '— $ l Z 3aro•"" 22. Construct concrete curb ramp. S.F. 890 $ Z. . $ (Zap, �- 23. Construct parkway drain(modified). EA. 24. Construct asphalt concrete pavement TON base course {type III-B2-PG 64-10). 400 $ Construct asphalt concrete pavement 25. surface course (type III-C2-PG 64- TON 230 $ 10). Bid Alternate. Construct asphalt 25 A. concrete pavement surface course TON(type III-C2-PG 64-10). Not shown 2300 $ $ on plans. 8 3 . -~— 1q0900- 26. Construct seal coat. S.Y. 15,400 $ 2-e30 $ 27. Construct crushed miscellaneous CY i base. 840 € $ d — $ �- Construct retaining wall and cable 28. railing (including excavation and L.F. 266 backfill). $ �'SS• '' $ 2Z73�1. 29. Construct chain link fence and gate. L.F. 460 $ 3 _ — $ /5-kF10. 30. Construct bioswale system. LS Lump sum Lump sum $ 31. Construct removable guard post. EA. 32. Modify monument sign. LS Lump sum Lump sum $ 3209, -- 33. Adjust utility cover/box to grade. EA. 7 ITEM DESCRIPTION UNIT ESTIMATED UNIT EXTENDED NO. QUANTITY PRICES AMOUNT 34. Adjust manhole to grade. EA. 1 $ 1200. $ 35. Raise manhole to grade. EA. 1 [ $ --;5®®- -' $ 3500.r BRIDGE f 36. (F) Bridge removal (portion). L.S, Lump sum Lump sum $ �- f�• -- E 37. (F) Structure excavation (bridge). C.Y. [ 38. (F) Structure backfill (bridge). C.Y. 400 $ BS. $ ®ce 39. (S) Furnish steel piling (HP 12 X 53). L:F, 3,518 1 $ $ /00 40. (F-S) Drive steel piling (HP 12 X 53). EA 69 $ 1!�D• _ $ 7,T �© 41. (F) Structural concrete, bridge footing. C.Y. 115 $ $ -70150,- 42. -'Z® 15Or42. (F) Structural concrete, bridge. C.Y. 240 $ 271 200, 43. (F) Structural concrete, approach slab. C.Y. i 44. Refinish bridge deck. i S.F. 883 $ 2_ 10 $ [ SSC¢. ;0 45. (F-S) Furnish precast PS, concrete girder EA (40'-50'). 8 $ 74CC-— $ ..000 46. (F-S) Furnish precast PS, concrete girder EA (50'-60'). 4 $ 306v. _ $ 47. (F-S) Erect precast PS concrete girder. EA i 48. (F-S) Bar reinforcing steel (bridge). LBS. 93,188 $ 1• it-7 $ 36 49. (F-S) Joint seal (NSR 1/2"). L.F. 49 $ $ x,75 SQ. (F) Utility hangers, anchorages and LS supports. Lump sum Lump sum $ 51. (F) Bridge deck drainage system. LS Lump sum Lump sum $ y 7®oo.— 52. (F) Concrete barrier(special). LF 337 $ j • $ -7Z�f5�. 8 ITEM DESCRIPTION UNIT ESTIMATED UNITEXTENDED NO. QUANTITY PRICES AMOUNT CHANNEL Remove reinforced concrete channel 53. lining. S.Y. 900 $ 1$ ' 16260. - 54. 6Z6•54. Unclassified fill. C.Y. 200 $ ,- �- �o /0 � 55. Unclassified excavation. C.Y. 366 $ SO• ` /0 3CO. -� 56. Concrete channel lining. C.Y. 200 $ .35®-r $ 7000®.......- . 3 57. Channel structure concrete. C.Y. 190 $ '710, $ 13�ROd .- 58. Safety railing. L.1~ 315 $ 92. $ e 1780. 59. Breakaway safety railing. L.F. 20 $ �6c�. '� $ �- 60. Steel sheet pile. S.F. 3,800 $ Z " $ 9/ oCo. .- DOMESTIC WATER LINE Furnish and install 12-inch dia. --� 61: fusion bonded epoxy lined and L1. 158 $ $ coated steel water line. ��. Furnish and install 12-inch dia. C- ' 62: 900 PVC, Class 200 water line. L.F. 198 $ 3 8S. '' $ Connection to existing 8-inch dia. 63' ACP water line. EA' 2 $ 7700-- $ 15 64. Water line undercrossing or EA. overcrossing of 30-inch HP gas line. 1 $ 1 10©•- $ l Qca• 65. Expansion joint utility vault. EA. 2 20 00.-' $ 408W. .�-- 66. Pipe hanger support. EA. 67. Midspan pipe clamp support. EA. 1 $ 1-inch air release/air vacuum valve 6.8. assembly. EA. E 3 $ 2 SCO, Remove and dispose of existing 8- 6�' inch dia. ACP water line. LF 358 $ Remove and replace existing 8-inch 70. gate valve ( LG). A. 1 $ 9 ITEM ESTIMATED UNIT EXTENDED NO. DESCRIPTION TUNIT QUANTITY PRICES AMOUNT TRAFFIC SIGNALS, SIGNING AND STRIPING Traffic signal modification (Del 71. Obispo/Alipaz), L.S. Lump sum Lump sum $ 120 ! Traffic signal modification (Del 72' Obispo/Paseo Adelanto). L.S. Lump sum Lump sura $ 73. Signing and striping. L.S. Lump sum Lump sum $ LANDSCAPING AND IRRIGATION 74. Install landscaping. L.S. Lump sum Lump sura $ 75. Install irrigation system. L.S. Lump sum Lump sum $ 120-day landscape maintenance and 7�' plant establishment. L S Lump sum Lump sum $ g,po. --' DRY UTILITIES 77. SDG&E utility line. L.S. Lump sum. Lump sum $ q0 000. --- 78. Cox Communication utility line. L.S. Lump sura Lump sum $ 13p,50, 79. MCI fiber optic cable line. L.S. Lump sura Lump sum $ 80. AT&T utility line. L.S. Lump sum Lump sum $ 3 3 000- * F indicates Final Pay Quantities per Section 9 of the Caltrans Standard Specifications. S indicates Specialty Item Total Base Bid Price for Bid Items 1 through 80, excluding Bid Item 25A(Eater Dere and on Page 3) -hre,z rnilli o nd� i y s»e' asa - �r wo dar/� . lgv 94w& $ 3,25-61 �6 Words Figures Total Alternate Bid Price for Bid Items i through 80, including Bid Item 25A (Enter here and on Page 3) 3 ��7 Words Vigures 10 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of /Q°4 On On 1-31-2011 before me, Date Here Insert Mme and Title of 1he Officer P11 personally appeared G/ Name s igner S 3 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 MONICA V SAFARIK his/her/their authorized capacity(ies), and that by �31 commission 0 1869115 Z his/her/their signature(s) on the instrument the ornta z rotary Public-Calif Z person(s), or the entity upon behalf of which the UIEE� OT-ange County Z Comm. erson(s) acted. executed the instrument. 6, W. My0MM.ExpireSNoV20,2013 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing iii paragraph is true and correct. WITNESS my hand and official see'l. 6 Signature: ,/�/ Place Notary 5eal and/or Stamp Above sigrialu _eTy Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on tho document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: F-1 Corporate Officer—Title(s): D Corporate Officer—Title(s): it L. Individual [I Individual 0 Partner— .J Limited E General Top of Thumb here 1-1 Partner—-_1 Limited -7 General Top of thumb here _J Attorney in Fact El Attorney in Fact J 01 Trustee D Trustee Guardian or Conservator Guardian or Conservator D Other: Other: .. ................. Signer Is Fiepresenting: Signer Is Representing: 61 C)2008NafEoral Notary gam De Soto Ave.,P.O.Box 2402-Chatswortli,CA 11313-2402-www.Nat'onalNotaryarg Item 115907 Reorder:Call Tolf-Free 1-800-876-6827 NON-COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID STATE OF CALIFORNIA ) ) SS. County of 01-go e } being Frst duly sworn deposes and says that he is l/rW 9r,L,,Svd,-'wy of_ C1eWra/ esrl F)` ( �ucD�7�r, �rlc the party making the foregoing bid;that such bid is not m2e in the interest of or on behalf of any undisclosed person,partnership,company,association,organization or corporation; that such bid is genuine and not collusive or sham; that said bidder has not directly or indirectly induced or solicited any other 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 said bidder has not in any manner, directly or indirectly, sought by agreement, communication or conference with anyone to fix the bid price of said bidder or of any other bidder, or to fix the bid price of or cost element of such bid price, or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in such bid are true; and further, that said bidder has not directly or indirectly, submitted his 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 in connection therewith, to any corporation, partnership, company, association, organization,bid depository,or to any member or age nt thereof, or to any other individual except to any person or persons as have a partnership or other financial interest with said bidder in this general business. DATED: 1-31—20 I11�ilcv SjdNATURE On this the day of ,2011,before me,the undersigned,a Notary Public in and for said Mate, personally appeared , personally known to me/proved to me on the basis of satisfactory evidence,to be the person(s)whose name(s) subscribed to the within instrument, and acknowledge that executed it. WITNESS my hand and official seal. e� At"O- Notary Public in and for said State 11 DESIGNATION OF SUB-CONTRACTORS Submit with Proposal. In compliance with the Provisions of Section 4100-4107 of the Government Code of the State of California as amended,the undersigned certifies that he has used the sub-bids of the following listed sub-contractors in making up his bid,and that the sub-contractors listed will be used for the work for which they bid, subject to the approval of the Engineer, and in accordance with the applicable provisions of the Specifications. It is understood and agreed that all those portions of the work called for in the contract documents for which a sub-contractor is not listed will be performed by the undersigned through his forces. If no sub-contractors are listed, all bonds and insurance will be written in the name of the general contractor only. Item of Work Sub-contractor License No. Address Phone &Classification 1. 7 -- 76 5-l®886 764) Z1i5-1776 �•r°Sfri�>� 2. 73 4S�9e15Z 79 3. �//0 �o61/�® 14 h Ftfl�nei_ CA '70q) y r 4. '74 5;__25411 t d '.t#4/ cv, C 5. /6 203 977 Cs-o � 7. 717� 1�rz 73 A� 8, cry a 6 � B. PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION INC. BIDDER'S NAME A O D SIGNATURE 12 BO D# 0284226 BID BOND PREMIUM: NIL n KNOW ALL MEN BY THESE PRESENTS, that we, PETERSON--CHASE GENERAL ENGINEERING CONSTRUCTION, INC., as PRINCIPAL, and GREAT AMERICAN INSURANCE COMPANY as SURETY,hereinafter c4ledSurety,are held and firmly bound unto the CITY OF SAN JUAN CAPISTRANO,•Oblige,hereinafter called City, in the sum of S t07 for payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, successors, and assigns,jointly and severally, fairly by these presents. ** TEN PERCENT OF AMOUNT BID TBE CONDITION OF TMS OBLIGATION is such that whereas the Principal has submitted the accompanying bid dated JANUARY 31, 2011 for the construction of: DEL OBISPO SI. WIDENING PRO.I. NO.. 07107 for the City of San Juan Capistrano,Orange County, California. NOW,THEREFORE,if the Principal shall not withdraw said bad within thirty(30)days after the opening of same, and shall, within. fifteen (15) days after the agreement has been presented to hiam,for execution,enter into a written contract with the City in accordance with the bid as accepted, and if the Principal shall give the required bond with good and sufficient sureties, or sureties for the faitliU performance and proper fulfillment of such contract and for the protection of laborers and materialmen, or in the event of the withdrawal of said bid within the periods specked,or the failure to enter into said contract and give said bond-within the time specified,if the Principal shall within sixty(60)days after request by the City,pay the City the difference between the amount specified in said bid and the amount for which the City may ,procure the required work and/or supplies if the latter amount be in excess of the farmer,then the above obligation shall be void and of no effect, otherwise to remain in full force and effect. Further, as a part of the obligation secured hereby, and in addition to the face amount specified therefor, there shall be included costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by City in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered. Executed•tlus 28TH day of_ _ JANUARY � , 20-11—,, at ANAHEIM , California. PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC. Principal By: k uj . VOG ELS GREAT AMERICAN12,�1 INS , CE COMPANY SuTety( RL LAW Title: ATTORNEY-IN--FACT (Nauaization and Seal) Approved as to form: City Attorney BB-2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of orancle On 1/28/ 1 before me, Jan C. Mora, Notary Public Date Here Insert Name and Title of the Office( personally appeared _ Charles L. Flake Narne(s)of StRner(sl 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 ' SAN MCJRAN which the person(s) acted, executed the instrument_ f Comm, 4�1789349 I NOTARY PUBLIC-CALIFORNIA� 1 certify under PENALTY OF PERJURY under the laws ORANGE c4uNTY s of the State of California that the foregoing paragraph is COMM.EXPIRES FEB.i7,2012'.14 true and correct. WITNESS my hand and official seal. Signature C P€aae Notary Seal Above Signature of Notary Public OPTIONAL JanUC. Mo�a� Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s)Other Than Named Above: —_ Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name:. ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): - _ ❑Corporate Officer—Title(s) ❑ Partner—❑ Limited ❑ General ❑ Partner----❑ Limited ❑ General ❑ Attorney in Fact . ❑Attorney in Fact • ❑ Trustee Top of thumb here i❑Trustee Top of thumb here ❑ Guardian or Conservator ❑Guardian or Conservator ❑ Other: ❑Other: Signer Is Representing: Signer Is Representing: 02007 National Notary Association-9350 De Soto Ave„PO,Boz 2402•Chats o?th,CA 9191a-2402•ewm.NationalNotaryorg ftem#5907 Reotden Call Toll-Free 1-800-875-6827 GREAT AMERICAN INSURANCE COMPANY® Administrative Office:580 WALNUT"STREET° CINCINNATI,OHIO 45202 * 513-369-5000• FAX 513-723-2740 The number of persons authorized by this power of attomey is not more than FOUR No. 014406 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS.,That the GREAT AMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below, each individually if more than one is named, its true acid lawful attorney-in-fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof; provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shalt not exceed the limit stated below. Mame Address Limit of Power DAVID L,CULBERTSON ALL OF ALL CHARLES L.FLAKE ANAHEIM, $75,000,000.00 RICf1ARDA.COON CALIFORNIA LEXIS SHER OOD This Power of Attorney revolves all previous powers issued in behalf of the attorney(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seat hereurlo affixed this 25"' day of, MAY, 2010. s AttestGREAT'AMERICAN INSLANCE COM1'AN� ,�.tisistaruSccrc7arf• Di3isinncrlSaiirr l�icc Nr=siden! STATE OF OHIO,COUNTY OF HAMILTON-ss: DAvu)c.xrrcxrIi(513-412-4602) �— On this 25r" day of MAY,2010, before me personally appeared DAVID C.KITCI IN,to me known,being duly sworn,deposes and says that lie resides in Cincinnati, Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great Ameriean Insurance Company, the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seat affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by fake authority. �•`.t KAREN L GROSHEIM NOTARY PUBLIC,STATE OF OHIO MY COMMISSION EXPIRES 02-20-11 This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,200$. RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Trice Presidents and Divisional Assistant mice Presidents, or any one of them, be and hereby is authorized,from time to time, to appoint one or more Aelormys-in-Fact to execute on behalf of the Company, as surety, any and all bonds, undertakings and contracts of suretyship,or other written obligations in the nature thereof, to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid afficers and any Secretary or Assistant Secretary of the Coanpany may be affsxed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyship, or other 11ritten obligation in the nature thereof,such signature and seat when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company ivith the same force and effect as though manually affixed. CERTIFICA'T'ION 1, STEPHEN C.X31:RAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of lune 9,2005 have not been revoked and are now in full force and effect_ Signed and sealed this 28TH day of JANUARY 2011 r> Ryt ,„,„,� �ss�slaii15'carcda�� .- 51029Y(107C6) Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNAT URE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION PETERSON-CHASE GENERAL ENGINEERING The bidder proposed subcontractor hereby certifies that he has has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that,where required,he has fled with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance, a Federal Government contracting of administering agency,or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently, Standard Form 100 (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 or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Co plianee,U.S.Department of Labor. Page 12-79 LPP 01-04 March 15,2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment C PS&E Checklist Instructions A Page 12-80 March 15,2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder,under penalty of perjury, certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner, director, officer, and manager: a Is not currently under suspension, debarment,voluntary exclusion,or determination of ineligibility by any federal agency;. a Has not been suspended,debarred,voluntarily excluded or.determined ineligible by any federal agency within the past 3 years; a Does not have a proposed debarment pending; and • Has not been indicted,convicted, or had a civil judgment rendered against it by a court of competent - jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPA' 01-04 March 15,2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment E PS&E Checklist Instructions Page 12-84 March 15,2001 ILPP"01-€14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL-.AID CONTRACTS The prospective participant certifies;by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that`. (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment,or modification of any federal contract,grant, loan, or cooperative agreement, (2) If any funds other than federal appropriated.funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress,or an employee of a Ivlember.of Congress in connection with this federal contract, grant, loan,or cooperative agreement,the undersigned shall complete and submit Standard Forth-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S.'Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Cl Page 12-85 LPP 01-44 March 15,20(01 EXHIBIT 12-E Lacal Assistance Procedures Manual Attachment F IPS&E Checklist Instructions ANIL Page 12-86 March 15,2001 LPP 01-04 Local Assistance Procedures Manual h l LL:5 Y11Y6 EXHIBIT 12-E PS&E Checklist Instructi6ns i Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 1, Status of Federal Action: 3. Report Type: a. contract Fla, bid/offerlapplication Fla. initial b. grant b. initial award b, material change c. cooperative agreement c. post-award d. loan For Material Ch ge Only: e. loan guarantee year quarter f, loan insurance elate of 1 t report 4. Name and Address of Reporting Entity 5, If Reporting Entity in No,4' Subawardee, Enter Name and Address Prime. Prime Sublivvardee Tier ,if known Congressional District,if known Congression istrict,if known 5. Federal Department/Agency: 7. Federal Pr gram Name/Description: CFD Number,if applicable 8. Federal Action Number,if known: g. A and Amount,if 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual,last name,first name,MI) address if different from No. 1©a) (last name,first name,Mi) (attach Can 'nuation Sheet(s)if necessary) 11. Amount of Payment(check all that app ) 13, Type of Payment(check all that apply) $ El actual lanned a. retainer b: one-tune fee 12. For of Payment(check all that pply): c, commission Ha. cash d. contingent fee b. in-kind; specify: n ure e deferred value f. other,specify 14. Brief Description of Se ices.Performed or to be performed and Date(s)of Service,including officer(s),eimployee(s,ter member(s)contacted,for Payment Indicated in Item 11: (attach Continuation Sheets)if necessary) 15. Continuatio beet(s)attached: Yes F1 No 16. Information r uested through this form is authorized by Title '31 U.S.C.S ction 1352. This disclosure of lobbying reiiance Signature: was place by the tier above when his transaction was made or entered' to. This disclosure is required pursuant to 31 U.S.C. print Name: .1352 is information will be reported to Congress se annually and will be available for public inspection. Any P. san who fails to file the required disclosure shall be subject• Title: o a civil penalty of not less than$10,000 and not more than $100,000 for each such failure. Telephone No-: lute: Authorized for Local Reproduction ederal Use Only: Standard Form-LLL Standard Form LLL Rev.49-12-97 Page 12-87 LPP 01-04 March 15,2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions O Page 12-90 Murch 15,2001 LPP 01-04 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee;or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The ding of a form is required for such payment or agreement to make payment to lobbying entity for influencing.or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in.connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which_ lobbying activity is and/or has been secured to influence,the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. .Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported;enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the.reporting entity.s Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prince federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7� Enter the federal program,name or description for the covered federal action(item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g., Request for Proposal(RFP) number, Invitation for Bid(IFB)number, grant announcement number, the contract grant. or loan award number,the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-00 L' 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address,city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b)Enter the full navies of the individuaI(s)performing services and include full address if different from 10(a). Eater Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made(actual)or will be rhade (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment laude or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15,2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 4. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and, related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s)employee(s)or Member(s)of Congress that were contacted. 15. Check whether or not a continuation sheets) is attached. 16. The certifying official shall.sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources,gathering and maintaining the data needed, and completing and reviewing the collection of information. Send cornments regarding the burden estimate or any other aspect of this collection.of information, including suggestions for reducing this burden,to the Office of Management and Budget, Paperwork Reduction Project(0348-0046),Washington, D.C. 20503. SF-1,LL-Instructions Rev,06-04.90%ENDIF>r PP q1-q4 Page 12-89 2� March 15,2001