Project 183- 2 -Proposal - Nikola Corp. - 2010-09-02 COSTA MESA SANITARY DISTRICT
ORANGE COUNTY CALIFORNIA
BID PROPOSAL FORM
BRISTOL STREET SEWER REPLACEMENT
N/O RANDOLPH AVENUE
Project No. 183-2
b/` /
Name of Bidder' 4/ ,/°1 a ponM T UN
Address: / So I Z Caw (/�' nr 11,/We" a
2 6,y,
Phone No. (1G( ft 1 `7
TO THE BOARD OF DIRECTORS
COSTA MESA SANITARY DISTRICT
Pursuant to and in compliance with the Notice Inviting Sealed Proposals (Bids) and the other documents
relating thereto, the undersigned bidder has carefully examined and is completely familiar with the plans,
specifications, and contract documents including the local conditions affecting the performance of the
contract, the character, quality quantities, and scope of the work, and the materials to be furnished as to
the requirements of the specifications and the contract.
If awarded the contract, the undersigned bidder hereby proposes and agrees to perform within the time
stipulated in the contract, including all of its component parts and everything required to be performed,
and to furnish any and all of the labor, material, tools, equipment, transportation, services, permits,
utilities, and all other items necessary to perform the contract and complete in a workmanlike manner all
of the work required in connection with the construction of said work all in strict conformity with the
plans and specifications and other contract documents, including addenda Nos. _, _,_, , and ,
on file in the District office for the prices hereinafter set forth.
The undersigned as bidder, declares that the only persons or parties interested in this proposal as
principals are those named herein, that this proposal is made without collusion with any person, firm, or
corporation; and he proposes and agrees, if the proposal is accepted, that he will execute a contract with
the District in the form set forth in the contract documents and that he will accept in full payment thereof
the following prices, to wit:
CMSD Project No. 183-2 Bid Proposal Form— 1 of
CMSD SEWER REPLACEMENT PROJECT NO. 183-2
SCHEDULE OF WORK ITEMS (SCHEDULE A)
BRISTOL STREET SEWER REPLACEMENT
N/O RANDOLPH AVENUE
BID APPROX. UNIT TOTAL
ITEM QUANTITY DESCRIPTION PRICE AMOUNT
Lump Sum Bonds, Insurance, and Permits: Work under this item
includes any costs incurred for securing bonds, Lump
insurance permits and financing for construction work. Sum $ 1121.99
2 Lump Sum Mobilization, Demobilization and Cleanup: Work
under this item shall include preparatory and cleanup
operations including, but not limited to, those
necessary for the movement of personnel, equipment,
materials, and incidentals to and from the project site,
securing a temporary construction yard, and
maintaining the project site in a safe and orderly Lump
manner during construction. Sum $ 3 1°O
3 Lump Sum Traffic Control: Furnish all labor, materials, and
equipment for the installation and removal of the
required traffic control including, but not limited to,
changeable message boards, signs, delineators, traffic
cones, barricades, flashing arrow signs, steel plates,
and all other traffic control devices necessary to Lump �ZS
comply with the traffic control drawings. Sum $
4 Lump Sum Geotechnical Evaluation During Construction: Work
under this item shall include laboratory testing of
trench backfill, aggregate base, asphalt, and concrete
during construction. Work under this item shall also
include the monitoring of batch time, temperature, mix
designs, and placement time for all pavement
replacement.
Note: Contractor shall provide a report(4 copies) of
the geotechnical observation and testing Lump
upon project completion to the District. Sum $ / `tea a
5 Lump Sum Provide Diversion Plan for Existing Sewage Flow
During Construction: Work under this item shall
include, but is not limited to, pumps, temporary hoses
or piping, pumper trucks, plugs, and all other
equipment necessary to provide diversion of existing Lump
sewage flow during construction complete in place. Sum $ )OoD
6 Lump Sum Replace Pavement Striping: Work under this item
shall include furnishing and installing all labor,
material, and work necessary to replace existing
pavement striping damaged during construction to Lump
original condition complete in place. Sum $ /000
CMSD Project No. 183-2 Bid Proposal Form—2 of 9
CMSD SEWER REPLACEMENT PROJECT NO.183-2
SCHEDULE OF WORK ITEMS(SCHEDULE A)
BRISTOL STREET SEWER REPLACEMENT
N/O RANDOLPH AVENUE
BID APPROX. DESCRIPTION UNIT TOTAL
ITEM QUANTITY PRICE AMOUNT
7 175 LF Remove Existing 8-inch VCP sewer and Install New fl-
inch PVC SDR 35 Sewer Main With Gasketed Joints
Per Plans and Specifications. Work under this item
shall include, but is not limited to, temporary paving
and patching or trench plates, trench excavation,
control of ground water and surface water, bedding,
backfill, and compaction per City Standard 813,
installation of pipe and fittings, removal or protection
of interfering portions of existing utilities or
improvements, temporary and permanent support of
utilities, disposal of excess excavation materials and all
other work necessary to install the sewer main
complete in place.
Work under this item shall also include adequate
sheeting, shoring and bracing or equivalent methods
for the protection of the life and limb, which shall
comply to applicable safety orders including, but not
limited to, planning, designing, engineering,
furnishing, constructing, and removing temporary
sheeting, shoring and bracing, and any other work
necessary to conform to the requirements of any
permits, OSHA and the Construction Safety Orders of$j 5
the State of California, pursuant to the provisions of
Section 6707 of the California Labor Code. LF $ 27700
8 3 each Remodel and reconnect Existing 6-inch VCP Sewer
Laterals Per Plans and Specifications. Work under
this item shall include, but is not limited to
remodeling lateral connections, temporary paving
and patching or trench plates, trench excavation,
control of ground water and surface water, trench
restoration including bedding, backfill, and
compaction per City Standard 813, and base
pavement, protection of existing utilities or
improvements, temporary and permanent support of
utilities, disposal of excess excavation materials and
all other work necessary to reconnect the sewer
laterals complete in place. $ I la
Each $ 3yn
9 1 Each Modify Manhole Channel per Detail 2 on Sheet 3 of
Plans: Work under this item shall include furnishing $88 y
and installing all labor,material, and work necessary to
modify manhole channel complete in place. Each $
CMSD Project No. 183-2 Bid Proposal Form—3 of 9
CMSD SEWER REPLACEMENT PROJECT NO. 183-2
SCHEDULE OF WORK ITEMS (SCHEDULE A)
BRISTOL STREEI SEWER REPLACEMENT
N/O RANDOLPH AVENUE
BID APPROX. DESCRIPTION
UNIT TOTAL
ITEM QUANTITY PRICE AMOUNT
10 2 Each Remove Existing Channel and shelf 2' in depth
(minimum) and Pour New Manhole Base and Channel
To Match Proposed Sewer Grades Per CMSD Std.
Dwg. No. S-100. Work under this item shall include
furnishing and installing all labor material, and work s /0o,„
necessary to pour new manhole base and channel
complete in place. Each $ /oo-°
11 Lump Sum Pavement Replacement per City of Costa Mesa Std.
813 and Detail 1 on Sheet 3 of Plans: Work under this
item shall include all material and labor for pavement
replacement including final asphalt concrete pavement Lump
installation, except for paving for bid item#13. Sum $ 1 900*
TOTAL AMOUNT OF
ITEMS 1 THROUGH 11 S. z••••
(TOTAL IN WORDS—SCHEDULE A)
Additive Lump Sum Remove Existing Private 6-inch VCP Sewer Lateral
Bid Item and Construct New 6' PVC SDR3S Private Sewer
B1 Lateral Per Plans and Specifications. Work under
this item shall include, but is not limited to testing,
temporary paving and patching or trench plates,
trench excavation, control of ground water and
surface water trench restoration including bedding,
backfill, compaction, and base pavement, protection
of existing utilities or improvements, temporary and
permanent support of utilities, disposal of excess
excavation materials and all other work necessary to
remove and construct the sewer lateral complete in $3 ,386
place, including final paving and striping.
Lump 9 j
Sum $ t
Bidders Initials/
Note: In case of a discrepancy between the words and figures,the words shall prevail. !7`�
CMSD Project No. 183-2 Bid Proposal Form—4 of 9
The Contractor agrees that the District will not be held responsible if any of the approximate
quantities shown in the foregoing proposal shall be found incorrect, and he shall not make any claim for
damages or for loss of profits because of a difference between the quantities of the various classes of
work as estimated and the work actually done. If any error, omission or mis-statements shall be
discovered in the estimated quantities, it shall not invalidate this contract or release the Contractor
from the execution and completion of the whole or part of the work herein specified, in accordance with
the specifications and the plans herein mentioned and the prices herein agreed upon and fixed therefor, or
excuse him from any of the obligations or liabilities hereunder, or entitle him to any damages or
compensation otherwise than as provided for in this contract.
The Contractor agrees that the District shall have the right to increase or decrease the quantity of
any bid item or portion of the work or to omit portions of the work as may be deemed necessary or
expedient, and that the payment for incidental items of work, not separately provided in the proposal
shall be considered included in the price bid for other various items of work.
Accompanying this proposal is A dQ�C r
o/a .1 'NT Art .O d Pr«(� )•
NOTICE: Insert the words 'Cash' 'Certified Check' or 'Bidder s Bond' as the case may be in an
amount equal to at least 10%of the total bid price, payable to the Costa Mesa Sanitary District.
The undersigned deposits the above named security as a proposal guaranty and agrees that it shall
be forfeited to the Costa Mesa Sanitary District as liquidated damages in case this proposal is accepted
by the District and the undersigned shall fail to execute a contract for doing said work and to furnish
good and sufficient bonds in the form set forth in the specifications and contract documents of the
District with surety satisfactory to the District within 10 Days after the bidder has received written
notice of the award of the contract; otherwise, said security shall be returned to the undersigned.
Respectfully submitted,
///0 of e n* ,o,1
Contractor's Business N e 99 c . tor J Title
/SO/L (.,Qta�AA! l /
n- 4J
Business Address: 4treet :y ,Jo' ow+y /A Ham✓ Title "Wei' WC_
-7711/wr 02- qi cly 5,' 33c7 .0/3,/,
City State Zip Contractor's License, Expiration
Date&Classification
g9q I7 f2 /4 n)
usiness Phone Number
Name Title
Residence Phone Number
Bidder's Residence: Street
City State Zip
CMSD Project No. 183-2 Bid Proposal Form-5 of 9
I declare under penalty of perjury under the laws of the State of California that the forgoing is true
and correct.
R v,friJ -
Da -: at 4 ,.: this L day of J P k^ hat 20 /V
tr.The full names and residences of all persons and parties interested in the foregoing proposal, as
principals, are as follows:
NOTICE- Give first and last names in full, in case of corporation, give names of President, Secretary
Treasurer and Manager, and affix corporate seal; in all cases of partnerships and joint ventures give
names of all the individual members. C,..99_,2o-rf er i
�0 /V k .
to r(dl den f- 7-220,-l..vt6-n.
svo 7..oc-t id- ..
•
CONSTRUCTION PROJECT REFERENCES
In order to more fully evaluate your background and experience for the project herein proposed, it is
requested that you submit a list of Public Works and/or similar construction projects completed, or in
progress, within the last 24 months. Your cooperation in this matter is greatly appreciated.
DATE PROJECT AGENCY'S CONTRACT
AWARDED AWARDING AGENCY ADMINISTRATOR
c it"x- it
CMSD Project No. 183-2 Bid Proposal Form—6 of 9
IV/KOLA
C O R
, ORATION
General Engineering Contractor
CA Lic.#813357
REFERENCES - PROJECTS 2008
21 OWNER: City of San Bernardino
CONTACT Mr Michael D Wolff Construction Engineer
(909) 384 — 5166
DATE. December 2007 — March 2008
PROJECT Sewer & Street Improvements (Cedar Canyon, Wallace, 24)
8 000 L.F of 8' PVC Pipe and Manholes and Laterals
AMOUNT $ 950 000
22.OWNER: Rutter Development Corporation
MESA CONSOLIDATED WATER DISTRICT
CONTACT Mr Jay Rutter President
Mr Mark Pelka, (949) 631 1291
(949) 863-1298
DATE. March 2008 — May 2008
PROJECT Pacifica Residences, Costa Mesa
On-site Storm Drain System: 1 000 LF
On-site Sewer System. 600 LF including Manholes
On-site/Off-site Water System. Domestic & Fire Water (hyd)
AMOUNT $ 310 000
23.OWNER: City of Anaheim
CONTACT Mr Sean Razmy Construction Engineer
(714) 765-5059
DATE. June 2008 —August 2008
PROJECT Sewer Improvements (St. College Blvd & La Palma Ave.)
1 500 L.F of 18' VCP and Manholes and Laterals
AMOUNT $ 565 000
24 OWNER: City of San Bernardino
CONTACT Mr Michael D Wolff Construction Engineer
(909) 384 — 5166
DATE. September 2008 — November 2008
PROJECT Sewer & Street Improvements (Tippecanoe, `I' Sterling Ave)
21 15' PVC Pipe and Manholes and Laterals & Bursting
AMOUNT $ 720 000
18012 COWAN, SUITE 290, IRVINE, CA 92614
TEL. (949)752 1900 FAx (949)752 1910
WWW.NIKOLACORP.COM
NIlCOLA
C O R P O R A T I O N
General Engineering Contractor
CA Lic#813357
REFERENCES - PROJECTS 2009
25.OWNER: City of Pasadena
CONTACT Mr Bob Gardner
(626) 744-4312
DATE. November 2008 — January 2009
PROJECT 2009 Sewer Pipe Repairs
Sewer Main 'point repairs and Manholes
AMOUNT $ 109 000
26.OWNER: Jurupa Community Services District
CONTACT Mr Kiran 'Sam Sampat
(951) 685-7434
DATE. February 2009 —April 2009
PROJECT JCSD Headquarters On-site Sewer Improvements
Sewer Main, Manholes, Vaults and Electrical
AMOUNT $ 275 000
27 OWNER: City of Redondo Beach
CONTACT Mr Mazin Azzawi, Project Engineer
(310) 318-0661
DATE. June 2009 — November 2009
PROJECT Sanitary Sewer Rehabilitation — Phase 8A
5 300 LF of 12' VCP and 24 Manholes
AMOUNT $ 1 066 000
18012 COWAN, SUITE 290, IRVINE, CA 92614
TEL. (949)752 1900 FAX (949) 752 1910
WWW.NIKOLACORP.COM
All/COLA
C O M P O A A T I O N
General Engineering Contractor
CA LIC#813357
REFERENCES - PROJECTS 2010
28.OWNER: City of Redondo Beach
CONTACT Mr Mike Shay Project Engineer
(310) 318-0661
DATE. November 2009 — Present
PROJECT Sapphire Storm Low Flow Diversion
Pump Station, Forced Main, Electrical & Filtration System
AMOUNT $ 690 000
29.OWNER: City of Fullerton
CONTACT Mr Eliseo Bravo Construction Inspector
(714) 738-5348
DATE. May 2010 — Present
PROJECT Riverside Dr and Raymond Ave Sewer& Street Imp
4 300 L.F of 8' and 10' Verified Clay Pipe and Manholes
AMOUNT $1 060 000
18012 COWAN, SUITE 290 IRVINE, CA 92614
TEL (949)752 1900 FAX (949) 752 1910
WWW NIKOLACORP.COM
PROJECT ADDENDA
Bidder shall signify receipt of all Addenda here, if any
ADDENDUM NO. DATE RECEIVED BIDDER'S SIGNATURE
N/fr
DESIGNATION OF SUBCONTRACTORS
In compliance with the Subletting and Subcontracting Fair Practices Act' being Sections 4100-4113
of the Government Code of the State of California, and any amendments thereto, each bidder shall set
forth below the name and location of the place of business of each Subcontractor who will perform
work or labor or render service to the prime Contractor in or about the construction of the work or
improvement in an amount in excess of 1/2 of 1%of the prime Contractor's total bid and shall further
set forth the portion of the work which will be done by each such Subcontractor Only one
Subcontractor for each such portion shall be listed.
If the Contractor fails to specify a Subcontractor for any portion of the work to be performed under
the contract, he shall be deemed to have agreed to perform such work himself, and he shall not be
permitted to subcontract that portion of the work except under the conditions hereinafter set forth.
Subletting or subcontracting of any portion of the work to which no Subcontractor was designated in
the original bid, shall only be permitted in cases of public emergency or necessity and then only after a
finding reduced to writing as a public record of the Legislative Body of the owner.
Portion State License
Of Work Subcontractor's Name and Address Number Class
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CMSD Project No. 183-2 Bid Proposal Form—7 of 9
Bond No. 5376
10%BIDDER'S BOND TO ACCOMPANY PROPOSAL
required if the bidder desires to submit bond instead of a certified or cashier's check).
KNOW ALL PEOPLE BY THESE PRESENTS.
That we, Nikola Corporation as principals, and
Merchants Bonding Company (Mutual) as surety are held and firmly bound unto the Costa
Mesa Sanitary District,a special district,organized under the laws of the State of California and situated
in Orange County in the sum of TEN PERCENT OF THE AMOUNT OF THE BID*****
***Rae** assigns, for which payment
(S l0i ) to be paid to the District, its successors and assi
well and truly to be made, we bind ourselves, our heirs, executors, and administrators, successors or
assigns,joint and severally firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH,
That if the certain proposal of the above bounden
Nikola Corporation , is accepted by the Costa Mesa
Sanitary District, and if the above bounden, Nikola Corporation his
heirs,executors,administrators, successors and assigns, shall duly enter into and execute a contract
for such construction, and shall execute and deliver the LABOR AND MAT tt' • and the FAITHFUL
PERFORMANCE BONDS described within 10 daNs (not including Sunday) from the date of the
mailing of a notice of the above bounden, rnrpnTari nn , by and from District, that said
contract is ready for execution, then this obligation shall become null and void; otherwise it shall be and
remain in full force and virtue.
HV WITNESS WHEREOF
We hereunto set our hands and seals this . 2nd day
of September , 2010.
Niko j or'oration
-
By._ , l% _
Jo chan, silent _
Merchants Bonding Company (Mutual)
By• /
Rya Mantle Attorney-in-Fact
ti
CMSD Project No, 183-2 Bid Proposal Form- 8 of 4
CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Da_plirq[S+f
On 1-6-1 0 before me,CA(Z()l (( _ LIST h � (RR\r ?0.62--1C
Ku(Here insert ame anf title of the offs r)
� fl
personally appeared b N Ny N Ku cti A
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/aye subscribed to
the within instrument and acknowledged to me that he/she/they executed the same in hiss' authorized
capacity(ies), and that by his/hen/their signatures) 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. -- ." ^ "
r CAROL A. LUSTIG 4
U Aer_y� comm. #1717578
()r ": 0'� NOTARY PUBLIC-CALIFORNIA I{/
WITNESS my hand and a ficial seal. 2 "�, �J` ORANGE COUNTY O
r•Araar COMM.EXPIRES JAN.16,2011 s
-• kik 411110 -i,I . (Notary Seal) vvv
Signatur of Notary 'ublic
•
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Securely attach this document to th signed document
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
coerV cr crccere rcec(tcccrcr-cnoccetcconce' Ccaicocecr•-erw cecccr'icecrs wc(x cecacKtccorccttz, tra
State of California
County of Orange
on _ c7-2-2070 before me, Mary Martignoni - Notary Public
Dar Here Insert Name and Title of the Officer
personally appeared Ryan Mantle
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
_ �•�^` � MA he/she/they executed the same in his/her/their authorized
RY MARTIGNONI capacity(ies), and that by his/her/their signature(s) on the
ry,;t"NO
COMM i 171251 sC instrument the person(s), or the entity upon behalf of
UBLIC CµrFORNfAZ which the person(s) acted, executed the instrument.
ORANGE COUNTY
My Comm,Expires Sept,9,2011 _ 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
Pla No ary Seal Above &gnat e o Diary Pudic
OPTIONAL
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: Ryan Mantle Signers Name:
❑ Individual ❑ Individual
❑ Corporate Officer—Title(s): ❑Corporate Officer—Title(s):
❑ Partner—0 Limited ❑ General RIGHT THUMBPRINT ❑ Partner—0 Limited ❑General RIGHTTNUMBPRIN7
❑ Attorney in Fact OF SIGNER ❑Attorney in Fact OFSGNER
Top of thumb he Top of thumb he
❑ Trustee ❑Trustee
❑ Guardian or Conservator ❑Guardian or Conservator
❑ Other ❑Other
Signer Is Representing: Signer Is Representing:
Merchants Bonding
Company (Mutual)
02037 Nalio al Notary Associate•9360 De Soto Ave.PO Box 2402•Chats9mM.OA 91313-2402•www Na r alNotaryorg Item NE907 Reorder:Call Toll-Fr V1.800876-6827
Merchants Bonding Company
(Mutual)
POWER OF ATTORNEY
Know All Persons By These Presents,that the MERCHANTS BONDING COMPANY(MUTUAL),a corporation duly organized under
the laws of the State of Iowa,and having its pnncipal office in the City of Des Moines,County of Polk,State of Iowa,hath made,
constituted and appointed, and does by these presents make,constitute and appoint
Les M. Mantle, Ryan Mantle
of Fullerton and State of California its true and lawful Attorney-in-Fact,with full power
and authority hereby conferred in its name,place and stead,to sign, execute,acknowledge and deliver in its behalf as surety any
and all bonds,undertakings,recognizances or other written obligations in the nature thereof,subject to the limitation that any such
instrument shall not exceed the amount of.
SIX MILLION($6,000,000.00) DOLLARS
and to bind the MERCHANTS BONDING COMPANY(MUTUAL)thereby as fully and to the same extent as if such bond or
undertaking was signed by the duly authorized officers of the MERCHANTS BONDING COMPANY(MUTUAL),and all the acts of
said Attorney-in-Fact,pursuant to the authority herein given, are hereby ratified and confirmed.
This Power-of-Attorney is made and executed pursuant to and by authority of the following Amended Substituted and Restated By-
Laws adopted by the Board of Directors of the MERCHANTS BONDING COMPANY(MUTUAL)on November 16,2002.
ARTICLE II, SECTION 8 The Chairman of the Board or President or any Vice President or Secretary shall have power and
authority to appoint Attorneys-in-Fact,and to authorize them to execute on behalf of the Company and attach the Seal of the
Company thereto,bonds and undertakings, recognrzances,contracts of indemnity and other writings obligatory in the nature
thereof
ARTICLE II, SECTION 9 The signature of any authorized officer and the Seal of the Company may be affixed by facsimile
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 Witness Whereof,MERCHANTS BONDING COMPANY(MUTUAL)has caused these presents to be signed by its President and
its corporate seal to be hereto affixed, this 20th day of January 2009
*0MAC CO,A MERCHANTS BONDING COMPANY(MUTUAL)•00 000,2 9
G 4i y<•
z 7,
y • 1933 C 6y
c
STATE OF IOWA Jd�- {'• �1d President
COUNTY OF POLK ss.
On this 20th day of January 2009 before me appeared Larry Taylor,to me personally known,who being by me duly sworn did say that
he is President of the MERCHANTS BONDING COMPANY(MUTUAL),the corporation descnbed in the foregoing instrument,and that the
Seal affixed to the said instrument is the Corporate Seal of the said Corporation and that the said instrument was signed and sealed in behalf
of said Corporation by authority of its Board of Directors.
In Testimony Whereof,I have hereunto set my hand and affixed my Official Seal at the City of Des Moines,Iowa.the day and year first
above wntten. ///l
CINDY SMYTH / ini�-/-,/��r�.
Comm March 16 on Ex 177504 Wrt-"__;Vl jjj"""�
OW My Commission Expires
March 16,2009 Notary Public,Polk County,lo
STATE OF IOWA
COUNTY OF POLK ss.
I, Wiliam Warner,Jr. Secretary of the MERCHANTS BONDING COMPANY(MUTUAL),do hereby certify that the above and foregoing
is a true and correct copy of the POWER-OF-ATTORNEY executed by said MERCHANTS BONDING COMPANY(MUTUAL),which is
still in full force and effect and has not been amended or revoked.
In Wan ss Whereof, I have hereunto set my hand and affixed the seal of the Company on this
2nd day of September 2010
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POA 0001 (1/06) �d';4 , C'4'
NON-COLLUSION AFFIDAVIT
The bidders, by its officers and agents or representatives present at the time of filing this bid, being
duly sworn on their oaths say, that neither they nor any of them have in any way, directly or
indirectly entered into any arrangement or agreement with any other bidder, or with any public officer
of Costa Mesa Sanitary District whereby such affiant or affiants or either of them has paid or is to pay to
such bidder or public officer any sum of money, or has given or is to give to such other bidder or public
officer anything of value whatever, or such affiant or affiants or either of them has not directly or
indirectly entered into any arrangement or agreement with any other bidder or bidder,which tends to
or does lessen or destroy free competition in the letting of the contract sought for on the attached bids;
that no bid has been accepted from any Subcontractor or supplier through any bid depository, the By-
Laws, Rules, or Regulation of which prohibit or prevent the Contractor from considering any bid from
any Subcontractor or supplier which is not processed through said bid depository or which prevent any
Subcontractor or supplier from bidding to any Contractor who does not use the facilities of or accept
bids from or through such bid depository that no inducement of any form or character other than that
which appears upon the face of the bid will be suggested,offered, paid or delivered to any person of the
contract, nor has this bidder any agreement or understanding of any kind whatsoever, with any person
whomsoever to pay deliver to, or share with any other person in any way or manner, any of the
proceeds of the contracts sought by this bid.
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l7;/w^y N K4entr"
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Subscribed and sworn to before me by
(S% A-rtac+rro)
This day of 20
My Commission expires:
Notary Public
CMSD Project No. 183-2 Bid Proposal Form—9 of 9
This certificate is attached to a page document dealing with/entitled and dated
California JURAT
State of California
County of 0 apt\IG
Subscribed and sworn to (or affirmrd) before me on this Ik day of SE.M. 4 -M\ ,
2010 , by-a N N. �` i_ cf-I*\J , proved to me on the basis of satisfactory
evidence to be the person.* who appeared before me.
ill ^ries CAROL A. LUSTIG 7
O _„ ��;�'� COMM. #1717576
(ryt.'8q NOTARY PUBLIC-CALIFORNIA W
t ✓ T ORANGE COUNTY O
COMM.EXPIRES JAN.16,2011
Seal
Signature( . ,V , '