APPENDICES_(1.13.23).pdf

APPENDICES

Appendix 1 Payment and Performance Bonds

Appendix 2 Construction Administration Forms

Appendix 3 Hazardous Materials Survey [NOT USED]

Geotechnical Survey [NOT USED] Appendix 4

Appendix 5 Federal Minimum Wages [APPLICABLE]

APPENDIX 1

Payment and Performance Bonds

PAYMENT BOND

(Labor and Material Bond)

KNOW ALL PERSONS BY THESE PRESENTS THAT:

WHEREAS, the City of Pasadena has awarded to

(Name, address, and telephone number of Contractor) designated as the “Contractor” or “Principal” herein, a Contract for the Work described as follows: Fire Station 31 – Sesimic Retrofit and Tenant Improvements located at 135 S Fair Oaks Ave in the City of Pasadena (hereinafter “Building”), which Contract and all Contract Documents set forth therein are incorporated herein and made a part hereof by this reference.

WHEREAS, by the terms of said Contract Documents, as well as Civil Code Section 9550, Principal is required to furnish a bond for the prompt, full and faithful payment to any Claimant, as hereinafter defined, for all labor, materials or services used or reasonably required for use in the performance of the Work of the Project, concurrently with delivery to the City of Pasadena of the signed Contract;

NOW THEREFORE, we the undersigned Principal, and

(Name, address, and telephone number of Surety) as Surety are held and firmly bound to the CITY OF PASADENA (“Obligee”) for payment of the penal sum of ($ ), this amount being not less than one hundred percent (100%) of the total Contract Sum, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we hold and firmly bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, by these presents.

THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if said Principal, shall fail to pay any of the persons named in Civil Code Section 9100 (“Claimants”), for all labor, materials or services used or reasonably required for use in performance of the Work of the Project, or for any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant on the Project, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the Contractor and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor, that the surety or sureties herein will pay for the same in an amount not exceeding the sum specified in this bond, otherwise the above obligation shall be void.

In case suit is brought upon this bond, the said Surety will pay a reasonable attorneys’ fee to be fixed by the court. Principal and Surety agree that this Payment Bond shall not be considered a part of the Contract. Principal and Surety further agree that this Payment Bond is a separate obligation of the Principal and its Surety, and that any attorneys’ fee provision contained in this Payment Bond shall not apply to the Contract. In the event there is any litigation between the parties arising from the breach of the Contract, each party will bear its own attorneys’ fees in the litigation.

This bond shall inure to the benefit of any of the persons named in Civil Code Section 9100 as to give a right of action to such persons or the assigns in any suit brought upon this bond.

The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition, modification or supplement to the terms of the Contract, or to the Work to be performed thereunder, or to the Contract Documents, shall in any way affect or release the obligations of the Surety under this bond, and Surety does hereby waive notice of any such change, extension of time, alteration, addition, modifications, or supplement to the terms of the Contract, or to the Work, or to the Contract Documents.

IN WITNESS WHEREOF, two (2) originals of this instrument, each of which shall for all purposes be deemed an original hereof, have been duly executed by the Principal and Surety, on the day of , 20___, the name of each corporate party being hereto affixed and duly signed by its undersigned representative pursuant to authority of its governing body.

Surety Name

By:

(Signature)

Printed Name/Attorney-in-Fact

Principal Name

(Printed Name)

Its:

(President/Vice-President/Chairman of the Board)

(Corporate Seal)

(Secretary/Assistant Secretary/

CFO/Assistant Treasurer)

(Attach Attorney-in-Fact Certificate, Corporate Seal and Surety Seal)

NOTE:

1. Execution of this bond must be acknowledged by both PRINCIPAL and SURETY before a Notary Public and Notary’s certificate of each acknowledgement must be attached.

2. A corporation must execute this bond by duly authorized officers or agents, and a certified copy of a resolution of its Board of Directors authorizing such execution, or other evidence of authority for such execution, must be attached if executed by persons other than the officers listed in Section 313, California Corporations Code.

PERFORMANCE BOND

KNOW ALL PERSONS BY THESE PRESENTS THAT:

WHEREAS, the City of Pasadena has awarded to

(Name, address, and telephone number of Contractor) designated as the “Contractor” or “Principal” herein, a Contract for the Work described as follows: Fire Station 31 – Sesimic Retrofit and Tenant Improvements located at 135 S Fair Oaks Ave in the City of Pasadena (hereinafter “Building”), which Contract and all Contract Documents set forth therein are incorporated herein and made a part hereof by this reference.

WHEREAS, by the terms of the Bidding Documents and Contract Documents, Principal is required to furnish a bond guaranteeing the, prompt, full and faithful performance of its obligations under the Contract Documents, concurrently with delivery to the City of Pasadena of the signed Contract.

NOW THEREFORE, we, the undersigned Principal, and

(Name, address, and telephone number of Surety) as Surety are held and firmly bound unto the CITY OF PASADENA (“Obligee”) in the penal sum of ($ ), this amount being not less than one hundred percent (100%) of the total Contract Sum, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we hold and firmly bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, by these presents for the prompt, full and faithful performance of the Contract Documents, which are hereinabove incorporated by reference.

THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the Principal shall promptly, fully and faithfully perform each and all of the obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract Documents as said Contract Documents may be modified or amended from time to time; and if the Principal shall indemnify and save harmless the Obligee and all of its officers, agents and employees from any and all losses, liability and damages, claims, judgments, stop notices, costs, and fees of every description, whether imposed by law or equity, which may be incurred by the Obligee by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract Documents, as they may be amended and supplemented including, but not limited to, Principal’s liability for Obligee’s damages (including direct and consequential damages incurred by the Obligee for: rental expenses; losses of use, income, profit, business, and reputation; increased financing costs; and loss of management or employee productivity or of the services of such persons) caused by Principal’s delays, as well as Principal’s liability for other delay damages or liquidated damages, and any warranties or guarantees required thereunder; then this obligation shall be void; otherwise, it shall be, and remain, in full force and effect.

The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, addition, modification or supplement to the terms of the Contract, or to the Work to be performed thereunder, or to the Contract Documents, shall in any way affect or release the obligations of the Surety under this bond, and Surety does hereby waive notice of any change, extension of time, alteration, addition, modification, supplement to the terms of the Contract, or to the Work to be performed thereunder, or to the Contract Documents.

The guarantees contained herein shall survive the final completion of the Work called for in the Contract Documents with respect to the obligations and liabilities of the Principal which survive such final completion.

In case suit is brought upon this bond, the said Surety will pay a reasonable attorneys’ fee to be fixed by the court. Principal and Surety agree that this Faithful Performance Bond shall not be considered a part of the Contract. Principal and Surety further agree that this Faithful Performance Bond is a separate obligation of the Principal and its Surety, and that any attorneys’ fee provision contained in this Faithful Performance Bond shall not apply to the Contract. In the event there is any litigation between the parties arising from the breach of the Contract, each party will bear its own attorneys’ fees in the litigation.

IN WITNESS WHEREOF, two (2) originals of this instrument, each of which shall for all purposes be deemed an original hereof, have been executed by Principal and Surety, on the day of , 20___, the name of each corporate party being hereto affixed and duly signed by its undersigned representatives pursuant to authority of its governing body.

Surety Name

Printed Name/Attorney-in-Fact

Principal Name

(President/Vice-President/Chairman of the Board)

(Secretary/Assistant Secretary/

CFO/Assistant Treasurer)

(Attach Attorney-in-Fact Certificate, Corporate Seal and Surety Seal)

NOTE:

1. Execution of this bond must be acknowledged by both PRINCIPAL and SURETY before a Notary Public and Notary’s certificate of each acknowledgement must be attached.

2. A corporation must execute this bond by duly authorized officers or agents, and a certified copy of a resolution of its Board of Directors authorizing such execution, or other evidence of authority for such execution, must be attached if executed by persons other than the officers listed in Section 313, California Corporations Code.

APPENDIX 2

Construction Administration Forms

Construction Administration Forms

1. Change Order

2. Construction Change Directive

3. Unilateral Change Order

4. Work Directive

5. Conditional Waiver Upon Progress Payment

6. Unconditional Waiver Upon Progress Payment

7. Conditional Waiver Upon Final Payment

8. Unconditional Waiver Upon Final Payment

9. Declaration to Procure Progress Payment (Conditional)

10. Declaration to Procure Progress Payment (Unconditional)

11. Declaration to Procure Final Payment (Conditional)

12. Declaration to Procure Final Payment (Unconditional)

13.

14.

Affidavit of Final Completion

Contractor General Warranty Form

15. Consent of Surety to Release of Retention or Final Payment

16. Sworn Statement and Warranty Regarding Continuing Insurance Obligations

CHANGE ORDER

Agreement Date: Change Order #:

To: Date Issued:

The following change is hereby made a part of the Contract Documents enumerated in the Agreement Between Owner and Contractor on the date referenced above and shall be performed under the same terms and conditions as required by the original Contract Documents. Except as modified herein, the original Contract Documents and all prior amendments shall remain in full force and effect and all of the terms of the Contract Documents are hereby incorporated in this Change Order.

Description of this Change and Approved CPR/COR’s:

[Description of changes to Drawings and/or Specifications, insert CPR/COR # and Description] requested by Owner.

Reason:

Credit/Add

Original Contract Sum ……………………………………………………... $ Net change by previous Change Orders…………………………………. $ Contract Sum prior to this Change Order was…………………………… $ Contract Sum will be increased/decreased by this Change Order in the amount of ………………………………………………………………..

Adjusted Contract Sum including this Change Order is ……………... $ Contract Time will be increased/decreased by: ………………………… ________ days Calendar Date of Substantial Completion as of this Change Order…...

This Change Order is in full compromise and settlement of all adjustments to Contract Time and Contract Sum, and compensation for any and all delay, extended or additional field and home office overhead, disruption, acceleration, inefficiencies, lost labor or equipment productivity, differing site conditions, construction interferences and other extraordinary or consequential damages (hereinafter called “Impacts”), including any ripple or cumulative effect of said Impacts on the overall Work under the Contract arising directly or indirectly from the performance of Work described in this Change Order. By execution of this Change Order, Contractor agrees that this Change Order constitutes a complete accord and satisfaction with respect to all claims for schedule extension, Impacts, or any costs of any nature, character or kind arising out of or incidental to this Change Order.

City of Pasadena

100 North Garfield Avenue Pasadena, CA 91101

BY:

Name:

DATE:

OWNER

ARCHITECT:

ARCHITECT

CONTRACTOR

CONSTRUCTION CHANGE DIRECTIVE

Distribution to: OWNER □ ARCHITECT □ CONTRACTOR □

PROJECT:

DIRECTIVE NO.: ____________

ADDRESS: ______________________________________

DATE: ___________________

CONTRACT DATE: ___________________

TO CONTRACTOR: ___________________

CONTRACT FOR: ___________________

You are hereby directed to make the following change(s) to this Contract:

PROPOSED ADJUSTMENTS

1. The proposed basis of adjustment to the Contract Sum is:

[ ] Lump Sum (increase)(decrease) of $ __________________.

[ ] Unit Price of $ ______________ per _______________.

[ ] Daily time and materials records of actual costs plus a Contractor Fee for overhead and profit, as provided in Subparagraph 7.3.11 of AIA Document A201-2017, subject to a Not-To-Exceed Amount of

[ ] as follows:

2. The Contract Time is proposed to (be adjusted) (remain unchanged). The proposed adjustment, if any, is (an increase of days) (a decrease of days).

If Contractor disagrees with the proposed adjustments he must submit his own proposal within 10 days of date pursuant to Contract Documents or proposed adjustment will become final and binding on Contractor.

When signed by the Owner and Architect and received by the Contractor, this document becomes effective IMMEDIATELY as a Construction Change Directive (CCD), and the Contractor shall proceed with the change(s) described above.

100 N. Garfield Avenue

ARCHITECT:

CONTRACTOR

UNILATERAL CHANGE ORDER

Distribution to: OWNER X ARCHITECT X CONTRACTOR X

PROJECT: UNILATERAL CHANGE NO:

ADDRESS:

ISSUE DATE:

CONTRACT DATE:

TO CONTRACTOR: CONTRACT FOR:

The following changes are hereby made a part of the Contract Documents enumerated in the Agreement Between Owner and Contractor on the date referenced above. Except as modified herein, the original Contract Documents and all prior amendments shall remain in full force and effect and all of the terms of the Contract Documents are hereby incorporated in this Unilateral Change Order.

Description Add/Deduct

TOTAL

Original Contract Sum ………………………………………………………. $ Net change by previous Change Orders and Construction Change Directives ………………………………………………………………………

Contract Sum prior to this Unilateral Change Order was………………… $ Contract Sum will be increased/decreased by this Unilateral Change Order in the amount of ……………………………………………………….

Adjusted Contract Sum including this Unilateral Change Order is… $ Contract Time will be increased/decreased by: ………………………….. ________ days Date of Substantial Completion as of this Unilateral Change Order is…..

When signed by the Owner and Architect and received by the Contractor, this document becomes effective IMMEDIATELY as a Unilateral Change Order (UCO).

ARCHITECT:

WORK DIRECTIVE

Distribution to: OWNER □ ARCHITECT □ CONTRACTOR □ FIELD □ OTHER □

PROJECT: (Name, Address) WORK DIRECTIVE NO.:

Project: ______________________________________________________ DATE:

ADDRESS: __________________________________________________

TO CONTRACTOR: __________________________________________ CONTRACT DATE:

(Name, Address):

CONTRACT FOR:

You are hereby directed to continue performance of the following Work, without delay, pending resolution of the dispute concerning such Work and maintain the cost data described in paragraph 7.3.4 of the General Conditions for the performance of such Work:

Provide labor and material according to the scope, procedures and schedule identified in Exhibit F, at no cost to the

Owner.

Work to commence on ___________________, 20_____.

Neither the issuance of this Work Directive nor the requirement for the Contractor to maintain cost data constitutes approval by the Owner of a change in the Work or Modification of the Contract Documents.

CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT

[California Civil Code § 8132]

NOTICE: THIS DOCUMENT WAIVES THE CLAIMANT’S LIEN, STOP PAYMENT NOTICE, AND

PAYMENT BOND RIGHTS EFFECTIVE ON RECEIPT OF PAYMENT. A PERSON SHOULD NOT RELY

ON THIS DOCUMENT UNLESS SATSIFIED THAT THE CLAIMANT HAS RECEIVED PAYMENT.

Identifying Information

Name of Claimant:

Name of Customer:

Job Location:

Owner:

Through Date:

Conditional Waiver and Release

This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job through the Through Date of this document. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant are waived and released by this document, unless listed as an Exception below. This document is effective only on the claimant’s receipt of payment from the financial institution on which the following check is drawn:

Maker of Check:

Amount of Check: $

Check Payable to:

Exceptions

This document does not affect any of the following:

(1) Retentions.

(2) Extras for which the claimant has not received payment.

(3) The following progress payments for which the claimant has previously given a conditional waiver and release but has not received payment:

Date(s) of waiver and release:

Amount(s) of unpaid progress payment(s):

(4) Contract rights, including (A) a right based on rescission, abandonment, or breach of contract, and

(B) the right to recover compensation for work not compensated by the payment.

Signature

Claimant’s Signature:

Claimant’s Title:

Date of Signature:

UNCONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT

[California Civil Code § 8134]

NOTICE TO CLAIMANT: THIS DOCUMENT WAIVES AND RELEASES LIEN< STOP

PAYMENT NOTICE, AND PAYMENT BOND RIGHTS UNCONDITIONALLY AND STATES

THAT YOU HAVE BEEN PAID FOR GIVING UP THOSE RIGHTS. THIS DOCUMENT IS

ENFORCEABLE AGAINST YOU IF YOU SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF

YOU HAVE NOT BEEN PAID, USE A CONDITIONAL WAIVER AND RELEASE FORM.

Identifying Information

Name of Claimant:

Name of Customer:

Job Location:

Through Date:

Unconditional Waiver and Release

This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job through the Through Date of this document. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant are waived and released by this document, unless listed as an Exception below. The claimant has received the following progress payment:

(1) Retentions.

(2) Extras for which the claimant has not received payment.

(3) Contract rights, including (A) a right based on rescission, abandonment, or breach of contract, and (B) the right to recover compensation for work not compensated by the payment.

CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT

[California Civil Code §8136]

NOTICE: THIS DOCUMENT WAIVES THE CLAIMANT’S LIEN, STOP PAYMENT NOTICE,

AND PAYMENT BOND RIGHTS EFFECTIVE ON RECEIPT OF PAYMENT. A PERSON

SHOULD NOT RELY ON THIS DOCUMENT UNLESS SATSIFIED THAT THE CLAIMANT HAS

RECEIVED PAYMENT.

Identifying Information

Name of Claimant:

Name of Customer:

Job Location:

Owner:

Conditional Waiver and Release

This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant are waived and released by this document, unless listed as an Exception below. This document is effective only on the claimant’s receipt of payment from the financial institution on which the following check is drawn:

Maker of Check:

Amount of Check: $

Check Payable to:

Exceptions

This document does not affect any of the following:

Disputed claims for extras in the amount of: $

Signature

Claimant’s Signature:

UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT

[California Civil Code §8138]

NOTICE TO CLAIMANT: THIS DOCUMENT WAIVES AND RELEASES LIEN, STOP

PAYMENT NOTICE, AND PAYMENT BOND RIGHTS UNCONDITIONALLY AND STATES

THAT YOU HAVE BEEN PAID FOR GIVING UP THOSE RIGHTS. THIS DOCUMENT IS

ENFORCEABLE AGAINST YOU IF YOU SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF

YOU HAVE NOT BEEN PAID, USE A CONDITIONAL WAIVER AND RELEASE FORM.

Identifying Information

Name of Claimant:

Name of Customer:

Job Location:

Unconditional Waiver and Release

This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant are waived and released by this document, unless listed as an Exception below. The claimant has been paid in full.

Disputed claims for extras in the amount of: $

ISSUED FOR BID

2/10/2022

APPENDIX 2 – CONSTRUCTION ADMINISTRATION FORMS

00 04 02-10

DECLARATION TO PROCURE PROGRESS PAYMENT AND RELEASE OF CONTRACT RIGHTS

[Name of Releasing Company As It Appears On The Release]

[Project]: _____________________________________________________________________

[Through Date As It Appears On The Release]

The company named above has executed a Conditional Waiver and Release Upon Progress Payment, pursuant to Cal.

Civil Code section 8132 through the date shown above. The statutory form of release provides that it does not release extras furnished before the Through Date for which payment has not been received or the right to recover compensation for furnished labor, services, equipment or material that was not compensated by the progress payment. The statutory release also provides that it does not cover contract rights, including rights based on rescission, abandonment or breach of contract.

In order to induce payment of the amount shown in the statutory release, the undersigned individual hereby declares that the company named above did not furnish any extras or any labor, services, equipment or material before the Through Date that was not compensated by the progress payment, except for the items listed below.

By execution of this document, the company also hereby releases all contract rights and all other legal and equitable claims that it has with regard to labor, service, equipment or material furnished through the Through Date including rights and claims for direct and indirect costs based on rescission, abandonment, breach of contract, delay, disruption or acceleration.

This Declaration and Release of Contract Rights is conditional, and shall be effective only when the check described on the statutory Conditional Waiver and Release form that accompanies this document has been properly endorsed and paid by the bank upon which it is drawn.

EXCEPTIONS

[Record Any Exceptions In This Space. If No Exceptions, Write “None.”]

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Signed at

__________________________________ California, on [Location] [Date of Signature]

[Signature]

[Print Name]

[Title]

NOTE: This form is designed to accompany a statutory

CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT.

00 04 02-11

DECLARATION TO PROCURE PROGRESS PAYMENT AND RELEASE OF CONTRACT RIGHTS

[Project]: _____________________________________________________________________

[Through Date As It Appears On The Release]

The company named above has executed an Unconditional Waiver and Release Upon Progress Payment, pursuant to Cal. Civil Code section 8134 through the date shown above. The statutory form of release provides that it does not release extras furnished before the Through Date for which payment has not been received or the right to recover compensation for furnished labor, services, equipment or material that was not compensated by the progress payment.

The statutory release also provides that it does not cover contract rights, including rights based on rescission, abandonment or breach of contract.

In order to induce payment of the amount shown in the statutory release, the undersigned individual hereby declares that the company named above did not furnish any extras or any labor, services, equipment or material before the Through Date that was not compensated by the progress payment, except for the items listed below.

By execution of this document, the company also hereby releases all contract rights and all other legal and equitable claims that it has with regard to labor, service, equipment or material furnished through the Through Date including rights and claims for direct and indirect costs, based on rescission, abandonment, breach of contract, delay, disruption or acceleration.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

UNCONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT.

00 04 02-12

DECLARATION TO PROCURE FINAL PAYMENT AND RELEASE OF CONTRACT RIGHTS

[Project]

[Date As It Appears On The Release]

The company named above has executed a Conditional Waiver and Release Upon Final Payment, pursuant to Cal. Civil Code section 8136 on the date shown above.

In order to induce payment of the amount shown in the statutory release, the undersigned individual hereby declares that the company named above did not furnish any extras or any labor, services, equipment or material on the Project that was not compensated by the final payment, except for the items listed below.

By execution of this document, the company also hereby releases all contract rights and all other legal and equitable claims that it has with regard to labor, service, equipment or material furnished on the Project including rights and claims for direct and indirect costs based on rescission, abandonment, breach of contract, delay, disruption or acceleration.

This Declaration and Release of Contract Rights is conditional, and shall be effective only when the check described on the statutory Conditional Waiver and Release form that accompanies this document has been properly endorsed and paid by the bank upon which it is drawn.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

CONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT.

00 04 02-13

DECLARATION TO PROCURE FINAL PAYMENT AND RELEASE OF CONTRACT RIGHTS

[Project]

[Date As It Appears On The Release]

The company named above has executed an Unconditional Waiver and Release Upon Final Payment, pursuant to Cal. Civil Code section 8138 on the date shown above.

In order to induce payment of the amount shown in the statutory release, the undersigned individual hereby declares that the company named above did not furnish any extras or any labor, services, equipment or material on the Project that was not compensated by the final payment, except for the items listed below.

By execution of this document, the company also hereby releases all contract rights and all other legal and equitable claims that it has with regard to labor, service, equipment or material furnished on the Project including rights and claims for direct and indirect costs based on rescission, abandonment, breach of contract, delay, disruption or acceleration.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

UNCONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT.

APPENDIX 2 – CONSTRUCTION ADMINISTRATION

FORMS

AFFIDAVIT OF FINAL COMPLETION

To: City of Pasadena

From:

Project: ________________________________________________

ADDRESS: ________________________________________________

Contract No.: ____________________________

Contract Date: ___________________________

I, , declare to the best of my knowledge and belief that:

1. I am the person and officer of

(“Contractor”) as indicated on the execution line of this affidavit; I am duly authorized to make this affidavit and to execute and deliver the attached Application for Final Payment and I am familiar with the terms and conditions of the construction contract for the Project (“Contract”);

2. The Work of the Contract has been completed in strict accordance with the Contract Documents;

3. No lawful debts of Contractor for labor or materials or other claims are outstanding for the Work.

4. No Federal Excise Tax has been included in the Contract Price;

5. No additional compensation, over and above the amount set forth in the enclosed Application for Final Payment is due Contractor under the Contract for the Work and any changes in the Work;

6. Upon receipt of Final Payment in the amount of $ , Contractor, on behalf of itself and its Subcontractors and Suppliers acknowledges that City and any and all employees of City and its authorized representatives will thereby be released from any and all Claims or liability for additional sums for Work or changes in the Work and Contractor encloses herewith an original duly executed and complete conditional waiver and release upon final payment in accordance with California Civil Code section 8138 from Contractor and from

7. Contractor has obtained release of all claims by Subcontractors, Suppliers and others against Contractor and the Project;

8. Contractor has no reason to believe that any third party has a valid claim against the Contractor, the Work, the Project or the City which has not been communicated in writing by the Contractor to City as of the date of this affidavit;

9. Any guarantees and warranties are in full force and effect;

10. I understand that this affidavit is made for the purpose of inducing City to consent to release of retention and to make Final Payment to Contractor and City will rely upon the accuracy of the matters stated in this affidavit.

I declare, under penalty of perjury of the laws of the State of California that the foregoing is true and correct.

Executed this day of , 20__ at , California.

(Name)

(Title)

CONTRACTOR GENERAL WARRANTY FORM

To: City of Pasadena

From:

Contract No.:

We, ______________________________, performed work at the above referenced project per our contract agreement and do hereby warrant that all labor and materials furnished and work performed are in accordance with the contract documents and authorized modifications thereto, and will be free from defects due to defective materials or workmanship for a period of one year from Date of Final Completion. This warranty commences on ____________ (Date of Final Completion) and expires on _____________ (One year from Commencement Date and/or Correction Date).

Should any defect develop during the warranty period due to improper materials, workmanship or arrangement, the defect, including adjacent work displaced, shall be made good by the undersigned at no expense to the Owner.

Written notice of defective work will be given to the Contractor. Should the Contractor fail to correct defective work within a reasonable time after receiving written notice, the Owner may, at his option, correct defects and charge the Contractor costs for such correction. The Contractor agrees to pay such charges upon demand.

Nothing in the above shall be deemed to apply to work which has been abused or neglected by the Owner.

Signature Date

Printed Name

Title

CONSENT OF SURETY TO RELEASE OF RETENTION OR FINAL PAYMENT

To Owner: City of Pasadena

Pasadena, CA 91101

Attention:

To Contractor: _______________________________________

Contract Date:

Bond No(s):

In accordance with the provisions of the Contract between Owner and Contractor, as indicated above, as Surety on bond number(s) , hereby consents to [full/partial] release of [retention/final payment] to Contractor and agrees that neither payment, nor any other act pursuant to final payment to Contractor, shall exonerate, abrogate, relieve or in any way discharge any duties or obligations of the Surety to Owner or any other obliges under the bond(s).

IN WITNESS, WHEREOF, consent to the foregoing is hereby given this _____________ day of _____________, 20___.

[INSERT NAME OF SURETY]

By

(Signature of authorized representative)

Its (Printed name and title)

STATE OF ______________ )

) ss.

COUNTY OF ____________ )

[Attach notary acknowledgement and power of attorney]

SWORN STATEMENT AND WARRANTY

REGARDING CONTINUING INSURANCE OBLIGATIONS

FROM:

(Name or Title of Person Making Declaration) [insert Contractor name and address]

TO: City of Pasadena

PROJECT:

ADDRESS:

DECLARATION

Attached hereto is a true and correct copy of the current Certificate of Insurance and Additional Insured Endorsement which complies with the insurance requirements of the aforementioned Project as set forth in the Construction Contract and incorporated into the undersigned’s Contract (“Contract”).

I declare under penalty of perjury under the laws of the State of California that the above statement is true and correct.

Signed on ________________, 20___, at _______________________________

(Date) (City, State)

(Signature of Individual Who is Making Declaration)

APPENDIX 3

Hazardous Materials Survey

APPENDIX 4

Geotechnical Survey

APPENDIX 5

Federal Minimum Wages

"General Decision Number: CA20230022 01/13/2023

Superseded General Decision Number: CA20220022

State: California

Construction Types: Building, Heavy (Heavy and Dredging) and Highway

County: Los Angeles County in California.

BUILDING CONSTRUCTION PROJECTS; DREDGING PROJECTS (does not include hopper dredge work); HEAVY CONSTRUCTION PROJECTS (does not include water well drilling); HIGHWAY CONSTRUCTION PROJECTS

Note: Contracts subject to the Davis-Bacon Act are generally required to pay at least the applicable minimum wage rate required under Executive Order 14026 or Executive Order 13658.

Please note that these Executive Orders apply to covered contracts entered into by the federal government that are subject to the Davis-Bacon Act itself, but do not apply to contracts subject only to the Davis-Bacon Related Acts, including those set forth at 29 CFR 5.1(a)(2)-(60).

|If the contract is entered |. Executive Order 14026 | |into on or after January 30, | generally applies to the | |2022, or the contract is | contract. | |renewed or extended (e.g., an |. The contractor must pay | |option is exercised) on or | all covered workers at | |after January 30, 2022: | least $16.20 per hour (or | | | the applicable wage rate | | | listed on this wage | | | determination, if it is | | | higher) for all hours | | | spent performing on the | | | contract in 2023. | |If the contract was awarded on|. Executive Order 13658 | |or between January 1, 2015 and| generally applies to the | |January 29, 2022, and the | contract. | |contract is not renewed or |. The contractor must pay all| |extended on or after January | covered workers at least | |30, 2022: | $12.15 per hour (or the | | | applicable wage rate listed| | | on this wage determination,| | | if it is higher) for all | | | hours spent performing on | | | that contract in 2023. |

The applicable Executive Order minimum wage rate will be adjusted annually. If this contract is covered by one of the Executive Orders and a classification considered necessary for performance of work on the contract does not appear on this wage determination, the contractor must still submit a conformance request.

Additional information on contractor requirements and worker protections under the Executive Orders is available at http://www.dol.gov/whd/govcontracts.

Modification Number Publication Date 0 01/06/2023 1 01/13/2023

ASBE0005-002 07/04/2022

Rates Fringes

Asbestos Workers/Insulator (Includes the application of all insulating materials, protective coverings, coatings, and finishes to all types of mechanical systems).....$ 49.58 25.27 Fire Stop Technician (Application of Firestopping Materials for wall openings and penetrations in walls, floors, ceilings and curtain walls)...........................$ 32.09 19.66

ASBE0005-004 07/04/2022

Rates Fringes

Asbestos Removal worker/hazardous material handler (Includes preparation, wetting, stripping, removal, scrapping, vacuuming, bagging and disposing of all insulation materials from mechanical systems, whether they contain asbestos or not)....$ 23.52 13.37

BOIL0092-003 01/01/2021

Rates Fringes

BOILERMAKER......................$ 46.03 38.81

* BRCA0004-007 05/01/2020

Rates Fringes

BRICKLAYER; MARBLE SETTER........$ 41.53 19.48

*The wage scale for prevailing wage projects performed in Blythe, China lake, Death Valley, Fort Irwin, Twenty-Nine Palms, Needles and 1-15 corridor (Barstow to the Nevada State Line) will be Three Dollars ($3.00) above the standard San Bernardino/Riverside County hourly wage rate

BRCA0018-004 06/01/2022

Rates Fringes

MARBLE FINISHER..................$ 37.87 14.13

TILE FINISHER....................$ 32.44 12.54

TILE LAYER.......................$ 45.05 18.33

BRCA0018-010 09/01/2022

Rates Fringes

TERRAZZO FINISHER................$ 38.37 14.13

TERRAZZO WORKER/SETTER...........$ 46.49 14.66

CARP0213-001 07/01/2021

CARPENTER

(1) Carpenter, Cabinet Installer, Insulation Installer, Hardwood Floor Worker and acoustical installer...................$ 51.60 16.28

(2) Millwright..............$ 52.10 16.48

(3) Piledrivermen/Derrick Bargeman, Bridge or Dock Carpenter, Heavy Framer, Rock Bargeman or Scowman, Rockslinger, Shingler (Commercial)................$ 51.73 16.28

(4) Pneumatic Nailer, Power Stapler...............$ 51.85 16.28

(5) Sawfiler...............$ 51.69 16.28

(6) Scaffold Builder.......$ 42.80 16.28

(7) Table Power Saw Operator....................$ 51.70 16.28

FOOTNOTE: Work of forming in the construction of open cut sewers or storm drains, on operations in which horizontal lagging is used in conjunction with steel H-Beams driven or placed in pre- drilled holes, for that portion of a lagged trench against which concrete is poured, namely, as a substitute for back forms (which work is performed by piledrivers): $0.13 per hour additional.

CARP0213-002 07/01/2021

Rates Fringes

Diver

(1) Wet.....................$ 834.40 16.28

(2) Standby.................$ 445.84 16.28

(3) Tender..................$ 437.84 16.28

(4) Assistant Tender........$ 413.84 16.28

Amounts in ""Rates' column are per day

CARP0213-004 07/01/2021

Rates Fringes

Drywall

DRYWALL INSTALLER/LATHER....$ 51.60 16.28

STOCKER/SCRAPPER............$ 22.16 8.62

CARP0721-001 07/01/2021

Rates Fringes

Modular Furniture Installer......$ 21.85 7.15

ELEC0011-004 07/25/2022

Rates Fringes

ELECTRICIAN (INSIDE

ELECTRICAL WORK)

Journeyman Electrician......$ 55.05 3%+29.37

ELECTRICIAN (INTELLIGENT

TRANSPORTATION SYSTEMS Street Lighting, Traffic Signals, CCTV,and Underground Systems) Journeyman Transportation Electrician.................$ 57.20 3%+29.37 Technician..................$ 42.90 3%+29.37

FOOT NOTE:

CABLE SPLICER & INSTRUMENT PERSON: Recieve 5% additional per hour above Journeyman Electrician basic hourly rate.

TUNNEL WORK: 10% additional per hour.

SCOPE OF WORK - TRANSPORTATION SYSTEMS

ELECTRICIAN:

Installation of street lights and traffic signals,including electrical circuitry, programmable controllers, pedestal-mounted electrical meter enclosures and laying of pre-assembled multi-conductor cable in ducts, layout of electrical systems and communication installation, including proper position of trench depths and radius at duct banks, location for man holes, pull boxes, street lights and traffic signals.

Installation of underground ducts for electrical,telephone, cable television and communication systems.

Pulling,termination and splicing of traffic signal and street lighting conductors and electrical systems including interconnect,detector loop, fiber optic cable and video/cable.

TECHNICIAN:

Distribution of material at job site, manual excavation and backfill, installation of system conduits and raceways for electrical, telephone, cable television and communication systems. Pulling, terminating and splicing of traffic signal and street lighting conductors and electrical systems including interconnect, detector loop, fiber optic cable and video/data.

* ELEC0011-005 12/27/2021

COMMUNICATIONS & SYSTEMS WORK (excludes any work on Intelligent Transportation Systems or CCTV highway systems)

Rates Fringes

Communications System Installer...................$ 43.87 3%+15.03 Technician..................$ 33.30 3%+27.82

SCOPE OF WORK The work covered shall include the installation, testing, service and maintenance, of the following systems that utilize the transmission and/or transference of voice, sound, vision and digital for commercial, education, security and entertainment purposes for TV monitoring and surveillance, background foreground music, intercom and telephone interconnect, inventory control systems, microwave transmission, multi-media, multiplex, nurse call system, radio page, school intercom and sound, burglar alarms and low voltage master clock systems.

A. Communication systems that transmit or receive information and/or control systems that are intrinsic to the above listed systems SCADA (Supervisory control/data acquisition

PCM (Pulse code modulation) Inventory control systems Digital data systems Broadband & baseband and carriers Point of sale systems VSAT data systems Data communication systems RF and remote control systems Fiber optic data systems

B. Sound and Voice Transmission/Transference Systems Background-Foreground Music Intercom and Telephone Interconnect Systems Sound and Musical Entertainment Systems Nurse Call Systems Radio Page Systems School Intercom and Sound Systems Burglar Alarm Systems Low-Voltage Master Clock Systems Multi-Media/Multiplex Systems Telephone Systems RF Systems and Antennas and Wave Guide

C. *Fire Alarm Systems-installation, wire pulling and testing.

D. Television and Video Systems Television Monitoring and Surveillance Systems Video Security Systems Video Entertainment Systems Video Educational Systems CATV and

CCTV

E. Security Systems, Perimeter Security Systems, Vibration Sensor Systems Sonar/Infrared Monitoring Equipment, Access Control Systems, Card Access Systems

*Fire Alarm Systems

1. Fire Alarms-In Raceways: Wire and cable pulling in raceways performed at the current electrician wage rate and fringe benefits.

2. Fire Alarms-Open Wire Systems: installed by the Technician.

ELEC1245-001 06/01/2022

Rates Fringes

LINE CONSTRUCTION

(1) Lineman; Cable splicer..$ 64.40 22.58

(2) Equipment specialist (operates crawler tractors, commercial motor vehicles, backhoes, trenchers, cranes (50 tons and below), overhead & underground distribution line equipment).............$ 50.00 21.30

(3) Groundman...............$ 38.23 20.89

(4) Powderman...............$ 51.87 18.79

HOLIDAYS: New Year's Day, M.L. King Day, Memorial Day, Independence Day, Labor Day, Veterans Day, Thanksgiving Day and day after Thanksgiving, Christmas Day

* ELEV0018-001 01/01/2023

Rates Fringes

ELEVATOR MECHANIC................$ 63.95 37.335+a+b

FOOTNOTE:

a. PAID VACATION: Employer contributes 8% of regular hourly rate as vacation pay credit for employees with more than 5 years of service, and 6% for 6 months to 5 years of service.

b. PAID HOLIDAYS: New Year's Day, Memorial Day, Independence Day, Labor Day, Veterans' Day, Thanksgiving Day, Friday after Thanksgiving, and Christmas Day.

ENGI0012-003 07/01/2022

Rates Fringes

OPERATOR: Power Equipment (All Other Work)

GROUP 1....................$ 51.90 30.70

GROUP 2....................$ 52.68 30.70

GROUP 3....................$ 52.97 30.70

GROUP 4....................$ 54.46 30.70

GROUP 5....................$ 48.96 25.25

GROUP 6....................$ 54.68 30.70

GROUP 8....................$ 54.79 30.70

GROUP 9....................$ 49.29 25.25

GROUP 10....................$ 54.91 30.70

GROUP 11....................$ 49.41 25.25

GROUP 12....................$ 55.08 30.70

GROUP 13....................$ 55.18 30.70

GROUP 14....................$ 55.21 30.70

GROUP 15....................$ 55.29 30.70

GROUP 16....................$ 55.41 30.70

GROUP 17....................$ 55.58 30.70

GROUP 18....................$ 55.68 30.70

GROUP 19....................$ 55.79 30.70

GROUP 20....................$ 55.91 30.70

GROUP 21....................$ 56.08 30.70

GROUP 22....................$ 56.18 30.70

GROUP 23....................$ 56.29 30.70

GROUP 24....................$ 56.41 30.70

GROUP 25....................$ 56.58 30.70

OPERATOR: Power Equipment (Cranes, Piledriving & Hoisting)

GROUP 1....................$ 53.25 30.70

GROUP 2....................$ 54.03 30.70

GROUP 3....................$ 54.32 30.70

GROUP 4....................$ 54.46 30.70

GROUP 5....................$ 54.68 30.70

GROUP 6....................$ 54.79 30.70

GROUP 7....................$ 54.91 30.70

GROUP 8....................$ 55.08 30.70

GROUP 9....................$ 55.25 30.70

GROUP 10....................$ 56.25 30.70

GROUP 11....................$ 57.25 30.70

GROUP 12....................$ 58.25 30.70

GROUP 13....................$ 59.25 30.70

OPERATOR: Power Equipment (Tunnel Work)

GROUP 1....................$ 54.53 30.70

GROUP 2....................$ 54.82 30.70

GROUP 3....................$ 54.96 30.70

GROUP 4....................$ 55.18 30.70

GROUP 5....................$ 55.29 30.70

GROUP 6....................$ 55.41 30.70

GROUP 7....................$ 55.71 30.70

PREMIUM PAY:

$3.75 per hour shall be paid on all Power Equipment Operator work on the followng Military Bases: China Lake Naval Reserve, Vandenberg AFB, Point Arguello, Seely Naval Base, Fort Irwin, Nebo Annex Marine Base, Marine Corp Logistics

Base Yermo, Edwards AFB, 29 Palms Marine Base and Camp Pendleton

Workers required to suit up and work in a hazardous material environment: $2.00 per hour additional. Combination mixer and compressor operator on gunite work shall be classified as a concrete mobile mixer operator.

SEE ZONE DEFINITIONS AFTER CLASSIFICATIONS

POWER EQUIPMENT OPERATORS CLASSIFICATIONS

GROUP 1: Bargeman; Brakeman; Compressor operator; Ditch Witch, with seat or similar type equipment; Elevator operator-inside; Engineer Oiler; Forklift operator (includes loed, lull or similar types under 5 tons;

Generator operator; Generator, pump or compressor plant operator; Pump operator; Signalman; Switchman

GROUP 2: Asphalt-rubber plant operator (nurse tank operator);

Concrete mixer operator-skip type; Conveyor operator;

Fireman; Forklift operator (includes loed, lull or similar types over 5 tons; Hydrostatic pump operator; oiler crusher (asphalt or concrete plant); Petromat laydown machine; PJU side dum jack; Screening and conveyor machine operator (or similar types); Skiploader (wheel type up to 3/4 yd.

without attachment); Tar pot fireman; Temporary heating plant operator; Trenching machine oiler

GROUP 3: Asphalt-rubber blend operator; Bobcat or similar type (Skid steer); Equipment greaser (rack); Ford Ferguson (with dragtype attachments); Helicopter radioman (ground);

Stationary pipe wrapping and cleaning machine operator

GROUP 4: Asphalt plant fireman; Backhoe operator (mini-max or similar type); Boring machine operator; Boxman or mixerman (asphalt or concrete); Chip spreading machine operator;

Concrete cleaning decontamination machine operator;

Concrete Pump Operator (small portable); Drilling machine operator, small auger types (Texoma super economatic or similar types - Hughes 100 or 200 or similar types -drilling depth of 30' maximum); Equipment greaser (grease truck); Guard rail post driver operator; Highline cableway signalman; Hydra-hammer-aero stomper; Micro Tunneling (above ground tunnel); Power concrete curing machine operator; Power concrete saw operator; Power-driven jumbo form setter operator; Power sweeper operator; Rock Wheel Saw/Trencher; Roller operator (compacting); Screed operator (asphalt or concrete); Trenching machine operator (up to 6 ft.); Vacuum or much truck

GROUP 5: Equipment Greaser (Grease Truck/Multi Shift).

GROUP 6: Articulating material hauler; Asphalt plant engineer; Batch plant operator; Bit sharpener; Concrete joint machine operator (canal and similar type); Concrete planer operator; Dandy digger; Deck engine operator;

Derrickman (oilfield type); Drilling machine operator, bucket or auger types (Calweld 100 bucket or similar types

- Watson 1000 auger or similar types - Texoma 330, 500 or 600 auger or similar types - drilling depth of 45' maximum); Drilling machine operator; Hydrographic seeder machine operator (straw, pulp or seed), Jackson track maintainer, or similar type; Kalamazoo Switch tamper, or similar type; Machine tool operator; Maginnis internal full slab vibrator, Mechanical berm, curb or gutter(concrete or asphalt); Mechanical finisher operator (concrete, Clary-Johnson-Bidwell or similar); Micro tunnel system (below ground); Pavement breaker operator (truck mounted);

Road oil mixing machine operator; Roller…