ATTACHMENT A: SUPPLEMENTAL BID INFORMATION &

AUTHORIZATION & ACKNOWLEDGEMENT FORM

SIGNATURE PAGE

Organization

Company Name Company Address Website Federal Tax ID #

i. I am authorized by the bidder to submit this Invitation to Bid. NOTE: FAILURE TO COMPLY MAY RESULT IN DISQUALIFICATION OF YOUR BID. ALL SIGNATURES MUST BE NOTARIZED IF THE ENTITY IS LOCATED OUTSIDE THE STATE OF CALIFORNIA (see acknowledgment page).

a. INDIVIDUAL (Doing Business As): The only acceptable signature is the owner of the company. (Only one signature is required.)

b. PARTNERSHIP: The only acceptable signature(s) is/are that of the general partner or partners.

c. CORPORATION: Two (2) officers of the corporation must sign; OR the signature of one officer or the signature a of person other than an officer is acceptable if the Bid is accompanied by a certified corporate resolution granting express authority to said person to execute contracts on behalf of the corporation.

d. LIMITED LIABILITY COMPANY: The signature on the bid must be a member or, if the Articles provide for a manager, must be the manager. (Only one signature is required.)

ii. Under penalty of perjury that this bid is genuine and not a sham or collusive, or made in the interest or on behalf of any person or entity not herein named; that the Bidder has not directly or indirectly induced or solicited any other Bidder to submit a sham bid, or any other person or entity to refrain from bidding, and that the Bidder has not in any manner sought by collusion to secure to himself any advantage over other Bidders.

iii. No City employee whose position in the City enables him/her to influence the award of the Contract or any competing Contract, and no spouse or economic dependent of such employee is or shall be employed in any capacity by the Bidder herein, or does or shall have any direct or indirect financial interest in a potential resulting Contract.

iv. Inter-Agency Participation If other agencies express an interest in participating in this bid, would you supply the same items?

Yes No (If yes, any agency electing to participate in this Bid will order its own requirements without regard to the City of Long Beach. The City of Long Beach assumes no liability or payment guarantee on any units sold to participating agencies.)

v. I have read and agree to the City of Long Beach Vendor Code of Conduct.

Authorized Representative Signature Date

Title Email Address Phone Number

CITY OF LONG BEACH AUTHORIZATION

IN WITNESS WHEREOF the City of Long Beach has caused this contract to be executed as required by law as of the date stated below.

Director of Financial Management Signature Date

CITY OF LONG BEACH APPROVAL AS TO FORM

Deputy City Attorney Signature Date https://www.longbeach.gov/globalassets/city-manager/media-library/documents/ethics-commission/resources/vendor-code-of-conduct-2023

ACKNOWLEDGMENT

A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

State of California County of _________________________________)

On __________________________ before me, ____________________________________

(insert name and title of the officer) personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Signature _________________________ (Seal)

OPTIONAL

Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form.

CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT

INDIVIDUAL

CORPORATE OFFICER

TITLE OR TYPE OF DOCUMENT

TITLE(S)

PARTNER(S) LIMITED

GENERAL

ATTORNEY-IN-FACT NUMBER OF PAGES

TRUSTEE(S)

GUARDIAN/CONSERVATOR

OTHER:

DATE OF DOCUMENT

ATTACHMENT B: REFERENCES

PROPOSER CONTACT INFORMATION

Organization

Company Name

Company Address

Federal Tax ID Number

DIR Number

Website

Authorized Representative

Name

Title

Email Address

Phone Number

Other Point of Contact

Name

Title

Email Address

Phone Number

PROPOSER CAPACITY & EXPERIENCE

What type of enterprise is the organization?

☐ Non-Profit

☐ Sole Proprietorship

☐ General Partnership

☐ Corporation

State.and Date of.incorporation¿

☐ Limited Liability Company

☐ Other _________________________________

REFERENCES

Reference 1

Company

Project Manager

Phone Number

Project Description

Project Start and

End Dates

Reference 2

Company

Project Manager

Phone Number

Project Description

Reference 3

Project Manager

Phone Number

Project Description

Reference 4

Project Manager

Phone Number

Project Description

Reference 5

Project Manager

Phone Number

Project Description

TITLE RFP

Exhibit D 1 | P a g e

Debarment, Suspension, Ineligibility and Voluntary Exclusion Certification Please read Acceptance of Certification and Instructions for Certification before completing

As a current or potential Contractor for the City of Long Beach (City) your firm, through its business relationship with the City, may be the recipient of federal grant funds. As such, the City is required to document that neither your business entity or organization, nor any of your principals are debarred, suspended, ineligible, or have voluntarily been excluded from receiving federal grant funds.

Consistent with Executive Order No. 12549 Title 2 CFR Part 180 Subpart C, all potential recipients of federal grant funds are required to comply with the requirements specified below. By submission of proposal/bid/agreement, the undersigned, under penalty of perjury, certifies that the participant, nor any of its principals in the capacity of owner, director, partner, officer, manager, or other person with substantial influence in the development or outcome of a covered transaction, whether or not employed by the participant:

• Are not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal department or agency;

• Have not, within a three (3) year period preceding this bid/agreement/proposal, been suspended, debarred, voluntarily excluded or declared ineligible by a federal agency;

• Do not presently have a proposed debarment proceeding pending;

• Have not, within a three (3) year period preceding this bid/agreement/proposal, been indicted or convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct;

• Have not, within a three (3) year period preceding this bid/agreement/proposal, had one or more public transactions (Federal, State, or local) terminated for cause or default.

If reorganization, management turnover, or a shift or change of principals’ status occurs, written notice must be submitted within 21 days. Subsequent disclosure of unfavorable information will be subject to thorough review and remedial action. Updated versions of this certification may be requested on a routine basis.

Where the potential prospective recipient of Federal assistance funds is unable to certify to any of the statement in this certification, such prospective participant shall attach an explanation to the applicable bid/agreement/proposal.

Business/Contractor/Agency

Name of Authorized Representative Title of Authorized Representative

Signature of Authorized Representative Date r20141001

ATTACHMENT IV: DEBARMENT, SUSPENSION, INELIGIBILITY AND

VOLUNTARY EXCLUSION CERTIFICATION

TITLE RFP

Exhibit D 2 | P a g e

Acceptance of Certification

1. This bid/agreement/proposal or like document has the potential to be a recipient of Federal funds.

In order to be in compliance with Code of Federal Regulations, the City requires this completed form. By signing and submitting this document, the prospective bidder/Contractor is providing the certification and acknowledgement as follows:

2. The terms “covered transaction,” “debarred,” “suspended,” “ineligible,” “lower tier covered transaction,” “participant,” “person,” “primary covered transaction,” “principal,” “proposal,” and “voluntarily excluded,” as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549.

3. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective recipient of Federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

4. The potential recipient of Federal assistance funds agrees by submitting this bid/agreement/proposal or like document that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated.

Instructions for completing the form, Attachment –Debarment Certification

1. The City of Long Beach sometimes receives Federal funding on certain purchases/projects. To ensure that the City is in compliance with Federal regulations we require this form to be completed.

2. The City of Long Beach checks the System for Award Management at www.sam.gov to make sure that Contractors who are awarded City contracts and/or purchase orders are not debarred or suspended. Prospective Contractors should perform a search on this website for your company and or persons associated with your business.

3. If your business is in compliance with the conditions in the form, please have the appropriate person complete and sign this form and return with your bid/proposal/agreement.

4. If at any time, your business or persons associated with your business become debarred or suspended, we require that you inform us of this change in status.

5. If there are any exceptions to the certification, please include an attachment. Exceptions will not necessarily result in denial of award but will be considered in determining bidder responsibility.

For any exception, indicate to whom it applies, initiating agency and dates of action.

6. Note: Providing false information may result in criminal prosecution or administrative sanctions.

ATTACHMENT I: EQUAL BENEFITS ORDINANCE

As a condition of being awarded a contract with the City of Long Beach ("City"), the selected Contractor/Contractor ("Contractor") may be required during the performance of the Contract, to comply with the City's nondiscrimination provisions of the Equal Benefits Ordinance ("EBO") set forth in the Long Beach Municipal Code section 2.73 et seq. The EBO requires that during the performance of the contract, the Contractor shall provide equal benefits to its employees with spouses and employees with domestic partners. Benefits include but are not limited to, health benefits, bereavement leave, family medical leave, membership and membership discounts, moving expenses, retirement benefits and travel benefits. A cash equivalent payment is permitted if an employer has made all reasonable efforts to provide domestic partners with access to benefits but is unable to do so. A situation in which a cash equivalent payment might be used if where the employer has difficulty finding an insurance provider that is willing to provide domestic partner benefits.

The EBO is applicable to the following employers:

• For-profit employers that have a contract with the City for the purchase of goods, services, public works or improvements and other construction projects in the amount of $100,000 or more

• For-profit entities that generate $350,000 or more in annual gross receipts leasing City property pursuant to a written agreement for a term exceeding 29 days in any calendar year

Contractors who are subject to the EBO must certify to the City before execution of the contract that they are in compliance with the EBO by completing the EBO Certification Form, attached, or that they have been issued a waiver by the City. Contractors must also allow authorized City representatives access to records so the City can verify compliance with the EBO.

The EBO includes provisions that address difficulties associated with implementing procedures to comply with the EBO. Contractors can delay implementation of procedures to comply with the EBO in the following circumstances

1. By the first effective date after the first open enrollment process following the contract start date, not to exceed two years, if the Contractor/Contractor submits evidence of taking reasonable measures to comply with the EBO; or

2. At such time that the administrative steps can be taken to incorporate nondiscrimination in benefits in the Contractor/Contractor's infrastructure, not to exceed three months; or

3. Upon expiration of the Contractor's current collective bargaining agreement(s).

Compliance with the EBO

If a Contractor has not received a waiver from complying with the EBO and the timeframe within which it can delay implementation has expired but it has failed to comply with the EBO, the Contractor may be deemed to be in material breach of the Contract. In the event of a material breach, the City may cancel, terminate or suspend the City agreement, in whole or in part. The City also may deem the Contractor an irresponsible bidder and disqualify the Contractor from contracting with the City for a period of three years. In addition, the City may assess liquidated damages against the Contractor which may be deducted from money otherwise due the Contractor. The City may also pursue any other remedies available at law or in equity.

By my signature below, I acknowledge that the Contractor understands that to the extent it is subject to the provisions of the Long Beach Municipal Code section 2.73, the Contractor shall comply with this provision.

Printed Name: Title:

Signature:_________________ Date: ____________________ Business Entity Name: _____________

Rev 02/09/17

LIST OF SUBCONTRACTORS

In accordance with the requirements provided in the "Subletting and Subcontracting Fair Practices Act" Division 2 Part 1, Chapter 4 of the California Public Contract Code, the Bidder shall set forth hereon the name, the location of the place of business, Department of Industrial Relations registration number, and the California contractor license number 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, or a subcontractor licensed by the State of California who, under subcontract to the prime contractor, specially fabricates and installs a portion of the work or improvement according to detailed drawings contained in the plans and specifications, in an amount in excess of one‐half of 1 percent of the prime contractor's total bid or, in the case of bids or offers for the construction of streets or highways, including bridges, in excess of one‐ half of 1 percent of the prime contractor's total bid or ten thousand dollars ($10,000), whichever is greater. The prime contractor shall set forth thereon the portion of the work (type and dollar value) that will be done by each subcontractor. The prime contractor shall list only one subcontractor for each portion as defined by the prime contractor in his or her bid. Information requested, other than the sub contractor's name, location of business, contractor license number and the portion of work that will be done by each subcontractor may be submitted by the prime contractor within 24 hours after the deadline for submission of bids.

Name Type of Work

Address

City Dollar Value of Subcontract $

Phone No.

License No. DIR Registration No. ___________________________________

License No. DIR Registration No. __________________________________

02-09-2023

LABOR AND MATERIAL BOND

KNOW ALL MEN BY THESE PRESENTS: That we, __________________________________, as PRINCIPAL, and ____________________________, located at _______________________________, a corporation, incorporated under the laws of the State of ________________, admitted as a surety in the State of California, and authorized to transact business in the State of California, as SURETY, are held and firmly bound unto the BOARD OF PUBLIC UTILITIES COMMISSIONERS OF THE CITY OF LONG BEACH and THE CITY OF LONG BEACH, a municipal corporation, in the sum of Six Million Eight Hundred Twenty Thousand DOLLARS ($6,820,000), lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, our respective heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents.

THE CONDITION OF THIS OBLIGATION IS SUCH THAT:

WHEREAS, said Principal has been awarded and is about to enter the annexed contract (incorporated herein by this reference) with said Board for the _______________________________________________ and is required by law and by said Board to give this bond in connection with the execution of said contract;

NOW, THEREFORE, if said Principal, as Contractor of said contract, or any subcontractor of said Principal, fails to pay for any materials, provisions, equipment, or other supplies, used in, upon, for or about the performance of the work contracted to be done, or for any work or labor done thereon of any kind, or for amounts due under the Unemployment Insurance Act, during the original term of said contract and any extensions thereof, and during the life of any guaranty required under the contract, or shall fail to pay for any materials, provisions, equipment, or other supplies, used in, upon, for or about the performance of the work to be done under any authorized modifications of said contract that may hereafter be made, or for any work or labor done of any kind, or for amounts due under the Unemployment Insurance Act, under said modification, said Surety will pay the same in an amount not exceeding the sum of money hereinabove specified and, in case suit is brought upon this bond, a reasonable attorney's fee, to be fixed by the court; otherwise this obligation to be void;

PROVIDED, that any modifications of, or alterations or changes which may be made in said contract, or in any of the work or labor required to be done thereunder, or in any of the materials, provisions, equipment, or other supplies required to be furnished pursuant to said contract, or the giving by said Board of any extension of time for the performance of said contract, or the giving of any other forbearance upon the part of either the Board or the Principal to the other, shall not in any way release the Principal or the Surety, or either of them, or their respective heirs, administrators, executors, successors or assigns, from any liability arising hereunder, and notice to the Surety of any such modifications, alterations, changes, extensions or forbearances is hereby waived. No premature payment by the City to said Principal shall release or exonerate the Surety, unless said Board, at the time it orders such payment made, shall have actual notice that such payment is in fact premature, and then only to the extent that such payment shall result in actual loss to the Surety, but in no event in an amount more than the amount of such premature payment.

THIS BOND shall inure to the benefit of any and all persons, companies and corporations entitled by law to file claims so as to give a right of action to them or their assigns in any suit brought upon this bond.

IN WITNESS WHEREOF, the above named Principal and Surety have executed, or caused to be executed, this instrument under their respective hands and seals, and with all the formalities required by law on this _____ day of _______________, 20__.

Contractor/Principal

BY: ____________________________________

NAME: __________________________________

Title: _________________________________

Surety, admitted in California

Approved as to form this __________ day of __________, 20__.

Approved as to sufficiency this __________ day

DAWN MCINTOSH, City Attorney BOARD OF PUBLIC UTILITIES COMMISSIONERS OF THE CITY OF

LONG BEACH

By: ______________________________ By: ____________________________________________ Deputy General Manager

NOTE: 1. Execution of the bond must be acknowledged by both PRINCIPAL and SURETY before a Notary Public and a Notary's certificate of acknowledgment must be attached.

2. A corporation must execute the bond by 2 authorized officers or, if executed by a person not listed in Sec. 313, Calif. Corp.

Code, then a certified copy of a resolution of its Board of Directors authorizing execution must be attached.

02-09-2023

BOND FOR FAITHFUL PERFORMANCE

KNOW ALL MEN BY THESE PRESENTS: That we, _____________________________________, as PRINCIPAL, and, ______________________________________________ located at _________________________________________________________, a corporation, incorporated under the laws of the State of _________________, admitted as a surety in the State of California, and authorized to transact business in the State of California, as SURETY, are held and firmly bound unto the BOARD OF PUBLIC UTILITIES COMMISSIONERS OF THE CITY OF LONG BEACH and THE CITY OF LONG BEACH, a municipal corporation, in the sum of Six Million Eight Hundred Twenty Thousand DOLLARS ($6,820,000), lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, our respective heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents.

THE CONDITION OF THIS OBLIGATION IS SUCH THAT:

WHEREAS, said Principal has been awarded and is about to enter the annexed contract (incorporated herein by this reference) with said Board for the _______________________________________________________________ and is required by said Board to give this bond in connection with the execution of said contract;

NOW, THEREFORE, if said Principal shall well and truly keep and faithfully perform all of the covenants, conditions, agreements and obligations of said contract on said Principal's part to be kept, done and performed, at the times and in the manner specified therein, then this obligation shall be null and void, otherwise it shall be and remain in full force and effect;

PROVIDED, that any modifications, alterations or changes which may be made in said contract, or in the work to be done, or in the services to be rendered, or in any materials or articles to be furnished pursuant to said contract, or the giving by said Board of any extension of time for the performance of said contract, or the giving of any other forbearance upon the part of either said Board or the Principal to the other, shall not in any way release the Principal or the Surety, or either of them, or their respective heirs, administrators, executors, successors or assigns, from any liability arising hereunder, and notice to the Surety of any such modifications, alterations, changes, extensions or forbearances is hereby waived. No premature payment by said Board to said Principal shall release or exonerate the Surety, unless said Board, at the time it orders such payment made, shall have actual notice that such payment is in fact premature, and then only to the extent that such payment shall result in actual loss to the Surety, but in no event in an amount more than the amount of such premature payment.

IN WITNESS WHEREOF, the above named Principal and Surety have executed, or caused to be executed, this instrument with all of the formalities required by law on this _________ day of ______________, 20__.

Contractor/Principal

BY: _____________________________________

Title: ____________________________________

Surety, admitted in California

Approved as to form this __________ day

Approved as to sufficiency this __________ day

DAWN MCINTOSH, City Attorney BOARD OF PUBLIC UTILITIES COMMISSIONERS OF THE CITY

OF LONG BEACH

By: ____________________________ By: ____________________________________________ Deputy General Manager

NOTE: 1. Execution of the bond must be acknowledged by both PRINCIPAL and SURETY before a Notary Public and a Notary's certificate of acknowledgment must be attached.

2. A corporation must execute the bond by 2 authorized officers or, if executed by a person not listed in Sec. 313, Calif. Corp.

Code, then a certified copy of a resolution of its Board of Directors authorizing execution must be attached.