C1547025_Checklist___Bid_Submittal_Docs.pdf

State of California Natural Resources Agency Edmund G. Brown Jr., Governor

DEPARTMENT OF PARKS AND RECREATION Lisa Ann L. Mangat, Director San Diego Coast District 4477 Pacific Highway San Diego, CA 92110

Invitation for Bid (IFB) Bidder’s Checklist

Items below must be submitted with your Bids. Bids missing this information will be regarded as non-responsive and therefore rejected.

_____ Public Works Bid Forms (DPR482B) and subsequent pages _____ Small business Preference (DPR 85)

_____ Bidder’s DVBE Participation (for incentive only) (DPR 486)

_____ Disabled Veteran Business Enterprises Declarations (for incentive only) (STD843

_____ Darfur Contracting Act Certification (DPR 74) - Public Contract Code section

10478

_____ California Public Contract Code Section 10162 Questionnaire (DPR 20)

_____ Non-Collusion Affidavit (DPR 837) (Original)

YOUR RETURN ADDRESS

(REQUIRED)

INVITATION FOR BID– CONFIDENTIAL

Park Name:

Silver Strand State Beach Contract Number and Project Name: C1547025 Replace Tile Roof at Residence #1 Bid Opening Day:

Wednesday, March 16, 2016 @ 2:00PM Department of Parks and Recreation San Diego Coast District 4477 Pacific Highway San Diego, CA 92110

14:00 3/16/2016

Nondiscrimination Compliance Statement: The prospective contractor's signature affixed hereon and dated shall constitute a certification under penalty of perjury under the laws of the State of California that the bidder has, unless exempted, complied with the nondiscrimination program requirements of Government Code Section 12990 and Title 2, California Code of Regulations, Section 8103.

Verification: By signing this Bid Form, the bidder assures the state that it has not been convicted of violating a state or federal law regarding the employment of undocumented aliens, in the preceding five years.

The prospective contractor's signature affixed hereon and dated shall constitute a certification that the representations made by the prospective contract in the bid are made under penalty of perjury under the laws of the State of California.

Important: Pursuant to Title 2, California Code of Regulations, Section 8103 and Business and Professions Code Section 7028.15, no bid will be considered unless it contains the certifications and license information requested on this form. The State reserves the right to waive any irregularity in any bid or to reject any or all bids.

LICENSE NO.

DPR 482B (Rev. 10/2003)(Excel 10/15/2003)

KIND OF WORK NAME AND ADDRESS

5000 Highway 75, Coronado, CA 92118

Replace Tile Roof Project at Residence #1 Silver Strand

State Beach

State of California - The Resources Agency

DEPARTMENT OF PARKS AND RECREATION

PUBLIC WORKS BID FORM

PROJECT LOCATION

PROJECT NAME

STATUS OF BUSINESS (Check appropriate box.)

Individual.

Corporation. State in which incorporated:

Partnership. Full names of partners:

Listed hereinafter are the names, addresses and contractor's license numbers of all subcontractors who will perform work or labor or render services in an amount in excess of one-half of one percent of the general contractor's total bid if this bid is accepted and the portion of the work that each will perform. Material vendors are not included.

FAX NO.

BY (Authorized Signature)

CITY/STATE/ZIP CODE

PRINTED NAME AND TITLE OF PERSON SIGNING

CONTRACTOR/BIDDER FIRM NAME (Printed)

ADDRESS

LICENSE CLASSIFICATION

DATE

BID DATE BID TIME

CERTIFICATION

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to the clause(s) listed above. This certification is made under the laws of the State of California. I understan d that failure to submit the Public Works Bid Form without the appropriate bidder signature will result in rejection of the bid.

LICENSE EXPIRATION DATE LICENSE NO.

Exhibit B, Attachment 1

PHONE NO.

Exhibit B, Attachment I, BID FORM Silver Strand State Beach, Residence #1 (Bayside), Replace Tile Roof Project.

C1547025

Contractor is to provide all labor, tools, materials and equipment necessary to: Replace underlayment on the existing tile roof at Park Residence Building #1. The residence is approximately 1200 Sq. Ft. The contractor will do all work to remove tiles (expect to replace 50% of tiles) and underlayment, replace any rotted wood as needed, install tile and mortar bird stops, install flashing, and install torch down on small porch.

All According to the Scope of work and specifications hereby attached and made a part of this bid booklet.

Contractor is to provide all labor, tools, materials and equipment necessary to:

Est… Labor:$________________________________________________________

Est… Labor Amount Written Out:___________________________________________

Materials & Related Expenses:$_____________

Materials & Related Expenses Amount Written out:_____________________________________________

Total Bid: $ ______________________________________________

Total Bid Amount Written Out: __________________________________________________________

**If progress payments (if applicable) are required for this for this public works project, each task WILL be itemized out for each required progress payment according to the general conditions 00700 page 9, Schedule of Values 1.09 item A., work schedule. (If progress payments are needed, the Performance bond will be required to awarded contractor. The Payment bond is always required both at 100% of bid amount).

In case of discrepancy between the stipulated totals and the actual sum of the totals, the actual sum of all item totals shall prevail.

State of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

NON-COLLUSION AFFIDAVIT TO BE EXECUTED BY

BIDDER AND SUBMITTED WITH BID FOR PUBLIC WORKS

STATE OF CALIFORNIA

COUNTY OF

SS

(Name)

DATED: By

(Position title)

(The bidder)

(Person signing for bidder)

Subscribed and sworn to (or affirmed) before me on this___________ day of ___________________, 20_____ , by the

THIS FORM MUST REMAIN WITH THE BID

(Notary Public) (Notarial Seal)

DPR 837 (Rev. 6/2011)(Excel 6/22/2011) the party making the foregoing bid that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation, that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true;

and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid.

, being first duly sworn, deposes and says that he or she is person named above, proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.

COMPANY NAME CONTRACTING WITH NATURE OF WORK TIER

DOLLAR

VALUE

OF

Total Small Business Subcontractor Dollar Value

Total Amount of Bid

TOTAL % OF BID FOR ALL SMALL BUSINESS SUBCONTRACTORS

DPR 85 (Rev. 6/2011)(Excel 6/6/2011)

COMPLETION INSTRUCTIONS

SMALL BUSINESS PREFERENCE

State of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

Certified Small Businesses (SBs) may receive a 5% preference. Non Certified Small Business (SB) contractors may receive a 5% preference by subcontracting a minimum of 25% of the total monetary amount of their bid to Certified Small Businesses.

See the DPR 478, Small Business Notice for more information about the SB Preference.

COMPANY NAME: List the names of the subcontractors and suppliers proposed for the 25% Small Business (SB) subcontractor participation.

CONTRACTING WITH: Enter the name of the company with which the company listed is contracting.

NATURE OF WORK: Identify the proposed work (or materials or equipment) to be provided.

TIER: The Bidder may count toward its 25% Small Business participation goal the dollar value of work and supplies to be obtained by its primary subcontractors and suppliers from SB subcontractor firms as second and third level tier subcontractors/suppliers. Using the following codes, indicate the contracting tier for each SB company listed for participation:

0 = Prime or Joint Contractor 1 = Primary Subcontractor or Supplier 2 = Subcontractor/Supplier of Level 1 Subcontractor/Supplier 3 = Subcontractor/Supplier of Level 2 Subcontractor/Supplier

DOLLAR VALUE: Enter the dollar amount of the bid to be performed by the listed company’s own forces.

PERCENTAGE OF BID: Enter the percentage of the total bid amount the dollar value represents.

PRINTOUT: In order to claim the 25% Small Business participation credit, a printout from the Office of Small Business and DVBE Services eProcurement website for each SB listed.

PRINT-

OUT

DATE CONTRACTOR NAME

PART I

IS CONTRACTOR A CALIFORNIA CERTIFIED SMALL BUSINESS?

YES NO

If Yes, attach Contractor's certification printout from the eProcurement website to this form and stop here.

If No, you still may qualify for the Small Business Preference, complete Part II below.

PART II

SB CERT NO.

SB CERT NUMBER:

SB CERT NUMBER:

SB CERT NUMBER:

SB CERT NUMBER:

DPR 486 (New 1/2010)(Excel 1/26/2010)

COMPANY INFORMATION

COMPANY INFORMATION: List the information (Company Name, Contact information) of subcontractor(s) and supplier(s) proposed for DVBE. If prime contractor is a DVBE, the name must be listed for participation.

COMPLETION INSTRUCTIONS

PART 1 — SUMMARY OF DISABLED VETERAN BUSINESS ENTERPRISE (DVBE) PARTICIPATION

State of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

COMPANY NAME

CONTACT

COMPANY NAME

CONTACT

I hereby certifiy that I have made a diligent effort to ascertain the facts with regard to the representations made herein. In making this certification, I am aware of Section 12650 et seq. of the Government Code providing for the imposition of treble damages for making false claims against the State and Section 10115.10 of the Public Contract Code making it a crime for intentionally making an untrue statement in this certificate.

PART 2 — BIDDER'S CERTIFICATION

BIDDING COMPANY'S NAME

SIGNATURE

DATE

TITLE (e.g. BUSINESS OWNER/CHIEF EXECUTIVE OFFICER, ETC.)

CONTRACTING WITH: Show the name of the department or company with which the company listed is contracting.

PRINT OUT: In order to claim DVBE participation credit, a printout from the eProcurement system showing their supplier ID and the status of their certification must be furnished with the bidder's bid or upon the signing of contract documents. Check mark if a copy of the printout is included.

NATURE OF WORK: Identify the proposed work (or materials or equipment) to be provided.

TIER: Bidder may count toward its participation goal the dollar value of work and supplies to be obtained by its primary subcontractors and suppliers from DVBE firms as second and third level tier subcontractors/suppliers. Contracting tier should be indicated with the following designations:

DVBE company listed for participation.

0 = Prime or Joint Contractor 1 = Primary Subcontractor or Supplier 2 = Subcontractor/Supplier of Level 1 Subcontractor/Supplier 3 = Subcontractor/Supplier of Level 2 Subcontractor/Supplier

DOLLAR VALUE: The dollar amount of the bid to be performed by the listed company’s own forces.

PERCENTAGE OF BID: The percentage of the total bid amount the dollar value represents.

CONTRACTING WITH

PERCENT OF BID

PRINT-

OUT

TIER

NATURE OF WORK

CONTACT PHONE

DOLLAR VALUE

COMPANY NAME

CONTACT

CONTRACTING WITH

PERCENT OF BID

PRINT-

OUT

TIER

NATURE OF WORK

CONTACT PHONE

DOLLAR VALUE

CONTRACTING WITH

PERCENT OF BID

PRINT-

TIER

NATURE OF WORK

CONTACT PHONE

DOLLAR VALUE

COMPANY NAME

CONTACT

CONTRACTING WITH

PERCENT OF BID

PRINT-

TIER

NATURE OF WORK

CONTACT PHONE

DOLLAR VALUE

BIDDER'S DVBE PARTICIPATION

PRINTED NAME

OUT

OUT

SOLICITATION NUMBER

DVBE CERTIFICATION NO.

DVBE CERTIFICATION NO.

DVBE CERTIFICATION NO.

DVBE CERTIFICATION NO.

DVBE CERTIFICATION NO.: Provide the DVBE Certification Number assigned to company.

http://www.documents.dgs.ca.gov/pd/poliproc/STD-843FillPrintFields.pdf http://www.documents.dgs.ca.gov/pd/poliproc/STD-843FillPrintFields.pdf

DPR 74 (Rev. 9/2010)(Excel 9/2/2010)

FOR DEPARTMENT USE ONLY

C1547025

State of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

DARFUR CONTRACTING ACT CERTIFICATION

Public Contract Code Sections 10475 -10481 applies to any company that currently or within the previous three years has had business activities or other operations outside of the United States. For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company that has been granted permission by the Department of General Services to submit a proposal.

If your company has not, within the previous three years, had any business activities or other operations outside of the United States, you do not need to complete this form.

AGREEMENT/PAPO NO.

OPTION #1 - CERTIFICATION

If your company, within the previous three years, has had business activities or other operations outside of the United States, in order to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete the certification below.

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that a) the prospective proposer/bidder named below is not a scrutinized company per Public Contract Code 10476; and b) I am duly authorized to legally bind the prospective proposer/bidder named below. This certification is made under the laws of the State of California.

COMPANY/VENDOR NAME (Printed)

BY (Authorized Signature)

PRINTED NAME AND TITLE OF PERSON SIGNING

DATE EXECUTED EXECUTED IN THE COUNTY AND STATE OF

FEDERAL ID NUMBER

OPTION #2 - WRITTEN PERMISSION FROM DGS

Pursuant to Public Contract Code section 10477(b), the Director of the Department of General Services may permit a scrutinized company, on a case-by-case basis, to bid on or submit a proposal for a contract with a state agency for goods or services, if it is in the best interests of the state. If you are a scrutinized company that has obtained written permission from the DGS to submit a bid or proposal, complete the information below.

We are a scrutinized company as defined in Public Contract Code section 10476, but we have received written permission from the Department of General Services to submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission from DGS is included with our bid or proposal.

COMPANY/VENDOR NAME (Printed)

INITIALS OF SUBMITTER

PRINTED NAME AND TITLE OF PERSON INITIALING

FEDERAL ID NUMBER

Bidders are cautioned that making false certification may subject the certifier to criminal prosecution.

The Department of Parks and Recreation (DPR) reserves the right under California Public Contract Code Section 10162 to reject any bidder, any officer of such bidder, or any employee of such bidder who has a proprietary interest in such bidder who has been disqualified, removed or otherwise prevented from bidding on, or completing a federal, state or local govern-ment project because of a violation of law or violation of safety regulations.

Failure to return this form with the bid shall not be cause for rejection; however, bidders must furnish the completed form within the time frame prescribed by the DPR. Failure to submit this form within the time frame prescribed by the DPR may be deemed refusal of an award which shall be cause for forfeiture of bidder's security.

By my signature, I certify under penalty of perjury under the laws of the State of California that the foregoing questionnaire and statements pursuant to California Public Contract Code Section 10162 are true and correct.

DPR 20 (New 10/2003)(Excel 10/24/2008)

Replace Tile Roof Project at Residence #1 Silver Strand State Beach

NOTICE TO BIDDERS

CERTIFICATION

State of California - The Resources Agency

DEPARTMENT OF PARKS AND RECREATION

CALIFORNIA PUBLIC CONTRACT CODE SECTION 10162

PARK UNIT NAME

In accordance with Section 10162 of the California Public Contract Code, bidders shall complete, HAVE YOU, ANY OFFICER OF YOUR BUSINESS, OR ANY EMPLOYEE OF YOUR BUSINESS WHO HAS PROPRIETARY INTEREST IN YOUR BUSINESS EVER BEEN DISQUALIFIED, REMOVED, OR OTHERWISE PREVENTED FROM BIDDING ON, OR COMPLETING A FEDERAL, STATE, OR LOCAL GOVERNMENT PROJECT BECAUSE OF A VIOLATION OF LAW OR

VIOLATION OF SAFETY REGULATIONS?

Yes (Explain circumstances below. Attach additional pages if needed.) No

BIDDER SIGNATURE PRINTED NAME DATE

under penalty of perjury, the question below. Please answer the following:

— Questionnaire —

PROJECT NAME

NAME OF BUSINESS