Exhibit C Required Forms IFB M26127.pdf

EXHIBIT C

REQUIRED FORMS

INFORMATION REQUIRED OF OFFEROR/BIDDER

Additional Information Required of Offeror/Bidder

Offeror/Bidder is required to supply the following information. Additional sheets may be attached if necessary.

1. Name of Offeror, Firm, or Corporation: ___________________________________

2. Business Address: ___________________________________________________

3. Telephone: _________________________________________________________

4. Type of Firm: Individual, Partnership or Corporation: ________________________

5. Corporation organized under the laws of state of: ___________________________

6. Contractor/Business License No.: _______________________________________

Years of Experience: __________________________________________________

License Type/Expiration Date: __________________________________________

7. List the names and addresses of all owners of the firm or names and titles of all officers of the corporation:

8. Key Personnel to work on this Project (include title):

i. ___________________________________________________________

ii. ___________________________________________________________

iii. ___________________________________________________________

9. List at least three project references for services rendered as of recent date:

Reference A

Contract Type

Type of Service/Product

Contract Value $

Date Completed

Name and Address of Owner

Contact Name, Email, and Phone

Reference B

Contract Type

Type of Service/Product

Contract Value $

Date Completed

Name and Address of Owner

Contact Name, Email, and Phone

Reference C

Contract Type

Type of Service/Product

Contract Value $

Date Completed

Name and Address of Owner

Contact Name, Email, and Phone

10. List of Suppliers for Major Items (provide an attachment if necessary):

i. Name: _____________________________________________________________

Address: ___________________________________________________________

Item Being Supplied: __________________________________________________

11. Labor Agreements

i. Union(s): ___________________________________________________________

ii. Local No.(s): _________________________________________________________

iii. Expiration date of current agreement(s): ___________________________________

CERTIFICATION OF PRIMARY PARTICIPANT

Regarding Debarment, Suspension and Other Responsibility Matters

For use by prime contractors submitting a proposal in an amount equal to or greater than $25,000.

The certifies to the best of its knowledge and (firm name/principal) belief, that it and its principals:

1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;

2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (2) of this certification; and

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

If unable to certify to any of the statements in this certification, the participant shall attach an explanation to this certification.

The primary participant, certifies or (firm name/principal) affirms the truthfulness and accuracy of the contents of the statements submitted on or with this certification and understands that the provisions of 31 U.S.C. sections 3801 et seq. are applicable thereto.

Signature and Title of Authorized Official

Standard Required Forms Revised 04.06.2023

CERTIFICATION OF LOWER-TIER PARTICIPANTS

Regarding Debarment, Suspension and Other Ineligibility and Voluntary Exclusion

For use by sub-contractors who submitted proposals to the prime contractor in an amount equal to or greater than $25,000.

The (firm name/principal) certifies by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participant in this transaction by any Federal department or agency.

If unable to certify to any of the statements in this certification, such participant shall attach an explanation to this proposal.

The (firm name/principal) certifies or affirms the truthfulness and accuracy of the statements submitted on or with this certification and understands that the provisions of 31 U.S.C. sections 3801 et seq. are applicable thereto.

Signature and Title of Authorized Official

Standard Required Forms

CERTIFICATION

OF

RESTRICTIONS ON LOBBYING

I, ____________________________________, hereby certify on behalf (name of proposer) of

__________________________________________ that:

(name of company)

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds, other than Federal appropriated funds, have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form - LLL, "Disclosure of Lobbying Activities," in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in all subcontracts, and that all subcontractors shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance is placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Executed this day of , 20 ________

By (signature of authorized official)

(title of authorized official)

Agreement No.

Standard Required Forms

CERTIFICATION OF DRUG FREE WORKPLACE

I, ___________________________________________ (name of authorized official), hereby certify on behalf of (name of company) that the CONTRACTOR named above, and all Sub-Contractors working on this contract, will comply with California Government Code Section 8355 in matters relating to providing a drug-free workplace. The CONTRACTOR and all Sub-Contractors will therefore:

1. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance are prohibited, and that specified actions will be taken against employees for violation of these prohibitions, as required by California

Government Code Section 8355(a).

2. Establish a Drug-free Awareness Program, as required by California Government Code

Section 8355(b), to inform employees all of the following:

a. The dangers of drug abuse in the workplace;

b. The firm’s policy of maintaining a drug-free workplace;

c. Any available counseling, rehabilitation and employee assistance programs, and;

d. Penalties that may be imposed upon employees for drug abuse violations, including that no employee who tests positive for use of a controlled substance shall be permitted to work on this contract.

3. Provide, as required by California Government Code Section 8355(c), that every employee who works on the proposed contract:

a. Will receive a copy of the firm’s drug-free policy statement, and;

b. Will agree to abide by the terms of the firm’s statement as a condition of employment on the contract.

CERTIFICATION:

I, ______________________________________________ (name of authorized official), hereby certify that the above-named company, which I am duly authorized to represent, will comply with the Drug Free Workplace requirements of this contract. I understand that this certification is made under penalty of perjury, under the laws of the State of California.

Executed this ________ day of , 20 _________.

Signature of Authorized Official Title

Standard Required Forms

PARTY DISCLOSURE FORM

Information Sheet

RIVERSIDE TRANSIT AGENCY

California Government Code §84308, commonly referred to as the “Levine Act,” precludes an officer, and his or her alternate, of a local government agency from participating in the award of a contract if he or she receives any political contributions totaling more than $250 in the 12 months preceding the pendency of the contract award, and three months following the decision, from the person or company awarded the contract. This prohibition applies to contributions to the officer or received by the officer on behalf of any officer, or on behalf of any candidate for office or on behalf of any committee.

IMPORTANT NOTICE

Basic Provisions of Government Code Section 84308

A. If you are an applicant for, or the subject of, any proceeding involving a license, permit, or other entitlement for use, you are prohibited from making a campaign contribution of more than $250 to any board member or his or her alternate. This prohibition begins on the date your application is filed or the proceeding is otherwise initiated, and the prohibition ends three months after a final decision is rendered by the Board of Directors. In addition, no board member or alternate may solicit or accept a campaign contribution of more than $250 from you during this period.

B. These prohibitions also apply to your agents, and, if you are a closely held corporation, to your majority shareholder as well. These prohibitions also apply to your subcontractor(s), joint venture(s), and partner(s) in this proceeding. Also included are parent companies and subsidiary companies directed and controlled by you, and political action committees directed and controlled by you.

C. You must file the attached disclosure form and disclose whether you or your agent(s) have in the aggregate contributed more than $250 to any board member or his or her alternate during the 12-month period preceding the filing of the application or the initiation of the proceeding.

D. If you or your agent have in the aggregate contributed more than $250 to any individual board member or his/or her alternate during the 12 months preceding the decision on the application or proceeding, that board member or alternate must disqualify himself or herself from the decision. However, disqualification is not required if the board member or alternate returns the campaign contribution within 30 days from the time the director knows, or should have known, about both the contribution and the fact that you are a party in the proceeding. The Party Disclosure Form should be completed and filed with your proposal, or with the first written document, you file or submit after the proceeding commences.

1. A proceeding involving “a license, permit, or other entitlement for use” includes all business, professional, trade and land use licenses and permits, and all other entitlements for use, including all entitlements for land use, all contracts (other than competitively bid, labor or personal employment

Standard Required Forms contracts), and all franchises.

2. Your “agent” is someone who represents you in connection with a proceeding involving a license, permit or other entitlement for use. If an individual acting as an agent is also acting in his or her capacity as an employee or member of a law, architectural, engineering, consulting firm, or similar business entity, both the business entity and the individual are “agents.”

3. To determine whether a campaign contribution of more than $250 has been made by you, campaign contributions made by you within the preceding 12 months must be aggregated with those made by your agent within the preceding 12 months or the period of the agency, whichever is shorter.

Contributions made by your majority shareholder (if a closely held corporation), your subcontractor(s), your joint venture(s), and your partner(s) in this proceeding must also be included as part of the aggregation. Campaign contributions made to different directors or their alternates are not aggregated.

4. A list of the members and alternates of the Board of Directors is attached.

This notice summarizes the major requirements of Government Code Section 84308 of the Political Reform Act and 2 Cal. Adm. Code Sections 18438-18438.8.

Standard Required Forms

PARTY DISCLOSURE FORM

RIVERSIDE TRANSIT AGENCY

AND ITS AFFILIATED AGENCIES

_____ No contributions have been made during the preceding 12 months.

(Skip following portion and have authorized person sign where indicated.)

_____ Contributions have been made during the preceding 12 months as detailed below.

Party’s Name: ____________________________________________________

Party’s Address: __________________________________________________

City State Zip Phone

Application or Proceeding Title and Number: _________________________________________________

Board Member(s) or Alternate(s) to whom you and/or your agent made campaign contributions and dates of contribution(s) in the preceding 12 months:

Name of Member: ________________________________________________

Name of Contributor (if other than Party): _______________________________

Date(s): _________________________________________________________

Amount(s): ______________________________________________________

Name of Member: ________________________________________________

Name of Contributor (if other than Party): _______________________________

Date(s): _________________________________________________________

Amount(s): ______________________________________________________

Name of Member: ________________________________________________

Name of Contributor (if other than Party): _______________________________

Date(s): _________________________________________________________

Amount(s): ______________________________________________________

Date: _________ __________________________________ Signature of Party and/or Agent

Standard Required Forms

Standard Required Forms

RTA Board Members & Alternates 2026

Director Alternates

City of Banning: Leroy Miller, Council Member Colleen Wallace, Council Member

City of Beaumont: David Fenn, Council Member Mike Lara, Council Member

City of Calimesa: Linda Molina, Mayor Eric Cundieff, Council Member

City of Canyon Lake: Jeremy Smith, Mayor Dale Welty, Council Member

City of Corona: Jim Steiner, Council Member Tom Richins, Council Member

City of Eastvale: Jocelyn Yow, Mayor Mike McMinn, Council Member

City of Hemet: Linda Krupa, Mayor Joe Males, Mayor Pro Tem

City of Jurupa Valley: Brian Berkson, Mayor Armando Carmona, Council Member

City of Lake Elsinore: Timothy J. Sheridan, Mayor Pro Tem Robert Magee, Mayor

City of Menifee: Dean Deines, Council Member Robert “Bob” Karwin, Mayor Pro Tem

City of Moreno Valley: Cheylynda Barnard, Council Member Ulises Cabrera, Mayor

City of Murrieta: Cindy Warren, Council Member Jon Levell, Mayor

City of Norco: Fia Sullivan, Council Member Kevin Bash, Council Member

City of Perris: Marisela Nava, Council Member Elizabeth Vallejo, Council Member

City of Riverside: Steve Hemenway, Council Member Clarissa Cervantes, Council Member

City of San Jacinto: Valerie Vandever, Council Member Clarisa Sanchez, Council Member

City of Temecula: Zak Schwank, Council Member Jessica Alexander, Mayor

City of Wildomar: Bridgette Moore, Council Member Joseph Morabito, Council Member

County of Riverside (Dist. I):

Jose Medina, Supervisor Cesar Gomez, Deputy Chief of Staff

County of Riverside (Dist. II):

Karen Spiegel, Supervisor Liliana Allin, Deputy Chief of Staff

County of Riverside (Dist. III):

Chuck Washington, Supervisor Sundae Sayles, At-Large

County of Riverside (Dist. V):

Dr. Yxstian Gutierrez, Supervisor Ruben Perez, Chief of Staff

Updated 05/13/2026

PARTICIPANT DISCLOSURE FORM

Information Sheet

RIVERSIDE TRANSIT AGENCY

California Government Code §84308, commonly referred to as the “Levine Act,” precludes an officer, and his or her alternate, of a local government agency from participating in the award of a contract if he or she receives any political contributions totaling more than $250 in the 12 months preceding the pendency of the contract award, and three months following the decision, from the person or company awarded the contract. This prohibition applies to contributions to the officer, or received by the officer on behalf of any officer, or on behalf of any candidate for office or on behalf of any committee.

IMPORTANT NOTICE

Basic Provisions of Government Code Section 84308

A. If you are a participant in a proceeding involving a license, permit, or other entitlement for use, you are prohibited from making a campaign contribution of more than $250 to any board member or his or her alternate. This prohibition begins on the date you begin to actively support or oppose an application for license, permit, or other entitlement for use pending before the Riverside Transit Agency or any of its affiliated agencies, and continues until three months after a final decision is rendered on the application or proceeding by the Board of Directors.

No board member or alternate may solicit or accept a campaign contribution of more than $250 from you and/or your agency during this period if the board member or alternate knows or has reason to know that you are a participant.

B. The attached disclosure form must be filed if you or your agent have contributed more than $250 to any board member or alternate for the Riverside Transit Agency or any of its affiliated agencies during the 12-month period preceding the beginning of your active support or opposition. (The disclosure form will assist the board members in complying with the law.)

C. If you or your agent have made a contribution of more than $250 to any board member or alternate during the 12 months preceding the decision in the proceeding, that board member or alternate must disqualify himself or herself from the decision. However, disqualification is not required if the member or alternate returns the campaign contribution within 30 days from the time the director knows, or should have known, about both the contribution and the fact that you are a participant in the proceeding.

The Participant Disclosure Form should be completed and filed with the proposal submitted by a party, or should be completed and filed the first time that you lobby in person, testify in person before, or otherwise directly act to influence the vote of the board members of the Riverside Transit Agency or any

Standard Required Forms of its affiliated agencies.

1. An individual or entity is a “participant” in a proceeding involving an application for a license, permit or other entitlement for use if:

a. The individual or entity is not an actual party to the proceeding, but does have a significant financial interest in the Riverside Transit Agency’s or one of its affiliated agencies’ decision in the proceeding.

AND

b. The individual or entity, directly or through an agent, does any of the following:

(1) Communicates directly, either in person or in writing, with a board member or alternate of the Riverside Transit Agency or any of its affiliated agencies for the purpose of influencing the member’s vote on the proposal;

(2) Communicates with an employee of the Riverside Transit Agency or any of its affiliated agencies for the purpose of influencing a member’s vote on the proposal; or

(3) Testifies or makes an oral statement before the Board of Directors of the Riverside Transit Agency or any of its affiliated agencies.

2. A proceeding involving “a license, permit, or other entitlement for use” includes all business, professional, trade and land use licenses and permits, and all other entitlements for use, including all entitlements for land use; all contracts (other than competitively bid, labor, or personal employment contracts) and all franchises.

3. Your “agent” is someone who represents you in connection with a proceeding involving a license, permit, or other entitlement for use. If an agent acting as an employee or member of a law, architectural, engineering, or consulting firm, or a similar business entity or corporation, both the business entity or corporation and the individual are agents.

4. To determine whether a campaign contribution of more than $250 has been made by a participant or his or her agent, contributions made by the participant within the preceding 12 months shall be aggregated with those made by the agent within the preceding 12 months or the period of the agency, whichever is shorter. Campaign contributions made to different members or alternates are not aggregated.

5. A list of the members and alternates of the Board of Directors is attached.

This notice summarizes the major requirements of Government Code Section 84308 of the Political Reform Act and 2 Cal. Adm. Code Sections 18438-18438.8.

Standard Required Forms

PARTICIPANT DISCLOSURE FORM

RIVERSIDE TRANSIT AGENCY

AND ITS AFFILIATED AGENCIES

_____ No contributions have been made during the preceding 12 months.

(Skip following portion and have authorized person sign where indicated.)

_____ Contributions have been made during the preceding 12 months as detailed below.

Party’s Name: ____________________________________________________

Party’s Address: __________________________________________________

City State Zip Phone

Application or Proceeding Title and Number: _________________________________________________

Board Member(s) or Alternate(s) to whom you and/or your agent made campaign contributions and dates of contribution(s) in the preceding 12 months:

Name of Member: ________________________________________________

Name of Contributor (if other than Party): _______________________________

Date(s): _________________________________________________________

Amount(s): ______________________________________________________

Name of Member: ________________________________________________

Name of Contributor (if other than Party): _______________________________

Date(s): _________________________________________________________

Amount(s): ______________________________________________________

Name of Member: ________________________________________________

Name of Contributor (if other than Party): _______________________________

Date(s): _________________________________________________________

Amount(s): ______________________________________________________

Date: _________ __________________________________ Signature of Party and/or Agent

Standard Required Forms

AFFIDAVIT OF NON-COLLUSION (required)

I hereby swear (or affirm) under penalty of perjury that:

1. I am the bidder (if the bidder is an individual), a partner in the bid (if the bidder is a partnership), or an officer or employee of the bidding corporation and have authority to sign on its behalf (if the bidder is a corporation);

2. The bidder has independently produced the attached bid(s) without collusion, agreement, understanding or planned common course of action, with any other source, that would limit independent bidding competition;

3. The contents of the bid(s) have not been communicated by the bidder and or its employees and or agents to any person not an employee and or agent of the bidder and or its surety, on any bond furnished with the bid, and will not be communicated to any such person prior to the official opening of the bid, and

4. I have fully informed myself regarding the accuracy of the statements made in this affidavit.

Bidder’s Company Name

Legal Structure (corp./partner/proprietor)

Principal Office Address

City, State, Zip

Phone Number / Fax Number

E-Mail

Federal Employer Identification Number System for Award Management

(SAM.gov) Unique Entity Identifier

Dun & Bradstreet Number (DUNS)

Signature

Title of Person Authorized to Sign

Print Name of Person Authorized to Sign

Date Signed by Authorized Signatory

Standard Required Forms

Insurance Acknowledgement Form

Insurance Acknowledgment Form

OFFEROR/BIDDER HEREBY CERTIFIES that they have reviewed and understands the insurance coverage requirements specified in the RFP/IFB/RFQ. Should the OFFEROR/BIDDER be awarded a contract, OFFEROR/BIDDER further certifies that they can meet the specified requirements for insurance, including insurance coverage of any subcontractors, and agrees to name Riverside Transit Agency, its officers, officials, employees, and volunteers as additional insured.

OFFEROR/BIDDER acknowledges and certifies that proof of insurance will be provided, according to the terms and conditions specified in the RFP/IFB/RFQ, within 14 days of award, if awarded the contract.

Name of OFFEROR/BIDDER (Firm or Corporation)

Signature of OFFEROR/BIDDER Authorized Representative

Name & Title of OFFEROR/BIDDER Authorized Representative

Date Signed

RTA highly recommends OFFEROR/BIDDER share the insurance requirements with their insurance carrier(s) prior to submitting a BID/PROPOSAL. If awarded the contract, this will assist in the timely and accurate submittal of insurance documents to RTA for review and approval.

Subcontractor Information

1. As the PRIME, are you a DBE certified by the State of California? ☐‘YES’ or ☐‘NO’

2. Are subcontractors utilized for this project? ☐‘YES’ or ☐‘NO’

If ‘YES’, please fill out the subcontractor information below:

Subcontractor Name 1

Is subcontractor a DBE?

Address, City, State

Contractor’s License Number

DIR Number

Contract Amount $ Participation

Percentage % of Total Contract Value

Work to be performed

Subcontractor Name 2

Is subcontractor a DBE?

Address, City, State

Contractor’s License Number

DIR Number

Contract Amount $ Participation

Percentage % of Total Contract Value

Work to be performed

Subcontractor Name 3

Is subcontractor a DBE?

Address, City, State

Contractor’s License Number

DIR Number

Contract Amount $ Participation

Percentage % of Total Contract Value

Work to be performed

Subcontractor Name 4

Is subcontractor a DBE?

Address, City, State

Contractor’s License Number

DIR Number

Contract Amount $ Participation

Work to be performed

Subcontractor Name 5

Is subcontractor a DBE?

Address, City, State

Contractor’s License Number

DIR Number

Contract Amount $ Participation

Work to be performed

PREPARED BY (PRINT NAME): _____________________________________________________

SIGNATURE: _____________________________________________________

TITLE: _____________________________________________________

DATE: _____________________________________________________

PUBLIC WORKS CONTRACT AWARD INFORMATION

Contract award information must be sent to your Apprenticeship Committee if you are approved to train. If you are not approved to train, you must send the information (which may be this form) to ALL applicable Apprenticeship Committees in your craft or trade in the area of the site of the public work. Go to: http://www.dir.ca.gov/databases/das/pwaddrstart.asp for information about programs in your area and trade. You may also consult your local Division of Apprenticeship Standards (DAS) office whose telephone number may be found in your local directory under California, State of, Industrial Relations, Division of Apprenticeship Standards.

Do not send this form to the Division of Apprenticeship Standards.

NAME OF YOUR COMPANY CONTRACTOR'S STATE LICENSE NO

MAILING ADDRESS- NUMBER & STREET, CITY, ZIP CODE AREA CODE & TELEPHONE NO.

NAME & ADDRESS OF PUBLIC WORKS PROJECT DATE YOUR CONTRACT EXECUTED

DATE OF EXPECTED OR ACTUAL START OF PROJECT

NAME & ADDRESS OF PUBLIC AGENCY AWARDING CONTRACT ESTIMATED NUMBER OF JOURNEYMEN HOURS

OCCUPATION OF APPRENTICE

THIS FORM IS BEING SENT TO: (NAME & ADDRESS OF APPRENTICESHIP PROGRAM(S)) ESTIMATED NUMBER OF APPRENTICE HOURS

APPROXIMATE DATES TO BE EMPLOYED

This is not a request for dispatch of apprentices.

Contractors must make a separate request for actual dispatch, in accordance with Section 230.1(a) California Code of Regulations

Check One Of The Boxes Below

1. We are already approved to train apprentices by the Enter name of the Committee Apprenticeship Committee. We will employ and train under their Standards.

2. We will comply with the standards of Enter name of the Committee Apprenticeship Committee for the duration of this job only.

3. We will employ and train apprentices in accordance with the California Apprenticeship Council regulations, including § 230.1 (c) which requires that apprentices employed on public projects can only be assigned to perform work of the craft or trade to which the apprentice is registered and that the apprentices must at all times work with or under the direct supervision of journeyman/men.

Signature Date

Typed Name

Title

State of California - Department of Industrial Relations DIVISION

OF APPRENTICESHIP STANDARDSDAS 140 (REV. 1/04)

http://www.dir.ca.gov/databases/das/pwaddrstart.asp

Explanation to box 1 ‐ 3 on form DAS 140

• Box 1 is for contractors who are already approved to train by an apprenticeship program (signatory/member).

• Box 2 indicates that a contractor is willing to comply with a program's Standards for the current project only. This generally means that the fringe benefits and the training funds will be paid to that Committee's Trust Fund. It also allows a contractor to take advantage of a more generous maximum ratio than the CAC Standards, but does not affect the minimum ratio of 1 apprentice hour for every 5 journeyman hours.

• Box 3 means that a contractor will be governed by the regulations of the California Apprenticeship Council. Generally this means that the minimum and maximum ratio for apprentices is the same – 1 apprentice hour for every 5 journeyman hours per each craft, totaled at the end of the project. It also means the Training Fund Contribution is usually paid to the California Apprenticeship Council.

REQUEST FOR DISPATCH OF AN APPRENTICE – DAS 142 FORM

DO NOT SEND THIS FORM TO DAS

You may use this form to request dispatch of an apprentice from the Apprenticeship Committee in the craft or trade in the area of the public work. Go to: http://www.dir.ca.gov/databases/das/pwaddrstart.asp for information about programs in your area and trade. You may also consult your local Division Apprenticeship Standards (DAS) office whose telephone number may be found in your local directory under California, State of, Industrial Relations, Division of Apprenticeship Standards. Except for projects with less than 40 hours of journeyworkers work, you must request and employ apprentices in no less than 8 hour increments.

List one occupation/craft per form Date:

To Applicable Apprenticeship Committee:

Name:

Address:

Tel. No. Fax No.

Contractor Requesting Dispatch:

Name:

Address:

License No.

PWC Registration Number:

Tel. No. Fax No.

Project Information: PWC Project Number _________________ Contract Number __________________________

Total Contract Amount. _____________________________ Sub-Contract Amount ___________________________

Name of the Project:

Address:

Dispatch Request Information:

Number of Apprentice(s) Needed: Craft or Trade:

Date Apprentice(s) to Report: (72 hrs. notice required) Time to Report:

Name of Person to Report to:

Address to Report to:

You may use this form to make your written request for the dispatch of an apprentice. Requests for dispatch must be in writing and submitted at least 72 hours in advance (excluding weekends and holidays) via first class mail, fax or email. Proof of submission may be required. Please take note of California Code of Regulations, Title 8, § 230.1 (a) for all applicable requirements regarding apprenticeship requests and/or visit https://www.dir.ca.gov/das/PublicWorksForms.htm

DAS 142 (Revised 10/18) https://www.dir.ca.gov/das/PublicWorksForms.htm http://www.dir.ca.gov/databases/das/pwaddrstart.asp

BID BOND FOR RIVERSIDE TRANSIT AGENCY

KNOWN ALL MEN BY THESE PRESENTS that ___________________________________, as BIDDER, and ______________________________________, as SURETY, are held and firmly bound unto Riverside

Transit Agency, as RTA, in the sum of ______________________________ dollars ($ _______________), which is ten percent (10%) of the total amount bid by BIDDER to RTA for the above stated project, for the payment of which sum, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents.

THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to submit a bid to

RTA for the above stated project, if said bid is rejected, or if said bid is accepted and a Contract is awarded and entered into by BIDDER in the manner and time specified, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of RTA.

IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seals, this __________ day of _____________, 20______.

BIDDER* __________________________________________________________________

SURETY* __________________________________________________________________

Subscribed and sworn to this ______________day of _________________, 20_______/

NOTARY PUBLIC ______________________________________________________________________

* Provide BIDDER/SURETY name, address and telephone number and the name, title, address and telephone number of authorized representatives.

Bid Bond

Bond No. ____________

FAITHFUL PERFORMANCE BOND FOR RIVERSIDE TRANSIT AGENCY

KNOW ALL MEN BY THESE PRESENTS that __________________________________ as

CONTRACTOR and _________________________________, as SURETY, are held and firmly bound unto

Riverside Transit Agency, as RTA, in the penal sum of _______________________________________

Dollars ($ __________________), which is ONE-HUNDRED PERCENT (100%) of the total Contract amount for the above stated project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly and severally, firmly by these presents.

THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has been awarded and is about to enter into the annexed Contract Agreement with RTA for the above stated project, if

CONTRACTOR faithfully performs and fulfills all obligations under the Contract Documents in the manner and time specified therein, then this obligation shall be null and void, otherwise it shall remain in full force and in effect in favor of RTA; provided that any alterations in the obligations or time for completion made pursuant to the terms of the Contract Documents shall not in any way release either CONTRACTOR or

SURETY, and notice of such alterations is hereby waived by SURETY.

IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seals this ___________ day of _______________, 20_____, CONTRACTOR* __________________________________________________________________

SURETY* __________________________________________________________________

Subscribed and sworn to this __________ day of __________________, 20_____.

NOTARY REPUBLIC

* Provide CONTRACTOR/SURETY name, address and telephone number and the name, title, address and telephone number of authorized representatives.

Faithful Performance Bond

MATERIAL AND LABOR BOND FOR RIVERSIDE TRANSIT AGENCY

KNOW ALL MEN BY THESE PRESENTS that __________________________________ as

CONTRACTOR and _________________________________, as SURETY, are held and firmly bound unto

Riverside Transit Agency, as RTA, in the penal sum of _______________________________________

Dollars ($ __________________), which is ONE HUNDRED PERCENT (100%) of the total Contract amount for the above stated project, for the payment of which sum, CONTRACTOR and SURETY agree to be bound, jointly and severally, firmly by these presents.

THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas CONTRACTOR has been awarded and is about to enter into the annexed Contract Agreement with RTA for the above stated project, if

CONTRACTOR or any subcontractor fails to pay for any labor or material of any kind used in the performance of the work to be done under said contract, or fails to submit amounts due under the State Unemployment

Insurance Act with respect to said labor, SURETY will pay for the same in an amount not exceeding the sum set forth above, which amount shall insure to the benefit of all persons entitled to file claims under the State

Code of Civil Procedures; provided that any alterations in the work to be done, materials to be furnished, or time for completion made pursuant to the terms of the Contract Documents shall not in any way release either

CONTRACTOR or SURETY and notice of said alterations is hereby waived by SURETY.

IN WITNESS WHEREOF the parties hereto have set their names, titles, hands, and seals this ___________ day of _______________, 20 __________, CONTRACTOR* __________________________________________________________________

SURETY* __________________________________________________________________

Subscribed and sworn to this __________ day of __________________, 20 ________.

NOTARY REPUBLIC

* Provide CONTRACTOR/SURETY name, address and telephone number and the name, title, address and telephone number of authorized representatives.

Material and Labor Bond

Form W-9 (Rev. March 2024)

Request for Taxpayer Identification Number and Certification

Department of the Treasury Internal Revenue Service Go to www.irs.gov/FormW9 for instructions and the latest information.

Give form to the requester. Do not send to the IRS.

Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.

P ri n t o r ty p e

S ee

S p ec if ic In st ru ct io n s on p ag e

3.

1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner’s name on line 1, and enter the business/disregarded entity’s name on line 2.)

2 Business name/disregarded entity name, if different from above.

3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes.

Individual/sole proprietor C corporation S corporation Partnership Trust/estate

LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner.

Other (see instructions)

3b If on line 3a you checked “Partnership” or “Trust/estate,” or checked “LLC” and entered “P” as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See instructions

4 Exemptions (codes apply only to certain entities, not individuals;

see instructions on page 3):

Exempt payee code (if any)

Exemption from Foreign Account Tax Compliance Act (FATCA) reporting code (if any)

(Applies to accounts maintained outside the United States.)

5 Address (number, street, and apt. or suite no.). See instructions.

6 City, state, and ZIP code

Requester’s name and address (optional)

7 List account number(s) here (optional)

Part I Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.

Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter.

Social security number or

Employer identification number

Part II Certification

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue

Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.

Sign Here

Signature of

U.S. person Date

General Instructions Section references are to the Internal Revenue Code unless otherwise noted.

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

What’s New Line 3a has been modified to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the “LLC” box and enter its appropriate tax classification.

New line 3b has been added to this form. A flow-through entity is required to complete this line to indicate that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065).

Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they

Cat. No. 10231X Form W-9 (Rev. 3-2024)

Form W-9 (Rev. 3-2024) Page 2 must obtain your correct taxpayer identification number (TIN), which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following.

• Form 1099-INT (interest earned or paid).

• Form 1099-DIV (dividends, including those from stocks or mutual funds).

• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds).

• Form 1099-NEC (nonemployee compensation).

• Form 1099-B (stock or mutual fund sales and certain other transactions by brokers).

• Form 1099-S (proceeds from real estate transactions).

• Form 1099-K (merchant card and third-party network transactions).

• Form 1098 (home mortgage interest), 1098-E (student loan interest), and 1098-T (tuition).

• Form 1099-C (canceled debt).

• Form 1099-A (acquisition or abandonment of secured property).

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.

Caution: If you don’t return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later.

By signing the filled-out form, you:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued);

2. Certify that you are not subject to backup withholding; or

3. Claim exemption from backup withholding if you are a U.S. exempt payee; and

4. Certify to your non-foreign status for purposes of withholding under chapter 3 or 4 of the Code (if applicable); and

5. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting is correct. See What Is FATCA Reporting, later, for further information.

Note: If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9.

Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien;

• A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States;

• An estate (other than a foreign estate); or

• A domestic trust (as defined in Regulations section 301.7701-7).

Establishing U.S. status for purposes of chapter 3 and chapter 4 withholding. Payments made to foreign persons, including certain distributions, allocations of income, or transfers of sales proceeds, may be subject to withholding under chapter 3 or chapter 4 of the Code (sections 1441–1474). Under those rules, if a Form W-9 or other certification of non-foreign status has not been received, a withholding agent, transferee, or partnership (payor) generally applies presumption rules that may require the payor to withhold applicable tax from the recipient, owner, transferor, or partner (payee). See Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign Entities.

The following persons must provide Form W-9 to the payor for purposes of establishing its non-foreign status.

• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the disregarded entity.

• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the grantor trust.

• In the case of a U.S. trust (other than a grantor trust), the U.S. trust and not the beneficiaries of the trust.

See Pub. 515 for more information on providing a Form W-9 or a certification of non-foreign status to avoid withholding.

Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person (under Regulations section 1.1441-1(b)(2)(iv) or other applicable section for chapter 3 or 4 purposes), do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Pub. 515). If you are a qualified foreign pension fund under Regulations section 1.897(l)-1(d), or a partnership that is wholly owned by qualified foreign pension funds, that is treated as a non-foreign person for purposes of section 1445 withholding, do not use Form W-9. Instead, use Form W-8EXP (or other certification of non-foreign status).

Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a saving clause. Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes.

If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items.

1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien.

2. The treaty article addressing the income.

3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions.

4. The type and amount of income that qualifies for the exemption from tax.

5. Sufficient facts to justify the exemption from tax under the terms of the treaty article.

Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if their stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first Protocol) and is relying on this exception to claim an exemption from tax on their scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption.

If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233.