ATTACHMENT 6 BID/BIDDER CERTIFICATION SHEET

Invitation For Bid IFB Number 04A5390

Page 1 of2

Only an individual who is authorized to bind the bidding finn contractually shall sign the Bid/Bidder Certification Sheet. The signature must indicate the title or position that the individual holds in the firm. This Bid/Bidder Certification Sheet must be signed and returned along with all "required attachments" as an entire package with original signatures. The bid must be transmitted in a sealed envelope in accordance with IFB instructions.

A. Our all-inclusive bid is submitted in a sealed envelope marked "Bid Submittal -Do Not Opeu". B. All required attachments are included with this certification sheet. C. I have read and understand the DBE participation requirements and have included documentation demonstrating

that I have met the pmiicipation goals. D. The signature affixed hereon and dated certifies compliance with all the requirements of this bid document. The

signature below authorizes the verification of this certification. E. The signature and date affixed hereon certifies that this bid is a film offer for a 90-day period.

An Unsigned Bid/Bidder Certification Sheet May Be Cause for Bid Rejection

I. Company Name 2. Telephone Number 2a. Fax Number

'626}869-0192 CROSSTOWN ELECTRICAL & DATA. INC. (626) 813-6693 2b. Emai!Address DAVE@CROSSTOWNDATA.COM 3. Address

5454 DIAZ ST., IRWINDALE, CA 91706

Indicate your organization type: 4. D Sole Proprietorship I 5. D Partnership I 6. 0 Corporation

Indicate the applicable employee and/or corporation number:

7. Federal Employee ID No. (FEIN) 22-3611877

Indicate the Department of Industrial Relations information: 9. Contractor Registration Number

Indicate applicable license and/or certification information: IO. Contractor's State Licensing

Board Number 756309

C-10

12. Bidder' Name (Print)

I 8. California Corporation No. 2122963

1000000155

11. PUC License Number CAL-T-

N/A

13. Title

PRESIDENT

15. Date 1/17/2018

ent of General Services, Office of Small Business and Disabled Veteran Business

Yes D No IXJ b. Disabled Veteran Business Enterprise Yes D No 0 If yes, enter your service code below:

NOTE: A copy of your Certification is required to be included if either of the above items is checked "Yes".

Date application was submitted to OSDS, if an application is pending:

STATE OF CALIFORNIA · DEPARTMENT OF TRANSPORTATION

BID PROPOSAL ADM-1412 (REV. 1112015)

CONTRACTOR'S NAME (Please Print):

ITEM ESTIMATED UNIT OF NO. QUANTITY MEASURE

1 450 One (1) Hour

2 45 One ( I) Hour

3 90 One ( I) Hour

4 10 One (1) Hour

5 350 One ( I) Hour

6 35 One (1) Hour

7 450 One (1) Hour

8 45 One (I) Hour

9 600 One (1) Hour

10 80000 One ( I) Linear Foot

11 1000 One (I) Linear Foot

12 450 Each

13 150 Each

14 90 Each

15 70 Each

16 10 Each

17 10 Each

18 135 Each

ATTACHMENT 1

CROSSTOWN ELECTRICAL & DATA, INC.

ITEM

Journeyman Electrician rate

Overtime Journeyman Electrician rate

Journeyman Apprentice Electrician rate

Overtime Journeyman Apprentice Electrician rate

Laborer rate

Overtime Laborer rate

Telecommunications Technician rate

Overtime Telecommunications Technician rate

Traffic Control per Exhibit A, Scope of Work, Item 16

DLC Replacement

Conduit Replacement (up to 3" diameter)

Loop Replacement (Freeway mainline)

Loop Replacement (Freeway on/off ramp)

Loop Replacement (State highway)

Loop Replacement (Deep loop - freeway mainline)

Loop Replacement (Deep loop - Freeway on/offramp)

Loop Replacement (Deep loop - State highway)

Loop detector hand hole box replacement

UNIT PRICE (Price Per Unit of

Measure)

$ 155.00 $ I '18. 00 $ 120 .00 $ /55". 00 $ J/0 . 00 $ 142 . Ql) $ 112 . 00 $ 144.00 $ 450.00 $ 2.50 $ (o0.00 $ l,150.00 $ BS5. oo $ 82~. oo $ 1,550.00 $ 1,450 .00 $ t, ;oo. oo $ i,ooo . oo

Agreement Number 04A5390 Page 1of2

TOTAL (Estimated Quantity X Unit Price)

$ (oC{ .150. 00 $ 8,q10.oo $ 10,wo .oo $ 1,55'0 . 00 $ 38,500. 00 $ 4,q70.oo $ 50,400.00 $ Co,4W. 00 $ 2. 70, 000 . 00 $ 200,000.00 $ (oO, 000 -00 $ 517,500 .00 $ 132 ,750 .00 $ 74 I 25Q.()Q $ 108 I 5'00 ·00 $ 141560 .00 $ / 3, 000. 0 () $ 135,000. 00

SUBTOTAL PAGE I (Items 1-18) $ \ 1 l l(o ,8<DO. dO

ATTACHMENT 1

ITEM ESTIMATED UNIT OF UNITPRlCE

NO. QUANTITY MEASURE ITEM (Price Per Unit of Measure)

19 65 Each Traffic rated pull box and lid replacement (up to number 6 pull box) $ 2,900.00 20 180 Each Vehicle sensor node replacement (wireless magnetometer) $ I, 800. DO 21 15 Each Access point replacement (wireless magnetometer) $ 0,400. 00 22 15 Each Repeater replacement (wireless magnetometer) $ 2,Cfoo. oo 23 15 Each Solar panel replacement (wireless magnetometer) $ 1,aoo.00 24 15 Each Charge controller replacement (wireless magnetometer) $ qso.oo 25 15 Each Battery bank replacement (wireless magnetometer) $ I /?OO. 00 26 4 Each Microwave vehicle detection system replacement $ 12, ;oo. oo 27 I Lump Sum Stom1 water pollution control plan $ 2,1500 . 00 28

Miscellaneous materials and supplies (not included in items 1-27 listed above) for equipment and parts and miscellaneous equipment rental per Exhibit B, Item 6, Materials/Supplies and Equipment Rentals.

SUBTOTAL (Lines l -28)

Maximum allowable expenditure fo r miscellaneous materials and supplies as defined in Exhibit B, Item 6 Materia ls/Supplies and

29 Equipment Rentals. Actual costs shall be reimbursed based on submitted original receipts and invoices. TIDS AMOUNT SHALL BE 10% OF SUBTOTAL. (0.10 x subtotal}

( 1) THE ABOVE QUANTITIES ARE ES TIM A TES ONLY AND ARE GNEN AS A BASIS FOR TOTAL THIS COMPARISON OF BIDS. NO GUARANTEE IS MADE OR IMPLIED AS TO THE EXACT PROPOSAL QUANTITY THAT WlLL BE NEEDED. (Subtotal +Line 29)

(2) TN CASE OF DISCREPANCY BETWEEN THE UNIT PRICE AND THE TOTAL SET FORTH FOR A UNIT BASIS ITEM, THE UNIT PRlCE SHALL PREY AIL.

Agreement Number 04A5390 Page 2 of2

TOTAL (Estimated Quantity X Unit Price)

$ 188, 500 .00 $ 1171000 .00 $ C/0,()00 . 00 $ 4;, 500 . 00 $ 27,000. 00 $ 14,250 .00 $ 1q ,500 .oo $ 4q,zoo -OD $ 2,500. 00 $140,000.00

$ 2, 4 l4, 310. 00

$ 2Al1431 . 00

$ 2,~55,'74LO 0

STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION SUBCONTRACTING PROVISIONS/LIST Form ADM 1511 (REV. 9/06)

Agreen1ern U"l-A::>.)l::1U

Attachment 2 Page 1 of 1

List all subcontractors that will be used in this Agreement. All subcontractors listed below must be used in accordance with the Agreement. This includes, if applicable, compliance with the subcontracting provisions and any Disabled Veteran Business Enterprise (DVBE), Small Business, Micro-Business, and Disadvantaged Business Enterprises (DBE) subcontractors. If none, bidder to write "NONE" in this space.

NAME

CALIFORNIA PROFESSIONAL ENGINEERING, INC. CONTACT: VAN NGUYEN

BUSINESS ADDRESS

929 OTTERBEIN AVE, UNIT F LA PUENTE, CA 91748

TRAFFIC MANAGEMENT,18399 EDGEWATER DR. INC. OAKLAND CA 94621 CONTACT: ' MARK COLEMAN

DESCRIPTION OF PORTION OF WORK WHICH WILL BE DONE BY EACH CONTRACTOR*

LOOPS

TRAFFIC CONTROL

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STATE OF CALIFORNIA · DEPARTMENT OF TRANSPORTATION

DISADVANTAGED BUSINESS ENTERPRISE (DBE) INFORMATION ADM-0227F (Rev. 06/2012) (CONTRACTS FEDERALLY FUNDED IN WHOLE OR IN PART)

Attachment 3 Agreement 04A5390

Page 1of2

PART A - CONTRACTORS INFORMATION (Refer to Instructions on Page 2 of this form. Bidder/Proposer shall ensure all information provided is complete and accurate.)

CONTRACTOR'S BUSINESS NAME I AGREEMENT NUMBER I CONTRACT DOLLAR AMOUNT

04A5390 21C,55',74 l . 00 CROSSTOWN ELECTRICAL & DATA, INC. DATE

1/17/2018 CONTRACTOR'S BUSINESS ADDRESS

5454 DIAZ ST. CONT ACT PERSON

DAVID P. HEERMANCE

CITY IRWINDALE STATE

CA ZIP CODE

91706 EMAIL ADDRESS

DAVE@CROSSTOWNDATA.COM PART B - DBE INFORMATION AND DOCUMENTATION (Refer to Instructions in Page 2 of this form. Bidder/Proposer shall verify DBE certifications.) Contractor shall attach a copy of the bid (or price

quote) from the DBE (on the DBE's Letterhead) for all DBEs listed below.

(1) Prime and Subcontractors: List Name(s} and addresses (2) Area Code & (3) (4) Description of Work, (5) DBE or CUCP (6)

(7) DBE (8)

(9) Caltrans of all DBEs that will participate in this Agreement: Phone Number Tier Service, or Materiel Supplied

Certification Ownership $Amount Claimed

"lo of$ Value Use Only "lo Number. Code Claimed

CALIFORNIA PROFESSIONAL 626-81 0-1322 31277 lti 'J._ c;\) ~·

't()O/.O ENGINEERING, INC. 1 LOOPS 4 ~~ l::JZl::J u I I cKtsclN A.VcNUc, UNI I t-

DBE.-::: ~ ~~s,02~ '{) LA PUENTE, CA 91748

DB£ ojo =" 25.l51o

PART C - FOR CAL TRANS USE ONLY (Verification Completed by Civil Rights, Office of Business and Economic Opportunity):

PRINT VERIFIER'S NAME AND TITLE I SIGNATURE IDATE CIVIL RIGHTS STAMP OF APPROVED

DBE PARTICIPATION DYES ( %) ONO

CALIFORNIA. PROFESSIONAi.. ENGINEERING, INC.

Project Name: Electrical Rehab./Restore

929 Otterbein Avenue Unit E, La Puente, CA 91748 License # 793907 Exp: 04/30/2019

Classifications: A C-10 C-20; 8A Certified LSBE Certified LA County #54567 Exp : 11/30/2018

SBE Certified DGS #54567 Exp: 11/30/2018 SMBE/DBE/ UDBE Certified Caltrans #31277

DIR #1000001980 Exp. 06/30/2018 Union Signatory

Certifications subject to verification by quote recipient.

Project#: 04A5390

Agency: CAL TRANS DISTRICT 04

Bid Due Date: 1/18/2018 Bid Due Time: 2:15 pm Conditions Set Forth:

1. Estimate Based On One (1) Mobilization Only Unless Otherwise Noted. Additional Mobilizations at $3,500.00/ea. 2. I f Loop Work Quoted: Loop Stub-Out Must Be Existing & Marked If Not Called Out To Replace Per Plans; Cat-Tracking Must be Approved Prior.

3. At Least 3-Weeks Notification Required For Any Loop Work. 1-Work Day Based on Eight (8) Consecutive Work Hours per Day. 4. If You Are The Lowest Bidder & listed CPE, Please Inform Us Within 48 Hours. Electrical Material May Also Contain Long-Lead Items.

5. Quote Valid For 30 Days; California Professional Engineering, Inc. reserves the right to revise quotation as necessary.

eP& U ft{ea4ed to f!Mrdde tka e4timate ~ tk c.tteded «4e ol tk ~'(!zadM ta ~ tadM Md/ M ma'teltiat c.t 4ttiict ~ euit4 tk fda.t4 ad 4ft~tio"4 a4 ~:

If you are the apparent low, please inform CPE asap. Long lead materials apply.

Item# Description: UOM: Qty: Unit Price: Subtotal:

12 Loop replacement (freeway mainline) ea 450 875.00 393,750.00 13 Loop replacement (freeway on/off ramp) ea 150 700.00 105,000.00 14 Loop replacement (state highway) ea 90 650.00 58,500.00 15 Loop replacement (deep loop - freeway mainline) ea 75 2,000.00 150,000.00 16 Loop replacement (deep loop - freeway on/off ea 10 1,800.00 18,000.00

ramp) 17 Loop replacement (deep loop - state highway) ea 10 1,700.00 17,000.00

EXCLUDES: All Traffic Control

Exclusions: Bond & Bond Premium; All Permits; All Training Requirements; Signage; Lane Closure Request, Traffic Control, and Traffic Control Plan; Water; Sidewalk Concrete; Regulatory Signs; Hauling Dirt, Debris, & Concrete Foundation Away; Handicap Ramps; Repaving Street; Repaving Potholes; USA Marking Removals; Irrigation Work, Striping; Cold/Hot Mix; Temp. Asphalt; I nspection Fees; Temporary Loops; Temporary Signal; and/or High Voltage line Conflicts, Unless Otherwise Noted Above. Standard Certificate of Insurance will be provided upon request. Any additional requirements will be billed at cost. Terms: Unless other arrangements are made, payment is due & payable withinin 30 days upon completion; 1.5% monthly interest will apply thereafter. Bid based on entire bill of material and services and is inseparable unless written authorization is provided by CPE.

Acceptance TOTAL: $742,250.00

Ph: (626) 810-1338 / Fx: (626) 810-1322 /Email: estimating@cpengineeringinc.com

ATIACHMENT8 STATE OF CALIFORNIA· DEPARTMENT OF TRANSPORTATION BIDDER/PROPOSER DISADVANTAGED BUSINESS ENTERPRISE (DBE) GOOD FAITH EFFORTS DOCUMENTATION ADM-03121(REV06/2012) Page 1 of 4

CONTRACTOR'S NAME CROSSTOWN ELECTRICAL & DATA, INC. IFB OR RFP OR RFQ NUMBER

04A5390

Agreement 04A5390 Page 6 of9

DATE 1/17/18

BIDDER/PROPOSER INSTRUCTIONS: Submittal of only the Disadvantaged Business Enterprise (DBE) Information/Participation form, ADM-0227f, may not provide sufficient documentation to demonstrate that adequate good faith efforts (GFE) were made by the bidder/proposer. Bidder/proposers prosing goal attainment should always submit documentation for making GFE to protect its eligibility for award should Caltrans, in its evaluation, find that the goal was not met. Examples of disqualification may include but are not be limited to: 1) A DBE subcontractor was not certified by Caltrans or a state or local participating agency that has a reciprocal agreement with Caltrans, by the bid/proposal due date and time; or 2) Bidder/proposer made a mathematical error resulting in failure to meet the goal. Bidder/Proposer must make an adequate GFE to be responsive. When applying for a determination of a GFE when no contract goals have been attained or when only partial goallsl have been attained, bidders/proposers shall complete this Bidder/Proposer Disadvantaged Business Enterprise (DBE) Good Faith Efforts Documentation form, ADM-0312f, and submit the requested information below with its bid by the bid due date and time. Bidder/Proposer is responsible to: (11 ensure infonmation is complete and accurate, and (2) verify DBE certifications. 1. ADVERTISEMENT DOCUMENTATION List names and dates of each general circulation newspaper, trade paper and minority focused paper or other publication in which a request for DBE participation was placed. Attach a

"" '-'' "''""' ........ ._., "'""""''''-'' n ._., ..,,._....,, "'' ........ ~,...,...,.,...,,"

TITLE OF PUBLICATION PUBLICATION DATE(S) TITLE OF PUBLICATION PUBLICATION DATE(S)

.

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--2. DBE DOCUMENTATION

a. List the names and dates of written notices sent to certified DBE firms soliciting bids for the contract. b. List the dates and methods used for following up initial solicitations to determine with certainty whether or not the DBEs were interested. c. Attach a copy of any solicitation package, phone records, fax confirmations or solicitation follow-up correspondence sent to DBE firms. d. Identify information submitted to the bidder for this solicitation:

Check the appropriate box: 0 IFB 0 RFP 0 RFO

SOLICITATION DATE DATE DATE OF FOLLOW-UP METHOD NAME OF FIRM SOLICITED CONTACT NAME PHONE NUMBER

MAILED PHONED FOLLOW-UP PHONE/EMAIL

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ATTACHMENT 8 STATE OF CALIFORNIA· DEPARTMENT OF TRANSPORTATION

BIDDER/PROPOSER DISADVANTAGED BUSINESS ENTERPRISE (DBE) GOOD FAITH EFFORTS DOCUMENTATION ADM·0312f (REV 612012) Page 2 of 4

CONTRACTOR'S NAME IFB OR RFP OR RFQ NUMBER

2. DBE DOCUMENTATION (Continued)

SOLICITATION

Agreement 04A5390 Page 7 of 9

DATE

DATE DATE DATE OF FOLLOW-UP METHOD MAILED PHONED FOLLOW-UP PHONE/EMAIL

NAME OF FIRM SOLICITED CONTACT NAME PHONE NUMBER

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3. ITEMS OF WORK Identify the items of work made available to DBE firms, including, where appropriate, any breakdown of the contract work into economically feasible units to facilitate DBE participation. Bidder/Proposer shall demonstrate that sufficient work to facilitate DBE participation was made available to DBE fimis. ITEMS OF WORK:

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BREAKDOWN OF ITEMS:

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STATE OF CALIFORNIA· DEPARTMENT OF TRANSPORTATION ATIACHMENT8

Agreement 04A5390 Page 8 of9

BIDDER/PROPOSER DISADVANTAGED BUSINESS ENTERPRISE (DBE) GOOD FAITH EFFORTS DOCUMENTATION ADM-0312f (REV 06/2012) Page 3 of 4

CONTRACTOR'S NAME IFB OR RFP OR RFQ NUMBER DATE

4. DBE RESPONSES List the DBE firms that responded or submitted bids/proposals to your solicitation for participation in this contract that were not accepted. Provide a summary of your discussion and/or negotiations with each,

1f the firm selected for that oortion of work. and the reasons for vour choice. Attach cooies of auotes from DBE fi -··- ----- -- - - -- - ---- - . ·- -- - -- - ., ...

DBE FIRM NAME PHONE NUMBER RESPONDED SELECTED GIVE REASON FOR NON-SELECTION AND YES NO YES NO A SUMMARY OF DISCUSSIONS

. _/ \\'\' ~I

I

5. ASSISTANCE TO DBEs - Bonding, Insurance, etc. I

Identify efforts to assist DBEs in obtaining bonding, lines of credit, irsurance, and/or any technical assistance related to requirements for the work or for plans and specification provided to DBEs.

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ATTACHMENT 8 STATE OF CALIFORNIA· DEPARTMENT OF TRANSPORTATION BIDDER/PROPOSER DISADVANTAGED BUSINESS ENTERPRISE (DBE) GOOD FAITH EFFORTS DOCUMENTATION ADM-03121(REV06/2012) Page 4 of 4

CONTRACTOR'S NAME IFB OR RFP OR RFQ NUMBER

6. ASSISTANCE TO DBEs - Equipment/Materials, etc.

Agreement 04A5390 Page 9 of 9

DATE

Identify efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials, or related assistance or services excluding supplies and equipment the DBE subcontractor purchases or leases from the _Qrime contractor or its affiliate.

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7. ADDITIONAL DATA Provide any additional data to support a demonstration of GFE such as contacts with DBE assistance agencies. Identify the names of agencies, organizations, and groups providing assistance in contacting,

·--·-····· , -··- --··· --- ······-· .... __ .. -- ·-- -· ·--.----- -- - -··-·-- -··- -·· ·--.--··--- ----··--· ··-·· ,, __ , ···--···-·.-- __ , ---· NAME OF AGENCY/ORGANIZATION METHODS/DATE OF CONTACT RESULTS

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ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-641 O or TDD (916) 654-3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacrament, CA 95814.