HomeMy WebLinkAboutCDC/2009-27
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RESOLUTION NO. CDC/2009-27
RESOLUTION OF THE COMMUNITY DEVELOPMENT COMMISSION OF
THE CITY OF SAN BERNARDINO APPROVING AND AUTHORIZING THE
INTERIM EXECUTIVE DIRECTOR OF THE REDEVELOPMENT AGENCY
OF THE CITY OF SAN BERNARDINO ("AGENCY") TO EXECUTE A
CONSTRUCTION CONTRACT BY AND BETWEEN THE AGENCY AND
INLAND BUILDING CONSTRUCTION COMPANIES, INC., FOR A FIRE
SPRINKLER AND FIRE SUPPRESSION SYSTEM AT THE CALIFORNIA
THEATRE (CENTRAL CITY NORTH REDEVELOPMENT PROJECT
AREA)
WHEREAS, the City of San Bernardino, California (the "City"), is a municipal corporation
and a charter city duly created and existing pursuant to the Constitution and the laws of the State of
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California; and
WHEREAS, the Community Development Commission of the City of San Bernardino (the
"Commission") acting on behalf of the Redevelopment Agency of the City of San Bernardino (the
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"Agency"), is a redevelopment agency, a public body, corporate and politic of the State of
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California, organized and existing pursuant to the California Community Redevelopment Law (Part
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I of Division 24 commencing with Section 33000) of the Health and Safety Code of the State of
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California (the "Act"); and
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WHEREAS, pursuant to Section 33445 of the Act, the Agency may, with the consent of the
Mayor and Common Council of the City of San Bernardino (the "Council"), pay all or a part of the
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cost of installation and construction of any building, facility, structure or other improvement which
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is publicly owned either within or without the boundaries of a redevelopment project area if the
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Council determines: (I) that such buildings, facilities, structures or other improvements are of
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benefit to the redevelopment project area or the immediate neighborhood in which the project is
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located, regardless of whether such improvement is within another project area, or in the case of the
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project area in which substantially all the land is publicly owned, that the improvement is of benefit
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to an adjacent project area of the Agency; (2) that no other reasonable means of financing such
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buildings, facilities, structures or other improvements is available to the community, and such
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determination by the Commission and the Council shall be final and conclusive; and, (3) that the
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payment of funds for the cost of the facilities, structures or other improvements will assist in the
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1 elimination of one or more blighted conditions inside the project area or provide housing for low- or
2 moderate-income persons, and is consistent with the implementation plan adopted pursuant to
3 Section 33490; and
4 WHEREAS, the Council and the Commission have previously approved and adopted the
5 Redevelopment Plan for the Central City North Redevelopment Project Area (hereinafter referred to
6 as the "Redevelopment Plan"); and
7 WHEREAS, it is in the interests of the present landowners within the project area subject to
8 the Redevelopment Plan (the "Project Area") and the residents, both within the Project Area and
9 within the City generally, that the Agency cause the funding of the sprinkler installation and fire
10 suppression system contract with Inland Building Construction Companies, Inc. (the "Construction
11 Contract"), as the lowest responsible bidder, for the construction and installation of the fire sprinkler
12 and fire suppression system for the Agency-owned California Theatre located at 562 West 4th Street
13 (the "Property") within the Central City North Redevelopment Project Area; and
14 WHEREAS, the Agency-owned Property is required to have a fire suppression and sprinkler
15 system to assure safety to the public and to protect the Agency investment in this Property; and
16 WHEREAS, the improvements to the California Theatre will serve all residents of the City
17 and within certain redevelopment areas, and in particular the Project Area, the State College
18 Redevelopment Project Area ("State College") and the Tri-City Redevelopment Project Area ("Tri-
19 City") due to the fact that many of the patrons who will view performances and attend events at the
20 California Theatre either live within or maintain office locations within State College and/or Tri-
21 City (State College and Tri-City are herein sometimes referred to collectively as the "Benefited
22 Project Areas"); and
23 WHEREAS, the aforementioned Benefited Project Areas are in proximity to the Central City
24 North Redevelopment Project Area and serve commercial, retail and other community needs of the
25 Benefited Project Areas as to those functions that carmot be provided separately within the
26 Benefited Project Areas; and
27 WHEREAS, the Central City North Redevelopment Project Area is suffering from stagnant
28 property values and impaired investments, and in order to promote the City's health, safety and
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1 welfare, it is important that the Agency fund the costs of the aforementioned fire sprinkler and fire
2 suppression systems including the construction management thereof; and
3 WHEREAS, in connection with the funding of the fire sprinkler and fire suppression
4 systems, it is proposed that the Agency shall utilize certain funds attributable to the Benefited
5 Project Areas in an amount of $1,267,487.72 allocated in the amount of $641,365.66 from State
6 College and $621,122.06 from Tri-City payable from the net available bond proceeds of the 2002
7 Tax Allocation Refunding Bonds of the Agency.
8 NOW, THEREFORE, THE COMMUNITY DEVELOPMENT COMMISSION OF THE
9 CITY OF SAN BERNARDINO DOES HEREBY RESOLVE, DETERMINE AND ORDER AS
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Section 1.
The Recitals hereinabove are true and correct and are incorporated herein by
12 this reference.
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Section 2.
The Commission hereby authorizes the payment by the Agency of those costs
14 required by Construction Contract in the total amount not to exceed $1,267,487.72 in order to
15 ensure the economic enhancements and stability of the Benefited Project Areas and other
16 neighborhoods within the City for the reasons set forth in the Recitals hereinabove. Such payment
17 for the costs of the Construction Contract shall be funded from the net available bond proceeds of
18 the 2002 Tax Allocation Refunding Bonds of the Agency in the amount of $1,267,487.72 allocated
19 in the amount of$641,365.66 from State College and $621,122.06 from Tri-City as to the allocable
20 portions of said refunding bonds attributable to State College and Tri-City.
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Section 3.
The Commission also finds and determines that: (I )the buildings, facilities,
22 structures, or other improvements are of benefit to the Project Area and the Benefited Project Areas
23 or the immediate neighborhood in which the California Theatre is located, regardless of whether the
24 improvement is within another project area, or in the case of a project area in which substantially all
25 of the land is publicly owned that the improvement is of benefit to an adjacent project area of the
26 Agency; (2) no other reasonable means of financing the buildings, facilities, structures, or other
27 improvements comprising the fire sprinkler and fire suppression system to the California Theatre,
28 are available to the community; and (3) the payment of funds for the cost of buildings, facilities,
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1 structures, or other improvements will assist in the elimination of one or more blighting conditions
2 inside the Project Area, and is consistent with the implementation plan adopted pursuant to Section
3 33490.
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Section 4.
The Commission further authorizes the Interim Executive Director of the
5 Redevelopment Agency of the City of San Bernardino ("Agency") to execute the Construction
6 Contract in the form as attached to this Resolution as Exhibit "A" subject to approval as to form by
7 the Agency Counsel.
8 Section 5. The findings and determinations herein shall be final and conclusive. This
9 Resolution shall take effect from and after its date of adoption by this Commission.
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CDC/2009-27
RESOLUTION OF THE COMMUNITY DEVELOPMENT COMMISSION OF THE
CITY OF SAN BERNARDINO APPROVING AND AUTHORIZING THE INTERIM
EXECUTIVE DIRECTOR OF THE REDEVELOPMENT AGENCY OF THE CITY
OF SAN BERNARDINO ("AGENCY") TO EXECUTE A CONSTRUCTION
CONTRACT BY AND BETWEEN THE AGENCY AND INLAND BUILDING
CONSTRUCTION COMPANIES, INC., FOR A FIRE SPRINKLER AND FIRE
SUPPRESSION SYSTEM AT THE CALIFORNIA THEATRE (CENTRAL CITY
NORTH REDEVELOPMENT PROJECT AREA)
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Conununity
7 Development Conunission of the City of San Bernardino at a i oint regular
8 thereof, held on the 15th day of June
9 Conunission Members: Aves Navs
10 ESTRADA X
11 BAXTER X
12 BRINKER X
13 SHORETT X
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14 KELLEY X
15 JOHNSON X
16 MC CAMMACK X
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meeting
2009, by the following vote to wit:
Abstain
Absent
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Secretary
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20 The foregoing Resolution is hereby approved this /~ day of
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June
,2009.
!:T'T, ~_
atn k J. Morris, erson
unity Development Commission
of the City of San Bernardino
Approved as to Form:
26 By:
Agency Counsel
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CDC/2009-27
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EXHIBIT "A"
CONSTRUCTION CONTRACT
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PlAgenda.\Resolut;onslResolutions\2009\06-15-09 CA Theatre Fire Suppression System CDC Resodoc
CDC/2009-27
PROJECT CONTRACT
THIS PROJECT CONTRACT (the "contract" or "Contract"), is made and entered into this1Sth day of
June , 200~, by and between Redevelopment Agency of the City of San Bernardino (referred to
herein as the "Owner" or the <(Agency") and Inland Buildina Construction Comoanies Inc. (the
lIContractor").
WITNESSETH: That the parties hereto have mutually covenanted and agreed, and by these presents do
covenant and agree with each other as follows:
1. THE CONTRACT DOCUMENTS. The complete contract is comprised of and. includes: the
Notice of Inviting Bids, the fustructions to Contractors/ Bidders, the accepted Contractor's/ Bidder's Proposal,
the Bidding Schedule, this Project Contract, Contractor's! Bidder's Proposal Guaranty (Bid Bond), Contractor's!
Bidder's Bid, Contractor'sf Bidder's Certification Concerning Labors Standards and Prevailing Wage
Requirements, Contractor's I Bidder's Certlfication Concerning Equal Employment Opp6rtunity, Contractor's!
Bidder's Certification Concerning "Section 3" Clause, Contractor's! Bidder's and Vendors Certification
Concerning Affirmative Action Policy, Contractor's! Bidder's Certification Conceming Nonsegregated
Facilities, Contractor's! Information Good Faith Efforts, Contractor's/ Bidder's Certification Concerning N<?
Suspension and Debarment Requirements for Public Works Contracts Under the Public, Contracts Code and fot
all Contracts over $25,000 (49 CFR 29), Contractor'sl Bidder's Certification Concerning Trade Restrictions,
Contractor's / Bidder's Certification Concerning Worker's Compensation Insurance, Contractor's/ Bidder's
Certification Conceming Clean Air and Water Pollution Control, Contractor's! Bidder's Certification
Concerning Designation of Subcontractors, Contractor's/ Bidder's Certification Relating to Campaign
Contributions, Non-Collusion Affidavit, Contractor's/ Bidder's Certification Concerning Buy American,
Subcontractor's! Bidder's Statement of Experience, Subcontractor's Certification Concerning Labors Standards
and Prevailing Wage Requirements, Subcontractor's / Bidder's Certification Concerning Equal Employment
Opportunity, the Form o[Performance Bond, the Form of Labor and Material Bond, the Noncollusion Affidavit
the Certification of Insurance Coverage, Copies of State of California Contractor's Licenses, Worker's
Compensation Tnsurance, Liability Insurance per Contract, the complete Project Construction Plans and
Specifications and Provisions, General Conditions, the Special Conditions, the Detail Specifications, any
AddendunlS, Regulations, Ordinances, Codes, and Laws incorporated therein or herein by reference or otherwise
applicable to the Project.
All of the above docmnents are intended to cooperate so that any work called for in one and not mentioned in
the other, or vice versa, is to be executed the same as if mentioned in all said documents. The documents
comprising the complete contract are hereinafter referred to collectively as the Contract Documents.
2. THE WORK. Contractor agrees to furnish all tools, apparatus, facilities, equipment, labor and
materials (except that specifically mentioned as being furnished by others) necessary to perform and complete
the work in a good and worlcerlilce manner as called for, and, in the manner -designated in, and in strict
confonnity with the Project Construction Plans, Detail Specifications, and other Contract Documents which are
identified by the signatures of the parties to this Contract and are, collectively, entitled:
Redevelopment Agency of the City San Bernardino
CALIFORNIA THEATRE PROJECT-FlRE SUPPRESSION SYSTEM
562 WEST 4TH STREET, SAN BERNARDINO
3. CONTRACT PRICE. The Agency agrees to pay and the Contractor agrees to accept, in full payment
for the work above agreed to be done, the following compensation, to-wit: Amounts as determined by applying
unit prices contained in the Contractor's Bid Schedule to the actual quantities used for the Project.
nedevelopment AgeneyoftlLe Clt~ of San Bernardino
................................Project:CallfornlaTheatre562Wcsf4thStrcet (FfrcSuppr=lolI Systcm)
Addenduml
CONTRACT DOCUMENTS
00200
Rev.04f14/09
CDC/2009-27
For the purpose of fixing the amount of bonds referred to in Paragraph 23 of the Instructions to Contractorsl
Bidders, it is estimated by both Parties that the total contract price based on the foregoing is
EiQht hundred twenty four thousand dollars - - Dollars ($ 824,000.00 )
Redevelopmcnt Agency oftlleCityorSan Berllardlno
................." ProJed: CalifornIa Theatre 562 West 4th Street (Fire Suppre5,IOll System)
CONTRACT DOCUMENTS
0(1200
Rev.04fI4/Cl9
Addendum 1
CDC/2009-27
4. DISPUTES PERTAINING TO PAYMENT FOR WORK. Should any dispute arise respecting the
true value of any work done or any work omitted, or of any extra work which the Contractor may be required to
do, or respecting the size of any payment to the Contractor during the performance of this Contract, said dispute
shall be decided by a third party chosen by the Agency and the Contractor, and their decision shall be final and
conclusive. Under no condition shall there be a cessation of work by the Contractor during any such dispute.
This article does not exclude recovery of damages by either party for delays.
5. PAYMENT. Not later than the 20th day of each calendar month, the Contractor shall make a partial
payment request to the Agency on the basis of an estimate approved by the Construction Manager and Agency
of the work performed since the last partial payment request during the preceding month by the Contractor with
(10%) ten percent of the amount of each such estimate retained by the Agency, until completion of the Project
and the recordation of a Notice of Completion of all work covered by this Contract. The Agency shall make any
partial payments provided for in this contract to the Contractor within thirty (30) days of the Agency's receipt of
an undisputed and properly executed partial payment request from the Contractor. The Agency shall pay the
Contractor interest on the amount of any portion of a partial payment, excluding retention amounts, not made to
the Contractor within thirty (30) days of the Agency's receipt of an undisputed and properly executed partial
payment request from the Contractor at the legal rate set forth in California Code of Civil Procedure Section
685.010. Upon receipt of a partial payment request from the Contractor, the Agency shall review the partial
payment request for the purpose of determining whether or not the partial payment request is a proper partial
payment request. Any partial payment request determined by the Agency not to be a proper partial payment
request suitable for payment shall be returned to the Contractor by the Agency within seven (7) days of the
Agency's receipt of such partial payment request. A partial payment request returned to the Contractor by the
Agency under the provisions of this section shall be accompanied by a written document setting forth the
reason(s) why the partial payment request is not proper. The number of days for the Agency to make a certain
partial payment provided for in this Contract, without incurring interest pursuant to this section, shall be reduced
by the number of days by which the Agency exceeds the seven (7) days return period for such partial payment
request, if determined to be improper, as set forth in this section. For the purposes of this section, a "partial
payment" means all payments due to the Contractor under this contract, exclusive of that portion of the final
payment designated as retention earnings. Also, for the purposes of this section, a partial payment request shall
be considered properly executed by the Agency, if funds are available to pay the partial payment request and
payment is not delayed due to an audit inquiry by the Agency's financial officer. The Agency will release
Contractor's retention earnings within forty-five (45) days after recordation of Notice of Completion, as defined
in California Civil Code Section 3093. Recordation of a Notice of Completion for the Project by the Agency
shall constitute the Agency's acceptance of the Project work.
6. REAL PROPERTY LIENS. Contractor shall promptly pay all valid bills and charges for material,
labor, equipment or otherwise in connection with or arising out of the performance of this Contract, and will
hold the Agency free and harmless against all liens and! or claims of lien for material, labor or equipment filed
against the real property or any part thereof, and from and against all expenses and liability in connection
therewith, including, but not limited to, court costs and attorney's fees resulting or arising therefrom. In the
event any liens and! or claims of lien are filed for record against the real property, or the Agency receives notice
of any unpaid bill or charge in connection with the performance of this Contract, Contractor shall forthwith
either pay and discharge the liens and! or claims of lien and cause same to be released of record, or Contractor
shall furnish the Agency with proper indemnity, either by satisfactory corporate Surety Bond or satisfactory title
policy. Said indemnity shall also be subject to approval of Lien Holder.
7. TIME FOR COMPLETION. All work under this contract shall be completed within a period of one
hundred and sixteen (116) consecutive calendar days from the date of the Contractor's receipt of Notice to
Proceed from the Agency.
Redevelopment Agency of the City of S~n Bernardino
..............Project;Calif()rniaTheatre562West4thStrect(FireSuJlpressionSystem)
CONTRACT DOCUMENTS
00200
Rev.041l4/09
Addendum}
CDC/2009-27
8. EXTENSION OF TIME. If the Contractor is delayed by acts of negligence of the Agency, or its
employees or those under it by Contract or otherwise, or by changes ordered in the work, or by strikes, lockouts,
fire, unavoidable casualties, or any causes beyond the Contractor's control, or by delay authorized by the
Agency, or by any justifiable cause which the Construction Manager and Agency shall authorize, then the
Contractor shall make Qut a written claim addressed to the Agency setting forth the reason for the delay and the
extension of the time requested and forward a copy of the claim to the Construction Manager and Agency for
approval. The Construction Manager and Agency will evaluate the claim and if the claim is justifiable, will
request the Agency's approval. No such extension will be allowed unless written claim therefore has been made
within three (3) days after the delay became apparent.
9. LIQUIDATED DAMAGES FOR DELAY. If the Contractor is unahle to complete the work within
the specified time, the Contractor agrees to pay as liquidated damages, the sum of $1,000.00 for each
consecutive calendar day, Wltil the work has been completed pursuant to the terms of this Contract.
10. INDEMNIFICATIONS AND HOLD HARMLESS. The Contractor shall defend, indenmify,
protect and hold free and harmless the Agency, its officers, employees, and agents from and against any and all
actions, suits, proceedings, claims, demands, losses, costs, injuries to or death of any person or persons and
expenses, including attorney's including attorney's fees, for injury or damage of any type claimed which is
brought by any individual or entity, whether public or private, as a result of the acts, errors or omissions of the
Contractor, its officers, employees, agents, and its Subcontractors arising from or related to performance of the
work required hereunder to complete the Project.
11. INSURANCE. The Contractor shall procure and maintain insurance policies meeting the
minimum requirements set forth below. Insurance shall be provided by insurers satisfactory to the Agency.
Certificates evidencing insurance coverage shall be delivered to the Agency for each policy required herein prior
to commencement of any work. All insurance certificates shall name the Agency as an additional insured and
provide for thirty (30) days prior to written notice of cancellation to the Agency.
a. Comprehensive General Liability Insurance. The Contractor shall maintain comprehensive
generalliahility insurance of not less tlie One Million Dollars ($1,000,000) combined single limit per
occurrence. The Contractor must provide CGL Policy with appropriate endorsement for builders course
of construction and fire casualty loss.
b. Automobile Insurance. The Contractor shall maintain comprehensive automobile liability
insurance of not less than One Million Dollars ($1,000,000) combined single limit per occurrence.
c. Worker's COffinensation. The Contractor shall maintain worker's compensation coverage
III accordance with the Laws of the State of California for all workers under it employ and
Subcontractors performing the work required herein.
12. LABOR PROVISIONS.
a. Minimum Wal!es.
(1) All lahorers and mechanics employed or working upon the site of the Project will be paid
unconditionally and not less often than once a week, and without subsequent deduction or rebate on any account
(except such payroll deductions as are permitted by regulations issued by the Secretary of Labor under the
Copeland Act (29 CFR Part 3)), the full amount of wages and hona fide fringe benefits (or cash equivalents
thereof) due at time of payment computed at rates not less than those contained in the wage determination of the
Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship
which may be alleged to exist between the Contractor and such laborers and mechanics. Contributions made or
Redevelopment Agency of the City or San Be~na~dino
..... Project: California Theat~e 562 We~t 4th Street (Fire SUpp~es~ion System)
CONTRACT DOCUMENTS
00200
Rev.04f14/09
Addendllml
CDC/2009-27
costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis-Bacon Act on behalf
of laborers or mechanics are considered wages paid to laborers or mechanics, subject to the provisions of
subparagraph a.(4) below; also, regular contributions made or costs incurred for more than a weekly period (but
not less often than quarterly) under plans, funds, or programs which cover the particular weekly period, are
deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be
paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work
actually performed, without regard to skill, except as provided in paragraph d. of this clause. Laborers or
mechanics performing work in more than one classification may be compensated at the rate specified for each
classification for the time actually worked therein: provided, that the employer's payroll records accurately set
forth the time spent in each classification in which work is performed. The wage determination (including any
additional classification and wage rates conformed under a.(2) of this section) and the Davis.Bacon poster (WH-
1321) shall be posted at all times by the Contractor and its Subcontractors at the site of the Project in a
prominent and accessible place where it can easily be seen by the workers.
(2) (i) Any class oflaborers or mechanics which is not listed in the wage determination and which is to
be employed under the contract shall be classified in conformance with the wage detennination. The Agency
shall approve an additional classification and wage rate and funge benefits therefor only when the following
criteria have been met:
(A) The work to be performed by the classification requested is not performed by a classification in
the wage determination; and
(B) The classification is utilized in the area by the construction industry; and
(C) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship
to the wage rates contained in the wage determination.
(ii) If the Contractor and the laborers and mechanics to be employed in the classification (if
known), or their representatives, and the Agency agree on the classification and wage rate (including the amoW1t
designated for fringe benefits where appropriate), a report of the action taken shall be sent by the Agency to the
Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of
Labor, Washington, D.C. 20210. The Administrator, or an authorized representative, will approve, modifY, or
disapprove every additional classification action within thirty (30) days of receipt and so advise the Agency or
will notifY the Agency within the 30-day period that additional time is necessary.
(Hi) In the event the Contractor, the laborers or mechanics to be employed in the classification or
their representatives and the Agency do not agree on the proposed classification and wage rate (including eh
amount designated for fringe benefits where appropriate), the Agency shall refer the questions, including the
views of all interested parties and the recommendation of the Agency, to the Administrator for determination.
The Administrator, or an authorized representative, will issue a determination within thirty (30) days of receipt
and so advise the Agency or will notify the Agency within the thirty (30) day period that additional time is
necessary. (Approved by the Office of Management and Budget under OMB control number 1215-0140.)
(iv) The wage rate (including fringe benefits where appropriate) determined pursuant to
subparagraphs (2)(ii) or (iii) of this paragraph, shall be paid to all workers performing work in the classification
under this Contract from the first day on which work is performed in the classification.
(3) Whenever the minimum wage rate prescribed in the Contract for a class of laborers or
mechanics includes a fringe benefit which is not expressed as an hourly rate, the Contractor shall either pay the
benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash
equivalent thereof.
Redevelopment Agency of the City of San Bernardino
................w. ....... .... Project: CaUfornia Theatre 562 West 4th. Street (Fire Suppression System)
CONTRACT DOCUMENTS
00200
Rev.04I14f09
Addendum I
CDC/2009-27
(4) If the Contractor does not make payments to a trustee or other third person, the Contractor may
consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in
providing bona fide fringe benefits under a plan or program, provided, that the Secretary of Labor has found,
upon the written request of the Contractor, that the applicable standards of the Davis-Bacon Act have been met.
The Secretary of Labor may require the Contractor to set aside in a separate account assets for the meeting of
obligations under the plan or program.
b. Withholding. The Agency shall upon its own action or upon written request of an authorized
representative of the Department of Labor withhold or cause to be withheld from the Contractor under this
contract or any other Federal contract with the same Contractor, or any other federally-assisted contract subject
to Davis-Bacon prevailing wage requirements, which is held by the same Contractor, so much of the accrued
payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices,
trainees, and helpers, employed by the Contractor or any subcontractor the full amount of wages required by the
contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper,
employed or working on the site of the Project, all or part of the wages required by the contract, the Agency may
after written notice to the Contractor, take such action as may be necessary to cause the suspension of any
further payment, advance, or guarantee of funds until such violations have ceased.
c. Payrolls and Basic Records.
(I) Payrolls and basic records relating thereto shall be maintained by the Contractor during
the course of the work and preserved for a period of three (3) years thereafter for all laborers and mechanics
working at the site of the Project. Such records shall contain the name, address, and social security number of
each such worker, his or her correct classification, hourly rates of wages paid (including rates of contributions or
costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in section
l(b)(2)(B) of the Davis-Bacon Act), daily and weekly number of hours worked, deductions made and actual
wages paid. Whenever the Secretary of Labor has found under paragraph a(4) of this clause that the wages of
any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a
plan or program described in section I (b )(2)(B) of the Davis-Bacon Act, the Contractor shall maintain records
which show that the commitment to provide such benefits is enforceable, that the plan or program is financially
responsible, and that the plan or program has been communicated in writing to the laborers or mechanics
affected, and records which show the costs anticipated or the actual costs incurred in providing such benefits. If
the Contractor employs apprentices or trainees under approved programs shall maintain written evidence of the
registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices
and trainees, and the ratios and wage rates prescribed in the applicable programs.
(2) (i) The Contractor shall submit weekly for each week in which any Contract work
is performed a copy of all payrolls to the Agency. The payrolls submitted shall set out accurately and
completely all of the information required to be maintained under paragraph c(l) above. This information may
be submitted in any form desired. Optional Form WH-347 is available for this purpose and may be purchased
from the Superintendent of Documents (Federal Stock Number 029-005-00014-1), U.S. Government Printing
Office, Washington, D.C. 20402. The Contractor is responsible for the submission of copies of payrolls by all
Subcontractors.
(ii) Each payroll submitted shall be accompanied by a "Statement of Compliance,"
signed by the Contractor or Subcontractor or his or her agent who pays or supervises the payment of the persons
employed under the Contract and shall certify the following:
Redevelopment Agency of tbe City of San Bernardino
.. .. Project: CaHrornJa Theatre 562 West 4tb Street (Fire Suppression System)
CONTRACT DOCUMENTS
0020{)
Rev.04J14/09
Addendum I
CDC/2009-27
(A) That the payroll for the payroll period contains the information required
to be maintained under paragraph c( 1) above and that such information is correct and complete;
(B) That each laborer and mechanic (including each helper, apprentice and
trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without
rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the
full wages earned, other than permissible deductions as set forth in 29 CFR Part 3;
(C) That each laborer or mechanic has been paid not less than the
applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as
specified in the applicable wage determination incorporated into the Contract.
(iii) The weekly submission of a properly executed certification set forth on the
reverse side of Optional Form WH-347 shall satisfy the requirement for submission of the "Statement of
Compliance" required by paragraph c.(2)(b) of this section.
(iv) The falsification of any of the above certifications may subject the Contractor
or Subcontractor to civil or criminal prosecution under Section 1001 of Title 18 and Section 231 of Title 31 of
the United States Code.
(3) The Contractor or Subcontractor shall make the records required under paragraph c(1)
of this section available for inspection, copying or transcription by authorized representatives of the Agency, the
Department of Labor, and shall permit such representatives to interview employees during working hours on the
job. If the Contractor or Subcontractor fails to submit the required records or to make them available, the
Department of Labor may, after written notice to the Contractor or Agency take such action as may be necessary
to cause the suspension of any further payment, advance, or guarantee of fimds. Furthermore, failure to submit
the required records upon request or to make such records available may be grounds for Debarment of the
Contractor or Subcontractor pursuant to 29 CFR 5.12.
d. Aoorentices and Trainees.
(1) Anmentices. Apprentices will be permitted to work at less than the predetermined rate
for the work they perform when they are employed pursuant to and individually registered in a bona fide
apprenticeship program registered with the United States Department of Labor, Employment and Training
Administration, Bureau of Apprenticeship and Training, or with a State Apprenticeship Agency recognized by
the Bureau, or if a person is employed in his or her first ninety (90) days of probationary employment as an
apprentice in such an apprenticeship program, who is not individually registered in the program, but who has
been certified by the Bureau of Apprenticeship and Training or a State Apprenticeship Agency (where
appropriate) to be eligible for probationary employment as an apprentice. The allowable ratio of apprentices to
journeymen on the Project site in any craft classification shall not be greater than the ratio permitted to the
contractor as to the entire work force under the registered program. Any worker listed on a payroll at an
apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the
applicable wage rate on the wage determination for the classification of work actually performed. In addition,
any apprentice performing work on the job site in excess of the ratio permitted under the registered program
shall be paid not less than the applicable wage rate on the wage determination of the work actually performed.
Where a Contractor is performing construction on a project in a locality other than that in which its program is
registered, the ratios and wage rates (expressed in percentages of the journeyman's hourly rate) specified in the
contractor's or Subcontractor's registered program shall be observed. Every apprentice must be paid at not less
than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage
of the journeymen hourly rate specified in the applicable wage determination. Apprentices shall be paid fringe
Redevelopment Agency of the City of San Bernardino
.......... Project: California Theatre 562 West 4th Street (Fire Supprl'.'lsion System)
CONTRACT DOCUMENTS
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benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does
not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage
determination for the applicable classification. If the Administrator determines that a different practice prevails
for the applicable apprentice classification, fringes shall be paid in accordance with that determination. In the
event the Bureau of Apprenticeship and Training, or a State Apprenticeship Agency recognized by the Bureau,
withdraws approval of an apprenticeship program, the Contractor will no longer be permitted to utilize
apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is
approved.
(2) Trainees. Except as provided in 29 CFR 5.16, trainees will not be permitted to work at
less than the predetermined rate for the work performed unless they are employed pursuant to and individually
registered in a program which has received prior approval, evidenced by formal certification by the United
States Department of Labor, Employment and Training Administration. The ratio of trainees to journeymen on
the Project site shall not be greater than permitted under the plan approved by the Employment and Training
Administration. Every trainee must be paid at not less than the rate specified in the approved program for the
trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable
wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee
program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe
benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines
that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage
determination which provides for less than full fringe benefits for apprentices. Any employee listed on the
payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment
and Training Administration shall be paid not less than the applicable wage rate on the wage determination for
the classification of work actually performed. In addition, any trainee performing work on the Project site in
excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on
the wage determination for the work actually performed. In the event the Employment and Training
Administration withdraws approval of a training program, the Contractor will no longer be permitted to utilize
trainees at less than the applicable predetermined rate for the work performed until an acceptable program is
approved.
(3) Equal Emolovment Oooortunitv.
journeymen under this part shall be in conformity with the
Executive Order 11246, as amended, and 29 CFR Part 30.
The utilization of apprentices, trainees and
equal employment opportunity requirements of
e. Comoliance With Cooeland Act Requirements. The Contractor shall comply with the
requirements of 29 CFR Part 3, which are incorporated by reference into this Contract.
f. Subcontracts. The Contractor and each Subcontractor shall insert in any subcontracts the
clauses contained in paragraphs a. through j. of this Contract and such other clauses may by appropriate
insbuctions require, and also a clause requiring the Subcontractors to include these clauses in any lower tier
subcontracts. The Contractor shall be responsible for the compliance by any Subcontractor or lower tier
Subcontractor with all the Contract clauses in 29 CFR 5.5.
g. Contract Termination: Debarment. A breach of the Contract clauses in paragraphs a. tlrrough j.
of this Section 8 and a. through e. of Section 9 below are grounds for termination of this Contract, and for the
Debarment of the Contractor or Subcontractor as provided in 29 CFR 5.12.
h. COilloliance With Davis-Bacon and Related Act Requirements. All rulings and interpretations
of the Davis-Bacon and Related Acts contained in 29 CFR Parts 1,3, and 5 are herein incorporated by reference
in this Contract.
Redevelopment Agency of the City of Sail Bemardino
.........Project:CaliforniaTheatre562West4thStreet(FireSuppressionSyslem)
Addenduml
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1. DisDutes Concemine Labor Standards. Disputes arising out of the labor standards provisions of
this Contract shall not be subject to the general disputes provision of this Contract. Such disputes shall be
resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR Parts 5, 6 and 7.
Disputes within the meaning of this clause include disputes between the Contractor (or any of its subcontracts)
and the Agency, the U.S. Department of Labor, or the employees or their representatives.
J. Certification of Eligibilitv.
(1) By entering into this contract, the Contractor certifies that neither it (nor he or she) nor
any person or firm who has an interest in the Contractor's firm is a person or firm ineligible to be awarded
Government contracts by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5. 12(a)(I).
(2) No part of this contract shall be subcontracted to any person or firm ineligible for award
of a Government contract by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).
(3) The penalty for making false statements or certifications in the making of this Contract
is prescribed in the U.S. Criminal Code, 18 U.S.c. 1001.
13. CONTRACT WORK HOURS AND SAFETY STANDARDS REQUIREMENTS. As used in the
following provision, the term "laborers" and "mechanics" include watchmen and guards.
a. Overtime ReQuirements. Neither the Contractor nor any Subcontractor contracting for any part
of the Project which may require or involve the employment of laborers or mechanics shall require or permit any
such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of
forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one
and one-half times the basic rate of pay for all hours worked in excess of forty (40) hours in such workweek,
whichever is greater.
b. Violation: Liabilitv for Unoaid Wages: Liauidated Damages. In the event of any violation of
the clause set forth in paragraph a. above, the Contractor and any Subcontractor responsible therefor shall be
liable for the unpaid wages. In addition, the Contractor and Subcontractor shall be liable to the Agency for
liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or
mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph a. above,
in the sum of$IO (ten dollars) for each calendar day on which such individual was required or permitted to work
in excess of the standard workweek of forty (40) hours without payment of the overtime wages required by the
clause set forth in paragraph a. above.
c. Withholding: for Unoaid Wag:es and Liauidated Damag:es. The Agency shall upon its own
action or upon written request of an authorized representative of the Department of Labor withhold or cause to
be withheld, from any monies payable on account of work performed by the Contractor or Subcontractor under
any such contract or any other Federal contract with the same Contractor, or any other Federally-assisted
contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same Contractor,
such sums as may be determined to be necessary to satisfy any liabilities of such Contractor or Subcontractor for
unpaid wages and liquidated damages as provided in the clause set forth in paragraph b. above.
d. Workimr conditions. Neither the Contractor nor any Subcontractor may require any laborer or
mechanic employed in the performance of any contract to work in surroundings or under working conditions
that are unsanitary, hazardous or dangerous to his health or safety as determined under construction safety and
health standards (29 CFR Part 1926) issued by the Department of Labor.
Redevelopment Agency of the City of San Bernardino
... ..... Proj~l: California Theatre 562 West 4111 Street (Fire Suppressioll System)
CONTRACT DOCUMENTS
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e. Subcontracts. The Contractor and any Subcontractor shall insert in any subcontracts the clauses
set forth in paragraphs a. through d. and also a clause requiring the Subcontractor to include these clauses in any
lower tier subcontracts. The Contractor shall be responsible for compliance by any Subcontractor or lower tier
Subcontractor with the clauses set forth in paragraphs a. through d.
14. NONDISCRlMINA TION. The Contractor, with regard to the work performed by it during the
Contract, shall not discriminate on the grounds of race, color, or national origin in the selection and retention of
Subcontractors, including procurements of materials and leases of equipment. The Contractor shall not
participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations,
including employment practices when the Contract covers a program set forth in Appendix B of the Regulations.
15. DISADVANTAGED BUSINESS ENTERPRISE PROGRAM PROVISIONS. The Contractor,
subrecipient or Subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the
performance of this contract Failure by the Contractor to carry out these requirements is a material breach of
this Contract, which may result in the termination of this Contract or such other remedy as recipient deems
appropriate.
The Contractor agrees to pay each Subcontractor under this contract for satisfactory performance of its Contract
no later than ten (10) days from the receipt of each payment the Contractor receives from Agency. The
Contractor agrees further to return retainage payments to each Subcontractor within seven (7) days after the
Subcontractor's work is satisfactorily completed. Any delay or postponement of payment from the above
referenced time frame may occur only for good cause following written approval of the Agency. This clause
applies to both Disadvantage Business Enterprises (DBE) and non-Disadvantage Business Enterprises
Subcontractors.
16. CIVIL RIGHTS. The Contractor assures that it will comply with pertinent statutes, Executive
Orders and such rules as are promulgated to assure that no person shall, on the grounds of race, creed, color,
national origin, sex, age or handicap be excluded from participating in any activity conducted with or benefiting
from Federal assistance. This Provision binds the Contractor from the bid solicitation period through the
completion of the Contract. This provision shall be inserted in all subcontracts, subleases and other agreements
at all tiers.
17. SOLICITATIONS FOR SUBCONTRACTS, INCLUDING PROCUREMENTS OF MATERIALS
AND EQUIPMENT. In all solicitations either by competitive bidding or negotiation made by the Contractor
for work to be performed under a subcontract, including procurements of materials or leases of equipment, each
potential Subcontractor or supplier shall be notified by the Contractor of the Contractor's obligations under this
Contract and the Regulations relative to nondiscrimination on the grounds of race, color or national origin.
18. INFORMATION AND REPORTS. The Contractor shall provide all information and reports
required by the Regulations or directives issued pursuant thereto and shall permit access to its books, records,
accounts, other sources of information, and its facilities as may be determined by the Agency to be pertinent to
ascertain compliance with such Regulations, orders, and instructions. Where any information required of a
Contractor is in the exclusive possession of another who fails or refuses to furnish this information, the
Contractor shall so certify to the Agency, as appropriate, and shall set forth what efforts it has made to obtain the
information.
19. SANCTIONS FOR NONCOMPLIANCE. In the event of the Contractor's noncompliance with the
nondiscrimination provisions of this contract, the Agency shall impose such contract sanctions as determine to
be appropriate, including but not limited to:
Redevelopment Agency of the City of San Bernardino
........ ....rroject:CaHrorniaTheatreS6ZWest4thStreet(FireSuppression System)
CONTRACT DOCUMENTS
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Addenduml
CDCj2009-27
a. Withholding of payments to the Contractor under the contract until the Contractor
complies, and/or
b. Cancellation, termination or suspension of the contract, in whole or in part.
20. INSPECTION OF RECORDS. The Contractor shall maintain an acceptable cost accounting
system. The Agency, the Comptroller General of the United States or any of their duly authorized
representatives shall have access to any books, documents, paper, and records of the Contractor which are
directly pertinent to this Contract or the Project for the purposes of making an audit, examination, excerpts, and
transcriptions. The Contractor shall maintain all required records for three (3) years after the Agency makes
final payment and all other pending matters are closed.
21. RIGHTS IN INVENTIONS. All rights to inventions and materials generated under this Contract are
subject to regulations issued by the Agency. Information regarding these rights is available from the Agency.
22. BREACH OF CONTRACT TERMS. Any violation or breach of terms of this Contract on the part of
the Contractor or its Subcontractors may result in the suspension or termination of this Contract or such other
action that may be necessary to enforce the rights of the Agency under this Contract. The duties and obligations
imposed by the Contract Documents and the rights and remedies available thereunder shall be in addition to and
not a limitation of any duties, obligations, rights and remedies otherwise imposed or available by Law.
23. TERMINATION OF CONTRACT BY AGENCY.
a. The Agency may, by written notice, terminate this Contract in whole or in part at any time,
either for the Agency's convenience or because of the Contractor's failure to fulfill it's Contract
obligations. Upon receipt of such notice, services shall be immediately discontinued (unless the notice
directs otherwise) and all materials as may have been accumulated in performing this Contract, whether
completed or in process, delivered to the Agency.
b. If the termination is for the convenience of the Agency, an equitable adjustment in the Contract
price shall be made, but no amount shall be allowed for anticipated profit on unperformed services.
c. If the termination is due to failure to fulfill the Contractor's obligations, the Agency may take
over the work and prosecute the same to completion by Contract or otherwise. In such case, the
Contractor shall be liable to the Agency for any additional cost occasioned to the Agency thereby.
d. If, after notice of termination for failure to fulfill Contract obligations, it is determined that the
Contractor had not so failed, the termination shall be deemed to have been effected for the convenience
of the Agency. In such event, adjustment in the contract price shall be made as provided in paragraph 2
of this clause.
e. The rights and remedies of the Agency provided in this clause are in addition to any other rights
and remedies provided by law or under this contract.
24. INCORPORATION OF PROVISIONS. The Contractor shall include the provisions of this Contract in
every subcontract, including procurements of materials and leases of equipment, unless exempt by the
Regulations of directives issued pursuant thereto. The Contractor shall take such action with respect to any
subcontract or procurement as the Agency may direct as a means of enforcing such provisions including
sanctions for noncompliance. Provided, however, that in the event the Contractor becomes involved in, or is
Redevelopmelll Agellcy of the City of Sail BernardillO
.....,............... ,.........Project:CaliforniaTheatre562West4thStreet(fireSuppressiOllSys{em)
Addenduml
CONTRACT DOCUMENTS
00200
Rev.04/14/09
CDC/2009-27
threatened with, litigation with a Subcontractor or supplier as a result of such direction, the Contractor may
request the Agency to enter into such litigation to protect the interests of the Agency and, in addition, the
Contractor may request the United States to enter into such litigation to protect the interests of the United States.
25. CONTRACTOR CLAIMS OF $375,000 OR LESS. Claims by the Contractor relating to the Project for
(a) a time extension, (b) money or damages arising from work done by, or on behalf of, the Contractor on the
Project for which payment is not expressly provided for or to which the Contractor is not otherwise entitled, or
(c) an amount that is disputed by the Agency, with a value of $375,000 or less, are subject to the claims
procedures set forth in California Public Contract Code Sections 20104, et seq., except as otherwise provided in
this Contract and the incorporated documents, conditions and specifications. A copy of California Public
Contract Code Sections 20104 through 20104.6 is attached to this Contract.
26. LOBBYING AND INFLUENCING FEDERAL EMPLOYEES.
(1) No Federal appropriated funds shall be paid, by or on behalf of the Contractor or its Subcontractors,
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
making of any Federal grant or the amendment or modification of any Federal grant.
(2) If any funds other than Federal appropriated funds have been paid or will be paid by the Contractor
or its Subcontractors to any person for influencing or attempting to influence an officer or employee of the
Agency, any Federal Agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with any Federal grant, the contractor shall complete and submit Standard
Form-LLL, "Disclosure of Lobby Activities," in accordance with its instructions.
27. ASSIGNMENT OF CERTAIN RIGHTS TO THE AGENCY.
In entering into this Contract or a subcontract to supply goods, services, or materials pursuant to this
Contract, the Contractor and/or Subcontractor offers and agrees to assign to the Agency all rights, title, and
interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.c. Sec. 15) or
under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business
and Professions Code), arising from purchases of goods, services, or materials pursuant to this Contract or the
subcontract. This assignment shall be made and become effective at the time the Agency tenders final payment
to the Contractor, without further acknowledgement by the parties.
28. ENERGY CONSERVATION REQUIREMENTS.
The Contractor agrees to comply with mandatory standards and policies relating to energy efficiency
that are contained in the state energy conservation plan issued in compliance with the Energy Policy and
Conservation Act (Public Law 94-163)
29. PROTECTION.
The Contractor shall at all times provide protection against weather, rain, wind, storm and heat so as to
maintain all work, materials, apparatus and fixtures free from injury and damage. At the end of a day's work, all
new work, and the premises, likely to be damaged by failure to provide protection as required above shall be
replaced or repaired at Contractor's expense.
30. CONTRACTORS BEST SKILL.
Redevelopment Agency of the City of San Bernardino
................... ...... ..... Project: California Theatre 562 West 4th Street (Fire Sllppre~siGn System)
CONTRACT DOCUMENTS
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Addendllm!
CDC/2009-27
The Contractor shall supervise and direct the work using its best efforts, skill and attention to ensure the
workmanship and materials are of good quality and that the work is completed in accordance with the Contract.
Contractor shall be solely responsible for all construction means, methods, techniques, sequences and
procedures; safety on the work; and coordinating all portions on the Project to be performed by Contractor's
Laborers, Employees, Vendors and Subcontractors, if any.
3 L UTILITY SERVICES.
The Contractor will be able to use existing utilities without charge, including electric power and water.
If Contractor must disconnect or otherwise interrupt such services, including plumbing fixtures, to effect repairs
or replacement, the use or availability of such services shall not be deprive the Project's occupants, unless the
Project's occupants has been relocated. Where disruptions or disconnections will occur other than during
normal business hours, Contractor shall obtain approval of Project's occupant, at least twenty-four (24) hours
prior to such interruption.
32. LEAD-BASED PAINT.
The Contractor agrees that the use of any lead-based paints is strictly prohibited and shall not be used on
this Project. Contractor agrees to submit to the Agency an Abatement Plan (include days required and cost
breakdown) with minimum abatement! disturbance! encapsulation to surfaces indicated on Project Construction
Plans (cost effective method) per State of Cali fomi a Department of Health Services Regulations.
The Agency assumes no liability for damages for personal injury, illness, disability, or death to the
Contractors, or to any Consultant or employees, agents, or invitees of the Contractor or any Consultant, or to any
other person, including members of the general public, arising from or incident to the Agency Investigation
Work or other activity causing or leading to contact of any kind whatsoever with Lead-Based Paint on the
Agency Site, whether the Agency has properly warned, or failed to properly warn, any persons injured.
33. ASBESTOS CONTAINING MATERIALS.
Contractor agrees to submit to the Agency an Abatement Plan (include days required and cost
breakdown) with minimum abatement! disturbance! encapsulation to surfaces indicated on Project Construction
Plans (cost effective method) per State of California Department of Health Services Regulations.
The Agency assumes no liability for damages for personal injury, illness, disability, or death to the
Contractors, or to any Consultant or employees, agents, or invitees of the Contractor or any Consultant, or to any
other person, including members of the general public, arising from or incident to the Agency Investigation
Work or other activity causing or leading to contact of any kind whatsoever with Asbestos on the Agency Site,
whether the Agency has properly warned, or failed to properly warn, any persons injured.
34. CLEANUP.
The Contractor shall keep the subject Project clean and orderly during the course of the work. Upon
completion of the work contemplated by this Contract, the Contractor shall cause all debris resulting from such
construction to be removed from the subject Project and shall leave the subject Project in a neat and "broom-
clean" condition.
Redevelopment Agency of the City of San Bernardino
........Project:CaliforniaTheatre562West4IhStreet(FlreSuppressionSystem)
Addendum!
CONTRACT DOCUMENTS
00200
Rev.04ft4f09
CDC/2009-27
IN WITNESS WHEREOF, three identical counterparts of this Contract, each of which shall for all
purposes be deemed an original thereof) have been duly executed by the parties hereinabove named, on the day
and year first herein written.
AGENCY:
Redevelopment Agency of the City of San Bemardino [FIRST PARTY]
7~'
[SIGNATURE OF AUTHORIZED PRINCIPALI OFFICER! REPRESENTATNEJ
By:
Emil A.Marzullo, Interim Executive Director
[TYPE OR PRINT NAME OF AUTHORIZED REPRESENT A TNE & OFFICAL TITLE]
CONTRACTOR: Inland Building Construction Companies, Inc.
[TYPE OR PRINT NAME - SECOND PARTY]
By.
RINCIP ALl OFFICER! REPRESENT ATIVEJ
[SIGNA
Larry J. Hyder, Preoident
[TYPE OR PRINT NAME OF AUTHORIZED REPRESENT ATNE & OFFICAL TITLE]
323 S. Sierra Way San Bernardino, CA 92408
[TYPE OR PRINT CONTRACTOR! BIDDER BUSINESS ADDRESS (Suite, City, State, Zip Code)]
405281
[CONTRACTOR'S LICENSE]
B,C2,C8,C1 0, C61 ,016,024,028,042,052
[CONTRACTOR LICESNE CLASSIFICATION]
5/31/2011
[CONTRACTOR'S LICENSE EXPIRATION DATE]
[BOND NUMBER] 0490389
5/27/09
[DATE OF SIGNATURE]
Rcdc\'elopment Agenc)' of tbe City orsun Bernurdlno
...........,..,................. ProJect: Cnllfol'llln Thenfre 562 Wcsl 4lh Street {Fire Suppresslll nSystem)
Addendum 1
CONTRACT DOCUMENTS
00200
Rev.04f14f09
ACORI). CERTIFICATE OF LIABILITY INSURANCE OPIO KG l DATE (MMlDOIYYYY)
INBUI-l 05/28/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MA ITER OF INFORMATION
~liant Insurance Services,Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
(Li.c-OC36861) HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
735 Carnegie Drive, Ste 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Bernardino CA 92408 ,
Phone: 909-886-9861 Fax: 909-886-2013 INSURERS AFFORDING COVERAGE NAle#
--
INSURED INSURER A: North American Capacity
Inland Buildin~ Construction --
Co~anies Ine; oland Acoustics ~~~R B: Peerless Insurance Company ---
Inland Interior Contracting; Majestic Insuranc~ Company
Graphicline Sign Company ~.~c
POBox 5302 INSURER 0
San Bernardino CA 92412 i INSURERE
COVERAGES
THE POLICIES OF INSURANCE LISTED ~LOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
-- ! PD~~I':~JDI:8>>;'t: ! ~kWll~~b'1fJ!..~" -
u. .SR TYPE OF INSURANCE POLICY NUMBER LIMITS
GENERAL LIABILITY I EACH OCCURRENCE $1,000,000
A X ~-COMMERCIAL GENERAL LIABILITY PNGOO0362400 11/27/08 11/27/09 PREMISES Ea~curence} $50,000
+J CLAIMS_~E ~J OCC~~ MED EXP (Anyone peISon) $ 5, 000
PERSONAL & AOV INJURY $ 1/000 ,..qpo__
-.J_ , GENERAL AGGREGATE $2,000,000
$S,OOOPDOCCDEllUCTIBLE I
~'~ AGG~i~A_~1 ~~~~ APnS PER PRODUCTS. COM PlOP AGG $2,000,000
POLICY X JECT I LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT sl,OOO,OOO
B .!.. ANY AUTO CBP9651351 11/27/08 11/27/09 (Eaaccident)
-
,- ALL OWNED AUTOS BODILY INJURY
(Perpef1>on) .
, SCHEDULED AUTOS
.~
HIRED AUTOS ,
- BODILY INJURY .
NON-OWNED AUTOS (Per accident)
- ---.-
- , PROPERTY DAMAGE
IPeraccident) .
~RAG' UA"'Ur< AUTO ONLY. EA ACCIDENT .
ANYAlJTO r---
OTHER THAN EA ACC . ----
AUTO ONLY' AGG .
EXCESSJUMBRELLA LIABILITY EACH OCCURRENCE $5,000,000
D CLAIMS MADE --.-.-
A 'X OCCUR PNX200049500 11/27/08 11/27/09 AGGREGATE .5 OOO,O()_Q_
r---
, .
I , r----- ----
~DEDUCTIBLE I . .
,
RETENTION . .
WORKERS COMPENSATlON AND i X ITORY LIMITS IUER-
C EMPLOYER$' LIABILIlY C20080657301 11/27/08 ! 11/27/09 $1,000,000
ANY PROPRIETORiPARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? EL DISEASE EA EMPLOYEE $ ~L.QOO, 000
~~~~I~r~~~v~~?~~s below EL DISEASE. POLICY LIMIT .1,000,000
OTHER
B Install Floater CBP9651351 11/27/08 11/27/09 Per Occur $125,000
Deduct $1,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Job #1958-G-9488 California Theater Fire Suppression System.
Economic Development Agency of the City of San Bernardino c/o Vanir CM,
Design Engineer and Construction Manager are add'J. insd/pr~ wrdg/waiver as
respects gen'J. liab per end'ts CG2010 1185 . CG2404 10/93; Work Comp blkt
Waiver End't attached. **SEE ATTACHED NOTES**
CERTIFICATE HOLDER
Redevelopment Agency
of the City of San Bernardino
c/o Vanir CM
290 North D Street
San Bernardino CA 92401
CANCELLA nON
ECONOMI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPlRATlO
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN
NOTICE TO THE CERTlFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBUGATlON OR LIABILITY OF ANY I<IND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHO 0 EPRESENT Tl
@AC
CORPORATION 1988
ACORD 25 (2001/08)
NQTEPAD: . =~';'.;~IlQj,:J.@l9 COaIo~UO"
*30 day N 0 C except 10 day for non-payment of premium.
CARRIER WILL NOT MODIFY CANCELLATION CLAUSE/NO XXX OUT.
Null & Voids prior certificate issued 05/12/09.
. DlIIDX-l
OPIDM
. PAGE 3
DATIl. OS/28/09
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement{s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001108)
POLICY NUMBER PNG000382400
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - (FORM B)
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Pltrson or Orgilnizatlon:
Any person or organization to which you are obligated by .....irtue of a written contract to provide
insurance such as is afforded by this policy, but onty wit" respect to (1) occurrences laking
place after such written contract has been executed and (2) occurrences resulting trom work
performed by you during the policy period.
Of no entry appears abow, information required to complete this e"dorsement will be shown in lhe Declarations as
applicable 10 this endorsement.)
WHO IS AN INSURED (Section II) Is amended to include as an insured the person or organization shown in the
Schedule, bur only with respect to liability arising out of "your work" for that insured by or for you.
COIIerage provided by this policy to the Additional lnsured{s) shown in the Schedule shall be
primary insurance and any other insurance maintamed by the Additional Insured(51 shall be
excess and non-contrlbutory, but only if required at the Named Insured and by written contract
CG 20 10 t1 85
Copyright, Insurance Services Office. Inc_. 1984
Plget of1
Cl
POLICY NUMBER: (-"w,ooo If;:~-~ ()o
COMMERCIAL GENERAL LIABILITY
CO 240410 93
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under Ihe following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or OrganIzation:
Ariy person or organization 10 which you are obltgated by virtue of written conkacllo provide insurance
such as is afforded by (his policy, but only with respect to (1) occurrences taking place after such written
contract has been executed and (2) occurrences resulting from work performed by you during the pOlicy
period, or occurrences resulting from lhe conduct of your busines.s during the policy period.
(If no entry appears above, information required to complete this endorsement wHI be shown in the Declarations as
applicable to this endorsement.)
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV _
COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the fOllowing:
We waJVe any righl of recovery we may have against the person Of organization shown in the Schedule above
because of paymenls we make for injury 01 damage arising 001 of your ongoing operations or "your work" done
under a contract with thai person or cwganization arld included in the ~prodlJcts-completed operatIons hazard". This
waiver applies only 10 the person or organization shown in the Schedule above.
CG24041093
Copyright. Insurance Services OffICe, Inc., 1992
Page 1 011
a
~~s~'f1iJ~tE' WORKERS COMPENSATION ANO EMPLOYERS LIABIUTY INSURANCE POUCY I WC 04 03 06
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CAUFORNIA
We have the right to recover our payments from anyone liable for an injury covered by this policy. We wi' not enforce our
right against the person or organization named in the Schedule. (This agreement applies only to the extent that you
perform work under a \Mitten contract that requires you to obtain this agreement from us.)
You must maintain payron records accurately segregating the remuneration of your employees while engaged in the work
described in the Sche,dule.
The additional premium for this endorsement shal be 2.00 % of the California workers compensation premium
other-wise due on such remuneration. The Minimum PremIum charge for this endorsement is $250
Schedule
Person or Organization
C.rtifk:II" holden for whom th. IRlIuntd h...
contraelual obHga1ton to 'MIMI their rightl of
.ubroglltlon.
Job Description
Blanket walnr of subrogation.
AI corqbuction ope...tIons In Callfom".
All oth.". tenns and conditions of this policy remain unchanged.
(The infofTTlation below is f8quif9d to be completed only when this endorsement
is issued SUbsequent to the policy ef19Cffve date.)
Effective 11/21108
, this endorsement fonns part of Policy No, C200808573-01
of MAJESTIC INSURANCE COMPANY
Issued to INlAND BUILDING CONSTR~TIClN COfIPAHIES INC
EndOfSement No. , 6
--VI ~
I
-~
7,-...1i-~
"""~ItU'I'!Eltt:NI""1Vh
[SICl'r~.TURB gr trGT.\.R~T PUBUe] (Seal)
CERTIFICATION OF INSURANCE COVERAGE
THIS IS TO CERTIFY that the Contractor identified below is insured as of this date against all of the risks
required to be insured against by the specifications for the project identified below, including, but not limited to,
the types and amount of insurance, and the named insured required by said specifications.
The undersigned further certifies that the premiums for aforesaid insurance have been paid in full for a term not
less than the time between the estimated commencement and completion dates of the project, that the insurance
policies will not be reduced as to limits of liability or coverages without the prior written consent of Agency,
and that Agency shall be given (30) thirty days prior written notice, delivered to the Agency by registered mail,
of any intent to cancel said policies in which event Agency shall have the right, in its sole discretion, to continue
the respective coverages without alteration until satisfactory substitute coverage is provided.
Dated: May 27
,2009 .
[TYPE OR PRINT NAME AND ADDRESS
OF CONTRACTOR]
[TYPE OR PRINT NAME AND ADDRESS
OF INSURANCE COMPANY ANDI OR AGENCT]
Inland Building Construction Companies, Inc.
[NAME]
Alliant Insurance Services
[NAME]
323 S. Sierra Way
[ADDRESS]
735 East Carnegie St. Ste 200
[ADDRESS]
San Bernardino, CA 92408
San Bernardino, CA 92408
PRINCIP ALl
II~ riL!:
[SIGNATURE1JF AUTHORIZED PRINCIPALI
OFFICER! REPRESENTATNE]
Larry J. Hyder
[TYPE OR PRINT NAME OF AUTHORIZED
PRINCIP ALl OFFICER! REPRESENTATIVE]
Chuck Shanklin
[TYPE OR PRINT NAME OF AUTHORIZED
PRINCIP ALl OFFICER! REPRESENTATIVE]
President
[TYPE OR PRINT TITLE OF AUTHORIZED
PRINCIP ALl OFFICER! REPRESENT A TNE]
[TYPE OR PRINT TITLE OF AUTHORIZED
PRINCIP ALl OFFICER! REPRESENTATIVE]
[NAME OF PROJECT]:
Redevelopment Agency of the City of San Bernardino
Rcdc\'cloprnentAgcney afthcClly of San Dcrnardlno
..........."......... .......... ProJcct: California TllcaU'c 562 Wcst 4tllSlrcct (Fire SlIpprusion Sy.tem)
Alldenllllml
CONTRACT DOCUMENTS
00200
Rcv.04/14/09
Page19of21
)
State Of California
^ '!:::'..~ CONTRACTORS STATE LICENSE BOARD..~
'1\-- ACTIVE LICENSE ~
>> C<t~~~r \~
~lU..L"""" ~/
.~
!. ",,",,"'mbo< 405281 Em"y CORP
,
8,,;",~Nom' INLAND BUILDING CONSTRUCTION
COMPANIES INC .
.~
"'';''''" D.. 05/31/20 i 1
,.....
""~P!JI'
i "
:......~.,.-
':f;.~...~
CI,,''',,'oo(,] C-2 B CiO C6i/D42 C6i/D52
C6i/Di6 C6i/D24 C6i/D28 C-8
I.
)
~~^' ,',~
;,'~;
~,. ",""'k",'c~L~'__
NOT TRANSFERABLE . MUST HAVE A COLOJtBACKGROUND
ACCOUNT
NUMBER
12669
DATE PAID
7/29/2008
OWNER, FIRM OR
CORPORATION
BUSINESS NAME
CITY OF SAN BERNARDINO
BUSINESS REGISTRATION CERTIFICATE
ThiiBurine.. Rcgismu:ion Ccrtificate does not indicate the legal opcn.tion of this business III this location. Other appro""'" by otherOty
departments, sucb as Developmeut services may be required This Certificate is issued without yrnfication tlw the certificate is subject to or
excmptfromlicenllingbythe State of California
~ The Business Owner is responsible for timely renewal. Not receiving a renewal nOlice for any rca50n does not relieve
responsibility fur timely payment If not paid within 3C days of the expiration date .hown, .. 5C% penalty will be imposed
BUSINESS CLASS, GENERAL CONTRACTOR
NOTES:
BUSINESS WCATION, 323 S SIERRA WAY STE A
INLAND ACOUSTICS INC
INLAND ACOUSTICS INC
ATTENTION
MAILING ADDRESS PO BOX 5302
SAN BERNARDINO, CA, 92412-5302
EXPIRATION DATE
6/30/2009
Rachel G. Clark
CITY CLERK
POST IN A CONSPICUOUS PLACE . PHOTOCOPIES ARE NOT VALID
KEEP FOR YOUR RECORDS
ACcr NO.
DATEPAlD
545A
12669
07/29/2008
$150.00
BALANCE $0.00
CITY OF SAN BERNARDINO
Previously known as Inland Acoustics, Inc. When renewal canes in June we
will update tb reflect our new name.
Respecfully,
~~~
Natalie Price, Vice President
,.
n0657485
I, DEBRA BOWEN, Secretary of State of the State of
California, hereby certify:
That the attached transcript of page(s) has been compared
with the record on file in this office, of which it purports to be a copy, and
that it is full, true and correct.
See/State Form CE.107 (REV 1/2007)
IN WITNESS WHEREOF, 1 execute this
certificate and affix the .Great Seal of the
State of California this day of
MAR ~ 1 2007
&bl*- ~
DEBRA BOWEN
Secretary of State
iR:~ OSPOO99734
1\0657485
ENDORSED - FILED
CERTIFICATE OF AMENDMENT ofll'1he officeoflhe SecretsryofSlate
of1he Slate of~fornle
ARTICLES OF INCORPORATION
FEB.2 '1 2007
The undersigned certify that:
I. They are the president and the secretary, respectively, of INLAND
ACOUSTICS, INC., a California corporation, hereinafter referred to as "the
Corporation. II
2. Article One of the Articles of Incorporation of the Corporation is amended
to read as follows:
The name of this corporation IS INLAND BUILDING CONSTRUCTION
COMPANIES INe.
3. The foregoing amendment of Articles of Incorp oration has been duly approved by the
Board of Directors.
4. The foregoing amendment of Articles of Incorporation has been duly approved by the
required vote of Shareholders in accordance with California Corporations Code,
section 902. The total nnmber of outstanding shares of the Corporation is fifty (50).
The nnmber of shares voting in favor of the amendment equaled or exceeded the vote
required. The percentage vote required was more than fifty percent (50%).
We further declare under penalty of peljury under the laws of the State of California that the matters
set forth in this certificate are true and correct of our own knowledge.
L
Preside
Dated: February 14, 2007.
Dated: February 14, 2007
~tWtt ~1&~rb
CLAUDETTE D. RY C~
Secretary
F:\WORlC\ATl \CORP\Inland Acoumcs\Change ofName\Certificate of Amendment of .Articles
Foon W-g
(Rev. November 2005)
OepartmentoftheT_Uf)'
IntemalReveIlueServk;e
ci Name (as shown on your Income tax return)
~ Inland Building Construction Companle., Inc.
l! Business name, If different from above
Request for Taxpayer
Identification Number and Certification
c
o
JI
.ll
~,
,,-
~t
'"
m
<I)
D IndividuaV
Check appropriate box: Sole proprietor
Address {number, street, and apt. or suite no.}
323 S. Sierra Way
City, state, and ZIP code
San Bernardino, CA 92408
Ust account number(s) hero (optional)
[i2I Corporation
Tax a er Identification Number IN
Give fonn to the
requester. Do not
send to the IRS.
o Partnership D Other II> __________m__m
D Exempt from backup
wtthholdlng
Requester's name and address (optional)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Una 1 to avoid
backup withholding. For individuals, this is your social security number (SSN). However, for a resident
alien, sole proprietor, or disregarded entity, see the Part 1 Instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.
Note. If the account is in more than one name. see the chart on page 4 for guidelines on whose
number to enter.
or
Certification
Under penalties of perjury, I certify that
1. The number shown on this fonn 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 ~RS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (e) the IRS has
notified me that I am no longer subject to backup withholding, and
3. I am a U.S. person ~ncluding a U.S. resident alien).
Certification Instructions. You must cross out item 2 above if you have been notifted 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 ~RA). 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 instructi s on page 4.)
Sign
Here
,
S1gnab.lreot
u.s. person ..
Purpose of Form
A person who is required to file an information return with the
IRS, must obtain your correct taxpayer identification number
(TIN) to report, for example, income paid to you, real estate
transactions, mortgage interest you paid. acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
U.S. person. Use Form W-9 only if you are a U.S. person
Oncluding a resident alien), to provide your correct TIN to the
person requesting it (the requester) and, when applicable, to:
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.
In 3 above, if applicable, you are also certifying that as a
U.S. person, your allocable share of any partnership income
from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively
connected income.
Note. If a requester gives you a form other than Form W-Q to
request your TIN, you must use the requester's form If It is
substantially similar to this Form W-Q.
For federal tax purposes, you are considered a person if you
are:
Natalie Price, Vice President Date" 5/13/09
. An individual who is a citizen or resident of the United
States,
. A partnership, corporation, company, or association
created or organized in the United States or under the laws
of the United States. or
. Any estate (other than a foreign estate) or trust. See
Regulations sections 301.7701-6(a) and 7(a) for additional
information.
Special rules for partnerships. Partnerships that conduct a
trade or business in the United States are generally required
to pay a withholding tax on any foreign partners' share of
income from such business. Further, in certain cases where a
Form W-Q has not been received, a partnership is required to
presume that a partner is a foreign person, and pay the
withholding tax. Therefore, if you are a U.S. person that is a
partner in a partnership conducting a trade or business in the
United States, provide Form W-Q to the partnership to
establish your U.S. status and avoid withholding on your
share of partnership income.
The person who gives Form W-Q to the partnership for
purposes of establishing its U.S. status and avoiding
withholding on its allocable share of net income from the
partnership conducting a trade or business In the United
States is In the following cases:
. The U.S. owner of a disregarded entity and not the entity,
Form W-9 (Rev. 11-2(05)
Cat. No. 10231X
THt: r-n"AL PREMIUM IS
PREDICATED ON THE
FINAL CONTRACT PF\i':;;t;
Bond No. 0490389
Premium: $7,768.00
(1 of 6 Originals)
FORM OF PERFORMANCE BOND
KNOW ALL PERSONS BY THESE PRESENTS: That
WHEREAS, Redevelopment Agency of the City of San Bernardino
State of California, on May 11th , 20 09
Inland Building Construction Companies, Inc.
hereinafter designated as the "Principall1, the contract to
. awarded
Redevelopment Agency of the City of San Bernardino
CALIFORNIA THEATER PROJECT-FIRE SUPPRESSION SYSTEM
562 WEST 4TH STREET, SAN BERNARDINO, CA. 92401
NOW THEREFORE, we the Principal, and International Fidelity Insurance Company
as Surety, arc held and firmly
bound unto the Redevelooment A2encv of the City of San Bernardino , hereinafter called the uOwner" and!
or the "Agency", in the penal snm of Eight Hundred Twenty-Four Thousand and 00/100
Dollars ($ 824,000.00 )
in lawful money of the United States, for the payment of which sum we bind ourselves, our heirs, executors,
administrators, and successors, jointly and severally firmly by these presents.
THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, if the above bounden Principal, hisl her or its
heirs, executors, administrators, successors or assign, shall in all things stand to and abide by and keep and truly
and faithfully perform its duties, all undertakings, covenants, terms, conditions and agreements in the said
Contract and any alteration thereof made as therein provided, on hisl her or their part, to be kept and performed
at the time and in the manner therein specified, and in all respects according to their true intent and meaning,
and shall indemnify and save harmless the Agency, its officers and agents, as therein stipulated, then this
obligation shan become nun and void: otherwise, it shall be and remain in full force and virtue, and also-in case
suit is brought upon such Bond, the above bounden Principal and the said surety will pay a reasonable attorney's
fee which shall be awarded by the court to the prevailing party in said suit, said attorney's fee to be taxed as
costs in said suit and to he included in the judgment therein rendered,
And the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or
addition to the terms of the contract or to the work to be performed or materials and! or equipment to be
furnished thereunder or the Specifications accompanying the same, shall in anywise affect its obligations on this
Bond; and it does hereby waive notice of any such change, extension of time, alteration or addition to the tenns
of the contract or to the work or to the Specifications.
IN WITNESS WHEREOF (3) three identical counterparts of this instrument, each of which shall for all
purposes be deemed an original thereof, have been duly executed by the Principal and Surety above named, on
the 12\ day of May .2009 ,
matt Da I e lty ns~e c:.ompany Buildi~nstruction Companies, Inc.
By
By
.................................pro~~~lfDr.1ll
In SUPJ!I'esslDnSy,tim}
Atltlellduml
CONTRACT DOCUMENTS
00200
Rev.04/1411l9
l'age16Gf21
TcI(973)624"7200 POWER OF ATTORNEY
INTERNATIONAL FIDELITY INSURANCE COMPANY
HOME OFFICE, ONE NEWARK CENTER, 20TH FLOOR
NEWARK, NEW JERSEY 07102"5207
KNOW ALL MEN BY TIIESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation organized and existing
laws cifthc State of New Jersey, and having its principal office in the City of Newark, New Jersey, does hereby constitute and appoint
RANDY SPOHN, MATTHEW R.
Santa Ana, CA.
its true and lawful attomey(s)-in-fact to execute, sea] and deliver for and on its behalf as surety '. any and all bonds and undertakings, contracts of inderimity and
other writings Obligatory In the nature thereof, which are or may be allowed, required or penmned by law,_ stature, rule. regulation. contract or otherwise, and
the execution of such instrument(s) in pursuance of these presents, shall be as bindmg upon the Said INTERNATIONAL FIDELIlY INSURANCE
COMPANY, as fully and amply. to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at its
prmClpaloffice.
This Power of Attorney is executed. and may be revoked, pursuant to and by authority of Article 3-Section 3, of the By-Laws adopted by the Board of
Dlreclors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting called and held on the 7th day of February, 1974.
The President or any Vice President, Executive Vice President, Secretary or Assistant Secretary, shall have power and authority
(1) To appoint Attorneys-in-facl, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and
undertakings, contracts of indemnity and other writmgs obligatory in the narure thereof and,
(2) To remove, at any time, any such attorney-in-fact and revoke the authority given.
Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of said Company adopted at a meeting
duly called and held on the 29th day of April, 1982 of which the followmg is a true excerpt:
Now therefore the signarures of such officers and the seal of the Company may be affixed to any, such power of attorney or an)' certificate relating thereto by
faCSImile, and any such power of attorney or certificate bearing such facsimile slgnarures or facsimIle seal shall be valid and bindmg upon the Company and any
such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the furure with respect to any
bond or undertaking to which it is attached.
IN TESTIMONY WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY has caused this instrument to be
signed and its corporate seal to be affixed by its authorized officer, this 16th day of October, A.D. 2007.
INTERNATIONAL FIDELllY INSURANCE COMPANY
STATE OF NEW JERSEY
County of Essex
<:~ ~~
Secretary
On this 16th day of October 2007, before me came the individual who executed the preceding instrument, to me personally known, and, being by me duly
sworn, saId the he IS the therein described and authorized officer of the INTERNATIONAL FIDELITY INSURANCE COMPANY; that the seal affixed to
said instrument is the Corporate Seal of said Company: that the said Corporate Seal and his signature were duly affixed by order of the Board of Directors of
said Company.
IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal,
at the City of Newark, New Jersey the day and year first above written.
~,,~~
A NOTARY PUBLIC OF NEW JERSEY
My Commission Expires Nov. 21, 2010
CERTIFICATION
I, the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY do hereby certify.that.Ihave compared the foregoing copy. of the
Power of Attorney and affidavit, and the copy of the Section of the By-Laws of said Company as set forth in said Power of AttorneY , with the ORIGINALS ON
IN THE HOME OFFICE OF SAID COMPANY, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power
of Attorney has not been revoked and is now in full force and effect
IN TESTIMONY WHEREOF, I have hereunto set my band this 12th day of May, 2009.
k;t: Pr~
AssistantSecreta:ry
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of CALIFORNIA
County of ORANGE
On May 12, 2009
before me. Erika Guido. NOTARY PUBLIC .
personally appeared RANDY SPOHN
C3J
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.
Ie'. ;;,;",';':;'H ,
~ . COMM. # 1843731 :E
::E NOTARY PUBUC CALIFORNIA ;:
~. ORANGE COUNTY 2
1( My comm. expires May 5. 2013 It
- ~ - - - - - - ~ - - - - - - -
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.
l/!//! i/:t~II{L '\
Signature of Notary
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
D INDIVIDUAL
D CORPORATE OFFICER
DESCRIPTION OF ATTACHED DOCUMENT
D PARTNER(S) D UMITED
IZI ATTORNEY-IN-FACT
D TRUSTEE(S)
D GUARDIAN/CONSERVATOR
D OTHER:_
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
--'1
CALIFORNIA ALL-PURPOSE
CERTIFICA TE OF ACKNOWLEDGMENT
State of California
County of San Bernardino
On June 2, 2009
before me, Natalie Price, Notary Public
(h~rl: ill"~r1 n:lnle 'lTld I;Tle oj Thc Ojfll:C[1
personally appeared
Larry J. Hyder
I!
'!
\\'ho proved to me on the basis of satisfactory evidence to be the rcrson~ \\'hose nal11c~ is/fH"e subscribed to
the within instrument and acknowledged to me that he/J.[lt1.r;~. executed the same in hisJl\..lI',ll\..;l authorized
capacityr;e.j. and that by his'I",,'IL,;, signature~) on the II1strumcnt the personM. or the entity upon behalf of
\vhich the person~ acted, executed the instrument.
I certify under PENALTY Of PERJURY under the laws of the State ofCahflm,ia that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
d'PLJ~
Slgll<lllll'e of'\Jot<1l} Public
.
NATALIE PRICE
COMM #1751871
NOTARY PUBLIC - CALIFORNIA
SAN BERNARDINO COUNTY
MyComm Expires June 19, 2011
(Sea])
.
ADDITIONAL OPTIONAL INFORMATION
I!'\STRlTTIO:--JS FOR COMPLETING Tl-llS fOR1\.1
DESCRIPTION OF TIlE ATTACIIED DOC1\iFNT
{Tillcordc~crTpTlon (1f~llack,ld()cunlellt)
(Tillcord'-'~criplioll of~II"ch,-,d d'XUlll<.'nT cr'T1linuedJ
\:umbel of Pagcs Doculllt'IlI [);lle
It\ddilionalllil\!TII<llllll1l
CAPACITY CLAIMED BY THI.. SIGr-;ER
Individual (s)
,_J Curporate Office!
(Tille)
C- Parincr(s)
1,_ Al1orney-in-Fact
Truslec(s)
Other
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,of,;,,;.!(' d,!('s !lO/ 1'('(/11.'1','11.><' IWIWT I() do .'''IIIe/hing ,hailS Illegal lor u ,'wlurr i'l
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)1"1.:: 'lIld COlml) ;llt"),I11;lti,m II1mT hl: the SIal( and County whn,' Th," dOl'umel11
,igll(:n,) p<:l'.'<Jn~ltl! al'peiircd bc;lorc; The 1101ary puhli<.' for ackl1(l\\lcdgmcnl
. I),lle ofnCllariz:lljol1ll1UCI be tIle' d,lIe that thc ~;gn~r(,1 personally apP~'~II~L1 "bleh
tml't ,i1su he th~ ,amL' lblc th~ ;"'klll,,,'lcdgmC1l1 is COl11pklCd
rhe noLII')' puhlic must prim hi~ or hn !lalllC as il "pl'caL< \,.;lhm IllS or hn
"(lllnll1";ClIlfc,II,,\\cdhva.:nm'llaalldthenyollf tllk (n01arv plIblil'J
1"11111 tIll' n.lIlKh) (If d,)(lIl11enl ~igl~cr(q who p~I','''L:llly "Plwar ~T Ihe lime (,r
11<'lafl/,,1['O[l
Jr:Jicnle Ihe C()rrCCl .,in",u!ar l'r pl\lr~] f0rm~ by cr(ls~ing off inLOrn:;:1 1~,lfIm ri,c
ltt;'ihl'~ i, ,,~) or cil~lin.l' the corrcCl rorm~ Failllre Il1 correctly indil';lI,' Ih,s
;nformatiun rn~y lend IU re;ect;un ufdonllllent rc,'ording
;'11,' lll,li1ry \~,11 imprcssion rnu'l be ek,1I o.nd photogro.rh;cally r~pr{ld\Kibk
ImpreSSion must ]wt covcr Icxl (11' line,", Ii' Sl:i11 illlprcs~ion ,mudg.:s. h'-~cal if a
"1Ii'lieienl urco. permits, nrhcr\li.'c compklc a diffcrent o.cknowlcdgmcnl t,'rl11
Si.~I\"tu'-c <1r lhe !\<1lar)' public lIlUq 1l1~rch the ~i~nJture 011 tik \I;lh lhc officc "I
IIi(;L'(luntyclel'k
i\JdrtlOna: int'lrll1al;On is not rL'quircd bul could help 10 clI,m,' Il1i.,
al'kIlO\\lcd~Il1,~IlT i' not m;'lI~cd or ,l11achcd 10 a diffc-rcnl Ck'CUIl1,'1I1
Illd,cateTi!leorlypcorauachedd()cllll1cnl.lIumhL'r(1fpagc.,nndd"I<.'
Jl1dienTe llle capo.clly L'bimed hv The ~;bner, Ifllle c1o.;mcd eo.po.C;ly IS a
cnrpOfnTC ofticcr, incil<1Tcthc title (i.c. CLll.l'l'U. Sc':rctnr\)
SV<.'lLT\;ly atl'l~h Ihl,doc\lmenT ]l1lh.:signcd ducllmclll
;1
_1/
Bond No. 0490389
Premium: Included on
the Perfonnance Bond.
(1 of6 Originals)
FORJ'\1 OF LABOR Ai'll) MATERIAL BOND
KNOW ALL PERSONS BY TIlESE PRESENTS: That we Inlemational Fidelity Insurance' as Surety,
and Inland Building Construction Companies, Inc. , as Principal, are held and firmly
bound unto Redevelooment At!:encv of the Citv of San Bernardino , in the penal sum of
Eight Hundred Twenty-Four Thousand and 00/100 Dollars
($ 824,000.00 ), said sum being (100% of the estimated amount of the foregoing and
annexed Contract, to be paid to said bounded Principal , for which
payment, well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors or
assigns, jointly and severally, firmly by these presents. . Company
TIlE CONDffiON OF THIS OBLIGATION IS SUCH: That if the above bounden Principal, as Contractor in
the annexed Contract or hisJ her Subcontractors, shall fail to pay for any materials, provisions, provender, or
other supplies or teams used in, upon, for or about the performance of the work contracted to be done, or shall
fail to pay any person, company or corporation renting or biring teams or implements or machinery for or
contributing to said work to be done, or any person who supplies both work and materials therefore, or the
amount due under the Employment Insurance Act with respect to such work or labor, the Surety will promptly
pay for the same, in an amount not exceeding the above obligation, and also, in case suit is brought upon such
Bond, the above bounden Principal and the said Surety will pay a reasonable attorney's fee which shall be
awarded by the court to the prevailing party in said suit, said attomey.s fee to be taxed as CrJsts in said suit and to
be included in the judgment therein rendered. This obligation and Bond shall insure to the benefit of any and an
persons entitled to file claims under Section ll84C of the Code of Civil Procedure and said persons or "'y of
them or their assigns shall have a right to action thereunder,
[BY]
day of
<Am_Ie&, Jnc.
arry J. Hyder, President
IN WITNESS WHEREOF, we have hereunto set our hand
Mav ,2009
STATE OF CALIFORNIA )
COUNTY OF SAN BERNARDINO ) ss.
On this _ day of , 20 , before me
a Notary Public in and for the County of ,
known to me to be the person whose name is subscribed to the within instrument as the Attorney in Fact of and
acknowledged to me that he has subscribed the name of thereto as Surety,
and his! her own name as Attorney in Fact.
In witness whereof I have hereunto set my hand and affixed my official seal the day and year in this certificate
first above written.
Red~ell1plTlllnl Ageney of the CIty OrSllD DenlllrdlDo
.......................,......". ProJe1:t: CalJrornla Thelltre 561 West"'h St~cl (FIre Supprnslon Syslem)
Adllenduml
CONTRACT DOCUMENTS
00100
Rev.O""4109
Pallcl8ufl1
TcI(973)6247200 POWER OF ATTORNEY
INTERNATIONAL FIDELITY INSURANCE COMPANY
HOME OFFICE, ONE NEW ARK CENTER. 20TH FLOOR
NEWARK, NEW JERSEY 07102.5207
KNOW ALL lWEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation organized and existing
laws uflhe State of New Jersey, and having its principal office in the City of Newark, New Jersey, does hereby constitute and appoint
RANDY SPOHN, MATTHEW R, DOBYNS
Santa Ana, CA.
its true and lawful attomey(s)-in-fact to execute, seal and deliver for and on its behalf as surety,_ any and all bonds and undertakings. contracts of indemnity and
other writings obligatory In the nature thereof, which are or may be allowed, required or penDitted by law, stature, rule, regulation, contract or otherwise, and
the execution of such instrument(s) in pursuance of these presents, shall be as binding upon the said INTERNATIONAL FIDELITY INSURANCE
COMPANY, as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at its
principal office.
This Power of Attorney is executed, and mar be revoked, pursuant to and by authority of Article 3-Section 3, of the By-Laws adopted by the Board of
DIrectors of INTERNATIONAL FIDELITY NSURANCE COMPANY at a meeting called and held on the 7th day of Febl1.lary, 1974.
The President or any Vice President, Executive Vice President, Secretary or Assistant Secretary, shall have power and authority
(1) To appoint Attorneys-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and
undertakings, contracts of indemnity and other wfltings obligatory in the nature thereof and,
(2) To remove, at any time, any such attorney-in-facl and revoke the authority given.
Further, this Power of Attorney is signed and sealed by facsimile pursuant 10 resolution of the Board of Directors of said Company adopted at a meeting
duly called and held on the 29th day of April, 1982 of which the followmg is a true excerpt:
Now therefore the signatures of such officers and the seal of the Company may be affixed to any such power of attorney or any certificate relating thereto by
faCSImIle, and any such power of attorney or certificate bearing such facsimile slgnaUlres or facsimile seal shall be valid and bindmg uRon the Company and any
such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company m the future WIth respect to any
bond or undertaking 10 whIch it is attached.
IN TESTIMONY WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY has caused this instrument to be
signed and its corporate seal to be affixed by its authorized officer, this 16th day of October, A.D. 2007.
INTERNATIONAL FIDELITY INSURANCE COMPANY
STATE OF NEW JERSEY
Counry of Essex
<=#- ~~
Secretary
On this 16th day of October 2007. before me came the individual who executed the preceding instrument, to me ~rsona1ly known, and, being by me duly
sworn, said the he 1S the therein described and authorized officer of the INTERNATIONAL FIDELITY INSURANCE COMPANY; thaI the seal affixed to
said instrument is the Corporate Seal of said Company; that the said Corporate Seal and his signature were duly affixed by order of the Board of Directors of
said Company.
IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal,
at the City of Newark. New Jersey the day and year first above written.
~,~~
A NOTARY PUBLIC OF NEW JERSEY
My Commission Expires Nov. 21, 2010
CERTIFICATION
I, the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY do hereby certify that I have compared the foregoing copy of the
Power of Attorney and affidavit, and the copy of the Section of the By-Laws of said Company as set forth in said Power of Attorney, with the ORIGINALS ON
IN THE HOME OFFICE OF SAID COMPANY, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power
of Attorney has not been revoked and is now in full force and effect
12th d'yofMay, 2009.
k:rp,~
IN TESTIMONY WHEREOF, I have hereunto set my hand this
Assistant Secretary
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of CALIFORNIA
County of ORANGE
On
Mav 12. 2009
before me. Erika Guido. NOTARY PUBLIC.
personally appeared RANDY SPOHN
[g]
J@ ';;,,,',,,:" .~
o COMM. # 1843731
~. NOTARY PUBUC CAUFOANIA ~
'1. ORANGE COUNTY 1(1
. ~. ~.comm.expireSMaY5,2013 t
. . .. ... .
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.
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
D INDIVIDUAL
D CORPORATE OFFICER
DESCRIPTION OF ATTACHED DOCUMENT
D PARTNER(S) D UMITED
[g] ATTORNEY-IN-FACT
D TRUSTEE(S)
D GUARDIAN/CONSERVATOR
D OTHER:_
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of San Bernardino
On June 2, 2009
be!eJre me, Natalie Price, Notary Public
IIi~TC insert !lame ;lI1d title of the otli~Crl
personally appeared, Larry J. Hyder
who proved to me on the hasis of satisfactory evidence to be the person~ \vhose namc~ is/Me subscrihed to
the within instrument and acknowledged to me that hC/.'flell1.e.' executed the same in his,'I1\...~,'jJl""~l authorized
capacjty~, and that by his IL....,'lL.... ;1 signaturc~) on the instrument the personm, or the entity upon behalf of
\vhich the person~ acted, executed the instrument.
I certify under PENAL TY OF PERJURY under the laws of the State of Cali fomi a that the foregoing paragraph
].'1 true and correct.
WITNE~d and 0::2:a1
Si.""",,,,,~
NATALIE PRICE
COMM #1751871 'll
NOTARY PUBLIC - CALIFORNIA ~
SAN BERNARDINO COUNTY
MyComm Expires June 19,2011
(S,'i\l)
.
.
ADDITIONAL OPTIONAL INFORMATlO"i
I!'STRLC flO~S FOR COMPLETING THIS FORM
(Tlllc or JC,cri]1lion 01 all ached nOCUJllCIl1 cr,nliT1lJL'dJ
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d, k"""'!"(~'-'Il"'1II 1't,,'hiu,'<" us 11/(11' /'" prillled oil such a dO('l/menl .1'0 hillg LIS Ihe
ld/'lugC dUe\' '10/ /'i',/"i/'c lire 11(JIUlT ff! do .lrJl/w/hi'ig Ilwl is 111('gal)(II' (! 1)('/<111' i'l
('"I!I,"-"lo 1;.'-. ,crri!l'IIIg 111<' m'II,,,,-I:,,,.I C"f)(lcir. <Ii Ihe signeu. f'1c,Tse check Iii"
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D~~~R~II(]NOFTHF_AlTAC~:DD(](I ~F:I I
(TlllcordC'lrlptlOnuf,1II,1<;hcddmUlllll1tl
;\lumber of Pages
DOCLllllent Dale
Slate' and Couoty i:ltnl'l11,1tiDn I11mt bc the Sl~te and (ounly "hcre the' d,wumcl1t
,i.~IlL'r(') ]1('1',,,11;111) '!I'p,'an:d k,'"ol'-: thc nOI:!.11' publil: fur illkihlwlcdgmcnl
I),llc otll(lt~rlZal:(l;11)]1I,1 be' the' d,11c Ihal the slgncr{sl rcrsol1:!.II.\' ar]1~'arl:(J \\hleh
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111, Ilotar\' pUOllC 111\1't prim his (11' 11l'r l1,1mc ~s it appcnrs wilhll1 hi, or hl-r
l'o:mlli,siull f"lh,\\'cd by a~'(l11ll1M.\Il'] thcn your lille (l1l1t;iry rubli(1
1'IIIIt the n~n1C(,J llt di\Cumcl1l ~igllcr(,) \\'ho rL'r~"11ally ~I'pcar al the lime ,,[
lH'!arl/,ltIUII
f.-\ddi\iotul i<lfOlm~\iolll
iTltk)
Partner(s)
Atlorney-in-Fact
Tmstee(s)
~ Dlher
Indi(;lIc Ih.: COIT':l:1 ,inglllarl1r plural forms by cro,sing off incorrect F.lIllh lic
k shc'~ i, ''*'' ) ot rirdill!" lhc L"Orrcl:! fonn~. F;lilurc to correctly iT1dic~lc this
1I.j'(\rnl~tillIlIlWY k~d to reJccllun of documcnt n~,'orning
Thc IWlar\ ;cal impn:s~il'l1 Intl,l bc dC,iI ;lnd pbologr.lphlcalty r2rrodll~'ibk
Ill1l'rcs.'don 1l111-'1 nolCll\'cr lnl or lines. Ifs<;31 imprc-,sion smudges. r~'-,;::al if a
,,",ffiocnl ,lr;a pcrmits, Dlbcrwi,;c cllmrkle a diffcrent aekllowkdgnlcllt foml
Signalurc "j' tlK ]W'.Jf)' ]1ublic tntl,1 mat.:h the ~ign~lIurc on filc \\'ith thc nffic.: (\1
thi.'Cl1LlIltyclcrk
'.' ,\ d d IIi 01\:1 ~ i 11 fn r 111 d 1 i 0 11 i s n Ul re qui re d b \II C 0 U 1 d h cl p ((l C 11 S II r c 1 his
ackn",\lcdgment I..;nol mi,u~cd or <lllachcd III a diffcrent dCl\"tllll;nt
.:. Ind.""I" lii!cor Iypc"f"u"....hcddoeulncnl. nulllber',fpag"~and dalc
. Indicatc llic cilpacity clailllcd oy the ~it:ncr. If tlic clai1l1Cd car~Cil) IS a
Cllrjloralc ofticcr, illdi\,11C thc litk (i.c. (TO, en), S,'CrcIJf)J
Securely attach Ih!:' documcnt 10 1l1esigncd anC\ll11cnt
CAPACITY CLAIMED BY Till' SIGNER
IndIvidual (s)
~] CorporaJe Ofllcer
(,n., ',iilU"l>lnfun1.JIs,f.., "'\\'wN"I;w.,-('b'Se<.C0111