HomeMy WebLinkAbout05.R- Public Works dMOMMOm W"__
DOC ID: 3322
CITY OF SAN BERNARDINO —REQUEST FOR COUNCIL ACTION
Report/Information
From: Tony Frossard M/CC Meeting Date: 07/07/2014
Prepared by: Olivia Wolff, (909) 384-5140
Dept: Public Works Ward(s): 1
Subject:
Emergency Sewer Repairs (#3322)
Current Business Registration Certificate: Not Applicable
Financial Impact:
There is no financial impact to the City. SANBAG has reimbursed the City for all associated
costs.
Motion: Receive and file report.
Synopsis of Previous Council Action:
None.
Background:
During the construction of a new storm drain pipe at the Southwest corner of Rialto Avenue and
"B" Street, GRFCO, the contractor working for San Bernardino Associated Governments
(SANBAG), damaged the City's 18-inch trunk line sewer main. After several attempts at
repairing the sewer main, it was determined the contractor was not capable or qualified to
complete the repairs. SANBAG asked the Public Works Department to assess the situation.
Based upon the condition of the damaged pipe, and its importance in serving a large area of the
City and due to the significant volume of raw sewage flow it carried, the City Engineer
determined that immediate emergency repairs were needed for this sewer pipe. SANBAG agreed
to reimburse the City for all costs associated with the repair of the pipeline and restoration of the
surface street improvements.
Pursuant to Municipal Code Section 3.04.075, the Public Works Department engaged the
services of an experienced sewer contractor to make the required repairs. In order to complete
the repairs, staff solicited bids from contractors that have recently done this type of work in
and/or for the City. The contractors that offered bids for this work were El-Co Contractors,
Inc. of San Bernardino, CA; TBU, Inc. of Beaumont, CA; and Houston Harris of Grand
Terrace, CA.
El-Co Contractors, Inc. submitted a proposal at a cost of $96,200 (see attached). TBU, Inc.
submitted a proposal at a cost of$18,154 (see attached). Houston Harris submitted a proposal to
line the damaged pipe instead of replacing it at a cost of$9,700.
After discussing these bids with Operations and Maintenance, it was determined that lining the
existing sewer pipe in lieu of replacing the damaged section was not recommended as a
Updated: 7/2/2014 by Georgeann"Gigi"Hanna Packet Pg.433
3322
permanent solution and this was disregarded in favor of replacing the damaged section of sewer
main. Due to the important of this sewer main and the need for immediate action, TBU, Inc. was
directed to complete the work as an emergency repair.
Work was commenced by the contractor, but due to the volume flowing in the pipe and the
possibility of catastrophic failure, the contractor was directed to modify the scope of work to
provide a concrete encasement in lieu of replacing the pipe. Additionally, the scope of work
included relocation of a proposed sewer manhole, and an additional 8-inch sewer lateral needed
for the future transit center. The lateral installation also included some sidewalk replacement
and temporary asphalt repairs.
The second part of the emergency sewer repair was the street repair work. Separate bids were
obtained for the trench and street repairs. Proposals for this work were received from Jim Baker
Concrete, Inc. of Highland, CA; NBI General Contractors, Inc. of Redlands, CA; and All
American Asphalt,Inc. of Corona, CA.
All American Asphalt submitted a bid of $35,420 (see attached); NBI submitted a bid of
$32,400; and Jim Baker Concrete submitted a bid of$63,430. The lowest bidder, NBI General
Contractors, Inc., was directed to complete the street repair work, using temporary traffic
control provided by All American Asphalt since they were already mobilized for the sBX
project.
The total cost for the repairs was $67,208. All work was completed and inspected by City staff.
The City Engineer has accepted the pipeline repairs and the restoration of the surface
improvements, except for elements that will be disturbed by the Transit Center project being
constructed by SANBAG. SANBAG has issued a purchase order to the City and submitted
payment to the City in the amount of$67,208 to cover all costs of these repairs. All contractors
have completed their work and have been paid to date.
This report is being submitted to the Mayor and Common Council,pursuant to Municipal Code
Section 3.04.075, reporting the emergency work and actions taken.
Supporting Documents:
Supporting Attachments (PDF)
Updated: 7/2/2014 by Georgeann"Gigi"Hanna Packet Pg.434
5 R.a
"E" Street - Rialto Avenue
Emergency Sewer Repair
SANBAG Reimbursement
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Credits: 3
Storm Drain Bus Lane Repayment $ 35,640
Storm Drain Sewer Repair $ 31,568
$ 67,208
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Charges: N
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Sewer Repair—TBU, Inc. $ 19,156.39
Trench Repair— NBI General Contractors, Inc. $ 35,640.00
Dump Fees— NBI General Contractors, Inc. $ 600.00 E
All American Asphalt, Inc.- Traffic Control $ 5,698.19
Perm itsllnspection Fee $ 6,113.42 a
$ 67,208.00 =
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alAt• VLi/1°AfiVi/1V AV VVyDA1a-tl y...,•�..f.1DY1a.t�iV
ACCOUNTS PAYABLE CHECK NO. 613846
IHlisiCF DATL PO NUMBER UEBCPIP710N IbSLGUNt' �TAO#tN{
E ST. Bus Lane 2/1, 02/2412014 4001128 E ST.STORM DRAIN BUS LANE REPAYMEN' 0.00 35,840.00
E St.Drain Rep 03/11/2014 4001127 E ST.STORM DRAIN SEWER REPAIR 0100 31,668.00
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67,208 00 cn
PLEASE DETACH BEFORE DEPOSITING +-
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ACCOUNTS FAYA13LE• v
Govern ents 1170 W.3RD ST, 2ND FLOOR THROUrH
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SAN BERNARDINO,CA 92410 FoxuH^a aaaa Q
SPAPILN BAG- 909-884-8276 ��� DATE CHtCKAMOUNT
01901 0410112014 613146 67,208.00
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PAY Sixty Seven Thousand Two Hundred Eight Dollars and No Cents
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TO THE CITY OF SAN BERNARDINO
ORDER 300 N. "D"ST
SAN BERNARDINO, CA 92418
OF
u'06L3846n� 1: 122203470: 238033400
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SAN BERNARDINO ASSOCIATED GOVERNMENTS
ACCOUNTS PAYABLE CHECK NO. 613846
2rtvOlgNWb>TR t4ttC POIMW6R
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0.00 36,640.00
EST.Bus Lane 2/1, 02/2412014 '4001128 E ST.STORM DRAIN BUS LANE REPAYMEN'
E St. Drain Rep 03/11/2014 4001127 E ST.STORM DRAIN SEWER REPAIR 0.00 31,568.00
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PAYMENT DATE City of San Bernardino BATCH NO.
0-0/16/2014 300 North "D"Street 2014-10003352
COLLECTION STATION San Bernardino, CA 92418-0001 RECEIPT NO.
Vanessa Sanchez 2014-00015274
RECEIVED FROM CASHIER
San Bernardino Associated Ellen Rumple
Government(SANBAG)
DESCRIPTION
San Bernardino Associated Government (SANBAG)
PAYMENT CODE RECEIPT DESCRIPTION TRANSACTION AMOUNT
PW-0r81 Comang Public Works Prof Contract 0025 $35,640.00
San Bernardino Associated Government(SANBAG)INV NO E ST N
Bus Lane 211 Date 02/24/2014 PO Number 4001128 E ST Storm '-
Drain Bus Lane Repayment m
PW-Prof Cont0025 Public Works Prof Contract 0025 $31,668.00 0.
San Bernardino Associated Government(SANBAG) Inv No E St
Drain Rep Date 03/11/2014 PO Number 4001127 E St Storm Drain
Sewer Repair
Total Cash $0.00 �+
Total Check $67,208.00 v
Total Charge $0.00
Total Other $0.00 Q
Total Remitted $67,208.00 to
Change $0.00
Total Received $67,208.00
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Total Amount: $67,208.00
Printed by: Ellen Rumple Page 1 of 1 041161201410:56:03 AM
Packet Pg.438
CITY OF SAN BERNARDINO
PUBLIC WORKS DEPARTMENT
RECEIPT
Activity# :81400048
ROW Combination Permit
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SITE ADDRESS: 110 S E ST SB PARCEL: 0136-021-25-0000 C
LOCATION: E ST
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RECEIVED FROM: SANBAG of
RECEIPT NUMBER: 814003385 Copy Reprinted on 06-23-2014 at 08:56:17
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TRANSACTION DATE: 06/09/2014 TOTAL PAYMENT: 6,113.42
TOTAL PAID FROM TRUST: .00
TOTAL PAID FROM CURRENCY: 6,113.42
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Type Method Description Amount
Payment Check 613846 6,113.42 E
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TOTAL: 6,113.42
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ACCOUNT ITEMS:
Description Account Code Current Pmts 0
------------------------------ ---------------- ------------
After hrs inspection fee- C.
001-400-4362 1,606.33
PW-Issuance Fee 001-180-4351 45.00
PW-Lane Closure Fee 001-400-4352 4,424.00
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Technology Fee 001-180-4715-000 38.09
'DOTAL: 6,113.42
RECEIPT ISSUED BY: JTS INITIALS: JTS
ENTERED DATE: 06/09/2014 TIME: 03:43 PM
COMMENTS
NOTICES
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Public Works Department
300 North D Street,San Bernardino,CA
� 0� tt1 11(0 Ph:909-384-5111 Fax:909-384-5190, www.sbcity.org
RIGHT-4F-WAY PERMIT
Permit No. E1400048
Status:ISSUED
Issued Date:01/2112014
Applicant: Contractor:
TBU, INC TBU,INC
240 MAPLE AVE 244 MAPLE AVE
SUITE A SUITET L
BEAUMONT,CA BEAUMONT,CA
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951-759-0647 951-769-0647 �=
Insurance expiration date:09/13/2014
Location: E ST
Adjacent Address:110 S E ST SB insp.Area: USouth v7
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Purpose of Permit:SEWER REPAIR U
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Work Order Number:
Date(s):01/21/2014 - 01124/2014
Time(s): Sam-4pm(No weekends or holidays) w
Description Quantity Fee Amount N
Lane Closure Days: 2 $196.00 M
Special Event LC: $0.00 --
Special Event SC: $0.00
Const.Road Closure: 14 $4,228.00
Excavation Days: 0 $0.00 E
Encroachment Days w/o LC: 0 $0.00
After Hours Inspections: 18 $1,663.30 r
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Miscellaneous Fees: rn
Issuance Fee: $45.00 S
Supplemental Issuance Fee: ?? c
Archival Fee: $0.00 a
Technology Fee: $38.09
Total Fee Amount $6,113.42 to
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COMMENTS: E
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Inspection must be scheduled 24 hours In advance,before work is done. Call M-F 7:30 a.m.to 4:00 p.m. (909)384-7272 <(
"I certify that I have read and must perform in accordance with the General Provisions attached and certify that my
performance of work for which this permit is Issued shall comply with the Workman's Compensation Laws of California."
Applicant's Signature Date Signed
Issued By Date Signed
Packet Pg.440
"E" Street - Rialto Avenue
Emergency Sewer Repair
Sewer Repair
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Estimates: CL
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TBU, Inc. $ 18,154 N
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EI-Co Contractors, Inc. $ 96,200
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Houston-Harris $ 9,700 (lining and point repair only) uE,
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Invoices:
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TBU, Inc. $ 19,156.39 (including extra work) r
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LIII=IIIIC0 CONTRACTORS,INC.
1996 Nolan Street,San Bernardino,CA 92407•Telephone(909)987-2610 or 887-1013•Fax(908)880-9091
P.O.Box 9130 San Bernardino,CA 92427
TO: Name he City of San Bernardino PROJECT:
Addresl LOCATION:
City 300 N."D"Street
San Bernardino,CA raab_ma @sbclty.org
DATE: 1113/la14 ATTEN: AAvrk.Raab TELEPHONE:
We propose to furnish Labor & Material to perform the work hereafter specified.
18"Sewer Repair-Rialto Ave& "E"Street
1 Lump Sum Mobilization 10,000.00 10,000.00
2 1 Each 24"x 48" Manhole w/Stub-out 16,200.00 16,200.00
3 20 LF 18"Sewer Repair 23,500.00 23,500.00
4 Lump Sum By-Pass Pumping 42,000.00 42,000.00 m
5 Lump Sum Shoring 4,500.00 4,500.00
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TOTAL: 96,200.00
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Backfill materials to be used will be onsite. oa
NOTES: Traffic control and permits excluded. c�
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1. Permits & Inspection fee by others.
2. Engineering & Staking by others.
3. Construction water to be furnished & paid for by others.
4. All work completed by the 25th of each month is due and payable on the 10th of the following month.
5. Final billings will be based on actual measurements of work at the above prices_
General conditions, on the reverse side, are an Integral part of the agreement.
ACCEPTED: John Wiles,Sec/Gen.Mgr. EL-CO CONTRACTORS, INC.
STATE LICENSE NO. 317093
BY: BY:
DATED:
SIGN AND RETURN ORIGINAL COPY
Packet Pg.443
jY 21831 Barton Road•Grand Terrace-CA-92313 First in quality
909-422-8990.909-422-0841 Fax First in service
houstonandharris.com
CCTV Inspection-NASSCO,PACP, MACP CertKied Operators-Lateral Launch System-Laser Measurement
Database Customization-Data Conversion C/PP Point Repairs-Hydro-wash-Potholing- CA#884167
Estimate: This estimate is valid for 90 days
To: City of San Bernardlno Date: 01.16-14
Attn: John Van Havermaat From: Elizabeth Butler
Email/Fax: Vanhavermeat lo0Jsbcity.or_c Email/Fax: ebutlerRhoustonandharris.com
Re: "E"Street Pipe Repair Pages: 2
Our Prevailing Waste estimate on the above noted project is as follows, when scheduling this project please reference L
this estimate to ensure you are charged the appropriate rate: Q
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Five(5)48"x 18" Pipe Patch Repairs
3-Man Crew;Non-Prevailing Wage $8,200.00 rn
3-Man Crew; *Prevailing Wage $9,700.00
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' *As per Prevailing Wage labor code#1771, rates are based on Houston &Harris paying"Laborer, Group 3".
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Please see forms and conditions with this agreement. c
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Elizabeth Butler
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Office Manager, Q
Estimating&Contract Administrator
ebutler -houstonandharris.com
Used as defined:
Estimate:To calculate approximately(size,cost,etc.) Quote:To state a price Bid:To offer an amount as the price one will accept,or pay
Page 1 of 2
This faxtemall and all attachments to it are for the sole use of Intended recipients.This fax/email mayalso contain information which Is confidential or which is protected from
disclosure by privilege.Any unauthorized use,disclosure,or distribution of this fax/email and its attachments is prohibited.If you are not the intended recipient,please reply via email
or tax then destroy copies received,
Packet Pg.4"
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N 21831 Barton Road-Grand Terrace-CA•92313 First in quality
909-422.8990.909-422-0841 Fax
houslonandharrls.com First in service
CCTV Inspection-NASSCO,PACP,MACP Certified Operators•Lateral Launch System-Laser Measurement
Database Customization-Data Conversion C/PP Point Repairs-Hydro-wash-Potholing- CA#884167
Estimate: This estimate is valid for 90 days
To: City of San Bernardino Date: 01-16-14
Attn: John Van Havermaat From: Elizabeth Butler
Email/Fax: Vanhavermaat toCa abdiy.orn Email/Fax: ebutlerCdthoustonandharris.com
Re: "E"Street Pipe Repair Pages: 2
AGREEMENT TERMS AND CONDITIONS: ;n
Rates are subject to change without notice.
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Houston&Harris PCS,Inc.will not be signatory to any PLA.
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Time Estimate is based on one(1) Move-In, Monday through Friday, during day shift unless otherwise stated, as well as the job site being Uj
ready upon our arrival, including but not limited to manholes raised and lines being clean if only a video truck is ordered. If the job should go
over/under the estimated time,the customer will be charged for any worked hours over the four(4)hour minimum. _
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Overtime rate applies to all hours worked over an eight(8)hour on site time or eight(8)hour workday for the operator at a second job site. If
additional Move-Ins should be required our four(4)hour minimum applies. E
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To establish an account,our"First Time Customer Policy"of a"Good Faith"C.O.D.will apply and will be due prior to the start of such service.
If fuel surcharge and worked hours are less than the C.O.D.amount due at the time of service, excluding the 4-hour minimum,a refund will be N
issued for the difference. Account credit is at the sole discretion of management. M
It is the sole responsibility of the client to be in compliance with any State or Federal Prevailing Wage requirements.The client must U)
notify Houston & Harris PCS, Inc. at the time of scheduling of the correct status. It Is also agreed that if the project is discovered to be
Prevailing Wage after the fact,a change order will be issued and the client will be responsible for wages due,full amount of rate difference for E
work completed,legal fees,as well as all fines and penalties under California Labor Codes§1720, §1720.2,§1720.3,§1720.4, §1771,§1775, q
§1776, and§1813.
Estimate is based on standard deliverables consisting of Data DVD with printed hard copy reports.Reports are now offered in PDF format and Q
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placed on Inspection DVD.Various deliverable options are available upon request at an additional charge. e
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Any Insurance forms requested outside of standard procedure will be charged at cost. a
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Past due invoices are subject to a one and one half percent(1'/z%)late charge. Houston&Harris PCS, Inc.reports all delinquent accounts to r j
Dunn&Bradstreet.Account credit is at the sole discretion of the management.
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By signing this agreement the client has read and hereby agrees to the terms and conditions set forth above: m
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Signature Q
Printed Name
Date
Used as defined:
Estimate:To calculate approximately(size,cost,etc.) Quote:To state a price Bid:To offer an amount as the price one will accept,or pay
Page 2 of 2
This faxtemall and all attachments to It are forthe sole use of Intended recipients.This faxlemail may also contain information which is confidential orwhich Is protected from
disclosure by privilege.Any unauthorized use,disclosure,or distribution of this faxlemail and Its attachments is prohibited.If you are not the intended recipient,please reply via email
or fax then destroy copies received.
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"E" Street - Rialto Avenue
Emergency Sewer Repair
Street Repair
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Estimates:
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NBI General Contractors, Inc. $ 32,400 cn
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All American Asphalt, Inc. $ 35,420 F
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Jim Baker Concrete, Inc. $ 63,430 `"
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Invoices:
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NBI General Contractors, Inc. $ 35,640 (including actual quantities)
600 (dump fees) Q
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Q�n�rd Contraatore. Ina.
January 30,2014
City of San Bernardino
Public Works Department a
Attn:Mark Raab
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300 North"D"Street
San Bernardino,CA.92418
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Re: Proposal for Bus Pad Work on "E"Street,San Bernardino,CA. _
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Mr. Raab; E
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We propose to provide all labor, material and equipment necessary to perform the Cl)
following work for the Bus Pad Work on"E"Street In San Bernardino. Our proposal �?
includes but is not limited to the following scope of work:
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• Saw-cut of approximately 200'of asphalt. E
r Remove approximately 2,000 square feet of asphalt.
6 Remove approximately 175 cubic yards of base(Approximately 2,400 square feet
at 2 feet deep) c'
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o Replace approximately 90 cubic yards of base.
Re-compact to 95%(approximately 2,400 square feet at 1 foot deep), a
• Form,place and pour approximately 2,400 square feet of 3,250 PSI concrete(1
foot thick)
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• Saw-cut control joint as directed by City Engineer.
Raise existing man-hole covers to finish surface. U
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For the sum of: $32,400.00 Q
(Final price will be determined upon field verification of quantities/sizes by City Engineer
Our price is based on$13.50 a square foot:)
Price Excludes: Rebar
All engineering,permits,fees,Inspections,testing and bonds.
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Post Office Box 8580,Redlands,CA 92375 • 1770 Howard Place,Redlands,CA 92373
Phone(909)798-7300 . Fax(909)798-7340 • License 435915
Packet Pg. 449
We appreciate this opportunity to submit our proposal on this project. Please feel free
to contact me directly if you have any questions or need any further clarification.
(909)725-0695 We look forward to working with you on this project.
Sincerely,
.Eames P. ra,President
NBI Gene 1 ntractors,Inc.
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ALL AMERICAN ASPHALT
Engineering - Contractors - Asphalt Paving CAL. STATE
400 East Sixth St. LIC.#267073A
" ► P.O. Box 2229
Corona,California 92878-2229
Telephone:(951)736-7600 FAX: (951)736-7646
Serving:Los Angeles, Orange,Riverside,and San Bernardino Counties
To:MARK RAAB Date: 1128=14
SAN BERNARDINO,CITY OF DIV.OF PW DDS From: Cody Gawryluk
THIRD FLOOR CITY HALL 300 N.D ST. Quote No. 387
SAN BERNARDINO,CA 9241-8--
Phone Fax - -411
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We propose to furnish you labor and material in strict accordance with the plans and specifications as follows: m
PAVEMENT REHAB. ON THREE CITYSTREETS
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CITYOFSANBERNARDMO �
Item No. Description Quantity U/M UnitPrlce Total Price
1 1 RECONSTRUCT SBX LANE ON"E"STREET 2,200.0 SF 16.100 35,420.00
(12"PORTLAND CONCRETE CEMENT) w
! 35,420.00 N
Total Proposal Price: $35,420.00 M
Special Conditions:
1. BID BASED ON 6 SACK CONCRETE—560-C-3250 d
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Quotation Note:
""IMPROVEMENTS TO BE CONSTRUCTED PER ORIGINAL PROJECT SPECIFCATIONS""'`"
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Date: Accepted by:
Page 1 of 1
Packet Pg.451
JIM Baker Ce11CF019,INC. Estimate
29872 Havenwood Lane
Highland,CA 92346 Date Fstimate
Phone# (951)377-4464 jimbakerconcrete @roadrunner.com
2/6/2014 252
Fax# (9o9)864-1361
Name/Address
San Bernardino City
Public Works Department
1 234 S.Mountain Ave
San Bernardino,CA 92408
r 384..5020 f 384-5190
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Project
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Description Qty Cost Total &_
San Bernardino City J SBX/SanBag Project W
Concrete Driveway Pad at Sbx Station on"E"St. south of Rialto
Ave.in San Bernardino N
Concrete Bus Pad-2400 sq.ft.x 12"thick, No rebar,400opsi 2,400 12.70 30,480.00 M
concrete v
Removal-2400 cubic ft.-Asphalt and base 90 210.00 18,goo.00 N
Haul-off and Dump fee 1 5,400.00 5,400.00
j Saw Cutting AC 1 750.00 750.00 d
Level 2 Manholes 2 350.00 700.00 E
Temp Asphalt Patching/Cleaning 1! 7,200.00 7,200.00
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Total $63,430.00
Customer Signature
Packet Pg.452
NlI General Contractors,Inc.
Invoice
P.O.Box 8580 Date Invoice#
Redlands,CA.92375
1770!;Toward Place 2/2411014 1084
Redlands,CA 92373
Bill To Ship To
"E"Street Bus Pad Omnitrans
City of San Bernardino
Mark Raab
300 North"D"Street
San Bernardino,CA.92418 L
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P.O.Number Terms Rep Ship Vla F.O.B. Project N
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Due on receipt BMW 2/24/2014 us Mail y
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Quantity Item Code Description Prkm Each Amount ar
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I Const.Draw Bus Pad work on"E"Street;San Bernardino 0.00 0.00 w
I Const.Draw 2,640 square feet®$13.50 per foot(per proposal 35,640.00 35,640.00 N
dated 1130114) M
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it's been a pleasure working with you!
LTOtai s35,60.00
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NBT General Contractors,Inc. Invoice
P.O.Box 8580 Date Invt►ke�M
Redlands,CA.92375
1770 Howard Place 311/2014 1088
Redlands,CA 92373
B81 T6 Ship To
"E"Street Bus Pad OmnJtrans
City orsan Bernardino
Mark Raab
300North'D"SUM
San Bernardino,CA.92418 i
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P.O.Number Terms Rep Ship Via F.O.8. Project to
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Due on receipt EMW 3/18014 d
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QuentRy Rom Code Description Price Each Amount E LU
I Const.Draw Reimbursement for Dump Fees(Concrete Haul-off) 600.00 600.00
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i All work is complete!
Total s600.00
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AGUA MANSA PROPERTIES,INC.
P.O. BOX 127
RIVERSIDE.CA 92502-0127
(951)328-9349
NBI GENERAL CONTRACTORS Statement Date February 28,2014 L
P 0 BOX 8580 ca
REDLANDS, CA 92375 Customer Code 11305 a
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Date Ref.Num. Description Amount rn
Balance Forward 0.00 =
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02/20114 47505 CONCRETE 100.00 d
02/20/14 47509 CONCRETE 100.00 E
02/20/14 47523 CONCRETE 100.00 uj
02/20/14 47530 CONCRETE 100.00 cv
02/20114 47550 CONCRETE 100.00 M
02/20/14 47563 CONCRETE 100.00
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Statement Total 800.00
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F., W-a9 Request for Taxpayer 0)w Form to the
D! " "R013> Identification Number and Certiflcatlon r�°•�h• I not
ap��t a ut;. ury esnd to the IRS.
Hama(as shown andt lA.yaw Incemo�tayx return)
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yI� B"now name/dbraga rdod entity rune,It different from aWva
Check appropriate box for federal tax tassttkanon: Examptlone(a"Instructions):
❑indNlduaVaola propielor C Corporation ❑9 Corporation ❑ partnership 0 Truatlestata
Exempt payee code of airy)
tj ❑ Umlled Ilabiliy,company.Enter the tax claaatncetlon(C-C corporation,9-9 corporation,P=partnarohip)► Exemption from FATCA reporting
code of any) .�
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Accrues(number,streat,and apt.orsulte nos �^ Rcyuostor'e name and addross(oplionar)
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Taxpayer Identification iYum6er TIN} L)
Entar your 71N In the appropriate box.The TIN provided must match the name given on the"Nature'We soctat secur ynumber
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to avoid backup withholding.For individuals,this is your social security number(SSN).However,for a
realdent alien,sole proprietor,or dieregarded entity,see the Part I Instnactkrns on page 3.For other d-Ell entities,it is your employer identification number(EIN).ti you do not have a number,see Now to get a Ut E
77N on papa 3. W
Note.If the account is In more than one name,we the chart on page 4 for guidelines on whose Employer Watillcatfon number
ntrmbu to enter. �
Certification
Under penalties of perjury,I certify that; rn
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1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be Issued to me),and m
2. 1 am not subject to backup withholding because;(a)I am exempt from backup withholding,or(b)I have not been notifled by the Internal Revenue =
Service ORS)that I am subject to backup withholding as a result of a failure to report all Interest or dividends,or(o)the IRS has notified me that I am
no longer subject to backup withholding,and
3, 1 am a U.S.citizen or other U.S.person(defined below),and 'Z
4_The FATCA code(s)entered on this form Oi any)Indicating that I am exempt from FATCA reporting Is correct.
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Certification Instructions.You must cross out item 2 above If you have been notified by the IRS that you are currently subjact to backup withholding L
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 O
interest paid,acquisitian or abandonment of secured properly,cancellation of debt,contributions to an indlvkluai retirement arrangement(IRA),and iZ
generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TiN.See the O•
Instructions on page 3. O
Sign Signs Here . ;j
U.Spse � � J. o 3aate
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General Instructions jF withholding tau on foreign perMSa'share of affectivey connected income,and E
4.Certify that FATCA cods(s)enured on this form(if any)Indicating that you are U
Section references are to the Internal Revenue Code unrest otharwfse noted. exempt from the FATCA repodfng,Is correct,
Future davetcpments.The IRS has created a page on IRS.gov for Information Note.it you are a U.S.person and a requester
about Form W-8,at www.o}s.govhvg.Infamaation about any future developments net gives You a form other than Form Q
att"Ing Form W-9(such as teglstalion enacted after we Woes II)wall bs posted VJ-9 to o this Form W-0,you must we line roquester'a form N k b aubateMtatly
on that page. sknNar to ihle Form W-9_
Oetirnhton of a U.S.person For tederot tax purpata,you are considered a U.S.
Purpose of Form person If your am:
A person who Is required to fib an Information return with the IRS must obtean your "An individual who Is a US.odren or U.S.resident amen,
correct taxpayer Identification numosr(far}to report•for example,Incomo pad to •A partnership,corporation,company,or association created or organized in the
you.payments made to you In settfomont of payment cad and third party network United Sterf"or under the taws of the United States,
transactions,teal estato transactions,mortgage Interval you paid,acqulsnion or .An estate(other then a foreign estate),or
ebandamaent of secured property,cancellation of debt,or contributions you made
to an IRA A domestic trust u defined in Regulations section 301,7701-7),
Use Form W-9 only II you are a U.S.person(including a resident amen),to $W olal rule for partnerships.Partrcrshlpe that conduct a trade or business In
provide,your corrac TIN to the person requesting it(the requester)and,when the United States am ganeraNy requ'r4d to pay a withholding tax under section
applicable to., 1446 on any foreign partnero'stwo of effactNaty connected taxable Income from
i.Certify that"*TIN You are Bing m correct(or You are weRhp for a number such busV*s&Further,in ood&cases where s Form W-9 tats not been rocaMd,
the rules under faction 1440 require a partnership to proswna that a partner b a
to be issuad), foralgn person,and pay the section 1440 withholding tax,Therefore.If you ato a
2.Certify that you are not subject to backup wl0drolding,or U,S.poison that Is a p tin of In a pwtraashlp condweing a trade or business in the
1 Claim exemption from backup withholding it you are s U.S,exempt payee.If United States,provtds Form W9 to the partnership to astab4tr your U.S.status
applicable,You are also cer*ing that as a U.S.pin,Your Occable share of and avoid section 1448 wkhhoidhg on yaw sham of partnership Income,
any partnership Income from a U.S.trade or bustrwm Is not subject to the
Cat.No.10231X Form W-9(Rev.6-2013)
Packet Pg.456
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Packet Pg.457
All American Asphalt
Engineering - Contractors -Asphalt Paving
400 1;,6°i 4trect,110 Box 2229,Carom,California 92878.2220
Telephow. (951)'716-7600 Fax; (951)730-7646
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May 21,2014 C
City of San Bernardino
300 North"Kr Street 3
San Bernardino,CA 92413
Attention: Jeffrey Scharer
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Reference: Emergency Sewer Repair
E.Street to Rialto Ave, E
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Subj: Traffic Control--Rialto Ave.and t;Street N
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unit Price 1f@W Atttm
Set ti Trask Coatr+at it R _ 3672.22 5 672= _
llstiilMailtte"Reeof Traffic Control 1,c !c,zs(tB Da ) .__ #61147 $1.084.36
Remove Traiilt CaWrol(1 D�1Y} _ S dt= 5672M 0
Daily Traffic Conttrot bevi 7 Days) _ 121.0 s�S 89 CL
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Please issue a contract change order at your earliest convenience.If you have any questions,please cantact me Q
at(951)736-7600 or(931)737-9610.
Thanky
All Ai crican As salt CITY OF SAN BERNARDINC)
Cotly Gawryluk PUBLIC;V1f K -t TPAH it.4I:NrtENQINFERING DIVISION
Estimator l Project Manager Pi()I-tc:i�i�r h TAKEN
t E t;t fill tla, la Itt=>NOTED&
tt�".ytlllkfii�t�1f' 111,16 DAYS
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