HomeMy WebLinkAboutBid Documents_Redacted91 1Eel r1f1ULIKIT
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SOUTH TAHOE PUBLIC UTILITY DISTRICT
for the Construction of
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT
DOCUMENTS IN THIS SECTION CONSTITUTE THE BID FORMS. BIDDERS ARE TO
COMPLETE AND ATTACH THE DOCUMENTS CONTAINED IN THIS SECTION AS
INSTRUCTED IN SECTION 00 20 00, INSTRUCTIONS FOR BIDDERS, AND SUBMIT THE
COMPLETED BID PROPOSAL PACKAGE IN ITS ENTIRETY ELECTRONICALLY PRIOR TO
THE BID DEADLINE. BIDDER IS REQUIRED TO SUBMIT THE ORIGINAL DOCUMENTS
CONTAINED IN THIS SECTION WITHIN THE TIME STATED IN SECTION 0010 00,
SOLICITATION — INVITATION TO BID (SEE SECTION 00 20 00, INSTRUCTIONS FOR
BIDDERS, PART 2.03)
Name0oz, CooSit k�✓J (_o L/// L.
Bidder::
Business
Address: 14 CV4;nPG 12K14&rnr lk"5y Ai// r?cg70G
Phone No: �%q5) Rcei —K,ILI
To South Tahoe Public Utility District:
Pursuant to and in compliance with your Notice Inviting Bids and the other documents relating
thereto, the undersigned, Bidder, being fully familiarwith the terms of the Contract Documents, local
conditions affecting the performance of the Contract, the character, quality, quantities, and the
Scope of the Work, the cost of the Work at the place where the Work is to be done, hereby
proposes and agrees to perform within the time stipulated in the Contract, including all of Its
component parts and everything required to be performed, and to furnish any and all of the labor,
material, tools, equipment, transportation, services, permits, utilities, and all other items necessary
to perform the Contract and complete in a workmanlike manner, all of the Work required in
connection with the construction of said Work, all in strict conformity with the Specifications and
other Contract Documents, Including Addenda Nos.
for the prices hereinafter set forth.
Bids that are submitted via the District's electronic bidding system at the time set for opening of Bids
shall be irrevocable, and may not be withdrawn for a period of sixty (60) days after the date set for
the opening of the bids except as noted in Section 00 20 00, Part 3.14.
ELECTRONIC BID SCHEDULE PRICES:
NOVMEBER 2023 SECTION 00 41 00
2024 HERBERT WALKUP PIPELINE BID FORMS
REPLACEMENT PROJECT 1
All applicable sales taxes, State and/or Federal and any other special taxes, patent rights, or
royalties are included in the prices quoted In this Bid.
The quantities specified are the DISTRICT's estimates and are approximate only, being given as a
basis for the comparison of Bids. The DISTRICT does not, expressly or by implication, agree that
the actual amount of work will correspond therewith. The total amount bid will be used to determine
the lowest, responsive, responsible, Bidder.
Payment for each item will be based on the actual quantity of work performed times the item unit
contract price. Determinations of the actual quantities and classifications of unit price work
performed by the CONTRACTOR will be made by the DISTRICT and may be more or less than the
specified, estimated quantities. Unless otherwise indicated in the Bid Item Descriptions, the unit
price shall be valid for actual quantities up to 25% more than or less than the bid quantity.
All representations made by Bidder in this Bid are made under penalty of perjury.
DATED: 12 IP 1202 3
NOVMEBER 2023
2024 HERBERT WALKUP PIPELINE
REPLACEMENT PROJECT
BIDDER: (IrUZ
BY: 11% Il u-ta)r
TITLE: O! tn.Q, .[ 1q- a e#,t/
SECTION 00 4100
BID FORMS
2
INFORMATION REQUIRED OF BIDDER
DEPARTMENT OF INDUSTRIAL RELATIONS REGISTRATION:
Bidder hereby certifies that It Is aware of the registration requirements set forth in Labor Code
sections 1725.6 and 1771.1 and is currently registered as a contractor with the Department of
Industrial Relations.
Contractor DIR Realstration Number: 7 P—W—% 9— /Ul�llZOQ7p
LIST OF SUBCONTRACTORS:
The Bidder shall list in the space provided, the name and the location of the place of business of
each Subcontractor who will perform work or labor or render service to the prime CONTRACTOR in
or about the construction of the work or Improvement, or a Subcontractor licensed by the State of
California who, under subcontract to the prime CONTRACTOR, specially fabricates and installs a
portion of the work or improvement according to detailed drawings contained in the plans and
specifications, in an amount in excess of one-half of one percent of the prime contractor's total bid
or, in the case of bids or offers for the construction of streets or highways, including bridges, in
excess of one-half of one percent of the prime CONTRACTOR'S total bid or ten thousand dollars
($10,000), whichever is greater. The Bidder shall list the Subcontractors License Number and, in
accordance with Labor Code Section 1725.5 and 1771.1, the Subcontractor's Department of
Industrial Relations Registration Number. The Bidder shall also list the portion of the work that will
be done by each Subcontractor under this Contract. The prime CONTRACTOR shall list only one
SUB -CONTRACTOR for each portion as is defined by the prime contractor in his or her bid. Failure
to list subcontractors with portions of the Work in excess of the minimum amounts listed above
constitutes a declaration by the CONTRACTOR that it is qualified and able to self -perform the work.
Any CONTRACTOR found to be unqualified or unable to self -perform any part of the Work not listed
below may be disqualified. The Bidders attention is directed to the provisions of Section 00 T3 00,
Supplemental Conditions, Part 2.06, entitled Subcontracts.
NOVMEBER 2023 SECTION 00 41 00
2024 HERBERT WALKUP PIPELINE BID FORMS
REPLACEMENT PROJECT 3
ATTACH ADDITIONAL PAGES, 'E fyECESSARY
Work to be Performed Subcontractor's License # Subcontractor's DIR Percent of Subcontractor's Name and
Reoistration # Total Contract Address
1.
2.
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NOVMEBER 2023 SECTION 00 4100
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
4
EQUIPMENTIMATERIAL SUPPLIER LIST:
The Bidder shall indicate below which Supplier the Bidder intends to use to furnish under the Bid -
each item of equipment or material listed on this form by writing the supplier's name., Unless the
use of alternatives for a particular item has been restricted by these Contract Documents, the
Bidder may listany manufacturer whose productmeets all ofthe requirements and technical criteria
specified. The listing of more than one supplier for each equipment/material to be furnished with the
words "and/or" will not be permitted.
Equipment/Material Supplier
1. Aggregate base material
2.
Asphalt
3.
Concrete
4.
Water Piping
5.
Water Fittings
6.
Water Valves
7.
Fire Hydrants
8.
Sewer Piping
9.
Sewer Fittings
I0
Vrhoc 1!isohc,lr
30 iShC2��
,�1 4ji,U6Vd�d�/U j�
I
p f vte4r� WG�dl(a �`1�1' �
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�J�dar� Al�t/�1a�ilti
Manufacturer
� ldmoN d l�/as f'K .s/
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n- &/ VZA-e�/
519W, a
NeAl w
/'luaf(er
Dfaof +otid flcu6c-s/
�,ieyf{aka
NOVMEBER 2023 SECTION 00 4100
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
5
EQUIPMENT/MATERIAL SUPPLIER LIST:
The Bidder shall indicate below which Supplier the Bidder intends to use to furnish under the Bid
each item of equipment or material listed on this form by writing the supplier's name.. Unless the
use of alternatives for a particular item has been restricted by these Contract Documents, the
Bidder may list any manufacturer whose product meets all of the requirements and technical criteria
specified. The listing of more than one supplier for each equipmentImaterial to be furnished with the
words "and/or' will not be permitted.
Equipment/Material Supplier Manufacturer
1. Aggregate base material
2. Asphalt
3. Concrete
4. Water Piping
5. Water Fittings
6. Water Valves
7. Fire Hydrants
B. Sewer Piping
9. Sewer Fittings
lLO LYA 46V VPr\
Y_AIV�
NOVMEBER 2023 SECTION 0041 00
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
5
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NOVMEBER 2023 SECTION 00 41 00
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
6
BIDDER'S GENERAL INFORMATION:
The Bidder shall furnish the following information. Additional sheets shall be attached as required.
Failure to complete Item Nos. I through 7, at the time of bid submittal will cause the bid to be non-
responsive and may cause its rejection. Bidders shall submit Item Nos. 8 and 9 if requested by the
OWNER prior to award of contract. No award will be made until all of the Bidder's General
Information (i.e., Items I through 7, inclusive and Items 8 and 9, if requested) is delivered to and
accepted by the OWNER.
(1) Contractor's Name and Address:
(2) Contractor's Telephone Number:
(3) Contractor's Preferred Email Address: rI
(4) Contractor's License: Primary Classification COGS-Y /-r - /renew i ErMinwni
State License No.A1g1C&td0A Expiration Date: /e I311202v
Supplemental Classifications held, if any: PAZ
Name of Licensee, if different from (1) above:
/,✓/A
(5) Name of person who inspected site or proposed Work for your firm:
Namef(f 0 _ Date of Inspection: A/nVCr✓ k 1 � 7n 2T
(6) Name, address, and telephone number of surety company and agent who will provide the
required bonds on this contract:
$(B V1 ¢Sege S%` fSu:1�.`f3oLe4 Cie C53o� P�?-�i3T
(7) Complete the following forms: qDO( ( Ueann4 Ouinjeirc
a) "Non -collusion Declaration'
b) Iran Contracting Act Certification
c) Public Works Contractor Registration Certification
d) Contractor's Certificate Regarding Workers' Compensation
e) Bid Bond
NOVMEBER 2023 SECTION 0041 00
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
7
(8) List three projects completed as of recent date involving work of similar type and complexity:
Name, address, telephone
Proiect Contract Price 8 of OWNER
1.
�Ic�ael hd�� �'L�l�rcl CGS, Ib�.f�U
3.
VO Q V\ 03q r
4.
5.
(8) The experience resume of the person who will be designated chjef construction
superintendent or on -site construction manager. STP V2, biro' fR 1
$uQ¢.r tIrNkYe 1r'¢n T.
(9) A financial statement,references, and other information, sufficientlycomprehensive to permit
an appraisal of Contractor's current financial condition The financial statement shall be in
accordance with Section 00 20 00, Part 3.01.1).
NOVMEBER 2023 SECTION 00 41 00
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
0
NONCOLLUSION DECLARATION TO BE EXECUTED
BY
BIDDER AND SUBMITTED WITH BID
The undersigned declares: ,.L , I
I am the Y\1CA1.`St`t �"tN (position)of. �rUZ ��RS',`r`JC{�oYl (Firm),theparty
making the foregoing bid.
The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership,
company, association, organization, or corporation. The bid is genuine and not collusive or sham.
The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or
sham bid. The bidder has notdirectly or indirectly colluded, conspired, connived, or agreed with any
bidder
or anyone else to put in a sham bid, or to refrain from bidding. The bidder has not in any manner,
directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid
price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price,
or of that of any other bidder. All statements contained in the bid are true. The bidder has not,
directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents
thereof, or divulged information or data relative thereto, to any corporation, partnership, company,
association, organization, bid depository, or to any member or agent thereof, to effectuate a
collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.
Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint
venture, limited liability company, limited liability partnership, or any other entity, hereby represents
that he or she has full power to execute, and does execute, this declaration on behalf of the bidder.
I declare under penalty of perjury under the laws of the State of California that th f regoing is true
and correct ad that this declaration is executed on Ze23 date], at Ou OUj [city],
IViVO4a [state].
gpmu loft\ `aver \ 9 P1
1l, Sig9L�tum of Declarer
VA notary public or other officer completing this certificate verifies only the identity of the individual who signed the
VA
to which this certifCate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California J
County of 7A �GI Q o
LACY MUM
salary Pobbq Stated Nevada
Appointment No. 23-993"S
(Seal) MYAppt. Expires Feb 17, 1017
Subscribed and swo n to (or affir(ned) before me
This 8� day of \ .- - C{s:N\D-e� 20 ,
�AtA:✓1✓Q 1 yLtsM Y\5,sw.
Na signor
proved to me on the basis of satisfactory evidence
to be the person who appeared before me.
ignatifre 7otary
NOVMEBER 2023 SECTION 00 4100
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
9
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NOVMEBER 2023 SECTION 00 4100
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
10
IRAN CONTRACTING ACT CERTIFICATION
(Public Contract Code section 2200 at seq.)
As required by California Public Contract Code Section 2204, the Contractor certifies subject to
penalty for perjury thatthe option checked below relating to the Contractor's status in regard to the
Iran ConI cting AU of 2010 (Public Contract Code Section 2200 at seq.) is true and correct:
The Contractor is not:
(1) Identified on the current list of person and entities engaged in investment activities in
Iran prepared by the California Department of General Services in accordance with
subdivision (b) of Public Contract Code Section 2203; or
(2) a financial instruction that extends, for 45 days or more, credit in the amount of
$20,000,000 or more to any other person or entity identified on the current list of
persons and entities engaging in investment activities in Iran prepared by the
California Department of General Services in accordance with subdivision (b) of
Public Contract Code Section 2203, if that person or entity uses orwilI use the credit
to provide goods or services in the energy sector in Iran.
❑ The City has exempted the Contractor from the requirements of the Iran Contracting
Act of 2010 after making a public finding that, absent the exemption, the City will be
unable to obtain the goods and/or services to be provided pursuant to the Contract.
❑ The amount of the Contract payable to the Contractor for the Project does not
exceed $1,000,000.
SignaturL f YJ lO /
Primed Nama• Ir1gz. Paue_l�
Title:%il�inC-2 (/!/fGl✓IU�e✓
Firm Name:l.OA l'✓✓C-k 'el
Date: lZ /gl7d73
Note: In accordance with Public Contract Code Section 2205, false certification of this form shall be
reported to the California Attorney General and may result in civil penalties equal to the greater of
$250,000 or twice the Contract amount, termination of the Contract and/or ineligibility to bid on
contracts for three years.
NOVMEBER 2023 SECTION 0041 00
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
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2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
12
PUBLIC WORKS CONTRACTOR REGISTRATION CERTIFICATION
Pursuant to Labor Code sections 1725.5 and 1771.1, all contractors and subcontractors that wish to
bid on, be listed in a bid proposal, orenter into a contract to perform public work must be registered
with the Department of Industrial Relations. See mto//www.dir.ca.aov/Plmlir-
Works/PubllcWorks.html for additional information.
No bid will be accepted nor any contract entered into without proof of the contractor's and
subcontractors' current registration with the Department of Industrial Relations to perform public
work.
Bidder hereby certifies that it is aware of the registration requirements set forth in Labor Code
sections 1725.5 and 1771.1 and is currently registered as a contractor with the Department of
Industrial Relations.)
Name of Bidder (,/,fjZ ('o!l S l/u ciTotl
DIR Registration Number: etAl L& Z - l!>!)/1A32 Q
DIR Registration Expiration: i - 30 - 1-00,5
Small Project Exemption': _ yes or ✓ No
Unless Bidder is exempt pursuant to the small project exemption, Bidder further acknowledges:
1. Bidder shall maintain a current DIR registration for the duration of the project,
2. Bidder shall include the requirements of Labor Code sections 1725.5 and 1771.1 in
its contract with subcontractors and ensure that all subcontractors are registered at
the time of bid opening and maintain registration status for the duration of the
project.
3. Failure to submitthis form or comply with any of the above requirements may result
in a finding that the bid is non -responsive,
Name of Bidder t Ifiij%q (?001115-bi/C`ItJ4
Signature
NamemiHt9` l7i ems!! i7IGt✓
Dated 101,ebo23
1 If the Project is exempt horn the contractor registration requirements pursuant to Me small protect exemption under Labor Code
Sections 1725 5 and 1771.1, please mark 1yosr in response to 'Small Project Exemption."
NOVMEBER 2023 SECTION 00 4100
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
13
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NOVMEBER 2023 SECTION 00 41 00
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
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CONTRACTOR'S CERTIFICATE REGARDING WORKERS' COMPENSATION
I am aware of the provisions of section 3700 of the Labor Code which require every employer to be
insured against liability for workers' compensation orto undertake self-insurance in accordance with
the provisions of that code, and I will comply with such provisions before commencing the
performance of the work of this Contract.
Nameof Bidder 0,612,
rG/!d'/-r✓Ci-rail
Slgnatu A
Name and Title /if!iC Ma YtG5�61 /CIGrY 47✓F✓
Dated IZ��7oZ3
NOVMEBER 2023 SECTION 00 41 00
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
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NOVMEBER 2023 SECTION 00 41 00
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
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ACKNOWLEDGMENT OF INSURANCE REQUIREMENTS
This Document Must Be Full yy Executed By Contractor
and Suhmitted Wlth The Bid
The following insurance requirements have been adopted by The South Tahoe Public Utility District
hereinafter designated the "OWNER,' and shall be applicable to this Contract.
Insurance Reauirement Summary
The CONTRACTOR shall furnish, prior to Notice to Proceed, Insurance Certificates and
Endorsements as setforth in Section 00 20 00, Part 2.08.13 and Section 00 73 00, Supplementary
Conditions, Part 2.01. No other Insurance documents shall be accepted in substitution of, nor In
addition to, those set forth in Section 00 20 00, Instructions for Procurement. Insurance
requirements and coverage will be In accordance with Section 00 73 00, Supplementary Conditions,
Part 2.01.
The CONTRACTOR shall not commence work underthis Contract until all insurance required under
this heading Is obtained in a form acceptable to OWNER, nor shall the CONTRACTOR allow any
Subcontractor to commencework on a subcontract until all Insurance required of the Subcontractor
has been obtained. I�
the
of l( 1017 l'//}}��S t1C�0i�� `y'�.: (InsertTitle U
ame o ompany or Corporatronowner)
certify that the Insurance Requirements Summary has been read and understood and that as a
material consideration of our bid, we are able to provide the document and coverage specified.
Signature, r slit nsld Sec
M ger, Ow rr r Representative
Date:/Q /ZU2 3
NOVMEBER 2023 SECTION 00 4100
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
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2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
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CERTIFICATION BY CONTRACTOR'S INSURANCE BROKER
This Document Must he Fully Executed By Contractors
Insurance Broker and Submitted With the Bid
I, GCi.�CoY%/�G�i�aST/NScd?Afn authorized representative of
(ndmdual's name and brokerage name) ,
AW /Alr&A?A✓e6 Ce 7t0AAVI e,3 ThIs company is the insurance broker
(Insurance Company)
for GftO- lfo*XfX"417X� (°Contractor•).
(contractor)
By my signature below, I hereby attest to the following:
1. I have reviewed the insurance requirements for the South Tahoe Public Utility
District's 2024 Herbert Walkup Pipeline Replacement Project ('Project^), including the
requirements set forth in Section 00 73 00, Supplementary Conditions, Part 2.01 of the Contract
Documents.
2. The Contractor is eligible to be Insured for the policies necessary to satisfy the
insurance requirements for the Project.
This certification Is not intended to be binding of coverage and d try and/or alter the
terms and conditions of the insurance policies issued to Comic
Date: /eZ. /sj.�023
(Sig ure t horized representative)
for
A notary public or other officer completing this certificate verities only the Identity of the Individual who signed the
document to which this certiticale is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
�"�" ,� ) ss
County of Sau'^"b )
On D2rIPJW,6'13r7AZ3befure me, r>1lf"Cy o Scovtj�E personally appeared
who prov@ to me on the basis of satisfactory evidence to be the
persons) whose name(s) is/are subscribed to the within Instrument and acknowledged to me that he/shelthey
executed the same in his/her/their authorized capacity(ies), and that by his/herttheir 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. _ --- --- - —api
WITNESS and and official seal. �� ALFgfIS �EYIIS f{
p OBMM. / 241 B497
rc ° KKTA0WPUBLIC.CAu9T01MA
y COL11MOFS"RNIUa1U
Mortify Pubta I Comm.FaNr+6�.Is. �t
NOVMEBER 2023 SECTION F00 41 00
2024 HERBERT WALKUP PIPELINE REPLACEMENT PROJECT BID FORMS
21
SECTION 00 75 00
GRANTFORMS
PART1 GENERAL
1.01 SUMMARY
A. Section Includes:
1. To comply with the Contract requirements for Grant Funding, the contractor
must complete the following forms (attached) and submit them with the Bid:
a. Form 4500-3: DBE Subcontractor Performance
b. Form 4500-4: DBE Subcontractor Utilization
2. To comply with Contract requirements for Grant Funding, the Contractor must
complete the following forms and submit them at the District's reauPct in
accordance with Section 00 20 00, Part 2.06.A:
a. American Iron and Steel Certification
b. Build America, Buy America Certification
c. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion
d. Lobbying Forms, only one shall be completed, as applies:
1) Certification Regarding Lobbying, or
2) Disclosure of Lobbying Activities
e. Form 1: DBE "Good Faith" Effort List of Subcontractors Solicited
L Form 5: Summary of Bids Received — DBE and non -DBE.
3. To comply with Contract requirements for Grant Funding, the Contractor must
complete the following forms and submit them at the District's request
following award of the Oolect.
a. Certification of Non -Segregated Facilities
b. Drug -Free Workplace Certification
c. Non -Discrimination Clause
d. Form 4500-2: DBE Subcontractor Participation Form
B. The certification requirements included herein are described fully in
Section 00 74 00, Grant Conditions.
NOVEMBER 2023 SECTION 00 75 00
2024 HERBERT WALKUP PIPELINE GRANT FORMS
REPLACEMENT PROJECT t
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2024 HERBERT WALKUP PIPELINE GRANT FORMS
REPLACEMENT PROJECT 2
AMERICAN IRON AND STEEL CERTIFICATION
CONTRACTOR/APPLICANT:
1. Identification of American -made Iron and Steel: Consistent with the terms of the Purchaser's bid solicitation, the
Bidder certifies that this bid reflects the Bidders best, good faith effort to identify domestic sources of iron and steel
for every component contained in the bid solicitation where such American -made components are available on the
schedule and consistent with the deadlines prescribed in or required by the bid solicitation.
2. Verification of US. Production The Bidder certifies that all components contained in the bid solicitation that are
American -made have been so identified, and if this bid is accepted, the Bidder agrees that itwill provide reasonable,
sufficient, and timely verification to the Purchaser of the U.S. production of every component so identified.
3. Documentation Regarding Non -American made Iron and Steel The Bidder certifies that for any component or
components that are not American -made and are so identified In this bid, the Bidder has included in or attached to
the bid one or both of the following, as applicable
a. Identification of and citation to a categorical waiver published by the U.S. Environmental Protection Agency in the
Federal Register that is applicable in such component or components, and an analysis that Supports Its
applicability to the component or components.
b. Verifiable documentation sufficient to the Purchaser, as required in the bid solicitation or otherwise, that the
Bidder has sought to secure American made Components but has determined that such components are not
available on the schedule and consistent with the deadlines prescribed in the bid solicitation, with assurance
adequate for the Bidder under the applicable conditions stated in the bid solicitation or otherwise.
4. Information and Detailed Jushfication Regarding Non- Amencan-made Iron and Steel The Bidder canines that for
any such component or components that are not so available, the Bidder has also provided in or attached to this bid
information, including but not limited to the verifiable documentation and a full description of the bidder's effort to
secure any such American -made component or components, that the Bidder believes are sufficient to provide and as
far as possible constitute the detailed justification required for a waiver under section 1605 with respect to such
component or components. The Bidder further agrees that, if this bid is accepted, it will assist the Purchaser in
amending, supplementing, or further supporting such information as required by the Purchaser to request and, as
applicable, implement me terms of a waiver with respect to any such component or components
CERTIFICATION
I, the official named below, hereby swear that I am duly authorized legally to bind the contractor
or loan recipient to the above described certification. I am fully aware that this certification,
executed on the date and in the county below, is made under penalty of perjury under the laws
of the State of California,
OFFICIAL'S NAME: L(,iC,ta— \xe—Aj' _
DATE EXECUTED: tiJ7 EXECUTED IN COUNTY OF:
CONTRAtC�OR/APPLICANT SIGNATURE
TITLE
NOVEMBER 2023 SECTION 00 75 00
2024 HERBERT WALKUP PIPELINE GRANT FORMS
REPLACEMENT PROJECT 3
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2024 HERBERT WALKUP PIPELINE GRANT FORMS
REPLACEMENT PROJECT 4
BUILD AMERICA, BUY AMERICA CERTIFICATION
CONTRACTOR/APPLICANT: CrU2. COTIs�Lrjc�raYY riff i✓IG
The Contractor acknowledges to and for the benefit of the District ("Owner's and the California
Drinking Water State Revolving Fund (DWSRF) Program (the "Funding Authority") that it
understands the goods and services under this Agreement are being funded with federal
monies and have statutory requirements commonly known as "Build America, Buy America;"
that requires all of the iron and steel, manufactured products, and construction materials used in
the project to be produced in the United States ("Build America, Buy America Requirements')
including iron and steel, manufactured products, and construction materials provided by the
Contactor pursuant to this Agreement.
1. The Contractor hereby represents and warrants to and for the benefit of the Owner and
Funding Authority:
a) The Contractor has reviewed and understands the Build America, Buy America
Requirements,
b) All of the iron and steel, manufactured products, and construction materials used in the
project will be and/or have been produced in the United States in a manner that
complies with the Build America, Buy America Requirements, unless a waiver of the
requirements is approved, and
c) The Contractor will provide any further verified information, certification or assurance
of compliance with this paragraph, or information necessary to support a waiver of the
Build America, Buy America Requirements, as may be requested by the Owner or the
Funding Authority.
CERTIFICATION
I, the official named below, hereby swear that I am duly authorized legally to bind the contractor
or loan recipient to the above described certification. I am fully aware that this certification,
executed on the date and in the County below, is made under penalty of perjury under the laws
of the State of California.
OFFICIAL'S NAME. LILPlT
DATE EXECUTED: f � /� /1d%`� EXECUTED IN COUNTY OF! et Dor (Z4"
CONTRACTTOORp/APPLICANTSIGNATU nl,
TITLE'
NOVEMBER 2023 SECTION 00 75 00
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CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION
CONTRACTOR/APPLICANT: (;N2 'CC)
(1) The contractor certifies, by submission of this proposal, that it and its principals
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded by any Federal agencies;
(b) Have not within a three year period preceding this proposal been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction
or contract under a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental
entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph
(1)(b) of this certification; and
(d) Have not within a three year period preceding this application/proposal had one or more
public transactions (Federal, State or local) terminated for cause or default.
(2) Where the contractor is unable to certify to any of the statements in this certification, such
contractor shall attach an explanation to this proposal'.
`Exceptions will not necessarily result in denial of award, but will be considered in determining
bidder responsibility. For any exception noted, indicate to whom it applies, initiating agency,
dates of action, and the type of violation.
CERTIFICATION
I, the official named below, hereby swear that I am duly authorized legally to bind the contractor
or loan recipient to the above described certification. I am fully aware that this certification,
executed on the date and in the county below, Is made under penalty of perjury under the laws
of the State of California.
OFFICIAL'S NAME: Lae �/{J�( CI� r ''1�
DATE EXECUTED: �% / / �,�,3 EXECUTED IN COUNTY OF: G � I,WQ A-D
CONTRAC�1TTOR/APPLICANT SIGNATURE:
TITLE kVV(i VA
NOVEMBER 2023 SECTION 00 75 00
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CERTIFICATION OF NON -SEGREGATED FACILITIES
CONTRACTOR/APPLICANT: Ortiz Orts-�EucC 16Y-� eco-• .LYIt�'i
Environmental Protection Agency Region IX
75 Hawthorne Street
San Francisco, California 94105
(Applicable to federally assisted construction contracts and related subcontracts exceeding
$10,000 which are not exempt from the Equal Opportunity Clause.)
The federally assisted construction contractor certifies that he does not maintain or
provide for his employees any segregated facilities at any of his establishments, and that he
does not permit his employees to perform their services at any location, under his control, where
segregated facilities are maintained. The federally assisted construction contractor certifies
further that he will not maintain or provide for his employees any segregated facilities at any of
his establishments, and that he will not permit his employees to perform their services at any
location, under his control, where segregated facilities are maintained. The federally assisted
construction contractor agrees that a breach of this certification is a violation of the Equal
Opportunity Clause in this contract. As used in this certification, the term "segregated facilities"
means any waiting rooms, work areas, restrooms and wash rooms, restaurants and other eating
areas, time clocks, locker rooms and other storage or dressing areas, transportation, and
housing facilities provided for employees which are segregated by explicit directive or are in fact
segregated on the basis of race, creed, color, or national origin, because of habit, local custom,
or otherwise. The federally assisted construction contractor agrees that (except where he has
obtained identical certifications from proposed subcontractors for specified time period) he will
obtain identical certifications from proposed subcontractors prior to the award of subcontracts
exceeding $10,000 which are not exempt form the provisions of the Equal Opportunity Clause,
and that he will retain such certifications in his files.
CERTIFICATION
I, the official named below, hereby swear that I am duly authorized legally to bind the contractor
or loan recipient to the above described certification. I am fully aware that this certification,
executed on the date and in the county below, is made under penalty of perjury under the laws
of the State of California.
OFFICIAL'S NAME: L(,p�, / ,1�(T' 1A .-Ar j
DATE EXECUTED: 12 /.A / 2�Z.3 EXECUTED IN COUMV OF. FI ` Dw Alb
CONTRACCTTIO�R/APPLIC(A�NT SIGNATUI
TITLE: C�d�ti( o y�(�\b�t —
Nole:The pel'0f^"yJfor making false s t erns in offers is prescribed in 19 U.S.0 1001.
NOVEMBER 2023 SECTION 00 75 00
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DRUG -FREE WORKPLACE CERTIFICATION
/
CONTRACTOR/APPLICANT: ` h 1 %. C(3V) SI-f? 7 C-%r n eel
The contractor or applicant named above hereby certifies compliance with Government Code
Section 8355 in matters relating to providing a drug -free workplace. The above named
contractor or applicant will:
1. Publish a statement notifying employees that unlawful manufacture, distribution,
dispensation, possession, or use of a controlled substance is prohibited and specifying actions
to be taken against employees for violations, as required by Government Code Section 8355(a).
2. Establish a Drug -Free Awareness Program as required by Government Code Section
8355(b), to inform employees about all of the following:
(a) The dangers of drug abuse In the workplace,
(b) The person's or organiz ition's policy of maintaining a drug -free workplace,
(c)Any available counseling, rehabilitation and employee assistance programs, and
(d) Penalties that may be imposed upon employees for drug abuse violations.
3. Provide as required by Government Code Section 8355(c), that every employee who
works on the proposed contract or loan:
(a) Will receive a copy of the company's drug -free policy statement, and
(b) Will agree to abide by the terms of the company's statement as a condition of
employment on the contract a loan.
CERTIFICATION
I, the official named below, hereby swear that I am duly authorized legally to bind the contractor
or loan recipient to the above described certification. I am fully aware that this certification,
executed on the date and in the county below, is made under penalty of perjury under the laws
of the State of California.
OFFICIAL'S NAME: LQCJ.,f_'t A.Pf
DATE EXECUTED: I2 I,T Y%p% EXECUTED IN COUNTY
OF C.l Jil7V 0.LU1
CONTRACTOR/APPLICANT SIGNATURE-"
TITLE: {'�{,'[.�„[P ,1✓��r�A.�t
NOVEMBER 2023 d SECTION 00 75 00
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NON-DISCRIMINATION CLAUSE
CONTRACTORIAPPLICANT: Cruz C'O/�� kY1J Cato 1'T
During the performance of this contract, contractor and its subcontractors shall not
unlawfully discriminate against any employee or applicant for employment because of
sex, race, religion, color, national origin, ancestry, physical disability (including HIV and
AIDS), mental disability, medical condition (cancer), marital status, age (over 40) or
denial of family care leave. Contractors and subcontractors shall insure that the
evaluation and treatment of their employees and applicants for employment are free of
such discrimination and harassment. Contractors and subcontractors shall comply with
the provisions of the Fair Employment and Housing Act (Government Code Section
12900 (a-f) et seq.) and the applicable regulations promulgated thereunder (California
Administrative Cade, Title 2, Section 7285.0 et seq.). The applicable regulations of the
Fair Employment and Housing Commission implementing Government Code, Section
12900 (a-f), set forth in Chapter 5 of Division 4 of Title 2 or the California Administrative
Code are incorporated into this contract by reference and made a part hereof as if set
forth in full. Contractor and its subcontractor shall give written notice of their obligations
under this clause to labor organizations with which they have a collective bargaining or
other agreement.
The contractor shall include the nondiscrimination and compliance provisions of this
clause in all subcontracts to perform work under the contract.
CERTIFICATION
I, the official named below, hereby swear that I am duly authorized legally to bind the contractor
or loan recipient to the above described certification. I hereby certify that the Contractor will
abide by the above requirements. I am fully aware that this certification, executed on the date
and in the county below, is made under penalty of perjury under the laws of the State of
California.
OFFICIAL'S NAME: L )! l>ru-fr r'
DATE EXECUTED /Z I e I Za%3 EXECUTED I COUNTY OF: El Dby-& 0
CONTRAC;RJA..FPLICANT
n1p�aSI^GN,,ATU�RE-\r//,7IA
TITLE: u l./��'I\A.y 4:Y
NOVEMBER 2023 SECTION 00 75 00
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CERTIFICATION REGARDING LOBBYING
CONTRACTOR/APPLICANT: GYw 2.- Co r) S � Ve o C:-(ar-%,
The undersigned certifies to the best of his or her knowledge and belief that
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress,
an officer or employee of Congress, or an employee of a Member of Congress in conjunction with the
awarding of any Federal contract, the making of any Federaf grant, the making of any Federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
Influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract,
grant, loan or cooperative agreement, the undersigned shall complete and submit Standard Form LLL,
Disclosure Form to Report Lobbying, in accordance with its instructions.
CERTIFICATION
I, the official named below, hereby swear that I am duly authorized legally to bind the contractor or loan
recipient to the above described certification. I am fully aware that this certification, executed on the date and
In the county below, is made under penalty of perjury under the laws of the State of California.
OFFICIAL'S NAME:
DATE EXECUTED: lZ IAP✓L)2 3 EXECUTED IN . AUNTY OF:
CONTRALTO APPLICANT SIGNATURE:
TITLE: (lY U(�,.
NOVEMBER 2023 SECTION 00 75 00
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DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 034E-0046
(See reverse for public burden disclosure.)
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract El a. bid/offerdapplication a. initial fling
b. grant b. initial award b. material change
c. cooperative agreement c. post -award For Material Change Only:
J. loan year quarter
e. loan guarantee date of last report
f. loan insurance
4. Name and Address of Reporting Entity:
Prime ❑ Subwurdee
Tier, IF known:.
Congressional District, if known:
6. Federal Department/Agency:
B. Federal Action Number, if knot
10. a. Name and Address of Lobbying Re . trant
(if individual, last name, first n ,M):
5. If Reporting Entity in No. 4 is a Subawardee, Enter Name
and Address of Prime:
Co♦ fessional District, if known:
7. F2ral Program NamelDescription:
CFDA Number, if applicable:
9. Award Amount, if known:
b. Individuals Performing Services (including address if
different from No. 10a )
(last name, first name, MI):
11 "ronmebon requested MMUP the form is ammaam by lithe 31 U.S.0 sw.ann
3352 Tin:dismal Of nebyne anvmea hs a ream re,hraaamauwh Or rest
Signature:
sre
rise hch reoancs over pha m by me her above Weer MIS thansaem wits made
Print Name:
or Orono imw Thhs difil'Is ",red par:aary to 33 U SC. 1352. This
mformman sell ba mpwred to Me Coryress Seasonal ane.nu be all fd
Title:
Most hnspmMm. Any person sons fees to file me regmred u¢casure mall be
Sabin to a evil pamay a not foss that m0,000 and nor more Man Moll for
Telephone No.:
dace sore fil
Federal Use Only:
NOVEMBER 2023
2024 HERBERT WALKUP PIPELINE
REPLACEMENT PROJECT
Date:
AtMalzed for Local Reproduction
Standard Form LLL (Rev. ]-97I
SECTION 00 75 00
GRANT FORMS
17
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure farm shall be completed by the reporting entity, whether subawzrdee or prime Federal recpeM at the inmahan or receipt of a
covered Federal action, or a material change to a previous filing, pursuant to fide 31 U.S.C. section 1352 The fling of a form is required for each
payment or agreementto make payment to any lobbying entity 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 a covered Federal action
Complete all Items that apply fa both the ira l filing and malenal change report. Refer to the implementing guidance published by the Office of
Management and Budget far adds anal Information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal
action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report If this is a followup report caused by a material change to the information previously reported,
enter the year and quarter in which the change occurred. Enter the date aide last previously submitted report by this reporting away for this caveed
Federal action
4. Enterthe full name, address, city. Stare and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate
classification ofthe repomng entity that designates if it is, or expects to be, a prime or aIDaward recipient Identify theter of the subawardee, a g, the
first subawardee of the prime is the 1 sther Subawards include but are not limited to subcamrecs, subgants and contract awards under grants
5. If the organization filing the report in item 4 checks "Subawardee,"then enter the full name, address. city, State and Ap code of the prime Federal
redplent Include Congressional Dishil if known.
6. Enter the name of the Federal agency making the award or can commitment Include a[ least one organizational level below agency name, If known
For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name an description for the covered Federal action (Item 1) If known, enter Me full Catalog of Federal Domestic
Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.
B. Enter Me most appropriate Federal identifying number available for the Federal action Identified in item 1 (e.g , Request for Proposal (RFP)
number, Invitation for Bid (IFB) number, grant announcement number, the cantract, grant, or loan award number, the apple abondproposal control
number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-904101:
9 For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the
award)loan commitment far the prime entry Identfied In item 4 or 5.
10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged byte
reporting entity identified in item 4 to Influence the covered Federal action.
(b) Enter the full names of the Individuals) performing services, and include full address fi different from 10 (a) Enter last Name, First Name, and
Middle Initial (MI).
11 The certifying official shall sign and date the from. print his/her name, rule, and telephone number.
According to the Paperwork Reduction Ad, as amended, no persons are required to respond to a cdlection ofinfonnadon unless a displays a valid OMB Control
Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of Information
estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information Send comments regarding the burden estimate or any other aspect of [his collettlon
Information, Including suggesfions for reducing Ns burden, to the Office of Management and Budget, Paperwork Reduction Protect (0348-0046), Washingtal,
DC 20503.
NOVEMBER 2023 SECTION 00 75 00
2024 HERBERT WALKUP PIPELINE GRANT FORMS
REPLACEMENT PROJECT 18
Water Boards
Disadvantaged Business Enterprise (DBE) Program
DBE Subcontractor Participation Fonn
A Financial Assistance Agreement Recipient must require Its prime cantractors to provide this faro to its DBE
subcontractors. This form gives a DBE'subcontractor'the opportunity to describe work received and/or report
any concerns regarding the funded project (e.g., in areas such as termination by prime contractor, late
payments, etc.). The DBE subcontractor can, as an option, complete and submit this form to the DBE
Coordinator at any time during the project period of performance.
Subcontractor Name /( Pro ad Name
t ��r Trod Y r i/�` �fra'T„/ Xzr 0#6r� lt1Ai�Ku)p ?', w l; hp
r pocal No. - �Assl nce greeme IDNo. Aknown) I Poimof Corlett
Prime ContmctorName Issuing Fun m
CIM09 ()0r.S+G)C1-kQ^
Contract Item Description of Work Received from the Prime Contractor Involving
Number I Construction, Services, Equipment" Supplies
kfa��jG Canl�ro �
Amount Racelvad
aY Pdma
Cerdlaataf
'A DBE is a Disadvantaged, Minority, or Woman Business Enterprisethat has been certified by an enthyfrom which EPA
accepts certifications as described in 40 CFR 33.204-33.2025 or certified by EPA. EPA accepts certifications from entitles
that meet or exceed EPA certification standards as described In 40 CFR 33.202.
'subcontractor is defined as a company, firm, joint venture, or Individual who enters Into an agreement with a contractor
to provide services pursuant to an award of financial assistance.
FORM 45062 (DBE subcontractor PartretpaNnn Form)
NOVEMBER 2023
2024 HERBERT WALKUP PIPELINE
REPLACEMENT PROJECT
SECTION 00 75 00
GRANTFORMS
19
Please use the space below to report any concerns regarding the above funded project:
Subcgntrectar gnaWre Print Name
�a LTft Deft
11 s
I Dl ree+ee- nF nor ( �. r _ 2073
t
The public reporting and record keeping burden for this collection of information Is estimated to average three (3) hours per
response. Send comments on the Agencys need for this information, the accuracy of the provided burden estimates, and
any suggested methods for minimizing respondent burden, including through the use of automated collection techniques In
the Director, Collection Strategies Division, U.S. Environmental Protection Agency (26227), 1200 Pennsylvania Ave., NW,
Washington, D.C. 20450. Do not send the completed form to this address.
Send completed Form 45OD-2 to:
Mr. Joe Ochab, DBE Coordinator 1
US EPA, Region 9
75 Hawthorne Street
_San Francisco, CA 9410S
FORM 45OO.2 (OBESubconrrodor Partidpation Forml
NOVEMBER 2023 SECTION 00 75 00
2024 HERBERT WALKUP PIPELINE GRANT FORMS
REPLACEMENT PROJECT 20
Water Boards Disadvantaged Business Enterprise (DBE) Program
DBE Subcontractor Performance Form
This form is intended to capture the DBE' subcontractor's' description of work to be performed and the price of
the work submitted to the prime contractor. A Emanuel Assistance Agreement Recipient must require Its prime
contractor to have its DBE subcontractors complete this form and include all completed forms in the prime
contractor's bid or proposal package.
Subcontractor Name I project Name
1�/r2eza NebPr} wt+lwEr 5?� I�
Bid /Propose No. Aasstance Agreeme ID No. drf Brecon) f PdM OF Contact
a itee 11„gG.s
Prime Contractor Name _ I ssu ng in.
CiV z- eOP7SiY() �IC1}V] /A
Contract Item Description of Work Submitted from the Prime Contractor Involving
Number Construction, Services, Equipment or Supplies
q6 90c> �C. c'g rx�co t
Price of Work
Submitted to IM
Prime Contractor
DBE Certified By: DOT SBA Meets/exceeds EPA certification 5tandas7
Omer. YES ND Unknown
-A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an amity from which EPA
accepts certifications as described in 40 CFR 33.204-33.2015 or certified by EPA. EPA accepts certifications from entitles
that meet or exceed EPA certification standards as described in 40 CFR 33.202.
2Subcontractor is defined as a company, firm, toim venture, or individual who enters into an agreement with a contractor
to provide services pursuant to an award of financial assistance.
FORM 450"(DBE Subcontractor Per is monce Form)
NOVEMBER 2023
2024 HERBERT WALKUP PIPELINE
REPLACEMENT PROJECT
SECTION 00 75 00
GRANTFORMS
21
I canny under penalty of perjury that the forgoing statements are true and correct Signing this form does not
signify a commitment to utilize the subcontractors above. I am aware that in the event of a replacement of a
subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c).
Pri C `Of Signature Print Name
(IaQPt �lanagsar 1z no�st7,C)I,
Subcontractor S' nature Print Name
e "Clale I
%mtcee,4w Me- 6 porg i10 nS Der //I 2e27
The public reporting and record keeping burden for this collection of Information is estimated to average than (3) hours per
response. Send comments on the Agencys need for this infonnation, the accuracy of the provided burden estimates, and
any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to
the Director, Collection Strategies Division, O.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW,
Washington, D.C. 20460. Do not send the completed form to this address.
FORM 4SOO-3 (DBESubcontractur Performance Farm)
NOVEMBER 2023 SECTION 00 75 00
2024 HERBERT WALKUP PIPELINE GRAM FORMS
REPLACEMENT PROJECT 22
Water Boards Disadvantaged Business Enterprise (DBE) Program
DBE Subcontractor Performance Form
This form is Intended to capture the DBE'subcontractors2description of work to be performed and the price of
the work submitted to the prime contractor. A Financial Assistance Agreement Recipient must require its prime
contractor to have its DBE subcontractors complete this form and include all completed forms in the prime
contractor's bid or proposal package.
Subcontractor Name Project Name
MAPCA SURVEYS, INC. 2024 Herbert -Walkup Pipeline Replacement
Bid / Proposal No. Assistance Agreem ID No. (B known) Pointof Contact
Guillermo E. Carey
Address
Telephone No. - Email Address
Prime Contractor Name Issuing/Funding Entity
Cruz Construction Co., Inc. DWSRF and STPUD
Contract Item Description of Work Submitted from the Prime Contractor Involving Prim of Work
Number Construction, Services, Equipment or Supplies Submitted to the
Prima Contractor
Construction Surveying $27,650.00
DBE Certified By: ""DOT" SEA Meets/exoeeds EPA certification standai 1s9
Other: YES NO 11Unknown
'A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA
accepts certifications as described in 40 CPR 33.204-33.2015 or oevtfied by EPA EPA accepts certifications from entities
that meet or exceed EPA certification standards as described in 40 CFR 33,202.
2Subcontractor is defined as a company, firm, joint venture, or Individual who enters into an agreement with a contractor
to provide services pursuant to an award of financial assistance.
FORM 4500-3 (DBESubcontrector Performance Form)
NOVEMBER 2023
2024 HERBERT WALKUP PIPELINE
REPLACEMENT PROJECT
SECTION 00 75 00
GRANTFORMS
21
I certify under penally of perjury that the forgoing statements are true and correct. Signing this form does not
signify a commitment to utilize the subcontractors above. I am aware that in the event of a replacement of a
subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c).
/PrIme,fiontrector Signature
Title _
I - /Title
F1S LI ✓V1G I'�/ /
Subcgptract rSignalure
�(ww Title
President
Print Name
! 6v 14llGrrecI
Dole
✓ZOZ3
Prim Neale
Guillermo E. Carey
Data
12/15/2023
The public reporting and rectum keeping burden for this cdlection of imormatlon is estimated to average three (3) hours per
response. Send comments on the Agency's need for this Information, the accuracy of the provided burden estimates, and
any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to
the Director. Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW,
Washington, D.C. 20460. Do not send the completed form to this address.
FORM 4500-3 )DBE5ubcontractor Performance Form)
NOVEMBER 2023 SECTION 00 75 00
2024 HERBERT WALKUP PIPELINE GRANT FORMS
REPLACEMENT PROJECT 22
Water Boards Disadvantaged Business Enterprise (DBE) Program
DBE Subcontractor Utilization Form
This form is intended to capture the prime contractor's actual and/or anticipated use of identified certified DBE'
subcontractor's' and the estimated dollar amount of each subcontract. A Financial Assistance Agreement
Recipient must require its prime contractors to complete this form and include it in the bid or proposal package.
Prime contractors should also maintain a copy of this form on file.
Prime Contractor Name PmJect Name yyyy
CrtJz �a,sk�uck- I 2oZ� tV'1-
Bid /Proposal No. Assistance Agreement ID No. (if known Poin in Contac '
1
I have identified potential DBE certified subcontractors. ES NO
If yes, please complete the table below If no, pleaseexplain.
Subcontractor Name/ Company Address I Phone / Email
Estimated
Dollar
f
Currently
DBE
Company Name
P y
Amount
Certified?
wG�
1zo,o�
1
KAAPCck
SvrUcyj In c
--Continue on back if needed --
'A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA
accepts certifications as described in 40 CFR 33.204-33.2015 or certified by EPA. EPA accepts certifications from entities
that meet or exceed EPA certification standards as described In 40 CFR 33.202.
'Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor
to provide services pursuant to an award of financial assistance.
FORM 4500-4 (DBE Subcontractor Utilization Form)
NOVEMBER 2023
2024 HERBERT WALKUP PIPELINE
REPLACEMENT PROJECT
SECTION 00 75 00
GRANTFORMS
23
I certify under penalty of perjury that the forgoing statements are true and correct Signing this form does not
signify a commitment to utilize the subcontractors above. I am aware that in the event of a replacement of a
subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c).
Prime Contractor Signature Print Name
it i Lac _ Data
Date
rq Cmy gQX I K 0, 23
The public reporting and record keeping burden for this collection of information is estimated to average three (3) hours per
response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and
any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to
the Director, Collection Strategies Division, U S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW,
Washington, D.C. 20460. Do not send the completed form to this address.
FORM 4500-4 (DBE Subcontractor Utilization Form)
NOVEMBER 2023
SECTION 00 75 00
2024 HERBERT WALKUP PIPELINE
GRANT FORMS
REPLACEMENT PROJECT
24
South Tanoe Public UtDoryc� trio n
DBE Good - Faith Effort
p15ADVANTAGED BUSINESS ENTER""'SF SOLICITED
FORM1 .Type of N.&firade
"GOOD FAITH" EFFORT LIST OF SUBCONT
of I Contact
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provide complete list' Use additional sheets. If necessary
SECTION 0015 00
GRANT FORMS5
NOVEMBER 2023
REPLA EMENT PROJeC TPIPELINE
PROJEC
somb
DBE GoaU a Ic billit'y Distrkt
ffart OoCumenta;Mn
THIS PAGE LEFT INTENTIONALLY BLANK
SECTION 00 75 00
GRANT FORMS
26
South Tahoe Public Utility District
DBE Good - Faith Effort Documentation
FORM 5
SUMMARY OF BIDS RECEIVED
DBE & NON -DBE
THIS SUMMARYIS PREPARED BY THE PRIME CONTRACTOR
Type of Work or Company Name Selected Bid Amount DBE NON -DBE 1
Trade i[Yes or No) (Check) (Check)
(J/rL✓ p/fJHrN rot/rn'<'"v��t5 a9,Gr/y1,-13 //
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List type of jobs alphabetically, from low to high in each category and selected low bidder.
Include subcontractors, suppliers, and brokers. Use additional sheets, if necessary.
NOVEMBER 2023 SECTION 00 75 00
2024 HERBERT WALKUP PIPELINE GRANT FORMS
REPLACEMENT PROJECT 27
CRUZ CONSTRUCTION COMPANY, INC.
Financial Statements
(Unaudited) For the
Years Ended
December 31, 2022 and 2021
(With Independent Accountant's Review Report)
TABLE OF CONTENTS
Page
Independent Accountant's Report
2
Financial Statements
Balance Sheets (Unaudited)
3
Income Statements (Unaudited)
4-5
Statements of Shareholder's Equity (Unaudited)
6
Statements of Cash Flows (Unaudited)
7
Notes to Unaudited the Financial Statements
8 — 22
Supplemental Schedules 23 — 36
INDEPENDENT ACCOUNTANT'S REVIEW REPORT
To Management
Cruz Construction Company, Inc.
Mound House, Nevada
We have reviewed the accompanying financial statements of Cruz Construction Company, Inc.
(a corporation), which comprise the balance sheets as of December 31, 2022 and 2021,
and the related statements of income and statement of stockholder equity and cash flows for the
years then ended, and the related notes to the financial statements. A review includes primarily
applying analytical procedures to management's financial data and making inquiries of company
management. A review is substantially less in scope than an audit, the objective of which is the
expression of an opinion regarding the financial statements as a whole. Accordingly, we do not
express such an opinion.
Management's Responsibility for the Financial Statements
Management is responsible for the preparation and fair presentation of these financial
statements in accordance with accounting principles generally accepted in the United States of
America; this includes the design, implementation, and maintenance of internal control
relevant to the preparation and fair presentation of financial statements that are free from
material misstatement whether due to fraud or error.
Accountant's Responsibility
Our responsibility is to conduct the review engagement in accordance with Statements on
Standards for Accounting and Review Services promulgated by the Accounting and
Review Services Committee of the AICPA. Those standards require us to perform procedures
to obtain limited assurance as a basis for reporting whether we are aware of any material
modifications that should be made to the financial statements for them to be in accordance with
accounting principles generally accepted in the United States of America. We believe that the
results of our procedures provide a reasonable basis for our conclusion.
We are required to be independent of Cruz Construction Company, Inc. and to meet our other
ethical responsibilities, in accordance with the relevant ethical requirements related to our
review.
Accountant's Conclusion
Based on our review, we are not aware of any material modifications that should be made to the
accompanying financial statements in order for them to be in accordance with accounting
principles generally accepted in the United States of America.
/s/Pinnacle Accountancy Group of Utah
Pinnacle Accountancy Group of Utah
(a dba of Heaton & Company, PLLC)
Farmington, Utah
November 20, 2023
Page 12
CRUZ CONSTRUCTION COMPANY, INC.
Balance Sheets(Unaudited)
As of December 31, 2022 and 2021
ASSETS
Current Assets
Cash and cash equivalents
Marketable securities
Accounts receivable, net
Prepaid expenses
Other receivable and shareholder loans
Costs and estimated earnings in excess of billings on uncompleted contracts
Tote] Current Assets
Property and Equipment
Vehicles and equipment
Improvements
Less: accumulated depreciation
Net Property and Equipment
Other Assets:
Investment in closely held companies
Tom] Other Assets
Total Assets
LIABILITIES AND SHAREHOLDER'S EQUITY
Current Liabilities
Accounts payable
Credit cud payable
Payroll taxes payable
Related patty payable
Billings in excess of costs and estimated eamtngs on uncompleted contracts
Customer deposits
Line of credit payable
Other current liability
Comm portion of long -teen debt
Total Current Liabilities
Long-term liabilities
Long-term notes payable
Less current portion of notes payable
Total Long-term Liabilities
Total Liabilities
Shareholder's Equity
Common stock, 2,000issued and outstanding
Additional paid an capital
Retained earnings
Total Shareholder's Equity
Total Liabilities and Shareholder's Equity
See accomparrying notes and accountant's review report
Page 13
2022 2021
S
1,808,857
$
1,873,763
564,171
796,442
2,475,944
1,739,120
87,794
61,972
287,681
230,043
414,280
944,317
5,638,727
5,545,657
9,943,539
9,096,184
246,737
246,T37
10,190276
9,342,921
(5,425,914)
(4.539,953)
4,764,362
4.802,968
25,000
25,000
25,000
25,000
$
10,428,089
$
10,373,625
$
1,26Q367
$
1,378,982
178,149
94,255
48,624
45,047
50,000
50,000
370,746
46.071
29,931
628,529
495,000
155.000
37,824
41,116
449,144
518,317
2,919,785
2,957,316
1,726,507
3,046,164
(4,19,144)
(518,317)
1,277,363
2,527,947
4,197,148
5,485,163
2,000
Z000
29,107
29,107
6,199,834
4,857,355
62230rMl
4,888,462
$
10,428,089
$
10.373,625
CRUZ CONSTRUCTION COMPANY, INC.
Statements of Income (Unaudited)
For the Years Ended December 31, 2022 and 2021
2022
2021
REVENUE
Jobs
$ 22,047,552
$ 15,388,319
Toml Revenue
22,047,552
15,388,319
Job Costs
Materials
5,537,970
3,793,265
Labor and payroll taxes
5,479,003
4,473,377
Subcontractors
2,262,555
666,749
Otherjob cost
220,670
350,056
Trucking
2,082,567
803,766
Total Job Cost
15,582,765
10,087,213
Gross Profits
6,464,787
5,301,106
EXPENSES
Accounting fees
26,500
20,475
Advertising
50,315
20,944
Auto
387,872
309,421
Bad debt
8,625
-
Bank charges
41,088
70,591
Cleaning services
4,660
30640
Contributions
9,945
24,450
Does and subscriptions
29,760
17,164
Education
7,300
2,754
Employee be
420,593
374,329
Insurance
191,414
146,659
Interest
109,013
65,752
Legal and professional fees
58,477
70,194
Licenses and permits
31,879
38,265
Office supplies
68,927
53,899
Postage
1,077
1,589
Rent
120,000
120,000
Repairs and maintenance
241,216
191,745
Continued on the following page
See accompanying notes and accountant's review report
Page 14
CRUZ CONSTRUCTION COMPANY, INC.
Statements of Income (Unaudited)
For the Year Ended December 31, 2022
Salaries and payroll expenses
Officers
Other
Safely
Small tools and parts
Taxes
Telephone
Travel and entertainment
Utilities
Total Expanses
Operating Income
Other income
Interest income
Net income before depreciation and federal income taxes
Depreciation
Net Income before income taxes
Provision for income taxes (note 5)
Net Income
See accompanying notes and accountanfs review report
Page 15
2022
2021
483,995
720,597
1,034,880
834,051
12,686
12,410
332,221
412,151
260,003
238,193
23,460
24,553
98,086
30,797
17,191
14,912
4,070,983
3,919,535
2,393,804
1,481,571
879,362
897,072
17237
12,320
3,290,403
2,390,962
1,054,293
829,497
2,236,110
1,561,465
$ 2,236,110
$ 1,561,465
Statement oPSta W oldels Equity (Unaadltnd)
For the Years Ended December 31, 2022 and 2021
Additional Total
common Paid in Sbamkoldets
Stuck C Piral Rembled Eammita Equity
Shmeholdoes Equny at
December31,2020 S 2,000 E 20,107 $ 4.138,314 8 4,169.421
Net mcome U61,465 1,561,463
Shareholder dnbtbuboos (842,4]A) (842,424)
December 31, 2021 S ;OW S 29,107 S 4,85],333 8 4,888A62
Nttmcome 2,236,110 2,236,I10
Shareholder dentribudons (993,632) (893,632)
amholdels Equiy at
Daoember31,2022 T 2.000 S 29.107 S 6.199.832 S 6,230.939
See acconyanNne notes and accountamt review mpart
Page 16
CRM CONSMUCPION COWA", WC.
$mtanenta a Cash Flowa (D mmudited)
For the Years Ended December 31, 2022 end U21
Cub mows from Operating Acfivlfim
21M
2021
Net Income
S
2236,110
$ 1,561,465
Adjustments; to reconcile Net Income to cash provided by Operating Activities
Depreciation expense
1,054,293
829,497
(Crain) loss on marketable securities
291,844
(125,344)
Gam on forgiveness A PPP Loan
(1,107,727)
(750,000)
(Gam) loss on sale ofvuludes and equipment
(52,938)
(19,002)
Changes in operating assets and Ilahilitms
Accounts receivable
(n6,824)
(840.454)
Pretend experaes
(25,822)
(11,050)
Costs and estimatedearnings in excess of billings on uncompleted cataracts
430.03I
(733.353)
Other receivables
(1,950)
(1,349)
Accounts payable
(75,615)
986,912
Credit cud payables
83,894
24,960
Cuaromc deposits
(598,597)
466,083
Payroll taxes payable
3,M
(29,932)
Other current liabilities
(3,292)
8,937
Bigmgs in excess ofwsts and emmmed comings an uncompleted contracts
32g6/5
(166,00)
Net cash provided by(used in) Opentahg AcnvRies
1,821,665
1,20 ,682
Cash flows drum Investing Activities
Fumhaces of equipmem
(1,112,850)
(1,880,222)
Proceeds hint sale of vehicles and equipment
73,063
40,800
Shuehold loan
(55,688)
534,165
Purchase of dentinal documents
(70,098)
6Q110
Sak off mcml dstrumarts
10,524
(27F.992)
Net cash provided by(used by) Investing Activities
(1,155,W)
(1,523,OW)
Cash flows Ginn Financing Activities
Payments oolong -term debt
(52g932)
492,906
Proceeds from long-term debt
312,802
1,499,926
Payments an lme ofinedn
-
(350,000)
Proceeds fiom Ime ofcredat
3 coll
-
Shueholderdtrntbutiovs
(859,593)
(842,424)
Net Cash provided by (used d) Fuesumng Anlvifcs
(931,523)
80,409
Net Candice(decreau) on cash and cash equivalents
(64,906)
478,011
Cash and cash equivakents mthe begimdng ofthe year
1,873,70
1,4W,353
Cash and cash equivalents m the end of the year
$
1,808,857
$ 1.893.711
Supplemental ladotmation
Interest pad
$
113,713
S 0,952
Income cox paid
$
Notecash Investuig and Financing Activities
Accounts payable paid wrch sale of vehicles and equipment
$
43,000
$
Non -cash dtstnbutien m shareholder
S
34,038
$ -
See nexcepanying notes and accotmtsnt's review report
Page 19
CRUZCONSTRUCnONCOINPANY,INC
Notes to UnavdEedFtieancial&atemenis
December 31, 2022 and 2021
(SeelndependentAccoantant's Review Report)
L ORGANIZATION
Cruz Construction Company, Inc, (the Company) is incorporated in the state of
Nevada. The date of incorporation was April 30, 1997. The Company performs
paving and asphalt services in Northern Nevada and North= California.
2. SUMMARYOFSIGNIFICANTACCOUNTINGPOISCIES
a Basis ofAccounting- The Company's polity is to prepare its financial statements on
the accrual basis of accounting.
b. Revenue Rewgnitlon
Performance Obligations and Recognition Method
The Company evaluates whether two or more contracts should be combined and
accounted for m one single performance obligation and whether a single contract
should he accounted for as more than one performance obligation. Accounting
Standards Codification (ASC) Topic 606 defines a performance obligation as a
contractual promise to transfer a distinct good or service to a customer. A
contract's transaction price is al located to each distinct performance obligation
and recognized as revenue when, or as, the performance obligation is satisfied.
Contract revenues are primarily derived from fixed -price construction contracts.
The Company has determined that generally these fixed -price construction
projects provide a distinct service and, therefore, qualify as one performance
obligation as the promise to transfer the individual goods or services is not
separately identifiable from other promises in the contracts and, therefore, not
distinct.
Revenues from fixed -price construction contracts are recognized on the completed -
contract method. This method is used because the typical contract is completed in two
months or less, and the financial position and results of operations do not vary
significantly from those which would result from use ofthe percentage -of -completion
method. A contract is considered complete when all costs except insignificant items
have been incurred andthe installation is operating according to specifications or has
been accepted by the customer.
Revenues from time -and -material contracts are recognized currently as the work is
performed.
Page 18
CRUZCONSFRUCHONCOMPANY, INC.
Notes to UnauReafFinancial Statements
December 31, 2022 and 2021
(SeebtdepmolientAccomiar Ps Review Report)
Contract costs include all direct materials and labor costs and those indirect costs related
to contract performance, such as indirect labor, supplies, tools, repairs, and
depreciation costs. General and administrative costs we charged to expense as incurred.
Provisions for estimated losses on uncompleted contracts are made in the period in which
such losses are determined. Claims are included in revenues when received
Signicmrt Payment Terms
Smaller projects that arc under $150,000 are required to pay a deposit upon signing the
contract generally between 20-30%. Larger commercial projects are billed monthly
based on work completed that month.
Approximately 23%ofthe Company's revenue comes from its largest customer.
c AarountsReceivabte-Accounts r=ivablefrom services performed are based upon the
contracted prices. Contracts receivable consist primarily of large groups of smaller -
balance homogeneous accounts that are collectively evaluated for impairment.
Accordingly, the provisions of Fair Value Topic of the Financial Accounting Standards
Board (FASB) Standards Codification, do not apply.
Page 19
CRUZ CONSIRUMONCOMPANY,INC.
Notes to UrmudAdFinancial Statements
December 31, 2022 and2021
(See IndependentAccoantant's Review Report)
Allowance for doubtful accoums is based upon a review of outstanding receivables, historical
collection information, and existing economic conditions. Receivables past due more than 90
days are considered delinquent. Allowance for bad debt in both 2022 and 2021 was
$45,000 while bad debt expense was $9,625 in 2022 and $0 in 2021.
Delinquent receivables may be addressed with payment plans, mechanic liens, or are
written off based on individual credit evaluation and specific circumstances of the
customer.
d. Vehicles, Equipment, and Leaseholdlmprovements-Vehicles and equipment and
Leaseholdlmprovementsmemeordedatcost Depreciationis computed underthe
straight-line method forfinancial reportingpurposes. Vehicles are depreciated using an
estimated useful life of 5 years, construction equipment is depreciated at an estimated
useful life of 7 years, and Leasehold Improvements are depreciated between 10-40
years. The total depreciation expense for the year ended 2022 for vehicles and
equipment totaled $1,042,830 while the depreciation for leasehold improvements was
$11,463 and for the year ended 2021 was $813,412 for vehicles and equipment and
$11,463 for leasehold improvements. Accumulated depreciation was $5,425,914 for
the year ended 2022 and was $4,539,953 for the year ended 2021. h12022, $97,164 of
net assets were disposed of for $73,063 in cash proceeds, $43,000 of accounts payable
and the remaining amount of $34,038 was the fair market value of the truck taken as a
distribution. In 2021, $20,169 of net assets were disposed of for $40,800.
e. Estimates-Thepmpamtionoffinancialstatementsinconformitywithgenerally accepted
accounting principles requires management to makeestimatesandassumptionsthat affect
the reportedamounts ofassetsand liabilities and disclosureofcontingentassetsand
liabilities at the date ofthe financial statements and reported amounts oftevenues and
expenses during the reporting period. Actual results may differ from those estimates.
f. Cash and Cash Equivalents -For the purpose ofreporting cash flows, cash and cash
equivalents include cash in demand deposit accounts and money market accounts.
g. AdvertisingCosts-TheCompanyexpensesthecostsofadverlisingas they are incurred.
Advertising costs were $50,315 for the year ended 2022 and $20,914 for the year ended
2021.
h. Fab Value Measurements - ASC 820, Fair Value Measurements, defines fair value
and establishes a three -level valuation hierarchy for disclosures of fair value
measurement and enhances disclosure requirements for fair value measures. The three
levels are defined as follows:
Level I — Quoted prices in active markets for identical assets or liabilities.
Level 2 Observable inputs other than quoted prices included in Level 1.
We value assets and liabilities included in this level using dealer and brokerquotations,
Page 110 bidprices,
CRUZ C ONSIRUMON COMPANY, INC.
Notes to Untru ded Financial Statements
December 31, 2022 and 2021
(See Independent Accountant's Review Report)
quoted prices for similar assets and liabilities in active markets, or other inputs that are
observable or can be corroborated by observable market data.
Level — Unobservable inputs that are supported by little or no market activity and
that are significant to the fair value of the assets or liabilities. This includes certain
pricing models, discounted cash flow methodologies and similar techniques that use
significant unobservable inputs.
The following tables provide information on those assets measured at fair value on a recurring basis as
of December 31, 2022 and 2021, respectively:
Carrying
Amount In
Balance Sheel
Fairvalue
Fair Value
December 31,
December3l,
Measurement Usino
2022
2022
Level
Level
Level
Assets:
Money market funds
$ 66U62
$ 660,362
S
660.362
$ —
S
—
Marketable Securities
568,699
569,699
568,699
—
—
Equity in Private
Companies
25,000
25,000
—
—
25,000
Total Assets
$ 1,254,061
$ 1,254,061
S
1.229,061
$ —
$
25,000
Carrying
Amount to
Balance Sheet
Fair Value
Fair Value
December3l,
December 31,
Measurement Ushm
2021
2021
Level
Level
Level
Assets:
Money market funds
S 403,309
$ 403,309
S
403,308
S —
S
—
Marketable Securites
796,336
796,336
796,336
—
—
Equity an Private
Companies
25,000
25,000
—
—
25,000
Total Assets
$ 1,224.644
$ 12M.644
$
1,199.644
$ —
$
25,000
Page I II
CRUZ CONSTRUMONCOMPANY,INC
Notesto Unaudited Financial
Statements December 31, 2022 and 2021
(SeelndependentAccouniant'sReview Report)
i Marketable Securities — Marketable securities for sale are carried at fair value, with
unrealized holding gains and losses reported in other income. All marketable
securities for the Company are considered Level 1 in the fair value hierarchy as all of
the securities are quoted on stock exchanges. The unrealized gains for securities
held as of December 31, 2022 was $61,395 and $348,712 as of December 31, 2021.
j. Warranties— The Company provides a one-year warranty covering defects specific to
its portion on contracts on construction projects. This warranty historically has not
produced material costs; therefore, the Company does not accrue future estimated
expense against current operations.
k New and Recently Adopted Accounting Policies— In October 2020, the Financial
Accounting Standards Board ("FASB") issued Accounting Standards Update (ASU)
No. ASU 2018-17, Consolidation (Topic 810): Targeted Improvements to Related
Party Guidance far Variable Interest Entities, which provides private companies an
accounting alternative to elect not to apply variable interest entity guidance to legal
entities under common control if both the parent and the legal entity being evaluated
for consolidation are not public business entities.
Effectively, the amendments in this Update expand the private company alternative
provided by Accounting Standards Update No. 2014-07, Consolidation (Topic 810):
Applying Variable Interest Entities Guidance to Common Control Leasing
Arrangements, not to apply the VIE guidance to qualifying common control leasing
arrangements. Because the private company accounting alternative in this Update
applies to all common control arrangements that meet specific criteria and notjust
leasing arrangements, the amendments in Update 2014-07 are superseded by the
amendments in this Update.
For entities other than private companies, the amendments in this Update are effective
for fiscal years beginning after December 15, 2019, and interim periods within those
fiscal years. The amendments in this Update are effective for a private company for
fiscal years beginning after December 15, 2020, and interim periods within fiscal
years beginning after December 15, 2021. All entities are required to apply the
amendments in this Update retrospectively with a cumulative -effect adjustment to
retained earnings at the beginning of the earliest period presented.
The Company adopted accounting standard ASU 2018-17 effective January 1, 2021
which updated the standards for what qualifies as a Variable Interest Entity (VIE).
We have determined that companies that were disclosed as VIE's in the prior year no
longer are required to be consolidated or combined in the financial statements. The
adoption of ASU 2018-17 did not have an impact on our financial statements as we
have had GAAP departures in prior years related to not consolidating the VIE's into
our financial statements.
Page 112
CRUZCOMMUCTIONCOMPANY,INC. Notes
to Unaudited Financial
Statements December 3l, 2022 and 2021
(See Independent Accountants Review Report)
In November 2019, the Board issued ASU No. 2019-10, Financiallnstruments—
Credit Losses (Topic 326), Derivatives and Hedging (Topic 815), and Leases (Topic
842): Effective Dates. The amendments in Update 2019-10 deferred the effective
dates for Leases for entities in the "all other" category by an additional year.
Therefore, Leases was effective for all other entities for fiscal years beginning after
December 15, 2020, and interim periods within fiscal years beginning after December
15, 2021.
In June 2020, the FASB issued Accounting Standards Update (ASU) No. ASU 2020-
05, Revenue from Contracts with Customers (Topic 606) and Lease (Topic 842):
Effective Dines for Certain Entities. The amendments in this Update defer the
effective date for one year for entities that have not yet issued their financial
statements (or made financial statements available for issuance) reflecting the
adoption of Leases. Therefore, under the amendments, Leases is effective for entities
within the "all other" category for fiscal years beginning after December 15, 2021,
and interim periods within fiscal years beginning after December 15, 2022. Early
application continues to be permitted, which means that an entity may choose to
implement Leases before those deferred effective dates. The Company is currently
evaluating the potential impact that the adoption of ASU No. 2016-02 may have on
its financial statements.
The Company considers all new pronouncements and management has determined
that there have been no other recently adopted or issued accounting standards that had
or will have a material impact on its financial statements.
3. SUBSEQUENT EVENTS
The Company has evaluated subsequent events through November 6, 2023, the date the
financial statements were available to be issued and determined that there have been no
events that have occurred that would require adjustments to our disclosure in the financial
statements.
Page 113
CRUZ CONSTRUCTION C OMPANY, INC.
Notes to Unaudited Financial Statements
December 31, 2022 and 2021
(See Independent Accountant's Review Report)
4. INVESTMENTS
An investment of $25,000 is included in Other Assets at December 31, 2022 and 2021,
representing the ownership of 2,000 share of common stock in Terra -Core. Tema -Core is
a privately held corporation. This investment is valued at cost. Any variation of fair
market value from cost (if lower) would be immaterial to the financial statements.
5. OTHER RECEIVABLES AND SHAREHOLDER LOANS
December 31,
December 31,
2022
2021
Due from CANICO, LLC $969195
$909005
Due from NV Aggregates, LLC 1895536
140,038
Meter/Utility 15950
-
Total 5287.68]
230.043
Both loans are related party with the same owner and do not
have a term or interest rate.
6. ACCOUNTS RECEIVABLE
December 31,
December 31,
2022
2021
Completed contracts
$423,071
$675,569
Contracts in progress
2.097.873
1,108,551
Total
2,52%944
1,784,120
Less allowance for doubtful accounts
(45,000)
(45,000)
Net accounts receivable
92 475 944
1 Z39 M
Contracts receivable at December 31, 2022,
include approximately
$1,987,420 from
three customers. Contracts receivable at December 31,2021 include approximately
$1,242,795 from two customers.
Page 114
CRUZCONSTRUCf'IONCOMPANY,INC.
Notes to UnauditedFinancia!
Statements December 31, 2022 and 2021
(Sea In depen den t A c c a im tan t Is Review Report)
7. RELATEDPARTYACTIVr1'1ES
The Company leases the building itomupies and land used to store heavy equipmentfinm
CANICO, LLC (CANICO) arelated entityundercommon control. Rem acctuedto CANICO for
theycar ended December 31, 2022 and 2021, was $I20,000. As ofDecember31,2022 and
2021, $50,000 was owed to CANICO. The lease automatically renews annually until
terminated by landlord or tenant.
The Company's shareholder formed NV Aggregates, LLC (NVA) on February 12, 2020
for the purposes of crushing and mining aggregate used in construction. As of December
31, 2022 and 2021, the Company had a loan receivable balance of $189,536 and
$140,038, respectively, which was used to operate NVA. In 2021, the Company and
NVA entered into a mining lease agreement in which NVA grants to the Company the
exclusive right to explore and use as much of the property's gravel as necessary for the
Company's purposes. The Company shall pay to NVA 25% of the market rate for the
type and grade of gravel used. Other than the shareholder loan, there were no cash
transactions between the Company and NVA.
During the year ended December 31, 2022, the Company paid $67,784 on behalf of
NVA for the costs of utilities and engineering and then received $18,285 for
reimbursement of utility expense and the year-end difference between NVA's total
revenue and the Company's 75%portion. During the year ended December 31, 2021
the Company paid $30,523 on behalf of NVA for the costs of utilities and engineering
and then received $69,426 towards the year-end difference between NVA's total
revenue and the Company's 75%portion.
The Company's principal shareholder owned Mountain Valley Storage. The property was
sold in 2021 but the LLC remains with a payable to the Company. As of December 31,
2022, and 2021, Mountain Valley Storage owed the Company $96,195 and $90,005,
respectively. During the year ended December 31, 2022, the Company paid $6,190 in
engineering costs for Mountain Valley Storage. During the year ended December 31,
2021 the Company received $512,177 from the proceeds of the sale and 2,659 from a
utility refund. The Company paid $19,574 of expenses for Mountain Valley Storage
consisting of engineering costs and utilities.
8. TAXES
The Company with the consent of its stockholder elected to be taxed undersubchapter S ofthe
Internal Revenue Code, which provides that, in lieu ofcorporation income taxes, the stockholders
separately account for their pro cuts shares of the Company's items of income, deductions,
losses and credits. As a result of this election, no federal income taxes have been recognized in
theaccompanying financial statemems.
The State of Califomiataxes companies that have elected this S corporate status to pay atax at
Page115
CRUZCONRMUCnON COMPANY INC
Notes to Unaudited Financial
Statements December 31, 1022 and 2021
(See Independent Accountant's Review Report)
Ya% of California net source income, with a minimum tax of $800. For the year ended
December 31, 2021, the amount oftax paid to the State of California was $656 due to the
overpayment in 2020 of $344 as well as $3,000 in estimated tax payments. The total tax
liability for 2021 was $990, leaving a $2,354 carryover payment for 2022.
$1,000 in estimated taxes were paid to the State of California for the year ended
December 31, 2022 on April 15, 2023 The state of Nevada passed a commerce tax in
2015 requiring businesses whose gross revenue is over $4,000,000 to pay. For the year
ended December 31, 2022 the amount of commerce tax paid to the State of Nevada was
$12,060. For the year ended December 31, 2021 commerce tax paid to the State of
Nevada was $5,776.
Page 116
CRUZ CON5PRUCHONCOMPANYJNC.
Notes to UnauditedFinanctat
Statements December 31, 2022 and 2021
(See Independent Accoantan Ps Review Report)
9. UNCOMPLETED CONTRACTS AND BACKLOG
The Company had work -in -progress for work to be performed on 5 signed contracts at
December 31, 2022. The following is a summary of contracts in progress at December
31, 2022 and 2021;
December 31,
December 31,
2022
2021
Costs incurred on uncompleted contracts $ 8,46Z696
$ 3,8672047
Estimated earnings on uncompleted contracts 3,948,028
2,420,494
12,310,724
6,287,541
Billings to date (12,267.1901
5.489 294
$ 43,534
$ 798,246
Costs & estimated earnings in excess of billings on $ 414,280 $ 844,317
contracts in progress
Billings in excess of costs & estimated earning on 37! 0,7461 (46,071)
uncompleted contracts
$ 43,534 $ 798,246
Backlog represents the amount of revenue the Company expects to realize from work to be
performed on uncompleted contracts in progress at year end and from contractual agreements on
which work has not yet begun.
Revenue expected from work to be performed on
uncompleted contracts.
Revenue from contractual agreements on work not yet
begun
Backlog at 12/31/22 and 12/31/21
Page 117
December 31,
7022
$ 4,506,261
6682.,794
$ 10,789,044
December 31,
2021
$ 5,350,811
5,722,494
$ 11,073,295
CRUZCONSTRUCITONCOMPANY, INC.
Notes to Unaudited Financial
Statements December 31, 2012 and 2021
(See Independent AccountanCs Review Report l
10. LONG TERM DEBT
Followingis a summary of all Long Term Debt
2022
Note payable maturing March 2028, accruing interest at
5.39%arum, principal and interest payments of
33,869
approximately $620 due monthly, secured by a 2022 Ram
3500
Note payable maturing July 2027, accruing interest at
5.25%arum, principal and interest payments of
44,899
approximately $920 due monthly, secured by a 2022
Yanmar Excavator and three Yammer Buckets
Note payable maturing April 2028, accruing interest at
4.75%arum, principal and interest payments of
85,751
approximately $1,520 due monthly, secured by a 2022
Dodge Ram 1500
Note payable maturing August 2027, accruing interest at
4.825% arum, principal and interest payments of
148,282
approximately $2,963 due monthly, secured by a 2020
Hitachi Wheel Loader
Note payable maturing June 2025, accruing interest at
4.99%arum, principal and interest payments of
211,129
approximately $7,517 due monthly, secured by a 2014
Powerscreen 1000 Maxtrak Crusher
Note payable maturing December 2026, accruing interest
at 4.92% arum, principal and interest payments of
250,290
approximately $5,766 due monthly, secured by a 2018
Powerscreen Premiernak Jaw Crusher 300
Note payable maturing December 2027, accruing interest
at 4.89% arum, principal and interest payments of
273,571
approximately $5,158 due monthly, secured by a 2021
Powerscreen Chieftain Model 2100X
Note payable maturing October 2028, accruing interest at
5.1% per arum, principal and interest payments of
approximately $3,188 due monthly, secured by a 2020 Case
192,890
Excavator Model CX145C, and a 2021 Case Skid Steer
Model SV340B
Page 118
2021
289,170
306,158
321,300
220,617
CRUZ CONSPRUCTTON COMPANY, INC.
Notesto UnauditedFinancia!
Statements December 3I, 2022 and 2021
(See Independent Accountant's Review Report)
Note payable maturing in July 2026, accruing interest at
6.18%per annum, principal and interest payments of 160,263 199,023
approximately $4,164 due monthly, secured by a 2020
Peterbilt Model 567, a 2021 Peterbilt Model 367, a 2021
Rance ED32-34 Trailer, and a 2020 Reliance Model
2TROHD-21
Note payable maturing in December 2026, aceming
interest at 2.5% per annum, principal and interest payments 116,326 143,637
of approximately $2,549 due monthly, secured by a Leeboy
Model 8510E Paver
Note payable maturing in December 2023, accruing
interest at 5.95% per mum, principal and interest
payments of approximately $4,055 due monthly, secured by - 909954
two Peterbilt 2018 heavy duty dump trucks
Note payable maturing in December 2024, accruing
interest at 7.35% per mum, principal and interest
payments of approximately $1,873 due monthly, secured by - 60,097
Low Boy Trailer
Page 119
CRUMON5TRUCHONCOMPANYjNC.
Notesto Unaudited Financial
Statements December 31, 2022 and 2021
(See Independent Accountant's Review Report)
Note 10 LONG TERM DEBT Continued
Note payable maturing in August 2025 accruing interest
at 3.9%per annum principal and interest payments of
approximately $2,080 due monthly, secured by a 2019
Peterbilt
Note payable maturing in February 2024 accruing
interest at 4.34%per annum principal and interest payments
of approximately $1,916 due monthly, secured by a Leeboy
Paver
Note payable maturing in April 2024, accruing interest at
4.62%per annum principal and interest payments of
approximately $3,025 due monthly, secured by Laden
Financial
Note payable maturing in October 2025, accruing interest
at 4.74% per annum, principal and interest payments of
approximately $1,449 due monthly secured by two Chevy
Barbed trucks
Note payable maturing in March 2026, accruing interest
at 4.59% per annum, principal and interest payments of
approximately $849 due monthly, secured by a Chevy
Silvemdo
Paycheck Protection Program maturing in April 2022,
accruing interest at 1%per annum. The entire principal
balance of $1,107,727 was forgiven during 2022.
Subtotal
Current Portion
Non -current Portion
Page 120
59,811 79,891
26,163 47,629
46,856 809154
45,808 609642
30,599 39,165
1,1079727
1,726,507 3,046,164
(449,144) (518,317)
51277.363 $2.527.847
CRUZ CON91RUCTIONCOMPANY,INC.
Notes to Unaudited Financial
Statements December 31,2022 and 2021
(See Independent Accountant's Review Report)
Note 10 LONG TERM DEBT Continued
Total principal payments on debt after December 31, 2022 are as
follows:
Period Ending
Amount
Demmber3l
2023
$449,144
2024
427,570
2025
3749564
2026
2869739
2027
1492620
Thereafter
38,870
Total SI.726507
H. LINE OF CREDIT
In January 2010, the Company secured a bank line of credit (LOC) for cash flow with a
limit of $200,000. The LOC renews quarterly and bears a floating interest rate computed
as the Prime bank rate plus 2% with a floor of 5%. Interest is charged on the outstanding
balance and requires monthly payments. The Company paid off this line of credit in
August 2014 when they secured a new LOC. The new LOC has a limit of $750,000 and
carries a floating interest rate computed as the Bank of the West prime rate plus 0.650
percentage points. Under no circumstances will the interest rate be less than 4.000% per
annum. Interest accrues on the unpaid balance. The outstanding balance at December 31,
2022 was $495,000. At December 31, 2021, the outstanding balance was $155,000.
11 PENSION AND TAX DEFERRED PLAN
The Company maintains a 401(k) defused -contribution plan. Employees who are 21
years or older and have completed one year of service are eligible to participate in the
Plan. The Company may make a discretionary matching contribution equal to a uniform
percentage of an employee's salary deferrals up to 4% of the employee's compensation.
Each year, the Company will determine the amount of the discretionary percentage. Each
year, the Company may also make a discretionary profit-sharing contribution to
employee accounts. The 401(k) benefit costs of $76,786 and $68,389, for the years
ended December 31, 2022 and 2021, respectively, are included in "Employee Benefits"
in the income statement.
Page 121
CRUZC0NSIRUCI'10N COMPANY,INC.
Notes to U a u2isdFinancial
Statements December 31.2022 and 2021
(See IndenpdentAccountant's Review Report)
13. ENTITIES UNDER COMMON CONTROL
The Company leases the building it occupies and a warehouse shop building from
CANICO, LLC (CANICO) a related entity under common control. CANICO was formed
to hold and lease the buildings occupied by Cruz Construction Company, Inc. The
principal shareholder also owned NV Aggregates LLC For the purposes of crushing and
mining aggregate used in construction.
There are no liabilities to or from these entities under common control outside of the
loans from the Company discussed in Note 7.
14, EQUITY
President Steven Cruz owns 100% of the Company's 2,000 issued and outstanding
shares.
During the years ended December 31, 2022 and 2021, the Company paid cash
distributions of $859,953 and $842,424, respectively. During the year ended December
31, 2022, a vehicle was taken as a distribution valued at the blue book value of
$34,038.
Page 122
CRUZ CONSIRUCHON COMPANY, INC.
December 31, 2022
Supplementary Schedule # 1: Vehicles and Equipment (Unaudited)
Page 123
CRUZ CONSTRUCTION COMPANY, INC.
Supplementary Schedule#1 VehicfesandEqufpmenl(Onaud&O
December 31, 2022
Date Acquired
Description
Amount
1997
LO-1 7D 544 E Loader
$57,9341
1997
TR-1 Zieman trailer
19476
1998
TR-2 Towmaster Trailer
189880I
1999
GR-2 Large Smith Grinder
5,438
2000
SB-1 Wilson Sealcoat Buggy
17,000
2000
BH-1 Super LBackhoe
56,106I
2000
RO.4 2000 ingersol Rand Roller
19,791
2002
MISC - Other miscellaneous equipment
4,423
2003
MISC - Other miscellaneous equipment
5,358
2003
RO-1 Hyster C530A Pneum
3,149
2003
DT-1 1997 Peterbuilt Truck with Trailer
70,350
2003
SL-3 2003 Sealcoat Tank
21,250
2003
TR-4 2003 Towmaster Trailer
59636
2004
CM-1 Curb Machine
8,922
2004
AC-1 Compressor Sullair
122588
2004
WT-12000 Ford F750 Water Track
36,730I
2005
FT-1 Red Dye/Clear Fuel Tanks
252117
2005
SS-1 Security Camera System
5,743
2005
MISC - Other miscellaneous equipment
27,768
2005
TR-5 2006 Utility Trailer
8,708
2005
TR-6 Towmastster B-20 Trailer
17,775
2006
CF-22002 Crafco Crackfiller
25,400I
Page 124
CRUZ CONSTRUCTION COMPANY, INC.
Supplementary Schedule #1 Vehicles andEq*ment (Unaudited)
December 31, 2022
(See Independent Accountants Review Report)
Date Acquired
Description
Amount
2006
LO-2 Case Loader
5%683
2006
MX-1 Concrete Mixer
3,053
2006
TK-7 Interstate Enclosed Trailer
4,633
2007
FB-5 2003 Ford F450
15,749
2007
TR-8 Snake River Dump Trailer
6,668 l
2007
SK-2 Bobcat T-250
36,511
2007
MISC - Other miscellaneous equipment
27,882
2007
TR-10 Dragon End Dump Trailer
27,486
2008
DD-22 Roller
10,000
2008
T-5 1999 Peterbuilt Truck
32,3501
2008
MG-2 CAT 140 G Motor Grader
50po
2008
SL4 Cromer Built Sealcoat Tank (built in-house)
5,0001
2010
MISC - Other miscellaneous equipment
47,595
2010
EX-3 1994 D) 892 excavator
20,000
2010
FB-7 2002 Ford F550 Super flat bed
59000
2010
FB-8 2003 Ford F 450 flat bed
5,000
2010
SK-3 2005 Takeuchi TL140 Skid steer
20,000
2010
Z-1 1991 Zipper
17,000
2010
TT-2 WESCO
5001
2010
SN-I 2011 Ski-doo Snowmobile
12,648
2010
SK-1 S-185 Bobcat
20,000
2011
AS -AC Stamps
25,000
2011
LO-3 1993 CAT 950F Loader
10,000
Page 125
CRUZ CONSTRUCTION COMPANY, INC.
SrrpplemimtmySchedule#1 VehidevandEgngrrrrenl(Unaudited)
December 31, 2022
JSee Independent A^coumant's Review Renart)
Page 26
Date Acquired
Description
Amount I
2011
TR-13 2012 Towmaster Trailer
69900
2012
RO-7 Hypac Roller
20,000
2012
SW-2 Lay-Mor Sweeper
9,634
2012
Vibroplate
2,027
2012
EX-4 Takeuchi mini -excavator
28,907
2012
PU-10 2012 Toyota Tundra Truck
43,671
2012
MISC-Multiquip Ramma
2,950I
2012
MISC -Multi Quip Trash Pump
1,010
2012
TR-13B Towmaster Trailer 201 l
1,389.
2012
QB-1496 Asphalt Heater
7,341
2012
MISC - Crafco Paving Cutting RO
12900
2012
SIT-2-Snow removal equipment
13,190
2012
SN-3 Snow removal equipment
13,190
2012
Z-I Case Zipper New Engine
11,4741
2012
FB-9 2012 Ford Flatbed Truck
549181
2012
RO-8 Volvo Roller
30,546
2012
CF-3 Cmfco Crack Filler
449260
2013
SNB-1 2012 Erskine Snowblower
72979
2013
PU-11 Toyota Tundra pick-up 2013
50,002
2013
EX-5 Link Belt Excavator
74,645
2013
T-6 1987 Peterbilt
205000I
2013
TR-151990 Reliance hailer
10,0001
2013
TR-I62002 Wedco trailer
15,WO
2013
MG-3 Leeboy Molar Grader 635
30,000
CRUZ CONSTRUCTION COMPANY, INC.
Srr7plewmwySchedale#1 Vehic%sandEquipmem ((Unaudited)
December 31, 2022
ee Independent Accountants Review Report)
Date Acquired
Description
Amount
2013
P V-5 New Leeboy 8510 Paver
10%9881
2013
MISC -Mist equipment
11,910
2014
FB-11 2010 Dodge Ram 3500
30,5141
2014
PU-14 2006 Ford F250
14,3681
2014
L04 John Deere 624G Loader
35,0001
2014
LO-5 John Deere 544G Loader
25,0001
2014
SNB-3 Erskine ES 2410 snowblower (mist equip acct)
3,213
2014
LO-6 Wacker Loader
72,0651
2014
FB-12 2015 Dodge Ram
46,4891
2014
QB-1532 Meyers Super V snow plow
7,0971
2014
MISC- Plotter printer
1,3091
2015
FB-14 GMC Sierra
47,3811
2015
EX-7 Yanmar Excavator
75,332I
2015
PU-16 2015 GMC Sierra
53,3701
2015
SW-3 Sweeper
24,188
2015
QB-1551 Furniture
7,7961
2016
EX-10 Link Belt Spinace
950001
2016
EX -II John Deere 45OLC
18,0001
2016
EX-9 Caterpillar 330C
11,0001
2016
FL-2 Gradall 534010-45
10,0001
Page 127
CRUZ CONSTRUCTION COMPANY, INC.
StWerr idwSchedule#1VehiderandEgaiprtwm(UnautGW
December 31, 2022
aeIndependent 4,com1mdYYReview&Mr0
Date Acquired
Description
Amount
2016
LO-7 Cat 950F Series 2
7,0001
2016
RO-9 Ingersoll Rand Pro Pao SD70D
12,000
2016
DT-6A Rebuilt Box DT-6
19,0451
2016
TT-3A RELIANCE - Rebuilt Boxes
19,0451
2016
RO.10 Cat CB-14
14,9001
2016
SKA-4 Hammer
24,000
2016
SB-2 Wilson Sealcoat Buggy
25,0001
2016
SK-6 Bobcat T630
10,000
2016
PU-18 SIERRA DENALI
65,880
2016
FB-15 GMC SIERRA
56,1071
2016
WT-2 2000 Ford F750 Water Truck (WT-2)
7,500
2016
FB-16 SIERRA 3500HD
43,4991
2016
DT-8 PETERBR.T
48,224
2016
TT-4 RELIANCE see DT8
169094
2016
FB-17 3500 CREW TRUCK
5653761
2016
FL-3 Gradall 534D-10
27,0001
2017
PV-6 2016 Leeboy 851 OD Asphalt Paver
163,1921
2017
ST-3 2017 Ford F550
126,326
2017
WB-12017 Multiquip Water Trailer w/Hose Reel
7, 1621
2017
JJ-3 2017 Multiquip MTX70HD
2,993 1
2017
JJ-4 2017 Multiquip MTX70HD
2,9931
2017
TR-17 2017 Felling FT-121T Trailer
9,1571
2017
RO-I1 Dbl Drum Roller w/ Econimzer Display
55,6921
2017
SNIP-1 Swamp Cooler
2,581 1
Page 128
CRUZ CONSTRUCnON COMPANY, INC.
SuNle"idwySchedule #1 VehiciesandEgt*wnt(OnauakO
December 31, 2022
(See Independent Accoummu's Review Reoor p
Date Acquired
Description
Amount
2017
TR-18 2006 Ranco Bottom Dump Trailer
20,0001
2017
JJ-1 12017 Multiquip MTX70HD
2,993 1
2017
PU-20 2017 Dodge Ram
57,121 1
2017
EX-12 Yanmar Vi035 Mini -Excavator
54,300
2017
EX-13 Yanmar Vi035 Mini -Excavator
54,3001
2017
TR-19 2017 Mirage Trailer
4,8721
2017
TR-202015 LKUT Utility Trailer
5,000
2017
BRK-I 2017 Erskine 21OX Breaker
8,514
2017
FB-18 2017 Chevrolet Silverado
59,2091
2017
PW-3 PHW4030024G(208-1PM
7,3471
2017
WB-22017 WT5C
7,0961
2017
WB-3 2017 WT5C
7,0961
2017
D-9 2018 Peterbilt Model 567
172,274 1
2017
D-102018 Peterbilt Model 567
172,274I
2018
CM-2 Capitalized Repairs
179,066
2019
1627 - Vehicle Code Reading Sensor
3,213 1
2018
TR-21 Snake River Dump Trailer
991501
2018
PU-21 GMC Sierra 2500
54,7731
2018
T-7 2018 Peterbilt
161,1731
2018
RO-12 2018 CAT Roller
45,674
2018
TR-23 Lowboy Trailer
128,943
2018
GEN - Office Generator
18,0871
2018
PU-22 2018 Dodge RAM 3500
45,000
2018
PU-23 2019 Ford Track
79,1921
11I
2018
FB-20 2015 Dodge FB 5000
30,0001
Page 129
CRUZ COSSTRUCPION COMPANY, INC.
.SupplememarrScheddeW Ve6idaandEgrdpmeM(Unau*4
December 31, 2022
f Iee Independent Accountant's Revunv Report)
f Date Acquired
Description
Amount
2018
EX-14 2016 Case Excavator CX-80
56,0001
2018
ROCK - 2017 New Rock Grizzly HD
5,500
2018
SK-4'14 Bobcat Skid Steer T750
4256751
2018
TR-22 Trailer
5,800
2018
CHEV - 2019 Chev Silverado 2500
51,920
2018
JJ-13 Rammer 2018
2,999I
2018
JJ-14 Rammer 2018
2,999I
2018
PHONE - Mitel Phone System
6,1441
2018
SIM - Simulator
27,053
2018
EX-15 2018 Linkbelt Excavator
190,000
2018
FB-19 2000 Ford F750
4,069
2018
PL- Shop Power Lift
3,165 1
2018
OTHER - COMMERCIAL CONTAINER
395001
2019
LO-I IMP -I
5,745�
2019
BH-1 IMP -01 New Engine
13,091
2019
FB-5 IMP Engine
16,7861
2019
T- 5 Cylinder Head
11,0261
2019
MG-2 IMP Total New Blade Lazer & Electronics
28,6501
2019
FB-7 Total New Engine
8,8791
2019
TR-15 IMP Reliance Trailer
10,8611
2019
PV-5 IMP Total New Tracks
19,0631
2019
LO-5 IMP-0I New Rear Axle
18,066
2019
LO-7 IMP HVAC Pump and Tires
275855
2019
EX-9 IMP Thumb Link and Quick Coupler
7,625
Page 130
CRUZ CONSTRUCITON COMPANY, INC.
SnpptemerdmySchedidee#1 VehidesandEgr*ment((hwra&4
December 31, 2012
(See Independent Axoun mn'sReviewRevmO
Date Acquired
Description
Amount
2019
WT-2 IMP Total Engine
14,7741
2019
SK-4 IMP New Bucket
5,197
2019
WD5 MUG Welding Machine
3,327
2019
PU26 2019 GMC
80,5801
2019
LO-8 Loader Komatsu WA 320-8
155,2951
2019
EX-16 Thumb Link and Quick Coupler
51)4081
2019
PU-27 2017 Ford F350
4%0001
2019
PW-4Pressure Washer SN 15130920
4,1871
IJ 2019
FB-22 2019 Dodge Ram 3500
61,8671
1 2019
FB-21 2019 Dodge ram 3500
61,8671
2019
BP-2 LEE -BOY L250T SN 250215313
16,242
2019
JJ15 Rummer 2019
2,9991
2019
JJ16 Rummer 2019 SN E2187
2,9991
2019
FB-23 2019 Chevy Flatbed
55,235 1
2019
FB-24 2018 Chevy FB 3500
559235
2019
WT-4 Peterbilt 8095
157,4581
2019
TTR-120I7 KERV Bullet Trailer
1935001
2019
TR-24 2020 14k Tilt Trailer
7,1901
2019
FL-5 2013 Doosan Forklift
229491
2019
TR-25 Felling Tilt Trailer
3%7481
2019
FB-25 2019 Chevy Silverado DT
73,2531
2019
UV-5 2020 Jeep
51,8701
2019
CM-3 Curb Machine GT-3600
62,118
2019
EX-18 2007 CAT 308CCR
42,8401
2019
TTR-2 2015 Cole Trailer
1520001
Page 131
CRUZ CONSTRUC110N COMPANY, INC.
SW#ememmySchedule#I VehiclesandEquipment(Unaudd4
December 31, 2022
Date Acquired Description
2019 WT-51987 Water Truck
2019
EX -MINI John Deer 50c Mini Ex
2019
SIM BAP- Simulator
2020
CW-14 Cat Nine Wheel Roller
2020
S-I Truck Scale
2020
P-1 Trench Plates
2020
T-8 2020 Peterbilt 567
2020
DT-11 2021 Peterbilt 367
2020
TT-5 2020 Reliance Trailer
2020
TR-26 Rancho Ed32-34
2020
SP-1 Extec SN 7058
2020
DT-12 2021 Peterbilt 567
2020
PV-7 2020 Leeboy Model 8510E
2020
TR-28 Enclosed Trailer
2020
TR-24 2020 14k Tilt Trailer
2020
LO-8 Loader Komatsu A 320-8
2020
FB-20 General Transmission
2020
ST-3 General Transmission
2020
PU-15 Replacement Transmission
2020
FB-14 Replacement Transmission
2020
EX-9 Engine
2020
LO-4 Pape Machinery
2020
LO-3 Cat Lever Control and Cover
2020
SS-1 Security Camera System
2021
LO-3 1483 Bucket Repair
2021
EX-9 1539.04 Reconditioned Equip Thumb
2021
GS- 1698 Grizzly Screen
2021
OTHER 1699 Land Mont Blanc
2021
GPS 1700 GPS Lazer and System
2021
UV-6 1701 2022 Chevy
Page 132
Amount
10,710I
14,9941
27,053 II�
49,802
20,0001
99,6031
156,3401
141,218
116,4551
50,6261
31,1661
176,739
18795641
4,1471
2,201 1
1992781
8,1901
7,9511
4,343 1
6,042
7,146
15,4401
7,311
12,1051
12,9801
9,7431
4,0001
366,157 1
78,926
72,0831
CRUZ CONSTRUCRON COMPANY, INC.
Stg kmentmySchedule#1 Vehicles and Equipment(Unaudited)
December 31, 1022
(SealndependentACeOunttmtsBe "RgMH)
Date Acquired
Description
Amount
2021
PU-28 1702 2012 Toyota Tundra
29,1711
2021
RS-1 1703 Rock Splitter
25,1711
2021
EX-19 1704 2021 Case Excavator
173,7501
2021
SK-7 1705 2021 Case Skid Steer
65,7501
2021
SL 1706 Shop Lift
5,4711
2021
FB-26 1707 2021 3500 RAM
65,088
2021
PU-30 1708 2021 Dodge RAM 2500
53,252
I 2021
PU-29 1709 2021 GMC 2500
545253
2021
OTHER 1711 2014 Powerscreen Crusher SN7991
2895170 I
2021
OTHER 1712 2018 Powerscreen Jaw SN6229
319,158 I
I 2021
OTHER 1713 2021 Powerscreen Tracked Screen
321,3001
2021
OTHER 1714 Field Laser
3,800
2021
TR-29 1715 2022 Mirage
11,911
2022
EX-9 1539.05 Excavator Engine Electronic Control
5,4671
2022
EX-111540.01 Excavator Cab Assembly
515441
2022
EX-10 1544 Excavator Bucket Repair
5,7001
2022
EX-10 1544 Thumb Cylinder
6,5571
2022
IGR-1 iMP 1545 Reno Forklift (FL-2)
192133
2022
IGR-1 IMP 1545.01 Engine Repair
7,0001
2022
ISK-4 HAP 1565 New Motor
8,2671
2022
ST-31MP 1599 General Transmission
3,0921
I 2022
FB-27 1710 2022 RAM 3500
68,0001
2022
DTHER 1716 Wylie Water Trailer
30,856I
2022
DTHER1717 Hydraulic Hose Crimper
6,694
I 2022
EX-20 1718 2022 Yanmar VI035 Excavator
58,4721
2022
PU-31 1719 2022 Dodge RAM 3500
1003173
2022
LO-10 1720 Hitachi Wheel Loader
203,449
2022
LO-10 IMP 1720.01 Cylinders, Hydraulics
14,375
I 2022
DTHER 1721 GPS Laser System (SN 0259 1648)
31,563
2022
DTHER 1722 GPS Laser System (SN 76SW 34SY)
42,3911
2022
DTHER 1723 Tire Changer and Balancer
19,510
Page 133
CRUZ CONSTRUC'HON COMPANY, INC.
StWementmy Schedule#1 VehichsandEtl4wnt (Unaudited)
December 31, 2022
2022
LTV-7 1724 Sprinter Van
122,399
2022
DT-14 1725 1988 Peterbilt
19,0001
2022
EX-21 1726 Case 245 Ex avitor
221,589
2022
LO-9 1727 John Deere Loader
58,000
2022
SS-11400.01 Side by Side
28,700I
2022
SS-2 1044.02 Side by Side
26,569
TOTAL
$99905,693 1
Page 134
CRUZ CONSTRUCTION COMPANY, INC.
December 31, 2022
Page 135
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