HomeMy WebLinkAboutWilson Custom TreeCITY OF WATERLOO, IOWA
WATERLOO LEISURE SERVICES COMMISSION
BID FORM
for
2017 SPRING STUMP REMOVAL PROJECT
BIDDER: Vi I (s0 iu6 ,n rt v
COMPANY NAME
ADDRESS: C9140, 6liort Sfcce,f-
Ct"z , TA 5 totes
PHONE: (rJ(p3 ) 541— LI -a?
1. The undersigned, being a Corporation existing under the laws of the State of i\i fA ,
a Partnership consisting of the following partners: 1\)pq
having been familiarized with the existing conditions on the project area affecting the
cost of the work, and with all the Contract Documents now on file in the offices of the
City Clerk, City Hall, Waterloo, Iowa, and the Waterloo Leisure Services Commission,
1101 Campbell Ave., Waterloo, Iowa, hereby proposes to furnish all supervision,
technical personnel, labor, materials, machinery, tools, equipment, and services,
including utility and transportation services required to complete the proposed 2017
SPRING STUMP REMOVAL PROJECT, in accordance with the contract documents
and for the lump sum price for the removal of the 596 stumps along City owned rights-of-
way, parks & golf courses as listed in the attached documents for the following amount:
TOTAL BID PRICE: Q
G4 c� �n��nan(. es77u+ti�neQ ttw+tzc„D+ Dollars ($ giot`i/q. 5 )
2. In submitting this bid, the Bidder understands that the City reserves the right to reject
any or all bids. If written notice of acceptance of this Bid is mailed or delivered to the
undersigned within thirty (30) days after Bid Opening, of at any time thereafter before
this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the
prescribed form and furnish the required bond and certificate of insurance within ten (10)
days after the agreement is presented for signature, and start work within ten (10) days
after "Notice to Proceed" is issued.
3. Security in the sum of(5c�¥IVt Za aC Paid ityrio1l4 dollars ($ 5')y o (14yilwra
in the form of b'4 &Ad , is submitted herewith in accordance
with NOTICE TO BIDDERS.
4. Attached is a Non -Collusion Affidavit of Prime Contractor.
5. The Bidder is prepared to submit a financial and experience statement upon request.
BID FORM page I of 2
6. The Prime Contractor and Subcontractor(s), which have performed an aggregate of
$10,000.00 in work for the City in the current calendar year, are prepared to submit an
AAP or Update and an EOC, within ten (10) days of notification that the bid submitted is
lowest and acceptable.
7. The Bidder has received the following Addendum or Addenda:
Addendum No.
Date: / /
/ /
/ /
8. The Bidder shall list the MBE/WBE subcontractors, amount of subcontracts and bid
items listed on the City of Waterloo Minority and /or Women Business Pre-bid Contract
Information Form submitted with this Bid Form. The apparent low bidder shall submit a
list of all other subcontractor(s) to be used on this project to the City of Waterloo by 5:00
p.m. the business day following the day bids on this project are due along with the Non-
collusion Affidavits of ALL Subcontractor(s).
The subcontractors listed on this proposal and/or submitted to the Contract Compliance
Officer cannot be changed except for the following reasons.
1. The City of Waterloo does not approve the subcontractors.
2. The subcontractors submit in writing that they cannot fulfill their subcontracts
9. The Bidder shall list all equipment available for this project:
t%ttico j r nap /`r /nq err?
OSS/ L/ F F/W /iLllaA./
/La Zuni / Fdrs/ZJ r
10. The Bidder has filled in all blanks on this proposal. Those blanks not applicable are
marked "none" or "NA".
11. The bidder has attached all applicable forms.
12. The owner reserves the right to select alternatives, delete line items, and/or to reduce
quantities prior to the Award of Contract due to budgetary limitations.
SIGNED:
00011 e -r DATE: D,3 1.;)9 1 /7
131D FORM page 2 of 2
STATEMENT OF BIDDER'S QUALIFICATLONS
(To be submitted by the Bidder only upon request of the City of Waterloo, Iowa.)
All questions shall be answered and the data given must be clear and comprehensive. This
statement must be notarized. If necessary, questions may be answered on separate attached
sheets. The Bidder may submit any additional information desired.
1. Name of Bidder. (1)-4) U.h kte\
2. Permanent main office address. Q h Z S hot^t. Sfrect
ainicrn, . 5a -13L
3. When organized. lggo
4. If a corporation, where incorporated.WA.
5. How many years have you been engaged in the contracting business under your present firm
or trade name? cis ida,rs
6. Contracts on hand: (Schedule these showing amount of each contract and the appropriate
anticipated dates of completion.) Ol"4-vnnttto4.6,6 / ui Sance. Confrere Da, a a�
7. General character of work performed by your company:vet st,rvieep:a,tvn
8. Have you ever failed to complete any work awarded to you? If so, where and why?
Mo
9. Have you ever defaulted on a contract? If so, where and why?
NO
10. List the more important projects recently completed by your company, stating the
approximate cost for each and theonth and year o leted.
c OI to )Vttt-tern S Con &a c6 -ail w 66/7s -t).
6 7s o.
cuCU% latier!ob nix nex.arnt ea -de -Ad i 35, (3,6411. List your major equipment available for the contract.
DIZantext s .2,o -tee -Z Led -,tea Lt; PctPel nu
12. Experience in landscape work similar in importance to the project
13. Background and experience of the principal members of your organization, including the
officers. a5 iefestr-
14. Credit available: $ loo, 000
15. Give Bank reference: r -net X>S
I I - E;}Zcn S&t
[6. Will you, upon request, felt out a detailed financial statement and furnish any other
information that may be required by the City of Waterloo, Iowa?
17. The undersigned hereby authorizes and requests any person, firm, or corporation to furnish
any information requested by the City of Waterloo, Iowa, in verification of the recitals
comprising this Statement of Bidder's Qualifications.
STATEMENT OF BIDDERS QUALIFICATIONS PAGE 1 OF 2
Dated thisU1° y day of
State of TOtott )
) ss
County of /-knocerd )
kf WIIkvn
By:
Title:
Name of Bidder
, 20/%
deposes and says that she/he is 0 LCIIE-V
, being duly sworn
W I� ett`n (,/,15h7Y) �l".e P .
Name of Organization
of
and that the answers to the foregoing questions and all statements therein contained are true and
v -a
correct. Subscribed and sworn to before me this day of X744Lcb1
31A1
April D. Buis
Commission Number 783136
MY COMM EXP. t31f7/670
4. &Lo
Notary Public
My commission expires
, 20/'7
03/ 17 , 20 ao
STATEMENT OF BIDDER'S QUALIFICATIONS PAGE 2 OF 2
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of 1.0 Wq )
County of 4b1, ,gyp rd ) )
�1e F V\J ; �Oil
, being first duly sworn, deposes and says that:
1. He is Own r), (Partner), (Officer), (Representative), or (Agent) of 10 1 50n G1Skin I c
the Bidder that has submitted the attached Bid;
2. He is fully informed respecting the preparation and contents of the attached Bid and of all
pertinent circumstances respecting such Bid;
3. Such Bid is genuine and is not a collusive or sham Bid;
4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives,
employees, or parties in interest, including this affiant, has in any way colluded, conspired,
connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a
collusive or sham Bid in connection with the Contract for which the attached Bid has been
submitted or to refrain from bidding in connection with such Contract, or has in any manner,
directly or indirectly, sought by agreement or collusion or communication or conference with
any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other
Bidder, or, to fix any overhead, profit or cost element of the bid price or the bid price of any
other Bidder, or to secure through any collusion, conspiracy, connivance, or unlawful
agreement any advantage against the City of Waterloo, Iowa, or any person interested in the
Proposed Contract; and
5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any
collusion, conspiracy, connivance or unlawful agreement on the part of the Bidder or any of
its agents, representatives, owners, employees, or parties in interest, including this affiant.
igret,itcrN.,
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Title
Sulrbcr'a>ed'avtd sworn. to- lm fore mzthC4-'
_s1_ �' y of_ }= h , 2017.
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NON -COLLUSION AFFIDAVIT OF SUBCONTRACTOR
State of
County of N/A
that: 9,1
, being first duly sworn, deposes and says
1. He is (Owner), (Partner), (Officer), (Representative), or (Agent) of r� f A
hereinafter referred to as the "Subcontractor";
2. He is fully informed respecting the preparation and contents of the subcontractor's proposal
submitted by the subcontractor to XJ A , contract
pertaining to the 2017 SPRING STUMP MOVAL PROJECT in Waterloo, Black Hawk
County, Iowa;
3. Such subcontractor's proposal is genuine and is not a collusive or sham proposal;
4. Neither the subcontractor nor any of its officers, partners, owners, agents, representatives,
employees, or parties in interest, including this affiant, has in any way colluded, conspired,
connived or agreed, directly or indirectly, with any other bidder, firm or person to submit a
collusive or sham proposal in connection with such contract or to refrain from submitting a
proposal in connection with such contract, or has in any manner, directly or indirectly, sought
by unlawful agreement or connivance with any other bidder, firm or person to fix the price or
prices in said subcontractor's proposal, or to fix any overhead, profit or cost element of the
price of prices in said subcontractor's proposal, or to secure through collusion, conspiracy,
connivance or unlawful agreement any advantage against the City of Waterloo, Iowa, or any
person interested in the proposed Contract;
5. The price or prices quoted in the subcontractor's proposal are fair and proper and are not
tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the
bidder or any of its agents, representatives, owners, employees, or parties in interest,
including this affiant.
Ai
Signature /A N A
Title
Subbcrtbedi aunt&.s-worn/to- before/ me'th.iik
_NlA clay of ___NA , 2017.
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My com4n ton,e%ire - Nfil
EQUAL OPPORTUNITY CLAUSE
(As provided in Executive Order No. 11246)
All contractors, subcontractors, vendors and suppliers of goods and services doing business with
the City and value of said business equals or exceeds ten thousand dollars ($10,000.00) annually
agree as follows:
1. The contractor, subcontractor, vendor and supplier of goods and services will not
discriminate against any employee or applicant for employment because of race, color, creed,
sex, national origin, economic status, age, mental or physical handicap, political opinions or
affiliations. The contractor, subcontractor, vendor and supplier will develop an Affirmative
Action program to ensure that applicants are employed and that employees are treated during
employment without regard to their race, creed, color, sex, national origin, religion, economic
status, age, mental or physical disability, political opinions or affiliations. Such actions shall
include but not be limited to the following:
a. Employment
b. Upgrading
c. Demotion or Transfer
d. Recruitment and Advertising
e. Layoff or Termination
f. Rates of Pay or Other Forms of Compensation
g. Selection for Training Including Apprenticeship.
2. The contractor, subcontractor, vendor and supplier of goods and services will, in all
solicitations or advertisements for employees, state that all qualified applicants will receive
consideration for employment without regard to race, creed, color, sex, national origin,
religion, economic status, age, mental or physical disabilities, political opinion or affiliations.
3. The contractor, subcontractor, vendor and supplier or his/her collective bargaining
representative will send to each labor union or representative of workers which he/she has a
collective bargaining agreement or other contract or understanding, a notice advising said
labor union or workers' representative of the contractor's commitment under this section.
4. The contractor, subcontractor, vendor and supplier of goods and services will comply with all
published rules, regulations, directives, and order of the City of Waterloo Affirmative Action
Program Contract Compliance Provisions.
5. The contractor, subcontractor vendor and supplier of goods and services will furnish and file
compliance reports within such time and upon such forms as provided by the Affirmative
Action Officer. Said forms will elicit information as to the policies, procedures, patterns, and
practices of each subcontractor as well as the contractor himself/herself and said
subcontractor, vendor and supplier will permit access to his/her employment books, records
and accounts to the City's Affirmative Action Officer, for the purpose of investigation to
ascertain compliance with this contract and with rules and regulations of the City's
Affirmative Action Program — Contract Compliance Provisions relative to Resolution No.
24664.
EQUAL OPPORTUNITY CLAUSE PAGE 1 OF 2
6. In the event of the contractor's non-compliance with the non-discrimination clauses of this
contract or with any of such rules, regulations and orders, this contract may be canceled,
terminated or suspended in whole or in part and the contractor may be declared ineligible for
further contracts in accordance with procedures authorized by the City Council.
7. The contractor, subcontractor, vendor and supplier of goods and services will include, or
incorporate by reference, the provisions of the non-discrimination clause in every contract,
subcontract or purchase order unless exempted by the rules, regulations or orders of the
City's Affirmative Action Program, and will provide in every subcontract, or purchase order
that said provisions will be binding upon each contractor, subcontractor, or supplier.
8. We, the undersigned, recognize that we are morally and legally committed to non-
discrimination in employment. Any person who applies for employment with our company
will not be discriminated against because of race, creed, color, sex, national origin, economic
status, age, mental or physical disabilities.
Signed:
Appropriate Official
Title
Date
EQUAL OPPORTUNITY CLAUSE PAGE 2 OF 2
Bond No. 41367021
1#ll) BOND
KNOW ALL MEN 131' THESE PRISEN 1 S, that we, Jeff Wilson dba Wilson Custom Tree, 212 Short Avenue, _
Cresco, IA 52136 _ 1s print'4_1 t, .mil Platte River Insurance Company, PO Box 5900, Madison, WI 53705-0900
a.4 Surety are lteld an firmly bound unto the City of Waterloo. Iowa, hereinafter called -OW MLR". In the penal
Surety
dollars
5urt-r five percent (5%) of amount bid
(1, 5% of amount bid ) lawful riii-fnev of the United States, for 1.h..:
we hind cFlt]'.ic'li t?+, OUT hairs, executors, administrators, alrtd
presents, The condition of this obligation is such that 1.01`1,,as ,l i. 1
hid dated the30thday of` March 17 is
NOW, l'F1I RFF()RE.
;t) [(said Rid shall lea.
h) If said Hid shall be-
shall furnish a bond 1; '1.
labor or famishing taut:_
tar in the ;tlte_rii te,
:rat of which stint will <tracl truly be made,
altt-t firmly by these
pat Ims <ttl;nairted the accompanying
2017 Spring Stump Removal Project
and the 1'iitletp�ad shall execute and (leliver a c'.otatract itt thc form spet:rfred and
ritftil pertiarrart:,rt:e of said cotit 1tt.'t, arid iOr the ri tyttio at of 4111 persons performing.
;ta connection thc_rewith, rind shall in all Ether respects perform the agreement
created by the acceptant,: ,21 ; iic1 �tclT
Thein this obligation shrill be void. otherwise the same shall remain in farce and effect: it being expressly
understood and agreed that the liability c=1'the Surety for any and all claims ht reuttdet shall, in no event. exceed
the penaluriotirtt of this obligation as herein stated.
By virtue of staItutor• authority, the full amount of this hid pond sh ill be forfeited to the t•)\Wier in liquidation of
damages :aistaine 3 in the event tli:tt the Principal filils, to execute tir,• coil -tract and provide the bond as provided
in the specifications or by law.
The. Surety, for value received, hereby stipulates and agrees that the c•rblig tdkn:k of said Surety and its bond shall
be in no way impaired or affected by any extension ot't1te time within \Alleh the Owner may accept such Bid or
e"e.:ute such contract; and said Surety dt,4: i hereby waive notice of any such extension
Iti WI I NESS WHEREOF', the Principal and the Surety, have hcr•ctinto•pct their hand: and '.ctrl:;, and such of
tliem 411.!' corporations, have caused their corporate seals to be , 1 stlL} tltuse presents to be sil.=.iled
3 23rd day n 1' March < i '.r 1 17
by their proper officers this
-
Wttriesti Rita Jorgenson, ccount Specialist
Jeff Wilson dba Wilson Custom Tree
_
Princlpat _
l.�
Platte River Insurance Company
Sure
Lia: W o-s/�L
Atr4Smiy-In-F'u-
Jack Anderson
(Title)
ria
ACKNOWLEDGMENT OF PRINCIPAL (Individual)
State of rL o u,►q,
County of 'J -Jr u. tiL-
On this c:96/
}
personally comes
day of )' l2/a,C',Gi
, in the year ;,20/ 7 , before me
to me known and known to me to be the person who is described in and executed the foregoing instrument, and
aclaiowledges to me that he/she executed the same.
et^l. Aprii D. Buis
Commission Number 7$3136 /
ow MY COMM. EXP 03/11P-0 Notary Public
State of
ACKNOWLEDGMENT OF PRINCIPAL (Partnership)
County of
}
On this day of , in the year , before me
personally come(s)
a member of the co -partnership of
to me known and known to me to
e person who is described in and executed the foregoing instrument, and
acknowledges to me that he/she executed the same as the act and deed of the said co -partnership.
State of
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Corporation/LLC)
County of
On this day of
he/she resides in the City of
}
t
, in the ye
, before me personally come(s)
known, who being duly sworn, deposes and says that
that he/she is the of the
, the corporation described in and
which executed the foregoing instrument, and that he/she signed his/her name thereto by like order.
Notary Public
't1
01
Y4 ,74•:‘V�rS ' 1 ���+1f,.,.Ar+.V�y] f%O.�S`
PisS f ♦ e17 4 l 9
i�, ire 11 i11111Y 1111111 rely ,, �•
Sar: t Y IA
na x I II C Y ill..
PLATTE RIVER INSURANCE COMPANY
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, That the PLATTE RIVER INSURANCE COMPANY, a corporation of the State of Nebraska, having its
principal offices in the City of Middleton, Wisconsin, does make, constitute and appoint
41367021
JACK ANDERSON; RONALD KAIIIOI
its true and lawful Attorney(s)-in-fact, to make, execute, seal and deliver for and on its behalf, as surety, and as its act and deed, any and all bonds,
undertakings and contracts of suretyship, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in
amount the sum of
---ALL WRITTEN INSTRUMENTS IN AN AMOUNJ NOT TO EXCEED: $20,000,000.00
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board
of Directors of PLATTE RIVER INSURANCE COMPANY at a meeting duly called and held on the 8th day of January, 2002.
"RESOLVED, that the President, and Vice -President, the Secretary or Treasurer, acting individually or otherwise, be and they hereby are granted the
power and authorization to appoint by a Power of Attorney for the purposes only of executing and attesting bonds and undertakings and other writings
obligatory in the nature thereof, one or more vice-presidents, assistant secretaries and attorneys) -in -fact, each appointee to have the powers and duties
usual to such offices to the business of the company; the signature of such officers and the seal of the Corporation may be affixed to such power of
attorney or to any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile
seal shall be valid and binding upon the Corporation in the future with respect to any bond or undertaking or other writing obligatory in the nature
thereof to which it is attached. Any such appointment may be revoked, for cause, or without cause, by any of said officers, at any time."
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the
Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts
required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation
making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the
Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner — Department of
Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
IN WITNESS WHEREOF, the PLATTE RIVER INSURANCE COMPANY has caused these presents to be signed by its officer undersigned and
its corporate seal to be hereto affixed duly attested, this 27th day of July, 2015.
Attest:_
Gary W. Stumper 7
President
Surety & Fidelity Operations
STATE OF WISCONSIN
COUNTY OF DANE
ss.:
\\p\\\A0\IlIIlII11flpl///
\VJSUggNC�
` �!V c,pRPORAT� COgG •
SEAL
UpllNEe pAs111 11Pp\��\\'
PLATTE RIVER INSURANCE COMPANY
Stephen J. Sills
CEO & President
On the 27th day of July, 2015 before me personally came Stephen J. Sills, to known, who being by me duly sworn, did depose and say: that he
resides in the County of New York, State of New York; that he is President of PLATTE RIVER INSURANCE COMPANY, the corporation described
herein and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to said instrument is such corporate
seal; that it was so affixed by order of the Board of Directors of said corporation and that he signed his name thereto by like order.
STATE OF WISCONSIN l S.S.:
COUNTY OF DANE
yy 4ietN F
CERTIFICATE
`/cfwc� ct.
David J. Regele
Notary Public, Dane Co., WI
My Commission Is Permanent
I, the undersigned, duly elected to the office stated below, now the incumbent in PLATTE RIVER INSURANCE COMPANY, a Nebraska
Corporation, authorized to make this certificate, DO HEREBY CERTIFY that the foregoing attached Power of Attorney remains in full force and has
not been revoked; and furthermore, that the Resolution of the Board of Directors, set forth' in the Power of Attorney is now in force.
Signed and sealed at the City of Middleton, State of Wisconsin this 2 3 rd day of March , 2'01 7
041(434‘) cJ
SEAL
Antonio Cclii
Secretary
THIS DOCUMENT 15 NOT VALID UNLESS PRINTED ON GREEN SHADED BACKGROUND WITH A RED SERIAL NUMBER, IN THE UPPER RIGHT HAND
CORNER. IF YOU HAVE ANY QUESTIONS CONCERNING THE AUTHENTICITY OF THIS DOCUMENT CALL, 800-475-4450. PR -POA (Rev. 12.2016)
tl.'U 17
P� - �i i V IqH i ll4 I:
�N'.4`• i �V, t4 �7ja, lrlftt,,4,�j`,ft1i r7♦B�,1y
1ln1 11111 lYt �' HI t h 1i
'1YIi�t nll i. -f RIf'11t 1 xJ i `_ IHI
11r„t 1 e f t )ti„1 1�1 � 1 1fla +
rri:�•♦��1'. .'t��t ♦♦��d r.'�".���,�. ..��l�f 1V'�i#�?�;Ijirt;�,. :•i.4:''y ,,��,
k1.111.'_'
tr-
F
ACKNOWLEDGEMENT OF SURETY
STATE OF MINNESOTA
COUNTY OF CHIPPEWA
On this 23rd day of March , 2017 , before me, a Notary Public within and for said
County, personally appeared Jack Anderson to me personally known, who being by me duly
sworn he/she did say that he/she is the attorney-in-fact of Platte River Insurance Company ,
the corporation named in the foregoing instrument, and the seal affixed to said instrument is the
corporation seal of said corporation, and sealed on behalf of said corporation by authority of its
Board of Directors and said Jack Anderson acknowledged said instrument to be the free act
and deed of said corporation.
OttAa_
NOTARY PUBLIC
My Commission Expires
CARA
L. ABEL
Notary Public -Minnesota
My Commission Expires Jan 31, 2021
Bid Bond Result Form
Principal: Jeff Wilson dba Wilson Custom Tree
212 Short Avenue
Cresco IA 52136
You have received a bid bond for the project described below. The Surety Company needs the
results of this bid before issuance of further bonds. If you do not know the result, other than your
own bid amount, please indicate this when returning it. Thank you for your cooperation.
Reference #: 55374
Bond Number: 41367021 Estimate: $94,923.00
Obligee: City of Waterloo - Waterloo I eisure Services Commission
Description:
2017 Spring Stump Removal Project
Please fill in firm name and their bid price ( also, check off the winning bid )
Lowest Bidder
2nd Lowest Bidder
3rd Lowest Bidder
$
IF YOUR BID IS NOT LISTED ABOVE, WHAT WAS YOUR PRICE ? $
COMMENTS:
Dated: By: Title:
Please return this form to:
Acora Surety & Insurance Services, LLC.
PO BOX 506 Phone: (320) 269-8546
Montevideo, MN 56265 Fax: (320) 269-6287