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HomeMy WebLinkAboutK Cunningham ConstructionCUNNINGHAM K CUNNINGHAM CONSTRUCTION CO., INC. 1025 CENTER STREET Construction Co Inc CEDAR FALLS, IA 50613 Bid Security For: Reconstruct Taxiway C, Bid Package #1 Waterloo Regional Airport Waterloo, IA FAA AIP Project No. 3-19-0094-45 ;MN 22 2017 Pm12:48:33 CITY CLERK'S € it-FICE CITY OE WLrFR_ g�3 CUNNINGHAM K CUNNINGHAM CONSTRUCTION CO., INC. 1025 CENTER STREET CEDAR FALLS, IA 50613 Bid For: Reconstruct Taxiway C, Bid Package #1 Waterloo Regional Airport Waterloo, Iowa FAA AIP Project No. 3-19-0094-45 CITY OF WATERLOO CITY CLERKS OFFICE JUN 2:201 pH12 49°O8 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we K. Cunningham Construction Co., Inc. as Principal, and United Fire & Casualty Company as Surety are held and finnly bound unto the Waterloo Regional Airport, 2790 Livingston Lane, Waterloo, Iowa, hereinafter call "Owner", in the penal sum of Five Percent of Amount Bid Dollars ($ 5%--- ) lawful money of the United States, for the payment of which sum will and truly be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. The condition of this obligation is such that whereas the Principal has submitted the accompanying bid, dated June 22 ,2017, for Reconstruct Taxiway C, Bid Package #1, at the Waterloo Regional Airport, Waterloo, Iowa, FAA AIP Project No. 3-19-0094-45. NOW, THEREFORE, (A) If said Bid shall be rejected, or in the alternate, (B) If said bid shall be accepted and the Principal shall execute and deliver a Contract in the form specified and shall furnish a bond for his faithful performance of said Contract, and for the payment of all persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the agreement created by the acceptance of said bid. then this obligation shall be void, otherwise the same shall remain in force and effect; it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. By virtue of statutory authority, the full amount of this bid bond shall be forfeited to the Owner in liquidation of damages sustained in the event that the Principal fails to execute the Contract and provide the bond as provided in the Specifications or by law. The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall be in no way impaired or affected by any extension of the time within which the Owner may accept such bid or execute such Contract; and said Surety does hereby waive notice of any such extension. IN WITNESS WHEREOF, the Principal and the Surety, have hereunto set their hands and seals, and such of them as are corporations, have caused their corporate seals to be hereto affixed and these presents to be signed by their proper officers this 22ngay of June , A.D., 2017. Witness (Seal) Principal K. Cunning am Construction Co., Inc. By (Tiller -4'4c - Pres, de# t (Seal) Surety U"ited Fire & Casualty Company By ► , •.�c Nancy D. B. at,(Attorney-In-Fact) Attach Power -Of -Attorney FAA AIP #3-19-0094-045 P-9 Waterloo Regional Airport AECOM Project #60537973 -BP 1 Reconstruct Taxiway C UNITED FIRE & CASUALTY COMPANY, CEDAR RAPIDS, IA UNITED FIRE & INDEMNITY COMPANY, WEBSTER, TX FINANCIAL PACIFIC INSURANCE COMPANY, ROCKLIN,'CA CERTIFIED COPY OF POWER OF ATTORNEY (original on file at Horne Office of Company — See Certification) KNOW ALL PERSONS BY THESE PRESENTS, That UNITED FIRE& CASUALTY COMPANY, a corporation duly organized and existing under the laws of the State of Iowa; UNITED FIRE & INDEMNITY COMPANY, a corporation duly organized and existing under the laws of the State of Texas; and FINANCIAL PACIFIC ppINSURANCE COMPANY, a corporation duly organizedandexisting ander the laws of the State of' California (heroint GREG T. Ln A collectithe vely : NANCYm0 BALnd TUTATheir OR oMARKeEea quarters KEAIRNES Cedar PATRICK State K f DUFF, ORoes JEFFREYconstitute and KER, OR JOSEPH I. SCHMIT,;,OR JILL r':SHAFFER ,°:OR CHRISTOPHER R. SEIBERLING, ALL INDIVIDUALLY of WEST' DES BAKER, MOINES IA nqunies: Surety Departments 118 Second Ave SE Cedar Rapids, IA 52401 their tae and lawful Attorneys) -in -Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful bonds, undertakings and other obligatory instruments of similar nature provided that no single obligation shall exceed $100 , 000, 000.00 and to bind the Companies thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Companies and all of the acts of said Attorney, pursuant to the authority hereby given and hereby ratified and confirmed. The Authority hereby granted is continuous and shall remain in full force and effect until revoked by UNITED FIRE & CASUALTY COMPANY, UNITED FIRE & INDEMNITY COMPANY, AND FINANCIAL PACIFIC INSURANCE COMPANY. This Power of Attorney is made and executed pursuant to and by authority of the following bylaw duly adopted on May 15, 2013, by the Boards of Directors of UNITED FIRE & CASUALTY COMPANY, UNITED FIRE & INDEMNITY COMPANY, and FINANCIAL PACIFIC INSURANCE COMPANY "Article VI — Surety Bonds and Undertakings" Section, 2, Appointment of Attorney -in -Fact. "The President or any Vice President, or any other officer of the Companies may, from time to time, appoint by written certificates attorneys -in -fact to act in behalf of the Companies in the execution of policies of insurance, bonds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized hereby, and the Corporate seal, may be affixed by facsimile to any power of attorney or special power of attorney or certification of either authorized hereby; such signature and seal, when so used, being adopted by the Companies as the original signature of such officer and the original seal of the Companies, tobe valid and binding upon the Companies with the same force and effect as though manually affixed. Such attorneys -in -fact, subject to the limitations set forth in their respective certificates of authority shalt have full power to bind the Companies by their signature and execution of any such instruments and to attach the seal of the Companies thereto. The President or any Vice President, the Board of Directors or any other officer of the Companies may at any time revoke all power and authority previously given to any attorney-in-fact. ";;ois,:'°1,,, ml� ovo,, ,,,o""�Wi,,,,, IN WITNESS WHEREOF, the COMPANIES have each caused these presents to be signed bye its o. oy_ : <`` s rINS°q+ti�.- vice president and its corporate seal to be hereto affixed this 10t h day of March, 2014 neLY22 FO s UNITED FIRE & CASUALTY COMPANY Seo UNITED FIRE & INDEMNITY COMPANY rupo?y"'t, FINANCIAL PACIFIC INSURANCE COMPANY By: State of Iowa County of Linn ss: ice President On 10th day -of.- March, 2014, before me personally came Dennis J. Richmann to me known, who being by me duly sworn, did depose and say; that he resides in Cedar Rapids, State of Iowa; that he is a Vice President of UNITED FIRE & CASUALTY COMPANY, a Vice President of UNITED FIRE & INDEMNITY COMPANY, and a Vice President of FINANCIAL PACIFIC INSURANCE COMPANY the corporations described in and which executed the above instrument; that he knows the seal of said corporations; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporations and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporations. Judith A Davis lowa Notarial Seal Commission number 173041 My Commission Expires 04/23/2018 . r 1 Notary Public My commission expires: 04/23/2018 1, David A. Lange, Secretary of UNITED` FIRE & CASUALTY COMPANY and Assistant Secretary of' ITED FIRE & INDEMNITY COMPANY, and Assistant Sec etary of FINANCIAL PACIFIC INSURANCE COMPANY, do hereby certify that I have compared the foregoing copy of the Power of Attorneyand affidavit, and the copy of the Section of the bylaws and resolutions of said Corporations as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN THE HOME OFFICE OF SAID CORPORATIONS, and that the same are correct transcripts thereof, and of the whole of the •r said originals, and that the said Power of Attomey has not been revoked and is now in full force and effect. In testimony whereof I have hereunto subscribed my name and affixed the corporate seal of the said Corporations this 22nd day of June 20 17 AJI"gceB'iy[.'�Yi. CORPORATE — — SEAT BP0A0049 0115''- WLY 2g (°� CI CI 9efi n4UFORe". Secretary,tUF&C Assistant Secretary, OF&UFPIC The PROPOSAL FORM FOR IMPROVEMENTS TO THE WATERLOO REGIONAL AIRPORT CONSISTING OF RECONSTRUCT TAXIWAY C BID PACKAGE #1 AT THE WATERLOO REGIONAL AIRPORT WATERLOO, IOWA FAA AIP PROJECT NO. 3-19-0094-045 Waterloo Regional Airport 2790 Livingston Lane Waterloo, IA 50703 Gentlemen: 1. The undersigned hereby certifies that he has examined the Form of Contract, Plans, and Specifications for the Construction of Improvements to the Waterloo Regional Airport to Reconstruct Taxiway C, Bid Package #1, at the Waterloo Regional Airport, Waterloo, Iowa, FAA AIP Project No. 3-19-0094-45, and has examined the site of the work and is familiar with local conditions pertaining to the work. 2. The extent of the work involved is to Reconstruct Taxiway C, Bid Package #1, including the removal of Taxiway C-1, removal and replacement of Taxiway C north and south of Runway 12/30 with an 8 -inch Portland Cement Concrete Pavement section, replacement of the subdrain system, installation of a section of 18 -inch reinforcement concrete pipe storm sewer, replacement of the taxiway edge lighting system and guidance signs in the project area, pavement marking in the areas shown on the plans and all other incidental work associated with this project. This work and all other incidentals shall be performed as shown on the Drawings and described in the Specifications. 3. The undersigned, in compliance with your Invitation for Bids dated S// 7/i 7 , hereby proposes to do the work called for in said Contract and Specifications and shown on said Plans and Addendum Nos. f and to furnish all materials, tools, labor and all appliances and appurtenances necessary for the said work at the following rates and prices: ITEMIZED PROPOSAL WATERLOO REGIONAL AIRPORT WATERLOO, IOWA PROJECT: RECONSTRUCT TAXIWAY C BID PACKAGE #1 FAA AIP PROJECT NO. 3-19-0094-045 ITEM NO. SPEC. NO. DESCRIPTION UNIT ESTIMATED QUANTITY UNIT BID PRICE TOTAL BID PRICE 1 GP 105 MOBILIZATION AND DEMOBILIZATION LS 1 $ 23o/ 000, co $ 230,000. oo 2 GP50-06 CONSTRUCTION SURVEY LS 1 $ 27,000.0e $ 2....7oao,0o 3 " PLANS CONSTRUCTION BARRICADES LS 1 $ SS; ooz. .oc $ 5-6;cf:16o45..co. 4 P-101-5.1 PAVEMENT REMOVAL SY 19,855 $ 4j! So $ $9f 3 y7. So 5 P-152-4.1 UNCLASSIFIED EXCAVATION CY 7,900 3,200 $ La.. 5- $ $o. c. el $ 99 375, 00 $ 2 5-4toap. o0 6 P-154-5.1 1 SUBBASE COURSE CY FAA AIP #3-19-0094-045 AECOM Project #60537973 -BP I P-1 Waterloo Regional Airport Reconstruct Taxiway C ITEM NO. SPEC. NO. DESCRIPTION UNIT ESTIMATED QUANTITY UNIT BID PRICE TOTAL BID PRICE 7 P -156-5.1e INSTALLATION AND REMOVAL OF SILT FENCE LF 5,500 $ 2..4,5- $ /47"' 8 P -156-5.1f INSTALLATION AND REMOVAL OF INLET PROTECTION EA 6 $ 2.?Cv.,06 $ 1)77o. as 9 P -156-5.1g RIP RAP CHECK DAM EA 2 $ 2 Soe. o0 $ SJ pod. ao 10 P-208-5.1 AGGREGATE BASE COURSE CY 2,900 $ 8/.00 $ 2317;91>z). OO 11 P-501-8.1 8.0 -INCH PORTLAND CEMENT CONCRETE PAVEMENT SY 17,755 $ Co. 40 $ $9S/yp3,oa 12 P-620-5.1-1 RUNWAY AND TAXIWAY MARKING SF 8,800 $ /, 88 $ )4.)cy4/, oo 13 P-620-5.1-2 REFLECTIVE MEDIA (TYPE I, GRADATION A) LB 250 $ O, SD $ /2 S.Oa 14 P-620-5.1-4 TEMPORARY RUNWAY AND TAXIWAY MARKING SF 8,800 $ /, pa $ g/ gam. oe 15 0-701-5.1a 18 -INCH REINFORCED CONCRETE PIPE (RCP) LF 273 $ 67/.00 $ /4.) 4.5'3.06 16 D -701-5.1c 18 -INCH FLARED END SECTION WITH PIPE GUARD EA 1 $ 222 So. 00 $ ./.2 sp,p� 17 D-705-5.1 6 - INCH PERFORATED SUBDRAIN (SDR 35) COMPLETE INCLUDING POROUS BACKFILL AND FILTER FABRIC LFT 5,321 $ /2 SD $ c%3 !17.�d 18 D-705-5.2 6 - INCH NON -PERFORATED SUBDRAIN (SDR 35) LFT 1,346 $ /2-.00 $ /CoI 8.2.3`. oc 19 D-705-5.3 SUBDRAIN CLEANOUT EA 23 $ /,2 y`p,aa $ ,Z $ s-45 ..5... 20 D-751-5.2 CATCH BASIN EA 1 $ /D�ooa.00 )7 / $ /b, Gkates,oa 21 T-901-5.1 SEEDING AC 8.2 $ 2, j SD.Ob $ /7 G,3p,pp 22 T-905-5.1 TOPSOILING (OBTAINED ON SITE OR REMOVED FROM STOCKPILE) CY 3,500 $ < /.2 S $ /y ?375:.oa 23 T-908-5.1 MULCHING '61 -Ac 8.2 $ 3/ Seo. de $ 21174 o ,tea 24 L-108 5.1 NO. 8 AWG, SKV, L-824, TYPE C CABLE, INSTALLED IN TRENCH DUCT BANK OR CONDUIT LF 8,900 $ 0.945 $ 3/ D/p, �y 25 L-108-5.2 NO. 6 AWG, 5KV, L-824, TYPE C CABLE, INSTALLED IN TRENCH, DUCT BANK OR CONDUIT LF 1,250 $ /.Oo $ J/ Z 5'6.00 26 L-108-5.3 NO. 6 AWG BARE COPPER COUNTERPOISE WIRE, INSTALLED IN TRENCH, ABOVE THE DUCT BANK OR CONDUIT, INCLUDING GROUND RODS AND GROUND CONNECTORS LF 7,000 $ /, JO $ 7) 764 ,64 27 L 110-5.1 CONCRETE ENCASED ELECTRICAL DUCT BACK, 2- WAY, 4 -INCH SCHEDULE 40 PVC LF 260 $$ 2�•0� 7 oz. d 28 L-110-5.2 NON-ENCASED ELECTRICAL CONDUIT, 2 -INCH 40 PVC LF 7,000 $ Z • SG $ / 7 app, c>,5SCHEDULE 29 L-115-5.4 ELECTRICAL HANDHOLE, L-868 EA 4 $ 6.7 S. Oc $ 22 7tao.00 30 L -11S-5.4 ELECTRICAL HANDHOLE, 2'0" BY 2'0" EA 6 $ 3.,45aO.bd $ /Q Oen. Ob 31 L-125-5.1 L-861T(LED)TAXIWAY EDGE LIGHT- LED EA 60 $ $SD, o.i ) $ 57, an 6, eo 32 L-125-5.2 L-861 RUNWAY EDGE LIGHT - QUARTZ EA 2 $ $op, Do $ 4 lod25, ao 33 L-125-5.3 AIRFIELD GUIDANCE SIGN, SIZE 1, LED, 1 (ONE) MODULE EA 1 $ ZI 37s: oa $ 2/ 373 ac 34 L-125-5.3 AIRFIELD GUIDANCE SIGN, SIZE 1, LED, 2 (TWO) MODULE EA 1 $ 2/ `JSo. oes $ 2/95-0. ob 35 L-125-5.3 AIRFIELD GUIDANCE SIGN, SIZE 1, LED, 4 (FOUR) MODULE EA 2 $ < jf3�oa $ ?4574.66 36 L 125-5.3 AIRFIELD GUIDANCE SIGN, SIZE 3, LED, 3 (THREE) MODULE EA 1 $ 3,33a.ao $ 3,333. oe 37 L-125-5.4 L-804 (LED) RUNWAY GUARD LIGHT EA 2 $ Z�(oSo. co $ 573Je. oo 38 L-125-5.5 REMOVE DUCT BANK LF 225 $ 7, o o $ 4 5'7 5.44 FAA AIP 43-19-0094-045 AECOM Project #60537973 -BP P-2 Waterloo Regional Airport Reconstruct Taxiway C ITEM NO. SPEC. NO. DESCRIPTION UNIT ESTIMATED QUANTITY UNIT BID PRICE TOTAL BID PRICE 39 L-125-5.6 REMOVE TAXIWAY EDGE LIGHT EA 102 $ (A ?...%) $ 7, 4,38, o0 40 L-125-5.7 REMOVE ELECTRICAL HANDHOLE EA 12 $ , 9, ao $ 229, Da 41 L-125-5.8 REMOVE AIRFIELD GUIDANCE SIGN EA 9 $ 2. 5-0.oe $ ,Q ,2 SD. c> (9 TOTAL BID $ 2,26,399.ov 4. The undersigned understands that the above quantities of work to be done are approximate only and are intended principally to serve as a guide in evaluating the bids. All quantities are subject to increase or decrease and are to be performed at the unit prices stipulated herein. 5. It is understood that the schedule of minimum wage rates, as established by the Secretary of Labor and included in the Specifications, are to govern on this project, and the undersigned certifies that he has examined this schedule of wage rates and that the prices bid are based on such established wage rates. 6. The bidder shall make good faith efforts, as defined in Appendix A of 49 CFR Part 26, Regulations of the Office of the Secretary of Transportation, to subcontract 7.33 percent (7.33%) of the dollar value of the prime contract to small business concerns owned and controlled by socially and economically disadvantaged individuals (DBE). Individuals who are rebuttably presumed to be socially and economically disadvantaged include women, Blacks, Hispanics, Native Americans, Asian -Pacific Americans, and Asian -Indian Americans. The apparent successful competitor will be required to submit information concerning the DBE's that will participate in the contract. The information will include the name and address of each DBE, a description of the work to be performed by each named firm, and the dollar value of the contract. If the bidder fails to achieve the contract goal stated herein, it will be required to provide documentation demonstrating that it made good faith efforts in attempting to do so. In the event that the apparent successful competitor for this solicitation qualified as a DBE, the contract goal shall be deemed to have been met. A bid that fails to meet these requirements will be considered nonresponsive. 7. The undersigned 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 undersigned 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 undersigned 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 washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, or national origin, because of habit, local custom, or any other reason. The undersigned agrees that (except where he has obtained identical certifications from proposed subcontractors for specific time periods) he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the equal opportunity clause, and that he will retain such certifications in his files. 8. The undersigned agrees, upon written notice of the acceptance of this bid, within sixty (60) days after the opening of the bids, that he will execute the Contract in accordance with the bid as accepted and give Contract (Performance and Payment) bond on attached forms within fifteen (15) days after the prescribed forms are presented for signature. 9. The undersigned understands, award of contract is contingent upon receipt of project funding from the Federal Aviation Administration. If funding is not received, bid bonds will be returned to all bidders and the project will be postponed. FAA AIP #3-19-0094-045 P-3 Waterloo Regional Airport AECOM Project #60537973 -BP1 Reconstruct Taxiway C 10. The undersigned further agrees that if awarded the Contract, he will commence the work within ten (10) calendar days after the receipt of a "Notice to Proceed" and that he will substantially complete all work according to the terms of the entire contract within ninety (90) calendar days from the date established in the Notice to Proceed. An extension of time may be allowed when extra or additional work is ordered by the Engineer. 11. The undersigned agrees that within 30 days after award of this contract, the Contractor/Subcontractor shall file a compliance report (Standard Form 100) if s/he has not submitted a complete compliance report within 12 months proceeding the date of award. This report is required if the Contractor/Subcontractor meets all of the following conditions: a. Contractors/Subcontractors are not exempt based on 41 CFR 60-1,5. b. Has 50 or more employees. c. Is a prime contractor or first tier subcontractor. d. There is a contract, subcontract, or purchase order amounting to $50,000 or more. 12. To satisfy Clear Air and Water Pollution Control Requirements on all Construction Contracts and Subcontracts exceeding $100,000.00 Contractors and Subcontractors agree: a. That any facility to be used in the performance of the Contract or to benefit from the Contract is not listed on the Environmental Protection Agency (EPA) List of Violating Facilities. b. To comply with all the requirements of Section 306 of the Clean Air Act (42 USC 1857(h)), and Section 508 of the Clean Water Act (33 USC 1368), Executive Order 11738, and Environmental Protection Regulations (40 CFR Part (15)). c. That as a condition for award of a Contract he shall notify the awarding official of the receipt of any communication from EPA indicating that a facility to be utilized for performance of or benefit from the Contract is under consideration to be listed on the EPA List of Violating Facilities. d. To include or cause to be included in any Contract or Subcontract which exceeds $100,000.00 the aforementioned criteria and requirements. 13. The contractor, by submission of this offer and/or execution of a contract, certifies that it: a. is not owned or controlled by one or more citizens or nationals of a foreign country included in the list of countries that discriminate against U.S. firms published by the Office of the United States trade Representative (USTR); b. has not knowingly entered into any contract or subcontract for this project with a contractor that is a citizen or national of a foreign country on said list, or is owned or controlled directly or indirectly by one or more citizens or nationals of a foreign country on said list; c. has not procured any product nor subcontracted for the supply of any product for use on the project that is produced in a foreign country on said list. Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance with 49 CFR 30.17, no contract shall be awarded to a contractor or subcontractor who is unable to certify to the above. If the contractor knowingly procures or subcontracts for the supply of any product or service of a foreign country on the said list for use on the project, the Federal Aviation Administration may direct, through the sponsor, cancellation of the contract at no cost to the Government. FAA AlP #3-19-0094-045 P-4 Waterloo Regional Airport AECOM Project #60537973 -BP I Reconstruct Taxiway C Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will incorporate this provision for certification without modification in each contract and in all lower tier subcontracts. The contractor may rely upon the certification of a prospective subcontractor unless it has knowledge that the certification is erroneous. The contractor shall provide immediate written notice to the sponsor if the contractor learns that its certification or that of a subcontractor was erroneous when submitted or has become erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate written notice to the contractor, if at any time it learns that its certification was erroneous by reason of changed circumstances. This certification is a material representation of fact upon which reliance was placed when making the award. If it is later determined that the contractor or subcontractor knowingly rendered an erroneous certification, the Federal Aviation Administration may direct, through the sponsor, cancellation of the contract or subcontract for default at no cost to the Government. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by this provision. The knowledge and information of a contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. This certification concerns a matter within the jurisdiction of an agency of the United States of America and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code, Section 1001. 14. The bidder/offeror certifies, by submission of this proposal or acceptance of this contract, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. It further agrees by submitting this proposal that it will include this clause without modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts. Where the bidder/offer/contractor or any lower tier participant is unable to certify this statement, it shall attach an explanation to this solicitation/proposal. 15. As an evidence of good faith in submitting this Proposal, the undersigned encloses bid security in the amount of five (5) percent of the bid which, in case he refuses or fails to accept an award and to enter into a Contract and file the required bonds within the prescribed time, shall be forfeited to the Waterloo Regional Airport as liquidated damages. 16. By entering into this contract, the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). 17. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). 18. The undersigned hereby declares that the only parties interested in this Proposal are named herein, that this Proposal is made without collusion with any other person, firm or corporation, that no member of the Council, Waterloo Regional Airport or agent of the City of Waterloo, Iowa, is directly or indirectly financially interested in this bid. 19. In submitting this bid, it is understood that the right to reject any and all bids has been reserved and that this bid may not be withdrawn for a period of sixty (60) days from the opening thereof. 20. Contractor certifies that all employees employed by Contractor or any subcontractor working on behalf of the Contractor are in compliance with the Immigration Refonn Control Act of 1986 (IRCA) and indemnifies the Owner and holds harmless Owner for any violations of IRCA as a result of the Contractor's employees or his subcontractor's employees working on behalf of the Contractor on the Owner's project. FAA AIP #3-19-0094-045 P-5 Waterloo Regional Airport AECOM Project #60537973 -BP 1 Reconstruct Taxiway C 21. The undersigned certifies, to the best of his or her knowledge and belief, that: a. No Federal appropriated funds shall be paid, by or on behalf of the Contractor, 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 Congress in connection with the making of any Federal grant and the amendment or modification of any Federal grant. b. 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 grant, the Contractor shall complete and submit Standard Form -LLL, "Disclosure of Lobby Activities", in accordance with its instructions. c. The Undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, Loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $200,000 for each such failure. 22. Buy American Certificate (Title 49 U.S.C. Chapter 501) As a condition of bid responsiveness, the bidder must how it intend to comply with the Buy American preferences established under Title 49 U.S.C. Section 50101. Bidder must complete the attached Buy American certification. If the bidder requests a permissible waiver to the Buy America requirements, the Bidder identified as with the successful bid must submit a formal waiver request and component cost calculation within the prescribed time identified on the Buy America certification. 23. Drug Free Work Place, Act of 1988. a. By submission of this offer, the offeror, if other than an individual, who is making an offer that equals or exceeds $25,000, certifies and agrees that with respect to all employees of the offeror to be employed under a contract resulting from this solicitation, it will --no later than 30 calendar days after contract award (unless a longer period is agreed to in writing, for contracts of 30 calendar days or more performance duration;) or as soon as possible for contracts of less than 30 calendar days performance duration, but in any case, by a date prior to when performance is expected to be completed -- (1) Publish a statement notifying such employees that the unlawful manufacturer, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor's workplace and specifying the actions that will be taken against employees for violations of such prohibition; (2) Establish an on going drug-free awareness program to inform such employees about -- (a) The dangers of drug abuse in the workplace; (b) The Contractor's policy of maintaining a drug-free workplace; (c) Any available drug counseling, rehabilitation, and employee assistance programs; and (d) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (3) Provide all employees engaged in performance of the contract with a copy of the statement required by subparagraph a.(1) of this provision; FAA AIP #3-19-0094-045 P-6 Waterloo Regional Airport AECOM Project #60537973 -BP 1 Reconstruct Taxiway C (4) Notify such employees in writing in the statement required by subparagraph a.(1) of this provision that, as a condition of continued employment on the contract resulting from this solicitation, the employee will -- (5) (a) Abide by the terms of the statement; and (b) Notify the employer in writing of the employee's conviction under a criminal drug statute for a violation occurring in the workplace no later than 5 calendar days after such conviction; Notify the Contracting Officer in writing within 10 calendar days after receiving notice under subdivision a.(4) (b) of this provision, from an employee or otherwise receiving actual notice of such conviction. The notice shall include the position title of the employee; and (6) Within 30 calendar days after receiving notice under subdivision a.(4)(b) of this provision of a conviction, take one of the following actions with respect to any employee who is convicted of a drug abuse violation occurring in the workplace; (a) Take appropriate personnel action against such employee, up to and including termination; or (b) Require such employee to satisfactorily participate in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency. (7) Make a good faith effort to maintain a drug-free workplace through implementation of subparagraphs a.(1) through a.(6) of this provision. b. By submission of its offer, the offeror, if an individual who is making an offer of any dollar value, certifies and agrees that other offeror will not engage in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance in the performance of the contract resulting from this solicitation. c. Failure of the offeror to provide the certification required by paragraphs a. or b. of this provision, renders the offeror unqualified and ineligible for award. [See FAR 9.104-1(g) and 19.602-1a.(2)(a)]. d. In addition to other remedies available to the Government, the certification in paragraphs a. or b. of this provision concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under title 18, United States Code, Section 1001. 24. Attachment to This Bid. The following documents are attached to and made a part of this Bid: a. Bid Guaranty in the form of �arid b. Non -Collusion Affidavit of Prime Bidder. c. Statement of Intent — Non -Discrimination and Equal Opportunity Statement. d. Buy American Certification Statement. e. Bidder's Information Sheet. f. Synopsis of Experience Record. (IDOT Certification may be substituted.) g. Completed DBE forms "Utilization Statement" and "Letter of Intent." FAA AIP #3-19-0094-045 P-7 Waterloo Regional Airport AECOM Project #60537973 -BP l Reconstruct Taxiway C 25. The Bidder shall indicate whether the bid is submitted by a/an: ❑ Individual, Sole Proprietorship ❑ Partnership Cif' Corporation ❑ Joint -venture: all parties must join -in and execute all documents ❑ Other Respectfully submitted, By Bidder Signature - ;den,' Title /OSS L?- h7'"er Sir.eeef Address Cedar F //r, =A 5%04/3 (Include Zip Code) 3I? - 277 -3odj Telephone No. FAA AIP #3-19-0094-045 P-8 Waterloo Regional Airport AECOM Project #60537973-BP1 Reconstruct Taxiway C NON -COLLUSION AFFIDAVIT OF PRIME BI DDER State of — -W4 ) )ss County of Flack K4 W 1{ Jae�� tAie h , being first duly sworn, deposes and says that: (1) He is (Owner, Partne Representative, or Agent) of zn< • , 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. (Signed) Title V "�r-e5:sien?� Subscribed and sworn to before me this aof day of el•.1t2-� ,2017. Oil 1ti4-,Ar7 1'eV- itle My Commission Expires ,, 2011 FAA AIP #3-19-0094-045 P -l0 Waterloo Regional Airport AECOM Project #60537973-[3P l Reconstruct Taxiway C STATEMENT OF INTENT NONDISCRIMINATION AND EQUAL OPPORTUNITY STATEMENT The Contractor does hereby certify to the Waterloo Regional Airport, that no person shall, in any way, be favored or discriminated against because of his race, political or religious opinions and affiliations, national origins, sex, age, sexual orientation, gender identity, disability, color, creed, marital status, employee union or association membership or office herein. If selected as the successful bidder, this contractor hereby agrees to file either a nondiscrimination and equal opportunity statement and/or an Affirmative Action Program. Improvements to the Waterloo Regional Airport consisting of Reconstruct Taxiway C Bid Package #1 COMPANY J. E DWE,✓ EXECUTIVE OFFICER AFFIRMATIVE ACTION OFFICER ADDRESS OF THE AFFIRMATIVE ACTION OFFICER /v z s' Ceti -lee S7ree4 Li��tri al/s .TA 5'440 i3 PHONE NUMBER 317 — .7 7 — 34. o FAA AIP #3-19-0094-045 P-12 Waterloo Regional Airport AECOM Project #60537973 -BP 1 Reconstruct Taxiway C BIDDER'S INFORMATION SHEET A. BIDDER'S CAPACITY: (Check One) 1. Individual 0 2. Co -Partnership 0 3. Corporation L�3 B. (IF ITEM 2 IS CHECKED, COMPLETE THE FOLLOWING) State of Names and Addresses of Partners 1. 2. 3. 4. 5. C. (IF ITEM 3 IS CHECKED, COMPLETE THE FOLLOWING) State of Incorporation . 2 WQ Names and Addresses of Officers: President ale //y Cohn;h��a /o2 T- CeK7 r�bre / Ccc�cr Z/S, Z� Stair 3 Secretary Treasurer FAA AIP #3-19-0094-045 P713 Waterloo Regional Airport AECOM Project #60537973-BP1 Reconstruct Taxiway C SYNOPSIS OF EXPERIENCE RECORD f J (This synopsis must accompany Proposal Form.) t� Name of Bidder . G"hniAIM 21'775)4k4,4;en hc. Business Address /d,2 S Cen7'er Tree-' Zec(dr 2A 5:044 3 Individual ( ) Partnership ( ) Corporation (.-y' (Check One.) Construction successfully completed within past five years similar in size, scope, and difficulty of construction to the work bid upon. Name of Owner Name of Location of Amount of Pro'ect Project Contract 1 44 Se., A7T,4,k,Y Aoec7 of Xp -' Grier« 2 3 4 5 Number of Contract Days Actual Number of Days to Allowed for Above Projects Complete above Project 1 3 4 5 (Signed) k eu hn; 9144,3, (By) Com. (TITLE) /11:4e - �r�esafe i Cob' 711-1... Name of Company Date 6/2.5A 7 FAA AIP #3-19-0094-045 P-14 Waterloo Regional Airport AECOM Project #60537973-BP1 Reconstruct Taxiway C RECORD OF PAST EXPERIENCE (Continued) Project Owner or Engineer Project No., and Date, Phone No. of Reference Location Description of Work (Bridge, PCC, ACC, Grading Patching, Erosion, Etc. Include quontiesfor ACC PCC, and Grading) Dollar Value YR 2014 UNIVERSITY OF NORTHERN IOWA 319-273-2611 UNI SOUTH ART PARKING LOT UNI, CEDAR FALLS, IA PCC 14,985 SY $508,059 CITY OF ALLISON 319-267-2245 ALLISON OAK STREET IMPROVEMENT ALLISON, IA PCC 2,480 SY $182,146 PETERSON CONTRACTORS, INC. 319-345-2713 WAVERLY, CEDAR RIVER PARKWAY WAVERLY, IA PCC 21,357 SY $813,833 ASPRO, INC. 319-232-6537 1-380 BLACK HAWK CO. 1-380 BLACK HAWK CO. C & G 2,713 LF 597,488 ASPRO, INC. 319-232-6537 2014 STREET RESTORATION VARIOUS STREETS, CEDAR FALLS, IA PCC 814 SY-C & G 5,906 LF 5146,977 LOCKARD CONSTRUCTION 319-277-8000 WESTERN HOME 6TH ADDITION WESTERN HOME, CEDAR FALLS, IA PCC 9,290 SY $270,855 AOI CORPORATION 402-896-5520 MCDONALDS WATERLOO, IA PCC 4,258 SY $123,725 PETERSON CONTRACTORS, INC. 319-345-2713 PRAIRIE PARKWAY STREET CEDAR FALLS, IA PCC 30,036 5920,700 METRO INVEST -HUFF CONTRACTING 319-233-9000 FORT DODGE RETAIL CENTER FORT DODGE, IA PCC 6,604 SY $175,737 PETERSON CONTRACTORS, INC. 319-345-2713 2014 CF STREET RECONSTRUCTION VARIOUS STREETS, CEDAR FALLS, IA PCC 22,048 SY 5883,060 IOWA EROSION CONTROL 319-647-3561 W. AIRLINE HWY REHAB AIRLINE HIGHWAY, WATERLOO, IA PCC 1,271 SY $63,680 OCWEN FINANCIAL 319-236-5200 OCWEN FINANCIAL OCWEN FINANCIAL, WATERLOO, IA PCC 659 SY 555,000 HAWKEYE PROPERTY MANAGEMENT 319-624-5233 HAMMOND HILLS 6TH ADDITION HAMMOND HILLS, WATERLOO, IA PCC 2,373 SY $67,333 HAWKEYE COMMUNITY COLLEGE 319-234-5734 HAWKEYE CC PARKING LOT HCC WATERLOO, IA PCC 7,043 SY $426,774 PETERSON CONTRACTORS, INC. 319-345-2713 US 20, B.O. 4 GRUNDY CO. U5 20 GRUNDY CO., IA PCC 1,544 SY $177,602 PETERS CONSTRUCTION CO. 319-236-2003 JOHN DEERE PEC TRACK WATERLOO IA PCC 9,753 SY 5542,932 HAWKEYE COMMUNITY COLLEGE 319-234-5734 HAWKEYE CC CONCRETE REPAIR HCC WATERLOO, IA PCC 548 SY 572,506 PETERSON CONTRACTORS, INC. 319-345-2713 DYSART ROAD, BO 102 BLACK HAWK CO, IA PCC 19,802 SY 5601,668 Page 1 RECORD OF PAST EXPERIENCE (Continued) Project Owner or Engineer Project No., and Date, Phone No. of Reference Description of work Location (Bridge, PCC, ACC, Grading Patching, Erosion, Etc. Dollar Value Include quanties Jar ACC, PCC, and Grading) CITY OF CEDAR FALLS 319-273-8600 WEST VIKING INDUSTRIAL PARK. CEDAR FALLS, IA PCC 10,086 SY $769,572 VR 2015 CITY OF WATERLOO 319-266-2621 GERALDINE ROAD PHASE III GERALDINE ROAD, WATERLOO, IA PCC 5,489 SY $147,788 LOCKARD CONSTRUCTION 319-277-8000 PINNACLE PRAIRIE NORTH II CEDAR FALLS, IA PCC 5,707 SY $180,506 HUFF CONTRACTING, INC 319-233-9000 RIDGEWAY DEVELOPMENT RETAIL CENTER WATERLOO, IA PCC 6,166 SY $168,340 STANDARD DISTRIBUTION 319-266-1110 STANDARD DISTRIBUTION INDUSTRIAL PARK CEDAR FALLS, IA PCC 8,093 SY $300,136 ASPRO, INC. 319-232-6537 2015 STREET RESTORATION VARIOUS STREETS, CEDAR FALLS, IA PCC 1,145 SY-C & G 5,616 LF $172,228 PETERSON CONTRACTORS, INC. 319-345-2713 DUNKERTON ROAD BO 102 DUNKERTON ROAD, BLACK HAWK CO PCC 2,336 SY $96,548 WRIGHT COUNTY 515-532-3597 BELMOND 150TH ST BO 112 150TH STREET, BELMOND, IA PCC 2,038 SY $184,466 PETERS CONSTRUCTION CO. 319-236-2003 JOHN DEERE PEC HILL TRACK WATERLOO IA PCC 2,239 SY $177,846 JOHN DEERE PEC 319-292-4964 JD PEC DURABILITY TRACK 2015 WATERLOO, IA PCC 3,655 SY $368,788 PETERSON CONTRACTORS, INC. 319-345-2713 WAVERLY DRY RUN CREEK WAVERLY, IA PCC 16,129 SY-C & G 3,157 LF $915,673 BOLTON & MENK, INC. 952-890-0509 IOWA FALLS DOWNTOWN STREETSCAPE IOWA FALLS, IA PCC 9,565 SY-C & G 2,247 LF $3,965,935 PETERS CONSTRUCTION CO. 319-236-2003 MARTIN BROTHERS EXPANSION CEDAR FALLS, IA PCC 50,809 SY $1,395,216 JOHN DEERE PEC 319-292-4964 JD PEC NO ENTRANCE DRIVE WATERLOO, IA PCC 4,950 SY $418,552 DAVE SCHMIDT CONSTRUCTION 319-365-8669 PRAIRIE WEST 2ND ADDITION CEDAR FALLS, IA PCC 4,641 SY $133,184 BOLTON & MENK, INC. 952-890-0509 WASHINGTON AVE BO 105 HARDIN CO WASHINGTON AVE, HARDIN CO. PCC 4,951 SY-C & G 1,448 LF $576,877 HIGH DEVELOPMENT 319-363-3900 GREENHILL VILLAGE 10TH ADDITION CEDAR FALLS, IA PCC 3,330 SY $107,844 PETERSON CONTRACTORS, INC. 319-345-2713 2015 CF RECONSTRUCTION VARIOUS STREETS CEDAR FALLS, IA PCC 24,314 SY $1,034,775 Page 2 RECORD OF PAST EXPERIENCE (Continued) Project Owner or Engineer Project No., and Date, Phone No. of Reference Location Description of Work (Bridge, PCC, ACC, Grading Patching, Erosion, Etc. Include quontiesfor ACC, PCC, and Grading) Dollar Value IIII LOCKARD CONSTRUCTION, INC 319-277-8000 WESTERN HOME 7TH ADDITION WESTERN HOME CEDAR FALLS, IA PCC 9,217 SY $286,337 PETERSON CONTRACTORS, INC. 319-345-2713 NORMA AVENUE EXTENSION EVANSDALE, IA PCC 2,055 SY $62,600 YR 2016 PETERSON CONTRACTORS, INC. 319-345-2713 WAVERLY DRY RUN CREEK WAVERLY, IA PCC 1,677 SY - C&G 378 LF $355,635 BOLTON & MENK, INC. 952-890-0509 IOWA FALLS DOWNTOWN STREETSCAPE IOWA FALLS, IA PCC 270 SY - C&G 110 LF $1,084,997 PETERS CONSTRUCTION CO. 319-236-2003 MARTIN BROTHERS EXPANSION CEDAR FALLS, IA PCC 21,470 SY $616,163 LOCKARD CONSTRUCTION, INC 319-277-8000 WESTERN HOME 7TH ADDITION WESTERN HOME CEDAR FALLS, IA PCC 8,812 SY $246,137 LOCKARD CONSTRUCTION, INC 319-277-8000 HOME PLAZA HOME PLAZA CEDAR FALLS, IA PCC 5,777 SY $181,682 BAKER CONCRETE & EXCAVATING 563-423-5000 PINNACLE RIDGE SUBDIVISION PINACLE RIDGE, CEDAR FALLS, IA PCC 11,866 SY $365,350 HUDSON HARDWARE PLUMBING & HEATING 319-988-3231 UPPER RIDGES 2ND ADDITION UPPER RIDGES CEDAR FALLS, IA PCC 4,323 SY $113,479 MURPHY TRACTOR 319-235-7085 MURPHY TRACTOR LOT WATERLOO, IA PCC 2,627 SY $113,790 ASPRO, INC. 319-232-6537 2016 STREET RESTORATION VARIOUS STREETS, CEDAR FALLS, IA PCC 1,272 SY - C&G 4,216 LF $163,763 CITY OF CEDAR FALLS 319-243-2704 UNIVERSITY AVENUE RECONSTRUCTION CEDAR FALLS, IA PCC 51,785 SY - C&G 1,631 LF $9,306,760 HUFF CONTRACTING, INC. 319-233-9000 KWWL RENOVATION WATERLOO, IA PCC 3,003 SY - C&G 675 LF $108,610 DAVE SCHMIDT CONSTRUCTION 319-365-8669 CENTENIAL BUSINESS PARK WAVERLY, IA PCC 3,338 SY $110,138 DAVE SCMIDT CONSTRUCTION 319-365-8669 Omni Development 1st Addition WAVERLY, IA PCC 3,023 SY $86,156 CITY OF WATERLOO 319-266-2621 SHAULIS ROAD TRAIL BO 101 WATERLOO, IA PCC 10,181 SY $565,328 BAKER CONCRETE & EXCAVATING 563-423-5000 PRAIRIE WEST/WINDS 3RD ADDITION CEDAR FALLS, IA PCC 11,298 SY $316,344 CITY OF CEDAR FALLS 319-273-8600 CEDAR FALLS RECONSTRUCTION 2016 VARIOUS STREETS, CEDAR FALLS, IA PCC 20,224 SY $724,998 Page 3 RECORD OF PAST EXPERIENCE (Continued) Project Owner or Engineer Project No., and Date, Phone No. of Reference Location Description of Work (Bridge, PCC, ACC, Grading Patching, Erosion, Etc. Include quanties for ACC, PCC, and Grading) Dollar Value UNIVERSITY OF NORTHERN IOWA 319-273-2611 UNI INSTITUTIONAL ROADS UNI, CEDAR FALLS, IA PCC 3,762 SY $284,382 PETERSON CONTRACTORS, INC. 319-345-2713 UNI SW CAMPUS STORMWATER MANAGEMENT UNI, CEDAR FALLS, IA PCC 7,448 SY $232,966 PETERSON CONTRACTORS, INC. 319-345-2713 RIVER FOREST ROAD BO 101 WATERLOO, IA PCC 16,906 SY $700,541 PRAIRIE RAPIDS, LLC 319-352-0055 PRAIRIE RAPIDS SQUARE CEDAR FALLS, IA PCC 7,063 SY $212,635 PETERSON CONTRACTORS, INC. 319-345-2713 HWY21 & SHAULIS ROAD BLACK HAWK CO, IA PCC 2,490 SY $319,422 S & D DEVELOPMENT 319-290-7001 HIGHPOINT 2ND ADDITION WAVERLY, IA PCC 3,680 SY $115,000 DEER CREEK DEVELOPMENT, LLC 319-269-4081 GREENBELT TITAN TRAIL WATERLOO, IA PCC4,308 SY $137,849 Page 4 UTILIZATION STATEMENT Disadvantage Business Enterprise The undersigned bidder/offeror has satisfied the requirements of the bid specification in the following manner. (Please mark the appropriate box) ❑ The bidder/offeror is committed to a minimum of % DBE utilization on this contract. ttc The bidder/offeror, while unable to meet the DBE goal of 7.3 3 %, hereby commits to a minimum of 7.20 % DBE utilization on this contract and also submits documentation, as an attachment demonstrating good faith efforts (GFE). The undersigned hereby further assures that the information included herein is true and correct, and that the DBE firm(s) listed herein have agreed to perform a commercially useful function in the work items noted for each firm. The undersigned further understands that no changes to this statement may be made without prior approval from the Civil Right Staff of the Federal Aviation Administration. Il. G4nh,fi9�a►►s. Cbhsftu4-11eti cod Z . Bidder's/Offerorss Firm Name Signature /7 Date DBE UTILIZATION SUMMARY Contract Amount DBE Amount Contract Percentage DBE Prime Contractor $ — x 1.00 = $ — % DBE Subcontractor $ i l03//5'S!oo x 1.00 = $ /63/4"Y.04, 7.2 DBE Supplier $ — x 0.60 = $ DBE Manufacturer $ — x 1.00 = $ % Total Amount DBE DBE Goal $ /(.34Ply ,6 $ I6,(1C3-3,75- 72� % 3 3 % Note: If the total proposed DBE participation is less than the established DBE goal, Bidder must provide written documentation of the good faith efforts as required by 49 CFR Part 26. FAA AIF 43- 19-0094-04.5 AECOM Project 160537973-8P I P- l5 Waterloo Regional Airport Reconstruc. Taxiway, C tib FRS"( }`J?, _.Qi�fl�1t4111wid+l�jJytiIIY ..:u34.:. �kl�f.7Stii Bidder/Offer LETTER OF INTENT 1>isueiv iirlugi` BuSine•.,i' lstru r/rrise (This page shalt be submitted for each DSE firm) o Name: h r, 4 G7,pizt'Lrurf;4.n i � -/hz Address: /aa'S rEEt City: -roc74r : /j State: [',�°'/YSPE' Sakt+l�ia9%Wt�l6l+hrSa"irxCL;m°1�'.''.fi'eBztAMle3//::3.A�%NtJ2WAl,G DBE Firm: e d* 44','s zip 7- ZA DBE Contact Person: DBE Certifying Agency: Address;,j9 Clty:o�e/ Y Name: Lim / Mi%rv� State: -1-'417 Zip: 'Sa&/3 Zip: Phone: L ) 7Sr-OW Expiration Dato; Feb Each OBE Firm shalt submit evidence (such as a photocopy) of their certificatiorr status. \kre ;dFut� iii* •f• �,fe n r^. r zr. s t :: i r� r * r ^ • ra t s a.uc. i s `� aw 5 Classification: Work item(s) to be performed by , DBE LDPrirno Contractor DManufacturer Description of Work Item EIS 11 bconiractor Supplier %if cy I� ! /1 Pc3-�-j C /t .Je✓" 7 + "1 ins ��. rh: frac 4-r '7 Cts Quantity ,r= S - ©.Joint venture 5s3_ ai 2•Z_ �.c Total �.+t+} r22 2 7dc, • cU The hirider/yfforor is committed to utilizing the above-named DBE firm for the work described above. The estimated participation is as follows: 3 DBE contract amount; $ � 77 f_�, � j ' o�� Percent of total contract: •- 3 AFFIRMATION: The above-named DBE firm affirms that it will perform the portion of the contract for the estimated dollar value as slated above, / By: ,1A:e. Ldms s" n� Pro'e'. t r:Oar:n (Signature) - � Tlife) c In the event the bidderfofferor does not receive award of the prime contract, any and all representations in this Letter of Intent and Affirmation shall be null and void. (ttt;�2iJ-; IOWADOT SMARTER 1 SIMPLER 1 CUSTOMER DRIVEN February 13, 2017 Vallarie I. Holm Tiedt Nursery, Ltd. 2419 E. Bremer Avenue _ Waverly, IA 60677 www: iowa dot.gov Employee Services/Civil Rights Tenn 800 Lincoln Way, Ames, IA 50010 Phone: 515-239-1833 or 319-730-1512 Fax: 515-817-6551 Email: hector.torr rc a ha pow ot.tis RE; Affidavit of Continued DBE Certification Eligibility Dear Ms. Holm, This letter confirms receipt of your annual No Change Affidavit and supporting documentation. The Iowa Department of Transportation (lowa DOT), in compliance vulth 49 Code of Federal Regulations Part 26 (49 C.F.F. §§26 et seq.), is pleased to inform you that your firm's information has been reviewed and approved. Your firm's Disadvantaged Business Enterprise (DBE) certification will remain valid for another year. The DBE Directory, located at haps://secure.iowadot.gay/DBE/Directory will continue to list your contact information and will include the following NAICS codes and description of services performed: NAICS Code: 661730, 238990, 237990 Work Typets): Erosion Control (Seed, Sod, Mat, and Silt Fence), Fencing, Herbicide Application; Landscaping (Trees and Shrubs), Mowing, and Retaining Walls; Supplier. Trees, Shrubs, Seed, Fertilizer, Erosion Control Products, Plastic Tubing, and Fencing. As a DBE, you have the responsibility to comply with all aspects of 49 C.F.R. Part 26; maintain an accurate mailing address and phone number with Iowa DOT and promptly return all solicitation inquiries. If you have any questions, please contact this office. Sincerely Hector Torres -Cacho, AICP Compliance Officer PROPOSAL ATTACHMENT: Bidder/Offer DBE Firm: DBE Contact Person: DBE Certifying Agency: Classification: PART F — ADDITIONAL REQUIREMENTS ITEM 3 — DBE FORMS LETTER OF INTENT Disadvantage Business Enterprise (This page shall be submitted for each DBE firm) Name: K. Cz4f,n; h4N► �i1Jy'yti�-Fs�, ?hG. Address: /e).25- dekder City: —r «.S State: X74 DBE Firm: Advanced Traffic Control, Inc. Zip: 5-4'4.• r 3 Address: PO Box 8958 City: Cedar Rapids Name: Vaugn Miller State: Iowa Zip: 52408 Phone: (319) 396-5269 Iowa Department of Transportation Expiration Date: 12/31/17 (renewal) Each DBE Firm shall submit evidence (such as a photocopy) of their certification status. ❑ Prime Contractor 0 Manufacturer Subcontractor 0 Supplier 0 Joint Venture Work item(s) to be performed by DBE Description of Work Item Quantity Total 1 Mobilization LS $15,000.00 3 Construction Barricades LS $45,000.00 12 Runway and Taxiway Marking SF $16,544.00 13 Reflective Media LB $125.00 14 Temporary Markings SF $8,800.00 The bidder/offeror is committed to utilizing the above-named DBE firm for the work described above. The estimated participation is as follows: DBE contract amount:$ 3 5.;171‘..e:).> iPercent of total contract: 3..7-7 % AFFIRMATION: The above-named DBE firm affirms that it will perform the portion of the contract for the estimated dollar value as stated above. By: President (Title) Note: In the event the bidder/offeror does not receive award of the prime contract, any and all representations in this Letter of Intent and Affirmation shall be null and void. DBE -- ,, Iowa Department r ofTransportation Date Certified: December 31, 2013 Certificate No. H13343 Disadvantaged Business Enterprise Certification This Certifies That Advanced Traffic Control, Inc. Has met the requirements under the rules promulgated by the U.S. Department of Transportation pursuant to 49 Code of Federal Regulations, Part 26, and is eligible to participate as a Disadvantaged Business Enterprise in the Iowa Department of Transportation DBE Program Todd A. Sadler, Director, Office of Employee Services This certification may be revoked by the department upon finding of ineligibility and said company is subject to examination at any time and maybe required to supply additional information for review notwithstanding the issuance of this certificate. BUY AMERICAN CERTIFICATION FORM FOR MANUFACTURED PRODUCTS (Non -building projects such as oilfield/roadway construction, equipment acquisition, etc.) As a matter of bid responsiveness, the Bidder or Offeror must complete, sign, date, and submit this certification statement with their proposal. The Bidder or Offeror must indicate how they intend to comply with 49 USC § 50101 by selecting one on the following certification statements. These statements are mutually exclusive. Bidder must select one or the other (not both) by inserting a checkmark (✓) or the letter "X". LrJ The Bidder or Offeror hereby certifies that it will comply with 49 USC § 50101 by: a) Only installing steel and manufactured products produced in the United States, or; b) Installing manufactured products for which the FAA has issued a waiver as indicated by inclusion on the current FAA Nationwide Buy American Waivers Issued listing, or; c) Installing products listed as an Excepted Article, Material or Supply in Federal Acquisition Regulation Subpart 25.108. By selecting this certification statement, the Bidder or Offeror agrees: 1. To provide to the Owner evidence that documents the source and origin of the steel and manufactured product. 2. To faithfully comply with providing US domestic product. 3. To furnish US domestic product for any waiver request that the FAA rejects. 4. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. ❑ The Bidder or Offeror hereby certifies it cannot comply with the 100% Buy American Preferences of 49 USC § 50101(a) but may qualify for either a Type 3 or Type 4 waiver under 49 USC § 50101(b). By selecting this certification statement, the apparent Bidder or Offeror with the apparent low bid agrees: 1. To the submit to the Owner within 15 calendar days of the bid opening, a formal waiver request and required documentation that support the type of waiver being requested. 2. That failure to submit the required documentation within the specified timeframe is cause for a non- responsive determination may result in rejection of the proposal. 3. To faithfully comply with providing US domestic products at or above the approved US domestic content percentage as approved by the FAA. 4. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. Required Documentation Type 3 Waiver - The cost of the item components and subcomponents produced in the United States is more that 60% of the cost of all components and subcomponents of the "item". The required documentation for a type 3 waiver is: a) Listing of all product components and subcomponents that are not comprised of 100% US domestic content (Excludes products listed on the FAA Nationwide Buy American Waivers Issued listing and products excluded by Federal Acquisition Regulation Subpart 25.108; products of unknown origin must be considered as non-domestic products in their entirety). b) Cost of non-domestic components and subcomponents, excluding labor costs associated with final assembly at place of manufacture. FAA AIP #3-19-0094-045 P-17 Waterloo Regional Airport AECOM Project #60537973-13P 1 Reconstruct Taxiway C c) Percentage of non-domestic component and subcomponent cost as compared to total "item" component and subcomponent costs, excluding labor costs associated with final assembly at place of manufacture. Type 4 Waiver — Total cost of project using US domestic source product exceeds the total project cost using non- domestic product by 25%. The required documentation for a type 4 of waiver is: a) Detailed cost information for total project using US domestic product. b) Detailed cost information for total project using non-domestic product. False Statements: Per 49 USC § 47126, this certification concerns a matter within the jurisdiction of the Federal Aviation Administration and the making of a false, fictitious or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code. 6/22//-7 Date (i Cuhn;n�Xewt Company Name 77'71-rG G.Yj bn dal 2-..h . Signature 17,:e - 7:71"C-5;,,,e/r Title FAA AIP #3-19-0094-045 P-18 Waterloo Regional Airport AECOM Project #60537973-BP1 Reconstruct Taxiway C Buy America Waiver Request Title 49 U.S.0 Section 50101 (b) For Airfield Development Projects funded under the Airport Improvement Program (Revised 4/19/2010) Instructions for Permissible Waivers Section 50101(6)(1) Waiver: The bidder may not request a waiver based upon the best interests of the public. The FAA Office of Airports publishes such waivers at: http:/Avww. faa.gov/airports/aip/procurement/federal_contract_provisions/media/buy_american_waiver.xls Section 50101(6)(2) Waiver: The bidder may not request a waiver based upon insufficient supply of U.S. manufactured. The FAA Office of Airports publishes such waivers at: http:/Avww. Eta. gov/airports/aip/procurement/federal_contract_provis ions/media/buy_americanwaiver.xls Section 50101(6)(3) Waiver: The bidder may request a waiver if 60% or more of the components are produced in the United States and final assembly occurs in the U.S. Bidder is hereby advised that the Owner's approval with the bidder's waiver request is contingent upon FAA approval. I. "Equipment" in Section 50101 shall mean the following: a) Individual type "L" items (Airfield Lighting Equipment) as listed in FAA Advisory Circular 150/5345-53. b) Individual bid items as established within FAA Advisory Circular 150/5370-10. The bid item application may not be applied for the type "L" items listed in AC 150/5345-53. c) A waiver request may only address one specific equipment item. Submit separate requests for each equipment item for which a waiver. d) Items listed under the Nationwide Waiver do not require further review. Please refer to the following webpage: http://www faa.gov/airports/aip/procurement/federal_contract_provisions/mediebuy_american_waiver.xls 2. The bidder must base the U.S. percentage upon the value that results from completing a component cost calculation table similar to the attached format. Bidder shall avoid mere pro forma efforts to establish the waiver request percentage. The Bidder must submit the component cost calculation table as an attachment to the waiver request. 3. Components/subcomponents are the material and products composing the "equipment". 4. The final assembly of the AIP-funded "equipment" must be within the USA (Section 50101(b)(3)(B)). Final assembly is the substantial transformation of the components and subcomponents into the end product. 5. All steel used in the "Equipment" must be produced in the United States. 6. The Buy American requirements apply to all tier contractors and subcontractors. All contractors/subcontractors are required to provide appropriate documentation that indicates origin of manufacturer and percentage of domestic made product. 7. The bidder is hereby advised there is no implied or expressed guarantee that a requested waiver will be issued by the Federal Aviation Administration (FAA). Less than 60% USA component/subcomponent proposed for this facility CANNOT be waived. Products made with foreign steel are not eligible for a waiver. 8. North America Free Trade Act (NAFTA): Free Trade Agreements such as NAFTA do not apply to the AIP. Products and material made in Canada or Mexico must be considered as foreign made products. 9. Preparation of a Component Cost Calculation Table is not necessary for equipment listed on the FAA national listing: http://www. faa.gov/airports/aip/procurement/federal_contract_provisions/media/buy_american_waiver.xls. Bidder however shall submit a listing of any equipment it proposes to install on the project that is included on the National Buy American conformance list. Instructions for Section 50101(6)(4) Waiver: 1. The bidder may request a waiver if application of Buy America preferences results in a 25% cost increase in the overall project. This waiver is rarely applicable. Consult the Owner before making this request. FAA AIP #3-19-0094-045 AECOM Project #60537973-13P I P-19 Waterloo Regional Airport Reconstruct Taxiway C Buy America Waiver Request Title 49 U.S.0 Section 50101 (b)(3) For Airfield Development Projects funded under the Airport Improvement Program COMPONENT COST CALCULATION TABLE (Type 3 Waiver) • In lieu of completing this table, bidder may prepare a spreadsheet that addresses the same information and calculations as presented herein. • Preparation of a Component Cost Calculation Table is not necessary for equipment listed on the FAA national listing: lutp::.,irulrfaa.eowairporls.Jainiprocurementfederal contract provisions/media/buy american u'aiver.xls. • The component breakout shall be along major components of the equipment. Submit separate calculation for each different equipment types. Do not combine the component cost calculations of dierent types of equipment. • For Airfield development projects, equipment is defined as the "L" items (Airfield Lighting Equipment) as listed in FAA Advisory Circular 150/5345-53 and the b) individual bid items as established within FAA Advisory Circular 150/5370-10. The individual bid item method may not be applied to the "L" type items. • An authorized person shall attest under signature and date that the submitted information is accurate and complete. Equipment Type: Component/Subcomponents Name of Manufacturer Country of Origin Cost of Foreign Manufactured Components/Subcomponents Cost of USA Manufactured Components/Subcomponents Sum of US Manufactured Component/Subcomponent Costs: Sum of all Equipment Components and Subcomponents: Percentage of Equipment Components Manufactured in the United States: Place of Final Assembly: Certification Signature Bidder hereby requests a waiver to Buy America preferences based upon Section 50101(b)(3) for the equipment identified above. The bidder certifies that the cost of components and subcomponents comprising the equipment are produced in the United States and that final assembly occurs within the United States. I hereby certify the above information is accurate and complete. Bidder's Firm Name Date Signature % of FAA AIP #3-19-0094-045 AECOM Project # 60537973-BP1 P-20 Waterloo Regional Airport Reconstruct Taxiway C Buy America Conformance Listing Title 49 U.S.0 Section 50101 (b) For Airfield Development Projects funded under the Airport Improvement Program • Preparation ofa Component Cost Calculation '!'able is not necessa'y for equipment listed on the FAA national listing: hllp:duvv.fact ?ov/cliruorts/aitvhrocuremenl'/ederal contractJn'arisions5neclitlil>ul' cuuerican wairer..X/.s • Bidder shall submit a listing of equipment it proposes to install ori the project that is included on the current National Buy American conformance list. Equipment Type Name of Manufacturer Product Number Certification Signature: Bidder hereby certifies that the above listed equipment, which we propose for installation on the subject project, are on the current National Buy America Conformance list as established at: http://www.laa.gov/airports/aip/procurement/federal contractjrovisions/tliedia/buy american waiver.xls I hereby certify the above information is accurate and complete. Bidder's Firer Name Date Signature FAA AIP #3-19-0094-045 P-21 Waterloo Regional Airport AECOM Project # 60537973-BP1 Reconstruct Taxiway C Intentionally Left Blank FAA AIP #3-19-0094-045 P-22 Waterloo Regional Airport AECOM Project # 60537973-BP1 Reconstruct Taxiway C