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Revised Per Addendum No. 2 - 111112017
FORM OF BID OR PROPOSAL
FLOW EQUALIZATION FACILITY OVERFLOW CONNECTION TO SATELLITE WPCF
CONTRACT NO. 880
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
1. The undersigned, being a Corporation existing under the laws of the State of 1 OW \ , a
Partnership consisting of the following partners:
having familiarized (himself) (themselves) (itself) with the existing conditions on the project area
affecting the cost of the work, and with all the contract documents listed in the Table of Contents and
Addenda (if any), as prepared by the City Engineer of the City of Waterloo now on file in the office of
the City Clerk, City Hall, Waterloo, Iowa, hereby proposes to furnish all supervision, technical
personnel, labor, materials, machinery, tools, appurtenances, equipment, and services, including
utility and transportation services required to construct and complete this FLOW EQUALIZATION
FACILITY OVERFLOW CONNECTION TO SATELLITE WPCF, City Contract No. 880„ all in
accordance with the above -listed documents and for the unit prices for work in place for the following
items and quantities:
FLOW EQUALIZATION FACILITY OVERFLOW CONNECTION TO SATELLITE WPCF
CONTRACT NO. 880
Item
No.
Description
Unit
Estimated
Quantity
Unit Bid
Price
Total Bid
Priect
1
Flow Equalization Facility Overflow
Connection to Satellite WPCF
LS
1.0
$
$
TOTAL BID
r
$ 1.131,C00 • L(
2. It is understood that the quantities set forth are approximate only and subject to variation and that the
unit bid price for the work done shall govern in the actual payment to Contractor.
3. In submitting this bid, the bidder understands that the right is reserved by the City of Waterloo, Iowa,
to reject any or all bids. If written notice of the acceptance of this bid is mailed, telegraphed, or
delivered to the undersigned within thirty (30) days after the opening thereof, or 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before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the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 the insurance within ten (10) days
after the agreement is presented to him for signature, and start work within ten (10) days after
"Notice to Proceed" is issued. `,
4. Security in the sum of P. i c�Y1 -\ ;l5r lr�-luo ht p(,lY`P�� Dollars ($
L }1 ZOO. (. O ) in t a form of r� ,n , is submitted herewith in
accordance with the INSTRUCTIONS TO BIDDERS.
5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor.
6. Attached hereto is a Resident Bidder Certification (
( ). (Mark one.)
), or Non -Resident Bidder Certification
7. The bidder is prepared to submit a financial and experience statement upon request.
FORM OF BID
AECOM 60336756-2017
FB -1 to 2 Flow Equalization Facility
City Contract No. 880 Overflow Connection to Satellite WPCF
Revised Per Addendum No. 2 - 11/1/2017
8. 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.
9. The bidder has received the following Addendum or Addenda:
Addendum No. Date ID -26-17
2
11-1 _i 7
3
10. The bidder shall list the MBEMIBE subcontractor(s), amount of subcontracts and bid items on the
City of Waterloo Minority and/or Women Business Pre-bid Contact Information Form submitted with
this Form of Bid or Proposal. 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 Contractor shall submit information on subcontractors on "SUBCONTRACTOR REQUEST AND
APPROVAL" Form to be provided by City prior to approval of contract.
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.
11. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none"
or "NA".
12. The bidder has attached all applicable forms.
13. The Owner reserves the right to select alternates, delete line items, and/or to reduce quantities prior
to the award of a contract due to budgetary limitations.
Cxtevc,/inCi TOL. /I-/ -I 7
(Name of Bidder) / (Date)
BY: nik D ( Title Pre iJer1/
Official Address: (Including Zip Code):
203 F65/ _5hit $/ e -I
TWo IA 523L/Z
I.R.S. No. Cl f .. 2 f L// L1OQ
FORM OF BID
AECOM 60336756-2017
FB -2 to 2 Flow Equalization Facility
City Contract No. 880 Overflow Connection to Satellite WPCF
Attachment 1
SRF Required Front -End Specifications
(This form must be completed and signed by Prime Contractor and
submitted with the bid.)
U.S. Environmental Protection Agency
Certification of Non -Segregated Facilities
(Applicable to contracts, subcontracts, and agreements with applicants who are themselves
performing Federally assisted construction contracts, exceeding $10,000 which are not exempt
from the provisions of the Equal Opportunity clause.)
By the submission of this bid, the bidder, offeror, applicant, or subcontractor 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. He 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 bidder, offeror,
applicant, or subcontractor 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, time clocks, 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, creed, color, or national original, because of habit, local custom, or otherwise. He further
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; that he will retain such certifications in his files; and that he will
forward the following notice to such proposed subcontractors (except where the proposed
subcontractors have submitted identical certifications for specific time periods):
NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR
CERTIFICATIONS OF NON -SEGREGATED FACILITIES
A Certification of Non -segregated Facilities, as required by the May 9, 1967, order (33
F.R. 7808, May 28, 1968) on Elimination of Segregated Facilities, by the Secretary of Labor,
must be submitted prior to the award of a subcontract exceeding $10,000 which is not exempt
from the provisions of the Equal Opportunity clause. The certification may be submitted either
for each subcontract or for all subcontracts during a period (i.e., quarterly, semiannually, or
annually).
14 117 77
Signature / rc Date
Thfkc. U'fc_E f rewe,F
Name and Title of Signer (Please Type)
NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.
EPA -7 5720-4.2
SRF -2 May 2015
Attachment 2
SRF Required Front -End Specifications
(This form must be completed and signed by the Prime Contractor and
submitted with the bid.)
Debarments and Suspensions
Any bidder or equipment supplier whose firm or affiliate is listed in on the U.S. General Services
Administration Excluded Parties List System web site at http://www.epls.pov/ will be prohibited
from the bidding process. Anyone submitting a bid who is listed on this web site will be
determined to be a non-responsive bidder in accordance with 40 CFR Part 31.
United States Environmental Protection Agency Washington, DC 20460
Certification Regarding Debarment, Suspension, and
Other Responsibility Matters
The prospective participant certifies to the best of its knowledge and belief that it and the
principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from covered transactions by any Federal department or
agency;
(b) Have not within a three year period preceding this proposal been convicted of or had a
civil judgment rendered against them for commission o f 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 otherwise criminally or civilly charged by a government
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 transaction s (Federal, State, or local) terminated or cause or default.
understand that a false statement on this certification may be ground for rejection of this
proposal or termination of the award. In addition, under 18 U SC Sec. 10 01, a false statement
ma y /result in arfine
Lof up to $10,000 or imprisonment for up to 5 years, or both.
Typed Name & Title of Authorized Representative
/Ho.l7
Signature of Authorized Representative Date
❑ I am unable to certify to the above statements. My explanation is attached.
EPA Form 5700-49 (11-88)
SRF -3 May 2015
Attachment 3
SRF Required Front -End Specifications
(This form must be completed and signed by Prime Contractor and
submitted with the bid.)
Disadvantaged Business Enterprise (DBE) Solicitation
It is EPA's policy that recipients of EPA financial assistance through the State Revolving Fund
programs award a "fair share" of subagreements to small, minority and women -owned
businesses, collectively know as Disadvantaged Business Enterprises (DBEs). Iowa's Fair
Share goals are:
Only work performed by certified DBEs can be counted toward the goals. In Iowa, DBEs must
be certified through the Iowa Department of Transportation (IDOT). Information on certification
requirements and a list of certified DBEs is on the IDOT website at
http://www.iowadot.gov/contracts/contracts eeoaa.htm.
Prime contractors' DBE requirements for SRF projects include:
• Taking affirmative steps for DBE participation
• Documenting the efforts and the proposed utilization of certified DBEs
PROJECT INFORMATION
SRF Applicant:
Minority -Owned Business
Enterprise (MBE) Goal
Women -Owned Business
Enterprise (WBE) Goal
Construction
1.7%
2.2%
Supplies
0.6%
5.6%
Services
2.5%
11.3%
Goods/Equipment
2.5%
10.4%
Average
1.8%
7.4%
Only work performed by certified DBEs can be counted toward the goals. In Iowa, DBEs must
be certified through the Iowa Department of Transportation (IDOT). Information on certification
requirements and a list of certified DBEs is on the IDOT website at
http://www.iowadot.gov/contracts/contracts eeoaa.htm.
Prime contractors' DBE requirements for SRF projects include:
• Taking affirmative steps for DBE participation
• Documenting the efforts and the proposed utilization of certified DBEs
PROJECT INFORMATION
SRF Applicant:
Bidder:
6Rff ieccvc/ loci1-04_
Address:
_
x'03 & cfc.l MO- Tokio 1 A 5Zi%
Contact Person:
m,kt %rci-v
Signature:
filkei
Phone Number:
(cd_ L50 -,S i 8$
E -Mail Address:
/ j�
frig c��s @� c_ 4. lid hil ej Yci40p .CJS'.,
Check if Prime Contractor7s: ❑ Minorit'-Owned ❑ Women -Owned
SRF -4
May 2015
GOOD FAITH EFFORTS CHECKLIST
Please complete the checklist to determine if you have complied with the requirement to make
good faith efforts to ensure that certified DBEs have the opportunity to compete for
procurements funded by EPA financial assistance funds. Bidders/offerers must make good faith
efforts prior to submission of bids/proposals.
1. Did you ensure that DBEs are made aware of contracting opportunities to the fullest extent
practicable through outreach and recruitment activities? al Yes ❑ No
2. Did you make information on forthcoming opportunities available to DBEs and arrange time
frames for contracts and establish delivery schedules, where the requirements permit, in a way
that encourages and facilitates participation by DBEs in the competitive process? This includes,
whenever possible, posting solicitation for bids or proposals for a minimum of 30 calendar days
before the bid or proposal closing date. ® Yes ❑ No
3. Did you consider in the contracting process whether firms competing for large contracts
could subcontract with DBEs? This will include dividing total requirements, when economically
feasible, into smaller tasks or quantities to permit maximum participation by DBEs in the
competitive process. IT Yes ❑ No
4. Did you encourage contracting with a consortium of DBEs when a contract is too large for
one of these firms to handle individually? 2 Yes 0 No
5. Did you use the services of the Small Business Administration and the Minority Business
Development Agency of the Department of Commerce to identify potential subcontractors?
a, Yes ❑ No
6. List the potential DBE subcontractors that were contacted. Only list those that are certified
through the Iowa Department of Transportation.
Name
How Contacted
(e.g. letter, phone
call, fax, e-mail)
Response (e.g. did not respond,
not interested, not competitive)
PROPOSED UTILIZATION OF DBE SUBCONTRACTORS
Please include Attachments 4 and 5 to document the proposed utilization of certified DBE
subcontractors.
SRF -5 May 2015
CONTRACT ADMINISTRATION PROVISIONS
Several contract provisions are required to prevent unfair practices that adversely affect DBEs.
These include:
1. Prime Contractor must pay its Subcontractor for satisfactory performance no more than 30
days from the Prime Contractor's receipt of payment from the SRF loan recipient.
2. Prime Contractor must notify the SRF loan recipient in writing prior to termination of a DBE
subcontractor for convenience.
3. Prime Contractor must employ the six Good Faith Efforts to solicit a replacement
subcontractor if a DBE subcontractor fails to complete work under a subcontract for any
reason.
SRF -6 May 2015
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Graff Excavating, Inc.
as Principal, and Employers Mutual Casualty Company
as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called "OWNER."
in the penal sum Five Percent of the Amount of Bid
Dollars ($ ( 5%1 ) 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 the 16th day of November , 2017, for Flow Equalization
Facility Overflow Connection to Satellite WPCF, City of Waterloo, Iowa - Contract No. 880
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 pres-
ents to be signed by their proper officers this 8th day of November , A.D. 20 17 .
1!�71u A A� ��\
7 • IS
me 1 AP
,-
nne Crowner,
BID BOND
AECOM 60336756-2017
ness to Surety
Graff Excavating, Inc.
BY tl1,lu a�ele6il)(1)
Principal
(Seal)
Title
Employers Mutual Casualty Com • any
S
Dione R. Young, Attorn
(Seal)
BB -1 of 1 Flow Equalization Facility
City Contract No. 880 Overflow Connection to Satellite WPCF
SEMC
INSURANCE
P.O. Box 712 • Des Moines, Iowa 50306-0712
CERTIFICATE OF AUTHORITY INDIVIDUAL ATTORNEY-IN-FACT
KNOW ALL MEN BY THESE PRESENTS, that:
1. Employers Mutual Casualty Company, an Iowa Corporation
2. EMCASCO Insurance Company, an Iowa Corporation
3. Union Insurance Company of Providence, an Iowa Corporation
4. Illinois EMCASCO Insurance Company, an Iowa Corporation
hereinafter referred to severally as "Company" and collectively as "Companies", each does, by these presents, make, constitute and appoint:
CRAIG E. HANSEN, LACEY CRAMBLIT, BRIAN M. DEIMERLY, JAY D. FREIERMUTH, TIM MCCULLOH, CINDY BENNETT, ANNE CROWNER,
STACY VENN, DIONE R. YOUNG, SHIRLEY S BARTENHAGEN
its true and lawful attorney-in-fact, with full power and authority conferred to sign, seal, and execute the following Surety Bond:
5. Dakota Fire Insurance Company, a North Dakota Corporation
6. EMC Property & Casualty Company, an Iowa Corporation
7. Hamilton Mutual Insurance Company, an Iowa Corporation
ANY AND ALL BONDS
and to bind each Company thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of each such Company, and all
of the acts of said attorney pursuant to the authority hereby given are hereby ratified and confirmed.
The authority hereby granted shall expire April 1, 2018 unless sooner revoked.
AUTHORITY FOR POWER OF ATTORNEY
This Power -of -Attorney is made and executed pursuant to and by the authority of the following resolution of the Boards of Directors of each of the Companies at the
first regularly scheduled meeting of each company duly called and held in 1999:
RESOLVED: The President and Chief Executive Officer, any Vice President, the Treasurer and the Secretary of Employers Mutual Casualty Company shall have
power and authority to (1) appoint attorneys -in -fact and authorize them to execute on behalf of each Company and attach the seal of the Company thereto, bonds
and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof; and (2) to remove any such attorney-in-fact at any time
and revoke the power and authority given to him or her. Attorneys -in -fact shall have power and authority, subject to the terms and limitations of the power-of-attorney
issued to them, to execute and deliver on behalf of the Company, and to attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of
indemnity and other writings obligatory in the nature thereof, and any such instrument executed by any such attorney-in-fact shall be fully and in all respects binding upon
the Company. Certification as to the validity of any power-of-attorney authorized herein made by an officer of Employers Mutual Casualty Company shall be fully and in all
respects binding upon this Company. The facsimile or mechanically reproduced signature of such officer, whether made heretofore or hereafter, wherever appearing upon
a certified copy of any power-of-attorney of the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed.
IN WITNESS THEREOF, the Companies have caused these presents to be signed for each by their officers as shown, and the Corporate seals to be hereto affixed this
21st day of January, 2016.
Seals
, O INSU ,
PATRICIA A. WRIGHT
Commission Number 225346
My Commission Expires
November 01, 2017
Bruce G. Kelley, Chairman
of Companies 2, 3, 4, 5 & 6; President
of Company 1; Vice Chairman and
CEO of Company 7
Michael Freel
Assistant Secretary
On this 22nd day of June, AD 2010 before me a Notary Public in and for the State of Iowa,
personally appeared Bruce G. Kelley and Michael Freel, who, being by me duly sworn,
did say that they are, and are known to me to be the Chairman, President, Vice Chairman
and CEO, and/or Assistant Secretary, respectively, of each of the Companies above; that
the seals affixed to this instrument are the seals of said corporations; that said instrument
was signed and sealed on behalf of each of the Companies by authority of their respective
Boards of Directors; and that the said Bruce G. Kelley and Michael Freel, as such officers,
acknowledged the execution of said instrument to be their voluntary act and deed, and the
voluntary act and deed of each of the Companies.
My Commission Expii November 1, 2017.
O G
/-7.1-c. cICE
Notary Public in and for the State ofIowa
CERTIFICATE
I, James D. Clough, Vice President of the Companies, do hereby certify that the foregoing resolution of the Boards of Directors by each of the Companies, and
this Power of Attorney issued pursuant thereto on 22nd day of June, 2010, are true and correct and are still in full force and effect,
In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 8th day of November , 2017
Vice President
032sPC "For verification of the authenticity of the Power of Attorney you may call (515) 345-2689."
Vice
46 2689."