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Home My WebLink AboutHydro KleanIb E� Legal Express Envelope e v. e �u as o00 foo sol Visit up,,,coin® or call 1 -800 -PICK UPS® (1-800-742-5877) to schedule a pickup or find a drop off location near you. Domestic Shipments • To qualify for the Letter rate, UPS Express Envelopes may only contain correspondence, urgent documents, and/or electronic media, and mu weigh 8 oz. or less. UPS Express Envelopes containing items other that those listed or weighing more than 8 oz. will be billed by weight. International Shipments • The UPS Express Envelope m.;y be used only for documents of no comn value. Certain countries consider electronic media as documents. Visit ups.com/importexport to verify if your shipment is classified as a docur • To qualify for the Letter rate, the UPS Express e must weih 8 oz. 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These comma/or c, technology or software werC exported from the U.S. at accordance Certain with the et to ' ) an /ed Parcel Service. innot Carriageis. Div (the"Warsawar Convention") and/or Exportministration Regulations. Diversion contrary to U.S. law prohibited. gents e top. r-- 1 r hlml&loc=en_ iS&instr=A&doc=shipment_137388554..- 111 0101951033 1/15 BL United Parcel Service HC333 NW 49th Place HYDRO KLEAN Des Moines, IA 50313 City Clerk City of Waterloo, Iowa 715 Mulberry Street Waterloo, Iowa 50703 FY 2017 CIP Pipelining Phase IIIA City Contract No. 919 HYDRO 333 NW 49th Place Des Moines, IA 50313 City Clerk City of Waterloo, Iowa 715 Mulberry Street Waterloo, Iowa 50703 FY 2017 CIP Pipelining Phase IIIA City Contract No. 919 BID SECURITY Revised Per Addendum No. 1 - 2/24/2017 FORM OF BID OR PROPOSAL FY 2017 CIP PIPELINING PHASE IIIA CITY OF WATERLOO, IOWA CITY CONTRACT NO. 919 Honorable Mayor and City Council Waterloo, Iowa Gentlemen: 1. The undersigned, being a Corporation existing under the laws of the State of Iowa , 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 FY 2017 CIP PIPELINING PHASE IIIA, CITY CONTRACT NO. 919, all in accordance with the above -listed documents and for the unit prices for work in place for the following items and quantities: FY 2017 CIP PIPELINING PHASE IIIA CITY OF WATERLOO, IOWA CITY CONTRACT NO. 919 Item Description Unit Estimated Quantiles Unit Price Total Amount 1 8 -Inch Diameter CIP Pipe Lining LF 12,740.0 $ 20.30 $ 258,622.00 2 10 -Inch Diameter CIP Pipe Lining LF 2,665.0 $ 24.50 $ 65,292.50 3 12 -Inch Diameter CIP Pipe Lining LF 2,630.0 $ 28.70 $ 75,481.00 4 18 -Inch Diameter CIP Pipe Lining LF 281.0 $ 69.50 $ 19,529.50 5 21 -Inch Diameter CIP Pipe Lining LF 326.0 $ 82.90 $ 27,025.40 6 24 -Inch Diameter CIP Pipe Lining LF 706.0 $ 103.20 $ 72,859.20 7 36 -Inch Diameter CIP Pipe Lining LF 766.0 $ 200.10 $ 153,276.60 8 Pipe Televising - 8" LF 25,480.0 $ 1.60 $ 40,768.00 9 Pipe Televising - 10" LF 5,330.0 $ 1.60 $ 8,528.00 10 Pipe Televising - 12" LF 5,260.0 $ 1.60 $ 8,416.00 11 Pipe Televising - 18" LF 562.0 $ 1.60 $ 899.20 12 Pipe Televising - 21" LF 652.0 $ 1.60 $ 1,043.20 13 Pipe Televising - 24" LF 1,412.0 $ 1.60 $ 2,259.20 14 Pipe Televising - 36" LF 1,532.0 $ 5.07 $ 7,767.24 15 Pipe Cleaning - 8" LF 12,740.0 $ 2.66 $ 33,888.40 16 Pipe Cleaning - 10" LF 2,665.0 $ 2.66 $ 7,088.90 17 Pipe Cleaning - 12" LF 2,630.0 $ 2.66 $ 6,995.80 18 Pipe Cleaning - 18" LF 281.0 $ 6.13 $ 1,722.53 19 Pipe Cleaning - 21" LF 326.0 $ 6.13 $ 1,998.38 20 Pipe Cleaning - 24" LF 706.0 $ 6.13 $ 4,327.78 21 Pipe Cleaning - 36" LF 766.0 $ 11.33 $ 8,678.78 FORM OF BID AECOM 60504645 CONTRACT NO. 919 BF -1 OF 4 Revised Per Addendum No. 1 - 2/24/2017 Item Description Unit Estimated Quantiles Unit Price Total Amount 22 Type C Root Removal - 8"-10" LF 1,154.0 $ 1.00 $ 1.154.00 23 Type C Root Removal - 12" LF 196.0 $ 1.00 $ 196.00 24 Type C Root Removal - 18"-24" LF 98.0 $ 1.00 $ 98.00 25 Type C Root Removal - 36" LF 57.0 $ 1.00 $ 57.00 26 Lateral Reinstatement EA 368.0 $ 75.00 $ 27,600.00 27 3 -FT Lateral Grouting EA 368.0 $ 375.00 $ 138,000.00 28 Manhole Inspection EA 649.0 $ 42.00 $ 27,258.00 29 Internal Chimney Seal EA 391.0 $ 309.75 $ 121,112.25 30 Manhole Barrel Joint Leak Repair EA 257.0 $ 498.75 $ 128,178.75 31 Manhole Lining EA 211.0 $ 945 $ 199,395.00 32 Grout Work EA 78.0 $ 498.75 $ 38,902.50 33 Miscellaneous Manhole Work LS 1.0 $ 30,240.00 $ 30,240.00 34 DWG 36 - MH 08-09-05 - Wet Well LS 1.0 $ 23,625.00 $ 23,625.00 TOTAL BID $ 1,542,284.11 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 seventy seven thousand one hundred fourteen Dollars ($ 77,114.21 ) in the form of 5% Bid Bond , 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 ( X ) or Non -Resident Bidder Certification ( ). (Mark one.) 7. The bidder is prepared to submit a financial and experience statement upon request. 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: FORM OF BID AECOM 60504645 Addendum No. 1 Date 2/24/2017 CONTRACT NO. 919 BF -2 OF 4 Revised Per Addendum No. 1 - 2/24/2017 10. The bidder shall list the MBE/WBE 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. BY: Hydro-Klean, LLC /; Nam of Bidder) Official Address: (Including Zip Code): 333 NW 49th Place Title Vice President 3/2/2017 (Date) Des Moines, IA 50313 I.R.S. No. 45-2473053 FORM OF BID AECOM 60504645 CONTRACT NO. 919 BF -3 OF 4 Mayor QUENTIN M. IAR'I' COUNCIL MEMBERS TOM POWERS Ward 1 BRUCE JACOBS Ward 2 PATRICK MORRISSEY Ward 3 CITY OF WATERLOO, IOWA WATERLOO ENGINEERING DEPARTMENT 715 Mulberry St. • Waterloo, IA 50703 ' (319) 291-4312 Fax (319) 291-4262 ERIC THORSON, Y.E. ' City Engineer INFORMATION NEEDED FOR IOWA CONSTRUCTION SALES TAX EXEMPTION CERTIFICATE CONTRACTOR NAME: Hydro-Klean, LLC ADDRESS: 333 NW 49th Place, Des Moines, IA 50313 (Check One) PRIME: X FEDERAL ID#: 45-2473053 SUBCONTRACTOR: JEROME PROJECT NAME: FY 2017 CIP Pielining Phase IIIA AMOS, JR. Ward 4 RON WELPER Ward 5 TOM LIND At -Large STEVEN SCHMITT At -Large SALES TAX EXEMPTION AECOM 60504645 PROJECT CONTRACT NO.: 919 DESCRIPTION OF WORK: ❑ Brickwork O Carpentry O Concrete O Drywall -Plaster -Insulation ❑ Landscaping O Painting ❑ Paving ❑ Plumbing ❑ Electrical 0 Roofing -Siding -Sheet Metal ❑ Excavation/Grading 0 Windows O Flooring 0 Wrecking -Demolition ❑ Heavy Construction ® Other (Please Specify) ❑ Heating -Ventilating -Air Cond. ❑ Sewer Rehabilitation WE'RE WORKING FOR YOU! An Equal Opportunity/Affirmative Action Employer CONTRACT NO. 919 Page STE-1 OF 2 NON -COLLUSION AFFIDAVIT OF PRIME BIDDER State of Iowa County of Polk )ss Paul Govoni , being first duly sworn, deposes and says that: 1. He isVice President (ower, Partner, Officer, Representative, or Agent) , of Hydro-Klean, LLC , 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 agre ent op the part of the Bidder or any of its agents, representatives, owners, employees, or parties in interei(including this affiant. (Signed) cif/�U� e Vice President Subscribed and sworn to before me this My commission expires Title day of 0/7 Title isea JESSICA FELTZ Commission Number 7861 My Commission Expires September 18, 201? NON -COLLUSION CONTRACT NO. 919 NCA -1 OF 2 AECOM 60504645 NON -COLLUSION AFFIDAVIT OF SUBCONTRACTOR State of /(,i to q ) County of u 971(�`YI ) ss: Ofitio r being first duly sworn, deposes and says that: He is Owne ,)Partner Officer .Representative, or Agent) of gen �+ C'� 14+- i{anh1 1 /p�C . hereinafter referred to as the Subcontractor;" J 2. He is fully informed respecting the prepara ipn and contents of the subcontractor's proposal submitted by the subcontractor to d ^I l?am contract pertaining to the Fr 20'7 GI Jj fjrim • tiQ //1 project in Wj-[(I001 (OWcx (City or County and State) 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; and 5. The price or prices quoted in the subcontractor's proposal are fair and pr er and are not tainted by any collusion, conspiracy, connivance or unlawful agement on the rt of the bidder or any of its agents, representatives, owners, employe s, or parti4ss in interest, ' cluding this affiant. (Signed) Subscribed and sworn to before me this My commission expires lU/id%/9 7 Title 21 day of'FC..CflarLYU ( j 1�t ] (4e 1,A P T .S w a �" .r a / JESSICA SNYDER 4 Notarial Seal • Iowa + Commission # 76516, r My Commission Expires fD l f NON -COLLUSION ACCOM 60604646 20( 7 CONTRACT NO. 919 NCA -2 OF 2 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 contractors, 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 contractor, 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. 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, EQUAL OPPORTUNITY CLAUSE AECOM 60504645 CONTRACT NO. 919 EOC-1 of 2 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, natio at -origin, economic status, age, mental or physical disabilities. EQUAL OPPORTUNITY CLAUSE AECOM 60504645 (Signed) (Ap opriate Official) Vice President (Title) 3/2/2017 (Date) CONTRACT NO. 919 EOC-2 of 2 TITLE VI CIVIL RIGHTS During the performance of this contract, the contractor (for itself), its assignees, and successors in interest (hereinafter referred to as the "contractor") agrees as follows: 1. Compliance with Regulations: The contractor shall comply with the Regulations relative to non- discrimination in Federally assisted programs of the DOT Title 49, Code of Federal Regulations, Part 21, as they may be amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and made a part of this contract. 2. Nondiscrimination: The contractor, with regard to the work performed by it during the contract, shall not discriminate on the grounds of race, color, national origin, sex, age, or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B of the Regulations. 3. Solicitations for Subcontracts, Including Procurement of Materials and Equipment: In all solicitations either by competitive bidding or negotiation made by the contractor for work to be performed under a subcontract, including procurement of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the contractor of the contractor's obligations under this contract and the Regulations relative to non-discrimination on the grounds of race, color, national origin, sex, age, or disability. 4. Information and Reports: The contractor shall provide all information and reports required by the Regulations or directives issued pursuant there to, and shall allow access to its books, records, accounts, other sources of information, and its facilities as may be determined by the Contracting Authority, the Iowa DOT, or FHWA to be pertinent to ascertain compliance with such Regulations, orders and instructions. Where any information required of a contractor is in the exclusive possession of another who fails or refuses to furnish this information the contractor shall so certify to the Contracting Authority, the Iowa DOT, or the FHWA as appropriate, and shall set forth what efforts it has made to obtain the information. 5. Sanctions for Noncompliance: In the event of the contractor's noncompliance with the nondiscrimination provisions of this contract, the Contracting Authority, the Iowa DOT, or the FHWA shall impose such contract sanctions as they may determine to be appropriate, including, but not limited to: a. Withholding of payments to the contractor under the contract until the contractor complies, and/or b. Cancellation, termination, or suspension of the contract, in whole or in part. 6. Incorporation of Provisions: The contractor shall include the provisions of paragraphs (1) through (6) in every subcontract, including procurement of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. The contractor shall take such action with respect to any subcontract or procurement as the Contracting Authority, the Iowa DOT, or the FHWA may direct as a means of enforcing such provisions including sanctions for non-compliance: Provided, however, that, in the event of a contractor becomes involved in, or it threatened with, litigation with a subcontractor or supplier as a result of such direction, the contractor may request the Contracting Authority or the Iowa DOT to enter into such litigation to protect the interests of the Contracting Authority or the Iowa DOT; and, in addition, the contractor may request the United States to enter into such litigation to protect the interest of the United States. TITLE VI CIVIL RIGHTS AECOM 60504645 CONTRACT NO. 919 CR -1 OF 2 RESIDENT/NON-RESIDENT BIDDER RESIDENT BIDDER: In accordance with Section 73A.21 of the Iowa Code, all non -federal -aid public improvement projects, which include road construction, shall be performed by a qualified resident bidder. The resident bidder has been further defined as follows: Resident Bidder: A person or entity authorized to transact business in this state and having a business for at least three years prior to the date of the first advertisement for the public improvement. If another state or foreign country has a more stringent definition of a resident bidder, the more stringent definition is applicable as to bidders from that state or foreign country. The contractor shall provide the City with a certification that he is a qualified resident bidder according to the above definition. The Certification shall be submitted with the contractor's bid. A copy of the form of "Resident Bidder Certification" is included in the Contract Documents. If it is determined that the contractor does not meet this qualification after he begins work, a shutdown notice shall be issued and the voiding of the contract shall begin unless the contractor becomes qualified. NON-RESIDENT BIDDER: The contractor shall provide the City with a certification that he is a non-resident bidder according to the above definition. The Certification shall be submitted with the contractors bid. A copy of the form of "Non -Resident Bidder Certification" is included in the Contract Documents. DJG 01/02/12 RESIDENT BIDDER AECOM 60504645 CONTRACT NO. 919 RB -1 OF 4 CONTRACT NO: PROJECT NAME: DATE OF LETTING: RESIDENT BIDDER CERTIFICATION 919 FY 2017 CIP Pipelining Phase IIIA 3/2/2017 To be a qualified resident bidder, the bidder shall be a person or entity authorized to transact business in this state and having a business for at least three years prior to the date of the first advertisement for the public improvement. If another state or foreign country has a more stringent definition of a resident bidder, the more stringent definition is applicable as to bidders from that state or foreign country. This qualification as resident bidder shall be maintained by the contractor and his subcontractors at the work site until this project is completed. I hereby certify that I am a resident bidder as defined above. RESIDENT BIDDER AECOM 60504645 COMPANY NAME Hydro -K1 : n CORPORATE OFFICER TITLE Vice President DATE 3/2/2017 CONTRACT NO. 919 RB -2 OF 4 Revised February 2003 CONTRACTOR'S OR SUBCONTRACTOR'S AFFIRMATIVE ACTION PROGRAM Check box that applies to party completing program: ( X ) General Contractor ( ) Subcontractor I. Section A to be completed by GENERAL CONTRACTORS only: A. Name of Company Hydro-Klean, LLC Address of Company 333 NW 49th Place, Des Moines, IA Telephone Number ( 515 ) 283-0500 Zip 50313 Federal ID Number (if no Federal ID Number, Owner/President's Social Security Number) 45-2473053 Name of Project FY 2017 CIP Pipelining Phase IIIA Project Contract Number 919 Estimated Construction Work Dates TBD / 10/27/2017 Start Finish Section B to be completed by SUBCONTRACTORS only: B. Name of General or Prime Contractor Hydro-Klean, LLC Name of Subcontractor Dependable Drain and Plumbing, Inc. Subcontractor's Address 212 34th Ave. North, Clinton, IA Zip 52732 Subcontractor's Telephone Number ( 563 ) 243-4953 Subcontractor's Federal ID Number (if no Federal ID Number Owner/President's Social Security Number) 42-1506493 Name of Equal Employment Officer Jeff C. Remainder of program to be completed by party completing program, either Prime or Subcontractor. -1 - 1. The Owners and/or Principals of your company: Name Ethnic Address Position Sex Origin 2. Other Areas of Interest: If your company has branches or subsidiaries, or if your company is a branch or subsidiary of a parent organization, give the following information: Name Type of Address Affiliation Degree Il. EMPLOYER'S POLICY (Please read carefully.) A. We, the undersigned, recognize that we are morally and legally committed to nondiscrimination in employment. Any person who applies for employment with our company will not be discriminated against because of race, color, creed, sex, national origin, economic status, age, mental or physical handicap. B. The employment policies and practices of the undersigned are to recruit and hire employees without discrimination, and to treat them equally with respect to compensation and opportunities for advancement, including training, upgrading, promotion, and transfer. However, we realize the inequities associated with employment training, upgrading, contracting and subcontracting for minorities and women and we will direct our efforts to correcting any deficiencies to the maximum extent possible. The same will be required of our SUBCONTRACTORS and suppliers. C. We submit this program to assure compliance with Executive Order 11246, as amended, and other subsequent orders that may pertain to equal employment opportunity and merit employment policies, fully realizing that our qualification and/or merit system should be evaluated and revised, if necessary. D. We agree to put forth the maximum effort to achieve full employment and utilization of capabilities and productivity of all our citizens without regard to race, creed, color, sex, national origin, economic status, age, and mental or physical handicap. E. Hydro-Klean, LLC win give training (Name of Company) -2 - and employment opportunities to local residents of Waterloo, Iowa, to the greatest extent feasible. III. AFFIRMATIVE ACTION A. B. C. D. Hydro-IQean, LLC recognizes that the (Name of Company) effective application of a policy of merit employment involves more than just a policy statement, and Hydro-Klean, LLC (Name of Company) will, therefore, re-evaluate our Affirmative Action Program to ensure that equal employment opportunities are available on the basis of individual merit, and to actively encourage minorities, women and local residents to seek employment with our company on this basis. Hydro-IQean, LLC will undertake the (Name of Company) following six (6) steps to improve our Affirmative Action Program: 1. Minority Recruitment and Employment; 2. Local Recruitment and Employment; 3. Disabled Veteran and Vietnam Era Veteran Recruitment and Employment; 4. Handicapped Recruitment and Employment; 5. Female Recruitment and Employment; and 6. Training, Upgrading and Promotional Opportunities. Hydro-Klean, LLC will take (Name of Company) whatever steps are necessary to ensure that our total work force has adequate minority, female, and local representation. We will utilize the following methods in our recruitment attempts: 1. Local advertising media (newspapers, radio, TV); 2. Community organizations (churches, clubs, schools); 3. Public and private institutions in the area (UNI, Hawkeye Community College); 4. Job Service of Iowa; and 5. Other. Hydro-Klean, LLC will seek qualified minority, (Name of Company) female, and local group applicants for all job categories and will make asserted efforts to increase minority, female and group representation in occupations at the higher levels or skill and responsibility. E. All sources of employment used shall be aware that we are an Equal Employment Opportunity Employer. Labor organizations representing our employees will be notified of our Equal Employment Opportunity Policy and Affirmative Action Program. 3 F. Training, upgrading, promotion and transfer activities at all levels will be monitored to ensure that full consideration has been given to qualified minority, female, and local group employees. G. Hydro-Klean, LLC will encourage other (Name of Company) companies with whom we are associated and/or do business, to do the same and we will assist them in their efforts. H. Hydro-Klean, LLC has taken the following (Name of Company) Affirmative Action to ensure that minority, female, local contractors and/or suppliers were provided opportunities to negotiate and/or bid on this project: (if none, write "NONE") 2. Sent out RFQ's to local and minority contractors As a result of the above efforts, we have involved minority, female, and local contractors and/or suppliers in the following areas of subcontracting: (if none, write "NONE") 1. None- Project was outside of territory they cover. 2. J. Hydro-Klean, LLC will require approved (Name of Company) Affirmative Action Programs from all nonexempt contractors who propose to work on this project and will take whatever steps are necessary to ensure that non - minority contractors have adequate representation of minority, female and local persons in their total work force. K. In further accordance with rules and guidelines issued pursuant to Executive Order 11246 as amended, we establish the goals for our company, based on parity percentages supplied by the City, and we realize these goals will be reviewed on an annual basis. L. Hydro-Klean, LLC will keep records of (Name of Company) specific actions relative to recruitment, employment, training, upgrading and promotion and will provide the City of Waterloo with any information relative to same, including activities of our SUBCONTRACTORS and suppliers as necessary or when requested. M. Parity figures for companies located in Waterloo are as follows: N. Minority Parity = .08 (8%) Hydro-Klean, LLC (Name of Company) Affirmative Action Employment Goals: The definition of Affirmative Action Goals is as follows: "Goals may not be rigid and inflexible quotas which must be met, but must be targets, reasonably attainable by means of applying every good faith effort to make all aspects of the entire Affirmative Action Program work." For the year 201 7, please submit percentage targets for employing minorities and women. If you already have reached your target for hiring minorities and women, please submit that percentage. *Goals for Minorities: ok Goals for Women: *Your affirmative action goals should be between 1% and 10% or more for minorities and 1% and 5% or more for women. Please be advised that the goals or targets are purely your estimation of how many women and minorities your company can reasonably expect to hire in 201 . Note, that none of the goals are rigid or inflexible. They are targets that your company calculates as reasonably attainable. This will help the City in its monitoring procedures as required by City of Waterloo Resolution No. 1984- 142(4). -5 - CONTRACTOR'S TOTAL WORK FORCE (WATERLOO) NAME AND ADDRESS JOB CATEGORY RACE SEX HOURLY WAGE INDICATE: DISABLED VETERAN: DV VIETNAM ERA VETERAN: W HANDICAPPED: H -6 - We hereby certify that we are in compliance with all City and Federal Affirmative Action Regulations and agree to accept all liability for failure to comply. Respectfully submitted, By: Com yany xecu ' e 3/2/2017 By: Date Equal Employment Opportunity Officer City of Waterloo Affirmative Action Officer Approved Disapproved Reason: By: Date: -7 - MBEIWBE BUSINESS ENTERPRISE PRE-BID CONTACT INFORMATION FORM Prime Contractor Name: Hydro-Klean, LLC Project:FY 2017 CIP Pipeliningetting Date: /2/2017 Phase IIIA NO MBEIWBE SUBCONTRA -S: ;If you'are NOT using any MBENVBE.scontractors to complete this project, sign below. Attach a brief explanation as to why subcontracting was not -asie w hj" project. If any MBNVBE sybcon t�actors will be used, please use the bottom portio r} of this form. Contractor Signature: Title: A ei,1.9'..for- Date: C�///a-0/7 SUBCONTRACTORS APPLICABLE: You are required, in order for your bid to be considered responsive, to provide 'the'information on this form showing ALL of your MBENVBE subcontractor contacts made for your bid submission. This information is subject to verification. Any questions should be directed to Contract Compliance Office 319-291-4429. You are required, in order for your bid to be considered responsive, to provide the information on this Form showing your MBENVBE Business Enterprise contacts made prior to your bid submission. This information is subject to verifications and confirmation. If you are unable to identify MBENVBE firms to perform portions of the work, please contact Louis Starks, Contract Compliance Officer, for assistance at (319) 291- 4429. In the event it is determined that the MBENVBE Business Enterprise goals are not met, then before awarding the contract the City of Waterloo will make a determination as to whether or not the apparent successful low bidder made good faith efforts to meet the goals. TABLE OF INFORMATION SHOWING BIDDER'S PRE-BID MBEIWBE BUSINESS ENTERPRISE CONTACTS Quotes Received Quotation Used in Bid MBEIWBE Subcontractors Dates Contacted Yes/No Dates Contacted Yes/No Dollar Amount Proposed to be Subcontracted None. Location and work type. (Form CCO-4) Rev. 06-20-02 MBE/WBE PARTICIPATION AECOM 60504645 CONTRACT NO. 919 M-6 OF 6 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 Tots, 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,sub ontra t or ix all subcontracts during a period (i.e., quarterly, semiannually, or annus Iy). , �1 3/2/2017 Date Signature Paul Govoni- Vice President 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 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: Hydro-Klean, LLC Address: 333 NW 49th Place, Des Moines, IA 50313 Contact Person: pa oni Signature: j Phone Number: 515-283-0500 E -Mail Address: pgovoni@hydro-klean.corn Check if Prime Contractor is: ❑ Minority -Owned ❑ Women -Owned SRF -4 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.e_pls.gov/ 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 a fine of up to $10,000 or imprisonment for up to 5 years, or both. Paul Govoni- Vice President Typed Name--& Title o " Autf}orized Representative 3/2/2017 Signature of'Authoriz'ed Representative Date ❑ 1 am unable to certify to the above statements. My explanation is attached. EPA Form 5700-49 (11-88) SRF -3 May 2015 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, Hydro-Klean, LLC as Principal, and Merchants Bonding Company (Mutual) as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called "OWNER." In the penal sum ---Five Percent of the Bid Submitted— Dollars ($, ---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 the 2nd day of March , 2017 ,for FY 2017 CIP Pipelining Phase IIIA, Waterloo, Iowa - City Contract No. 919 NOW, THEREFORE, (a) if said Bid shall he 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 fumish 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 arid 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 aro corporations, have caused their corporate seals to be hereto affixed and these presents to be signed by their proper officers this 21st day of February , A,D, 2017 4Mer Wit ss Witness SunnBartenhagen 13y Hydro-Klean _ LC Princip s Bondin ompany (Mutual) (Seal) Attorney-in-fact Anne Crowner _(Seal) (Title)