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FORM OF BID OR PROPOSAL
F.Y. 2017 SERGEANT ROAD TRAIL BRIDGE NO. 1 REPLACEMENT
CONTRACT NO. 917
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
1. Th undersigned, being a Corporation existing under the laws of the State of
, 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 F.Y. 2017 SERGEANT ROAD TRAIL BRIDGE NO. 1
REPLACEMENT, Contract No. 917, all in accordance with the above -listed
documents and for the unit prices for work in place for the following items and
quantities:
F.Y. 2017 SERGEANT ROAD TRAIL BRIDGE NO. 1 REPLACEMENT
CONTRACT NO. 917
BID
ITEM
DESCRIPTION
UNIT
EST. QTY.
UNIT BID
PRICE
TOTAL. BID PRICE
1
Mobilization
LS
1
$ f 5?X)
$ `IS�oo
2
Traffic Control
LS
EACH
1
4
$.1)A5-6
$ /00
$ (ASO.-
ASO-3
$ «) 0
3
Safety Closure
4
Remove Bridge
LS
1
$ 6, S -Z)('
$ 6 5 oG ,.
5
Remove Trail
SF
120
$ 760 —
$ 7Uo
6
Excavation, Class 10, Waste
CY
80
$ /) —
$ A°d --
7
Embankment-In-Place, Contractor
Furnish
CY
410
$ )3 f
$ a� 33o
8
Compaction with Moisture and
Densit Control
CY
410
$ ) 2.-_
$ 615
9
Recreation Trail, PCC, 6"
SY
103.7
$ 56'
$ 6)d/`/ ----
10
Granular Subbase, 6"
TON
47.5
$g
$ leo —
11
Granular Shoulder, 6"
TON
13.5
-
$ r6
$ 35
12
Culvert, Concrete Roadway Pipe, 48"
LF
96.0
$ /- U —
$ /� W)
FORM OF BID
CONTRACT NO. 917
Page 1 of 3
13
Apron, Concrete, 48"
_ EACH
6
$ 1) 72,5-
$ /())65-6 --
14
Erosion Stone
TON
• 20.0
$ (4 —
$ ,c/;‘) `
15
Furnish and Spread Topsoil, 6"
r--
CY
80
$ 4 1 -
$ r fid`'
16
Seedin• & Fertilizins, Urban
ACRE
0.66
$ 3 `%Sof
$ 667 --
17
17
Seedin• & Fertilizin•, Rural
ACRE
0.42
$ (' `'
$ 3,93
18
Rolled Erosion Control Product,�1
RECP
SY
311.7
$ —
$ J!5 7
19
Silt Fence, Install
LF
410
$ 9
$ I lay '''--
20
Silt Fence Remove
LF
410
$ /
$ cir`) —
21
Construction Entrance
LS
1
$ ! `)
$ 6. 5°
TOTAL BID
$ C?&) i`. S
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
Dollars ($ ) in the form of
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 ( ), 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.
FORM OF BiD
CONTRACT NO. 917 Page 2 of 3
L.:
9. The bidder has received the following Addendum or Addenda:
Addendum No. Date
10. The bidder shall list the MBENVBE 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.
LS-fruc-S' 1�(
(N a of Bidder) (Date)
Title
Official Address: (Including Zip Code):
1? O.',BO /may
1Qe J'F,q 5-0619
;'. I.R.S. No. C / L/ L/3O
FORM OF BID CONTRACT NO. 917 Page 3 of 3
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of X; 9 )
County of ru ren e r )
)ss
, being first duly swom, deposes and says that:
1. He is (Owner Partner. Officer Representative, or Agent) , of L C- &n5►rkcit obi ..Ac
, 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) `
`�
6w„e✓'
(12 -tin - Title
313Vcd and sworn to before me this v1
�oei 20110 A/ /
1/
day of
My commission expires Partin 151 620(
Title
4.skA[ MELODY KIEWIET
o
Z ACOMMISSION NUMBER 795107
MY COMMISSION EXPIRES
�OWP March 15, 2019
c.
s.
RESIDENT BIDDER CERTIFICATION
CONTRACT NO: qI 7
PROJECT NAME: Fy. oar% s -1- R,C -f•ch; 1 BW61-3fc
DATE OF LETTING:
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.
COMPANY NAME La Cc45-i-nAi i c •
CORPORATE OFFICER
TITLE
DATE 6
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Quotes Received Quotation used in bid
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(Form CCO-4) Rev. 06-20-02
BID BOND
KNOW ALI. MEN BY THESE PRESENTS, that We, Lodge Construction, Inc.
as Principal, and North American Specialty Insurance Company
as Surety are held and firmly bound unto the CITY OF WATERLOO Iowa, hereinafter called
"OWNER." In the penal sum Five Percent of Amount Bld
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 8th day of September
2016 for FY 2017 Sergeant Road Trail Bridge No. 1 Replacement,
Waterloo, Iowa, Contract No. 917
NOW, THEREFORE,
(a) If said Bid shall be rejected, or in the alternate,
(b) If said 131d 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 falls to execute the contract and provide the bond as
provided In the specifications or by taw.
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.
fN 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 Stn day of September
A. D. 201 6
Witness
Witness Stac
erican S
r -
Su
/like•:
Lodge Construction, Inc, /16 e /
—.._._ (Seal)
Principal
(Title)
cialty Insurance Company(Seal)
orney-in-fact
1
EQUAL OPPORTUNITY
CLAUSE
(As provided in Executive
Order No. 11246)
All contractors,, subcontractors, vendors
business the City and value and suppliers
doing thousand dollars with 000.00 of
of said business equals
and services
annually agree as follows; 4uals or exceeds ten
1. The contractors
will not , subcontractor, vendor and supplier
discriminate against any employee or
because of race of goods and services
mental or ' color, creed, sex, national origin,
applicant is e
contractor, physical handicap,9 economic status,
ActioAction 'subcontractor, vendorpollfical opinions or
programand supplier will develop an i The
n
are treated ensure that
emp
creedcreed during employment wpplicants are employed Affirmative
color, sex, national origin, religion, without re and that
,
color,
sexy, natipolitional
opinions
regard to their race,
physicinclude but notbePinions economic status, age, mental or
limited to the following; affiliations. Such
actions shall
a. Employment
b. Upgrading
c. Demotion or Transfer
d. Recruitment and Advertising
f Ratee. s of ff r ay orTermination
f. Selection for Training
Forms of Com
2 9 Including Apprenticeship ion 1
The contractor, PPrenticeship
will in subcontractor, vendor and supplier
all solicitations
ces
will,
qualified applicants will or re advertisements for loyees s and
regard to consideration for Seryl all
t
age, mental race,r creed, color, sex, o state that
physical disabilities political
l opinion
religion,employment without
3. � political opinion raffiliations. lc status,
bargaining The contractor, subcontractor,
of workers which pr, s ubco t , vendor and supplier
re will send to each labor nor his/herrcollective
contractor he/she has a collective bargaining
union or re
representative understanding, a notice gainla Presentative
of the contractor's commitment
said r this s union
r or other
4. mitment under this section.
r workers'
The contractor, subcontractor, venes
dored and suppliergoods an
will
Com of Waterloo regulatiodirectives, of d order of
Provisions.thAffirmative Action
Program Contract and order of
Compliance
EQUAL OPPORTUNITY CLAUSE
PAGE 1 OF 2 PAGES
Revised February 2003
CONTRACTOR'S OR SUBCONTRACTOR'S AFFIRMATIVE ACTION PROGRAM
Check box that applies to party completing program:
(
) General Contractor
Subcontractor
I. Section A to be completed by GENERAL CONTRACTORS only:
A.
Name of Company Looe cL4 C- -
Address of Company Pa. Pox 4/51 cArk9h//l ip cp6I
Telephone Number (3 / 1 ) 3cj— G STO
Federal ID Number (if no Federal ID Number, Owner/President's Social
Security Number) 1/7—E2e/egega_
Name of Equal Employment Officer Sieve Loc,(✓ c.
Name of Project FX 0 Cr P,£. _rm ..1 861(11.5"e' .jam (i',6.Eev'le -
Project Contract Number /-"7
Estimated Construction Work Dates //`/—/&
Start Finish
Section B to be completed by SUBCONTRACTORS only:
B.
Name of General or Prime Contractor
Name of Subcontractor
Subcontractor's Address Zip
Subcontractor's Telephone Number )
Subcontractor's Federal ID Number (if no Federal ID Number
Owner/President's Social Security Number)
•
Name of Equal Employment Officer
-1 -
C. Remainder of program to be completed by party completing program,
either Prime or Subcontractor.
1. The Owners and/or Principals of your company:
Ethnic
Name Address Position Sex Origin
s# . t.a5f P.O B°x
G t,-- vie,/
nzt
c (h i tc5,1 1je 'f%" lv (
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:
Type of
Name Address Affiliation Degree
II. 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
-2 -
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. 1"1-j J rc-43-4r'c4 — c - will give training
(Name of Company)
and employment opportunities to local residents of Waterloo, Iowa, to
the greatest extent feasible.
III. AFFIRMATIVE ACTION
A. recognizes that the
(Name of Company)
effective application of a policy of merit employment involves more than
just a policy statement, and Gm6yG -
(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.
B. /_.eye GG��s � -7� � ' .,- c.- 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.
C. G o o (c-,t3will 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
6. Other.
-3 -
D. Z ' 5cwill 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.
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.
Lc,d-sc. - 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. LpWSc. CPKs r u' -t. - 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")
1. 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.
2.
Seel k4.5
c 1-+'f" i
J. t 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.
F
is
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. 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:
Minority Parity = .08 (8%)
L�v�jIJE C,t�c
(Name of Company)
Employment Goals:
Affirmative Action
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,, 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:
Goals for Women: 2
*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
sq-&ue GtL,e
CA.,.ti..s
Ci
M
e-Ieri
Sit Gdd-ye-
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&Ll
pi. )c Re s6---"
Pi La-y&AlG
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-lc
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INDICATE:
DISABLED VETERAN: DV
VIETNAM ERA VETERAN: VV
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:
Company Executive
Date
By:
Equal Employment
Opportunity Officer
Date
City of Waterloo Affirmative Action Officer
Approved
Disapproved Reason:
By:
Date:
7