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FORM OF BID OR PROPOSAL
F.Y. 2017 REPAIRS TO 6TH ST., 18TH ST., AND ANSBOROUGH AVE. BRIDGES
CONTRACT NO. 916
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 Iowa
a Partnership consisting of the following partners: Peterson Contractors, Inc.
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 AECOM 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 REPAIRS TO 61ST., 18TH ST., AND
ANSBOROUGH AVE. BRIDGES, Contract No. 916, 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. 2014 REPAIRS TO 6TH ST., 18TH ST., AND ANSBOROUGH AVE. BRIDGES
CONTRACT NO. 916
Item
No.
Ref. No.
;Description .'
unit;
I Est .,
Qty..
Unit Bid Price
Total Bid Price
1
2
2403-0100000
STRUCTURAL CONCRETE
(MISCELLANEOUS)
CY
6.6
$
2404-7775005
REINFORCING STEEL, EPDXY
COATED
LB
700.0
$
3
2413-1200100
NEOPRENE GLAND
INSTALLATION AND TESTING
LF
584.0
$
$
4
5
2426-6772016
CONCRETE REPAIR
SF
22.0
$
2426-6772020
PARTIAL DEPTH BRIDGE DECK
FINISH PATCH
SF
255.0
$
$
6
2518-6910000
SAFETY CLOSURE
EACH
32.0
$
7
2526-8285000
CONSTRUCTION SURVEY
LS
1.0
$
8
2528-8445110
TRAFFIC CONTROL
LS
1,0
$
$
9
2533-4980005
MOBILIZATION
LS
1.0
$
$
10
2599-9999005
FURNISH AND INSTALL LIGHT
POLE ANCHOR BOLT COVERS
EACH
40.0
$
$
11
2599-9999005
REMOVE AND REPLACE
EXPANSION JOINT CURB PLATE
EACH
6.0
$
$
FORM OF BID
AECOM #60509356
SEE ATTACHED BID SHEET FOR UNIT PRICING
CONTRACT NO. 916
FB -1 of 3
6'"118`"/Ansborough Bridge Repairs
fltrt�
�No`v
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T � `'�Desgrr tion r � s �
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' "�Umf
� a
��J�Ik Bid'Pnce�
(ot�l Brd Prioe z'
'.". zl
12
2599-9999005
FURNISH AND INSTALL
EXPANSION JOINT
COVERPLATE
EACH
10.0
$
$
13
2599-9999009
REMOVE EXISTING FLOOD
WALL CHANNEL
LF
31.3
$
14
2599-9999009
FURNISH AND INSTALL FLOOD
WALL CHANNEL
LF
31.3
$
15
2599-9999009
REMOVE EXISTING UTILITY BOX
FRAME
LF
19.0
$
$
16
2599-9999009
FURNISH AND INSTALL UTILITY
BOX FRAME AND COVERS
LF
19.0
$
$
17
2599-9999010
FURNISH AND INSTALL
DEFLECTOR PLATE
LS
1.0
$
$
TOTAL BID
$227,407.50
2. It is understood that the quantities set forth are approximate only and subject to variation and that the
unit bid price for the work done shall govern in the actual payment to Contractor.
3. In submitting this bid, the bidder understands that the right is reserved by the City of Waterloo, Iowa,
to reject any or all bids. If written notice of the acceptance of this bid is mailed, telegraphed, or
delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter
before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the
prescribed form and furnish the required bond and certificate of the insurance within ten (10) days
after the agreement is presented to him for signature, and start work within ten (10) days after
"Notice to Proceed" is issued.
4. Security in the sum of 5% of the bid amount Dollars
($ ) in the form of a bid security , 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:
Addendum No.
01 Date 8/15/2016
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)
FORM OF BID CONTRACT NO. 916 FB -2 of 3
AECOM #60509356 61"/18`"/Ansborough Bridge Repairs
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.
PETERSON CON " ' : '"+1%
me .f,. eer)
PIA
BY: A //4110.,
INC.
8/18/2016
(Date)
1-itle
Official ids - s: (Includig Zip Code):
104 BLACKHAWK STREET
REINBECK, IA 50669
I.R.S. No. 42-0921654
FORM OF BID CONTRACT NO. 916 FB -3 of 3
AECOM #60509356 6'/10 "iAnsboruugh BI idge Repairs
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of IOWA
County of GRUNDY
)ss
}
C✓d r i .-Pe-AY--rsoin
, being first duly sworn, deposes and says that:
1. He is (Owner, Partner, Officer, Representative, or Agent) , of PETERSON CONTRACTORS,
INC . , 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 •, oper and are not tainted by
any collusion, conspiracy, connivance or unlawful a t on th- •. of the Bidder or
any of its agents, representatives, owners, emplo : including this
affiant.
(Signe
Title
Subscribed and sworn to before me this 18TH day of
AUGUST , 2016.
`L
My commission expires
@e fOfERT J. WATERMILLER, JR.
misslonittumt�er 77 1313
My Comm'ssion Expires
January 24, 2018
Title
NON -COLLUSION AFFIDAVIT CONTRACT NO. 916 NCA -1 of 2
AECOM #60509356 6'"/18th/Ansborough Bridge Repairs
RESIDENT BIDDER CERTIFICATION
CONTRACT NO: 920
PROJECT NAME: F.Y. 2017 REPAIRS TO 6TH ST. , 18TH ST. , AND ANSBOROUGH AVE BRIDGES
DATE OF LETTING: 8/18/2016
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 PET
CORPORATE OFFICER
TITLE
DATE 8/18/2016
RESIDENT BIDDER CONTRACT NO. 916 RB -2 of 3
AECOM #60509356 61b/18th/Ansborough Bridge Repairs
MBE/WBE BUSINESS ENTERPRISE
PRE-BID CONTACT INFORMATION FORM
6TH, 18TH, ANSBOROUGH
Prime Contractor Name: PETERSON CONTRACTORS, INC. Project: BRIDGE REPAIRS
Letting Date: 8/18/2016
NO MBEIWBE SUBCONTRACTORS: If you are NOT using any MBE/WBE subcontractors to complete this project, sign below. Attach a brief
explanation as to why subcontracting was not feasible with this project. If any MBENVBE subcontractors will be used, please use the bottom
portion of this form.
Contractor Signature:
Title: PROJECT MANAGER Date: 8/18/2016
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 MBE/WBE 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 MBE/WBE Business
Enterprise contacts made prior to your bid submission. This information is subject to verifications and confirmation.
If you are unable to identify MBE/WBE 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
MBE/WBE BUSINESS ENTERPRISE CONTACTS
Quotes Received Quotation used in bid
MBEIWBE
Subcontractors
Dates Yes/No Dates
Contacted Contacted
Yes/No Dollar Amount Proposed to
be Subcontracted
NO MBE/WBE SUBCONTRACTORS CONTACTED: TRAFFIC CONTROL
WILL BE THE ONLY WORK SUBCONTRACTED.
(Form CCO-4) Rev. 06-20-02
MBENVBE PARTICIPATION
AECOM #60509356
CONTRACT NO. 916 M-6 of 6
6t1718'"/Ansborough Bridge Repairs
INFORMATION NEEDED
FOR
IOWA CONSTRUCTION SALES TAX EXEMPTION CERTIFICATE
CONTRACTOR NAME: PETERSON CONTRACTORS, INC.
ADDRESS: 104 BLACKHAWK STREET
REINBECK, IA 50669
(Check One) PRIME X SUBCONTRACTOR
FEDERAL ID#: 42-0921654
PROJECT NAME: REPAIRS TO 6TH ST„ 18TH ST. AND ANSBOROUGH AVE BRTDQES
PROJECT CONTRACT NO.: 916
DESCRIPTION OF WORK:
❑ Brickwork
N Carpentry
N Concrete
❑ Drywall -Plaster -Insulation
❑ Electrical
N Excavation/Grading
❑ Flooring
N Heavy Construction
❑ Heating -Ventilating -Air Cond.
❑ Landscaping
[1 Painting
N Paving
O Plumbing
❑ Roofing -Siding -Sheet Metal
❑ Windows
N Wrecking -Demolition
❑ Other (Please specify)
SALES TAX EXEMPTION CONTRACT NO. 916 STE-1 of 1
AECOM #60509356 6'"/18'"/Ansborough Bridge Repairs
PETERSON CONTRACTORS, INC.
www.petersoncontractors.com
104 Blackhawk Street
PO. BoxA
Reinbeck, Iowa 50669
Phone: 319-345-2713
QUOTE
PROPOSAL FOR: 6TH ST 18TH ST ANSBOROUGH AVE BRIDGE REPAIRS - 916
THE FOLLOWING ITEMS AND PRICES ARE QUOTED:
ITEM # DESCRIPTION
10 STRUC CONC
20 REIN STEEL (EPDXY)
30 NEOPRENE GLAND INSTALL/TEST
40 CONC REPAIR
50 PARTIAL DEPTH DECK PATCH
60 SAFETY CLOSURE
70 CONSTRUCTION SURVEY
80 TRAFFIC CONTROL
90 MOBILIZATION
100 FURNISH/INSTALL LIGHT POLE ANCH
110 REMOVE/REPLACE EXPANSION JOINT
120 FURNISH/INSTALL EXPANSION JOINT
130 REMOVE EXISTING FLOOD WALL CHAN
140 FURNISH/INSTALL FLOOD WALL CHAN
150 REMOVE EXISTING UTILITY BOX FRA
160 FURNISH/INSTALL UTILITY BOX FRA
170 FURNISH/INSTALL DEFLECTOR PLATE
TOTAL QUOTED AMOUNT:
PETERSON CONT AC ,.RS, INC.
UNIT TYPE QUANTITY
CY 6.600
LBS 700.000
LF 584.000
SF 22.000
SF 255 000
EA 32.000
LS 1.000
LS 1.000
LS 1.000
EA 40.000
EA 6.000
EA 10.000
LF 31. 300
LF 31. 300
LF 19.000
LF 19.000
LS 1.000
UNIT PRICE
1, 085.00
3. 75
141.50
375.00
111.00
50.00
5, 000. 00
14, 700. 00
10, 000. 00
110.00
1,100.00
1, 341.00
190.00
345.00
425.00
700.00
4, 600. 00
Fax: 319-345-2991
TOTAL AMOUNT
7, 161.00
2, 625. 00
82,636.00
8, 250. 00
28, 305. 00
1, 600. 00
5, 000.00
14, 700.00
10, 000. 00
4, 400. 00
6, 600. 00
13, 410. 00
5, 947. 00
10, 798. 50
8, 075. 00
13, 300. 00
4, 600. 00
227, 407.50
Fftf:r Br.. Nf
1‹.N(.7.)\A! ,nl:i."r 1;'t" FI it ::;i 'ic ,`_{ is r` th::a Peterson Contractors, Inc.
Travelers Casualty and Surety Company of America
;is purely arc held and firmly bound unto the CIITYOF WATERLOO R{ t ; _._..- i;>
"OVVN1_R." In the penal: sum ,---Five Percent of Amount of Bid ---
Dollars ($ ---5%--- ) {awful 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 thft5 obligation is such
that whereas the Principal has submitted the accompanying bid dated the 18th day of
August , 2016 , for FY 2017 Repairs to 6th St., 18th St.,
and Ansborough Ave. Bridges, Contract No. 916, Waterloo, Iowa
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 boni.l 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 andseals,
and such of them as are corporations, have caused their corporate seals to he hereto affixed and
these presents to be signed by their proper officers this 8th day of August A.D.
2016.
_(seal)
(Seal)
Witness
BID BOND
AECOM #60509356
Peterson Contractors, Inc.
Princip
By
J
(Titlpres jdent
Traveler Casualty and Su et ompany of America
Suret
By
Attorney-in-fact/ Dion . Young
CONTRACT NO. 916 E36-1 of 1
69718'"/Ansborough Bridge Repairs
TRAVELERS .1
Attorney -In Fact No.
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
POWER OF ATTORNEY
Farmington Casualty Company
Fidelity and Guaranty Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc.
St. Paul Fire and Marine Insurance Company
St. Paul Guardian Insurance Company
226103
St. Paul Mercury Insurance Company
Travelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
Certificate No. 0 067 9 8323
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian insurance
Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the
laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint
Craig E. Hansen, Jay D. Freiermuth, Brian M. Deimerly, Cindy Bennett, Anne Crowner, Tim McCulloh, Stacy Venn, Lacey Cramblit, Shirley S.
Bartenhagen, and Dione R. Young
of the City of West Des Moines , State of Iowa , their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 17th
day of May 2016
Farmington Casualty Company
Fidelity and Guaranty Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc.
St. Paul Fire and Marine Insurance Company
St. Paul Guardian Insurance Company
St. Paul Mercury Insurance Company
Travelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
State of Connecticut
City of Hartford ss.
By:
Robert L. Raney,: Senior Vice President
On this the 17th day of May 2016 before me personally appeared Robert L. Raney, who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul
Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers
Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
In Witness Whereof, I hereunto set my hand and official seal.
My Commission expires the 30th day of June, 2021.
58440-5-16 Printed in U.S.A.
\OkGtftidt C
.
Marie C. Tetvault, Notary Public
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER