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FORM OF BID OR PROPOSAL
FY 2018 ANSBOROUGH AVENUE IMPROVEMENTS
FROM U.S. 20 TO SAN MARNAN DRIVE
CITY CONTRACT NO. 942
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
1.Ther 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 FY 2018 Ansborough Avenue Improvements
From U.S. 20 to San Marnan Drive, City Contract No. 942, all in accordance with the
above -listed documents and for the unit prices for work in place for the following items
and quantities:
FY 2018 ANSBOROUGH AVENUE IMPROVEMENTS
FROM U.S. 20 TO SAN MARNAN DRIVE ,
CITY CONTRACT NO. 942
BID
ITEM
DESCRIPTION
UNIT
EST.
QTY.
UNIT BID
PRICE
TOTAL BID
PRICE
Division 1
1
EXCAVATION, CLASS 10, ROADWAY AND
BORROW
CY
3150
$ /� '�
$3PO
Q
2
TOPSOIL, FURNISH AND SPREAD
CY%
2175
$ a—
-
$ 76 As
3
MODIFIED SUBBASE
CY
808
$ 1
$ 37� q76
4
STANDARD OR SLIP FORM PORTLAND CEMENT_
CONCRETE PAVEMENT, CLASS C, CLASS 3
DURABILITY, 10 IN.
SY
2510
$ I i I
..
$ j,9 } c fio
1 `/U
5
PORTSAMPLAND CEMENT CONCRETE PAVEMENT S
LS
1
$ 3)000
$ 3000
6
REMOVAL OF SIGN
EACH
4
$ 50 `
$0200
8
INTAKE, SW -507
EACH
2
$ S)
}�
$ 1O/oJ
FORM OF BID
CITY CONTRACT NO. 942
BF -1 of 5
9
INTAKE, SW-509
EACH
6
$ 51775
$ 3 r) 0-0
10
SUBDRAIN, PVC, STANDARD, PERFORATED, 6
IN.
LF
1504
$ f�
$ p)O y
y
11
SUBDRAIN OUTLET, DR-303
EACH
20
$ 0.3-o ✓
$ ,oa6
12
STORM SEWER GRAVITY MAIN, TRENCHED,
REINFORCED CONCRETE PIPE (RCP), 2000D
(CLASS III), 15 IN.
LF
91
$ / '�
1v
$ Jp) )pC7
(
13
STORM SEWER GRAVITY MAIN, TRENCHED,
REINFORCED CONCRETE PIPE (RCP), 2000D
(CLASS III), 18 IN.
LF
24
.---
$ �
---
$ 2
14
REMOVE STORM SEWER PIPE LESS THAN
OR EQUAL TO 36 IN.
LF
86
$ )
/
$ i>a9a
REMOVAL OF PAVEMENT
SY
706
$ 1 �1S —
$ Q) L/ /IC
U
Vol
16
REMOVAL OF INTAKES AND UTILITY ACCESSES
EACH
3
r
$ �'��
'
$
17
RECREATIONAL TRAIL, PORTLAND CEMENT
CONCRETE, 6 IN.
SY
75
$ t-%�
!!
,)
$ 3) V
18
REMOVAL OF SIDEWALK
SY
155
$ y r.-
'
$ 1> ,Ryo
o
19
SIDEWALK, P.C. CONCRETE, 4 IN.
SY
31
$ GlV
$) 7
20
SIDEWALK, P.C. CONCRETE, 6 IN.
SY
110
$ 0
/ Q
$ //(p
21
DETECTABLE WARNINGS
SF
125
$ 56 '�
�]
$ o�j(�
22
CURB AND GUTTER, P.C. CONCRETE, 1.5 FT.
LF
1586
$ /
$ I r °,3A
23
CURB AND GUTTER, P.C. CONCRETE, 2.0 FT.
LF
76
$� f
oJ�
$ )) /-4
24
REOTABNING WALL RETE SIDEWALK AND
CY
79
$;03 r
$ 3 /35770
25
REMOVE AND REINSTALL SIGN AS PER PLAN
EACH
9
$ 02,25-
$ a)daS�
26
PERFORATED SQUARE STEEL TUBE POSTS
LF
4
$ /
$6/PERFORATED
27
STEEL TUBE POST
ANCHOR, BREAK-AWAY SOIL IN STALLATION
EACH
4
n
$ �� v
%
$'/ coo'
28
TYPE A SIGNS, SHEET ALUMINUM
SF
86
$ 13
$i)iI6 I
29
TRAFFIC SIGNALIZATION
LS
1
$(20)00°
y
$2/ O)o�U /
30
OR SOLVENT-BASEDPAINTED PAVEMENT MARKING, WATERBORNE
STA
49
$ SU
$.)U l
PAINTED SYMBOLS AND LEGENDS,
WATERBORNE
OR SOLVENT-BASED
EACH
17
$ 1 x'1o�5-
$ //15"31
)
32
PAVEMENT MARKINGS REMOVED
STA
31
.r
$ 37
$ 77
33
SYMBOLS AND LEGENDS REMOVED
EACH
12
$ i 3.5-
$ tj S-(0 p
34
TEMPORARY BARRIER RAIL, CONCRETE
LF
1617
$'
$ 41) 1%
FORM OF BID
CITY CONTRACT NO. 942
BF -2 of 5
35
TRAFFIC CONTROL
LS
1
$ �dQo
$ ',Dele'
36
FLAGGERS
EACH
25
$54.°
$M�S-DO
37
MOBILIZATION
LS
0.92
T
$5Cy00
$ 4/6000
)
38
TEMP CRASH CUSHION
EACH
6
'
$ I
-
$ 9�%C
� / `�O
39
CONVERT RA -40 INTAKE TO SW -406 MANHOLE
EACH
1
$ j1 O
'
$ V 060
40
CONVERT RA -70 INTAKE TO SW -406 MANHOLE
EACH
5
$1rl��o
$ deo%a d O
41
INTAKE PROTECTION
EACH
8
$ �G r
$ j Q06
42
MAINTENANCE OF INTAKE PROTECTION
EACH
8
$63r
�/
$sGy�
43
REMOVAL OF INTAKE PROTECTION
EACH
8
$
$ 3-6 /
44
TEMPORARY PAVEMENT SYMBOLS AND
LEGENDS
EACH
15
$32S----
i
$
J
46
TEMPORARY PAVEMENT MARKINGS
STA
42
)�
$ o '
$ SO/ Q�
47
SUBGRADE PREPARATION
SY
2845
$ 3
$ "> �3
48
MULCHING, BONDED FIBER MATRIX
ACRE
1
$JJ g�Q ---
$39001
49
SEEDING AND FERTILIZING (URBAN)
ACRE
1
$ `^J 900 `
$ )9e0, J
50
SILT FENCE
LF
540
$c
$ I on
54
PERIMETER AND SLOPE SEDIMENT CONTROL
DEVICE, 9 IN. DIA.
LF
1652
$02 -6
$ (/ )30.-
55
REMOVAL OF PERIMETER AND SLOPE
SEDIMENTCONTROL DEVICE
LF
1652
$ /
$ / ''3'-
Division 1 Total
$8631030
Division 2
1
EXCAVATION, CLASS 10, ROADWAY AND
BORROW
CY
350
$ ! J
r
$ 6J300
7
APRONS, CONCRETE, 12 IN. DIA.
EACH
2
$ y57) -
$ 1) 9QO I
17
RECREATIONAL TRAIL, PORTLAND CEMENT
CONCRETE, 6 IN.
SY
895
$ 31
$ 717/6
20
SIDEWALK, P.C. CONCRETE, 6 IN.
SY
5
$ 7r
$ 390 --
21
DETECTABLE WARNINGS
SF
40
$ 3 Sr-
$ /� 5-09-0-
37
MOBILIZATION
LS
0.06
$ /5-)0 0 0 -
$ '700--
45
VERT, CONCRETE ENTRANCE PIPE, 12 IN.
DIA.
LF
21
$ c0
$ Il / �Q -�
50
SILT FENCE
LF
710
$ a.-
$ t)ad --
51
51
SILT FENCE FOR DITCH CHECKS
LF
225
$ 3 v
$787 --5:°'
52
REMOVAL OF SILT FENCE OR SILT FENCE
FOR DITCH CHECKS
LF
1470
$
$ �J L/ 7 V��
/ !
FORM OF BID
CITY CONTRACT NO. 942
BF -3 of 5
53
MAINTENANCE OF SILT FENCE OR SILT FENCE
FOR DITCH CHECK
LF
1470
Division 2 Total
Overall Construction Total = Division 1 + Division 2
Division 1 — Ansborough Avenue from U.S. 20 to San Marnan Drive
Division 2 — Trail along north side of San Marnan Drive
$9dq v.�.s
2. It is understood that the quantities set forth are approximate only and subject to
variation and that the unit bid price for the work done shall govern in the actual
payment to Contractor.
3. In submitting this bid, the bidder understands that the right is reserved by the City
of Waterloo, Iowa, to reject any or all bids. If written notice of the acceptance of
this bid is mailed, telegraphed, or delivered to the undersigned within thirty (30)
days after the opening thereof, or at any time thereafter before this bid is
withdrawn, the undersigned agrees to execute and deliver an agreement in the
prescribed form and furnish the required bond and certificate of the insurance
within ten (10) days after the agreement is presented to him for signature, and
start work within ten (10) days after "Notice to Proceed" is issued.
%4. Security in the sum of S
Dollars ($ ) in the form of so cr
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
Bidder Certification ( ). (Mark one.)
), or Non -Resident
7 The bidder is prepared to submit a financial and experience statement upon
request.
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 3--x3-/e
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
FORM OF BID
CITY CONTRACT NO. 942 BF -4 of 5
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.
i%1AuGX 0,71 1 C-
3 (meq-/�
ame of Bidder) (Date)
BY: Ja\''‘ .13 Srn ;� Title
Official Address: (Including Zip Code):
c ).
I.R.S. No. 7
FORM OF BID
CITY CONTRACT NO. 942 BF -5 of 5
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of
County of /31c,.,c 14, )
, being first duly sworn, deposes and says that:
1. He is (Owner, Partner, Office epresentative or Agent) , of Ze1 Zj
re. .^4:. , 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;
Such Bid is genuine and is not a collusive or sham Bid;
4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives,
employees, or parties in interest, including this affiant, has in any way colluded,
conspired, connived or agreed, directly or indirectly, with any other Bidder, firm or person
to submit a collusive or sham Bid in connection with the Contract for which the attached
Bid has been submitted or to refrain from bidding in connection with such Contract, or
has in any manner, directly or indirectly, sought by agreement or collusion or
communication or conference with any other Bidder, firm or person to fix the price or
prices in the attached Bid or of any other Bidder, or, to fix any overhead, profit or cost
element of the bid price or the bid price of any other Bidder, or to secure through any
collusion, conspiracy, connivance, or unlawful agreement any advantage against the City
of Waterloo, Iowa, or any person interested in the Proposed Contract; and
5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by
any collusion, conspiracy, connivance or unlawful agreement on the part of the Bidder or
any of its agents, representatives, owners, employees, or parties in interest, including this
affiant.
(Signed)
Title
Subscribed and sworn to before me this 3"019'' 18 day of
M. -fa k , 2018.
My commission expires 3 -is- 0+`0 az)
NON -COLLUSION AFFIDAVIT PRIME
Sec.
Title
LINDA K SENN
COMMISSION NO. 803307
MY COMMISSION EXPIRES
3-ls-oWt2.0
CITY CONTRACT NO. 942 NCAP-1 of 1
Bidder Status Form
Tobe completed by all bidders Part A
Plese answer "Yes" or "No" for each of the following:
Yes ❑ No My company is authorized to transact business in Iowa.
(To help you determine if your company is authorized, please review the worksheet on the next page).
Yes ❑ No My company has an office to transact business in Iowa.
Yes ❑ No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail.
es ❑ No My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
Yes ❑ No My company is not a subsidiary of another business entity or my company is a subsidiary of another
business entity that would qualify as a resident bidder in Iowa.
If you answered "Yes" for each question above, your company qualifies as a resident bidder. Please
complete Parts B and D of this form.
If you answered "No" to one or more questions above, your company is a nonresident bidder. Please
complete Parts C and D of this form.
To be completed by resident bidders Part B
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates: / / °257cO/s— to / a / /,1/O Address: ZU, 1 e.< / S 1
City, State, Zip. Cf�' k5` t'/ , ._$Z /'
Dates: / / to / / Address:
City, State, Zip.
Dates: / / to / / Address:
You may attach additional sheet(s) if needed. City, State, Zip:
To be completed by non-resident bidders Part C
1. Name of home state or foreign country reported to the Iowa Secretary of State:
2. Does your company's home state or foreign country offer preferences to resident bidders, resident labor
force preferences or any other type of preference to bidders or laborers? ❑ Yes n No
3. If you answered "Yes" to question 2, identify each preference offered by your company's home state or foreign country
and the appropriate legal citation.
You may attach additional sheet(s) if needed.
To be completed by all bidders Part D
I certify that the statements made on this document are true and complete to the best of my knowledge and I know that my
failure to provide accurate and truthful information may be a reason to reject my bid.
�e s--
Firm Name: o �� r� l � ci
Signature:
Date: D -c -a
You must submit the completed form to the governmental body requesting bids per 875 Iowa Administrative Code
Chapter 156. This form has been approved by the Iowa Labor Commissioner.
309-6001 (09-15)
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(Form CCO-4) Rev. 06-20-02
BID BOND
KNOW ALL. 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 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 29th day of March
, 2018 , for FY 2018 Ansborough Avenue Improvements From U.S. 20 to San Marnan Drive, City
Contract No. 942
NOW, THEREFORE,
(a) If said Bid shall be rejected, or In the altemate,
(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 and agrees that the obligations of said Surety and its bond
shall be in no way impaired or affected by any extension of the time within which the Owner may accept
such Bid or execute such contract; and said Surety does hereby waive notice of any such extension.
IN WITNESS WHEREOF, the Principal and the Surety, have hereunto set their hands and seals, and such
of them as are corporations, have caused their corporate seals to be hereto affixed and these presents to be
signed by their proper officers this 27th day of March , A.D. 2018 ,
Witn= .s
By
Lodge Construction, Inc. Rai)
O
Principal
Nprt A ican Specialty Insurance Compar(Seal)
Witness Cind
Suret
nnett
Attorney-in-fact Anne Crowner
1 ,GLI�t"Y C'7
(Title)
I
SWISS RE CORPORATE SOLUTIONS
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
WESTPORT INSURANCE CORPORATION
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under
laws of the State of New Hampshire, and having its principal office in the City of Overland Park, Kansas and Washington International Insurance
Company a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland
Park, Kansas, and Westport Insurance Corporation, organized under the laws of the State of Missouri, and having its principal office in the City of
Overland Park, Kansas each does hereby make, constitute and appoint:
JAY D. FREIERMUTH, CRAIG E. HANSEN, BRIAN M. DEIMERLY, SHIRLEY S. BARTENHAGEN, CINDY BENNETT, ANNE CROWNER,
TIM McCULLOH„ STACY VENN, DIONE R. YOUNG, and WENDY ANN CASEY JOINTLY OR SEVERALLY
Its true and lawful Attomey(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: ONE HUNDRED TWENTY FIVE MILLION ($125,000,000.00) DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on March 24, 2000 and Westport Insurance Corporation by written consent of its Executive Committee dated July 18, 2011.
"RESOLVED, that any two of the President, any Senior Vice President, any Vice President, any Assistant Vice President,
the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached."
�,aoaStONwtuur%
yc Pt??;..... A4p
(4: �ORPOr� FSG,�
sEAL
m is
Stteev n 1. Anderson, Senior Vice President of Washington International Insurance Company
& Senior Vim President or North American Specialty Insurance Company
& Senior Vice President of Westport Insurance Corporation
a
By
Mitre A. Ito, Senior Vire President of Washington International Insurance Company
& Senior Vire President of North American Specialty Insurance Company
& Senior Vire President of Westport Insurance Corporalim,
IN WITNESS WHEREOF, North American Specialty Insurance Company, Washington International Insurance Company and Westport
Insurance Corporation have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this
this 3rd day of November , 20 17 .
State of Illinois
County of Cook
On this 3rd day of
ss:
North American Specialty Insurance Company
Washington International Insurance Company
Westport Insurance Corporation
November , 20 17, before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of
Westport Insurance Corporation and Michael A. Ito Senior Vice President of Washington International Insurance Company and Senior Vice President
of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation, personally known to me, who
being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the
voluntary act and deed of their respective companies.
1
OFFICIAL SEAL
M. KENNY
Notary Puhiic_ State of Illinois
My Commission Expires
1210412021
M. Kenny, Notary Public \l
I, Jeffrey Goldberg , the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company, Washington
International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a true and correct copy of a
Power of Attorney given by said North American Specialty Insurance Company, Washington International Insurance Company and Westport Insurance
Corporation which is still in full force and effect.
IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this27th day of March , 2018
Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company &
North American Specialty Insurance Company & Vire President & Assistant secretary of Westport Insurance Corporation