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Revised Per Addendum No. 1 - 04/30/2018
FORM OF BID OR PROPOSAL
FY 2018 BRIDGE AND CULVERT REPAIRS
CONTRACT NO. 950
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 ofi
, a Partnership consisting of the following partners: NIA
, 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 BRIDGE AND CULVERT REPAIRS, CONTRACT NO. 950, 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 BRIDGE AND CULVERT REPAIRS
CONTRACT NO. 950
BID
ITEM
REF. NO.
DESCRIPTION
UNIT
EST.
QTY.
UNIT BID
PRICE
TOTAL BID
PRICE
1
2107-0425020
COMPACTING BACKFILL
ADJACENT TO BRIDGES,
CULVERTS OR STRUCTURES
CY
10.0
$ i 3 .-.--,
$ 1 33(3 ""
2
2301-0685550
ASIPER PLAN APPROACH PAVEMENT,
SY
107.0
$ 33S
$357 8tts c
3
2413-1100000
PREFORMED ELASTIC
NEOPRENE JOINT
LF
48.0
$ —,5�
$ 36
4
2413-1200100
NEOPRENE GLAND
INSTALLATION AND TESTING
LF
143.0
$ '�
`�S
$ 0, ISS;
5
2426-6772016
CONCRETE REPAIR
SF
33.0
$ 1-70.r4'
$ 5 00:"
6
2426-6772020
PARTIAL DEPTH BRIDGE DECK
FINISH PATCH
SF
130.0
$ 1 q0.")
.'`)
$ 24''�00`
7
2511-7526004
SIDEWALK, P.C. CONCRETE, 4
SY
10.0
$ 24O0,i°
$
8
2518-6910000
SAFETY CLOSURE
EACH
4.0
$ 250. `U
$ t Cron."_
9
2528-8445110
TRAFFIC CONTROL
LS
1.0
$ i-Io�CX70,"
$ VU + CiJp "�
10
2529-8200200
PRESSURE RELIEF JOINT, CF
LF
56.0
$ LS'
$ Z S-20. e')
11
2533-4980005
MOBILIZATION
LS
1.0
$ 2:3-0a).'-'
$ 25 -vim
12
2599-9999005
HMA APPROACH REPAIRS
SY
50.0
$ b—t, Sp
$ -3 3.-t
13
2599-9999005
REPAIR GUARDRAIL AND
TIMBER POSTS
LF
120.0
$
$ "'
�`.
Deleted
4-4-
REPAIR TIPPED SIDEWALK RAIL
L�
1-:9
$ t-1 -
$ )- f
AND POSTS
FORM OF BID
AECOM #60569633
CONTRACT NO. 950
Page FB -1 of 3
FY 2018 Bridge and Culvert Repairs
Revised Per Addendum No. 1 - 04/30/2018
BID
ITEM
REF. NO.
DESCRIPTION
UNIT
EST.
QTY.
UNIT BID
PRICE
TOTAL BID
PRICE
15
2599-9999005
FURNISH AND INSTALL
EXPANSION JOINT CURB PLATE
EA
1.0
$ I tcc
$ l .
16
2599-9999005
FURNISH AND INSTALL LIGHT
POST ACCESS COVER SCREWSGc0.�
EA
10.0
$ + w
$
17
2599-9999005
REPAIR PEDESTRIAN PIPE
RAILINGS
LF
100.0
$ `�
I
$ 9'�
t e, C�c�.
TOTAL BID
$ i b57.2)35,°C1
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 vu_ , c,•
Dollars
($ E ) 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 ( 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. I Date -A -2,3, \t
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.
FORM OF BID CONTRACT NO. 950 Page FB -2 of 3
AECOM #60569633 FY 2018 Bridge and Culvert Repairs
Revised Per Addendum No. 1 - 04/30/2018
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.
0 ,(Am r Ano I\SSO' O j -r-nC -
(Na of Bidder) (Date)
BY: Title Prag'. cF (C'
Official Address: (Including Zip Code):
7-kxD Ski-) —64-00V-Skc9 �r•k-,2
�^ir„v4j , .. so1\"
I.R.S. No. LZ- \07-'kUB
FORM OF BID CONTRACT NO. 950 Page FB -3 of 3
AECOM #60569633 FY 2018 Bridge and Culvert Repairs
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of
County of 1\k
)ss
C wCk r.,tiCL�
, being first duly sworn, deposes and says that:
1. He is (Owner, Partner, Officer, Representative, or Agent) , of ( �a �� c - A c_ p.
, 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 . the part of the Bidder or any of its
agents, representatives, owners, employees, or parties ter- .including this affiant.
i 1
(Signed) al
Yi-eS:� (e r CJ
Title n�
Subscribed and sworn to before me this �_ day of f`- let v
My commission expires
, 2018.
eon, I..# DANIEL KESPER
� Commission Number 809450
My Commission Expires
cw March 13, 2021
NON -COLLUSION AFFIDAVIT CONTRACT NO. 950
Page NCA -1 of 2
AECOM #60569633 FY 2018 Bridge and Culvert Repairs
Bidder Status Form
To be completed by all bidders Part A
Please answer "Yes" or "No" for each of the following:
• Yes ❑ No
O Yes ❑ No
O Yes ❑ No
O Yes ❑ No
0 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).
My company has an office to transact business in Iowa.
My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail.
My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
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: / `` / 0to
pe5
/ Address: -31C0 S u kS",
City, State, Zip -
Dates: / / to / / Address:
City, State, Zip:
Dates: / / to / / Address:
You may attach additional sheet(s) if needed. City, State, Zip:
r'.��J
X111
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 ❑ 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
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.
Firm Name: L.{'
Signature:
Date: osp2_6 ?
You must submit the completed form to the governmental body requesting bids per 875 lowa Administrative Code
Chapter 156. This form has been approved by the Iowa Labor Commissioner.
309-6001 (09-15)
Worksheet: Authorization to Transact Business
This worksheet may be used to help complete Part A of the Resident Bidder Status form. If at least one of the following
describes your business, you are authorized to transact business in Iowa.
❑ Yes ❑ No My business is currently registered as a contractor with the Iowa Division of Labor.
❑ Yes ❑ No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes.
❑ Yes ❑ No My business is a general partnership or joint venture. More than 50 percent of the general
partners or joint venture parties are residents of Iowa for Iowa income tax purposes.
❑ Yes ❑ No My business is an active corporation with the Iowa Secretary of State and has paid all fees
required by the Secretary of State, has filed its most recent biennial report, and has not filed
articles of dissolution.
❑ Yes ❑ No
My business is a corporation whose articles of incorporation are filed in a state other than Iowa,
the corporation has received a certificate of authority from the Iowa secretary of state, has filed
its most recent biennial report with the secretary of state, and has neither received a certificate of
withdrawal from the secretary of state nor had its authority revoked.
❑ Yes ❑ No My business is a limited liability partnership which has filed a statement of qualification in this
state and the statement has not been canceled.
❑ Yes ❑ No My business is a limited liability partnership which has filed a statement of qualification in a
state other than Iowa, has filed a statement of foreign qualification in Iowa and a statement of
cancellation has not been filed.
❑ Yes ❑ No My business is a limited partnership or limited liability limited partnership which has filed a
certificate of limited partnership in this state, and has not filed a statement of termination.
❑ Yes ❑ No My business is a limited partnership or a limited liability limited partnership whose certificate of
limited partnership is filed in a state other than Iowa, the limited partnership or limited liability
limited partnership has received notification from the Iowa secretary of state that the application
for certificate of authority has been approved and no notice of cancellation has been filed by the
limited partnership or the limited liability limited partnership.
❑ Yes ❑ No My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
❑ Yes ❑ No My business is a limited liability company whose certificate of organization is filed in a state other
than Iowa, has received a certificate of authority to transact business in Iowa and the certificate
has not been revoked or canceled.
309-6001 (09-15)
BSF-2
MBENVBE BUSINESS ENTERPRISE
PRE-BID CONTACT INFORMATION FORM
Prime Contractor Name: kSz,..: oAqSVic, Project: �Q� -��'� v• Letting Date:
rb.
NO MBE/WBE SUBCONTRACTORS: If you are NOT using any MBE/WBE subcontractors to complete this project, sign below. Attach a brief
explanation as to why subco ratting was not feasible with this project. If any MBE/WBE subcontractors will be used, please use the bottom
portion of this form.
Contractor Signature: ,I Title: P(03"‘ Date: Date: c5,211`.
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 MBE/WBE 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
MBE/WBE
Subcontractors
Dates
Contacted
Yes/No
Dates
Contacted
Yes/No
Dollar Amount Proposed to
be Subcontracted
(Form CCO-4) Rev. 06-20-02
MBEWBE PARTICIPATION
AECOM #60569633
CONTRACT NO. 950
Page M-6 of 6
FY 2018 Bridge and Culvert Repairs
w
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1
1
1
A
4
4
e
ITEMS OF POTENTIAL MBE/WBE PARTICIPATION
NOTICE TO PROSPECTIVE BIDDERS:
The following are items from the FY 2018 BRIDGE AND CULVERT REPAIRS, CONTRACT NO. 950,
that have a potential for MBE/WBE Participation. This listing, however, is not intended to be all
encompassing; to preclude MBE/WBE Contractors from bidding on any items of the Proposal as a
Subcontractor or the entire Proposal as a Prime Contractor.
BID
ITEM
DESCRIPTION
UNIT
EST. QTY.
8
Safety Closure
Each
4.0
10
Traffic Control
LS
1.0
MBE/WBE GOALS FOR THIS PROJECT
IMPORTANT: Prime Contract Bidders should be aware that ten percent (10%) MBE goal and a two
percent (2%) WBE goal is attached to this project. "Certified Return Receipt" letters are no longer needed
with the bid showing proof of contacting MBE or WBE Subcontractors, but the Pre -Bid Contact
Information Form must be filled out completely.
City of Waterloo Contract Compliance Officer:
Contract Compliance Officer
Community Development Board
Carnegie Annex, Suite 202
620 Mulberry Street
Waterloo, IA 50703
Phone: (319) 291-4429
c'.:?..4(-(2 u./X�" Co v p‘0,r.L(2._ oCC. 1-2u4 _,_,,,,Q r,,., c ,,,i
.l-& -,-,.\ . L. ,_Q \ \o,v ,. a.;(i \o' Q ►-k /& -, E ; -- -e-A---k Aa, ---:'-
i-.0 -E`� c: „'' ;\ \3g. v -‘ c, c1 0, --t1.g ?'\Q
MBE/WBE PARTICIPATION CONTRACT NO. 950
AECOM #60569633
CH -G, a �5S�4a 3 ) r
Page M-1 of 6
FY 2018 Bridge and Culvert Repairs
INFORMATION NEEDED
FOR
IOWA CONSTRUCTION SALES TAX EXEMPTION CERTIFICATE
CONTRACTOR NAME: C(62n.-v..r Cv.cl_g�4
r�C
ADDRESS: -3w S‘.4.3 marks; 17. �e
6,-VA/2-3 Sit ll
(Check One) RIME
FEDERAL ID#:
/4Z- \oZ4a
SUBCONTRACTOR
PROJECT NAME: FY 2cAB Aja (1,4 CL -
PROJECT CONTRACT NO.: QST
DESCRIPTION OF WORK:
❑ Brickwork
❑ Carpentry
q Concrete
❑ Drywall -Plaster -Insulation
0 Electrical
❑ Excavation/Grading
❑ Flooring
LI Heavy Construction
❑ Heating -Ventilating -Air Cond
SALES TAX EXEMPTION
❑ Landscaping
❑ Painting
❑ Paving
❑ Plumbing
❑ Roofing -Siding -Sheet Metal
❑ Windows
❑ Wrecking -Demolition
❑ Other (Please specify)
CONTRACT NO. 950 STE-1 of 1
AECOM #60569633 FY 2018 Bridge and Culvert Repairs
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Cramer and Associates, Inc.
as Principal, and Western Surety Company
as Surety are held and firmly bound unto the
CITY OF WATERLOO Iowa, hereinafter called
"OWNER." In the penal sum Five percent of the amount bid
Dollars ($ 5% of amount bid ) 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 3rd day of May
,20 18 , for FY 2018 Bridge and Culvert Repairs, Contract No. 950
NOW, THEREFORE,
(a) If said Bid shall be rejected, or in the alternate,
(b) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the form
specified and shall furnish a bond for his faithful performance of said contract, and for the payment of all
persons performing labor or furnishing materials in connection therewith, and shall in all other respects
perform the agreement created by the acceptance of said Bid,
Then this obligation shall be void, otherwise the same shall remain in force and effect; it being expressly
understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event,
exceed the penal amount of this obligation as herein stated.
By virtue of statutory authority, the full amount of this bid bond shall be forfeited to the Owner in
liquidation of damages sustained in the event that the Principal fails to execute the contract and provide
the bond as provided in the specifications or by law.
The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its
bond shall be in no way impaired or affected by any extension of the time within which the Owner may
accept such Bid or execute such contract; and said Surety does hereby waive notice of any such
extension.
IN WITNESS WHEREOF, the Principal and the Surety, have hereunto set their hands and seals, and
such of them as are corporations, have caused their corporate seals to be hereto affixed and these pres-
ents to be signed by their proper officers this 3rd day of May , A.D. 2018_,
Cramer/ d Ass•ciates, Inc. (Seal)
Princip
BID BOND
AECOM #60569633
By
Pet -5 ! 1(c pv (Title)
Western Surety Company
Surety
By
torney-in-fact L. Briggs
CONTRACT NO. 950
('Seal)
Page BB -1 of 1
FY 2018 Bridge and Culvert Repairs
Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby
make, constitute and appoint
Timothy J Smith, Scott A Saveraid, Laura A Foust, Brian C Matlock, Michael F Wernsman,
Joyce L Briggs, Debra J Mills, Timothy P Brunkhorst, Thomas R Schwab, Individually
of Davenport, IA, its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and un its behalf bonds,
undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be
hereto affixed on this 25th day of January, 2018.
State of South Dakota
County of Minnehaha
}
SS
55pT}, WESTERN SURETY COMPANY
i ratio Sol
Avs•sAv JO
oral T. Bruflat, Vice President
On this 25th day of January, 2018, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that
he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which
executed the above instrument that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so
affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation.
My commission expires
June 23, 2021
CERTIFICATE
C7)724 -11/1--}
J. Mohr, Notary Public
I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force, and further certify that the By -Law of the corporation(printed on the reverse he eof is still in force. In testimony whereof I have hereunto subscribed
my name and affixed the seal of the said corporation this _J f day of
WESTERN SURETY COMPANY
Form F4280 7-2012
Go to www.cnasurety.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity.
Cs:7T I,. Nelson, Assismnt Secretary