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CITY OF WATERLOO, IOWA
Planning AND ZONING DEPARTMENT
BID FORM
BIDDER* \J1ISOn (usknn Trot
COMPANY NAME.
ADDRESS: C )LL Short Ave,
Qfesco , ZA 52.I31,9
for
2018 MOWINGS
PHONE: (254:3 ) 5111— 1-1-335
1. The undersigned, being a Corporation existing under the laws of the State of — , or a limited liability company
existing under the laws of the State of'Iowa , or a Partnership consisting of the following partners:
having been familiarized with the existing conditions on the project area affecting the cost of the work, and with all the
Contract Documents now on file in the offices of the City Clerk, City Hall, 715 Mulberry Street, Waterloo, Iowa, and the
Planning and Zoning Department, 715 Mulberry Street, Waterloo, Iowa hereby proposes to furnish all supervision,
technical personnel, labor, materials, machinery, tools, equipment, and services, including utility and transportation
services required to complete the proposed MOWINGS, in accordance with the contract documents and for the unit price
in place for the following amount:
OPTION A: Provide all specified as needed mowing and trimming services for city owned lots under 1 acre:
Price per lot Less than one acre.
Price Per Occurrence:
i�la,�r,.e) (,vv>J w//a - dollars ($ b )
13: Pall specified as needed mowing and trimming services on lots
OPTION p 1 acre or more.
Price per acre for lots one acre or more.
Price Per Occurrence: /�
Stitt p• i>f � �•U (M.�� C • 13 dollars ($ c9c90 i )
2. In submitting this bid, the Bidder understands that the City reserves the right to reject any or all bids and to award one
or more contracts for a single Option, all Options together, or any combination of Options. If written notice of acceptance
of this Bid is mailed or delivered to the undersigned within thirty (30) days after Bid Opening, of 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before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the prescribed form and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 insurance within ten (10) days after the agreement is presented for signature,
and start work within ten (10) days after "Notice to Proceed" is issued.
3. Security in the sum of (S�tvt ni,044 Q) .it. /�t>n.i/cien4 dollars ($ 1�0• )
in the form of Pan —, , is submitted herewith in accordance with NOTICE TO BIDDERS.
4. Attached is a Non -Collusion Affidavit of Prime Contractor.
5. The Bidder is prepared to submit a financial and experience statement upon request.
6. 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.
7. The Bidder has received the following Addendum or Addenda:
Addendum No. ii Date:
8. The Bidder shall list the MBE/WBE subcontractors, amount of subcontracts and bid items listed on the City of
Waterloo Minority and /or Women Business Pre-bid Contract Information Form submitted with this Bid Form. 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 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
9. The Bidder shall list all equipment available for this project:
4 tA2ta I,t uat flt- JLit Avnte `4,4j4J
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10. The Bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none" or "NA".
11. The bidder has attached all applicable forms.
12. The owner reserves the right to select alternatives, delete line items, and/or to reduce quantities prior to the Award of
Contract due to budgetary limitations.
SIGNED:
vun7 DATE /9J/(201/5
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of Toaiu )
County of 4-4-cricccvd )
13 14.2 tics -1)y) , being first duly sworn, deposes and says that:
1. He is (Own)), (Partner), (Officer), (Representative), or (Agent) of WI 1p, Cushm kee.,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, cum 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.
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Title
Subscri3O cwwl,sworn/to-before/ me/ thiy
4245._ - of Mi.y3 , 2018.
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NON -COLLUSION AFFIDAVIT OF SUBCONTRACTOR
State of A//Q )
County of A//A ) )
//A , being first duly sworn, deposes and says that:
1. He is (Owner), (Partner), (Officer), (Representative), or (Agent) of A tbe)
as the "Subcontractor";
hereinafter referred to
2. He is fully informed respecting the preparation and contents of the subcontractor's proposal submitted by the
subcontractor to Add / , contract pertaining to the 2018 MOWINGS in
Waterloo, Black Hawk County, Iowa;
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;
5. The price or prices quoted in the subcontractor's proposal 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.
wI/A
Signature
h1/41
Title
subacva €d, cuvt& to -before wte, attar
_NIA day of PIA 2018.
S(g-nat, e/ ride
•
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 contractor, 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 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, 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, national origin, economic status, age, mental or physical disabilities.
Signed:
�+t�ne.v
Appropriate Official
5126/15
Title
Date
Bond No. 41393558
BID MOND
KNOW ALL MEN BY THESE PRESENTS, that we, Jeff Wilson dba Wilson Custom Tree, 212 Short. Ave, Cresco, IA 52136
as Principal, and Platte River Insurance Company, PO Box 5900, Madison, WI 53705-0900
as Surety are hold and flrmly bound unto the CiTY OF WATERLOO , Iowa, hereinafter ra
"OWNER" In the penal sum One Thousand Five Hundred & No/100
Dotlors ($ 1,500.00
) lawful money of the United States, for the payment
of which sum will and truly be made, we hired ourselves, our heirs,
firmly by these presents. The condition of thisabftgation Is such that
the 31st day of a
De.artment 2018 Residentia of owm;s
exocutora, administrators, and successors, jointly and severally,
whereas the Principal has submitted the accompanying anyina bid dated
• 20 18 for City of Waterloo, Iowa - Manning and Zoning
NOW, THEREFORE,
(a) If said Bid ehall be rejected, or in the alternate,
(b) If said Bid stall be accented and the Principal shalt execute and deliver a contract In the form specified and shall furnish a bond for
his faithful performance of said contract, and k r 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,
i hen thio obligation shall be void, otherwise the same shall retrain in force and sffed; it being expressly understood and agreed that
the liability of the Surety for any and ail claims hereunder Shall, In no event, exceed the penal amount of this obligation ax herein stated
By virtue of etatutnry authority, the full amount of this bid bond shall be forfeited to the Owner in liquidation of darn3ries 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 al them :as am corporations.
have caused their corporate seals to be hereto affixed and these precentF to he signed by their proper officers Inns 24th day , f
(X?XXX May, 2018.
ness
Rita Jorgenson
Account Specialist
Jeff Wilson dba Wilson Custom Tree (Seat)
Principal
Platte River Insurance Company
Surety
By
1
Attorney-in-fact
OGCt) e4�
(Titre)
Ronald Kaihoi
(Seal)
State of AO W el
County of
ACKNOWLEDGMENT OF PRINCIPAL (Individual)
�i
4 -47)1011 -At
On this a5day of 'f �,r „ , in the year c2010 , before me
personally comes
to me known and known to me to be the person who is described in and executed the foregoing instrument, and
acknowledges to me that he/she executed the same.
State of
County of
April D. Buis
Commission Number 7p136
MY COMM. EXP. 17
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Partnership)
}
On this day of _ • the year , before me
personally come(s)
a member of the co -partnership of
to me known and known to me to be the e on who is described in and executed the foregoing instrument, and
acknowledges to me that he/she executed the same as the act and deed of the said co -partnership.
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Corporation/LLC)
State of
County of
On this day of , in th - ear , before me personally come(s)
me known, who being duly sworn, deposes and says that
he/she resides in the City of that he/she is the of the
, the corporation described in and
which executed the foregoing instrument, and that he/she signed his/her name thereto by like order.
Notary Public
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PLATTE MTV IKR INSURANCE COMPANY
POWER OF K'1T"JT'ORNE,Y
41393558
KNOW ALL MEN BY THESE PRESENTS, That the PLATTE RIVER INSURANCE COMPANY, a corporation of the State of Nebraska, having
its principal offices in the City of Middleton, Wisconsin, does make, constitute and appoint
JACK ANDERSON; RONALD KAIHOI
its trreand lawful Attorney(s)-in-fact, to make, execute, seal and deliver for and on its behalf, as surety, and as its act and deed, any and all bonds, undertakings
and contracts of suretyship, provided that no bond or undertaking or.contract of suretyship.executed under this authority shall exceed in amount the sum of
--ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED: $20,000,000.00
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of
Directors of PLATTE RIVER INSURANCE COMPANY at a.meeting duly called and held on the 8th day of January, 2002.
"RESOLVED, that the President, Executive Vice President, Vice President, Secretary or Treasurer, acting individually or otherwise, be and they hereby
are granted the power:and authorization to appoint by a Power of:Attorney for'the purposes only of executing and attesting bonds and undertakingsrand
other writings obligatory in the nature thereof, one or more resident vice-presidents, assistant secretaries and attorney(s)-in-fact, each appointee to have
the powers and duties usual to such offices to the business of this company; the signature of such officers and 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 valid and binding upon the Company, and any such power so executed and certified by facsimile signatures and facsimile seal
shall be valid and binding upon the Company in the future with respect to any bond or undertaking or other writing obligatory in the nature thereof to
which it is attached. Any such appointment may be revoked, for cause, or without cause, by any of said officers, at any time."
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the
Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts
required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation
making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the
Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of
Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
•
IN WITNESS WHEREOF, the PLATTE RIVER INSURANCE COMPANY has caused these presents to be signed by its officer undersigned and its
corporate seal to be hereto affixed duly attested, this 3rd day of May, 2017.
Attest:
Jdtin E. Rzepinski
Vice President, Treasurer & CFO
whpsNia %11\ 1234310334.
Suzanne M. Broadbent
Assistant Secretary
STATE OF WISCONSIN S S
COUNTY OF DANE
.•4
CORPORATE
* 0/1�II1111EB 1IIIIIl1 111U\\
PLATTE RIVER INSURANCE COMPANY
Stephen J. Sills
CEO & President
On the 3rd day of May, 2017 before me personally carne Stephen J. Sills, to me known, who being by me duly sworn, did depose and say: that he resides
in the County of New York, State of New York; that he is President of PLATTE RIVER INSURANCE COMPANY, the corporation described in and
which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal; that it
was so affixed by order of the Board of Directors of said corporation and that he signed his name thereto by like order.
STATE OF WISCONSIN 1
COUNTY OF DANE j S.S.:
•/ }. i2 i2—
David J. Regele
Notary Public, Dane Co., WI
My Commission Is Permanent
1, the undersigned, duly elected to the office stated below, .now the incumbent in PLATTE RIVER INSURANCE COMPANY, a Nebraska
Corporation, authorized to make this certificate, DO HEREBYCERTIFY+that the foregoing attached Power of Attorney remains in full force and has
not been revoked; and furthermore, that the Resolution of the Board of Directors, set forth' in the Power of Attorney is now in force.
Signed and sealed at the City of Middleton, State of Wisconsin this 24th day of May , 20 18
CXYKrjet)
Antonio Cel i i
General Counsel, Vice President & Seccretary , .
•
THIS DOCUMENT IS NOT VALID UNLESS PRINTED ON GREEN SHADED BACKGROUND WITI-J A RED SERIAL NUMBER IN THE UPPER RIGHT HAND
CORNER. IF YOU HAVE ANY QUESTIONS CONCERNING THE AUTHENTICITY OF THIS DOCUMENT CALL 800-475-4450. PR -POA (Rev.' 10-2017)
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ACKNOWLEDGEMENT OF SURETY
STATE OF MINNESOTA
COUNTY OF CHIPPEWA
On this 24th day of May , 2018 , before me, a Notary Public within and for said
County, personally appeared Ronald Kaihoi to me personally known, who being by me duly
sworn he/she did say that he/she is the attorney-in-fact of Platte River Insurance Company ,
the corporation named in the foregoing instrument, and the seal affixed to said instrument is the
corporation seal of said corporation, and sealed on behalf of said corporation by authority of its
Board of Directors and said Ronald Kaihoi acknowledged said instrument to be the free act
and deed of said corporation.
4i/Lit_a/44;
OTARY PUBLIC
My Commission Expires / 31(xx
•
.. REBECCA J. RISA
Notary Public -Minnesota
My Commission Expires Jan 31, 2020
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