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V •�, 41. 11 11 1: .: :;tilaft O I • r FORM OF BID OR PROPOSAL FY 2019 LEVEE RIP RAP SPRAYING CONTRACT NO. 961 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 1 0 \ a Partnership consisting of the following partners: S'\ ; It c H \\Q./ 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 2019 LEVEE RIP RAP SPRAYING, Contract No. 961, all in accordance with the above -listed documents and for the unit prices for work in place for the following items and quantities: FORM OF BID CONTRACT NO. 961 Page 1 of 3 FY 2019 LEVEE RIP RAP CONTRACT NO. SPRAYING 961 BID ITEM DESCRIPTION UNIT EST. QTY. UNIT BID PRICE - TOTAL BID PRICE 1 CEDAR RIVER - 2300 FEET WEST OF CEDAR$ BEND PARK TO CEDAR BEND PARK LS 1.00 $ 1 ' 6 O 0 2 CEDAR RIVER - CONGER STREET TO 78 FEET SOUTH OF RAILROAD BRIDGE LS 1.00 $ $ 1 C 3 CEDAR RIVER - CEDAR RIVER PARK TO VIRDEN CREEK OUTLET LS 1.00 $ rip -0,c) 4 CEDAR RIVER - 150 FEET NORTH OF E. MULLAN AVE. TO E. 1ST STREET LS 1.00 $ $ Ci % o. p f> 5 CEDAR RIVER - E. 6TH STREET TO CITY LIMITS LS 1.00 $ $ it -ii Ied 0-60 6 FORRESTER DETENTION POND LS 1.00 $ $ 9 15 0 0 CEDAR RIVER - 3200 FEET WEST OF CONGER STREET TO 100 FEET SOUTH OF W. 1ST STREET LS 1.00 $ $ (3al 5-) O 07 8 BLACK HAWK CREEK - HWY 218 TO RIVER ROAD (WEST SIDE) LS 1.00 $ $ 3 $ S 9 BLACK HAWK CREEK - HWY 218 TO RIVER ROAD (EAST SIDE) LS 1.00 $ $a�1 ��1“ O 10 CEDAR RIVER - W. 6TH STREET TO HAWTHORNE AVENUE LS 1.00 $ $ 6 I 15 o 11 TREATMENT PLANT RING LEVEE LS 1.00 $ $5.43 S J . Q O TOTAL BID $ 41-11 1:106 0 0 FORM OF BID CONTRACT NO. 961 Page 1 of 3 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. c,nama,ll .to -k t� 5tv;(,$LSC `DI")) 14S (Name of Bidder) (Date) BY:%ftii•JA Title Pits; (Ac ± Official Address: (Including Zip Code): I.R.S. No. a C7 2,3 06,7r7 FORM OF BID CONTRACT NO. 961 Page 3 of 3 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, as Principal, and as Surety are held and firmly bound unto the CITY OF WATERLOO Iowa, hereinafter called "OWNER." In the penal sum Dollars ($ ) 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 day of 120 , for 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 hereeto01 d and these presents to be signed by their proper officers this day of By Principal (Seal) Witness Surety By Witness Attorney-in-fact (Seal) (Title) NON -COLLUSION AFFIDAVIT OF SUBCONTRACTOR State of County of ) being first duly sworn, deposes and says that: ) ss: 1. He is (Owner, Partner, Officer, Representative, or Agent) hereinafter referred to as the "Subcontractor;" He is fully informed respecting the preparation and contents of the subcontractor's proposal submitted by the subcontractor to contract pertaining to the project in (City or County and State) Such subcontractor's proposal is genuine and is not a collusive or sham proposal; 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; and 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. (Signed) Title Subscribed and sworn to before me this day of , 201 Title My commission expires Bidder Status Form To be completed by all bidders Part A Ple 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). [V ,Yes ❑ No My company has an office to transact business in Iowa. es ❑ No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail. Yes ❑ No My company has been conducting business in Iowa for at least 3 years prior to the first request for bids on this project. ReYes ❑ No My company is riot 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: cK / IC / b' o a gto 00 f c rpt Address: 5 n. `-1 WI ' IR 5 PJ M o n c -Q R (J City, State, Zip: I)yrn)Lcv+on,Ifl S(6dL 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 0 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. Firm Name: `—c\nA tnw/i( IAA/ f Scvviits Signature: reNtkik Date: `h) i ' i 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) C C G 0 O _ LL s Z J a NN O Lf. � tl' LU Z 2 e6 W )_ CAOL W Z_ Z ?UES: m WZ-, 03 0 0 v Cm 03 v/ W a r Prime Contractor Name: 4- cp 0 CO V. L U 0 N Q" 3 0 = a) N ca) .m a c N N O a.0 (_ Lc 3 0 N O O. 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O E ° L E irt.b a3 c limW mm -o W Y if/ m O W O 2 3 m 4E4 r, ' c C @ p N O 03a)m N 2 N N m E@o°% -I a) a� @ + N E L CU a) a O w a` L U o O O_ W -0 d N N @ TO mm a) C 'U L N - N N O o ,c a) 2 O) C .> G L @ a) N a U O a) O N O 'O a U P O N n c E oa)a)-c `O O 0 0) O C fl 1/4„0 <oww 'w O j N rn O 0 as ,F2.• c a U cr 0) 0 3fl @ O _ a) C a) r o U O r U O N V N o aN1ja 0 E N C 9 .0 a`) 0 = N N U 3 o •- OU a) •� E m U N C Y C a 0 c_4_ N OE mac O c = N U a N @ o C ® WOa0E c— E C @ ww0.0 rnW 0-) CO N C L (-) N 'C w U N a) 0 m ww.c 02 Form CCO-4A Rev. 07-08-02 LANDMARK TURF SERVICES, LLC 7524 N Raymond RD Dunkerton, IA 50626 Subcontractors not needed for 2019 Levee Rip Rap Spraying. Mike Hiller President Landmark Turf Services LLC (319)415-8523 mike@landmarkturf.com