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FORM OF AD OR PROPOSAL
F.Y. 2019 WATERLOO RL_OO YARD WASTE WATER AND SANITARY SEWER
EXTENSION
CONTRACT NO. 952
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
a Partnership consisting of the following partners:
havin
ries s ng con • ()leis on e project area
affecting the cost of the work, ander all the contract documents listed in the Table of
Contents and Addenda (if any), as prepared by Wayne Claassen Engineering &
Surveying, Inc. 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 RV. 2019.WATERLOO YARD WASTE
WATER AND SANITARY SEWER EXTENSION, Contract No. 952, City of Waterloo,
Iowa, 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. 2019 WATERLOO Mt) WASTE WATER ARD SANITARY SEWER
C*
ijTRACT NO. 952
BID`''
ITEM'
DESC.RIP'TION
BASE BID
;UNIT-
EST: 4TY:.
1lN(T`Bp`'TO't'AL
`
bI ICE 1-1-401.
. .y. , ,
Blb
,
. i. , I...
PRICE
_-
001
MOBILIZATION
L.S.
1.
$ 17o 6-00
$) 7,400
002
CLEARING AND GRUBBING
L.S.
1
$ /3)37,0
$ 4)51-00
003
SEED AND FERTILIZE
IDOT RURAL MIX
ACRES
1.6
$ 1 S-00
$
/oo
004
MULCH (IDOT RURAL MIX)
ACRES
1.6
$ 675-0
$
J Foo
005
STABILIZATION CROP SEEDING AND FERTILIZING
ACRES
1.6
$ i
20
$ )
9020
006
OMITTED
$
$
007
9" DIA., STRAW FILLED WATTLES _
L.F. _
735
$
$ R 0266
_
FORM OF BID
CONTRACT NO. 952
Page 1 of 4
FORM OF BID
CONTRACT NO. 952 Page 2 of 4
008
CHAIN LINK FENCE REMOVAL AND
REPLACEMENT
L.S.
1
$ 027�
�)
$ 2 7s6
009
TRAFFIC CONTROL
L.S.
1
$ &00 ✓
$ 6o
010
MAINTENANCE BOND, 2-YEAR
L.S.
'1
$ S UOQ'
$ 3j5'O0
$ 5 000
011
SWPPP COMPLIANCE
L.S.
1
$ 3J5-o0
012
MACADAM STONE BASE
TONS
300
$
$ 7
roc -
201
SANITARY SEWAGE FORCEMAIN, 2" DIA., IPS, DR
11 HDPE
L.F.
760
$
$ 7 I IV
202
TAP AND INSTALL WATER-TIGHT CONNECTION
TO EXISING MANHOLE
EA
1
$ a
000
$ 2 000 J
203
SANITARY SEWER SERVICE, 4" DIA. SDR 23.5 PVC
L.F.
10
$ `5s
$ .5.5 O
204
GRINDER PUMP STATION, COMPLETE
L.S.
1
$ f ► SW -
$ / 9 COO
401
402
WATER MAIN, 8" DIA., CL 52 D.I.P.
L.F.
_ _ 2,765
$ II
.—
Q
$ 14)873-
TEE, 8" DIA. X 8" DIA. X 6" DIA., D.I.P. COMPLETE
WITH THRUST RESTRAINT
EA
1
$ 7s0
-
$ 77o
403
BEND, 90°, 8" DIA., DUCTILE IRON, COMPLETE
WITH THRUST RESTRAINT
EA
1
$ 7.5"D
$ ' co
404
EA
1
_
$ 750
$ 75-0
BEND, 22 5°, 8" DIA., DUCTILE IRON, COMPLE
WITH THRUST RESTRAINT
I E
405
WATER SERVICE CONNECTION, 1" DIA.,
COMPLETE
EA
1
$ i
5V6
$ 6 SW
406
WATER SERVICE, 1" DIA.
L.F.
EA
55
3
$ 5
$ lOj OOo
$
$ /Coat)
, 97. .
407
NEW FIRE HYDRANT ASEMBLY, M.J., 6.5' BURY,
COMPLETE
408
TIE-IN TO EXISTING 16" WATER MAIN
EA
1
$ %SO -
$ 75-?
409
WATER METER MANHOLE, COMPLETE
L.S.
1
$ , 06°
$ A
$ 9 Ova
410
WATER AND/OR SANITARY FORCE MAIN,
INSULATE
L.F.
24
$ S o2
411
GATE VALVE, 8" DIA., M.J., WITH VALVE BOX AND
MECHANICAL THRUST RESTRAINT
EA
1
$ /45-0
$ 6a15-O
$
$
TOTAL BASE DID
aLIa a 53
.�.
FORM OF BID
CONTRACT NO. 952 Page 2 of 4
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 Dollars ($�
is submitted herewith in
)in the form of
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.
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. Date
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 ail 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.
FORM OF BID CONTRACT NO. 952 Page 3 of 4
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.
LO CL U Coos -hoc 1 kivL
l
Name of Bidder)
•
BY: Title b-54-r1�. c-
Official Address: (Including Zip Code):
-U -
)3ox it6
K..s\, MIe _TM 5-0 I`1
I.R.S. No.
% — 028%Z,g(9--
o
(Date)
FORM OF BID CONTRACT NO. 952 Page 4 of 4
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of .
County of 1)Ic,-c V-- /"_w1`. )
CAN s - , being first duly sworn, deposes and says that:
)ss
1. He is (Owner, Partner, Officer Rep esentativo, or Agent) , of 1
v,5.},,;c {-,(.Ul , 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;
Neither the said Bidder nor any of its officers, partners, owners, agents, representatives,
em p oyees, or par- es n in eres , me u s ng - s a ran , . r » . r co u • e
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)
Sq,
Title
Subscribed and sworn to before me this 2 3Aefa. day of
201.2.
My commission expires *'a /6- 00c20
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Title
LINDA K SENN
COMMISSION N0. 803307
MY COMMISSION EXPIRES
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(c=orm CCO-4) Rev. 06-20-02
ere Status Form
To be completed by all bidders
PartA
Please answer "Yes" or "No" for each of the following:
Ej 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.
Yes r No My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
es 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 i
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates: / /6/C to g / / Address: 4.0- 130)( l`S1
City, State, Zip: C ? cr L.� v i l I( 1 5-0‘o f' ,
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 ■ 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: toce5(
Signature:
diAel tI--c
Date: 2 --, 3
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)
VIkni l hoot: Atuith lliz toon to Transact L3ulshi amass
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.
CiSlies
■ �o My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes.
Yes
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
Yes LINo
Yes
Yes
Yes
Yes 4No
My business is a limited liability partnership which has filed a statement of qualification in this
state and the statement has not been canceled.
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.
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.
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.
My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
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)
CONTRACT NO:
PROJECT NAME.
DATE OF LETTING:
;h (DENT BIDDER CERTIFICATION
'715- a
I / ge/ VLct e (lQO )41-1-at-L.---c..,,C+C wL'
g _0 _-fir?
c gem{ r
To be a qualified resident bidder, the bidder shall be a person or
entity authonzed to transact business in this state and having a
business for at least three years prior to the date of the first
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 lo -
CORPORATE OFFICER 5Je.sc
TITLE 0w e ✓
DATE g
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 contractors, 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 agreementor 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.
EQUAL OPPORTUNITY CLAUSE PAGE 1 OF 2 PAGES
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 contractor,
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 ma be canceled, terminated or suspended in whole or in
part and the contractor may be declared ineiigi a or urt er 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)
i
(Appropriate Official)
(Title)
(Date)
EQUAL OPPORTUNITY CLAUSE PAGE 2 OF 2 PAGES
Revised February 2003
CONTRACT R'S OR SUBCONTRACTOR'S AFFORMATOVE ACTOON PROGR
Check box that applies to party completing program:
(
) General Contractor
) Subcontractor
I. Section A to be completed by GENERAL CONTRACTORS only:
A.
Name of Company Lei (4) et " t� "t
A ess a Company ?�L'" %�C')1 f c C
Telephone Number ( '/(,) % ('%
C. Remainder of program to be completed by party completing program,
either Prime or Subcontractor.
1. The Owners and/or Principals of your company:
Name Address
s4 -cut 1.0 c ?& UO)
6/crks\me�.Fw
Position
Ethnic
Sex Origin
2. Other Areas of Interest:
If your company has branches or subsidiaries, or if your company is a
branch or subsidiary of a parent organization, give the following
information:
Type of
Name Address Affiliation Degree
II. EMPLOYER'S POLICY (Please read carefully.)
A. We, the undersigned, recognize that we are morally and legally
committed to nondiscrimination in employment. Any person who
applies for employment with our company will not be discriminated
against because of race, color, creed, sex, national origin, economic
status, age, mental or physical handicap.
B The employment policies and practices of the undersigned are to recruit
and hire employees without discrimination, and to treat them equally
with respect to compensation and opportunities for advancement,
including training, upgrading, promotion, and transfer However, we
realize the inequities associated with employment training, upgrading,
contracting and subcontracting for minorities and women and we will
direct our efforts to correcting any deficiencies to the maximum extent
possible. The same will be required of our SUBCONTRACTORS and
suppliers.
C. We submit this program to assure compliance with Executive Order
11246, as amended, and other subsequent orders that may pertain to
equal employment opportunity and merit employment policies, fully
realizing that our qualification and/or merit system should be evaluated
and revised, if necessary.
D. We agree to put forth the maximum effort to achieve full employment
and utilization of capabilities and productivity of all our citizens without
regard to race creed, color, sex, national origin, economic status, age,
and mental or physical handicap.
E todcikr (:4.Lt(rt,-4will give training
(Name of Company)
and employment opportunities to local residents of Waterloo, Iowa, to
the greatest extent feasible.
1I1. AFFIRMATIVE ACTION
rr�r rt i cy batik
(Name of Company)
effective application of a policy of merit employment involves more than
just a policy statement, and G t,c. cc ;
(Name of Company)
will, therefore, re-evaluate our Affirmative Action Program to ensure that
equal employment opportunities are available on the basis of individual
merit, and to actively encourage minorities, women and local residents
to seek employment with our company on this basis.
B. Loi4r "s4L 4 c -"L I L will undertake the
(Name of Company)
following six (6) steps to improve our Affirmative Action Program:
C
1. Minority Recruitment and Employment;
2. Local Recruitment and Employment;
3. Disabled Veteran and Vietnam Era Veteran Recruitment and
Employment.
4. Handicapped Recruitment and Employment;
5. Female Recruitment and Employment; and
6. Training, Upgrading and Promotional Opportunities.
• Lcn-CS L C c-.a-c-frI i will take
(Name of Company)
whatever steps are necessary to ensure that our total work force has
adequate minority, female, and local representation. We will utilize the
following methods in our recruitment attempts:
1. Local advertising media (newspapers, radio, TV);
2. Community organizations (churches, clubs, schools);
3. Public and private institutions in the area (UNI, Hawkeye
Community College);
4. Job Service of Iowa; and
5. Other.
D . eyec L L_ will seek qualified minority,
(Name of Company)
female, and local group applicants for all job categories and will make
asserted efforts to increase minority, female and group representation
in occupations at the higher levels or skill and responsibility.
E All sources of employment used shall be aware that we are an Equal
Employment Opportunity Employer. Labor organizations representing
our employees will be notified of our Equal Employment Opportunity
Policy and Affirmative Action Program.
l°
Training, upgrading, promotion and transfer activities at all levels will be
monitored to ensure that full consideration has been given to qualified
minority, female, and local group employees.
G. will encourage other
(Name of Company)
companies with whom we are associated and/or do business, to do the
same and we will assist them in their efforts.
H .
has taken the following
(Name of Company)
Affirmative Action to ensure that minority, female, local contractors
and/or suppliers were provided opportunities to negotiate and/or bid on
this project: (if none, write "NONE")
1. 82-14 r.
2.
I. As a result of the above efforts, we have involved minority, female, and
local contractors and/or suppliers in the following areas of
subcontracting: (if none, write "NONE")
2.
L -�• u c will require approved
(Name of Company)
Affirmative Action Programs from all nonexempt contractors who
propose to work on this project and will take whatever steps are
necessary to ensure that non -minority contractors have adequate
representation of minority, female and local persons in their total work
force.
K. In further accordance with rules and guidelines issued pursuant to
Executive Order 11246 as amended, we establish the goals for our
company, based on parity percentages supplied by the City, and we
realize these goals will be reviewed on an annual basis.
L. /c/e15-c- etvi ,A -c -ti• will keep records of
(Name of Company)
specific actions relative to recruitment, employment, training, upgrading
and promotion and will provide the City of Waterloo with any information
relative to same, including activities of our SUBCONTRACTORS and
suppliers as necessary or when requested.
M. Parity figures for companies located in Waterloo are as follows:
Minority Parity ®.08 (8%)
N.
4-1 Att
(Name of Company)
Employment Goals:
Affirmative Action
The definition of Affirmative Action Goals is as follows: "Goals may not
be rigid and inflexible quotas which must be met, but must be targets,
reasonably attainable by means of applying every good faith effort to
make all aspects of the entire Affirmative Action Program work."
For the year 2012_, please submit percentage targets for employing
minorities and women. If you already have reached your target for
hiring minorities and women, please submit that percentage.
*Goals for Minorities:
0/0
Goals for Women:
*your affirmative action goals should be between 1% and 10% or more
for minorities and 1% and 5% or more for women.
Please be advised that the goals or targets are purely your estimation
of how many women and minorities your company can reasonably
expect to hire in 201®. Note, that none of the goals are rigid or
inflexible. They are targets that your company calculates as reasonably
attainable. This will help the City in its monitoring procedures as
required by City of Waterloo Resolution No. 1984-142(4).
CONTRACTOR'S TOTAL WORK FORCE
(WATERLOO)
INDICATE:
DISABLED VETERAN: DV
VIETNAM ERA VETERAN: VV
HANDICAPPED: H
RACE
SEX
HOURLY
WAGE
NAME AND ADDRESS
JOB CATEGORY
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INDICATE:
DISABLED VETERAN: DV
VIETNAM ERA VETERAN: VV
HANDICAPPED: H
We hereby certify that we are in compliance with all City and Federal
Affirmative Action Regulations and agree to accept all liability for failure to
comply.
Respectfully submitted,
By: j614,171 5 efl v1
Company Executive
# - 78
By: 51) -cue �U
Equal Employment
Opportunity Officer
Date
City of Waterloo Affirmative Action Officer
Approved
Disapproved Reason:
By:
Date:
7
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 23rd day of
August
2018 , for F.Y. 2019 Waterloo Yard Waste Water and Sanitary Sewer Extension,
Cnntract No, 952, City of Waterloo, lnwa
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 saki 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 Pnncipal 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 21st day of August , A D. 2018
Lodge Construction, Inc. (Seal)
Wi ess
Witness Jj dy Bennett
North American Specialty In rance Comparlseal)
rely
By
Attorn -fat Dione R. Young
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 Attorney(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 Intemational 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."
Otuitinsomi
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Steven P. Anderson, Senior Vico Pres dent of Washington International Insurance Company
& Senior Vice President of North American Specially Insurance Company
& Senior Vice Presiders of Westport Insurance Corporation
By
MIkcc A. Ito, Senior Vice President of Washington International Insurance Company
& Senior Vice President of North American Specialty Insurance Company
& Senior Vice President of Westport Insurance Corporation
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 ,
Stale of Illinois
County of Cook
On this 3rd day of
ss:
North American Specialty Insurance Company
Washington International Insurance Company
Westport Insurance Corporation
November , 20177 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.
OFFICIAL SEAL
Pec. KENNY
Notary mic- Soneofpinna
My Coommission rvpims
f voazoxt
\ \,
M. Kenny, Notary Public
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 Intemational 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 this 21st day of August , 2018 ,
Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company &
North American Specialty Insurance Company & Vice President & Assistant Secretary ofwestport Insurance Corporation