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FORM OF BID OR PROPOSAL
F.Y. 2019 LEVEE TREE CLEARING CEDAR RIVER
CONTRACT NO. 968
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
e;WGt. , a Partnership consisting of the following partners:
Verctcih EX cKVO± � LLQ
having familiarized himsel (themselves) (itself) with the existing conditions on
the project area affec a 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 F.Y. 2019 LEVEE TREE CLEANING CEDAR RIVER, Contract No.
968, 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 LEVEE TREE CLEANING CEDAR RIVER
CONTRACT NO. 968
BID:;
ITEM.-:
DESCRIPTION -.
UNIT
EST:QTY.
UNIT BID
-PRICE
TOTAL BID PRICE
1
MOBILIZATION
LS
1.00
$ of So o -,
$ 450o=
2
CLEARING AND GRUBBING
ACRE
6.55
$az„ Li So °'
$ )"13,'RW'1,5.9
3
SEEDING, FERTILIZING AND MULCHING
ACRE
6.55
$ x555.3-'
$ ((o 737, so
4
TRAFFIC CONTROL.
LS
1.00g
0000'Z
A 000
TOTAL B
D $ 19 , y gs
FORM OF BID
CONTRACT NO. 968 Page 1 of 3
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withdrawn, the undersigned agrees to execute and deliver an agreement in the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 51. 8P
Dollars ($ i3,1 ) in the form of &M Corti
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 ( ° ), or Non -Resident
Bidder Certification ( ). (Mark one.)
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 $10,000.00 in work for the City in the current calendar year, are prepared to
submit an AAP or Update and an EOC, within ten (10) days of notification that the
bid submitted is lowest and acceptable.
9. The bidder has received the following Addendum or Addenda:
Addendum No. Nana Date Pione
10. The bidder shall list the MBENVBE subcontractor(s), amount of subcontracts and
bid items on the City of Waterloo Minority and/or Women Business Pre-bid
Contact Information Form submitted with this Form of Bid or Proposal. The
apparent low Bidder shall submit a list of all other Subcontractor(s) to be used on
this Project to the City of Waterloo by 5:00 p.m. the business day following the day
Bids on this Project are due along with the Non -Collusion Affidavits of AH
Subcontractor(s).
The Contractor shall submit information on subcontractors on
"SUBCONTRACTOR REQUEST AND APPROVAL" Form to be provided by City
prior to approval of contract.
FORM OF BID CONTRACT NO. 968 Page 2 of 3
The subcontractors listed on this proposal and/or submitted to the Contract
Compliance Officer cannot be changed except for the following reasons:
1) The City of Waterloo does not approve the subcontractors.
2) The subcontractors submit in writing that they cannot fulfill their
subcontracts.
11. The bidder has filled in all blanks on this proposal. Those blanks not applicable
are marked "none" or "NA".
12. The bidder has attached all applicable forms.
13. The Owner reserves the right to select alternates, delete line items, and/or to
reduce quantities prior to the award of a contract due to budgetary limitations.
BY_..
Vtraci+1/ Exc&vti-"v LL /I c 9-cQei8
(Name of'$idder) (Date)
Member/
Title t7 VJ Vt e r
Official Address: (Including Zip Code):
/ CV") ID q Nara-7bn Rd,
LaPo/fe ()hitt, 50&s /
I.R.S. No. ' 2- /?9t 2/(PO
FORM OF BID
CONTRACT NO. 968 Page 3 of 3
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State ofo vJA )
County of £)C<ck 1-61.4-!k. )
Jc s ori Cve.171 , being first duly sworn, deposes and says that:
Y
1. is ,�(O�w`n�-e�/�, Partner, Officer, Representative, or Agent) of �,i'C�!,(
X c1 t/afi t%, 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 on the part of the Bidder or
any of its agents, representatives, owners, employees, or parties in interest, including this
affiant.
)ss
�y/Title
Subscribed and sworn to before me this Y
Newe. mbPv , 201B.
Mlo3-at-
day of
pcAJn1ic
My commission expires (.0 "I?)- iq
Title
1PRlA s,, BROOK A SKRAM
Commission Number 747410
M Commission fires
Bidder Status Form
To be completed by all bidders Part A
Please answer "Yes" or "No" for each of the following:
'Yes 0 No
• Yes 0 No
• Yes ❑ No
• Yes 0 No
Yes 0 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:
o LI
a 5 / 020I'/to Oz., ENr
Address. /000 1/73117) al .
City, State, Zip: 1-a ,'-k 0-13,€-sbo3✓7
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
1 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: Veracl�-y[ E)c7awa.-finq Lac'_
cJ
Signature: -.
Date: //- 0 - le?
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)
MBEIWBE BUSINESS ENTERPRISE
PRE-BID CONTACT INFORMATION FORM
Prime Contractor Name:\l�� l 0.G i�� L XCfi ✓c7 11 �c (� Project: 0701 g Lcvr� (kali nit Letting Date: / /- olQ I ce
NO MBEIWBE SUBCONTRACTORS: If you are NOT using any MBEIWBE subcontractors to complete this project, sign below. Attach a brief
explanation as to why subcontractinas not feasible with this project. If any MBEJWBE subcontractors will be used, please use the bottom
portion of this form.
Contractor Signa
SUBCONTRAC . - S APPLICABLE: You are required, in order for your bid to be considered responsive, to provide the information on this form
showing AL . 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.
Title: 014 Kiev– Date: / 9-1 Si
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 Rudy Jones, 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
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(Form CCO-4) Rev. 06-20-02
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Veracity Excavating LLC
as Principal, and WESTERN SURETY COMPANY
Bond No. 72101440
as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called
"OWNER." In the penal sum
5% of amount bid
Dollars ($
Five Percent 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 rincipal has subm1 ed the accompanying bid dated the �� i !r' day of
, 20, tX , for Levee Tree Clearing Cedar River
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 shell in all other respects perform the
agreement created by the acceptance of said Bid,
Then this obligation shalt 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 Prindpal 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 29th day of November p,, f}, 20f S
Veracity Excavating LLC
Principal
By; r��
WESTERN SURETY COMPANY
Witne s Sur ty
Witness
0, 'lr
LLO.
By i(1
Atttn ney)d-
(Seal)
(Seal)
(Title)
Western Surety Company
POWER OF ATTORNEY - CERTIFIED COPY
Bond No. 72101440
Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws
of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company"), does by these presents make,
constitute and appoint MATTHEW J ARENHOLZ,
its true and lawful attorney(s)-in-fast, with hill power and authority hereby conferred, to execute, acknowledge and deliver for and on its
behalf as Surety, bonds for:
Principal: Veracity Excavating LLC
Obligee: City of Waterloo
Amount: $1,000,000.00
and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Vice President, sealed with the
corporate seal of the Cotnpany and duly attested by its Secretary, hereby ratifying and confirming all that the said attorneys) -in -fact
may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety
Company which remains in full force and effect.
"Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile"
If Bond No. 72101440 is not issued on or before midnight of February 28, 2019 all
authority conferred in this Power of Attorney shall expire and terminate.
tug
----estern Surety Company has caused these presents to be signed by its Vice President, Paul T. Bruflat, and its
cor❑.4i',,te•?e'r Ptoke ai�ae✓13Lthis 29th day of November 2018
ST -.4 F•SOUTHD t'A l!
COUt�Yt`Yit?#vgfil,Yl'AHA Jf
On this " 29th day of November , in the year 2018 before me, a notary public, personally appeared
Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of
WESTERN SURETY COMPANY and acknowledged said instrument to be the voluntary act and deed of said corporation.
}444444444444444444444444}
8 8
s
SURE COMPANY
Paul T. rutlat, Vice
President
J. MOHR
NOTARY PUBLIC SEAL i
J1Y.at;JSOUTH DAKOTA a
1.44444444444,4440,4444ti
My Commission Expires June 23, 2021
I the undersigned officer of Western Surety Company, a stock corporation of the State of South Dakota, do hereby certify that the
attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as
set forth in the Power of Attorney is now in force.
In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this 2 9th day of
November 2018
Notary Public - South Dakota
WEST
SURE yY COMPANY
Paul T.fruflat, Vice President
To validate bond authenticity, go to www.cnasuretv.conl > Owner/Obligee Services > Validate Bond Coverage.
Form F5306-10-2017