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AL WATERMARK PRINTED ON THE BACK. THE FRONT OF THE DOCUMENT HAS A GREEN CHECK BACKGROUND ON WHITE PAPER
r i d i a n P.O. Box 6000, Waterloo, IA 50704
`�aedit union
PAY THE
SUM OF
PAY
TO THE
ORDER
OF
REF
800.235.3228 • www.veridiancu.org
DATE
03-20-19
ONE THOUSAND FIVE HUNDRED AND .00 DOLLARS
CITY OF WATERLOO
PAYABLE THROUGH
FIRST INTERSTATE BANK
BILLINGS. MT
93-541
920
CHECK NO :102009470
OFFICIAL CHECK
2739
AMOUNT
********1,500.00
AUTHORIZED SIGNATURE
u. 10 20094 7011' 1:0920054LL1:0is400L00493520
CITY OF WATERLOO, IOWA
Planning AND ZONING DEPARTMENT
BID FORM
for
2019 MOWINGS
BIDDER: G��`� C_G
COMP Y NAM
ADDRESS: l L\ C
C --
PHONE: CK ) o��� - 5y
1. The undersigned, being a Corporation existing under the laws of the State of ji}Aor a limited liability company
ex g under thea s of the State of , or a Partnership consisting of the following partners:
S
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 PerOccurrence:
Yl n lel.n v\J S9 )dollars($ 1—I. JV )
OPTION B: Provide all specified as needed mowing and trimming services on lots 1 acre or more.
Price per acre for lots one acre or more.
Price Per Occurrence:
Q t c 5(M11\ ✓\ (
dollars ($ I. hO
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before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the prescribed form and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 1 ( dollars ($ 1,SbD,�
in the form of C2 r , c, t, c Cy, of \C , is submitted herewith in accordance with NOTICE TO BIDDERS.
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of �pr4, /
County `of 616,_( 1 L
66,1 j�, ,-.1 , being first duly sworn, deposes and says that:
1. He is (Owner), (Partner), (Officer), (Representative), or (Agent) of cctvtCar LTitbe' idder 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 int luding this affiant.
Signature
i