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Home My WebLink AboutK. Cunningham Construction, Inc.UNNINGNAM K CUNNINGHAM CONSTRUCTION CO., INC. 1025 CENTER STREET CEDAR FALLS, IA 50613 CITY OF WITF Iain TY CLE fr'g t -'NCE 9 48:2 a Bid Security For: FY 2019 Dysart Rd. and W. 2nd St. Reconstruction Program Contract No. 970 City of Waterloo, IA 01J PH12:4S:u0 y JAI! FRrs OFF !CE BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, K. Cunningham Construction Co., Inc. as Principal, and United Fire & Casualty 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 amount 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 obligatiop is such that whereas the Principal has submitted the accompanying bid dated the 23rd day of M Y ,20 19 for FY 2019 Dysart Rd. and W. 2nd St. 11— construction Program Contract No. 970 Waterloo, iA 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 hereto a 01 d and these presents to be signed by their proper officers this 23rd day of May K. Cunningham Construction Co., InSea►) By .1,1—c— ..D �, United Fire & Casualty Company (Seal) Witness Surety,/ Ii V �i. , B Li.L�/i�i� Witness J I Sha fer Attorn-' i -fact Principal Tee owErv, (Title) uft4 INSURANCE UNITED FIRE & CASUALTY COMPANY, CEDAR RAPIDS, IA UNITED FIRE & INDEMNITY COMPANY, WEBSTER, TX FINANCIAL PACIFIC INSURANCE COMPANY, ROCKLIN, CA CERTIFIED COPY OF POWER OF ATTORNEY (original on file at Home Office of Company - See Certification) KNOW ALL PERSONS BY THESE PRESENTS, That United Fire & Casualty Company, a corpoation duly organized and existing under the laws uly ed Fof the State of Iowa; Unitedinan cal Pacific Insurance Company, I adcorporat oemnity n dulynorganized and exporation iting under the lawseof the Statxisting e of er 1Califorrnia (hereihe laws of the n colltate ect vely called the Companies), and having their corporate headquarters in Cedar Rapids, State of Iowa, does snake, constitute and appoint GREG T. LA MAIR, NANCY D. BALTUTAT, PATRICK K. DUFF, JEFFREY R. BAKER, JOSEPH I. SCHMIT, JILL SHAFFER, CHRISTOPHER R. SEIBERLING, EACH INDIVIDUALLY Inquiries: Surety Department 118 Second Ave SE Cedar Rapids, IA 52401 their true and lawflferred to sign, s d te n s behalf al undertakings and o0rterottorneys)-in-Fact with power and auority hereby bligat (ry instruments of similar t ature provided that noesingle obligation shallr exceed $100 $1100 `000, 000.lawful bonds, 00 and to bind the Companies thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Companies and all of the acts of said Attorney, pursuit to the authority hereby given and hereby ratified and confirmed. The Authority hereby granted is continuous and shall remain in full force and effect until revoked by United Fire & Casualty Company, United Fire & Indemnity Company, and Financial Pacific Insurance Company. DirectorsThis of United Fire &yis Casualty Cand san `United Fire & Int to ndemnity ynd by thority of Compa Company,e and ollowing Financial nPacific Iw nsuropted on ance rce Company. S 2013, by the Boards oI "Article VI - Surety Bonds and Undertakings" Section 2, pp bonds, o of theunCompaniings es other obligatory time, instruments of like mitten Appointment of Attorney -in -Fact. "The President or any Vice President, or any other officer the Companies may,from time to time, appoint by written may he affixed by facsimile to any power of attorney or special power of attorney or certification of ure. certificates attorneys -in -fact to act h, behalf of the Companies in the execution of policies of insurance, The eith signatureauhor e any officer s cahs sigpatuzed he and seal, mid then so used, seal,biy Companies, authorized to hereby; such sing upon the Companies withthesane forcevard effect as hohe ugh manually affianies as the xed! Such `ure of such attorneys--in-f etc subjeer ctthe original seal of the to the limitations set of Companthei tr be valid and certificates opus toe P to bind the by the (Cin ompanies theretor. `The President orla ytVice President, the Borard of Directors Companies anyothertofficerrrof the Compatiersrn of tnay ary t any tlimesre oke all power andand 10 lthe seal authority previously given to any attorney-in-fact. IN WITNESS WHEREOF, the COMPANIES have each caused these presents to be sigineOdby its ;P:Poo,_ "�'"'�,,. vice president and its corporate seal to be hereto affixed this 10th day of March, 14 UNITED FIRE & CASUALTY COMPANY UNITED FIRE & INDEMNITY COMPANY FINANCIAL PACIFIC INSURANCE COMPANY By: N Vice President State of Iowa, County of Linn, ss: ie On 10th day of being March, 2014, before me personalay; ly came Dennis J.. Richmann to me & Casu lty Com p y, ab Vice President ofd Unitedid Fise en&d sInd Indemnity Company, ahe resides ny, aCend Rapids, President of Financial Pacific e Insurance Compthe said anyent of United the ows e iis6vmentnis such corporate ate seal; that it wasted the above so affixed pursuant to authority ment; that le giveennn by the Board of Directors of said corpol of said corporations; rations and the seal that he to his name thereto pursuant to lice authority, and acknowledges same to be the act and deed of said corporations. g45.A.: Iowa Notarial Seal Patti Waddell Notary Public [ Commission number 713274 My Commission Expires 10/26/2019 My commission expires: 10/26/2019 I, Mary A. Bertsch, Assistant Secretary of United Fire & Casualty Company and Assistant Secretary of United Fire & Indemnity Company, and Assistant Secretary of Financial Pacific Insurance Company, do hereby certify that l have compared the foregoing copy of the Power of Attorney and affidavit, and in said HOMEyOFFICESection OF SAID the CORPORATIONS,resolutions and that the same area correct trans as set iscpripts thereof, andower of ofAttorney, the whole ofthe theOsa d originals, Oa and th IN said Power of Attorney has not been revoked and is now in full force and effect. In testimony whereof I have hereunto subscribed my name and affixed 19 corporate seal of the said Corporations this 23rd day of May — 1NSU aowunnbn aro mn'.- ..`°\4sp. ��,^y(y�l/t.({iV',,�1 4.. J \ MNi .00' '; •� t_� Ate" >��.._ `nf A1?1/4 pUIY 2j ��:O'_ BY: _,_c" _ • T seas ia= Assistant Secretary, sant '<� n%tea seer. `94roP"' to' UF&C & UF&I & FPIC to, nwuro � ��"sr niuno-ox ` dnmmn�oo"oe ggnn1aU0 BPOA0049 1217 CUNNINGHAM KCUNNINGHAM CONSTRUCTION CO., INC. 1025 CENTER STREET CEDAR FALLS, IA 50613 Bid Proposal For: FY 2019 Dysart Rd. and W. 2nd St. Reconstruction Program Contract No. 970 City of Waterloo, IA FORM OF BID OR PROPOSAL FY 2019 DYSART RD. AND W. 2ND ST. RECONSTRUCTION PROGRAM CONTRACT NO. 970 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 o a Partnership consisting of the following partners , having familiarize( (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), a: prepared by the City Engineer of the City of Waterloo now on file in the office of the City Clerk, Cit! Hall, Waterloo, Iowa, hereby proposes to furnish all supervision, technical personnel, labor materials, machinery, tools, appurtenances, equipment, and services, including utility an( transportation services required to construct and complete this FY 2019 DYSART RD. AND W. 2N1 ST. RECONSTRUCTION PROGRAM, Contract No. 970, all in accordance with the above -lister documents and for the unit prices for work in place for the following items and quantities: FY 2019 DYSART RD. AND W. 2ND ST. RECONSTRUCTION PROGRAM NTRACT NO. 970 BID ITEM SUDAS SPECIFICATION *SEE SUPPLEMENTAL SP = SPCL PROV DESCRIPTION UNIT EST QTY UNIT BID PRICE TOTAL BID PRICE DIVISION 2 - EARTHWORK 1 2010-108-D * TOPSOIL, 4 INCHES, ON OR OFF SITE SY 1,460.00 $ 3.5-o $ i2,y/4.66 2 2010-108-E-0 * EXCAVATION, CLASS 10 CY 6,299.00 $ 7. S' $ 1 2V2.Se 3 2010-108-G SUBGRADE PREPARATION SY 13,740.00 $ /.2_c" $ 17 r75 4 2010-108-H * SUBGRADE TREATMENT, WOVEN GEOTEXTILE OR GEOGRID SY 13,740.00 $ 2•1.-S $ 3.,"/Y: cut, 5 2010-108-1 * SUBBASE, MODIFIED TON 11,250.00 $ /9.5-4 $ 2-0,7r.6z 6 IDOT 2121 GRANULAR SHOULDER, TYPE B TON 1,200.00 $ 21.6 0 $ 257-m.c6 SUBTOTAL EARTHWORK $ 3sz 3'7.5 ' DIVISION 4 - SEWERS AND DRAINS - STORM 7 4020-108-A-1 STORM SEWER, TRENCHED, RCP 2000D, 24 INCH LF 10,00 $ 7 A B,Go $ Y80.oe 8 4020-108-A-1 * STORM SEWER, TRENCHED, RCP 2000D, 15 INCH LF 5,00 $ 8lo.eab $ 5'33.z FORM OF BID CONTRACT NO. 970 Page 1 of 20 21 SP#2 SP #3 , SW - 507, R&R TOP & INSERT ONLY INTAKE, E -1-C, R&R BOXOUT ONLY EACH EST QTY UNIT BID PRICE TOTAL BID PRICE 28.00 665.00 8,250.00 44.00 30.00 $ 7..co $ $ $ 32S.00 $ ‘9(.06.4,0 $ 6;902, so $ 7y2co. oo $ /V 300.0o $ /S.ob $ 1/4-6.66 $ FURNISH AND INSTALL SW -603 TYPE R CASTING EACH EACH SUBTOTAL STORM SEWER $ 1.00 1.00 4.00 2.00 1.00 3.00 $ SSea,00 $ SCoo.00 $ S$so•6n $ SBsll.00 $ (, 5-.0.&,0 $ vcc,6o `�8So6 9 97d. o0 $ 3 .eaao.00 $ ?,a'.* 2.00 $ /, $i o 06 $ 3/ aoo, o0 2.00 $ 1,7m,64, $ 3Sbo.6.6 5;sdn,so 22 SP # 1 DIVISION 5 - WATER MAINS AND APPURTENANCES WATER SERVICE KILL SUBTOTAL WATER APPURTENANCES EACH 2.00 $ DIVISION 7 - STREETS AND RELATED WORK 23 24 25 26 27 28 29 7010-108-A-0 7010-108-A-0 7010-108-A-0 PCC PAVEMENT 7020-108-H-0 11,050-108-A-0 7010-3.04 PAVEMENT, PCC, 7 INCH, C-SUD OR IDOT QMC PAVEMENT, PCC, 9 INCH, C-SUD OR IDOT QMC SY 548.00 PAVEMENT, PCC, 10 INCH, C-SUD OR IDOT QMC PCC PAVEMENT SAMPLES AND TESTING CONCRETE WASHOUT SY 990.00 SY LS 11, 937.00 LS 7010,3.02, J * COLD WEATHER CONCRETE PROTECTION SY LINSEED OIL TREATMENT SY 30 31 32 33 7030-108-A-0 7030-108-E-0 7030-108-E-0 SIDEWALKS, SHARED USE PATHS AND DRIVEWAYS 1.00 1.00 600.00 4,233.00 $ 3 9, fo $ 31.re, Yrys $ rooc.o.c $ ,sagem r.Go $ /. 2 s $ 2 /, 4`/$ $ y9 oosdd sd'2.s14.45- $ 6;04.0, co $ /, Ssao.oa $ 3e6c,no $ 5,Zy/.2 7030-108-G-0 34 35 7030-108-H-1 7030-108-H-2 REMOVAL OF SIDEWALK AND DRIVEWAY SIDEWALK, PCC, 4 INCH, C-4 SY 260.10 SIDEWALK, PCC, 6 INCH PEDESTIAN RAMP, C-4 DETECTABLE WARNING DRIVEWAY AND SIDEWALK, PAVED, PCC, 7 INCH, C-4 DRIVEWAY, GRANULAR SY 16.30 $ So,vo SY 79.80 SF 104.00 SY 92.00 TON 15.00 $ $ $9.4,a $ 3e.00 $ 3,90/• se $ S.Seo $s"52G.% $ y36800 $ G,3Y8oz, $ yro.00 36 37 7040-108-H-0 * 7040-3.02-A PAVEMENT REHABILITATION PAVEMENT REMOVAL, CONCRETE SY SAW CUT LF 13,161.00 SUBTOTAL STREETS AND RELATED WORK FORM OF BID 657.00 $ *,7 $ S o0 $ G2,siy,7$ $ 3Zta0 7/5; o87. Ss- CONTRACT r CONTRACT NO. 970 Page 2 of 4 BID ITEM SUDAS SPECIFICATION * SEE SUPPLEMENTAL SP = SPCL PROV DESCRIPTION UNIT DIVISION 4 - SEWERS AND DRAINS - STORM (CONTINUED) 9 4020-108-A-1 * STORM SEWER, TRENCHED, RCP 2000D, 12 INCH LF 10 4040-108-A-0 SUBDRAIN, TYPE SP, 6 INCH LF 11 4040-108-A-0 SUBDRAIN, TYPE SP, 4 INCH LF 12 4040-108-D-0 SUBDRAIN OUTLETS AND CONNECTIONS, CMP, 6 OR 8 INCH EACH 13 4040-108-E-0 STORM SEWER SERVICE STUB, TYPE S, 4 INCH LF DIVISION 6 - STRUCTURES FOR STORM SEWERS (CONTINUED) 14 6010-108-A-0 * MANHOLE, SW -402 EACH 15 6010-108-A-0 MANHOLE, SW -406, SHALLOW RECTANGULAR EACH 16 6010-108-H-0 * REMOVE MANHOLE OR INTAKE, STORM EACH 17 6010-108-B-0 INTAKE, SW -501, SINGLE GRATE EACH 18 1a 6010-108-B-0 co.H' INTAKE, SW -507 ,..-.-,,.,� EACH 20 21 SP#2 SP #3 , SW - 507, R&R TOP & INSERT ONLY INTAKE, E -1-C, R&R BOXOUT ONLY EACH EST QTY UNIT BID PRICE TOTAL BID PRICE 28.00 665.00 8,250.00 44.00 30.00 $ 7..co $ $ $ 32S.00 $ ‘9(.06.4,0 $ 6;902, so $ 7y2co. oo $ /V 300.0o $ /S.ob $ 1/4-6.66 $ FURNISH AND INSTALL SW -603 TYPE R CASTING EACH EACH SUBTOTAL STORM SEWER $ 1.00 1.00 4.00 2.00 1.00 3.00 $ SSea,00 $ SCoo.00 $ S$so•6n $ SBsll.00 $ (, 5-.0.&,0 $ vcc,6o `�8So6 9 97d. o0 $ 3 .eaao.00 $ ?,a'.* 2.00 $ /, $i o 06 $ 3/ aoo, o0 2.00 $ 1,7m,64, $ 3Sbo.6.6 5;sdn,so 22 SP # 1 DIVISION 5 - WATER MAINS AND APPURTENANCES WATER SERVICE KILL SUBTOTAL WATER APPURTENANCES EACH 2.00 $ DIVISION 7 - STREETS AND RELATED WORK 23 24 25 26 27 28 29 7010-108-A-0 7010-108-A-0 7010-108-A-0 PCC PAVEMENT 7020-108-H-0 11,050-108-A-0 7010-3.04 PAVEMENT, PCC, 7 INCH, C-SUD OR IDOT QMC PAVEMENT, PCC, 9 INCH, C-SUD OR IDOT QMC SY 548.00 PAVEMENT, PCC, 10 INCH, C-SUD OR IDOT QMC PCC PAVEMENT SAMPLES AND TESTING CONCRETE WASHOUT SY 990.00 SY LS 11, 937.00 LS 7010,3.02, J * COLD WEATHER CONCRETE PROTECTION SY LINSEED OIL TREATMENT SY 30 31 32 33 7030-108-A-0 7030-108-E-0 7030-108-E-0 SIDEWALKS, SHARED USE PATHS AND DRIVEWAYS 1.00 1.00 600.00 4,233.00 $ 3 9, fo $ 31.re, Yrys $ rooc.o.c $ ,sagem r.Go $ /. 2 s $ 2 /, 4`/$ $ y9 oosdd sd'2.s14.45- $ 6;04.0, co $ /, Ssao.oa $ 3e6c,no $ 5,Zy/.2 7030-108-G-0 34 35 7030-108-H-1 7030-108-H-2 REMOVAL OF SIDEWALK AND DRIVEWAY SIDEWALK, PCC, 4 INCH, C-4 SY 260.10 SIDEWALK, PCC, 6 INCH PEDESTIAN RAMP, C-4 DETECTABLE WARNING DRIVEWAY AND SIDEWALK, PAVED, PCC, 7 INCH, C-4 DRIVEWAY, GRANULAR SY 16.30 $ So,vo SY 79.80 SF 104.00 SY 92.00 TON 15.00 $ $ $9.4,a $ 3e.00 $ 3,90/• se $ S.Seo $s"52G.% $ y36800 $ G,3Y8oz, $ yro.00 36 37 7040-108-H-0 * 7040-3.02-A PAVEMENT REHABILITATION PAVEMENT REMOVAL, CONCRETE SY SAW CUT LF 13,161.00 SUBTOTAL STREETS AND RELATED WORK FORM OF BID 657.00 $ *,7 $ S o0 $ G2,siy,7$ $ 3Zta0 7/5; o87. Ss- CONTRACT r CONTRACT NO. 970 Page 2 of 4 BID ITEM SUDAS SPECIFICATION *SEE SUPPLEMENTAL SP m SPCL PROV DESCRIPTION UNIT EST QTY UNIT BID PRICE TOTAL BID PRICE DIVISION 8 - PAVEMENT MARKINGS AND TRAFFIC CONTROL PAVEMENT MARKINGS 38 8020-108-B-0 PAINTED PAVEMENT MARKINGS, SOLVENT/WATERBOURNE STA 87.67 $ 37.00 $ 3,243, i 9 TEMPORARY TRAFFIC CONTROL 39 8030-108-A-0 TEMPORARY TRAFFIC CONTROL LS 1.00 $ /Seoeo,00 $ /ceeo,00 40 8030-2.02 DIRECTIONAL SIGNS, PER DETAILS EACH 2.00 /SD.eo 3a7.co 41 8030-2.02 DETOUR, DYSART ROAD LS 1.00 $ ,2/sea, oc $ .2.,5-2,6 ..7.5 SUBTOTAL PAVEMENT MARKING AND TRAFFIC CONTROL $ .2 I10 y j. 77 DIVISION 9 - SITE WORK AND LANDSCAPING SEEDING 42 9010-108-B-0 * HYDRAULIC SEEDING, SEEDING, FERTILIZING AND MULCHING SY 1,936.00 $ 4Ce) $ 2/%1'.0o 43 9010-108-E-0 * WARRANTY SY 750.00 $ /.sem $ i,,zsao EROSION AND SEDIMENT CONTROL 44 9040-108-F-1 WATTLE, STRAW, 6 INCH LF 2,500.00 $ 2.3s $ 5,"87>:00 45 9040-108-F-2 WATTLE, REMOVAL LF 2,500.00 $ o.Ss" $ 11 i2S.00 46 9040-108-T-1 INLET PROTECTION DEVICE, INTERMEDIATE AND DROP IN OR SURFACE APPLIED EACH 8.00 $ /Ss -6o $ /jy80.„ 47 9040-108-T-2 * INLET PROTECTION DEVICE, MAINTENANCE EACH 8.00 $ 522,88 $ 1/4.a,eo SUBTOTAL SITE WORK AND LANDSCAPING $ I3) 90 9.� DIVISION 11 - MISCELLANEOUS CONSTRUCTION SURVEY 48 11010-108-A CONSTRUCTION SURVEY LS 1.00 $ '35e1a,oa $ 75:6pdc, SUBTOTAL MISCELLANEOUS $ TOTAL BID 1)Zs8 033.3"/ 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 i; ;ye_ r er<.er=f of �th ht fI Dollars ($ 5 . ) in the form of 8,,-/ 06174/ , is submitted herewith in accordance with the INSTRUCTIONS TO BIDDERS. 5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor. FORM OF BID CONTRACT NO. 970 Page 3 of 4 Attached hereto is a Bidder Status Form. 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 -/?//9 2. 31.2 / 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 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 Contractor shall submit information on subcontractors on "SUBCONTRACTOR REQUEST AND APPROVAL" Form to be provided by City prior to approval of contract. 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. r1• 1�(c1117;174/74 C�o)'1S7Lr(�< IiDr� Ldp ��yc. (Name of Bi• er) Official Address: (Including Zip Code): /025- eti-er 5-7L re.€ Title (//« S/23 (Date) /9 e•=11r //s TAi 5-0 13 I.R.S. No. 92 - /12.71/17 FORM OF BID CONTRACT NO, 970 Page 4 of 4 MBE/WBE BUSINESS ENTERPRISE PRE-BID CONTACT INFORMATION FORM Prime Contractor Name: 11/. Grahn;hJ/ain e.:>/i5+ a>.) c. Project: 114. 970 Letting Date: 57.23//p NO MBEIWBE SUBCONTRACTORS: If you are NOT using any MBE/WBE subcontractors to complete this project, sign below. Attach a brief explanation as to why subcontracting was not feasible with this project. If any MBE/WBE subcontractors will be used, please use the bottom portion of this form. Contractor Signature - SUBCONTRACTORS APPLICABLE: You are required, in order for your bid to be considered responsive, to provide the information on this form showing ALL of 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. 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 MBE/WBE BUSINESS ENTERPRISE CONTACTS Title: U�� -C'r :1; -*/en f Date: C43//9 Quotes Received Quotation used in bid MBE/WBE Dates Contacted Yes/No Dates Contacted Yes/No Dollar Amount Proposed to be Subcontracted /Subcontractors 'D. G . Cerpor.dtian 572.2.//9 r }/ es Cl2-09 Ye 5 2oi8Sg.94, `1)4,77;e%S fialn� ynrprovePHe+,'f 5./2-27/9 ISS 5/22//9 /1/2.5 �✓Qfe-.6 6h/4ru4-24;Dnp ..t -Le . 57/41/% Pe s' S1/4 -Z//9 IGS 69/ 9,2 S. S° 5/ 6// 9 yes 5/2 2// 9 Pe s 13/ ?. 0z, / i �-71 /V u r,"e,> y (Form CCO-4) Rev. 06-20-02 MBE/WBE BUSINESS ENTERPRISE PRE-BID CONTACT INFORMATION FORM INSTRUCTIONS Prime Contractor Responsibilities: Prime Contractors bidding on City of Waterloo contract work are regbired to ensure that MBE/WBE businesses are provided the opportunity to participate in the performance of contracts and subcontracts. Prime contractors are required to assist MBE/WBE businesses in overcoming barriers to participation, and must make good faith efforts to secure bids from, and award subcontracts to, MBENVBE businesses. For all contract bids of $50,000 or more, the following is required to demonstrate good faith efforts in accordance with this policy: 1. "MBE/WBE BUSINESS ENTERPRISE PRE-BID CONTACT INFORMATION FORM" submitted with the prime contractor bid, properly completed and signed on Form CCO-4 (Rev. 06-20-02). Please note that this document must include all subcontractor contacts, bids received, and awarded - not just those related to disadvantaged business enterprise vendors. 2. A minimum of three (3) MBE/WBE business contacts must be made and documented, if there are at least three (3) MBE/WBE businesses offering services in the areas to be subcontracted (see City of Waterloo MBENVBE Certified List). If less than three (3) are offering the services to be subcontracted, then a contact is required for any that are listed as providing that service. If you have submitted a MBE/WBE contact not on the City's MBENVBE list, attach a copy of the certification from another government agency. 3. Contacts to each MBE/WBE businesses are required to be a minimum of seven (7) working days prior to the date the prime contractor submits the bid to the City of Waterloo. 4. The following documentation must accompany the "MBENVBE BUSINESS ENTERPRISE PRE-BID CONTACT INFORMATION FORM" for each MBE/WBE business contacted: a. A copy of the bid received from the MBENVBE, OR b. If no bid was received, a copy of correspondence received from the MBENVBE with a "no bid" response, OR c. If no response was received, a copy of the solicitation sent to the MBE/WBE with proof of mailing attached. 5. If any MBENVBE business submitting bids are not selected for subcontract award, documentation must accompany the "MBE/WBE BUSINESS ENTERPRISE PRE-BID CONTACT INFORMATION FORM" on why the MBENVBE was not selected. These reasons could include: a. Not low bid. Copies of the competing bids may be required for verification. b. MBENVBE did not bid, withdrew bid or was non-responsive. c. Documentation of other business-related reason for not selecting the MBENVBE business for a subcontract. d. Prime contractor self performs work. e. Any other reason relied on by the Prime Contractor. The Contract Compliance Officer will determine the weight to be given to each item listed above (supported by appropriate documentation) based on overall program goals. Subcontractors Responsibilities: 1. Each MBENVBE firm planning to submit quotes on construction projects with goals, shall submit a Letter of Intent to Bid (Form CCO-5) to the City Contract Compliance Officer seven (7) working days prior to bid opening, listing specific items which the MBE/WBE firm is interested in bidding. If the City Contract Compliance Officer does not receive sufficient scope letters seven (7) working days prior to bid opening, goals on subject project will be reduced accordingly. Agreements between the bidder/proposer and an MBENVBE in which the MBE/WBE promises not to provide subcontracting quotations to other bidders/proposers are prohibited. Form CCO-4A Rev. 07-08-02 NON -COLLUSION AFFIDAVIT OF PRIME BIDDER State of r t `' 2 County of BJ4 k ,%4) ) )ss -me_ (I&/eh , being first duly sworn, deposes and says that: 1. He is (Owner, Partner icer -( representative, or Agent) , of /! eimn.Yr� ),,, G'.6) -+t}. e' .) _Z./1z • , the idd r 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. (Signed) Title Subscribed and sworn to before me this 43 TV)LLy ,201 My commission expires day of \-)g).cra.( itle ��"` • DIANE L CALEY « COMMISSION NO.703084 MY COMMIES R_ . PIRES "Di& MAY 0, Bidder Status Form To be completed by all bidders Part A Please answer "Yes" or "No" for each of the following: J "Yes 0 No [yes 0 No (]Yes 0 N [Yes ❑ No El/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). 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: 6 / 27 / 7 9 Dates: to ' / 23 / /9 Address* /a.25 (n7`e✓ 5.:7lv / City, State, Zip* ----0-€24,1 - 572 /4 •1-4 Coe. 13 / / to / / Address: City, State, Zip: / Address: City, State, Zip* Dates: / / to / You may attach additional sheet(s) if needed. 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 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: nif)p; i4a.rrn Go15J71ru' /p}? 2 ) 2./74. • Signature: Date: s1,2 3 /i9 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) Worksheet: Authorization to Transact Business 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. ErYes ❑ No O Yes 12 -No ❑ Yes ErNo ❑-Yes 0 N O Yes 0'No O Yes a1Jo My business is currently registered as a contractor with the Iowa Division of Labor. My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. 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. 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. 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. My business is a limited liability partnership which has filed a statement of qualification in this state and the statement has not been canceled, O Yes ErNo 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. ❑ Yes No 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. O Yes ErNo 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. O Yes ErNo My business is a limited liability company whose certificate of organization is filed in Iowa and has not filed a statement of termination. O Yes Er -No 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)