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Bond Number: BB00209
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HUDSON
1N�tii:•�Nt 1.Gl:(7tJI
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That IJUDSON INSURANCE COMPANY, a corporation of' the State of Delaware, with
offices at 100 William Street, New York, New York, 10038, has made, constituted and appointed, and by these presents, does make, constitute and
appoint
David Gonsalves
of the State of North Carolina
its true and lawful Attorney(s)-in-Fact, at New York, New York, each of them alone to have full power to act without the other or others, to make,
execute and deliver on its behalf, as Surety, bonds and undertakings given for any and all purposes, also to execute and deliver on its behalf as
aforesaid renewals, extcnstons, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that no single
bond or undertaking shall obligate said Company for any portion of the penal sum thereof in excess of the sum of
Five Hundred and Eighty Three ($583.00 ) Dollars
Such bonds and undertakings when duly executed by said Attorneys) -in -Fact, shall be binclung upon said Company as fully and to the same
extcnt as if signed by the President of said Company under its corporate seal attested by its Secretary.
In Witness Whereof, HUDSON INSURANCE COMPANY has caused these presents to be of its Senior Vice President thereunto duly
authorized, on this 16th day of November , 20 17 at New York, New York.
(Corporate seal)
Attest LA
Dina Daskalakis
Corporate Secretary
1,
STATE OF NEW YORK
COUNTY OF NEW YORK. SS.
HUDSON INSURANCE COMPANY
By
Michael P. Cifone
Senior Vice President
On the 16th day of November , 20 17 before me personally came Michael P
depose and say that he is a Senior Vice President of HUDSON INSURANCE COMPANY, the corporatio
that he knows the seal of said Corporation, that the seal affixed to said instrument is such corporate seal, th
Corporation, and that he signed his name thereto by like order.
amino, ,tt,`Nt'
(Notarial Seal) `PNM
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STATE OF NEW YORK •, A' ' ' ' ' ' ' •,��
COUNTY OF NEW YORK 'SKr/ j0
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The undersigned Dina Daskalakis hereby certifies:
That the original resolution, of which the following is a true and correct copy, was duly adopted by unanimous written consent of the Board of Directors of
Hudson Insurance Company dated July 27s, 2007, and has not since been revoked, amended or modified:
"RESOLVED, that the President, the Executive Vice Presidents, the Senior Vice Presidents and the Vice Presidents shall have the authority and
discretion, to appoint such agent or agents, or attorney or attorneys -in -fact, for the purpose of carrying on this Company's surety business, and to
empower such agent or agents, or attorney or attorneys -in -fact, to execute and deliver, under this Company's seal or otherwise, bonds obligations, and
recognizances, whether made by this Company as surety thereon or otherwise, indemnity contracts, contracts and certificates, and any and all other
contracts and undertakings made in the course of this Company's surety business, and renewals, extensions, agreements, waivers, consents or stipulations
regarding undertakings so made; and
FURTHER RESOVLED, that the signature of any such Officer of the Company and the Company's seal may be affixed by facsimile to any power
of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature
thereof or related thereto, such signature and seal when so used whether heretofore or hereafter, being hereby adopted by the Company as the original
signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though
manually affixed."
THAT the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and of the whole of the original and that the
said Power of Attorney is still in full force and effect and has not been revoked, and furthermore that the Resolution of the Board of Directors, set forth in the said
Power of Attorney is now in force.
Witness the hand of the undersigned and the seal of said Corporation this 26th day of June , 2019 .
(Corporate seal)
ifone to me known, who being by me duly sworn did
described herein and which executed the above instrument,
it was so : ffi _ d by order of the Board of' Directors of said
CERTIFICATION
iV1V7.1 IFP
Notary P?'ufilic, State of Ne , York
No. 01MU6067553
Qualified iii NaTaau County
Commission Expires December 10, 2021
By
Dina Daskalakis, Corporate Secretary
6600209
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Todd Miller dba Ted Electric
as Principal, and Hudson Insurance Company
as Surety are held and firmly bound unto the C of Waterloo Iowa, hereinafter called
"OWNER." In the penal sum Five Hundred Eighty Three and 00/100
Dollars ($ 583.00 ) 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 26th day of June
for termiaaL6uilding I Fl 1 ighting - TERMINAL. IMPROVEMENTS
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 affixed and these pres-
ents to be signed by their proper officers this 26th day of June , A.D. MO( 2019
Todd Miller dba Ted Electric (Seal)
Principal
By (6,,) Oa,
(Title)
Witness
Witness Nick B
BID BOND
AECOM 60600098
hudson Insurance Company (Seal)
Surety
By ,;.1_
Attr ey-in-fact David Gonsalves
CSVI 91109AL0200 Terminal Bldg LED Lighting -Terminal Imprvmnts
CONTRACT NO. 20601 BB -1 of 1
FORM OF BID OR PROPOSAL
Terminal Building LED Lighting -
TERMINAL IMPROVEMENTS
WATERLOO REGIONAL AIRPORT
In the 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 4,n, a
Partnership consisting of the following partners: NI A
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 AECOM 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 Terminal Building LED Lighting - TERMINAL
IMPROVEMENTS, all in accordance with the above -listed documents and for the unit prices for
work in place for the following items and quantities:
2. It is understood that the quantities set forth are approximate only and subject to va iation 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 Go fro. --.4A t\Ff I / 'i i <
Dollars ($ /goc,�-ir ) in the form of 0card , is submitted herewith
in accordance with the INSTRUCTIONS TO BIDDERS.
FORM OF BID CSVI 91109AL0200 Terminal Bldg LED Lighting -Terminal Imp -amnia
AECOM 60600098 CONTRACT NO. 20601 BF -1 of 2
Terminal Building LED Lighting -
TERMINAL IMPROVEMENTS
CSVI PROJECT NO. 91190AL0200
IDOT CONTRACT NO. 20601
Item
Ref.
Item
Unit
Estimated
Quantity
Unit Bid
Price
Total Bid Price
1
Terminal
LED Lamps,
Lobby Area
Building
Terminal
/ Bag
Relamp
Claim
with
Building
EA
148
$t•I`�
`j L.
$
y
sr:
/i •
Ballast
EA
74
1
$ 7--- , 4a=
$
.i
$
$
/ Ch00 . '"-
,r
2
Replace
3
Interior Office
(3EA
'-0" by 7
-0")
Door
A o a
4
Metal Frame for Door
EA
1
s
$ too°.
$
/coo.
5
Demolish and Reframe for
Door
LS
1
$ 00 '
$ 33co.
TOTAL BASE BID
$
2. It is understood that the quantities set forth are approximate only and subject to va iation 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 Go fro. --.4A t\Ff I / 'i i <
Dollars ($ /goc,�-ir ) in the form of 0card , is submitted herewith
in accordance with the INSTRUCTIONS TO BIDDERS.
FORM OF BID CSVI 91109AL0200 Terminal Bldg LED Lighting -Terminal Imp -amnia
AECOM 60600098 CONTRACT NO. 20601 BF -1 of 2
Attached hereto is a Non -Collusion Affidavit of Prime Contractor,
Attached hereto is a Bidder Status Form indicating Resident Bidder Certification ( ) or
Non -Resident Bidder Certification ( N iR ). (Mark ane.)
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.
The bidder has received the following Addendum or Addenda:
Addendum No.
PSf�
0
Date N I1\
NIA
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.
BY:
e eF e-rR f c -
(Name of Bidder)
(Date)
Official Address: (Including Zip Code):
peevifca►,M,F_r�,
C flPik rA tF60- -A A+ S0 13
I.R.S. No. 166"Z - *LI 3 05-93
Title o'ua r£PP
FORM OF BID CSV191109AL0200 Terminal Bldg LED Lighting -Terminal Imprvmnts
AECOM 60600098 CONTRACT NO. 20601 BF -2 of 2
Main Office:
Phone: 319-269-7173
ELECTRICAL PROPOSAL
Estimating Dept.:
Phone: (330) 633-3889
Fax: (330) 633-7313
Date: 6/26/19
Project: Terminal Building LED Lighting Terminal Improvements
Proposal includes all electrical labor, material and equipment as per electrical plans sheets. Drawings
are by AECOM and are undated.
Inclusions:
Furnish and install new ballast. (QTY:73)
Furnish and install new lamps. (QTY:146)
Cleaning of existing fixtures.
Disposal of existing ballast and lamps.
Hollow metal frame door.
Demo existing metal door.
Drywall, painting repair for the installation of new door as shown on plans and bid form.
Sales tax.
All work to be performed during normal business hours.
Permits.
Exclusions:
Liability for errors or omissions in designs by others, nor inadequacies of materials and equipment
specified or supplied by others.
merits-. Alt-t'neswarre-te-be toVTr Ty -GC: `7v:\
Roof penetrations. All to be performed by a bonded roofing contractor.
Temp power and lighting.
Lighting control. Figured all existing.
Independent electrical testing if required.
Base Bid $11,654.00
Respectfully submitted,
Ted Electric
INFORMATION NEEDED
FOR
IOWA CONSTRUCTION SALES TAX EXEMPTION CERTIFICATE
CONTRACTOR NAME:
�4 GTA
ADDRESS: (o3 t I 36-0 LL,oPnr\ rJ-r
< cc,'3
(Check One PRIME X
SUBCONTRACTOR
FEDERAL ID#: ce2, coct171
PROJECT NAME: J t 2PoA-r
cl7'Arh Ira At (c t( 1-4TIwis
D ROJECT CONTRACT NO.:
D ESCRIPTION OF WORK:
D Brickwork
»Carpentry
D Concrete
D Drywall -Plaster -Insulation
NI Electrical
D Excavation/Grading
D Flooring
D Heavy Construction
D Heating -Ventilating -Air Cond.
SALES TAX EXEMPTION
AECOM 60600098
D Landscaping
D Painting
D Paving
D Plumbing
D Roofing -Siding -Sheet Metal
D Windows
D Wrecking -Demolition
D Other (Please specify)
CSVI 91109AL0200 Terminal Bldg LED Lighting-Temiinel Imprvmnts
CONTRACT NO. 20601 STE-1 of 1
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
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.
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 agreement or other contract or understanding, a notice advising said labor union or
workers' representative of the contractor's commitment under this section.
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.
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.
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 may be canceled,
terminated or suspended in whole or in part and the contractor may be declared ineligible for
further contracts in accordance with procedures authorized by the City Council.
EQUAL OPPORTUNITY CLAUSE
AECOM 60600098
CSVI 91109AL0200 Terminal Bldg LED Lighting -Terminal Imprvmnts
CONTRACT NO. 20601 EOC-1 of 2
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.
EQUAL OPPORTUNITY CLAUSE
AECOM 60600098
(Signed)
(Appropriate Official)
04.—A-A*rac-t-e-.1
(Title)
(Date)
CSVI 91109AL0200 Terminal Bldg LED LIghtIng-Terminal Imprvmnts
CONTRACT NO, 20601 EOC-2 of 2
D -1
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W z Project# ✓�1 a, Porker_"ri Ito/4L TARGETED SMALL BUSINESS (TSB)
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PRE-BID CONTACT INFORMATION
County %.-A-C\L., Amit,
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In order for your bid to be considered responsive, you are required to provide information on this form showing your Targeted Small Business contacts made with your bid
o submission. This information is subject to verification and confirmation.
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(To Be Completed By AI Bidders per the Current Contract Provision)
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In the event it is determined that the Targeted Small Business goals are not met, then before awarding the contract the Contracting Authority will make a determination as
to whether or not the apparent successful low bidder made good faith efforts to meet the goals,
NOTE: Every effort shall be made to solicit quotes or bids on as many subcontractable items as necessary to achieve the established goals. If a TSB's quote is used in the
bid, it is assumed that the firm fisted will be used as a subcontractor
TABLE OF INFORMATION SHOWING BIDDERS PRE-BID
TARGETED SMALL BUSI
Total dollar amount proposed to be subcontracted to TSB on this pro ect s .5r/ 00>
List items by name to be subcontracted:
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DATES
CONTACTED
QUOTES RECEIVED
QUOTATION USED IN BID
YES/
NO
DATES
CONTACTED
YES/
NO
DOLLAR AMT. PROPOSED
TO BE SUBCONTRACTED
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Total dollar amount proposed to be subcontracted to TSB on this pro ect s .5r/ 00>
List items by name to be subcontracted:
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NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of -FoaJc`
Q/ f� )ss
County of �t(CE r� 4 die )
f//,
being first duly sworn, deposes and says that:
1 He is r, Partner, Officer, Representative, or Agent) , of 771 Sad??
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,
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)
Subscribed and sworn to before me this ° day of
My commission expires l6 -
NON -COLLUSION AFFIDAVITS
AECOM 60600098
Title
Club,
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20a.
KARLA TR!
icon Number 171479
"mrrild- ton
CSVI 91109AL0200 Terminal Bldg LED Lighting -Terminal Imprvmnts
CONTRACT NO. 20601 NCAA of 2
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