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FORM OF BID OR PROPOSAL
FY 2020 LEVEE TREE REMOVAL
CONTRACT NO. 990
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/1 Partnership consisting of the following partners:
t.. C
a,.l ws
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 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 FY 2020 LEVEE TREE REMOVAL, Contract No. 990, all in
accordance with the above -listed documents and for the unit prices for work in
place for the following items and quantities:
FY 2020 LEVEE TREE REMOVAL
CONTRACT NO. 990
FORM
BID';
ITEM
DESCRIPTION..
.UNIT
EST. QTY.
UNIT BID :
PRICE
TOTAL BID PRICE
1
MOBILIZATION
LS
1.00$
1zIS06r
—
$ 1215604
2
CLEARING AND GRUBBING
ACRE
2.40
$ ®co ¢'
4 --3
$ 6/4•000,--
3
CLEARING AND GRUBBING, LILAC BUSH
EA
1.00
$ 309 ,
$ sec,
4
CLEARING AND GRUBBING, 10 INCH
WALNUT
EA
1.00
$ spa ,
$ sap ,_
5
CLEARING AND GRUBBING, 18 INCH
WALNUT
EA
1.00
$ 7sz_
$ 75.-25,�
6
CLEARING AND GRUBBING, 36 INCH ELM
EA
1.00
$ Astor
$ ice;
7
CLEARING AND GRUBBING, 46 INCH ELM
EA
1.00
$ 35-00,
$ 3sco
8
CLEARING AND GRUBBING, CUT AND
SPRAY
ACRE
0.41
$ 7 jr�
$ ee,-525 i
9
SEEDING, FERTILIZING, AND MULCHING
ACRE
2.40
$ 32c0 r
$ 7650[
10
TRAFFIC CONTROL
LS
1.00
$ ase° r
$ /SVO,COr
TOTAL B
D $ //23 sea
ea-
--
1
FORM OF BID
CONTRACT NO, 990
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withdrawn, the undersigned agrees to execute and deliver an agreement in the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 S7
Dollars ($ ) in the form of 23,o &sn
is submitted herewith in accordance with the INSTRUCTIONS TO BIDDERS
5.
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
Attached hereto is a Non -Collusion Affidavit of Prime Contractor.
8. The Prime Contractor and Subcontractor(s), which have performed an aggregate
of $10,000.00 in work for the City in the current calendar year, are prepared to
submit an AAP or Update and an EOC within ten (10) days of notification that the
bid submitted is lowest and acceptable.
The bidder has received the following Addendum or Addenda:
Addendum No. Date
10. The bidder shall list the MBENVBE subcontractor(s), amount of subcontracts and
bid items on the City of Waterloo Minority and/or Women Business Pre-bid
Contact Information Form submitted with this Form of Bid or Proposal. The
apparent low Bidder shall submit a list of all other Subcontractor(s) to be used on
this Project to the City of Waterloo by 5:00 p.m the business day following the day
Bids on this Project are due along with the Non -Collusion Affidavits of All
Subcontractor(s).
The Contractor shall submit information on subcontractors on
'SUBCONTRACTOR REQUEST AND APPROVAL" Form to be provided by City
prior to approval of contract.
FORM OF BID
CONTRACT NO. 990 Page 2 of 3
The subcontractors listed on this proposal and/or submitted to the Contract
Compliance Officer cannot be changed except for the following reasons:
1) The City of Waterloo does not approve the subcontractors.
2) The subcontractors submit in writing that they cannot fulfill their
subcontracts.
11. The bidder has filled in all blanks on this proposal. Those blanks not applicable
are marked 'none' or 'NA'
12. The bidder has attached all applicable forms.
13. The Owner reserves the nght to select alternates, delete line items, and/or to
reduce quantities prior to the award of a contract due to budgetary limitations.
1 TETL.SorJ
c&ts.
BY.
/019/2ol9
(Name of Bidder) ( )
Title eSnMAizr2
Official Address (Including Zip Code):
) U 1 ; I acYJn.a.u0 IC. S--•
.,nloder f Sr) CO CI
I.R.S. No. g2-ogZl(ri.5t1
FORM OF BID
CONTRACT NO. 990 Page 3 of 3
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we
as P cipal, and
as Sure are held and firmly bound unto the CITY OF WATERLOO Iowa, hereinafter called
"OWNER." n the penal sum
Dollars ($ ) lawful money of the United States, for the paym= t
of which sum w and truly be made, we bind ourselves, our heirs, executors administrators, and
successors, jointly - d severally, firmly by these presents The condition of this .bligation is such that
whereas the Principal 'as submitted the accompanying bid dated the day of
20 for
NOW, THEREFORE,
(a) If said Bid shall be rejected, or the alternate,
(b) If said Bid shall be accepted and t Principal shall execute a • deliver a contract in the form specified
and shall furnish a bond for his faithful rformance of said coract, and for the payment of all persons
performing labor or furnishing materials in nnection therewitr and shall in all other respects perform the
agreement created by the acceptance of said id,
Then this obligation shall be void, otherwise the -ame
understood and agreed that the liability of the Su
exceed the penal amount of this obligation as herein
all remain in force and effect; it being expressly
r any and all claims hereunder shall, in no event,
ted.
By virtue of statutory authority, the full amount of is bid band shall be forfeited to the Owner in liquidation of
damages sustained in the event that the Prinpal fails to -xecute the contract and provide the bond as
provided in the specifications or by law.
The Surety, for value received, hereby sti
shall be in no way impaired or affecte
such Bid or execute such contract an
lates and agrees that e obligations of said Surety and its bond
y any extension of the. t ' e within which the Owner may accept
said Surety does hereby waiv notice of any such extension.
IN WITNESS WHEREOF, the Pri ipal and the Surety, have hereunto t their hands and seals, and such
of them as are corporations, hay: caused their corporate seals to be heret affixed and these presents to be
signed by their proper officers is day of A.D. 01.
Witness
Witnes
By
(Seal)
Principal
(Sea
Surety
By
Attorney-in-fact
(Title)
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of 4 -ow
County of u¢') .k )
14,{ -Tr reekt-r lti being first duly sworn, deposes and says that:
)ss
He is (Owner Partner, Officer, epresentative or Agent) of \-1'4n:7
the Bidder thatas summit ed the attached Bid;
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
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)
77H!/l�'L
Title
Subscribed and sworn to before,(ne this 1 I
0 rx-v 201 N.
My commission expires
1IyI27-1
day of
LoI -L✓ Act . ite4 veer
IL 4 JENNIFER R WISSLER
c Commission Number 761292
My Commission Expires
�
January 04, 2022
Title
State of
Coun
that:
NON --COLLUSION AFFIDAVI F OF SUBCONTRACTOR
) ss:
being first duly sworn deposes and says
1. He is (Owner, Partner, Officer, Representative, or Mien , of
hereinafter referred to as the "Subcontractor;"
2. He is fully informed respecting the preparation and c• tents of the subcontractor's
proposal sub itted by the subcontractor to
contract pertaining to the
(City or County and Stat
project in
3. Such subcontractor's p •posal is genuine and is of a collusive or sham proposal;
4. Neither the subcontractr nor any of its officers, partners, owners, agents,
representatives, employees, •r parties in i terest, including this affiant, has in any way
colluded, conspired, connived, •r agreed, • irectly or indirectly, with any other bidder, firm
or person to submit a collusive • sha proposal in connection with such contract or to
refrain from submitting a proposal co nection with such contract, or has in any manner,
directly or indirectly, sought by unla ,► uI agreement or connivance with any other bidder,
firm or person to fix the price or • is -s in said subcontractor's proposal, or to fix any
overhead, profit or cost element o the ice of prices in said subcontractor's proposal, or
to secure through collusion, 'onspira• , connivance or unlawful agreement any
advantage against the City of aterloo, lo a, or any person interested in the proposed
contract; and
5. The price or prices quoted 'n the subcontractor's •roposal are fair and proper and are not
tainted by any collusion, r.onspiracy, connivance o unlawful agreement on the part of the
bidder or any of its ag-°nts, representatives, owne s, employees, or parties in interest,
including this affiant.
(Signed)
Subscribe • and sworn to before me this _ day of
201
My c
mission expires
Title
Bidder Status Form
To be completed by all bidders Part A
Please answer "Yes" or "No" for each of the following:
IPl� 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.
El -Yes ❑ No My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
Q Yes ❑ 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
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates:
iy / 2y /11(_S _ to e jlV-41 Address: (tai �1d.-l'.1�.-4`P,.N1u S}
- G7
City, State, Zip: '.�}._iu�'�.t. - I1 w9
Dates: /.. /_.. ___ _. to / ,/ .. Address.
City, State, Zip:
Dates: 1./.. 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 bidders who are residents? ❑ 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.
-) t
Firm Name.i..(.{ x i271'"l _ ( •A cg�c Ac7Yw c
G"1Date: i�(� r
4`
Signature
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 02-14
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.
[✓Yes ❑ No
❑ Yes ET -No
❑ Yes E110
a - Yes❑ No
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.
❑ Yes Pe -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 allo My business is a limited liability partnership which has filed a statement of qualification in this
state and the statement has not been canceled.
Yes [a -No
❑ Yes 2 rvo
•
■
Yes
Yes ❑'No
❑ Yes [] No
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 02-14
111F MI ME MI IS MI MU
MBEIWBE BUSINESS ENTERPRISE
et= C NTACT INFORMATIO FORM `7^
Prime Contractor Name: S �.N1'!4L'Qt6 . Project: ?ni .� 1 (/j,(Letting Date: TUI t 1 znii q
NO MBE/WBE SUBCONTRACTORS: If you are NOT using any MBE/WBE subcontractors to complete th's project, sign below. Attach a brief
explanation as to why subcontract p was not feasible v ith this project. If any MBE/WBE subcontractors will be used, please use the bottom
portion of this form.
Contractor Signature:
Title: ,t`6Tii#h'f-7d C— Date: /V/O Z.✓7`�'
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 MBEMJBE 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
10i
yes
ioflo
yes
7080.
fitter-thhAlaell
?et. -its stc �,
..
.- ..,,,.e
(Form CCO-4) Rev. 06-20-02
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Peterson Contractors, Inc.
as Principal, and Travelers Casualty and Surety Company of America
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 ($ ) 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 10th day of October
2019 , for FY 2020 Levee Tree Removal - Contract No.29_0 in the City Qf Watwloo,
_Iowa
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 matenais 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 presents to be
signed by their proper officers this 30th day of September , A D. 2019
Wi
By
Peterson Contractors, Inc.
Prince
(Seal)
president
Travelers Cas city . n • Surety Company of iknArAv
Witness Dione R. Young
B
Attorney-in-fact Anne Crowner
(Title)
TRAVELERS.'
Travelers Casualty and Surety Company of America
Travelers Casualty and Surety Company
St. Paul Eire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St.
Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the
"Companies"), and that the Companies do hereby make, constitute and appoint Anne Crowner of Waukee
Iowa , their true and lawful Attorney -in -Fact to sign, execute, seal and acknowledge any and all bonds, recognizances,
conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the
fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any
actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 17th day of January,
2019.
of rtamay.
(ARTFORD1
ON%
ONM. e
M@4 .0647
tian y
urnrA#
State of Connecticut
City of Hartford ss.
On this the 17th day of January, 2019, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President
of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and
that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said
Companies by himself as a duly authorized officer.
IN WITNESS WHEREOF, 1 hereunto set my hand and official seal.
hJ \rG
c HARTFORD, 1
CONN. / on
By:
Robert L. Rane
Senior Vice President
My Commission expires the 30th day of June, 2021
fitNb
.
v
VOTARY
p1)T'L1C
74 i
ZAC
Anna P. Nowik, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and
Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which resolutions are now in full
force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any
Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and
Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign
with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a
bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke
the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice
President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such
delegation Is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional
undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any
Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any
Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary, or (b) duly executed (under seal, if
required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one
or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice
President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of
Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of
executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing
such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile
signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety
Company, and St. Paul Fire and Marine Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of the Power of
Attorney executed by said Companies, which remains in full force and effect.
Dated this 30th day of September , 2019
1' yL'k
Kevin E. Hughes, Assistant Secretary
To verify the authenticity of this Power of Attorney, please call us at 1-800-421-3880.
Please refer to the above-named Attorney -in -Fact and the details of the bond to which this Power of Attorney is attached.