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FORM OF BID OR PROPOSAL
FY 2020 CEDAR RIVER BLADDER DAM REPAIRS
CONTRACT NO. 996
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 Iowa , a
Partnership consisting of the following partners: none
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 CEDAR RIVER
BLADDER DAM REPAIRS, City Contract No. 006, 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 CEDAR RIVER BLADDER DAM REPAIRS
CITY CONTRACT NO. 996
ITEM
NO.
ITEM
UNIT
TOTAL
QTY.
UNIT BID
PRICE
TOTAL BID PRICE
1
3/4" ELBOW, SCH 40, BRASS
EA
5
$ 75.00
$ 375.00
2
3/4" NPT to 3/4" HOSE BARB, BRASS
EA
5
$ 80.00
$ 400.00
3
3/4" WORM DRIVE HOSE CLAMP, STAINLESS
EA
20
$
17.00
$ 340.00
4
3/4" HOSE INSERT, STAINLESS, 24" LENGTH
EA
5
$ 83.00
$ 915.00
5
3/4" HOSE, EDPM, POLYESTER REINFORCED,
26"LENGTH
EA
5
$
80.00
$ 400.00
6
3/4" NPT TO 3/4" HOSE BARB, STAINLESS
EA
5
$ 85.00
$ 425.00
7
3/4" DIA x 1" LONG PLASTIC TUBE
EA
5
$ 60.00
$ 300.00
8
8"WIDE x110"t RESTRAINING STRAP
EA
10
$ 1 100.00
$ 11,000.00
9
BLADDER LEAK REPAIR
EA
5
$ 750.00
$ 3,750.00
10
AIR PRESSURE TESTING
LS
1
$10,000.00
$ 10, 000.00
11
SANDBAG COFFERDAM
TON
90
$ 700.0f
$ 63,000.00
12
COFFERDAM PUMPING
LS
1
$ 15, 000.00
$ 15, 000.00
13
CONCRETE GROUT
CY
200
$ 230.00
$ 96, 000.00
14
TRAFFIC CONTROL
LS
1
$25,000.00
$ 25,000.00
15
MOBILIZATION
LS
1
$110,
000.00
$ 410,
000.00
Five Hundred eighty—six thousand four TOTAL BID AMOUNT
$ 586,
405.00
hundred five dollars 00/100
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
FORM OF BID
AECOM #60612964
FB -1 of 3 FY 2020 Cedar River Bladder Dam Repairs
City Contract No. 996 City of Waterloo, Iowa
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 Bid Bond
Dollars ($
5% )in the form of
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 Bidders 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.
The bidder has received the following Addendum or Addenda:
Addendum No. none Date
10. The bidder shall list the MBE/VVBE 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".
FORM OF BID
AECOM #60612964
FB -2 of 3 FY 2020 Cedar River Bladder Dam Repairs
City Contract No. 996 City of Waterloo, Iowa
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.
Peterson Contractors, Inc.
(Name of Bidder)
Title
icial Address: (Including Zip Code):
104 Blackhawk Street - PO Box A
Reinbeck, IA 50669
LR.S. No. 42-0921654
10-29-19
(Date)
FORM OF BID
AECOM #60612964
FB -3 of 3 FY 2020 Cedar River Bladder Dam Repairs
City Contract No. 996 City of Waterloo, Iowa
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of Iowa )
)ss
County of Grundy )
Jordan Muller , being first duly sworn, deposes and says that:
He is (Owner, Partner, Officerepresentativor Agent) , of Peterson Contractors, Inc
the Bidder that has submitted the attached Bid;
He is fully informed respecting the preparation and contents of the attached Bid and of all
pertinent circumstances respecting such Bid;
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 e part of the Bidder or any of its
agents, representatives, owners, employees, or parti est, including this affiant.
(Signed)
"PM c- •
Title
Subscribed and sworn to before me this d day of 0 G'+tb tr
201q
QW ACX br (JI'
Title
My commission expires 1 I f y%ir
NON -COLLUSION AFFIDAVITS
AECOM #60612964
t r JENNIFER R WISSLER
r Commission Number 761292
My Commission Expires
January 04, 2022
0
NCA -1 of 2 FY 2020 Cedar River Bladder Dam Repairs
City Contract Nol. 996 City of Waterloo, Iowa
Bidder Status Form
To be completed by all bidders Part A
Please answer Yes" or "No" for each of the following:
n 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.
C 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.
n Yes X 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
P art B
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates: 01 / 01 / 66 to 10 / 24 / 19 Address: 104 Blackhawk Street
City, State, Zip: Reinbeck, IA 50669
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 ■ 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
P art 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: Peterson Co tractors, Inc
Signature:
Date:
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.
■
Yes • No My business is currently registered as a contractor with the Iowa Division of Labor.
Yes ® No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes.
Yes ® No 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.
Yes • No 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 [] 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 X No 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 ® 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.
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.
Yes lit No 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.
❑ Yes X No My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
Yes I 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)
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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 Amount Bid
Dollars ($ 50/0
) 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 24th day of
October , 20 19, for FY 2020 Cedar River Bladder Dam Repairs, City Contract No. 996
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 affixed and these pres-
ents to be signed by their proper officers this 11th day of October , A.D. 2019 .
Peterson Contractors, Inc. (Seal)
Bsk
Traveler as an
president
et Corn an of America (Seal)
Witne!s
Witness
Dione R. Yo
BID BOND
AECOM #60612964
BB -1 OF 1
City Contract No. 996
torney-in-fact
Anne Crowner
FY 2020 Cedar River Bladder Dam Repairs
City of Waterloo, Iowa
TRAVELERS J
Travelers Casualty and Surety Company of America
Travelers Casualty and Surety Company
St. Paul Fire 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 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.
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.
078
IN WITNESS WHEREOF, 1 hereunto set my hand and official seal. /J
By:
Robert L. Raneenior Vice President
My Commission expires the 30th day of June, 2021
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.
1, 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 11th
day of October
, 2019 .
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,