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Home My WebLink AboutWRH, Inc.WRH, Inc. PO Box 256 Amana, IA 52203 BID BOND* F.Y. 2020 Wastewater Treatment Plant Biosolids Modifications City Contract No. 994 s. �o� City Clerk City Hall City of Waterloo 715 Mulberry Street Waterloo, IA 50703 WRH, Inc. PO Box 256 Amana, IA 52203 BID• F.Y. 2020 Wastewater Treatment Plant Biosolids Modifications City Contract No. 994 City Clerk City Hall City of Waterloo 715 Mulberry Street Waterloo, IA 50703 BID BOND K NOW ALL MEN BY THESE PRESENTS, that we, WRH, Inc. as Principal, and Merchants Bonding Company (Mutual) 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 D ollars ($ 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 obligation is such that whereas the Principal has submitted the accompanying bid dated the 23rd day of January , 20 20 , for F.Y. 2020 Wastewater Treatment Plant Biosolids Modifications, City Contract No. 994, City of Waterloo, Waterloo, Iowa N OW, 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 presents to be signed by their proper officers this 15th day of January , A.D. 20 20 . 1, twa Witness Virginia= Possehl orporate Secretary Witness Sty Venn WRH, Inc. (Seal) Principal By Vic( President Jamie Rich BusiON procurement Merchants Bonding Company (Mi al) Surety � � r By (meal) Attorney-in-fact R. Young BID BOND Section BB -1 4463.004/City Contract No. 994 MERCHANTS BONDING COMPANYna POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Anne Crowner; Brian M Deimerly; Cameron M Burt, Cindy Bennett; Craig E Hansen; Dana Wiebers; Dione R Young; Jay D Freiermuth, Kathleen Brewer; Kevin J Knutson; Michelle R Gruis; Sarah Brown; Seth D Rooker; Shirley S Bartenhagen; Stacy Venn; Sydney Burnett; Tim McCulloh; Wendy A Casey their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments 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. This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused • :I?"Rpf°•e..• • ';= 2003 ;;,o; this instrument to be signed and STATE OF IOWA COUNTY OF DALLAS ss. On this this 5th day of June 2019 before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC. and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. •••+.;:..••• ••O0NG Cp4•40.% 4O�p4P0q '�9' •1--:_' -0- 0• • • y• , • 3• • a 1933 • y C: By • 0 ti. .b •a• • • sealed this 5th day of June , 2019 . MERCHANTS BONDING COMPANY (MUTUAL) MERCHANTS NATIONAL BONDING, INC.. President ALICIA K. GRAM Commission Number 767430 My Commission Expires April 1, 2020 aLse&-e- Notary Public (Expiration of notary's commission does not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, 1 have hereunto set my hand and affixed the seal of the Companies on this GA1. RP Os g\•o2 2 2003 o.c• :o•• POA 0018 (3/17) • o ttG CQ • '•• •. .•„4,..,‘17.P 0 4 • h-. -0- t^ : • a'• 1933 �: c •• 15th day of January 2020. Secretary FORM OF BID OR PROPOSAL F.Y. 2020 WASTEWATER TREATMENT PLANT BIOSOLIDS MODIFICATIONS CITY OF WATERLOO, IOWA Honorable Mayor and City Council Waterloo, Iowa 1. The undersigned, being of Iowa add per Addenda 41 CITY CONTRACT NO. 994 a Corporation existing under the laws of the State a Partnership consisting of the following partners: , 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 FN. 2020 Wastewater Treatment Plant Biosolids Modifications, City Contract No. 994, all in accordance with the above -listed documents and for the lump sum base bid cost: LUMP SUM BASE BID' �,��y„ �„ � Ladia*al�G 'Dollars $ � 3,1200, aDo °sife (Words) (Numbers) See Section 01 29 00—Contract Considerations for discussion of cash allowances to include in the Bid. Contract award will be made based on the Lump Sum Base Bid or Lump Sum Base Bid with any combination of Bid Alternatives selected. The price for all Base Bid Equipment items shall be included in the Lump Sum Base Bid Bid Alternatives will be added or deducted from the Lump Sum Base Bid, if they are accepted, prior to Notice of Award being made. CITY reserves the right to accept or reject any Bid Alternatives or Equipment Alternatives to the Lump Sum Base Bid. Should CITY wish to consider Bid Alternatives listed, Bidder may be required to provide additional information prior to, Notice of Award. Consideration of Equipment Alternatives of the selected Bidder will be made by CITY within 60 days after the Effective Date of the Agreement. delete per Addenda. #1 If a Bid Equipment -Alternative is selected by CITY, the awarded Contract price will include the selectod Alternative(s). "The Contract, if awarded, will be on the basis of materials and equipment specified or described in the Bidding Documents without evaluation of Equipment Alternatives listed in the Lump Sum Base Bid, if any, and without evaluation of possible substitute or "or equal" items. Whenever it is specified or described in the Bidding Documents that an Equipment Alternative listed in the Lump Sum Base Bid or that a substitute or"or equal" item of material or equipment may be furnished or FORM used by CONTRACTOR if acceptable to CONSULTANT, application for acceptance will not be evaluated by CONSULTANT until after the Effective Date of the Agreement." 2. Bid Alternatives BID ALTERNATIVE NO. 1: CONTRACTOR shall include in the cost of the Bid Alternative ALL work associated with providing the scope listed below. The price of $ I 3 zr 0" � shall be deducted from the Contract Lump Sum Base Bid if CITY elects to have CONTRACTOR eliminate the addition of the metal canopy, framing, wall panels, concrete walls and footings associated with the outdoor biosolids loadout area located between the Dewatering Building (Structure 330) and the Centrate Equalization Tanks (Structure 350) as indicated in the Drawings and in the Specifications as specified in Section 07 61 00 Sheet Metal Roofing and Section 41 12 13 Shaftless Screw Conveyors. BID ALTERNATIVE NO. 2. CONTRACTOR shall include in the cost of the Bid Alternative ALL work associated with providing the scope listed below. 6 O OOthe Contract LumpSum Base Bid if CITY elects to Theprice ofq � shall be deducted from $ have CONTRACTOR eliminate the addition of the Chemical Building (Structure 300) and related items as indicated in the Drawings and in the Specifications as specified in SECTION 21 11 00—Water-Based Fire P rotection, Section 22 30 00—Plumbing Equipment, Section 46 33 42—Chemical Phosphorus Removal E quipment and Section 43 41 45—Fiberglass Reinforced Plastic Chemical Tanks. B ID ALTERNATIVE NO. 3: CONTRACTOR shall include in the cost of the Bid Alternative ALL work associated with providing the scope listed below. The price of $ S I i D 0 0 coshall be deducted from the Contract Lump Sum Base Bid if CITY elects to have CONTRACTOR eliminate the addition of Primary Sludge Pumps (P-3-15-1 and P-3-15-2) and associated piping, modifications to existing WAS Well No. 2 and No. 3 and related items in the WAS Building (Structure 170) as indicated in the Drawings and in the Specifications as specified in Section 13 34 23 25—FRP Flat Panel Cover System and Section 43 23 57 Progressing Cavity Pumps. BID ALTERNATIVE NO. 4: CONTRACTOR shall include in the cost of the Bid Alternative ALL work associated with providing the scope listed below. ao 2 7The price of $ k', X 00 shall be deducted from the Contract Lump Sum Base Bid if CITY elects to have CONTRACTOR eliminate the replacement of Boilers No. 1 and No. 3 (M -i 11 24 1 and M-11-24-3), recirculation pumps (P-11-31-1 and P-11-31-2), associated piping modifications and related items in the D igester Control Building (Structure 310) as indicated in the Drawings and in the Specifications as specified in Section 23 21 16—Hydropic Piping Specialties, Section 23 21 23—Hydropic Pumps, S ection 23 25 00—HVAC Water Treatment, and Section 23 52 39 Fire Tube Boilers. FORM OF BID Section BF -2 4463.004/City Contract No. 994 3. Equipment Alternatives The name of the Base Bid equipment manufacturer which Bidder shall include in the Lump Sum Base Bid is listed for each equipment item. Where an alternative manufacturer is listed, Bidder shall include an add or deduct to the price of the equipment that Bidder included in the Lump Sum Base Bid. Where spaces are provided, Bidder may also bid other alternative manufacturers by writing in the alternative manufacturer's name Equipment Alternative Bid prices shall include the entire cost of the Alternative, including cost for engineering changes to accommodate the Alternative, and additional work to be performed which is not shown on the Drawings, but which is required as a result of selection of the Alternative. Whether or not an alternative manufacturer is offered to one or more of the Base Bid equipment manufacturers provided for in the Bid Form, Bidder shall write (in numbers) the price for providing the Base Bid equipment manufacturer, as included in the Lump Sum Base Bid. When more than one Base Bid equipment manufacturer name is listed for an item, Bidder shall circle the name of the equipment manufacturer selected for the Lump Sum Base Bid and write in the price for the selected equipment. FORM OF BID Section BF -3 4463.004/City Contract No. 994 EQUIPMENT ALTERNATIVES FORM OF BID Revised Section BF -4 4463.004/City Contract No. 994 (Addendum No. 1) Item Equipment Base Bid Manufacturer Included in the Lump Sum Base Bid (circle One) Cost of Equipment Included in the Lump Sum Base Bid Alternative Manufacturer Add to Base Bid for Alternative Manufacturer Deduct From Base Bid for Alternative Manufacturer A. Fire Tube Boilers Burnham $ (+) (-) (Section 23 52 39)0 2.d1t, 000(+) (-) B. SCADA System Supplier (Section 26 09 00) Automatic +� Solutions OR Wunderlich-Malec Systems R- -_ -.a . - .-�.�-------�- Process $ ., (, 000 irIntegrated C. Shaftless Screw Conveyors Custom Conveyor $ (+) (-) (Section 41 12 13) Corporation OR., (+) (-) JDV Equipment 0. 0 -s:c,0e,000 " pirac Tech Conveying •'•• D Tri Positive -aeser Compressors, Inc.$ (+) (-) -Lobe tQ Displacement Blowers 43 11 33) OR Aerzen USAl 2.2,t 000 (+) (-) -(Section E Progressing Cavity Pumps Seepe $ (+) (-) (Section 43 23 57) oU 5?54 000 `- (-) F. Submersible Pumps Flygt $ (+) (-) , 00 (Section 43 25 10) 7 6 000 (+) (-) G. Macerators :. - • - $ (+) (-) (Section 46 24 13 ) ZOOtOott + (-) FORM OF BID Revised Section BF -4 4463.004/City Contract No. 994 (Addendum No. 1) FORM OF BID Revised Section BF -5 4463.004/City Contract No. 994 (Addendum No. 1) Bid Alternative Manufacturer Add to Base Bid for Alternative Manufacturer Deduct From Base Bid for Alternative Manufacturer Item Equipment Base Bid Manufacturer Included in the Lump Sum Base Bid r (-Circle One) Cost of Equipment Included in the Lump Sum Base H. Polymer Feed Equipment (Section 46 33 33) VeloDyne �: i $ 00 1 5 01 000"— (+) (-) (+) (-) UGSI Chemical Feed, Inc. -Fluid Dynamics I. Chemical Phosphorus Removal Equipment (Section 46 33 42) Blue-White $ 00 2 O� 0 o0 (+) (-) (-) (+) OR Prominent J. Submersible Mixers (Section 46 41 23) Flygt $ 0 COZ(0 o2.c) (+) (-) (-) + K. Coarse Bubble Diffusers (Section 46 51 21) L r Sanitaire-Xylem. __a,. $ a� jOOOVO (+) (-) (-) (+) L. Dewatering Centrifuge Equipment (Section 46 76 33) entrisys, Inc $ 00 ` q 00,000 (+) (-) (+) (-) __ FORM OF BID Revised Section BF -5 4463.004/City Contract No. 994 (Addendum No. 1) 4. Cash Allowances The following Cash Allowances shall be included in the Lump Sum Base Bid. The Cash Allowances for non Lump Sum items shall be equal to the product of the quantity included in the Lump Sum Base Bid and the Unit Price. The Cash Allowances will be adjusted in the event that estimated quantities to be included in the Lump Sum Base Bid are different from final measured quantities. A single Unit Price shall be bid for each item. Failure to include one or more of the following Unit Price items may result in rejection of the entire Bid as nonconforming. For items with a quantity of 1, the Cash Allowance shall be adjusted based on actual final costs. CASH ALLOWANCES Item Number Description Estimated Quantity Included in the Lump Sum Base Bid Unit Bid Unit Price Total Bid Price Included in the Lump Sum Base Bid 1 Concrete Surface Repair—Top of WaII Repairs Section 03 01 30 10 CF Dc do $ a� oc, 2 Concrete Surface Repair—Wall Vertical Surface and Underside of Slab Repairs Section 03 01 30 10 CF 04 $ /0' 4o� a+ 3 Concrete Surface Repair—Top of Slab Repairs Section 03 01 30 10 CF $ � 25 4 Masonry Restoration and Cleaning -100% Repointing S ection 04 01 20 8,000 SF $ 144,6m 5 Masonry Restoration and Cleaning— <100% Repointing S ection 04 01 20 1,000 LF 6 Brick Replacement S ection 04 01 20 250 SF 3 7S $ gs'Y 11$60 $ 2i12Sto' 7 E xcavation, Backfill, and Grading— U nsuitable Foundation Material for S tructures S ection 31 23 00 1,500 CY $ so 8 E xcavation, Backfill, and Grading— Unsuitable Foundation Material for Utility Trenches S ection 31 23 00 500 CY 5 0 75, otss $: 25& C FORM OF BID Section BF -6 4463.004/City Contract No. 994 5. In submitting this bid, the Bidder understands that the right is reserved by the City of Waterloo, Iowa, to reject any or all bids If written notice of the acceptance of this bid is mailed telegraphed, or delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the prescribed form and furnish the required bond and certificate of the insurance within ten (10) days after the agreement is presented to him for signature, and start work within ten (10) days after' Notice to Proceed" is issued. 6. Security in the sum of 5% of B i d Dollars ($ ) in the form of Bid Bond is submitted herewith in accordance with the INSTRUCTIONS TO BIDDERS. 7. Attached hereto is a Non -Collusion Affidavit of Prime Contractor. 8. Attached hereto is a Resident Bidder Certification ( XX ), or Non -Resident Bidder Certification ( ). (Mark one.) 9. The Bidder is prepared to submit a financial and experience statement upon request. 10. 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. 11. The Bidder has received the following Addendum or Addenda: Addendum No. 1 Date 01/10/20 2 01/17/20 3 01/21/20 12. 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. 13. The Bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none" or "NA" 14. The Bidder has attached all applicable forms. 15. CITY reserves the right to select alternates delete line items, and/or to reduce quantities pnor to the award of a contract due to budgetary limitations. FORM OF BID Section BF -7 4463.004/City Contract No. 994 WRH, Inc. January 23, 2020 BY: (Name of Bidder) (Date) Title Vice President Business Procurement Official Address: (Including Zip Code): PO Box 256 Amana, IA 52203 I.R.S. No. 42-1012899 END OF SECTION FORM OF BID Section BF -8 4463.004/City Contract No. 994 Attachment 1 SRF Required Front=End Specifications (This form must be completed and signed by Prime Contractor and submitted with the kid.) U S. Environmental Protection Agency Certification of Non -Segregated Facilities (Applicable to contracts, subcontracts, and agreements with applicants who are themselves performing Federally assisted construction contracts, exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause.) By the submission of this bid, the bidder, offeror, applicant, or subcontractor certifies that he does not maintain or provide for his employees any segregated facilities at any of his establishments, and that he does not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. He certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The bidder, offeror, applicant, or subcontractor agrees that a breach of this certification is a violation of the Equal Opportunity clause in this contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking Tots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national original, because of habit, local custom, or otherwise. He further agrees that (except where he has obtained identical certifications from proposed subcontractors for specific time periods) he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause; that he will retain such certifications in his files; and that he will forward the following notice to such proposed subcontractors (except where the proposed subcontractors have submitted identical certifications for specific time periods): NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CERTIFICATIONS OF NON -SEGREGATED FACILITIES A Certification of Non -segregated Facilities as required by the May 9, 1967, order (33 F.R. 7808, May 28, 1968) on Elimination of Segregated Facilities, by the Secretary of Labor, must be submitted prior to the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Opportunity clause. The certification may be submitted either for each subcontract or for all subcontracts during a period (i.e., quarterly, semiannually, or annually). Signature January 23, 2070 Date Jamie Rich, Vice President Business Procurement Name and Title of Signer (Please Type) NOTE The penalty for making false statements in offers is prescribed in 18 U S.C. 1001. EPA -7 5720-4.2 STATE REVOLVING FUND Section SRF -2 4463.004/City Contract No. 994 Attachment 2 SRF Required FrontsEnd Specifications (`phis form must be completed and signed by the Prime Contractor and submitted with the bid.) Debarments and Suspensions Any bidder or equipment supplier whose firm or affiliate is listed in on the U S General Services Administration Excluded Parties List System web site at http://wvvw.epls.gov/ will be prohibited from the bidding process. Anyone submitting a bid who is listed on this web site will be determined to be a non-responsive bidder in accordance with 40 CFR Part 31. United States Environmental Protection Agency Washington, DC 20460 Certification Regarding Debarment, Suspension, and Other Responsibility Matters The prospective participant certifies to the best of its knowledge and belief that it and the principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission o f fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transaction s (Federal, State, or local) terminated or cause or default. I understand that a false statement on this certification may be ground for rejection of this proposal or termination of the award. In addition, under 18 U SC Sec. 10 01, a false statement ma y result in a fine of up to $10,000 or imprisonment for up to 5 years, or both. Jamie Rich, Vice President Business Procurement Typed Name & Title of Authorized Representative January 23, 2020 Signature of Authorized Representative Date I am unable to certify to the above statements. My explanation is attached. EPA Form 5700-49 (11-88) STATE REVOLVING FUND Section SRF -3 4463.004/City Contract No. 994 yia9 or Status E®rrn To be completed byall bidders Part A p Please answer "Yes" or "No" for each of the following: E 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. El Yes No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail. 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. 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. X X To be completed byresident bidders Part B My company has maintained offices in Iowa during the past 3 years at the following addresses: Dates: 06 / 11 / 1985to Current / Address: 1648 T Avenue City, State, Zip:South Amana , IA 52334 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 DoesY our 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? 3.you ou answered "Yes" to question 2, identify each preference offered by your company's home state or foreign country and the appropriate legal citation. Yes I I No You may attach additional sheet(s) if needed. To be completed by all bidders Part D I certifythat 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: Signature: WRH, Ince 1:-- Jamie Rich Date: January 23, 2020 Ve President Business Procurement 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. RB -1 4463.004/City Contract No. 994 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. 11 Yes No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. ❑ Yes In No ® 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. 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 a 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 ® 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. in Yes G1 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 X 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 In No My business is a limited liability company whose certificate of organization is filed in Iowa and has not filed a statement of termination. 11 Yes in 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 RB -2 4463.004/City Contract No. 994 Attachment 3 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid) Disadvantaged Business Enterprise (DBE) Solicitation It is EPA's policy that recipients of EPA financial assistance through the State Revolving Fund programs award a "fair share" of subagreements to small, minority and women -owned businesses, collectively know as Disadvantaged Business Enterprises (DBEs). Iowa's Fair Share goals are: Only work performed by certified DBEs can be counted toward the goals. In Iowa, DBEs must be certified through the Iowa Department of Transportation (IDOT). Information on certification requirements and a list of certified DBEs is on the IDOT website at http://www.iowadot.gov/contracts/contracts eeoaa.htm. Prime contractors' DBE requirements for SRF projects include: ® Taking affirmative steps for DBE participation • Documenting the efforts and the proposed utilization of certified DBEs PROJECT INFORMATION SRF Applicant: Bidder: WRH, Inc. Address: P O Box 256, Amana, IA 52203 Contact Person: Signature: Phone Number: J amie Rich, Vice President Business Procurement ekr., 622-3816 E -Mail Address: jrich@wendlerinc.com Check if Prime Contractor is: Minority -Owned Women -Owned STATE REVOLVING FUND Section SRF -4 4463.004/City Contract No. 994 Minority -Owned Business Enterprise (MBE) Goal Women -Owned Business Enterprise (WBE) Goal Construction 1.7% 2 2% Supplies 0.6% 5.6% Services 2.5% 11.3% Goods/Equipment 2.5% 10.4% Average 1.8% 7.4% Only work performed by certified DBEs can be counted toward the goals. In Iowa, DBEs must be certified through the Iowa Department of Transportation (IDOT). Information on certification requirements and a list of certified DBEs is on the IDOT website at http://www.iowadot.gov/contracts/contracts eeoaa.htm. Prime contractors' DBE requirements for SRF projects include: ® Taking affirmative steps for DBE participation • Documenting the efforts and the proposed utilization of certified DBEs PROJECT INFORMATION SRF Applicant: Bidder: WRH, Inc. Address: P O Box 256, Amana, IA 52203 Contact Person: Signature: Phone Number: J amie Rich, Vice President Business Procurement ekr., 622-3816 E -Mail Address: jrich@wendlerinc.com Check if Prime Contractor is: Minority -Owned Women -Owned STATE REVOLVING FUND Section SRF -4 4463.004/City Contract No. 994 Paget GOOD FAITH EFFORTS CHECKLIST Please complete the checklist to determine if you have complied with the requirement to make good faith efforts to ensure that certified DBEs have the opportunity to compete for procurements funded by EPA financial assistance funds. Bidders/offerers must make good faith efforts prior to submission of bids/proposals. 1. Did you ensure that DBEs are made aware of contracting opportunities to the fullest extent practicable through outreach and recruitment activities? In Yes No 2. Did you make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs in the competitive process? This includes, whenever possible, posting solicitation for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date. E] Yes No 3. Did you consider in the contracting process whether firms competing for Targe contracts could subcontract with DBEs? This will include dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by DBEs in the Yes No competitive process. X 4. Did you encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually? ix Yes No 5. Did you use the services of the Small Business Administration and the Minority Business Development Agency of the Department of Commerce to identify potential subcontractors? Yes No X 6. List the potential DBE subcontractors that were contacted. Only list those that are certified through the Iowa Department of Transportation. PROPOSED UTILIZATION OF DBE SUBCONTRACTORS Please include Attachments 4 and 5 to document the proposed utilization of certified DBE subcontractors. STATE REVOLVING FUND Section SRF -5 4463.004/City Contract No. 994 Name How Contacted (e.g. letter, phone call, fax, e-mail) Response (e.g. did not respond, not interested, not competitive) Mid States Rebar & Suppy letter faxed NO 'e1 oy►rt Midwest Contractors letter faxed No )14 pnr-t OEL Construction Services letter faxed No RtJ Qys e Paco Construction r. epea Led ai. Leu pLs unable to contact/V; Rer DMrt p Rockette Trucking & Const. letter faxed Noktporce Tara Erosion Control letter faxed No (O/9sA f1( Tiedt Nursery letter faxed PROPOSED UTILIZATION OF DBE SUBCONTRACTORS Please include Attachments 4 and 5 to document the proposed utilization of certified DBE subcontractors. STATE REVOLVING FUND Section SRF -5 4463.004/City Contract No. 994 GOOD FAITH EFFORTS CHECKLIST Please complete the checklist to determine if you have complied with the requirement to make good faith efforts to ensure that certified DBEs have the opportunity to compete for procurements funded by EPA financial assistance funds. Bidders/offerers must make good faith efforts prior to submission of bids/proposals. 1. Did you ensure that DBEs are made aware of contracting opportunities to the fullest extent practicable through h outreach and recruitment activities? [xI Yes No 2. Did you make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs in the competitive process? This includes, whenever possible, posting solicitation for bids or proposals for a minimum of 30 calendar days before the bid orro osal closing date. ] Yes No p p 3. Did you consider in the contracting process whether firms competing for Targe contracts could subcontract with DBEs? This will include dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by DBEs in the competitive process. X Yes No 4 Did you encourage contracting with a consortium of DBEs when a contract is too Targe for one of these firms to handle individually?x Yes No 5. Did you use the services of the Small Business Administration and the Minority Business Development Agency of the Department of Commerce to identify potential subcontractors? Yes No x 6. List thep otential DBE subcontractors that were contacted. Only list those that are certified through the Iowa Department of Transportation. Name How Contacted (e.g. letter, phone call, fax, e-mail) Response (e.g. did not respond, not interested, not competitive) Astro Engineering letter faxed Chicago Ornamental Iron Collins Concrete letter faxed ✓ epeated attem u nable to cont pts act D&K Welding Service letter faxed Interstate Sealant & Concret e letter faxed t%sJ 0 ietsporri N o tevip °an /Vo /?opoan 1"' /t4,O$r'1 KSO Metalfab letter faxed t\Io gyp on.n N0 Reipote See Page 2 P ROPOSED UTILIZATION OF DBE SUBCONTRACTORS P lease include Attachments 4 and 5 to document the proposed utilization of certified DBE subcontractors. STATE REVOLVING FUND Section SRF -5 4463.004/City Contract No. 994 CONTRACT ADMINISTRATION PROVISIONS Several contract provisions are required to prevent unfair practices that adversely affect DBEs. These include: 1. Prime Contractor must pay its Subcontractor for satisfactory performance no more than 30 days from the Prime Contractor's receipt of payment from the SRF loan recipient. 2. Prime Contractor must notify the SRF loan recipient in writing prior to termination of a DBE subcontractor for convenience. 3. Prime Contractor must employ the six Good Faith Efforts to solicit a replacement subcontractor if a DBE subcontractor fails to complete work under a subcontract for any reason. STATE REVOLVING FUND Section SRF -6 4463.004/City Contract No. 994 Attachment 4 SRF Required Front=End Specifications (This form must be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid.) OMB Control No: 2090-0030 Approved 8/13/2013 Approval Expires 8/31/2015 United States Environmental Protection Agency Disadvantaged Business Enterprise Program DBE Subcontractor Performance Form This form is intended to capture the DBE1 subcontractor's2 description of work to be performed and the price of the work submitted to thep rime contractor. An EPA Financial Assistance Agreement recipient must require its prime contractor to have its DBE subcontractors complete this form and include all completed forms in the prime contractor's bid or proposal package. Subcontractor Name Bid/Proposal No. Project Na�eos��i�52bo�i�cs�L�8�isTreatmen Contract No. 994, Waterloo, Iowa Assistance Agreement ID No. (if known) Point of Contact Address Telephone No. Email Address Prime Contractor Name WRH, Inc. Contract Item Number Issuing/Funding Entity Description of Work Submitted to the Prime Contractor Involving Construction, Services, Equipment or Supplies Price of Work Submitted to the Prime Contractor Ale evoler�, DBE Certified by DOT SBA Other: Meets/exceeds EPA certification standards? YES NO Unknown g 1A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33 204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 2Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. EPA Form 6100-3 (DBE Subcontractor Performance Form) — Page 1 STATE REVOLVING FUND Section SRF -7 4463.004/City Contract No. 994 OMB Control No: 2090-0030 Approved 8/13/2013 Approval Expires 8/31/2015 United States Environmental Protection Agency Disadvantaged Business Enterprise Program DBE Subcontractor Performance Form I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c). Prime Contractor Signature Print Name 1..,,..---es Title Jamie Rich Date Vice President Business Procurement January 23, 2020 Subcontractor Signature Print Name Title Date Thep ublic reporting and recordkeeping burden for this collection of information is estimated to average three (3) hours per response. Send comments on the Agency's need for this information the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division U.S Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D C. 20460. Include the OMB control number in any correspondence Do not send the completed form to this address. EPA Form 6100-3 (DBE Subcontractor Performance Form) — Page 2 STATE REVOLVING FUND Section SRF -8 4463.004/City Contract No. 994 Attachment 5 SRF Required Front=End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid if utilizing DBE subcontractors.) OMB Control No: 2090-0030 Approved 8/13/2013 Approval Expires 8/31/2015 United States Environmental Protection Agency Disadvantaged Business Enterprise Program DBE Subcontractor Utilization Form This form is intended to capture the prime contractor's actual and/or intended use of identified certified DBE 1 subcontractors2 and the estimated dollar amount of each subcontract. An EPA Financial Assistance Agreement Recipient must require its prime contractors to complete this form and include it in the bid or proposal package. Prime contractors should also maintain a copy of this form on file. Prime Contractor Name WRH, Inc. Project Name FY0 0 a t Haat r Treatment Plant Bioso�i�s �oaifica�zons Contract No. 994, Waterloo, IA Bid/Proposal No. Assistance Agreement ID No. (if known) Point of Contact Address PO Box 256, Amana, IA 52203 Telephone No. (319) 622-3816 Email Address jrich@wendlerinc.com Issuing/Funding Entity I have identified potential DBE certified subcontractors If yes, please complete the table below. If no, please explain: Company Address/Phone/Email Subcontractor Name/Company Name YES NO Estimated Dollar Amount Currently DBE Certified? \\I r Ne e tied Continue on back if needed 1A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 2Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. EPA Form 6100-4 (DBE Subcontractor Utilization Form) — Page 1 STATE REVOLVING FUND Section SRF -9 4463.004/City Contract No. 994 OMB Control No: 2090-0030 Approved 8/13/2013 Approval Expires 8/31/2015 United States Environmental Protection Agency Disadvantaged Business Enterprise Program DBE Subcontractor Utilization Form I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c). Prime Contractor Signature Print Name Title Jamie Rich Date Vice President Business Procurement January 23, 2020 The public reporting and recordkeeping burden for this collection of information is estimated to average three (3) hours per response. Send comments on the Agency's need for this information the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U S Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D C. 20460. Include the OMB control number in any correspondence Do not send the completed form to this address. EPA Form 6100-4 (DBE Subcontractor Utilization Form) — Page 2 STATE REVOLVING FUND Section SRF -10 4463.004/City Contract No. 994 MBE/WBE BUSINESS ENTERPRISE PRE-BID CONTACT INFORMATION FORM Prime Contractor Name: WR H, Inc . Project: FY 2020 W WT P B i o s o l i d $_etting Date: 01/23/20 Modifications,#994, Waterloo, IA N O MBE/WBE 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: Jamie Rictitle: Vice President Date: 01/23/20 Business Procurement S UBCONTRACTORS 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 Louis Starks, 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. MBE/WBE Subcontractors Atlas Painting TABLE OF INFORMATION SHOWING BIDDER'S PRE-BID MBE/WBE BUSINESS ENTERPRISE CONTACTS ✓ ep n o Quotes Received Dates Contacted e dted at_Lempts Yes/No answer unable to 1 WATCO Construction Carter Electric DC Corporation tep n o ✓ ep left ✓ ep unab e ated attempts answer -unable to c Dates Contacted e ave a message Yes/No Quotation sed in bid Dollliar Amount Proposed to be Stuocontracted NQ e ated attempts message -no respon B ated attempts le to contact o ntact se Culpepper Electric 01/15/20 See Page 2 PRE-BID CONTACT INFORMATION FORM (Form CCO-4) Rev. 06-20-02 Section M-6 4463.004/City Contract No. 994 No No Alp Prime Contractor Name: WRH , Inc Page 2 . MBE/VW:= E USINESS ENTERPRISE PRE-BID CONTACT INFORMATION FORM Project: FY 2020 WWTPBiosolid$etting Date: 01/23/20 Modifications,#994, Waterloo, IA NO MBE/WBE 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: Jamie RicTifle: Vice President Date: 01/23/20 Business Procurement 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/V11BE Business Enterprise contacts made prior to your bid submission. This information is subject to verifications and confirmation. If you are unable to identify MBE/vVBE firms to perform portions of the work, please contact Louis Starks, 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. TA3LE OF oNRMATION SHOWING BIDDER'S PRE—[SOD MBE/WBE BUSINESS ENTERPRISE CONT CIS PRE-BID CONTACT INFORMATION FORM (Form CCO-4) Rev. 06-20-02 Section M-6 4463.004/Ctty Contract No. 994 Quotes Received Quotation used k bid MBE/WBE Dates Dollar Amount Pro-3osed► to Tates Subcontractors Contacted Yes/No Contacted Yes/`` o ae Subcontracted _ Greer Works Left Mail Voice 01/16/20 N6 Old Greer Works Left Voice 01 /1 6/ 2 0 /4\10 u. i.] D & D Construction emailed 01/16/20 9 E Castro Roofing emailed 01116/20 O PRE-BID CONTACT INFORMATION FORM (Form CCO-4) Rev. 06-20-02 Section M-6 4463.004/Ctty Contract No. 994