Loading...
HomeMy WebLinkAboutBockenstedt Excavating, inc.\C1c\F----Csn c\-QA-\c- cco,\Jo., fe •eX VV-40 Za..ic3 Cl*y) 1 SnAli e --L\rN4C Lov,krTho, A•Ja \cJ¼7 F y aoao uJecx.-kie.Acko)Nt‘ra� ?_„>:\ Park "Tree_ C\eArrorN3 • 1 AND EW B CKENSTEDT, PRESID T� BOCKENSTEDT EXCAVATING, INC. µ1 yPF9 dl-1rI:.P 'IaDA f'If n'I � 1. 3500 DOLPHIN DRIVE IOWA CITY, IA 52240 ANDY.J.BOCK@1 GMAIL.CON (319) 354-7613 'I" (319) 331-1558 FBI (319) 354-0351 0617 trAb 3 r \SC) C\--tend S-\--coak Es4 Lexvoc\-N, 'FU' Bla)t \R'iO CL CA7 ) Env\--bce_c\- Ni44 \O\7 i2-0/0 iv.)„,,,\Q(Apv, eckirAR Tree C „Ns Form_ cyr PiGpozokti FORM OF BID OR PROPOSAL FY 2020 WATERLOO AIR AND RAIL PARK TREE CLEARING CONTRACT NO. 1017 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 w Partnership consisting of the following partners: kin cam, w ociat s-, s-� 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 WATERLOO AIR AND RAIL PARK TREE CLEARING Contract No. 1017, 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 WATERLOO AIR AND RAIL PARK TREE CLEARING CONTRACT NO. 1017 :.PI.e o s aip�ri �, qt4 UN1T E$riTY: U1T;; PRICE. BID TOfAL BD PRICE _riEMr. 1 MOBILIZATION LS 1.0 37 G lo 2 TREE CLEARING AC 18.7 s1 (4/ czN f ;dedn 3 TRAFFIC CONTROL LS 1.0 $ f t' TOTAL BID $ , 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. FORM OF BID CONTRACT NO. 1017 Page 1 of 3 4. Security in the sum of i tr/d �► d 0 net Dollars ($ f (f Ov20 �s subrnittederefivith in accordance with the INSTRUCTIONS TO BIDDERS. ) in the form of 5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor. 6. Attached hereto is a Resident Bidder Certification ( ,2 ), or Non -Resident Bidder Certification L ) (Mark one ) "l The bidder is prepared to submit a financial and experience statement upon request 8. The Prime Contractor and Subcontractor(s), which have performed an aggregate of $10,000.00 in work for the City in the current calendar year, are prepared to submit an AAP or Update and an EOC within ten (10) days of notification that the bid submitted is lowest and acceptable. 9. The bidder has received the following Addendum or Addenda: Addendum No. Date D (t R tan a9 10. The bidder shall list the MBEANBE subcontractor(s), amount of subcontracts and bid items on the City of Waterloo Minority and/or Women Business Pre -bid Contact Information Form submitted with this Form of Bid or Proposal. The apparent low Bidder shall submit a list of all other Subcontractor(s) to be used on this Project to the City of Waterloo by 5:00 p.m the business day following the day Bids on this Project are due along with the Non -Collusion Affidavits of All Subcontractor(s). The Contractor shall submit information on subcontractors on 'SUBCONTRACTOR REQUEST AND APPROVAL" Form to be provided by City prior to approval of contract. The subcontractors listed on this proposal and/or submitted to the Contract Compliance Officer cannot be changed except for the following reasons: 1) The City of Waterloo does not approve the subcontractors. 2) The subcontractors submit in writing that they cannot fulfill their subcontracts. 11. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none' or "NA". 12. The bidder has attached all applicable forms. 13. The Owner reserves the right to select alternates, delete line items, and/or to reduce quantities prior to the award of a contract due to budgetary limitations. FORM OF BID CONTRACT NO. 1017 Page 2 of 3 goc\r_ey..sAtkva Lci,o.)0c-b\INJms Is )ea.7 fd,a (Name of Bidder) (Date) BY: Title v\-\-co \\ e i Official Address: (including Zip Code): go9, k `i0 ©tea Cky I.R.S. No. 39 sc7 FORM OF BID CONTRACT NO. 1017 Page 3 of 3 NON —COLLUSION AFFIDAVIT OF PRIME BIDDER State of (1-CA County of A otAhub'c h vea Q. is cauce chi! the Bi s being first duly sworn, deposes and says t at Representative. or Agent) , of at 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; 3. Such Bid is genuine and is not a collusive or sham Bid; 4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees, or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder, or, to fix any overhead, profit or cost element of the bid price or the bid price of any other Bidder, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against the City of Waterloo, Iowa, or any person interested in the Proposed Contract and 5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or partie -jl interest, including this affiant. igned) Title Subscribed and sworn to before me this 20tD. My commission expires G (M l t't • day of Title OWP CAREY L LANGDON 7r Commission Number 817083 ' My.9ommission Expires uLti w co a W 1- CO ,w w 6 w 0 41% r a d ai i a De 8 SIL u- u O 3 a O u u- • U . a) Fad 2 0 Z 1,5/ w � Prime Contractor Name: itisc E 0 rowa O 0 0 Q *� N o a) ro .a V) C Qro) 0) a - 0 a aoi o w 0. 0o 0E U 0 �0 ow U 0 O m w2 waco E co 2 o C fa C .c E-- d) O o zu, o46 a) 4- o Ci >, U 4— (tf re 0) O U ro c 0 Z z, O N O > L � 0 E CO Ca 0 C GU fl O Q'E Z axi a. mai cia Contractor Signature: C 0 C O a a /13 Cr tri Q 0 a 8 8 0 0 D) U = if., L. -" a O 0Li_ 0 0 g o ro O C• O cc o m 0 > U C a 03 Y d) a) W .Q o- •> 0) L GC lmw > a C C a .E _0 O C E asus N u) ao D o ON � ca m La co � H So f- 00 £Q d) LU O F- r/� 2 W+ w O0) w ct • N 0 ui Z m w O ill 111 CO h $7111- Doll Quotes Received Ouoi 8 O U A Yes/No .tel A c e ! va s r `i W Subcontract CCCYYY so �../ ® 4 (Form CCO-4) Rev. 06-20-02 z 0 h- LE 0 a? Wr4 O w zz 0) w Q (7ix 0 CO h. CO o 0 W a o a C ,5 e E ca 0 8 o O O .0 U) o- •C to (i) ,C _a0( yci.a 0 U)Lu as omW O Co F 2 2 a w (0 mr00Co f oflm m iiF-v ao N Cr C +S N a3 .c 2Tu) Wtffi toII0 0) 0 0fig • c 3�f�- noo N wc 00 al as 0b O U C ro 4 ts o o�" No• a) O Q. +O-' 4 O) N (13ou) bfiCS) OoEC o.t.. a U o Ca)Eo O a p a) o) o c L a) O Q., 0. 0 0�eo Q ,C as o -a o LO •o w O Ea) 'El)" 0 c_ a .0 a a)) U A a) a) 27 O.. U N 0 L a U E, O 0 tQ a) E o • o cn w U Pc =o ) E o=1 us z -0 c 0_(0a) P 4- r L. +,+ o o ila) o z 0 a cn0 O 0 0 0 0 0 O ci� o2) ro w°2 0 CC 0 �122 q•o 00•0 w Uro �- E 0 • LL /on CO o f O= Z• aaw c N �•0 c a 1 al 'O .D 0 0 0 Ev • o co oa) 00 o • 2 0 O co C a} U 0 •C w C o Uj m CO 0 2 M m 0 N 4- maV) 0 0.0 a4- 0 0 03 > (0 0 v v g. .a -) • "f_�sR 0 •092 U00 E 1-1 a o 0)0 m't3 E C G > E ai o > o 4 rn L a2� N O m E„ E ca o m0.0 C5C4.17 o O 0) 0 CaO ba a) C C q) 0 .0 .0 0- o 44 t)) 9- 0 mm,0)>, W o O m O c a3 Oco ay al B O 0 0 ca a) c n -..0 o 0 0 m E00m 0) 2 E.`=0 ¢a)0. c0i o a) o nor to the 0 'o • ti aoi CO O cu a) .K] ar a) to ([S 0 w- m O a) ro CO as oU O 0 • o 0 o O 0 O o a) CO m Fos z 0 m w m-- 2 LLf m L1 0 U C 0 C 0 Q. oa2i o o E . •0 0 0 C N v 00 0 4.0 0 m t6cc) 0) as 0 00 0 a 0) 2 C O 0 C a) E U O 0 0 C 0.. 2 O_ a Ca >, 0 0 0. 0 _ 0 0 C a) .n • o a°) pzo o U 0 13 2QnO) o ro E-- 00-0 U o 0 a) .0 ow h- 0 co v 0 w .Q a) c co O w 0 EL CO 0) m CO of 40 0 0 0 0.00c a) ?r 0) L 0 E 0 0 a)EOo� J Q) a ,i] 0 1 o m nio E o 0 o "Q O 0 V 0 C lw Pal :a 0o a) to O 's co)O et,oaa) n 0) 0 > a) c`3 °a8i -o� N n'D •0 .TWO co N -2 E N • °0cu Q,O O N 0 C�� � V 0 • �2 (0 o U O 0 p O o 0zip co a)0 5 o = 0 4' N V 2 U Eo O- .Q . a) o oO• 0 a U .0 0 roa—oo :E 0.i'o ULE Ecoa`) m1-Q0E + r C O O._ 0 C1 MWU.D rnw T.) m 2 ,a' w. to wC 6 'c 000m w 0.2 oM Form CCO-4A Rev. 07-08-02 odder Status Form To be completed by all bidders Part Please answer "Yes" or `No' for each of the following: 13 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 a -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. ❑ 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. Yes To be completed by resident bidders Part My company has maintained offices in Iowa during the past 3 years at the following addresses: Address: 354© bip\�'�n.v- ®r r City, State, Zip: T.owc1/4.- Leek? r Dates: ®\ / °It / \1 \1 to (1) 1 / 3 t / 'aa1 c\ Ore / ° / a©\ i� � j r, Dates: to Dates: / / to You may attach additional sheet(s) if needed. Address: 350 6 i�o\ S.: City, State, Zip: - °�''a L'-'C `, . tkie-i Address: 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 ❑ f f t b'dd I b 7 force preferences of any other type o pre erence o f ers or laborersYes ❑ 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 To be completed by all bidders You may attach additional sheet(s) if needed. Part D I certify that the statements made on this document are true and complete to the best of my knowledge and I know that my failure to provide accurate and truthful information may be a reason to reject my bid, Firm Name: OG `rN -re- k C. a �v cc, -C'v DNS Signature. `' Date: / `3f% l 0 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) Woricsheet Authorization to Transact Business This workseet may be used to help complete PartA of the Resident Bidder Status form. If at least one of the following describ;, your business, you are authorized to transact business in Iowa Yes No ❑ Yes ❑No ❑ Yes ❑ No Yes No ❑ Yes ❑ No ❑ Yes ❑ No • Yes No • Yes No ❑ Yes ❑ No r ❑ Yes No 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. My business is a corporation whose articles of incorporation are filed in a state other than Iowa, the corporation has received a certificate of authority from the Iowa secretary of state has filed its most recent biennial report with the secretary of state, and has neither received a certificate of withdrawal from the secretary of state nor had its authority revoked. My business is a limited liability partnership which has filed a statement of qualification in this state and the statement has not been canceled. 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 lowa 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 (09-15) BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, Bockenstedt Excavating, Inc as Principal, and United Fire and Casualty as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called "OWNER." In the penal sum Five Percent and 00/100 of bid Dollars ($ Five percent and 00/100 of bid) 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 27th day of February , 20 20 , for FY 2020 Waterloo Air and Rail Park Tree Clearing • 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 of 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 day of , A.D. 201 B Bockenstedt Excavating Andy ::ckenstedt, President United Fire and Casualty (Seal) Attorney -in -fact Joy Perkins • • • • • • • • • • • • • UNITED FiRIt & CA$UALTY:COMPANY CrnARItAPIDS,.IA UNITED FIRE & INISEMNI_rY COMPANY, WEBSTEIt T FINANCIAL:PACIFIC INSURANCE COMPANY, ItOCKLrN, CA CERTIFIED COPY OF POWER OF ATTORNEY (original;on file at I-Iome.Office of Company — See,Cet trfication) : KNOW ALL PERSONS BY THESE.PRESEN`TS ;That United Fire & Casualty Caixpany, a corporation duly organized andek stung: under the laws of the Sta e of Iowa; United.Fhe & 'Indem pity: Cotitpau , a cot) oration dilly organized and existing :tinder the laws of the,: State of !Texas; and Faiat cial Pacific lnsiirance.Company; a corporation duly organ zed and existing under tltelaws of the State of Califorma {lterea t cdlleetively called .tile Companies), and havmg Qieir corporate heatigi t ters ui Cedar Rapids,. -State of Iowa, doe;; ival\e, constitute and appoutt TERRY L. MCDONALD' JEAN A. WILSON, JOE WEGMAN SETH AMBRISCO, ltRISTI NIELSON, DIANE SANDERS, SCOTT ENYART „CRAIG SCHROEDER, JOY PERKINS,,,,:BRAD HODAPP ASHLEY LEE;, JENNIFER ADAMS, RORY TRIPLETT, KYLE AOSTEN EACH ,INDIVIDUALLY • rer -me their trite and latvfttl Attpmey(s)-in-Fact withtpower tend autliQrity hereby: conferred to sign, seal. and execute m its behalf lawful ;bonds, tmdertal.ingand other obligatory tnstrtiments oi>s milar,n n4. itre s'p dvided that no single obligation shall exceed $$ , 000, 00o . 00 and 3o b iid: the Companies thereby as: futly, and. to the San e extent* if shear instnititents;tverc signed by the duly authorized officers of tlteCompatties td'all of the acts of said Atioiiiey, puisttaut to the iutliirity hereby giveit and hereby ratified and coufnnted the Aiithoiity hereby granted • shall expire theist day of October 2021 uni ess"'sooner revoked by United Fire & Casualty`' Company, United h ire & I idennity Company, and Financial Pacific Insurance Company. : 11tis Potvei' of,Attonney is made and executed ptusuant to and by authority of the following bylaw duly adopted on May 15, 2013; l>y the Boards of Dk kctors ofUtuted Fire & Casualty Company, United Fite & Indemnity Company, and Financial Pacific Insurance Company. "Article VI — Surety Bonds and Undertakings' Section 2, Appoint rent of Attorney -in -Fact. "The President or any Vice President, or any other officer of the Companies may, from time to time, appoint by written certificates atteitteys..in_fact to net in beha f of the Companies in the execution of policies of insurance, bonds, undeitakings and other obligatory i nstntinenis of like nattue The signitttre'pf airy officer authorized hereby, and the Corporate seal, may be affixed by facsimile to any power of attorney or special power of attomekor certification of either authorized hereby, such signature and seal, when so used, being adopted by the Companies as the original s'gnaurrc of such officer and the original seal of the Companies, to be valid and binding upon the Companies with the same force and effect as though manually affixed. Such attorneys -in -fact, subject to the limitations set of forth i n:their respeetiu certificates of authority shall have full power to bind the Companies by their signature and execution of any such instnunents aitd.to attach tlte'seal he .Conpanies thereto. The President or any Vice President, the Board of Directors or any other officer of the Companies may at any time revoke ail pottier and authority pre\viotuiy g* en to any attorney -in -fact. \\\NLGSI/I)q \\\\\1\W llt/////// \,WIIUiitinitt gec41NUG44 fir/, `\ea.� 0449,•• vice president and its corporate seal to be hereto affixed this 1 s t day of Oct Ober , 2019 con wtrr y= =3 t= ;''a°tUlY24 N4.0 o' UNITED FIRE & CASUALTY COMPANY r. 2' "= UNITED FIRE & INDEMNITY COMPANY SEAL:: SrAL + y; �, 1986 \,'.i2y' y,r,I S;Sf. '�,/r,B +*AC. "�<<FOPti Yp�� FINANCIAL PACIFIC INSURANCE COMPANY /lfitlnllll\l_., 11//NIIII\\1\\ /ll1/11I11111,\�� By: of Iawa,.Coti try of Limn, ss: Vice President On 1st day `of Ocfiober 2Ci9:;::before me:;parsonai 1y^-came .::Oennis:;J R:icbmann to me l.neWn, Who being by me duly swam did depose and say; that he res'des-m Cedar Rapids; State of.Iowa; that he`ts a Vice President ofUnited Frye & Casualty Company, a Vice President of United Fire & Indenfty Company, and a Vice President of Financial Pacific Inst rune Company the coipbratrons described in and,whtch executed`;the allOVejus.trtirilet t :that he I • ::— ••tine seal: of said ern igration;:.... the. seam affixed to tine sand instrument is such:COT r ate seal; that it Was so affixed pursuant to aattltority giveu'by die Board of Directors of said'cogioratioits a td that he mg led his name thereto•pursuaiit to hke.futhority and acltimwkdges sane to;be the act and deed of said corliointions t�+e� Jud'ithA Jones' .er:`:Iowa Notana►$eat; crirnmission number 17041 ':Notary Public MyCommissionEx ires4/23/2021 ' P My commission expires. 4/23/2021 I, Mary A. I3ettscln, Assistant S�ecretary'nf United Fire & Casualty .Compairy andAssistant SectetarY of United Fire & indemnity Company aud:Assistaut Seetetary of ataneial P.acifrc Itisuratnee:CO°itlpany, do hereby.ceitify tinat I;have COrripared the foregoing cagy of rite Paiver of::Attorney and affidavit and the cagy of tl c Section of t%e b ..laws and reSOlutions of Said Coivotafons: tis set forth ii said Power of Aitoixicy, with the.ORIGINALS ON FILE, IN TFIE' < HOME OFFICE OF SAID CORPORATIONS, and that late wine ar4 correct transcripts thereof, and of the whole of the said ortgmals,!.and that the said Power of Attorney hasrtot been revoked 'ind-is now nt ftdl force' nid effect. :: 'In testimony whereof t have ereuuto subSeribeit my name anti affixed the corporate seaf.ofthe said Corpptattons this day of , 20 . `\itlii 11 ,it ' �µa1I111tIJ, cxstr�,+� \�\ilj%lI ,, ``FaG 1Ns i f_�i CORPORATE • IN WITNESS WHEREOF, the COMPANIES have each caused these presents to be sigrned by its q. A,rF I, pFt'••6.. ••T� • �4 CORPORATC �� - U iD 22 i0 ..'...k,.:'�. �.... - •;vw qC/FOP <r�:;. It. As [nquiries Surety Department 118 Second Aste SE' Cedar Rapids, IA 52401 airizelu Assistant Secretary, UI &C 8e U z&I &>FPIC BP0A0045 122017 This paper has a colored background and void pantograph