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Bond No. 41423190
B11) BOND
KINOW ALL MEN BY THESE PRESENT'S, that we, Jeff Wilson dba Wilson Custom Tree, 212 Short Avenue _
I Cresco IA 52136 as Principal, and Platte River Insurance Compapy.Po Box 5900, Madison, WI 53705-0900
a Surety are held and firmly bound unto the gLty of Waterloo, Iowa, hereinaftcr called "OWNER". In the penal
stun One Thousand Five Hundred and No/100----------------------------- ------------------------------------------------------------- dollars
($�111500.00 ) lawful money of the United States, for the payment of which sum will and truly be made,
w 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
bi dated the 9thday of April , 20 20 , for 2020 WWTP & Lift Stations Mowing
NOW, THEREFORE,
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a) $f said Bid shall be rejected, or in the alternate,
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b) if said Bid shall be accepted and the Principal shall execute and deliver a contract in the form specified and
sh11 furnish a bond for his faithful performance of said contract, and for the payment of all persons performing
lab r or furnishing materials in connection therewith, and shall in all other respects perform the agreement
cre4ted by the acceptance of said Bid,
Th n 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 enal amount of this obligation as herein stated.
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By tirtue 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 tle specifications or by law.
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The urety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall
be it� 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.
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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 th�ir proper officers this 6th day of April , A,D. 20 20
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Jeff Wilson dba Wilson Custom Tree (Seal)
Principal
r
By (Title}
owner
Platte River Insurance Company
Jarett Berg, Aunt Specialist
(Seal)
Surety
By
Attorney4n-Fact Rita enson
BID 80ND PAGE I OF I
State of _ i-
County ofJtiy�t{�1tiL'
On this 9 day of QQi, in the year, before me
personally comes
to me known and known to me to be the person who is described in and executed the foregoing instrument, and
acknowledges to me that he/she executed the same.
?pIAL ®Rc April Q. �Uis
Commission Number 783136
o MY COMM. EXP. 7 Notary Public
ACKNO EDGMENT OF PRINCIPAL (Partnership)
State of
County of }
On this
personally comes)
a member of the co -partnership of
to me known and known to me to 1
day of
in the year
before me
person who is described in and executed the foregoing instrument, and
acknowledges to me that he/she executed the same as the act and deed of the said co -partnership.
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Corporation/LLC)
State of
County of
On this
personally come(s)
day of
to me known, who being duly sworn, deposes
that he/she is the
corporation described in and which
thereto by like order.
the
in the year ,before me
that he/she resides in the City of
F
the
the foregoing instrument, and that he/she signed his/her name
Notary Public
KNOW ALL MEN BY THESE PRESENTS, That the PLATTE RIVER INSURANCE COMPANY, a corporation of the State of Nebraska, having
iIs principal offices in the City of Middleton, Wisconsin, does make, constitute and appoint
------------------------------------------------------ JACK ANDERSON; RONALD KAIHOI; RITA JORGENSON -----------------------------------------
its true and lawful Attorney(s)-in-fact, to make, execute, seal and deliver for and on its behalf, as surety, and as its act and deed, any and all bonds, undertakings
and contracts of suretyship, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in amount the sum of
-----------------------------ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED:$20,000,000.00---------------------I
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of
Directors of PLATTE RIVER INSURANCE COMPANY at a:meeting duly called and held on the 8th day of January, 2002.
"RESOLVED, that the President, Executive Vice President, Vice President, Secretary or Treasurer, acting individually or otherwise, be and they hereby
are granted the power and authorization to appoint by a Power of Attorney for the purposes only of executing and attesting bonds and undertakings, and
other writings obligatory in the nature thereof, one or more resident vice-presidents, assistant secretaries and attomey(s)-in-fact, each appointee to have
the powers and duties usual to such offices to the business of this company; the signature of such officers and seal of the Company may be affixed to any
such power of attorney or to any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures
or facsimile seal shall be valid and binding upon the Company, and any such power so executed and certified by facsimile signatures and facsimile seal
shall be valid and binding upon the Company in the future with respect to any, bond or undertaking or other writing obligatory in the nature thereof to
which it is attached. Any such appointment may be revoked, for cause, or without cause, by any of said officers, at any time."
In connection with obligations in favor of the Florida Department of Transportation. only, it is agreed that the power and authority 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 — Depaztment of
Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
IN WITNESS WHEREOF, the PLATTE RIVER INSURANCE COMPANY has caused these presents to be signed by its officer undersigned and its
corporate seal to be hereto affixed duly attested, this 3rd day of May, 2017.
Attest:
J E. Rzepinski
Vice President, Treasurer & CFO
Suzanne M. Broadbent
Assistant Secretary
IN
PLATTE RIVER INSURANCE COMPANY
op�Q�pQ`NS�U��I�III/lliUi�i0G0i
,gP
NOF
SEAL _ Stephen J. Sills
CEO & President
STATE OF WISCONS
'} '- m�uiiiiliiK�fm�o\oo�o
COUNTY OF DANE J S.S::
On the 3rd day of May, 2017 before me personally came Stephen J. Sills, to me known, tvho being by me duly sworn, did depose and say: that he resides
in the County of New York, State of New York; that he is President of PLATTE RIVER INSURANCE COMPANY, the corporation described in and
which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal; that it
was so affixed by order of the Board of Directors of said corporation and that he signed his name thereto by like order.
� JOJ-RE Z4�s-
�'' : i` ` David J. Regele
STATE OF WISCONSIN S.S.: 9 Notary Public, Dane Co., WI
COUNTY OF DANE My Commission Is Permanent
I, the undersigned, duly elected to the office stated below, now the incumbent in PLATTE RIVER INSURANCE COMPANY, a Nebraska
Corporation, authorized to make this certificate, DO HEREBY CERTIFX that the foregoing attached Power of Attorney remains in full force and has
not been revoked; and furthermore, that the Resolution of the Board of Directors; set forth in the Power of Attorney is now in force.
Signed and sealed at the City of Middleton, State of Wisconsin this 6 th dap of April 20 20
�SEAL�
Antonio Celli
General Counsel, Vice President & Seccretary
THIS DOCUMENT
IS NOT VALID UNLESS
PRINTED ON GREEN SHADED BACKGROUND WITH A RED SERIAL NUMBER
IN THE UPPER RIGHT HAND
CORNER. IF YOU
HAVE ANY QUESTIONS
CONCERNING THE AUTHENTICITY OF THIS DOCUMENT CALL 800-475-4450.
PR-POA (Rev. 10-2017)
ACKNOWLEDGEMENT OF SURETY
STATE OF MINNESOTA
COUNTY OF CHIPPEWA
On this 6th day of April , 2020 ,before me, a Notary Public within and for said
County, personally appeared Rita Jorgenson to me personally known, who being by me duly
sworn he/she did say that he/she is the attorney -in -fact of Platte River Insurance Company ,
the corporation named in the foregoing instrument, and the seal affixed to said instrument is the
corporation seal of said corporation, and sealed on behalf of said corporation by authority of its
Board of Directors and said Rita Jorgenson acknowledged said instrument to be the free act
and deed of said corporation.
NOTARYPUBLIC
My Commission Expires
LEANNE C. DUI
Notary Public -Minnesota
My Commission Expires JaM n 3
1,2023
N
cCIT OF W TER1LOO, NOW
JASTE MAl`�iAGEMENT SERVICES
fo 1°
�020 WWTP & LIFT STATIONS iVIOWING
BIDDER: VV 11son Wc,, m l f2 C
ADDRESS: >aor y-tvv
1. The undersigned, being a Corporation existing under the laws of the State of N/A ,
or a limited liability company existing under the laws of the State of N A , or a
Partnership consisting of the following partners:
having been familiarized with the existing conditions on the project area affecting the
cost of the work, and with all the Contract Documents now on file in the offices of the
City Clerk, City Hall, 715 Mulberry Street, Waterloo, Iowa, Waterloo Waste
Management, 3505 Easton Avenue, Waterloo, Iowa hereby proposes to furnish all
supervision, technical personnel, labor, materials, machinery, tools, equipment, and
services, including utility and transportation services required to complete the proposed
2020 WWTP & LIFT STATIONS MOWING, in accordance with the contract documents
and for the unit price in place for the following amount:
OPTION A: provide all specified mowing &trimming services for three mowing
monthly or every ten day mowing & two (2) weed control spraying services per contract:
For Wastewater Treatment Plant at 3505 Easton Ave., Waterloo, IA
Price Per Occurrence Mowing:
/joD
Price Per Occurrence Weed Control Spraying:
0
'L� �� ��l.L� 71�2F.t� L"4k
dollars
dollars ($ ��no,
L1 Q
BID FORM Page 1 of 5
OPTION D: provide all specified dike/slope mowing for W WTP EQ Basin Dike and
Lagoon Dike Four (4) times/year:
L3-325 2749 Independence Ave Lagoon Dike only
Wastewater Treatment Plant at 3505 Easton Ave., Waterloo, IA EQ PIIt' U1 ONLY
Price Per
e 1VIo g: &44t k /
YEARLY CONTRACT ESTIMATED AMOUNT:
OPTION A: o
16 x$ 000. =$
# of Mowings/year Mowing Price/Occurrence
dollars ($ a pf I )
Total
# of Weed Sprayings/year Weed Spraying Price/Occurrence Total
OPTION B:
12
# of Mowings/year Mowing Price/Occurrence Total
# of Weed Sprayings/year Weed Spraying Price/Occurrence Total
OPTION C:
6 x $ 3�5$
# of Mowings/year Mowing Price/Occurrence
11
# of Weed Sprayings/year
OPTION D:
0
#of Mowings/year
X $ `�DbO Ioo
Weed Spraying Price/Occurrence
x$ OlOy.•da
Mowing Price/Occurrence
Total
_$ ��D1�0• v�
Total
Total Estimate Yearly Cost = $
Total
387(�� o0
Note: While yearly contract estimated amount is based upon the estimated number of
times mowing and weed control sprayings, the actual payment will be based upon the
actual number of occurrences of mowing and weed control spraying work was
performed.
BID FORM Page 3 of 5
10. The Bidder shall list all equipment available for this project.
...
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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 alternatives, delete line items, and/or to reduce
quantities prior to the Award of Contract due to budgetary limitations.
SIGNED: Jzoore�OlA.)r}e-v DATE:
BID FORM Page 5 of 5
I�I®I'1=CVI,ILIUZI®1`yr AI±I;IDAVII ®F PRIME BIDDER
State of k'u )
County ofw
being first duly sworn, deposes and says that:
1. He is Owner), (Partner), (Officer), (Representative), or (Agent) of Vj&&6nLUS1-PM aG
the Bidder that has submitted the attached Bid;
2. He is fully informed respecting the preparation and contents of the attached Bid and of all
pertinent circumstances respecting such Bid;
3. Such Bid is genuine and is not a collusive or sham Bid;
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 parties in interest, including this affiant.
Title
S4natuYel
I�10mCO1LLUSIOI I AFFIDAVIT OF SUBCONTRACTOR
State of NZ /4
County of AV/ A
/Z7} , being first duly sworn, deposes and says
that:
1. He is (Owner), (Partner), kOfficer), (Representative), or (Agent) of
hereinafter referred to as the "Subcontractor";
2. He is fully informed respecting the preparation and contents of the subcontractor's proposal
submitted by the subcontractor to /V /i4 , contract
pertaining to the 2020 WWTP & LIFT STATION MOWING in Waterloo, Black Hawk
County, Iowa;
3. Such subcontractor's proposal is genuine and is not a collusive or sham proposal;
4. Neither the subcontractor 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 proposal in connection with such contract or to refrain from submitting a
proposal in connection with such contract, or has in any manner, directly or indirectly, sought
by unlawful agreement or connivance with any other bidder, firm or person to fix the price or
prices in said subcontractor's proposal, or to fix any overhead, profit or cost element of the
price of prices in said subcontractor's proposal, or to secure through collusion, conspiracy,
connivance or unlawful agreement any advantage against the City of Waterloo, Iowa, or any
person interested in the proposed Contract;
5. The price or prices quoted in the subcontractor's proposal are fair and proper and are not
tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the
bidder or any of its agents, representatives, owners, employees, or parties in interest,
including this affiant.
Signature Title
5�.+.l�ar.�'a� av�.aL �wav�w to-1>efo-Ye. vner thv�
S y�+�.ature'
EQUAL OPPORTUNITY CLAUSE
(As provided in Executive Order No. 11246)
All contractors, subcontractors, vendors and suppliers of goods and services doing business with
the City and value of said business equals or exceeds ten thousand dollars ($10,000.00) annually
agree as follows:
1. The contractor, subcontractor, vendor and supplier of goods and services will not
discriminate against any employee or applicant for employment because of race, color, creed,
sex, national origin, economic status, age, mental or physical handicap, political opinions or
affiliations. The contractor, subcontractor, vendor and supplier will develop an Affirmative
Action program to ensure that applicants are employed and that employees are treated during
employment without regard to their race, creed, color, sex, national origin, religion, economic
status, age, mental or physical disability, political opinions or affiliations. Such actions shall
include but not be limited to the following:
a. Employment
b. Upgrading
c. Demotion or Transfer
d. Recruitment and Advertising
e. Layoff or Termination
f. Rates of Pay or Other Forms of Compensation
g. Selection for Training Including Apprenticeship,
2. The contractor, subcontractor, vendor and supplier of goods and services will, in all
solicitations or advertisements for employees, state that all qualified applicants will receive
consideration for employment without regard to race, creed, color, sex, national origin,
religion, economic status, age, mental or physical disabilities, political opinion or affiliations.
3. The contractor, subcontractor, vendor and supplier or his/her collective bargaining
representative will send to each labor union or representative of workers which he/she has a
collective bargaining agreement or other contract or understanding, a notice advising said
labor union or workers' representative of the contractor's commitment under this section.
4. The contractor, subcontractor, vendor and supplier of goods and services will comply with all
published rules, regulations, directives, and order of the City of Waterloo Affirmative Action
Program Contract Compliance Provisions.
5. The contractor, subcontractor vendor and supplier of goods and services will furnish and file
compliance reports within such time and upon such forms as provided by the Affirmative
Action Officer. Said forms will elicit information as to the policies, procedures, patterns, and
practices of each subcontractor as well as the contractor himself/herself and said
subcontractor, vendor and supplier will permit access to his/her employment books, records
and accounts to the City's Affirmative Action Officer, for the purpose of investigation to
ascertain compliance with this contract and with rules and regulations of the City's
Affirmative Action Program — Contract Compliance Provisions relative to Resolution No.
24664.
EQUAL OPPORTUNITY CLAUSE PAGE I OF 2