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StE °EVELON
S.M. Hentges
& Sons Inc.
Est. 1981
1/4/dries •TRUCK/
S.M. Ilentges & Sons Inc.
6.50 Quaker Avenue, Suite 200
Jordan, NIN 55352
952.492.5700 Fax 952.492.5705
City Clerk's Office
715 Mulberry Street
Waterloo, IA 50703
BCD IN113
O S iz D :
FY 2020 Leversee Road
Sanitary Sewer & Water Main Improvements
Contract No. 987
June 25, 2020 - 1:00 PM
ORH OF BID OR PROPOSAL
2020 11_, . 9F=' S1H.E ' oAI SANITARY S HW11=R AND WATER MAIN
IMPROVIE,AMATS
CONTRACT MO. 987
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
The undersigned, being a Corporation existing under the laws of the State of
ZI;� AA.c--rs d / , a Partnership consisting of the following partners:
.' / 4 4,-7— Y ` cs (M 0 s /4./ \
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 Leversee Road Sanitary Sewer and Water Main
Improvements1 Contract 987, all in accordance with the above -listed
documents and for the unit prices for work in place for the following items and
quantities:
Y 2020 Leversee
RoadSanitary
Sewer
and
Water
Main
Improvements
Contract
987
BID
DESCRIPTION
UNIT
Div
1
Div
2
UNIT
BID
TOTAL
DIV
1
TOTAL
DIV
2
TOTAL
BID
ITEM
Est Qty
Est
Qty
PRICE
PRICE
PRICE
PRICE
2.01
CLEARING
AND
GRUBBING
LS
1.0
-
$
$
$
Xb64��
31/60°
$ fir`'
4,55:
SANITARY
SEWER
GRAVITY
4.01
TRENCHED,
PVC
TRUSS,
LF
8,220
-
$
Mitio
$4 fOpi%:$
2AIN,
//b77cS5
4.02
SANITARY
WITH
SEWER
GRAVITY
MAIN
$
$Ab�366
CASING
PIPE,
TRENCHLESS,
LF
130
-
elob‘
$ f05;36646.$
DIP,
12"
�Z�
� d
WATER
MAIN5.01,
TRENCHED,
DIP,
LF
_
20
$
1 i 3 et'
$
$
616
$
S
22‘.0
WATER
MAIN,
TRENCHED,
DIP,
5.02
LF
-
6,511
$
$
$
$
12
pet,
J�4�(��Z
J`�Ol,�.
�
WATER
MAIN
WITH
CASING
PIPE,
'�
5.03
LF
-
170
$ 076b
$
$�f �176a$
�jT
�L1�3
TRENCHLE55,
DIP,
12"
5.04
VALVE,
Mil
8"
EA
-
1
6a
$
66
$
5D
$
/tr4p
/64416
$ /e546
FORM OF BID
CONTRACT NO. 987
4-1
0 iv 0/11,
5.05
VALVE,
MJ,
12"
EA
-
11
$z3/s'"c'
$
$2gf Sir
$ ,��-��
5.06
FITTING,
TEE,
12"
x 8"
EA
-
1
$ Npv`D
$
$//6
d°h
$ yOb a wei
FITTING,
45
DEG
BEND,
12"
EA
-
5
$ `iCdrt
$
41."
5.07
$7.25.tf
$ 7244 6°
5.08
EA
-
2
$ .¢700°O
$
$
as
FIRE
HYDRANT
ASSEMBLY
?$cx(1°
$ 9¢5)
5.09
EA
-
1
�
$$
�`�6
�
$ � 656(771
DEAD
END
FIRE
HYDRANT
ASSEMBLY
$`�'$O
5.10
CONNECTION
WATER
MAW
TO
EXISTING
EA
-
1
$ 27oO°°
$
S77�°�
$ 4 7
d
p°°
5.11
RELOCATE
EXISTING
FIRE
EA
-
1
$/6.35,deb
$
$arge
$ 463Ccci
HYDRANT
6.01
EA
15
-
$ iisroe
$
$
$ ai 7cis 6
MANHOLE,
SW-301,
48"
‘975440
6.02
EA
9
-
$ Z¢�
$
$ 7jle‘
$ e3oes
MANHOLE,
SW-301,
60"
7.01
REMOVAL
PAVEMENT
AND
DISPOSAL
OF
PCC
SY
-
112
$ /3 ,sa
$
a°
$ /5 /eb
$ /45/2.
7.02
SY
-
112
$ ke 64.
$
$ ?Pm
°
$
y gg 6%
FULL
DEPTH
PCC
PATCH
1
8.01
TEMPORARY
TRAFIC
CONTROL
LS
0.5
0.5
$ ,/-tat,
$ ?OpOtsiss
6<s
$ 76,50
$ ii ��
9.01
AC
29.6
2.4
$ /lg'�'s/
$43i
Ws
ec
$ 3fl2
$ Td'6
FED
TILIZINGIOAND
MULCHING
9.02
AC
2
� Zp�66o
es
ab
HYDRAULIC
SEEDING,
$
$��ZO
$ cazo
FERTILIZING,
AND
MULCHING
9.03
SILT
FENCE,
INSTALLATION
LF
-
40
$ag6tr.
$
$ /0` 616 at
8,700
$ /
9.04
SILT
FENCE,
MAINTENANCE
LF
-
$ • ZC
$jITSeit
$
So
8,700
$ Z /7b
9.05
SILT
FENCE,
REMOVAL
LF
-
$ f ic
$ igor
$
$63Ar°°
8,700
9.06INSTALLATION
INLET
PROTECTION,
EA9
$ ?Oci°
$ �ll� fa
$
$ `6
at'
INLET
MAINTENANCE
PROTECTION,
EA
9
b
9.07
$ 3ccdc)
$
$ 9/C6
$ 3/C°°
9.08
INLET
PROTECTION,
REMOVAL
EA
9
A
as
$ �c3a�°a
$�4�1s'0o
$
$ 3/5-16x>
9
09
CONSTRUCTION
ENTRANCE,
EA
2
-
$ A3S6t
$ Wa°°
$
$ 2/656 675
INSTALLATION
9.10
CONSTRUCTION
MAINTENANCE
ENTRANCE,
EA
2
-
$ ZOO
so
$ le.
$
$Sao
9.11
CONSTRUCTION
ENTRANCE,
EA
2
-
$ �
��
$REMOVAL$g!essis
$ l
6�
9.12
LF
-
6,500
$ -°. i `
$
$13,‘CSbct 4656°e
WATTLERS,
INSTALLATION
9.13
LF
-
6,500
$ ;-
$
$ /(,Zit"$ 4 4 �g'e'
WATTLES,
MAINTENANCE
9.14
LF
-
6,500
$ _ c
$
$ 3zSeat$
WATTLES,
REMOVAL
gzstto
FORM OF BID
CONTRACT NO. 987
4-2
REMOVAL
OF
AND
$ co$
$
9.15
RECONSTRUCTION
OF
EXISTING
LF
200
-
Z�
42o04t
$
60
i260
FENCE,
AIRPORT
SECURITY
INSTALLATION
AND
REMOVAL
9.15A
OF
TEMPORARY
AIRPORT
LF
200
-
$ �
$
$
$ �
Zi
/Z6���
"
ZOO
SECURITY
FENCE
9.16
EROSION
CONTROL,
MULCHING
AC
31.6
2.4
$ 422e
$ 574
$ )?nocr.'
11.01
MOBILIZATION
LS
0.5
0.5
COO°
$l2/
Ott)
$ `Z(Oele$44Z
$7,¢;
(xzas
/, n ii
66
-n-0
IC4
A_
DIV 1
BID $
ao
r,56,i
O
A.
DIV
2 BID $
! I /
2/54?,,,
rc6t-
O_ A DIV
1
DIV
AID
_
+
2
$
2. It is understood that the quantities set forth are approximate only and subject to
variation and that the unit bid price for the work done shall govern in the actual
payment to Contractor.
3. In submitting this bid, the bidder understands that the right is reserved by the City
of Waterloo, Iowa, to reject any or all bids. If written notice of the acceptance of
this bid is mailed, telegraphed, or delivered to the undersigned within thirty (30)
days after the opening thereof, or at any time thereafter before this bid is
withdrawn, the undersigned agrees to execute and deliver an agreement in the
prescribed form and furnish the required bond and certificate of the insurance
within ten (10) days after the agreement is presented to him for signature, and
start work within ten (10) days after "Notice to Proceed" is issued.
4. Security in the sum of d SisaScoe,0
Dollars ($ ) in the form of
is submitted herewith in accordance with the INSTRUCTIONS TO BIDDERS.
5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor.
6. Attached hereto is a Bidder Status Form.
7. The bidder is prepared to submit a financial and experience statement upon
request.
8. The Prime Contractor and Subcontractor(s), which have performed an aggregate
of $10,000.00 in work for the City in the current calendar year, are prepared to
submit an AAP or Update and an EOC, within ten (10) days of notification that the
bid submitted is lowest and acceptable.
9. The bidder has received the following Addendum or Addenda:
FORM OF BID
CONTRACT NO. 987 4 - 3
Addendum No. Date ‘ 6-2 Z - Z o
‘--2,5eZict
10. The bidder shall list the MBENVBE subcontractor(s), amount of subcontracts and
bid items on the City of Waterloo Minority and/or Women Business Pre -bid
Contact Information Form submitted with this Form of Bid or Proposal. The
apparent low Bidder shall submit a list of all other Subcontractor(s) to be used on
this Project to the City of Waterloo by 5:00 p.m. the business day following the day
Bids on this Project are due along with the Non -Collusion Affidavits of All
Subcontractor(s).
The Contractor shall submit information on subcontractors on
"SUBCONTRACTOR REQUEST AND APPROVAL" Form to be provided by City
prior to approval of contract.
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 987 4 - 4
BY:
(5:712 / EA' ft4 (5764)45
(Name of Bidder)
/A,C s-a2t/e-2.0
(Date)
T
Title �v��'�'�"�.S age:Cr�.
Official Address: (Including Zip Code):
‘450 Qv,Virez AVE
Jg4O4A/, /�� SSJSaZ
I.R.S. No. -c737
FORM OF BID
CONTRACT NO. 987 4 - 5
INFOR1ATION NEEDED
FOR
IIOWA CONSTRUCTION SALES TAX EXEMPTION CERTIFICATE
CONTRACTOR NAME: S. �`'% Sri �c-� �-- Sons .Lire
ADDRESS: 6 .50 Ov9 49 er
v M.7/ Sir .? Sat
(Check One) PRIME X SUBCONTRACTOR
FEDERAL ID#:
PROJFCT I\IAMC: `-L,gzao LeAte (Tee /di .S'a .7 rder
41"/A le-arn7CCoi ..rentr co c/Seserr&
PROACT CONTRACT NO.: 948fr
DESCRIPTION OF WORK:
111
Brickwork
Carpentry
Concrete
Drywall -Plaster -insulation
Electrical
Excavation/Grading
Flooring
Heavy Construction
Heating -Ventilating -Air Cond
3
Landscaping
Painting
Paving
Plumbing
RoofingwSidingmSheet Metal
Windows
Wrecking@emolition
Other (Please specify)
County of
NON=COLLUSION AFFIDAVIT OF PRIME BIDDER
State of
Set )
ct--Wan
S
)ss
being first duly sworn, deposes and says that:
He is (Owner, Partner, Officer, Representative, or Agent) , of
'406j , 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.
DONNA K. Fr r. ,
TAR v►i•..iiJ • . F'h'iCC ... i; 1
(Signed)
Title
Subscribed and sworn to before me this 2� day of
MA,tte 1‹.
My commission expires
•
CJ
A3171N4444
, 2020.
Title
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 contractors, 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.
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.
The contractor, subcontractor, vendor and supplier of goods and services
will furnish and file compliance reports within such time and upon such
EQUAL OPPORTUNITY CLAUSE CONTRACT NO. 987 8 - 1
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 contractor,
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.
6. In the event of the contractor's non-compliance with the non-discrimination
clauses of this contract or with any of such rules, regulations and orders,
this contract may be canceled, terminated or suspended in whole or in
part and the contractor may be declared ineligible for further contracts in
accordance with procedures authorized by the City Council.
7 The contractor, subcontractor, vendor and supplier of goods and services
will include, or incorporate by reference, the provisions of the non-
discrimination clause in every contract, subcontract or purchase order
unless exempted by the rules, regulations or orders of the City's
Affirmative Action Program, and will provide in every subcontract, or
purchase order that said provisions will be binding upon each contractor,
subcontractor, or supplier.
8. We, the undersigned, recognize that we are morally and legally committed
to non-discrimination in employment. Any person who applies for
employment with our company will not be discriminated against because
of race, creed color, sex, national origin, economic status, age, mental or
physical disabilities.
(Signed)
GeratiA-
Appropriate Official)
(Title)
(Date)
EQUAL OPPORTUNITY CLAUSE
CONTRACT NO. 987 8 - 2
TITLE VI CIVIL RIGHTS
During the performance of this contract the contractor (for itself), its assignees, and
successors in interest (hereinafter referred to as the "contractor") agrees as follows:
1. Compliance with Regulations: The contractor shall comply with the Regulations
relative to non-discrimination in Federally assisted programs of the DOT Title 49,
Code of Federal Regulations, Part 21, as they may be amended from time to
time, (hereinafter referred to as the Regulations), which are herein incorporated
by reference and made a part of this contract
2. Nondiscrimination: The contractor, with regard to the work performed by it during
the contract shall not discriminate on the grounds of race color, national origin,
sex, age, or disability in the selection and retention of subcontractors, including
procurement of materials and leases of equipment. The contractor shall not
participate either directly or indirectly in the discrimination prohibited by section
21 5 of the Regulations, including employment practices when the contract
covers a program set forth in Appendix B of the Regulations.
3. Solicitations for Subcontracts, Including Procurement of Materials and
Equipment: In all solicitations either by competitive bidding or negotiation made
by the contractor for work to be performed under a subcontract, including
procurement of materials or leases of equipment, each potential subcontractor or
supplier shall be notified by the contractor of the contractor s obligations under
this contract and the Regulations relative to non-discrimination on the grounds of
race, color, national origin sex, age, or disability.
4. Information and Reports: The contractor shall provide all information and reports
required by the Regulations or directives issued pursuant there to, and shall
allow access to its books records, accounts, other sources of information, and its
facilities as may be determined by the Contracting Authority, the Iowa DOT, or
FHWA to be pertinent to ascertain compliance with such Regulations, orders and
instructions. Where any information required of a contractor is in the exclusive
possession of another who fails or refuses to furnish this information the
contractor shall so certify to the Contracting Authority, the Iowa DOT, or the
FHWA as appropriate, and shall set forth what efforts it has made to obtain the
information.
5. Sanctions for Noncompliance: In the event of the contractor's noncompliance
with the nondiscrimination provisions of this contract, the Contracting Authority,
the Iowa DOT, or the FHWA shall impose such contract sanctions as they may
determine to be appropriate, including, but not limited to:
a. Withholding of payments to the contractor under the contract until the
contractor complies, and/or
9-1
TITLE VI CIVIL RIGHTS CONTRACT NO. 987
b. Cancellation, termination, or suspension of the contract, in whole or in
part.
6. Incorporation of Provisions: The contractor shall include the provisions of
paragraphs (1) through (6) in every subcontract, including procurement of
materials and leases of equipment, unless exempt by the Regulations, or
directives issued pursuant thereto The contractor shall take such action with
respect to any subcontract or procurement as the Contracting Authority, the Iowa
DOT or the FHWA may direct as a means of enforcing such provisions including
sanctions for non-compliance Provided, however that, in the event of a
contractor becomes involved in or it threatened with, litigation with a
subcontractor or supplier as a result of such direction, the contractor may request
the Contracting Authority or the Iowa DOT to enter into such litigation to protect
the interests of the Contracting Authority or the Iowa DOT; and, in addition, the
contractor may request the United States to enter into such litigation to protect
the interest of the United States.
9-2
TITLE VI CIVIL RIGHTS CONTRACT NO. 987
idder Status Form
To be completed by all bidders Part A
Please answer "Yes" or "No" for each of the following:
XI
Yes
rad Yes ri No
Yes 1 No
fYes No
x
x
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).
My company has an office to transact business in lowa.
My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail.
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.
To be completed by resident bidders
Pari: B
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates: 11 / 14 / 2008 to CURREtT / Address: 3608 VANDAL IA ROAD
City, State, Zip: DES MOINES , IOWA 50 317
Dates: 05 / 13 / 2019 to CURRENT / Address: 3220 10 0 TH STREET
City, State, Zip: URRANDALE , IOWA 50323
Dates: 06 / 01 / 2018 to 05 / 13 / 2019 Address: 1275 1\
You may attach additional sheet(s) if needed.
W STREET
City, State, Zip: CLIVE, IOWA 50325
To be completed by non-resident bidders
Part C
1. Name of home state or foreign country reported to the Iowa Secretary of State:
2 Does your company's home state or foreign country offer preferences to resident bidders, resident labor
force preferences or any other type of preference to bidders or laborers?
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.
Yes I I No
You may attach additional sheet(s) if needed.
_,
To be completed by all bidders
Part D
1 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:
Signature:
S.M. HENTGEC SONS, INC.
care,
Date: 05116 21-e
You must submit the completed form to the governmental body requesting bids per 875 Iowa Administrative Code
Chapter 156. This form has been approved by the Iowa Labor Commissioner.
309-6001 (09-15)
Worksheet: Authorization to Transact Business
This worksheet may be used to help complete Part A of the Resident Bidder Status form. If at least one of the following
describes your business, you are authorized to transact business in Iowa.
Yes ■ No My business is currently registered as a contractor with the Iowa Division of Labor.
n Yes x No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes.
•
Yes fxi 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.
n Yes n No
x
My business is an active corporation with the Iowa Secretary of State and has paid all fees
required by the Secretary of State, has filed its most recent biennial report, and has not filed
articles of dissolution.
Yes ■ No My business is a corporation whose articles of incorporation are filed in a state other than Iowa,
the corporation has received a certificate of authority from the Iowa secretary of state has filed
its most recent biennial report with the secretary of state, and has neither received a certificate of
withdrawal from the secretary of state nor had its authority revoked.
Yes n 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 nNo
My business is a limited liability partnership which has filed a statement of qualification in a
state other than Iowa, has filed a statement of foreign qualification in Iowa and a statement of
cancellation has not been filed.
❑ Yes x 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 pi No My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
Yes x No My business is a limited liability company whose certificate of organization is filed in a state other
than Iowa, has received a certificate of authority to transact business in Iowa and the certificate
has not been revoked or canceled
309-6001 (09-15)
10-2
3
0
1
3
r
d
c
.9'
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BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, S.M. Hentges & Sons Inc.
as Principal, and Liberty Mutual Insurance Company
as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called
"OWNER." In the penal sum Five Percent (5%) of Total Amount Bid eve
Dollars ($ 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 25th, day of June
, 20 20 , for FY 2020 Leversee Road Sanitary Sewer and Water Main Improvements,
Contract No. 987, Waterloo, Iowa
NOW, THEREFORE,
(a) If said Bid shall be rejected, or in the alternate,
(b) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the form specified
and shall furnish a bond for his faithful performance of said contract, and for the payment of all persons
performing labor or furnishing 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 25th, day of June , A.D. 20 20 .
Witness
S.M. Hentges & Sons Inc. (Seal)
Principal
By
Liberty Mutual Insurance Company (Seal)
Surety
By
Jos ' a R. Loftis
ttorney-
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(Title)
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CORPORATE ACKNOWLEDGMM
State of Minnesota
) ss
County of Scott
On this 25th day of June 2020 , before me appeared N(A.4-4\_.....
to me personally known, who, being by me duly sworn, did say that he/she is the
of S.M. Hentcjes & Sons Inc. , a corporation, and that said instrument
was executed in behalf of said corporation by authority of its Board of Directors, and that said
t'3CJ44A45\ acknowledged said instrument to be the free act and deed of
said corporation.
•
NOTARY PUBLIC- MINNESOTA
My Corte "xp ea Jai. 31, 2021
State of Minnesota
) ss
County of Hennepin
Notary Public
160-1,ntinr-
SA-etti County, m d
My commission expires
SURETY ACKNOWLEDGMFNT
On this 25th day of June 2020 , before me appeared Joshua R. Loftis
to me personally know, who being by me duly sworn, did say that (s)he is the Attorney -in -Fact of
Liberty Mutual Insurance Company , a corporation, that the seal
affixed to the foregoing instrument is the corporate seal of said corporation and that said instrument was
executed in behalf of said corporation by authority of its Board of Directors; and that said
Joshua R. Loftis acknowledged said instrument to be the free act and deed of said corporation.
"�0 U� -s,. RACHEL THoMAS
4co
'NOTARY PUBLIC - MINNESOTA
-171My Commission Expires
January 31, 2025
Notary Public Ramsey
My commission expires 1/31/2025
County, Minnesota
Liberty
Mutual
SURETY
This Power of Attorney limits the acts of those named herein, and they have no authority to
bind the Company except in the manner and to the extent herein stated.
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
West American Insurance Company
POWER OF A 1- D t=tiN [��Y
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Colby D
White, Melinda C. Blodgett, R. C. Bowman, Tina L. Domask, R. Scott Egginton, Sandra M. Engstrum, R. W. Frank, Ted Jorgensen, Joshua R. Loftis, Kurt C. Lundblad
Brian J. Oestreich, Jerome T. Ouimet, Ross S. Squires, Nicole Stillings, John E. Tauer, Rachel Thomas, Lin Ulven, Emily White
Certificate No: 8200451 n190054
all of the city of Minneapolis state of Minnesota each individually if there be more than one named, its true and lawful attorney -in -fact to make,
execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings bonds, recognizances and other surety obligations, in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 4th day of February , 2019
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
West American Insurance Company
By:
David M. Carey, Assistant Secretary
State of PENNSYLVANIA
County of MONTGOMERY ss
On this 4th day of February 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance
Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes
therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Teresa Pastel's, Notary Public
Upper Merion Twp., Montgomery County
My Commission Expires March 28, 2021
Member, F'ennsylvawa Association of Notaries
By. Plitod ga,-614(i
Teresa Pastella, Notary Public
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
ARTICLE IV — OFFICERS: Section 12. Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the
President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety
any and all undertakings, bonds, recognizances and other surety obligations Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall
have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation When so executed, such
instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under the
provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE XIII — Execution of Contracts: Section 5. Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings,
bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in -
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 25th day of June ,2020 •
By:
Renee C. Llewellyn, Assistant Secretary
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