Loading...
HomeMy WebLinkAboutK Cunningham Construction Inc• 1 CUNNINGHAM K CUNNINGHAM CONSTRUCTION CO., INC. 1325 RAIL WAY CEDAR FALLS, IA 50613 Bid Proposal For: F.Y. 2020 Warp Drive R.I S.E Project No. RM-8155(764)--9D-07 Contract No. 979 Waterloo, Iowa • i • CUNNINGHAM K CUNNINGHAM CONSTRUCTION CO., INC. 1325 RAIL WAY CEDAR FALLS, IA 50613 gui Bid Security For: F.Y. 2020 Warp Drive R.I.S.E Project No. RM-8155(764)--9D-07 Contract No. 979 Waterloo, Iowa ENGINEERS WATERLOO, L4 7/042O 51/ • • • • BID BOND NTS that we IC Cunningham Construction Co., Inc. KNOW ALL MEN BY THESE PRESS , as Principal, and _ United Fire & Casualty Company as Surety are held and firmly bound unto the C]TY OF WATERLOO _, Iowa, hereinafter called "OWNER," In the penal sum Five Percent of Amount Bid Dollars SI5% ) lawful money of the United States, for the payment of which sumtruly will and be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. The conditi-�of this obligation is such that �day of July whereas the Principal has sub ed the accompanying bid dated the _ Say of 155 Z64 D-07 for 2020 WarpDrLVe_R�lS.F-s-Pro1ect_N.o_ ( ) _ , 20 , F.Y. • NOW, THEREFORE, (a) If said Bid shall be rejected, or in the alternate, (b) If said Bid sha ll be accepted and the Principal shall execute and deliver a contract in the form specified for the payment of all persons and shall furnish a bond for his faithful performance of said contract, and other respects perform the performing labor or furnishing materials in connection therewith, and shall in allp p 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 su stained 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 impaired shall. be in no way 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 9th day of July , q, p, 2020 --- K. Cunnin ham Construction Co., Inc. (Seal) Principal Witness BID BOND By roc owe, #k3;:rre7w United Fire & Casualty Company ,(Seal) Surety ByaupIattary Attorney -in -fact Nancy D. Baltutat (Title) CONTRACT 977 6 " 1 RM-8155(764)--9D-07 UNITED FIRE & CASUALTY COMPANY, CEDAR RAPIDS, IA UNITED FIRE & INDEMNITY COMPANY, WEBSTER TX FINANCIAL PACIFIC INSURANCE COMPANY, ROCKLIN, CA CERTIFIED COPY OF POWER OF ATTORNEY (original on file at Home Office of Company — See Certification) ng der he aws KNOW ALL PERSONS BY THESE Indemnity Company, adFire ral corporation duly oigaualty nizled and existingany, a lt dulyorganized theilaws of theiSttat otf Texas;land of the State of Iowa; United File & hide r y P Y Financial Pacific Insurance Company, a corporation duly organized and existing under the laws of the State of California (hereon collectively called the Companies), and having their corporate headquarters in Cedar Rapids, State of Iowa, does make, constitute and appoint GREG T. LA MAIR, NANCY D. BALTUTAT, PATRICK K. DUFF, JEFFREY R. BAKER, JOSEPH I. SCHMIT, JILL SHAFFER, CHRISTOPHER R. SEIBERLING, EACH INDIVIDUALLY Inquiries: Surety Department 118 Second Ave SE Cedat Rapids, IA 52401 thew tine and lawful Attorneys) -in -Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful bonds, undertakings and other obligatory instruments of similar nature provided that no single obligation shall exceed $100 , 000 , 000.00 and to bind the Companies thereby as fully and to the same extent as if such instruments were sighed by the duly authorized officers of the Companies and all of the acts of said Attorney, pursuant to the authority hereby given and hereby ratified and confirmed. The Authority hereby granted is continuous and shall remain in full force and effect until revoked by United Fire & Casualty Company, United Fire & Indemnity Company, and Finvicial Pacific Insurance Company This Power of Attorney is made and executed pursuant to and by authority of the following bylaw duly adopted on May 15, 2013, by the Boards of Directors of United Fire & Casualty Company, United Fire & Indemnity Company, and Financial Pacific Insurance Company. "Article VI — Surety Bonds and Undertakings" Section 2, Appointment 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 attorneys -in -fact to act in behalf of the Companies in the execution of policies of insurance, ponds, undertakings and other obligatory instruments of like nature. The signature of any officer authorized hereby, and the Corporate seal, may be affixed by facsimile to any power of attorney or special power of attorney or certification of either authorized hereby; such signature and seal, when so used, being adopted by the Companies as the original signature of such officer and the original seal of the Companies, to he valid and binding upon the Companies with the same three and effect as though manually affixed. Such attorneys -in -fact, subject to the limitations set of forth in their respective certificates of authority shall have fill power to bind the Companies by their signature and execution of any such instruments and to attach the seal the Companies thereto. The President or any Vice President, the Board of Directors or any other officer of the Companies may at any time revoke all power and authority previously given to any attorney -in -fact. IN WITNESS WHEREOF, the COMPANIES have each caused these presents to be signed by its vice president and its corporate seal to be hereto affixed this 10t h day of March, 2014 \\� OINDG' ti,l%i \` 4CORPOR\}} '' o SEAL w\J Neu, 4e4, e¢PrV0 De'Yq Cn _- " nULY 22 O -U• A', 1386 ;` #I11milip30 oo. UNITED FIRE & CASUALTY COMPANY UNITED FIRE & INDEMNITY COMPANY FINANCIAL PACIFIC INSURANCE COMPANY By: State of Iowa, County of Linn, ss: On loth day of March, 2014, before me personally came Dennis J.•Richmann to me known, who being by me duly sworn, did depose and say; that lie resides in Cedar Rapids, State of Iowa; that he is a Vice President of United Fire & Casualty Company, a Vice President of United Fire & Indemnity Company, and a Vice President of Financial Pacific Insurance Company the corporations described hn and which executed the above nnstniment; that he knows the seal of said corporations; that the seal affixed to the said instrument is �strunttorlikeseal; � authority, and aclaiowlec)gpursuant essame toobeauthority the act and deed of sBd corporations.oard of Directors of said corporations and that he signed his pursuant Hanle thereto 1 Judith A. Jones Iowa Notarial Seal Commission number 173041 My Commission Expires 4/23/2021 Vice President Notary Public My commission expires: 4/23/2021 I, Mary A. Bertsch, Assistant Secretary of United Fire & Casualty Company and Assistant Secretary of United Fire & Indemnity Company and Assistant Secretary of Financial Pacific Insurance Company, do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Section of the bylaws and resolutions of said Corporations as set forth in said Power of Attorney with the ORIGINALS ON FILE IN THE IIOME OFFICE OF SAID CORPORATIONS, and that the sane are correct transcripts thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect. In testimony whereof I have hereunto subset ibed my name and affixed 2 the corporate seal of the said Corporations this 9th day of July i5 SEAL T I CA y� O ' ije-4R1� I \ p``\\\s. • N.04411111114444. t e oS SS _s %2 SEAL ift _Q s5 'see isD P.:2$ c-4 •••.1.C/FOP?� <',: ''16,/illlllll I IIIi1\UI� `\. `.�003131111,1404 `QpGO POAgr/'CIA )ULY 24 00` Assistant Secretary UF&C & OF&I & FPIC BPOA0049 1217 FORM OF BID OR PROPOSAL F oYo 2020 WARP ) MOW RnOnSo E o PR JIG T V\90o RhS 15J(i64)r©9Dn07 CONTRACT RIOn 979 CITY OF W Honorable Mayor and City Council Waterloo, Iowa Gentlemen: TERLOO, IOWA 1. The undersigned, being a Corporation existing under the laws of the State of a Partnership consisting of the following partners: havingfamiliarized (himself) (themselves) (itself) with the existing conditions on ' ro 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 I ngineer of the Cityof Waterloo now on file in the office of the City Clerk, City g .. . Hall, Waterloo, Iowa, hereby proposes to furnish all supervision, technical personne l, labor, materials, machinery, tools, appurtenances, equipment, and services, including utility and transportation services required to construct and complete this F.Y. 2020 WARP DRIVE R.I.S.E. PROJECT NO. RM-8155(764)-- 9D-07 CONTRACT NO. 977, all in accordance with the above -listed documents and for the unit prices for work in place for the following items and quantities: F.Y. 2020 WARP DRIVE R.I.S.E. PROJECT NO. RM-8155(764)--9D-07 CONTRACT NO. 977 ITEM NO. ITEM UNIT ELIGIBLE NON - ELIGIBLE TOTAL EST. QTY. UNIT BID PRICE TOTAL BID PRICE 2.01 CLEARING AND GRUBBING AC 2 1.2 3.2 2.02 TOPSOIL, ON -SITE CY 1,800 15,200 17,000 2.03 EXCAVATION, CLASS 10 CY 3,500 51,500 55,000 2.04 SUBGRADE PREPARATION SY 4,158 4,158 2.05 SUBBASE, 6" MODIFIED, WARP DRIVE SY 4,158 4,158 2.06 2.07 2.09 SUBBASE, 4" MODIFIED, TEMPORARY TURNAROUND SUBBASE, 8" MACADAM STONE SUBGRADE OVEREXCAVATION GRANULAR STABILIZATION SANITARY SEWER GRAVITY, TRENCHED, PVC TRUSS, 12" SANITARY SEWER GRAVITY MAIN, TRENCHED, DIP, 12" SY SY CY TN LF LF 420 420 1,177 1,177 59 59 FORM OF BID CONTRACT NO 977 RM-8155(764)--9D-07 4-1 4.03 SANITARY TRENCHED, SEWER PVC SERVICE, 6" LF 120 120 $ $ 4.04 STORM GASKETED SEWER, RCP, TRENCHED, 15" LF 119 119 $ $ 4.05 STORM GASKETED SEWER, RCP, TRENCHED, 24" LF 652 652 $ $ 4.06 STORM GASKETED SEWER RCP, TRENCHED, 30" LF 455 455 $ $ 4.07 SUBDRAIN, HDPE, 6" LF 2,080 2,080 $ $ 4.08 SUBDRAIN CLEANOUT EA 2 2 $ $ 4.09 PIPE APRON, RCP, 15" EA 1 1 $ $ 4.10 PIPE APRON, RCP, 30" EA 1 1 $ $ 5.01 WATER DIP, 8" MAIN, TRENCHED, LF 1,158 1,158 $ $ 5.02 WATER DIP, 6" MAIN, TRENCHED, LF 32 32 $ $ 5.03 WATER TRENCHED, SERVICE, DIP, 8" LF 192 192 $ $ 5.04 FITTING, TEE, 8" x 6" EA 4 4 $ $ 5.05 FITTING, TEE, 8" x 8" EA 3 3 $ $ 5.06 FITTING, REDUCER, 8" x 6" EA 1 1 $ $ 5.07 FITTING, 22.5 DEG BEND, 8" EA 8 8 $ $ 5.08 VALVE, MJ GATE, 6" EA 4 4 $ $ 5.09 VALVE, MJ GATE, 8" EA 6 6 $ $ 5.10 FIRE HYDRANT ASSEMBLY EA 4 4 $ $ 5.11 DEAD ASSEMBLY END FIRE HYDRANT EA 1 1 $ $ 6.01 MANHOLE, SW-401, 60" EA 1 1 $ $ 6.02 MANHOLE, SW-301, 48" EA 3 3 $ $ 6.03 MANHOLE, SW-301, 60" EA 1 1 $ $ 6.04 INTAKE, SW-507 EA 2 2 $ $ 6.05 INTAKE, SW-509 EA 4 4 $ $ 7.01 PAVEMENT, C-SUD PCC, 9" SY 3,720 3,720 $ $ 7.02 PAVEMENT REMOVAL SY 75 75 $ $ 8.01 TEMPORARY CONTROL TRAFFIC LS 1 1 $ $ 9.01 CONVENTIONAL FERTILIZING MULCHING AND SEEDING, AC 1 31 32 $ $ 9 02 FILTER MAINTENANCE SOCK (INSTALL &REMOVAL) LF 3,000 3,000 $ $ 9.03 RIP RAP, EROSION STONE TON 25 25 $ $ 9.04 SILT MAINTENANCE,&REMOVAL) FENCE (INSTALL LF 2,000 2,000 $ $ 9.05 INLET (INSTALL, REMOVAL) PROTECTION MAINTENANCE,& EA 6 6 $ $ 9.06 CONSTRUCTION (INSTALL, REMOVAL) MAINTENANCE, ENTRANCE & EA 1 1 $ $ FORM OF BID CONTRACT NO 977 RM-8155(764)--9D-07 4-2 FENCE REMOVAL, FIELD LF 9.07 FENCE 11.01 11.02 MOBILIZATION MAINTENANCE BOND LS LS 1,900 1,900 $ 1 1 $ 1 TOTAL BID $ 903) g33?00 2. It is understood qu antities that the set forth are approximate only and subject to price and that the unit bid 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 anyor all bids. If written notice of the acceptance of of Waterloo, Iowa, to reject this bid is mailed, telegraphed, tele hed or delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter before this bid is p g withdrawn, the undersigned agrees ned a rees 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 / Ve ccs; ci` Dollars ($ l� o ) in the form of 'dimz5»mod , 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 Con tractor and Subcontractor(s), which have performed an aggregate of $10,000.00 inCity work for the in the current calendar year, are prepared to submit an AAP ®p r 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 7/7/,2o 10. 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 FORM OF BID CONTRACT NO 977 4 - 3 R M-8 155(764)--9 D-07 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. g 13. The Owner reserves the right to select alternates, delete line items, and/or to reduce prior rior to the award of a contract due to budgetary limitations. quantities kewm:,,Iam 1"0n5-Arucheon (Name of Bidder) r BY: Title I res: ieto f 7ft/2 (Date) Official Address: (Including Zip Code)' 3Zs / Way der/or %rmiiyf sq 5-.c‘/3 I.R.S. No. 92- /i27yi7 FORM OF BID CONTRACT NO. 977 4 - 4 RM-8155(764)--9D-07 F.Y. 2020 WARP DRIVE R.I.S.E. PROJECT RM-8155(764)--9D-08 CONTRACT NO 980 CITY OF WATERLOO, IOWA ITEM NO. Item UNIT ELIGIBLE ELIGIBLE NON- TOTAL QTY UNIT PRICE BID TOTAL BID PRICE 2 2.02 TOPSOIL, ON -SITE CY 1,800 15 200 17000 $ 4.25 $ 72,250.00 2 2 2.05 SUBBASE, WARP DRIVE 6' MODIFIED, SY 4,158 4158 $ 6.50 $ 27,027.00 2.06 SUBBASE, TEMPORARY 4' MODIFIED TURNAROUND SY 420 420 $ 5.00 $ 2,100.00 2.07 SUBBASE, STONE 8" MACADAM SY 420 420 $ 8.00 $ 3,360.00 2.08 SUBGRADE OVEREXCAVATION CY 350 350 $ 6.00 $ 2,100.00 2 SANITARY TRENCHED, SEWER PVC TRUSS, GRAVITY, 12" LF 1,177 1177 $ 45.00 $ 52,965.00 4.02 SANITARY MAIN, TRENCHED, SEWER GRAVITY DIP, 12" LF 59 59 $ 113.00 $ 6,667.00 4.03 SANITARY TRENCHED, SEWER PVC SERVICE, 6" LF 120 120 $ 39.00 $ 4,680.00 4.04 STORM GASKETED SEWER, RCP, TRENCHED, 15" LF 119 119 $ 39.00 $ 4,641.00 4.05 STORM GASKETED SEWER, RCP, TRENCHED, 24" LF 652 652 $ 52.00 $ 33,904.00 4.06 STORM GASKETED SEWER RCP, TRENCHED, 30" LF 455 455 $ 65.00 $ 29,575.00 4.07 SUBDRAIN, HDPE, 6' LF 2,080 2080 $ 11.50 $ 23,920.00 4.08 SUBDRAIN CLEANOUT EA 2 2 $ 500.00 $ 1,000.00 4.09 PIPE APRON, RCP, 15" EA 1 1 $ 2,100.00 $ 2,100.00 4.10 PIPE APRON, RCP, 30" EA 1 1 $ 2,900.00 $ 2,900.00 5.01 WATER DIP, 8" MAIN, TRENCHED, LF 1,158 1158 $ 48.00 $ 55,584.00 5.02 WATER DIP, 6" MAIN, TRENCHED, LF 32 32 $ 51.00 $ 1,632.00 5.03 WATER TRENCHED, SERVICE, DIP, 8" LF 192 192 $ 54.00 $ 10,368.00 5.04 FITTING, TEE, 8" X 6" EA 4 4 $ 400.00 $ 1,600.00 5.05 FITTING, TEE, 8" X 8" EA 3 3 $ 435.00 $ 1,305.00 5.06 FITTING, REDUCER, 8" X 6" EA 1 1 $ 180.00 $ 180.00 5.07 FITTING, 22.5 DEG BEND, 8" EA 8 8 $ 290.00 $ 2,320.00 5.08 VALVE, MJ GATE, 6" EA 4 4 $ 975.00 $ 3,900.00 5.09 VALVE, MJ GATE, 8' EA 6 6 $ 1,325.00 $ 7,950.00 5.10 FIRE HYDRANT ASEMBLY EA 4 4 $ 3,200.00 $ 12,800.00 5.11 DEAD ASSEMBLY END FIRE HYDRANT EA 1 1 $ 3,100.00 $ 31100.00 NON TOTAL UNIT BIB TOTAL BID PRICE ITEM NO. Item UNIT ELIGIBLE ELIGIBLE EST. QTY. PRICE MANHOLE SW-401, 60" EA 1 1 I 1 $ 3,100.00 1 $ 3,100.00 6. 01 , 3 I 3 ( $ 4,400.00 $ 13,200.00 MANHOLE, SW-301, 48" I EA 1 6.02 8,150.00 SW-301, 60" EA 1 1 ( 1 1 $ 8,150.00 $ 6.03 MANHOLE, 8,000.00 INTAKE, SW-507 EA 2 1 2 $ L,000.00 $ 6.04 6.05 INTAKE, SW-509 EA 4 1 I 4 $ 5,050.00 $ 20,200.00 167,400.00 3720 $ 45.00 $ PAVEMENT, C-SUD PCC, 9" SY 1 3,720 I 7.01 7. 02 PAVEMENT REMOVAL SY 1 75 I 1 75 I $ 20.00 1 $ 1,500.00 8.01 TEMPORARY TRAFFIC LS 1 $ 1,500.00 $ 1,500.00 CONTROL 9.01 CONVENTIONAL FERTILIZING, AND SEEDING, AC 1 31 32 $ 1,400.00 $ 44,800.00 MULCHING 9.02 FILTER MAINTENANCE, SOCK (INSTALL, & REMOVAL) LF 3,000 3000 $ 2.00 $ 6,000.00 1,250.00 RIP RAP, EROSION STONE T TON 25 25 $ 50.00 1 $ 9.03 9.04 SILT MAINTENANCE, FENCE (INSTALL, & REMOVAL) LF 2,000 2000 $ 2.00 $ 4,000.00 9.05 INLET (INSTALL, PROTECTION MAINTENANCE, & EA 6 6 $ 175.00 $ 1,050.00 - REMOVAL 9.06 CONSTRUCTION (INSTALL, MAINTENANCE, ENTRANCE & EA 1 1 $ 2,500.00 $ 2,500.00 REMOVAL 9.07 FENCE REMOVAL, FIELD LF 1,900 1900 $ 2.00 $ 3,800.00 FENCE 60 000.00 MOBILIZATION LS 1 1 $ 60 000. ,, 00 - 11.01 _ 11.02 MAINTENANCE BOND LS 1 1 $ 9,000.00 $ 9,000.00 TOTAL BID Joe Owen President K. Cunningham Construction Co., Inc. 903,835.00 NON -COLLUSION AFFIDAVIT OF PRIME BIDD R State of re W4_ ) )ss County otV4ck /1/16A �E r-1/1/trji , being first duly sworn, deposes and says that: 1. He is wn , Partner, Officer, Representative, or Agent) , of )eunn:r 4nt A,'/. et. ZsL, , the Bigdes 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. (Signed) re%• oiek.e Title Subscribed and sworn to before me this q day of , 2020. 0-05 Gellt My commission expires SAP4 o a j NON -COLLUSION AFFIDAVIT - PRIME RM-8155(764) 9D07 Title • DIANE L CALF COMMISSION NO.703084 MY COMMISSI RES MAY 8 CONTRACT NO 977 7 - 1 Bldder Status Norm To be completed by ali bidders Please answer "Yes" or "No" for each of the following: Yes Yes R'Yes Yes n Yes N o My company is authorized to transact business in Iowa. (To helpyou determine if your company is authorized, please review the worksheet on the next page). N o My company has an office to transact business in Iowa. N o My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail. My company No has been conducting business in Iowa for at least 3 years prior to the first request for p y bids on this project. My company No is not a subsidiary of another business entity or my company is a subsidiary of another p Y 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 Part B My company has maintained offices in Iowa during the past 3 years at the following addresses: /4.2s dey)74er 5trce* Dates: / 2.7 / 79 to / 2S / Address: City, State, Zip: eq:%56r ?usZs SDI 13 CP Dates: 6 / 2? / 20 to 7 / 9 / Address: y City, State, Zip: Oedar V/hi ?A Dates: / / to / / Address: COG 1? You may attach additional sheet(s) if needed. City, State, Zip: artC To be completed by nonresident bidders 1. Name of home state or foreign country reported to the Iowa Secretary of State: 2 Does company's your 's home state or foreign country offer preferences to resident bidders, resident labor p Y force preferences or any other type of preference to bidders or laborers? answered "Yes" to question 2, identify each preference offered by your company's home state or foreign country 3. If you and the appropriate legal citation. Yes ■ No You may attach additional sheet(s) if needed. To be completed by all bidders 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: k &»n4ain ems tebc t► �o Zh‘. Signature: ,«„G_, Date: 741/2o 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) 10-1 Worksheet: Authorization to Transact Business This worksheet may be used to help complete Part A of the Resident Bidder Status form. If at least one of the following describes your business, you are authorized to transact business in Iowa. [(Yes ❑ No My business is currently registered as a contractor with the Iowa Division of Labor. ■ ■ ■ ■ Yes EINo My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. Yes 'No My business is a general partnership or joint venture. More than 50 percent of the general partners or joint venture parties are residents of Iowa for Iowa income tax purposes. Yes I. No My business is an active corporation with the Iowa Secretary of State and has paid all fees required by the Secretary of State, has filed its most recent biennial report and has not filed articles of dissolution. Yes No Yes ErNo Yes ErNo Yes []`No Yes fNo Yes ®' No 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. 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 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. 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) MBE/WBE BUSINESS ENTERPRISE PRE -BID CONTACT INFORMATION FORM Prime Contractor Name: �i �chn hi4m Sr+.C. 'TA4.. Project° *at . AL. 9h7 Letting Date: 71/2/245 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: Title: rrel..��'h# Date: -7/9/0 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/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 Rudy Jones, 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. TABLE OF INFORMATION SHOWING BDJJER°S FRE-BID MBE/WBE BUSINESS ENTERPRISE CON ACT Quotes Received Quotation used itt bid MBE/WBE Subcontractors Dates Contacted Yes/No Dates Contacted Yes/No Doflkr Amount Proposed to :e Subcontracted ecerad- MA ri e/e y ity; Ye S 6-) 2S"o . a t (Form CCO-4) Rev. 06-20-02 CONTRACT 977 RM-8155(764)--9D-07 120 - 1 Form 730007WP 7-97 Contractor k CLendn,9%c»st &)thk east Zhu Project# 977 County rblcek hnoh' City TARGETED SMALL BUSINESS (TSB) PRE -BID CONTACT INFORMATION (To Be Completed By All Bidders Per The Current Contract Provision) Page# In order for your bid to be considered responsive, you are required to provide information on this form showing your Targeted Small Business contacts made with your bid submission. This information is subject to verification and confirmation. In the event it is determined that the Targeted Small Business goals are not met, then before awarding the contract, the Contracting Authority will make a determination as to whet her or not the apparent successful low bidder made good faith efforts to meet the goals. NOTE: Every effort shall be made to solicit quotes or bids on as many subcontractable items as necessary to achieve the established goals. If a TSB's quote is used in the bid, it is assumed that the firm listed will be used as a subcontractor. TABLE OF INFORMATION SHOWING BIDDERS PRE -BID TARGETED SMALL BUSINESS (TSB) CONTACTS SUBCONTRACTOR TSB DATES QUOTES RECEIVED QUOTATION USED IN BID CONTACTED YES/ NC) ffNTAC:TFf DATES YES/ NCl DOLLAR TC) RF SIIRC:QNTRACTFfl AMT. PROPOSED i% evert Mayer -7l7/a° Veg/at 4iN )- 5 S SC sd.d o 1 Total dollar amount proposed to be subcontracted to TSB on this project $ items by name to be subcontracted: SC ease.3'p, re ' 1' 1.'*L,, f /nit 4: he? FIT1fes••Sadc c;it 'rah At ++y,,lS Ts-fee1*iaf7 SS $S,,ese • List