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HomeMy WebLinkAboutThe Cahoy GroupCahy roup 24568 150th Street Sumner, Iowa 50674 Finct L aq vIT12V Na. 3 betAkk,+er; ti l.( I C&-od tio. t0 3 2 fzFA Ell cdt ,skt.a I�' ���- A!o . 1072. FORM OF 110 OR PROPOSAL FINAL. CLARIFIER NO. 3 DEWA T ERING WL LLS CONTRACT NO. 1032 CITY OF WATERLOO, IOWA Honorable Mayor and City Council Waterloo, Iowa Gentlemen: 1. The undersigned, being a Corporation existing under thp laws of the State of ovQ�- a Partnership consisting of the following partners: ea i P ‘;� Jiro ce , t nc. � condition's on the project area having familiarized (himself) (themselves) (itself) with the existing conditi n 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 AECOM 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 the FINAL CLARIFIER NO. 3 DEWA T ERING WELLS, CONTRACT NO 1032, all in accordance with the above -listed documents and for the unit prices for work in place for the following items and quantities: FINAL el .ARIFUER NO. 3 DEWA 1 LJIING WITS CONTRACT NO. 1032 Item Description 11, , ,. Unit -, r Ec t• Qty. U��it; did Pt*ic ; Total [1111 No. Prico o0 1 Mobilization and General Items LS 1r7; Ooo°9 $ ,7 f 000. 2 New Piezometer EA 1 $ 7 Not) $ 7 344 ft- ( 3 01 066 ° 3 New Dewatering Wells EA 0 022 1 /a® 1 $ ' $ 17/00 o0 4 72-Hour Pump Test on TW2 LS / 2 VD / Z 5 Pump and Discharge System LS �o ,� 6, 3.E �� Installation, Rental and Removal 2 6 3 5- 6 Extended Pumping System 24-Hour Day 7 $ 51 /72 00 $ 2? 2-ot o0 �r Standby Rental of 3-Well Pumping Month ����4 le 2�`�© System 3 Transducers EA 8 $ 6 6 75. v $ l3 V 00 Qs' o0 BID AMOUNT I $ TOTAL 2 23 8 5./ 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 hid, 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. o .c l _ '✓� r,,,. eIghz Dollars 4, Securityin the sum of ekVz , � i� ti w / ($ j?25'. 7 5 ) in the form of 1&O€ PVC( , o Y is submitted herewith in accordance with the INSTRUCTIONS TO BIDDERS. FORM OF BID AECOM ##60558763 CONTRACT NO. 1032 FB-1 Final Clarifier No. 3 Dewatering Wells 5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor. u Form indicatingResident Bidder Certification ( ) ), or G. Attached hereto is a Bidder Status None(Resident Bidder Certification ( ). (Mark one.) 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 MP 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. Alo tAA, Date .a"Mi•-. - . 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 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 kidder 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. 1Nameivvvw{� Q�/1�� �Q o Bid er) 9/q/1o2o ) BY: .ti''` `� Title PvtSickrv\F Official Address: (Including Zip Code): tilse co Are [ujvv\fr\err _ TiASo 6 71( I.R.S. No. q2a 5/3 0 27 FORM OF BID AECOM BB60558763 CONTRACT NO. 1032 FB-2 Final Clarifier No. 3 Dewatering Wells f • CahovThe Groun • n A 1.1l11t7 TITTA.411 Ccouiry taint; r tivir 3114f V It t4 The Prettier Provider of Municipal, Industrial, & Environmental Water Well Services • CORPORATE RESOLUTION Be it known that on this 12th Day of December, 2019 the Board of Directors of Cahoy Pump Senrice passed this Resolution authorizing the following individuals to sign any and all Bid Documents, Bid Bonds, Performance Bonds, and all Binding Agreements. S ee N IS a nos•;n 1 Cahoy .Viol HI J . '.,.uilvy Mike Whittenbaugh Anthony Sherman Jonathan Lilja Mike Stoddard Jon Smiley Authorized by, cfraitt, 4/614112 Darin J. Cahoy Chief Executive Officer • Cahoy Coperate Office: 24568 150th Street - Suite 200 Sumner, Iowa 50674 (563) 578-1130 Cahoy West: 200 Grant Street Marne, Iowa 51552 Witnessed by, Mike Whittenbaugh President • Cahoy Illinois South: 1822 North Lincoln Parkway Lincoln, Illinois 62656 WWW.CAHOYPUMP.COM • • CPS - IL North: 202 West Howard St. Durand, Illinois 61024 State of County of NON -COLLUSION AFFIDAVIT OF PRIME BIDDER )ss AD, �� } M i 6c- (A/ln 4 er 6ot,.n; 9 fel He is IevItaerrPartrter Officer, , being first duly sworn, deposes and says that: t) ,of edit Pip f2vVlck Z✓1,C , 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. (Signed) / Title r ,, . Subscribed and sworn to before me this 7 d.-- J �1�4 tt' , 20 2e. My commission expires NON -COLLUSION AFFIDAVIT CONTRACT NO. 1032 AECOM 1160558763 Title NCA-1 Final Clarifier No. 3 Dewatenng Wells To too completed by all bidders Please answer "Yes" or "No" for each of the following: cg Yes 11 No Yes [1 No Yes Ej No 1M Yes Li No Yes n No My company is authorized to transact business in Iowa. on the next page). if your company is authorized, please review the worksheetp d ) (To help you determine� My company has an office to transact business in Iowa. 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. My company is not a subsidiaryof another business entity or my company is a subsidiary of another business entity that would qualify as a resident bidder in Iowa "Yes" for each question above, your company qualifies as a resident bidder. Please If you answered 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 My company has maintained offices in Iowa during the past 3 years at the following addresses: p y o Co � SP: o?�o Address:. 2.L1 5-6 � / City, State, Zip: _cFMAA-1--- 2to0 tfit-. 57.5.5— 2_ Dates: � / Is / ?.a I Zto 09 / 09 Dates: 05 Dates: l / 2006 to D9 io9 0 I / Mitto / of izobq You may attach additional sheet(s) if needed. To be completed lay nonnr esident bidders Address: City, State, Zip: Address: City, State, Zip: if I( ParLI irk IcS tit el. Name of home state or foreign country reported to the Iowa Secretary of State: TA So63o Part G • 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? question 2 identifyeach preference offered by your company's home state or foreign country 3. If you answered Yes" to and the appropriate legal citation. To he completed by all bidders -_I Yes Li No You may attach additional sheet(s) if needed. Palili: _ I certify that the statements mad e 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: Date: (t1 #20 You must submit flip completed form to the governmental body requesting bids pperII76 Iowa Administrative Code Chapter 156. This form has boon approved by the Iowa Labor Commissioner. 309-6001 (09-15) BSF-1 Cahc�v Groun 4a 'ealer CAHOY PUMP SERVICE The Premier Provider of Municipal, Industrial, & Environinental Water Well Services STATEMENT OF QUALIFICATIONS KEY PERSONNEL: DARIN CAHOY — Chief Executive Officer: 31 years experience in the water well industry. Licensed well contractor in Iowa, Nebraska, Illinois, Kansas, Minnesota, and Missouri. Past member of National Groundwater Association's Government Affairs Committee. Past Board member and past President of the Iowa Water Well Association. MIKE WHITTENBAUGH — President / Project Manager: 6 years experience in the municipal water well industry. Graduate of Purdue University with a degree in Mechanical Engineering. Mike is experience in all facets of water well drilling, well rehabilitation, and well pump repairs. ANTHONY SHERMAN — Regional Manager 25+ years experience in the municipal water well industry. �slarn+1nn systems ��zI+1i ♦nnr.' T n»nnanniiil droll rehabilitation opc1aL111g s sLc111J with lllally (sucic�esslul Wcll lcllablliLauult his credit. Possess an Engineering degree. Well versed in geothermal drilling and andpimp repair / ran'nnamar%+ ns•n+on+n +n a11U pump repair 1cpiacic111c11L piUJCc) l LV MARK CLAASSEN — CPA / Project Manager: 36 years experience in the water well industry. Licensed well contractor in Iowa, Missouri, and South Dakota. 40 Hour OSHA HazMat certified. Holds the Master Groundwater Contractor designation as recognized by the National Groundwater Association. Is our in-house Certified Public Accountant. MIKE STODDARD — Regional Manager, Lincoln, Illinois: 25+ years experience in the municipal water well industry. Experienced in reverse circulation drilling, lineshaft turbine repairs, submersible turbine repairs, and well rehabilitation. SMILEY, JON — Regional Manager, Marne, Iowa: J years eXI enenee 111 the municipal water well industry. Experience in all facets of llllesilatt turorne, submersible turbine pumps, and water well rehabilitations. Is 40 Hour OSHA Hazwoper trained 10- hour OSHA Safety trained and certified. Is a licensed Iowa Water Well Contractor. LLOYD WURZER — Field Crew Foreman: 12 years experience in the water well industry. Licensed well contractor in Iowa and Wisconsin. 40 Hour OSHA HazWoper and 10-hr OSHA certified. Proficient in all facets of well pump installation / repair and well rehabilitation techniques. Cahoy Corporate Office: 24568 150th Street — Suite 200 Sumner, Iowa 50674 (563) 578-1130 Cahoy West: 200 Grant Street Marne, Iowa 51552 Cahoy Illinois South: 1822 North Lincoln Parkway Lincoln, Illinois 62656 CPS — IL North: 202 West Howard St. Durand, Illinois 61024 WWW.CAHOYPUMP.COM JON LILJA — Field Crew Foreman: 12 experience erience in the water well industry. 40 hour OSHA Hazwoper and 10-hr OSHA Safety yearsp trained. Experienced in all facets of water well pump installations and well rehabilitations. TONY THEIN — Senior Project Manager: 11 experience erience in the water well industry. Well experienced with reverse circulation drilling, well yearsp rehabilitation, and municipal well pump repairs. Licensed Iowa Water Well Contractor. 40 Hour nflTTA TT UT_._ _._J 10 1____._fl ATT�..______J J certified. OSnn riaz w oper and iu-Hour °SA.n trainee and certilieu. KAES DEGROOT — Lead Driller: T .irPncPrl Tlriller in Iowaanal Tllinnic nST-TA Ha7vvnner and ns IA 1 f_hr safety training LJ1VV11V Vl.i LJ 111V1 111 1V ••t.4. t.t.11%.i J11111%J1L VlJl lI 1 i1t.1LJ TV%J \.LII%4 'JLJJ S1 a 1 V 111 1J4i1Vt.7 Li\Allll llf.�• ENINGEERING REFERENCES: McCLURE ENGINEERING, Austyn Wolfe, Mike Trotter @ 515-576-7155. Ft. Dodge, IA. 516' deep, 28" borehole x 24" casing x 22" open hole. 2,000 gpm + Blairsburg, IA 450' deep, 14.75" borehole x 10" casing, 8" liner, 7" open hole FARNSWORTH GROUP, Robert Kohlhase, Joe Milulecky @ 309-663-8435 Atlanta, IL screened well project. 200' deep, 24" borehole x 12" screen & casing. T Pt # 1 Kelly 11 T"� /1 r 1 r rt A f1 !1 1 A f1 1SG, Kelly Evans ( J 1 J-243-9143 Anthon, IA. 15" borehole x 10" SS screen & casing. 450 gpm+ IMEG, Megan Crook @ 309-833-4594. LaHarpe, IL. Two (2), 1200' deep wells, 15" borehole, 8" casing MSA Engineering, Nick Wagner, Scott Duckett, Abby Mouw a. 563-445-3501. v Albany, Illinois Well # 4 project FOX ENGINEERING, Steven Troyer @ 515-233-0000. Grimes, Iowa Aquifer Storage Recovery well pump installation. FEHR GRAHAM ENGINEERING, Andy Kieser @ 217-352-7688 Long Creek Township Water District. 3 u" borehole x 16" screen i casing x 100' deep. SEH ENGINEERING, Tom Madden @ 641-424-6344. - Multiple well construction and pump installations. HDR ENGINEERING, Doug Haney @ 913-553-6883 Worked on multiple hydrogeological investigations throughout the Midwest. 1 d V V tJ tJ HOWARD R. GREEN, Greg Brennan @ 800-728-7805 Work with Greg on multiple shallow and deep well installations. GENERAL REFERENCES: MAHASKA RURAL WATER, Randy Pleirna @ 641-660-0332 FOR T MADISON WATER DEPARTMENT: Ft. Madison, Iowa: Norm Dodson @ 319-463-5200 UNIVERSITY OF NORTHERN IOWA: Cedar Falls, Iowa: Mike Hinney @ 319-273-2297 or 319-273- 4400 Tw J PELLO RURAL WATER ASSC: Ottumwa, Iowa: Dan jw estegard @ 641-682-835 l or 641- i r'- 0896 T TRW T TT1T TTV (TR (1T TP. fiiliiec, To yva. A ndr•e r Wood @ S 1 S_48 =31 76 OSKALOOSA WATER DEPT: Oskaloosa, Iowa: Chad Coon @ 641-673-8476 VILLAGE of CURTIS, WI. Todd Welch @ 715-613-2013. CITY OF ROCKFORD, IL: Kyle Saunders @ 779-348-7371 (Ernie Lilja has worked on multiple deep well pumps, booster pumps, and reservoirs for Rockford) IET IL: Nick Gornick 815-724-3675 (Darin, Derek, & Jon have worked on multiple CITY OF JO @ 450 HP x 1200' set submersible pumps) CITY OF NAPERVILLE, IL: Pat O'Malley @ 630-420-6681. (Darin, Derek, & Jon have pulled & inspected multiple 450 HP x 1000' set submersible pumps) DRILLING EXPERIENCE: BLAIRSBURG, IOWA — 2020 Drilled new production well. Contract value approximately $ 215,000. Drilled 14. /J" hole to 165. `Set and grouted lu" steel casing. Drilled 9.875" hole to 3 65' . Set 8" perforated liner. Drilled 7" open hole to 450. Test pumped well, install pitless U dt and pump. 115 gpm+ CONTACT: Austyn Wolfe @ 515-890-1713 ANTHON, IOWA — 2020 Drilled new production well. Contract value approximately $ 225,000. Drilled 15" hole to 190' . Installed 10" SS casing and 8" SS screen. Test pumped at 600 gpm+, install pitless unit and well pump CONTACT: Kelly Evans @ 515-243-9143 ALBANY, ILLINOIS — 2019 Drilled new production well. Contract value appioximate $ 400,000. Drilled 14.75" hole to 456'. Set and grouted 10" steel casing. Drilled 9.875" hole to 850'. Test pumped ::ell at 775 spm +. CONTACT: Nick Wagner @ 563-445-3801 LAHARPE, ILLINOIS — 2019 Drilled two production wells Contract value approximately $ 450,000 Drilled rilled 12" hole to approximately 74u) on each. Set and grouted 8" steel casing. Drilled 7.875" diameter hole to approximately 1200' Test pumped at 250 gpm+ CONTACT: Megan Cook @ 309-833-4594 FT. DODGE, IOWA — 2019 Drilled one production well. Contract value approximately $ 570,000. Drilled 28.25" diameter hole to 280'. Set and grouted 24" steel casing. Drilled 22" diameter open hole to 516' Test Mil + ninnnred well at 2.gptia r CONTACT: Austyn Wolf @ 515-890-1713 WATERLOO CAREER CENTER, WATERLOO IOWA - 2018: Drilled one production well and one injection well Contract value approximately $ 265,000. 1 n r,, _1 1. _ 1 _ �10' Drllleu 1 1.3 ulameter note io LGII . Set and grouted 12" steel casing Drilled 11.875' diameter open hole to 340'. Test pumped wells at 1,250 gpm. CONTACT: Tyler Sell @ 319-290-3670 ORCHARD HILLS SCHOOL, CEDAR FALLS, IOWA — 2018: - Drilled one production well and one injection well. Contract value. approximately $ 235,000. - ilriilea l 7.5' diameter hole to 2uu'. Set and grouted 12" steel casing Drilled 11.875' diameter open hole to 300'. Test pumped v. ells in excess of 500 gpm CONTACT: Zach Berends @ 319-233-5616 ILLINOIS AMERICAN WATER — LINCOLN, ILLINOIS — 2018: Drilled 280' x 8" screened test well. Estimated value was $ 110,000. — Test pumped at 400 gpm -r. CONTACT: Mike Stohl LONG CREEK TOWNSHIP WATER DISTRICT, DECATUR, ILLINOIS — 2017 Drilled 30" diameter borehole to 96' with 16" screen and casing. Install pitless unit and submersible pumping equipment. contract value approximately 90,000. CONTACTS: Andrew Kieser @ 217-352-7688 ( Engineer) Wayne Dotson @ 217-519-0199 (Owner's Rep) VILLAGE OF LEWISTOWN, ILLINOIS — 2016 & 2019 Contract value of $ 90,000.& $ 115,000 - Drilled 24" diameter borehole to a depth of 45'. Installed 12" screen and casing, pitless unit, and submersible pumping equipment in 2016 and 16"in2019. CONTACT: Dan Good w/ Mauer -Stutz, Engineer, @ 309-693-7615 CITY OF CARTHAGE, ILLINOIS — 2016 - Drilled to depth of 1,115' . 140' of 20" outer casing pipe grouted in place. 14" diameter pipe to 937' grouted in place. Test pumped the well at 600 gpm. Cn' NTT A CT; rharli Ruch T/ ACR A 6 314_ 5?d_ 730 MAJOR EQUIPMENT LIST: GEFCO 90K rotary drilling rig w/ support equipment. Porta-Drill Reverse circulation drilling rig Reichdrill rotary drilling rig w/ support equipment. GEFCO Jed "A" reverse circulation drilling rig w/ support equipment. 'Inv., AA'^1A 14AA1 LLVV luck Luu1 ui iiiing 1 ig. Six (6) various pump hoist rigs. Crane truck Hy -Rip chemical treatment trailer w/ support equipment. Miscellaneous compressors, trailers, support trucks, and downhole tooling. - Two (2), color downhole video systems. 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 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. ❑ Yes ■ No My business is a general partnership or joint venture. More than 50 percent of the general partners or joint venture parties are residents of Iowa for Iowa income tax purposes. My business is an active corporation with the Iowa Secretary of State and has paid all fees required by the Secretary of State, has filed its most recent biennial report, and has not filed articles of dissolution. ❑ Yes ❑ 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. fication in a n Yes ■ No My business is a limited liability partnership which has filed a statement of state other than Iowa, has fled a statement of foreign qualification ri Iowa and ira 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. NIYes ❑ No ❑ Yes ❑ No n Yes n No ❑Yes ❑No ❑ Yes ❑ No Yes ■ 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. 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) IISF-2 Prime Contractor Name: l h NO REBERNBE SUBCONTRACTORS: If you are NOT using any MBEIWBE subcontractors to complete this project, sign below. Attach a brief explanation as to why subcontracting was not feasible with this project. If any MBEIWBE subcontractors will be used, please use the bottom portion or this form. iVIBEMBE BUSINESS ENTEP.? R:SE PRE -BID CONTACT ilk C-ORft1AT1ON FORD kiz• Li R3/40 -eAt)Act, e Lac P r - i Letting Date: olds, Gay nt- o . 0 3 Contractor Signature: Title ca9-14- Date: 2o 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 3 19-29 1-4429. 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 MBEWBE firms to perform portions of the work, please contact Louis Starks, Compliance Officer, for assistance at (319) 291-4429. In the event it is determined that the MBEIWBE 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 C'F iN SRMA! CSN SHOWING BIDDER'S PRE -.JCL P9BEl° IBE BUSINESS ANT_ RPRISE CCN ACTT S Quotes Received Quotat!cn used in bid liB -P:iB E Subcontractors Dates Contacted Yes/ o Dates Contacted YeslNo Dollar Amount Proposed �_e be Subcontracted (Form CCO-4) Rev. 06-20-02 MBE/WBE PARTICIPATION AECOM - 60558763 CONTRACT NO. 1032 M-6 Final Clarifier No_ 3 Dewatering Wells BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, Cahoy Pump Service, Inc. as Principal, and Old Republic Surety Company as Surety are held and firmly bound unto the CITY OF WATERLOO Iowa, hereinafter called "OWNER." In the penal sum Five Percent of Amount Bid 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 3rd day of September 2020 for Final Clarifier No 3 Dewatermg Wells, 'Contract No. 1032 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 shallbe 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 causedtheir corporatte esseals rtobe hereto affixed and these pres•- ents to be signed by their proper officers this day of A.D. 2020. Witness Karla K. Hefty& Cahoy Pump Service, Inc. Prinftjpal By719 (Title) Old Republic Surety Company Surety • BY CV Conn'e Smi h Attorney -In -fact ;Seal) $ BIDIBOND CONTRACT NO. 1032 AECOM 060556783 (S 00.1 Final Clarifier No. 3 Dewatering Wells **** t OLD REPUBLIC SURETY COMPANY POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock insurance corporation, does make, constitute and appoint: MICHAEL J. DOUGLAS, CHRIS M. STEINAGEL, CHRISTOPHER MATHER KEMP, ROBERT S. DOWNEY, CONNIE SMITH, KORY C. MORTEL, ELIOT MOTU of HUDSON, WI its true and lawful Attorney(s)-in-Fact, with full power and authority for and on behalf of the company as surety, to execute and deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof, (other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, asbestos abatement contract bonds, waste management bonds, hazardous waste remedation bonds or black lung bonds), as follows: ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED ($20,000,000) FOR ANY SINGLE OBLIGATION and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed. This appointment is made under and by authority of the board of directors at a special meeting held on February 18, 1982. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD REPUBLIC SURETY COMPANY on February 18,1982. RESOLVED that, the president, any vice-president or assistant vice president, in conjunction with the secretary or any assistant secretary, may appoint attorneys -in -fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to execute and deliver and affix the seal of the company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may remove any such attorney -in -fact or agent and revoke any Power of Attorney previously granted to such person. RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company (i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant secretary; or (ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be required) by a duly authorized attorney -in -fact or agent; or (iii) when duly executed and sealed (if a seal be required) by one or more attorneys -in -fact or agents pursuant to and within the limits of the authority evidenced by the Power of Attorney issued by the company to such person or persons. RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the company; and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be ootmi imulaffixed this 3lst day of January 2020 Stifle 49/ 7 coPPOPATa \CQ 5 g SEAL _ O Nei e c• K a4ent Secrets. OLD REPUBLIC SURETY COMPANY President STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS On this 31st day of January 2020 , personally came before me Alan Pavlic and Karen J Haffner , to me known to be the individuals and officers of the OLD REPUBLIC SURETY COMPANY who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: that they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation. CERTIFICATE Notary Public My Commission Expires: September 28, 2022 (Expiration of notary's commission does not invalidate this instrument) I, the undersigned, assistant secretary of the OLD REPUBLIC SURETY COMPANY, a Wisconsin corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full .force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of Attorney, are now in force. 24-5172 ORSC 22262 (3-06) .46 Buffet. I.Ar, co °'A t \.0 SEAL i C`. lae, * Signed and sealed at the City of Brookfield, WI this 3 , Now— day of Assis:Sat Secrets 2020