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CIC mA Ten � � s , T � � .
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CITY OF WATERLOO
LEISURE SERVICES COMMISSION
BID FORM
FY2021 BYRNES TENNIS CENTER RESURFACING PROJECT
CONTRACT NO . 1038
IPBIDDER : l C
Company Name
ADDRESS : L10 9 ff 6 0"L S�.
lS�CITY/STATE : �" / (� NEE. ZIP CODE C09000
CONTACT PERSONde (� S
PHONE : �l " L! ( � 1 _l l 0 FAX : V02 � 2 � ? Q97
Having examined the Place of the Work and all matters referred to in the Notice to Bidders and
Contract Documents for the above mentioned project , we the undersigned , hereby offer
to enter into contract to perform the Work for the sum of:
BASE BID : (COURTS 1 -16 )
dollars ($�ZZ23 )
DATE : 1012120
Signature
I t / Zo
0 z 0
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of L56 )
County of Dow 10, )
40e�e being first duly sworn , derro'Tz
ses and says that :
1 . He is (Owner) , ( Partner) , ( Officer) , ( Representative ) , or (Agent) of uCJ rmk4 `
Bidder that has submitted the attached Bid ;
2 . He is fully informed respecting the preparation and contents of the attached Bid and of all pertinent
circumstances respecting such Bid ;
3 . Such Bid is genuine and is not a collusive or sham Bid ;
4 . Neither the said Bidder nor any of its officers , partners , owners , agents , representatives ,
employees , or parties in interest , including this affiant , has in any way colluded , conspired ,
connived or agreed , directly or indirectly , with any other Bidder , firm or person to submit a collusive
or sham Bid in connection with the Contract for which the attached Bid has been submitted or to
refrain from bidding in connection with such Contract , or has in any manner , directly or indirectly ,
sought by agreement or collusion or communication or conference with any other Bidder , firm or
person to fix the price or prices in the attached Bid or of any other Bidder , or , to fix any overhead ,
profit or cost element of the bid price or the bid price of any other Bidder , or to secure through any
collusion , conspiracy , connivance , or unlawful agreement any advantage against the City of
Waterloo , Iowa , or any person interested in the Proposed Contract ; and
5 . The price or prices quoted in the attached Bid are fair and proper and are not tainted by any
collusion , conspiracy , connivance or unlawful agreement on the part of the Bidder or any of its
agents , re resentative , owners , employees , or parties in interest , including this affiant .
Signature Title
i 5r Subscribed an sworn to before me this
l J Day of ( �:(� , 2 .
Signature Title
My commission expires IL 12
State d NONI*$ General Mary
8" MM
My Commission E"a
0slobw902021
EQUAL OPPORTUNITY CLAUSE
(As provided in Executive Order No . 11246 )
All contractors , subcontractors , vendors and suppliers of goods and services doing business with the
City and value of said business equals or exceeds ten thousand dollars ($ 10 , 000 . 00) annually agree
as follows :
1 . The contractor , subcontractor , vendor and supplier of goods and services will not discriminate
against any employee or applicant for employment because of race , color , creed , sex , national
origin , economic status , age , mental or physical handicap , political opinions or affiliations . The
contractor, subcontractor , vendor and supplier will develop an Affirmative Action program to
ensure that applicants are employed and that employees are treated during employment without
regard to their race , creed , color , sex , national origin , religion , economic status , age , mental or
physical disability , political opinions or affiliations . Such actions shall include but not be limited to
the following :
a. Employment
b . Upgrading
c . Demotion or Transfer
d . Recruitment and Advertising
e . Layoff or Termination
f. Rates of Pay or Other Forms of Compensation
g. Selection for Training Including Apprenticeship .
2 . The contractor, subcontractor, vendor and supplier of goods and services will , in all solicitations or
advertisements for employees , state that all qualified applicants will receive consideration for
employment without regard to race , creed , color , sex , national origin , religion , economic status ,
age , mental or physical disabilities , political opinion or affiliations .
3 . The contractor, subcontractor, vendor and supplier or his/her collective bargaining representative
will send to each labor union or representative of workers which he/she has a collective bargaining
agreement or other contract or understanding , a notice advising said labor union or workers '
representative of the contractor' s commitment under this section .
4 . The contractor , subcontractor , vendor and supplier of goods and services will comply with all
published rules , regulations , directives , and order of the City of Waterloo Affirmative Action
Program Contract Compliance Provisions .
5 . The contractor , subcontractor vendor and supplier of goods and services will furnish and file
compliance reports within such time and upon such forms as provided by the Affirmative Action
Officer . Said forms will elicit information as to the policies , procedures , patterns , and practices of
each subcontractor as well as the contractor himself/herself and said subcontractor, vendor and
supplier will permit access to his/her employment books , records and accounts to the City' s
Affirmative Action Officer , for the purpose of investigation to ascertain compliance with this
contract and with rules and regulations of the City' s Affirmative Action Program — Contract
Compliance Provisions relative to Resolution No . 24664 .
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
Appropriate Official
Title
Date
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TRACK AND TENNIS
Pro Track and Tennis, Inc will use all of its own workforce for this project and
will not need any subcontractors .
Pro Track and Tennis, Inc . 3213 N . 901h St . Omaha , NE 68134 402 - 238- 2900
www . protrackandtennis . com
BID BOND
KNOW ALL MEN BY THESE PRESENTS , that we Pro Track and Tennis , Inc . as
Principal , and American Contractors Indemnity Company as Surety are held and
firmly bound unto the City of Waterloo , Iowa , hereinafter called " OWNER" . In the penal sum
Five Percent of Bid Amount dollars ( $ 5 % of Bid )
lawful money of the United States , for the payment of which sum will and truly be made , we bind
ourselves , our heirs , executors , administrators , and successors , jointly and severally , firmly by these
presents . The condition of this obligation is such that whereas the Principal has submitted the
accompanying bid dated the Stn day of October , 20 20 , for
FY2021 Byrnes Tennis Center Resurfacing Project Contract No . 1038
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 23rd day of September A . U .
20 20
Pro Track and Tennis , Inc . ( Seal )
Principal
gy (Title ) 5 V^110r
Witness
American Contractors Indemnity Company ( Seal )
Surety
4esswit
TracyKrause , Attorney- In - Fact
BID BOND PAGE 1 of 1
TOKIO MARL N E
HCC -- ---------
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS :
That American Contractors Indemnity Company of the State of California , a California corporation , does hereby appoint,
TRACY KRAUSE
its true and lawful Attomey-in-Fact, with full authority to execute on its behalf bond number BB2011733
issued in the course of its business and to bind the Company thereby, in an amount not to exceed
Three million and 00/100 ( $3 000 000 .00 ).
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following resolutions adopted
by the Board of Directors of AMERICAN CONTRACTORS INDEMNITY COMPANY at a meeting duly called and held on the 18t day of
September, 2011 .
"Be if Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be
and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s )-in-Fact to represent and
act for and on behalf of the Company subject to the following provisions :
Aifomey-in-Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge
and deliver, any and all bonds, recognizances , contracts , agreements or indemnity and other conditional or obligatory undertakings ,
including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts ,
and any and all notices and documents canceling orterminating the Company's liability thereunder, and any such instruments so executed
by any such Attorney-in- Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate
Secretary.
Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of
attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached .
The Attorney-in -Fact named above may be an agent or a broker of the Company. The granting of this Power of Attorney is specific to this
bond and does not indicate whether the Attorney-in-Fact is or is not an appointed agent of the Company.
IN WITNESS WHEREOF , American Contractors Indemnity Company has caused its seal to be affixed hereto and executed by its
President on this 18t day of June , 2018. �o0acroRs
AMERICAN CONT CTO S INDEMNITY COMPANY
State of California <
U i INCORPORATED
County of Los Angeles ? y ; sEPT. 2s, f990 :on` By: `
6 � .... ;:, Ada S . Pessin , President
441 FORN�p
A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which
this certificate is attached , and not the truthfulness, accuracy, or. validity of that document.
On this 1st day of June , 2018 , before me , Sonia O . Carrejo, a notary public , personally appeared Adam S . Pessin , President of American
Contractors Indemnity Company , who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to
the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the
instrument the person , or the entity upon behalf of which the person acted , executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of CALIFORNIA that the foregoing paragraph is true and correct.
WITNESS my hand and official seal . , SONIAO. GRREIO
Notary Pubic - Calfforn4
# ' t los Angeles County i
Ccmmisslon M 2239479
Signature (seal) My Comm. ExpfresApr 23, 2022
I , Kio Lo, Assistant Secretary of American Contractors Indemnity Company, do hereby certify that the Power of Attorney and the
resolution adopted by the Board of Directors of said Company as set forth above , are true and correct transcripts thereof and that
neither the said Power of Attorney nor the resolution have been revoked and they are now in full force and effect.
IN WITNESS WHEREOF , I have hereunto set my hand this 23rd day of September 2020
\\VIA CTO
\ttnuulu,u
Bond No . BB2011733 ;'o°:' y
r ;
AssQ : AAA
oA =
_ INCORPORATED : .y = Kio Lo, As ' nt Secretary
Agency No. 700232 = a t SEPT. 25, 1990 : < `
yid oma:
96
... .: .
gLIF0PA` S\'A�` HCCSZZPOAACIC06/2018
visit tmhcc.com/surety for more information