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BID BOND
FY 2021 GREENBELT LAKE REAP GRANT
KNOW ALL MEN BY THESE PRESENTS, that we, Boulder Contracting, LLC
as Principal, and Westfield Insurance 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 eeQ000eoeoa
v v v v v v v v v ....... v v e v v e e v v v v v n v v 0
Dollars ($ 5% 7fihW1ul 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 _98th day of
January , 20 21 , for 2021 Greenbelt Lake Reap Grant project
•
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 28th day of January , A.D. 2021--
•
(Seal)
Witness
ess
Principal Boulder Contracting, LLC
By
(Title)
Westfield Insurance Company (Seal)
Surety
BY ___I,00-Ur-D11)0Dttribeii
Attorney -in -fact Nancy D. Baltutat
THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING THIS SAME
POWER # AND ISSUED PRIOR TO 06/07/16, FOR ANY PERSON OR PERSONS NAMED BELOW.
General
Power
of Attorney
CERTIFIED COPY
POWER NO. 1429172 00
Westfield Insurance Co.
Westfield National Insurance Co.
Ohio Farmers Insurance• Co.
Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as "Companies," duly
organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio,.. do by these
presents make, constitute and appoint
MARK E. KEAIRNES, JOSEPH I. SCHMIT, JEFFREY R. BAKER, JILL SHAFFER, GREG T. LAMAIR, NANCY D. BALTUTAT,
PATRICK K. DUFF, CHRISTOPHER R. SEIBERLING, JOINTLY OR SEVERALLY
of WEST DES MOINES and State of IA its true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship
LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE, OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate
seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in
the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
"Be It Resolved, that the President, any Senior Executive any Secretary or any Fidelity & Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys) -in -Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney -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 of indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney -in -Fact shall be as binding upon the Company as If signed by the President and sealed and attested by the Corporate Secretary."
"Be it Further Resolved, that the signature of any such designated person and the 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 signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which It is attached." (Each .adopted at a meeting
held on February 8, 2000).
In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto
affixed this 07th day of JUNE A.D., 2016 .
Corporate ufl •,
Seals ��g *** ••
Affixed v 0.44.
?el its. Nal
Itak
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State of Ohio °"W
County of Medina ss.:
�F.• S '•
PO.
LL
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SEAL
WESTFIELD INSURANCE COMPANY
WESTFIELD. NATIONAL INSURANCE COMPANY
OHIO FARMERS INSURANCE COMPANY
By
Dennis P. Baus, National Surety Leader and
Senior Executive
On this 07th day of JUNE A.D., 2016 , before me personally came Dennis P. Baus to me known, Who, being by me duly sworn did
depose and say, that he resides in Wooster, Ohio; that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE
COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which
executed the above instrument; that he knows the seals of said Companies; that the seals affixed to said Instrument are such corporate seals; that
they were so affixed by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order.
Notarial
Seal
Affixed
State of Ohio
County of Medina ss.:
�t.fH.N titttty„,
.. \AL IS:
AP.\..I//i: e
N
gTE• OF ttttt
David A. Kotnik, Attorney at Law, Notary Public
My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code)
I, Frank A. Carrino, Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS
INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said
Companies, which is still in full force and effect; and furthermore, the resolutions of the Boards of Directors, set out In the Power of Attorney are
in full force and effect.
In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 28th day of
January a "F"2;,,2021 bosom".t ",. .„,l„ t
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Frank A. Carrino, Secretary
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BPCAC2 (combined) (06-02)
FY 2021 green Belt Lake Reap Grant Project
Contract No. 1042
Align Architecture & Planning
BID FORM
TOTAL
DESCRIPTION
1
Mobilization
16, 06.c
2
Piles
&
Headwall
56,tycv.cm
3
Import
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Stone
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@
8
Locations
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la, (cry. (4®
8
Contingency
Allowance
$5,000.00
BASE
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M
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ADD
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ERNATES
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10
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with
LeAzci OF, CoLANY-TizAc_ cri
COMPANY NAME
AUTHORI ED StGNATURE
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Prime Contractor Name:
r
r'
\
STATEMENT OF BIDDER'S QUALIFICATIONS
(To be submitted by the Bidder only upon request of the City of Waterloo, Iowa.)
All questions shall be answered and the data given must be clear and comprehensive. This
statement must be notarized. If necessary, questions may be answered on separate attached
sheets. The Bidder may submit any additional information desired
1. Name of Bidder.
eoLt1Et (Care/-kt'pG / Ltc
2. Permanent main office address.
1 G• ? i G E r st
3. When organized.
avla
4. If a corporation, where incorporated.
criettir 145 A.SoV4
✓1/4-19y �6Nl et , ` 4 . 5664 38
5. How many years have you been engaged in the contracting business under your present firm
or trade name? a
6. Contracts on hand: (Schedule these showing amount of each contract and the appropriate
anticipated dates of completion )
/lvsPlertar heart/ Asfetttt445r
7. General character of work performed by your company.
atict-
8. Have you ever failed to complete any work awarded to you? If so, where and why?
No
9. Have you ever defaulted on a contract? If so, where and why?
No
10. List the more important projects recently completed by your company, stating the
approximate cost for each, and the month and year completed
rvo4p..tag r Avow eau ,c6 r
11. List your major equipment available for the contract.
Aet•t€44l3Lit Win/ geaag4r
12. Experience in construction work similar in importance to the project.
,4vwu4R442; ctnnwv a4aaltsr
13. Background and experience of the principal members of your organization, including the
officers. S,t„ty timpov,r/
14. Credit available: $ wtotge nisei n4C5 az.9c3
15. Give Bank reference:
AAci.-* 1u , wet 0.4e4K i; s r
•
16. Will you, upon request, fill out a detailed financial statement and furnish any other
information that may be required by the City of Waterloo, Iowa? kg. jw PRuQucC per Aaacr iltriws
17. The undersigned hereby authorizes and requests any person, firm, or corporation to furnish
any information requested by the City of Waterloo, Iowa, in verification of the recitals
comprising this Statement of Bidder's Qualifications.
STATEMENT OF BIDDERS QUALIFICATIONS PAGE 1 OF 2
Dated this M;iday of 1-Alvamti , 20 .3-- I .
By:
Name of Bidder
iefe
Title: C�'�,•��,
State of
)ss
County of 62NF/DY )
&Wee_ Gi\friffrara\C � LLC- i744q0 (42V6&c4 being duly sworn
deposes and says that she/he is DFFICe2
Fut/1061Z CAJ /Cc:
Name of'OOrganization
•
of
and that the answers to the foregoing questions and all statements therein contained are true and
correct. Subscribed and sworn to before me this ��day of Divv,i--42l
Notary Public
My commission expires
Lc/ e
DAVID B CAPSOPOULOS
Notarial Seal • Iowa
Commission Number 80139
��/r6
My Commission Expires
Za2
ripe Apr
, 20 2-i .
, 20 23
STATEMENT OF BIDDER'S QUALIFICATIONS PAGE 2 OF 2
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of
County of Gt1v 0 \-/
that:
)ss
LuVC KSc)KMG, being first duly sworn, deposes and says
1. He is (Owner, Partner, Officer, Representative, or Agent) , of
LLI)F,2 (t 'aT��(�IM� t a , 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;
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)
oirA/Clt
Title
Subscribed and sworn to before me this 2t;' 111 day of
r' ' 202 1
Title
My commission expires / 6 7(7.)e
DAVID 8 CAPSOPOULOS
Notarial Seal - Iowa
Commission Number 80t4393
My Commission Expires
- Lee: -","4".11111111.1nolne
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
e mployment because of race, color, creed, sex, national origin,
e conomic status, age, mental or physical handicap, political opinions
o r 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
o pinions 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
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.
EQUAL OPPORTUNITY CLAUSE PAGE 1 OF 2 PAGES
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 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)
P/)
(Appropriate Official)
(Title)
1/40/41
EQUAL OPPORTUNITY CLAUSE PAGE 2 OF 2 PAGES