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Home My WebLink AboutWoodruff Constructionism asi -c 7w rat p l,i 114,15 vj re`) R' rn E r! rri cro t� 1 "71 X' 0 st— • J T1 cn CD rf 0 0 1 r WOODRUFF CONSTRUCTION 1717 Falls Avenue j Waterloo, IA 50701 Iowa Contractor #.• C097864 40 CITY OF WATERLOO .ryrr. CLERK'S OFFICE PA 112021 P ; _:3` :48 PROPOSAL FOR: F.Y. 2021 Sanitary Sewer Gatewell Replacement, Phase p 1 for the City of Waterloo, Iowa Contents: Bid Form V Sales Tax Form ,/ SRF Docs i/ Non -collusion affidavit V Equal Opportunity Clause V Bidder Status Form ✓ Affirmative Action v MBE/MWE Pre -Bid Contact Info 715 Mulberry Street Waterloo, IA 50703 Bid Date: 2/11/2021 anima • • B I ID BOND KNOW ALL MEN BY THESE PRESENTS, that we, Woodruff Construction, Inc. as Principal, and Liberty Mutual Insurance Company as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called "OWNER." In the penal sum ---Five Percent of the Bid Submitted --- Dollars ($---5%--- ) lawful money of the United States, for the payment of which surn 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 11 th day of February 2021 , for FY 2021 Sanitary Sewer Gatewell Repairs, Phase 1, City of Waterloo, IA; Contract No. 951 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 3rd day of February , A D. 2021 4c Witness Witness Stacy Venn B Woodruff Construction, Inc. (Seal) Principal e'31 on ` re S i eVveh (Title) Liberty IVt al Insurance ompany (Seal) Atto'rney- Dione R. Young FORM OF RID OR PROPOSAL FY 2021 SANITARY SEWER GA I EWELL REPAIRS r, PHASF CONTRACT NO. 951 Honorable Mayor and City Council Waterloo, Iowa Gentlemen: CITY OF WATERLOO, IOWA 1. The undersigned, being a Corporation existing under the laws of the State of Iowa a Partnership consisting of the following partners. Woodruff Construction, Inc . , having familiarized (himself) (themselves) awith the existing conditions on the project area affecting the cost of the work, and with all the contract documents listed in the Table of Contents and Addenda (if any), as prepared by 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 FY 2021 SANITARY SEWER GATEWELL REPAIRS e PHASE I, CONTRACT NO. 951, all in accordance with the above -listed documents and for the unit prices for work in place for the following items and quantities: FY 2019 SANITARY GATEWELL REPAIRS CONTRACT NO. 951 Item No. Description Unit Est. Unit Price Bid Total Bid Price sty. 1 Mobilization General Items LS 1 S 574;;530 S51 67 3530 and 2 Gatewell 3C-1 LS 1 S t'' j 9 q 9 $ 1 oc73 l 9cri 3 Gatewell 3 C-3 LS 1 S j 60) 07 3 $ SO 1 0-7 3 4 Gatewell 3 C-4 LS 1 Ita,WC $ Ite2 1 %� C 5 Gatewell 3C-5 LS 1 S 109) sqg S jot 5(7/4 6 Gatewell 5 D-2 LS 1 S ci i i ®C(S ` 5 09 C Gatewell 5D-3 LS 1 571 , ocj 3 S 1 cl o 3 7 8 LS 1 S I® 0 5() S l o A 057 Gatewell 5F-1 9 LS 1 S S c a ) ►M t(C ) (4) S Gatewell 5F-2 S I Cf 1()$/cia lA 10 LS 1 Gatewell 5 F-3 11 LS 1 i S i lt-1 W r all o Gatewell 5F-4 S 1 tiO 12 LS 1 $ itigi0'3(o t` j rA 03e Gatewell 5 F-5 13 LS 1 S LA 19 (4 S t `,f jC6 Investigating Valvewell 5F-6 14 LS 1 S 15Gj ', Ss S 151, $j5 Gatewell 5F-7 15 Gatewell 3 D-2 LS 1 S i tit (01 c 7 WO 16 Gatewell 3D-3 LS 1 $ 131)1.761 S f j Mci Gatewell 3D-4 LS 1 1.3c5/6011 4313 , i 314 17 18 Gatewell 3D-5 LS 1 (sins V 613 S cii i 1 "1 3 19 LS 1$ i i t "i MO il l Gatewell 3 E-3 20 LS 1$9\C) f l I S. .) 1 i l I Investigating Gatewell 1-1 (Base Bid) 21 Gatewell 1-2 LS 1 S f .1 S 1oD grl jo l2 22 LS 1 $ »s.i'i i S ) 5'T7i Investigating Gatewell 3A-1 Bid) (Base FORM OF BID AECOM #60549334 CONTRACT NO. 951 i FB-1 of 4 FY 2021 SANITARY SEWER GATEWELL REPAIRS - PHASE I Total Item Unit Bid Bid Description Unit Est. 4ty. No. , Price ; Peke: 23 Gatewell 3A-2 LS 1 $ wa ia( $ I Oa i f.{a q ttA 24 Investigating Gatewell 5A-1 (Base Bid) LS 1 $ 31-711 $ ?li (`"j 25 Gatewell 5A-2 LS 1 $ V73 lick?, $ 1311g3 26 Gatewell 5A-3 LS 1 $ -113 511 $ `73, Si % 27 Gatewell 5A-4 LS 1 $tut V a s $ MA i 1 S- TOTAL BASE BID $ BID ALTERNATE 1 LS 1 $1I!, $ 28 1 Gatewell 1-1 (Bid Alternate) a(,*j i1a,alvt-i TOTAL BID ALTERNATE 1 $ in ' (A 2 BID ALTERNATE 29 Gatewell 3A-1 (Bid Alternate) LS 1 $11115 S 1 $ 11 j 15 51 TOTAL BID ALTERNATE 2 $111) 55\ BID ALTERNATE 3 30 Gatewell 5A-1 (Bid Alternate) LS 1 $19 1330 $ qq i4J30 TOTAL BID ALTERNATE 3 ctq t 030 BID ALTERNATE 4 31 Valvewell 5F-6 (Bid Alternate) LS 1 $ 5(0I'5'14 $ 5(p,iwp1 TOTAL BID ALTERNATE 4 $ N(,,Sc44 2. It is understood that the quantities set forth are approximate only and subject to variation and that the unit bid price for the work done shall govern in the actual payment to Contractor. 3. In submitting this bid, the bidder understands that the right is reserved by the City of Waterloo, Iowa, to reject any or all bids. If written notice of the acceptance of this bid is mailed telegraphed, or delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the prescribed form and furnish the required bond and certificate of the insurance within ten (10) days after the agreement is presented to him for signature, and start work within ten (10) days after "Notice to Proceed" is issued. 4. Security in the sum of 5 o of total bid Dollars ($ 1 l6D )175 3 a DO ) in the form of Tina p c,v,d , 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 indicating Resident Bidder Certification ( X ), or Non -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 AAP or Update and an EOC, within ten (10) days of notification that the bid submitted is lowest and acceptable The bidder has received the following Addendum or Addenda: Addendum No. 1 Date 0 2/ 0 8/ 2 0 21 FORM OF BID CONTRACT NO. 951 AECOM #60549334 FB-2 of 4 FY 2021 SANITARY SEWER GATEWELL REPAIRS - PHASE I 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 bidder has attached all applicable forms. 13. The Owner reserves the right to select alternates, delete line items, and/or to reduce quantities prior to the award of a contract due to budgetary limitations. BY: Woodruff Construction, Inc der) hn Mallen fficial Address: (Including Zip Code): 1717 Fails Avenue Waterloo, IA 50701 I.R.S. No. 76-0721180 Title 02/11/2021 (Date) ICE Region President FORM OF BID CONTRACT NO. 951 AECOM #60549334 FB-3 of 4 FY 2021 SANITARY SEWER GATEWELL REPAIRS - PHASE I ss This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Not valid for mortgage, note, loan, letter of credit, bank deposit, currency rate, interest rate or residual value guarantees. To confirm the validity of this Power of Attorney call 610-832-8240 between 9:00 am and 4:30 pm EST on any business day. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Craig E. Hansen, Jay D. Freiermuth, Brian M. Deimarly, Cindy Bennett, Anne Crowner, Stacy Venn, Tim McCulloh, Shirley S. Bartenhagen, Dione R. Young of the city of West Des Moines state of Iowa its true and lawful attomey-in-fact, with full power and authority hereby conferred to sign, execute and acknowledge the following surety bond: Principal Name: Woodruff Construction, Inc. Obligee Name: City of Waterloo, Iowa Surety Bond Number: Bid Bond Bond Amount: See Bond Form IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 30th day of March, 2017 By: STATE OF PENNSYLVANIA COUNTY OF MONTGOMERY On this 30111 day of March, 2017, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. The Ohio Casualty Insurance Company Liberty Mutual Insurance Company WesMmerican Insurance Company David Iv:Carey, Assistant Secretary COMMONWEALTH OF PENNSYLVANIA Notarial Seal Teresa Paslella, Notary Public Upper MerionTwp., Montgomery County My Commission Expires March 28,2021 Member, Pennsylvania Association of Notaries By: d CAO �4140 Teresa Pastella, otary Public This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV - OFFICERS - Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney - in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII - Execution of Contracts — SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizences and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys - in -fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 3rd day of February , 2021 By: telttarnili .Assistant Secretary INFORMATION NEEDED FOR IOWA CONSTRUCTION SALES TAX EXEMPTION CERTIFICATE CONTRACTOR NAME: ADDRESS: Woodruff Construction, Inc. 1717 Falls Avenue Waterloo, IA 50701 (Check One) FEDERAL ID#: PROJECT NAME: PRIME X 76-0721180 SUBCONTRACTOR FY 2021 Sanitary Sewer Gatewell Repairs, Phase 1 PROJECT CONTRACT NO.: DESCRIPTION OF WORK: 951 Brickwork Carpentry Concrete Drywall -Plaster -Insulation i Electrical C Excavation/Grading Flooring Heavy Construction Li Heating -Ventilating -Air Cond. SALES TAX EXEMPTION AECOM 460549334 Landscaping Painting Li Paving Plumbing Roofing -Siding -Sheet Metal Windows Wrecking -Demolition ❑ Other (Please specify) General Contractor CONTRACT NO. 951 STE-1 of 2 FY 2021 SEWER SANITARY GATEWELL REPAIRS - PHASE I jnC:. WOODRUFF CONSTRUCTION,4rL-& • 1717 Falls Avenue I Waterloo, IA 50701 Ph: (319) 233-3349 Fax: (319) 233-3369 February 11, 2021 City of Waterloo 715 Mulberry Street Waterloo, Iowa 50703 Re: FY 2021 Sanitary Sewer Gatewell Repair, Phase 1 To Whom It May Concern: John Mallen, being Northeast Region President of Woodruff Construction Inc., has authority to sign any and all documents for Woodruff Construction Inc. Page 1 Attachment 1: Attachment 2: Attachment 3: Attachment 4: Attachment 5: Attachment 6: Attachment 7: Attachment 8: Attachment 9: Please note: SRF Required Front -End Specifications Certification of Non -Segregated Facilities Form (to be completed and signed by Prime Contractor and submitted with the bid) STATE REVOLVING FUND Statement in Advertisement for Bids on Debarment and S uspension/Certification Regarding Debarment and S uspension Form (to be completed and signed by Prime Contractor and submitted with the bid) Disadvantaged Business Enterprise Certification Form (to be completed and signed by Prime Contractor and submitted with the bid) DBE Program Subcontractor Performance Form (to be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid) DBE Program Subcontractor Utilization Form (to be completed and signed by Prime Contractor and submitted with the bid) DBE Program Subcontractor Participation Form (for voluntary use of DBEs) Other Federal Requirements Language A. Standard Equal Employment Opportunity Specifications B. Federal Labor Standards Provisions (including Davis -Bacon prevailing wage rates) C. Preservation of Open Competition and Government Neutrality D. Historical and Archeological Finds E. Prohibitions on Procurement from Violating Facilities Right of Entry and Records Retention U se of American Iron and Steel The Davis Bacon wage determination received from the Iowa Finance Authority must also be included in the front-end specifications. INVESTING IN IOWA'S WATER WWW.iOW& (fi.;orn May 2015 Page 1 Attachment 1: Attachment 2: Attachment 3: Attachment 4: Attachment 5: Attachment 6: Attachment 7: Attachment 8: Attachment 9: Please note: SRF Required Front -End Specifications Certification of Non -Segregated Facilities Form (to be completed and signed by Prime Contractor and submitted with the bid) STATE REVOLVING FUND Statement in Advertisement for Bids on Debarment and S uspension/Certification Regarding Debarment and S uspension Form (to be completed and signed by Prime Contractor and submitted with the bid) Disadvantaged Business Enterprise Certification Form (to be completed and signed by Pnme Contractor and submitted with the bid) DBE Program Subcontractor Performance Form (to be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid) DBE Program Subcontractor Utilization Form (to be completed and signed by Prime Contractor and submitted with the bid) DBE Program Subcontractor Participation Form (for voluntary use of DBEs) Other Federal Requirements Language A. Standard Equal Employment Opportunity Specifications B. Federal Labor Standards Provisions (including Davis -Bacon prevailing wage rates) C. Preservation of Open Competition and Government Neutrality D. Historical and Archeological Finds E. Prohibitions on Procurement from Violating Facilities Right of Entry and Records Retention U se of American Iron and Steel The Davis Bacon wage determination received from the Iowa Finance Authority must also be included in the front-end specifications. INVESTING IN IOWA'S WATER ow May 2015 Page 2 Attachment 1 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid ) U.S. Environmental Protection Agency Certification of Non -Segregated Facilities STATE REVOLVING FUND (Applicable to contracts, subcontracts, and agreements with applicants who are themselves performing Federally assisted construction contracts, exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause.) By the submission of this bid, the bidder, offeror, applicant, or subcontractor certifies that he does not maintain or provide for his employees any segregated facilities at any of his e stablishments, and that he does not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. He certifies further that he will not maintain or provide for his employees any segregated facilities at any of his e stablishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained The bidder, offeror, applicant, or subcontractor agrees that a breach of this certification is a violation of the Equal Opportunity clause in this contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for e mployees which are segregated by explicit directive or are in fact segregated on the basis of race creed, color or national original, because of habit, local custom, or otherwise. He further agrees that (except where he has obtained identical certifications from proposed subcontractors for specific time periods) he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause; that he will retain such certifications in his files; and that he will forward the following notice to such proposed subcontractors (except where the proposed subcontractors have submitted identical certifications for specific time periods): NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CERTIFICATIONS OF NON -SEGREGATED FACILITIES A Certification of Non -segregated Facilities as required by the May 9, 1967, order (33 F.R. 7808, May 28, 1968) on Elimination of Segregated Facilities, by the Secretary of Labor, must be submitted prior to the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Opportunity clause. The certification may be submitted either for each subcontract or for all subcontracts during a period (i.e., quarterly, semiannually, or annually). 02/11/2021 Date John Mallen, NE Region President N ame and Title of Signer (Please Type) N OTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. EPA-7 5720-4.2 INVESTING IN IOWA'S WATER VWl WM I .0 r Cl May 2015 Page 3 Attachment 2 SRF Required Freiita nd Specifications (This form must be completed and signed by the Prime Contractor an submitted with the bid.) Debarments and Suspensions Any bidder or equipment supplier whose firm or affiliate is listed in on the U.S. GenerailiFSMIUMD Administration Excluded Parties List System web site at http://www.epls.gov/ will be prohibited from the bidding process. Anyone submitting a bid who is listed on this web site will be determined to be a non -responsive bidder in accordance with 40 CFR Part 31. United States Environmental Protection Agency Washington, DC 20460 Certification Regarding Debarment, Suspension, and Other Responsibility Matters STATE The prospective participant certifies to the best of its knowledge and belief that it and the principals: (a) Are not presently debarred, suspended, proposed for debarment declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission o f fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transaction s (Federal, State, or local) terminated or cause or default. I understand that a false statement on this certification may be ground for rejection of this proposal or termination of the award. In addition, under 18 U SC Sec. 10 01, a false statement ma y result in a fine of up to S10,000 or imprisonment for up to 5 years, or both. John Mallen, NF Region Presicent Typed Name & Title of Authorized Representative 40 r, ature of Authorized Representative 02/11/2021 Date I am unable to certify to the above statements. My explanation is attached. EPA Form 5700-49 (11-88) INVESTING IN IOWA'S WATER www.iowasr i.oUI I1 May 2015 Page 4 Attachment 3 SRF Required FrontnEnd Specifications (This ormn must be completed and signed by Prime Contractor and submitted with the bid.) Disadvantaged Business Enterprise (DBE) Solicitation STATE REVOLVING FUND It is EPA's policy that recipients of EPA financial assistance through the State Revolving Fund programs award a "fair share" of subagreements to small, minority and women -owned businesses, collectively know as Disadvantaged Business Enterprises (DBEs). Iowa's Fair Share goals are: Women Business Minority Business -Owned -Owned Enterprise Goal Enterprise Goal (WBE) (MBE) 2.2% Construction 1.7% Supplies 0.6% 5.6% Services 2 5% 11.3% 2 5% 10.4% Goods/Equipment Average 1.8% 7.4% Only work performed by certified DBEs can be counted toward the goals. In Iowa, DBEs must be certified through the Iowa Department of Transportation (IDOT). Information on certification requirements and a list of certified DBEs is on the IDOT website at http://www.iowadot.gov/contracts/contracts eeoaa.htm. Prime contractors' DBE requirements for SRF projects include: o Taking affirmative steps for DBE participation o Documenting the efforts and the proposed utilization of certified DBEs PROJECT INFORMATION SRF Applicant: Bidder: Construction, Inc Woodruff . Address: 1717 Falls Avenue Contact Person: John Mall Signature: '` z# l'i Phone number: A319 2 3 3- 3 3 4 9 10 3 x 1. E-Mail Address: build johnm@woodruff . Check if Prime Contractor is: Minority -Owned Women -Owned INVESTING IN IOWA'S WATER www.iowasrf.com May 2015 Page 5 GOOD FAITH EFFORTS CHECKLIST Please complete the checklist to determine if you have complied with the requirement good faith efforts to ensure that certified DBEs have the opportunity to compete for procurements funded by EPA financial assistance funds. Bidders/offerers must make efforts prior to submission of bids/proposals. 1. Did you ensure that DBEs are made aware of contracting opportunities to the fulleSTATE practicable through outreach and recruitment activities? x Yes No REVOLVING FUND 2. Did you make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs in the competitive process? This includes, whenever possible, posting solicitation for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date. x Yes No 3. Did you consider in the contracting process whether firms competing for large contracts could subcontract with DBEs? This will include dividing total requirements, when economically feasible into smaller tasks or quantities to permit maximum participation by DBEs in the competitive process. x Yes No 4. Did you encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually? x Yes No 5. Did you use the services of the Small Business Administration and the Minority Business Development Agency of the Department of Commerce to identify potential subcontractors? Yes x No 6. List the potential DBE subcontractors that were contacted. Only list those that are certified through the Iowa Department of Transportation. Name How (e.g. call, fax, Contacted letter, phone Response not interested, (e.g. did not not competitive) respond, e-mail) All Star Concrete Email/Call Not Interested Bonnies Barricades Not Interested Email/Call *See next page for additional attempts made* PROPOSED UTILIZATION OF DBE SUBCONTRACTORS Please include Attachments 4 and 5 to document the proposed utilization of certified DBE subcontractors. INVESTING IN IOWA'S WATER www.io` asrLcom May 2015 t _. Dormark Construction Classic Window Treatments Cart Construction Bosker Construction Bonnies Barricades Blackwell Construction A-Z Steel Manufacturing Ardent Lighting Group Alpha Services Weidner Construction Inc 'Marshalltown IA Carol 'Weidner r (E Trinity Construction Group Titan Roofing and Exteriors Stone General Masonry Signarama Ankeny R and D Painting Pro Wall Construction Premier Concrete Pumping Paco Construction 0EL Const Services McMahan Industrial Service LT Leon Associates . Hibbs Excavating and grading Ewing Concrete Duncan Enterprises n o c (+ p Concrete v N fTSB O c K -3 O Q iics Inc n O n ironmeni m n Des Moines IA 'Urbandale IA Waukee IA 'Des Moines IA 'Mason City IA Grimes IA 'Steamboat Rock IA Monroe IA (Des Moines IA Des Moines IA W Des Moines IA (Carlisle IA Des Moines IA Des Moines IA Des Moines IA Des Moines IA Des Moines IA Lamoni IA Knoxville IA Waterloo IA Urbandale IA Address O i C- O O C 3 < O 7 iT cD = a) n)D o ( PC _ D D m O.A. s r+ Jackie Jamie 'Socorro Ronnie Kristin Luis Jim David uesns V) (D 's 94, Pierre Marshall Tom Jeannie Contact Person 70 r 73 CO v O H Q D n n S v O C `�' 3 O S (=D rt cc)S v — - a�i �- is [D 0 < ahi (D -s < O M Cowden 'Correa 'Ciavarelli (Warren Kramer GA0.1D Seckington Hibbs Ewing Duncan Bayse Genz Monzon Shoemaker n o Blackwell ' Bennett Cooper D r < - G) W T < r- CT -s n o v — c o c = o `G op M 0 a" n n•- tD 1 M v r+ (515) 635-4168 (515) 987-2825 (515) 943-3593 (515) 216-1240 (515) 432-1343 (641) 696-5920 (515) 491-8099 (641) 858-5090, (319) 520-E (515) 422-70161 (515) 221-38 (515) 975-3576 (515) 770-E (515) 986-4270I (515) 287-2426' (515) 918-20231 (319) 290-2617 (515) 282-88771 (515) 710-2544 I (641) 275-2353 (641) 842-5969 1 (515) 271-59941 Telephone # W HI VD I-1 1) 259-4100 In 1784-694 NJ W U1 (0 O 0 co ?4C N ?4( CO O IV ,A ,Q O 'Won't Bid N o Response 1No Response N o Response asuodsad oN 'No Response N o Response 'No Response N o Response N o Response No Response N o Response N o Response N o Response N o Response 1No Response N o Response N o Response N o Response N o Response asuodsau ON N o Response N o Response N o Response N o Response N o Response N o Response N o Response Reason for Declining N \ N \ N \ N \ N \ N \ 2/4/2021 N \ N \ N \ N \ 2/4/2021 2/4/2021'' 2/4/2021, 2/4 N \ N \ NJ \ N \ N \ N \ 2/4/2021 N \ N \ 2/4/20211 N \ 2/4/20211 2/4/2021 NJ \ rtacted \ N O N \ N O N \ N 0 N I-1 \ N O N \ N O NJ \ N O N N \ N O N I-1 \ N \ N \ N \ N \ N \ N \ N \ N \ N \ N \ N \ N \ N O O O O O O O O O O O O O N NJ N N N N N N N N N I-1 N F-1 N I-1 I-1 I-1 1-1 I-1 H I-1 I-, I--1 1-1 f-1 1-1 1-1 I-1 )--1 m 0 0 3 OA v on rD ((DD V) 3 co cn 5 Cn (D 713 n 0 7 rn+ 0 Iv Q n. N n 5 (o 0- O '6 n O 0) r+ (D W 0 0 1 0 0 2 C zg n O 7 0) r+ C O n O 0) N 0 fin 'C 73 2 0 r r+ v Uq v 0 N 3 W tn 0 In Page 6 CONTRACT ADMINISTRATION PROVISIONS Several contract provisions are required to prevent unfair practices that adversely affe These include: 1. Prime Contractor must pay its Subcontractor for satisfactory performance no mor days from the Prime Contractor's receipt of payment from the SRF loan recipient. STATE 2. Prime Contractor must notify the SRF loan recipient in writing prior to termination's® Euroo subcontractor for convenience. 3. Prime Contractor must employ the six Good Faith Efforts to solicit a replacement subcontractor if a DBE subcontractor fails to complete work under a subcontract for any reason. INVESTING IN IOWA'S WATER VWw.tovifa rf .Gird May 2015 \)0 ww‘*-A\ose -c> sque,\)_eA Page 7 Attachment 4 SRF Required Front -End Specifications (This form must be completed and signed by Prime and DBE Su for each subcontract and submitted with the bid.) rol No: 2090-0030 proved 8/13/2013 Expires 8/31/2015 United States Environmental Protection Agency Disadvantaged BustSZ TErprise Program DBE Subcontifff ormance Form This form is intended to capture the DBE' subcontractor's2 description of work to be performed and the price of the work submitted to the prime contractor. An EPA Financial Assistance Agreement recipient must require its prime contractor to have its DBE subcontractors complete this form and include all completed forms in the prime contractor's bid or proposal package Subcontractor Name Project Name Bid/Proposal No. Assistance (if known) Agreement ID No. Point of Contact Address Telephone No. Email Address Prime Contractor Name Issuing/Funding Entity Contract Number Item Description of Construction, Work Submitted Services, to Equipment the Prime Contractor or Supplies Involving Price the of Work Prime Submitted Contractor to DBE Certified Other: by DOT SBA Meets/exceeds YES EPA certification NO standards? Unknown 'A DBE is a Disadvantaged, Minority or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202 2Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. EPA Form 6100-3 (DBE Subcontractor Performance Form) — Page 1 INVESTING IN IOWA'S WATER May 2015 Page 8 No: 2090-0030 proved 8/13/2013 Expires 8/31/2015 United States Environmental Protection Agency Disadvantaged Bus prise Program DBE Subcon rformance Form STATE I certify under penalty of perjury that the forgoing statements are true and correct. Signing thiserNOWINNAIritiot signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33 302 (c). Signature Print Name Prime Contractor Title Date Subcontractor Signature Print Name Title Date The public reporting and recordkeeping burden for this collection of information is estimated to average three (3) hours per response. Send comments on the Agency's need for this information the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden including through the use of automated collection techniques to the Director, Collection Strategies Division U S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave , NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address. EPA Form 6100-3 (DBE Subcontractor Performance Form) — Page 2 INVESTING IN IOWA'S WATER May 2015 f'iO DBE T3,'0ls Pece,;ed Page 9 Attachment 5 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and sub if utilizing DBE subcontractors.) rol No: 2090-0030 proved 8/13/2013 I Expires 8/31/2015 United States Environmental Protection Agency Disadvantaged BusSeTrrprise Program DBE Subcaffialittatilization Form This form is intended to capture the prime contractor's actual and/or intended use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract. An EPA Financial Assistance Agreement Recipient must require its prime contractors to complete this form and include it in the bid or proposal package. Prime contractors should also maintain a copy of this form on file Prime Contractor Construction, Name Inc. Project FY 2021 Name Sewer Gatewell Replacement Sanitary Woodruff Bid/Proposal No. Assistance (if known) Agreement ID No. Point Nate of Contact Goetsch Address 1717 Falls Avenue, Waterloo, IA 50701 Telephone No. 233-3349 x101 Email Address (319) nateg@woodruff.build Issuing/Funding Entity I If have yes, identified please potential DBE table certified below. subcontractors If no, please explain* YES NO complete the Name/Company Subcontractor Name Company Address/Phone/Email Estimated Dollar Currently Certified? DBE Amount Solicited TSBs were either unresponsive or not intersted in bidding. Continue on back if needed 1A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202 2Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. EPA Form 6100-4 (DBE Subcontractor Utilization Form) — Page 1 INVESTING IN IOWA'S WATER iovvasri, May 2015 Page 10 United States Environmental Protection Agency Disadvantaged Bu DBE Subc No: 2090-0030 oved 8/13/2013 xpires 8/31/2015 prise Program tilization Form I certify under penalty of perjury that the forgoing statements are true and correct. Signing this3r i . Teot signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacemaitointinuuttirontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33 302 (c). Contractor Signature Print Name Prime / VIZ-6 John Mallen j Title Date NE Region President 02/11/2021 The public reporting and recordkeeping burden for this collection of information is estimated to average three (3) hours per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden including through the use of automated collection techniques to the Director, Collection Strategies Division U S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave , NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address. EPA Form 6100-4 (DBE Subcontractor Utilization Form) — Page 2 INVESTING IN IOWA'S WATER May 2015 State of NON -COLLUSION AFFIDAVIT OF PRIME BIDDER Iowa County of Rlac K E awk )ss John Yallen , being first duly sworn, deposes and says that: 1 He is (Owner, Partner, Office,, Representativepor Agent) , of Woodruff Construction, Inc , the Bidder that has arritereHturalrached 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) nt Subscribed and sworn to before me this 1 BRANDY LUNA Commission Number 82080 My Commission Expires October 22, 2022 11t My commission expires 10/10/2022 NON -COLLUSION AFFIDAVIT AECOM #60549334 day of Title Fe oruary yamd Amiac) Title CONTRACT NO. 951 • , 2021 vn1i yr i*red; V2 AsMffik NCA-1 of 2 FY 2021 SANITARY SEWER GATEWELL REPAIRS - PHASE I EQUAL OPPORTUNITY CLAUSE (As provided in Executive Order No. 11246) All contractors, subcontractors, vendors and suppliers of goods and services doing business with the City and value of said business equals or exceeds ten thousand dollars ($10,000.00) annually agree as follows: 1. The contractors, subcontractor, vendor and supplier of goods and services will not discriminate against any employee or applicant for employment because of race, color, creed, sex, national o rigin, 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 o r advertisements for employees, state that all qualified applicants will receive consideration for e mployment 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 e ach 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. 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, EQUAL OPPORTUNITY CLAUSE CONTRACT NO. 951 EOC-1 of 2 AECOM #60549334 FY 2021 Sanitary Sewer Gatewell Repairs - Phase I 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. 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) ohn Mallen (Appropriate Official) NE Region President (Title) 02/11/2021 (Date) EQUAL OPPORTUNITY CLAUSE CONTRACT NO. 951 EOC-2 of 2 AECOM #60549334 FY 2021 Sanitary Sewer Gatewell Repairs - Phase I Bidder Status Form To be completed by all bidders Part A Please answer "Yes" or "No" for each of the following: X X IXI X X Yes Yes Yes Yes Yes N o My company is authorized to transact business in Iowa. (To help you determine if your company is authorized, please review the worksheet on the next page). N o My company has an office to transact business in Iowa. No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail. No My company has been conducting business in Iowa for at least 3 years prior to the first request for bids on this project. N o My company is not a subsidiary of another business entity or my company is a subsidiary of another business entity that would qualify as a resident bidder in Iowa. If you answered "Yes" for each question above, your company qualifies as a resident bidder. complete Parts B and D of this form. If you answered "No" to one or more questions above, your company is a nonresident bidder. complete Parts C and D of this form. Please Please To be completed by resident bidders P art B My company has maintained offices in Iowa during the past 3 years at the following addresses: Dates: Dates: 8 1 / 1990 to Present / 5 / 25 / 1996 to Present / Dates: 2 / 8 / 2016 to Present / You may attach additional sheet(s) if needed. Address: 1890 Kountry Lane City, State, Zip* Fort Dodge, IA 50501 Address: 1920 Philadelphia Street, Suite 102 City, State, Zip: Ames, IA 50010 Address 501 Greenfield Drive City, State, Zip: Tiffin, IA 52340 0 0 0 0 w To be completed by non-resident bidders Part C 1. Name of home state or foreign country reported to the Iowa Secretary of State: 2. Does your company's home state or foreign country offer preferences to resident bidders, resident labor force preferences or any other type of preference to bidders or laborers? Yes No 3. If you answered 'Yes' to question 2, identify each preference offered by your company's home state or foreign country and the appropriate legal citation You may attach additional sheet(s) if needed. To be completed by all bidders P art 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. Woodruff Constructioj,, Inc. Signature: J., MMallen, NE Region President Date: 02/11/2021 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) Additional Sheet for Bidder Status Form (continued) My company has maintained offices in Iowa during the past 3 years at the following addresses: Dates: 7 / 17 / 2017 to Present/ / Address 1717 Falls Avenue City, State, Zip: Waterloo, IA 50701 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 0 No My business is currently registered as a contractor with the Iowa Division of Labor. Yes 0 No 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 ❑ 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 My business is a corporation whose articles of incorporation are filed in a state other than Iowa, the corporation has received a certificate of authority from the Iowa secretary of state has filed its most recent biennial report with the secretary of state, and has neither received a certificate of withdrawal from the secretary of state nor had its authority revoked. Yes ■ No My business is a limited liability partnership which has filed a statement of qualification in this state and the statement has not been canceled. Yes ■ No My business is a limited liability partnership which has filed a statement of qualification in a state other than Iowa, has filed a statement of foreign qualification in Iowa and a statement of cancellation has not been filed. Yes ❑ No My business is a limited partnership or limited liability limited partnership which has filed a certificate of limited partnership in this state, and has not filed a statement of termination. ❑ Yes ❑ No My business is a limited partnership or a limited liability limited partnership whose certificate of limited partnership is filed in a state other than Iowa, the limited partnership or limited liability limited partnership has received notification from the Iowa secretary of state that the application for certificate of authority has been approved and no notice of cancellation has been filed by the limited partnership or the limited liability limited partnership. ■ Yes ❑ No My business is a limited liability company whose certificate of organization is filed in Iowa and has not filed a statement of termination. Yes 0 No My business is a limited liability company whose certificate of organization is filed in a state other than Iowa, has received a certificate of authority to transact business in Iowa and the certificate has not been revoked or canceled. 309-6001 (09-15) Revised February 2003 CONTRACTOR'S OR SUBCONTRACTOR'S AFFIRMATIVE ACTION PROGRAM Check box that applies to party completing program: ( ( x ) General Contractor Subcontractor Section A to be completed by GENERAL CONTRACTORS only: A. Name of Company Woodruff Construction, Inc Address of Company1717 Falls Avenue, Waterloo Zip 50701 Telephone Number ( 515 ) 232-4535 x22 - Sara Orr Federal ID Number (if no Federal ID Number, Owner/President's Social Security Number) 76-0721180 N ame of Project FY 2021 Sanitary Sewer Gatewell Repairs, Phase 1 P roject Contract Number 951 Estimated Construction Work Dates / March 2021 - April 2022 Start Finish Section B to be completed by SUBCONTRACTORS only: B. N ame of General or Prime Contractor N ame of Subcontractor S ubcontractor's Address Zip S ubcontractor's Telephone Number ( S ubcontractor's Federal ID Number (if no Federal ID Number Owner/President's Social Security N umber) N ame of Equal Employment Officer C. Remainder of program to be completed by party completing program, either Prime or Subcontractor 1. The Owners and/or Principals of your company* Ethnic Name Address Position Sex Origin Don Woodruff Fort Dodge, IA President Jason Rechkemmer Ames, IA Chief Operating Officer John Mallen Waterloo, IA ICE Region President Other Areas of Interest: If your company has branches or subsidiaries, or if your company is a branch or subsidiary of a parent organization, give the following information: Type of Name Address Affiliation Degree Woodruff Construction maintains office locations in Ames, Fort Dodge, Waterloo, and Tiffin, IA. II. EMPLOYER'S POLICY (Please read carefully.) A. We, the undersigned, recognize that we are morally and legally committed to n ondiscrimination in employment. Any person who applies for employment with our company will not be discriminated against because of race, color, creed, sex, national o rigin, economic status, age, mental or physical handicap. B. The employment policies and practices of the undersigned are to recruit and hire e mployees without discrimination, and to treat them equally with respect to compensation and opportunities for advancement, including training, upgrading, promotion, and transfer However we realize the inequities associated with employment training, u pgrading, contracting and subcontracting for minorities and women and we will direct o ur efforts to correcting any deficiencies to the maximum extent possible. The same will be required of our SUBCONTRACTORS and suppliers. C. We submit this program to assure compliance with Executive Order 11246, as amended, and other subsequent orders that may pertain to equal employment opportunity and merit employment policies, fully realizing that our qualification and/or merit system should be evaluated and revised if necessary D. We agree to put forth the maximum effort to achieve full employment and utilization of capabilities and productivity of all our citizens without regard to race, creed, color, sex n ational origin, economic status, age, and mental or physical handicap. E. Woodruff Construction, Inc. will give training (Name of Company) and employment opportunities to local residents of Waterloo, Iowa, to the greatest extent feasible. III. AFFIRMATIVE ACTION A Woodruff Construction, Inc. recognizes that the (Name of Company) B. C. effective application of a policy of merit employment involves more than just a policy statement, and Woodruff Construction, Inc. (Name of Company) will therefore, re-evaluate our Affirmative Action Program to ensure that equal e mployment opportunities are available on the basis of individual merit, and to actively e ncourage minorities, women and local residents to seek employment with our company o n this basis. Woodruff Construction, Inc. will undertake the (Name of Company) following six (6) steps to improve our Affirmative Action Program: 1. Minority Recruitment and Employment; 2. Local Recruitment and Employment; 3. Disabled Veteran and Vietnam Era Veteran Recruitment and Employment; 4. Handicapped Recruitment and Employment; 5. Female Recruitment and Employment; and 6. Training Upgrading and Promotional Opportunities. Woodruff Construction, Inc. will take (Name of Company) whatever steps are necessary to ensure that our total work force has adequate minority, female, and local representation. We will utilize the following methods in our recruitment attempts: 1. Local advertising media (newspapers, radio, TV); 2. Community organizations (churches, clubs, schools); 3. Public and private institutions in the area (UNI Hawkeye Community College); 4. Job Service of Iowa; and 5. Other. D. Woodruff Construction, Inc . will seek qualified minority, (Name of Company) female, and local group applicants for all job categories and will make asserted efforts to increase minority, female and group representation in occupations at the higher levels or skill and responsibility. E. All sources of employment used shall be aware that we are an Equal Employment Opportunity Employer. Labor organizations representing our employees will be notified of our Equal Employment Opportunity Policy and Affirmative Action Program F. Training, upgrading, promotion and transfer activities at all levels will be monitored to e nsure that full consideration has been given to qualified minority, female, and local group employees. Woodruff Construction, Inc. will encourage other (Name of Company) companies with whom we are associated and/or do business, to do the same and we will assist them in their efforts. Woodruff Construction, Inc. has taken the following (Name of Company) Affirmative Action to ensure that minority, female local contractors and/or suppliers were provided opportunities to negotiate and/or bid on this project: (if none, write "NONE") 1. Bid Invitations sent 2. Addenda Notifications sent As a result of the above efforts, we have involved minority, female, and local contractors and/or suppliers in the following areas of subcontracting: (if none write "NONE") 1. Mo Pi?iE (MBEVJ8C hfS re cCi 2. Woodruff Construction, Inc . will require approved (Name of Company) Affirmative Action Programs from all nonexempt contractors who propose to work on this project and will take whatever steps are necessary to ensure that non -minority contractors have adequate representation of minority, female and local persons in their total work force. In further accordance with rules and guidelines issued pursuant to Executive Order 11246 as amended, we establish the goals for our company based on parity percentages supplied by the City, and we realize these goals will be reviewed on an annual basis. Woodruff Construction, Inc. will keep records of (Name of Company) specific actions relative to recruitment, employment, training, upgrading and promotion and will provide the City of Waterloo with any information relative to same, including activities of our SUBCONTRACTORS and suppliers as necessary or when requested. M. Parity figures for companies located in Waterloo are as follows: Minority Parity = .08 (8%) Woodruff Construction, Inc. (Name of Company) Employment Goals: Affirmative Action The definition of Affirmative Action Goals is as follows: "Goals may not be rigid and inflexible quotas which must be met, but must be targets, reasonably attainable by means of applying every good faith effort to make all aspects of the entire Affirmative Action Program work." For the year 2021 . please submit percentage targets for employing minorities and women If you already have reached your target for hiring minorities and women, please submit that percentage. *Goals for Minorities: Goals for Women: % *Your affirmative action goals should be between 1 % and 10% or more for minorities and 1 % and 5% or more for women Please be advised that the goals or targets are purely your estimation of how many women and minorities your company can reasonably expect to hire in 2021 . Note, that none of the goals are rigid or inflexible. They are targets that your company calculates as reasonably attainable This will help the City in its monitoring procedures as required by City of Waterloo Resolution No. 1984-142(4). INDICATE: CONTRACTOR'S TOTAL WORK FORCE (WATERLOO) DISABLED VETERAN: DV VIETNAM ERA VETERAN: VV HANDICAPPED: H We hereby certify that we are in compliance with all City and Federal Affirmative Action Regulations and agree to accept all liability for failure to comply. Respectfully submitted, By: Company Executive 02/11/2021 Sara Orr Date Sara Orr Equal Employment Opportunity Officer 02/11/2021 Date City of Waterloo Affirmative Action Officer Approved Disapproved Reason: By: Date: if 0 o m n CD m 0 � D 0. wHco 0 D O —1 • O CD N O O LQ6 'ON 13db1NOo m 0 0) Z D ;U J3 0 m am m� cn D =m� D ao mr� rm n 0 Tass CO Quotation used in bid 0 G O m D co 9 a) A-b0 0 m A < m r* 0) O ® O � p) 5 O O Q (D SD r m 0 om 0* m a m ▪ m iv c m 5. W Q) 0 = (C)0 N 0 ▪ 0 CT a 0 � m Q o 0 3 op 00 Q 5 pi cD 0 5c co 0 0 m 0 0) 0 Sll Q lD at co 00 cv co 0 0 a) 0 5 0 0 0 0 0 0 3 o CI) 00 c W E. " 0 Z D n.r'� =- r W ET) o 0 Qo O O C 03 E O W -13 m .o OJ 0 mD c W sm sai- o 0 O O O m c O 0 All Lt. 0� 0 " m m 0 m CO o c c ' 0 O Q a o N 0 a O O -Al -F. 0 0 o o- o; o- O 0 d. CT 0 3 s (t (n O o o •cn rm m o Q o m 9ZS O O O < co O c a 0 o 0 <. 0 < 0 N n O D r o .sa c �. N o' �: m 0 Sv m IZOZ/TI/Z0 0 O 0 0 cQ O <D m Z 0 X O O E 00 Pa Ca-,, o. 00 En'sv co 0cm g O C W `< O C- .°i O O 0 5;0 co CD 0 O O c sv m � co Z o 0 <. 5 2. 3 Sll a E W 0 • m -h o0 • m = 0 `< c co o w 0Da m� c o a 0 0 0 0 •O 3 Al O tp 0 (D I. c O "O lD W m O c m D 00 = O- A) 0 o'er. rn TA- - r 0 0 SA 0 3 co 0 0 Sv 0 0 Z Sll 3 0 0 0 n sJ rh rt, 0 0 m n s; W 0 m 71 ct 0 oom vW O In Dm nN ce m O� Wal TZOZ/II/Z0 0 Weidner Construction Inc Marshalltown IA Trinity Construction Group Titan Roofing and Exteriors -c h Stone General Masonry Signarama Ankeny R and D Painting Pro Wall Construction Paco Construction OEL Const Services MG Masonry Inc McMahan Industrial Service JT Concrete Hibbs Excavating and grading Ewing Concrete Duncan Enterprises Dormark Construction Classic Window Treatments Cart Construction Bosker Construction Blackwell Construction Ben Ben Stone Environmental A-Z Steel Manufacturing Ardent Lighting Group Alpha Services Air Control Products Inc Name of TSB CO 0 0 0 m 0 0 a) 3 n CO v -1 n a) fates a) N = n ping (Des Moines IA Waukee IA Des Moines IA D = Gm) -' Steamboat Rock IA Monroe IA Des Moines IA W Des Moines IA n a) Clive IA Windsor Heights IA Grimes IA Des Moines IA Des Moines IA Des Moines IA Des Moines IA Des Moines IA Lamoni IA Knoxville IA Waterloo IA Urbandale IA D Q oz 0 0 m E 23 C = m 0 m (1) z C FF o v 0 n cn r = x- • v v) N O v cm D 5 D D _ D m D D D D D 0 Jackie Cheryl Socorro (Kathy Ronnie Kristin IDorrie Gustavo Malloree D r- `- Herb Steve uesns Serafin Apued Pierre Marshall Jeannie Contact Person 70 o r- v = Q c 0 -0 2 _i —1 0 3< Q 3 0 r cr, v Q 0 — Weidner 0 o Cowden Correa v Warren GJ o m- Leon Seckington Hibbs Duncan Bayse Genz Monzon s 0 1Bennett Lysinger Cooper Albrecht v < m Kramer _ aa)) °) < (D 4, w C o m v n C a) m da m — N - 0 (D r 0 r = ((D (D s a) ,c" 0 _ — (515) 280-2440 (515) 635-4168 (515) 987-2825 (515) 943-3593 (515) 216-1240 (515) 432-1 (515) 491-8099 (515) 240-0625 (641) 858-5090 (319) 521 (515) 422-7016 (515) 22] (515) 240-6400 (515) 975-3576 (515) 770-8499 (515) 986-4270 (515) 287-2426 (515) 918-2023 (319) 290-2617 (515) 282-8877 (515) 710-2544 (319) 235-9008 (515) 271-5994 m m r 0 L) 275-2353 L) 696-5920 1842-5969 L) 259-4100 L) 752-6665 1784-694 m it 1No Response Won't Bid N o Response N o Response INo Response asuodsaH oNl INo Response N o Response N o Response No Response No Response No Response No Response No Response N o Response N o Response N o Response N o Response N o Response N o Response N o Response N o Response N o Response N o Response N o Response N o Response N o Response N o Response N o Response Reason for Declining I Date Contacted N 4 N A 2/4/20211 N P 2/4/2021 2/4/2021 NJ a 2/4/20211 2/4/20211 2/4/2021 N A N N A 2/4/20211 N A N A 2/4/20211 N P 2/4/2021 2/4/2021 2/4/2021 N A 2/4/20211 N a N 2/4/20211 NJ 2/4/20211 N A N 0 N 1-1 N N 0 •P N 0 N N Ni N O N N O N N co N I" N O N I" N O Ni I" N N O N N O NJ I-' NJ O NJ I-' 0 O N 0 N O N N N I" I" I" I" I" I" I" I" I H m 0 0 C1U N fl4 m fz 3 a) co c rn 5 m In N (D 0 m m n 0 r+ v n m f1 v 0 0 m n W Q o 0 • m m n ▪ rt 0 Q Ni - O s Q ) (n n v 7 r# v) a) rt C (n o m 1 a) ▪ rr rD 0 m fD a)