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HomeMy WebLinkAboutLodge Constructioin*3 a4i iehe Ina/ /sat int • • \11.• j. P.O. Box = S `d (. amustrixaus t6 50619 Dit Vara- a a cn a ♦a. cci bbie3/y fiz: fivaa7/ Keleivenz it e 6744‘ i✓a�: ..: t 0 75. tan 0 wit`` 41 C? tin marl tic 411 Xey ten re.. 0 FORM OF BID OR PROPOSAL FY 2021 COMMERCIAL ST. KATOSKI DR., AND HAWKEYE RD. RT TURN LANE RECONSTRUCTION PROGRAM CONTRACT NO. 1024 CITY OF WATERLOO, IOWA Honorable Mayor and City Council Waterloo, Iowa Gentlemen: 1. The undersigned, being a Corporation existing under the laws of the State of /- a Partnership consisting of the following partners: , having familiarized (himself) (themselves) (itself) with 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 the City Engineer of the City of Waterloo 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 this FY 2021 COMMERCIAL ST KATOSKI DR., AND HAWKEYE RD RT TURN LANE RECONSTRUCTION PROGRAM Contract No. 1024, all in accordance with the above -listed documents and for the unit prices for work in place for the following items and quantities: FY 2021 COMMERCIAL ST. KATOSKI DR AND HAWKEYE RD. , PROGRAM RT TURN LANE RECONSTRUCTION CONTRACT N3 1024 BID SPECIFICATION SUPPLEMENTAL SUDAS * SEE DIVISION I - STREET RECONSTRUCTION UNIT BID TOTAL BID PRICE ITEM SP = SPCL PROV DESCRIPTION UNIT EST QTY PRICE DIVISION 2 - EARTHWORK 1 2010-108-D * TOPSOIL, 4 INCHES, ON OR OFF SITE SY 2,015.0 $ C $ /Q)O/5® 2 2010-108-E-0 * EXCAVATION CLASS 10 CY 5,516.0 $ g ` $ 41y)1 3 2010-108-G * SUBGRADE PREPARATION SY 15,086.0 $ 1 -- $ I S" v 8 4 2010-108-H * SUBGRADE TREATMENT, WOVEN GEOTEXTILE SY 1,500.0 $ 3 $ y S 0 5 2010-108-1 * SUBBASE, MODIFIED CY 6,500.30 $ 3 0 " $ Rig 0 11 6 IDOT 2121 GRANULAR SHOULDER, TYPE B TON 2,621.00 1 1 - tt 7qq -- � SUBTOTAL EARTHWORK $ DIVISION 4 - SEWERS AND DRAINS - STORM 7 4020-108-A-1 STORM INCH SEWER, TRENCHED, RCP 2000D, 15 LF 110.0 y , $ /`1 f $ 4T3jo J STORM SEWER, TRENCHED, RCP 2000D, 12 r " 8 4020-108-A-1 * INCH LF 150.0 Gi $ I � $ 6 3 0o RCP, STORM STORM SEWER,FLARED END SECTION, 9 4020-108-A-1 * 2000D, 15 INCH EACH 3.0 �, $ ) ye $ / REMOVAL OF STORM SEWER, RCP, LESS _ s 10 4020-108-D 0 * I.)‘ THAN OR EQUAL TO 36 INCH LF 211.0 $ $'1C3 SPECIFICATION SUDAS * SEE BID SUPPLEMENTAL DIVISION 1- STREET (CONTINUED) RECONSTRUCTION UNIT BID TOTAL BID " PRICE ITEM SP = SPCL PROV DESCRIPTION UNIT EST QTY PRICE: DIVISION (CONTINUED) 4 - SEWERS AND DRAINS — STORM 11 4040-108-A-0 SUBDRAIN, TYPE SP, 6 INCH LF 1,735.0 $ /'0 - $ (7735-0 12 4040-108-A-0 SUBDRAIN, TYPE SP, 4 INCH LF 9,834.0 $ 9 _ $ Th1 rO& - 13 4040-108 D-0 SUBDRAIN CMP, 6 INCH OUTLETS AND CONNECTIONS, EACH 68.0 �- q $ cR � $ P- 17/00 DIVISION SEWERS 6 - STRUCTURES FOR STORM 14 6010-108-A-0 * MANHOLE, SW-401, 48" EACH 1.0 $ '3,s 0-- 1 $ 3 d .5 15 6010-108-A-0 °'t' `% MANHOLE, SW-406, SHALLOW RECTANGULAR EACH 2.0 $ $ 00 16 6010-108-B-0 INTAKE SW-501, SINGLE GRATE EACH 6.0 $ Si 4100— $ ao, yao 17 6010-108-B-0 INTAKE, SW-507, SINGLE OPEN THROAT, CURB L - INTAKE, SMALL BOX EACH 2.0 $ /)56, $ I COr INTAKE, SW-509 DOUBLE OPEN THROAT, — 18 6010-108-8 0 CURB INTAKE, SMALL BOX EACH 1.0 $ ±5 `� $ i ����� 19 6010-108-H-0 CONNECTION TO EXISTING INTAKE, DRAIN , — Gry4, ,— TILE EACH 2.0 $ )2.O 5 j $ 20 6010-108-B-0 REMOVE MANHOLE OR INTAKE, STORM EACH 12.0 $ S,ZS" $ 4.3409 INTAKE SW 545, REMOVE AND REPLACE 21 SP #6 SPECIAL SHAPING AND TOP EACH 1.0 $ '3) / S v $ j 1 S' 49 INTAKE SW-545 SINGLE OPEN THROAT WITH 22 6010-108 B 0 EXTENDED EACH 1.0 $ 617s` $ �� / �d-- OPENING 23 6010-108 E * INTAKE, SW-501 REMOVE AND REPLACE '75' f S BOXOUT EACH 2.0 $ 5 $ MINOR ADJUSTMENT, MANHOLE W/ SW-601 24 6010-108-E * TYPE A CASTING & CITY OF WATERLOO EACH 2.0 AP— COVER $ 1 $ 075 a" MINOR ADJUSTMENT MANHOLE W/ SW-602 25 6010-108-E * TYPE CASTING & CITY OF WATERLOO EACH 2.0 .— COVER$ ���� $ e;/60 26 SP #3 FURNISH AND INSTALL SW-603 TYPE R .2- CASTING EACH 2.0 $ $ /768 SUBTOTAL STORM SEWER $ DIVISION APPURTENANCES 5 - WATER MAINS AND CONVERT WATER VALVE MANHOLE TO ' 27 SP # 4 ROADBOX EACH 1.0 $ 000 $ (06 28 SP # 2 WATER SERVICE KILL EACH 25.0 $ `%oo r $ / ?ow --- SUBTOTAL WATER APPURTENANCES $ DIVISION 7 - STREETS AND RELATED WORK PCC PAVEMENT 29 7010-108-A-0 PAVEMENT, PCC, 8 INCH, C-4 W/ CLASS 3 AGG SY 12,761.0 $ fill ' $ 51/0)7?3J 30 7010-108-A-0 PAVEMENT, PCC, 9 INCH, C-4 W/ CLASS 3 AGG SY 5,432.0 $ y 8 $ Retj 736 PAVEMENT, PCC, 10 INCH, C-4 W/ CLASS 3 - 31 7010-108 A-0 AGG SY 920.0 $ 60 $ LSJ ��co- CONCRETE MEDIAN, 6 INCH, C-4 W/ CLASS 3 -A-5 32 7010-108-G AGG SY 286.5 $ to $ % 8j b q 9 33 7010-108-1-0 PCC PAVEMENT SAMPLES AND TESTING LS 1.0 $ 8j0�e, " $ 9)000 34 7010-3.04 COLD WEATHER CONCRETE PROTECTION SY 2,000.0 $ ;`.. $ /0/0' 35 7010-3.02, J * LINSEED OIL TREATMENT SY 7,000.0 $ / 62% $ /000 SPECIFICATION SUDAS * SEE DIVISION 1- STREET RECONSTRUCTION UNIT BID TOTAL BID BID SUPPLEMENTAL (CONTINUED) ITEM SP = SPCL PROV DESCRIPTION UNIT. EST QTY PRICE PRICE SIDEWALKS, DRIVEWAYS SHARED USE PATHS AND 36 7030-108-A-0 REMOVAL OF SIDEWALK SY 459.6 $ (a "" $ d 757 4e 37 SY 235.7 $ 6 . $ y/`,/;z4i 7030-108-A-0 REMOVAL OF DRIVEWAY /, ' slY 38 7030-108-E-0 SIDEWALK, PCC C-4, 6 INCH, C-4 SY 480.2 $ let $ 211 /29 39 7030-108-G-0 DETECTABLE WARNING SURFACE SF 70.0 $ 5 2 - $ 3l &S'0 40 7030-108-H-1 DRIVEWAY PAVED, PCC, 6 INCH, C-4 SY 202 3 $ 1/ /( - $ $.) ?OI 41 7030-108-H-1 DRIVEWAY, PAVED, PCC, 8 INCH, C-4 SY 38.8 $ 6C7 y $ 91> 3 2d" PAVEMENT REHABILITATION 42 7040-108-H-0 * PAVEMENT REMOVAL CONCRETE SY 20,700.0 $ 5 " $ /403, sop r SUBTOTAL STREETS AND RELATED WORK. $ DIVISION TRAFFIC 8 CONTROL - PAVEMENT MARKINGS AND PAVEMENT MARKINGS PAINTED PAVEMENT MARKINGS, 43 8020-108-B O/SP#10 - SOLVENT/WATERBOURNE STA 206.61 $ 0 $ q,,'//D, 0 r 44 8020-108-H-0/SP#10 PRECUT SYMBOLS AND LEGENDS EACH 21.0 $ 6-00' $ A5l1 ` 45 8020-108-K-0 PAINTED PAVEMENT MARKINGS, REMOVED STA 12.0 $ / 3/ $ 4_5-76,7 TEMPORARY TRAFFIC CONTROL 46 8030-108-A-0 TEMPORARY TRAFFIC CONTROL LS 1.0 $ i ti0 "- $ 8 `ice SUBTOTAL PAVEMENT MARKINGS AND TRAFFIC CONTROL $ DIVISION 9 - SITE WORK AND LANDSCAPING SEEDING HYDRAULIC SEEDING, SEEDING, FERTILIZING 47 9010-108 B-0 * AND MULCHING SY 140.0 $ /6 $ �y I '- - 48 9010-108-E-0 * WARRANTY SY 100.0 $ fig; $ (j (000 EROSION AND SEDIMENT CONTROL 9040 108-T-1 */ INLET PROTECTION DEVICE, INTERMEDIATE 49 SP#13 AND DROP IN EACH 11.0 $ <R0�' $ , ad O' 50 9040-108-T-2 l b 0 */SP#13 11.0 $ $ l / INLET PROTECTION DEVICE, MAINTENANCE EACH SUBTOTAL SITE WORK AND LANDSCAPING $ DIVISION 11 - MISCELLANEOUS CONSTRUCTION SURVEY 51 11010-108-A CONSTRUCTION SURVEY (DIVISIONS I AND II) LS 1.00 $ aczootr $ )22 DOD ' - 52 11,050-108-A-0 CONCRETE WASHOUT LS 1.00 $ tj10 $ Z/,`c.' - 53 PLAN SHEET 2.09 REMOVE AND REINSTALL TREE GRATES EACH 4.0 $ VV $ 4!Q7"- SUBTOTAL MISCELLANEOUS $ i) % / i, 7,0 77 ' ...-- 96 TOTAL DIVISION I $ f 7/ SPECIFICATION SUDAS *SEE BID SUPPLEMENTAL DIVISION II - COMMERCIAL STREETSCAPE UNIT BID. TOTAL BID ITEM SP = SPCL PROV DESCRIPTION UNIT EST QTY PRICE PRICE 1 SUDAS 2010-108-A-0 CLEARING AND GRUBBING UN 7.8 $ /& .r $ 11 s 2 SUDAS 2010-108-D-0 OFFSITE TOPSOIL CY 28.0 $ '/9 $ /3/49- BID TEM 4 5 6 7 8 9 10 11 12 13 14 15 16 17 19 20 21 22 23 24 25 26 27 2$ 29 30 31 SUDAS SPECIFICATION *SEE SUPPLEMENTAL SP = SPCL PROV SUDAS 2010-108-E-0 SUDAS 2010-108-1-0 SUDAS 7030-108-A-0 SUDAS 7030-108-A-0 S UDAS 7030-108-A-0 S UDAS 7030-108-E-0 SUDAS 7030-108-E-0 SUDAS 7030-108-E-0 SUDAS 7030-108-G-0 SUDAS 7030-108-H-0 SUDAS 7030-108-H-0 PLAN SUDAS 7040-108-A-0 SUDAS 8020-108-B-0 SUDAS 8020-108-B-0 IA -DOT 2523- 0000100 IA-DOI-2523- 0000100 PLAN IA -DOT 2523- 0000200 IA -DOT 2523- 0000310 PLAN SUDAS 9030-108-B-0 S UDAS 9030-108-B-0 S UDAS 9030-108-B-0 S UDAS 9030-108-B-0 S U DAS 9030-108-B-0 PLAN PLAN PLAN sosapesiss DIVISION 11- COMMERCIAL STREETSCAPE (CONTINUED) DESCRIPTION _ __-- EXCAVATION, CLASS 10, WASTE SUBBASE, MODIFIED REMOVAL OF PAVEMENT REMOVAL OF SIDEWALK REMOVAL OF DRIVEWAY SIDEWALK, PCC, 6 IN. SIDEWALK, PCC, 8 IN. SIDEWALK, COLORED PCC, 6 IN. DETECTABLE WARNINGS, CAST IRON PAVED DRIVEWAY, PCC, 6 IN. PAVED DRIVEWAY, PCC, 8 IN. POROUS PAVE FULL DEPTH PATCH PAINTED PAVEMENT MARKINGS PAVEMENT MARKINGS REMOVED LIGHTING POLES, TYPE 1, STREET LIGHT LIGHTING POLES, TYPE 2, PED LIGHT REMOVAL OF LIGHT POLE FOOTINGS ELECTRICAL CIRCUITS HANDHOLES AND JUNCTION BOXES ELECTRICAL MODIFICATIONS PLANTS WITH WARRANTY, TYPE 1, SKYLINE HONEYLOCUST PLANTS WITH WARRANTY, TYPE 2, SKYLINE HONEYLOCUST PLANTS WITH WARRANTY, TYPE 3, SKYLINE HONEYLOCUST PLANTS WITH WARRANTY, TYPE 1, COMMON HACKBERRY PLANTS WITH WARRANTY, TYPE 3, AUTUMN BLAZE MAPLE REMOVE AND REINSTALL TREE GRATE INSTALL NEW TREE GRATE REMOVE AND REINSTALL BIKE RACKS TOTAL DIVISION II UNIT CY CY SY UNIT BID EST QTY PRICE 300.0 199.3 37.9 SY 1,003.3 SY SY SY SY SF SY SY SF SY STA STA EACH EACH EACH LF EACH LS 157.9 $ ae 0 TOTAL BIC PRICE $ 3/ am r $ y 347914 _15-9 147 $ 9qqW 857.6 16.7 _742.2 40.8 119,2 $ ys a77" $ 5"), 850.0 $ c 379 $�� 5.0 $ 7 /1 1tLA $ 16 QDo 20.0 12.0 2,083.0 1.0 EACH EACH 4.0 4.0 EACH EACH EACH EACH EACH LS atm- S cg $/J $ gar $ 69 L$A)rizo $ 63°' 4,Q $6 _$ 12.0 $ 63a� $ t?irOi 5.0 4.0 to 3'�t/) 3V& $ 60010 $ 3.0aer $ fdojsear 5 FOR $ Contract No. 1 023 Addendum No. 1 — Division 11 Quantity Correction Form of Bid Page 4 of S 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 ) in the form of 600&& the INSTRUCTIONS TO BIDDERS. Dollars ($ , is submitted herewith in accordance with Attached hereto is a Non -Collusion Affidavit of Prime Contractor. Attached hereto is a Bidder Status Form. 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. 9. The bidder has received the following Addendum or Addenda: Addendum No. / Date d 1G d/ 3-/-0/ 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: Vim/ (Date) Title Official Address: (Including Zip Code): /od. I.R.S. No. T%" 8 fig coal END SECTION NON -COLLUSION AFFIDAVIT OF PRIME BIDDER State of ) County of �=J / ) J )ss being first duly sworn, deposes and says that: 1. He is T (Owner, Partner, Officerpresentative,,or Agent) , of , the Bidder that has submitted the attached Bid; He is fully -informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid; S uch Bid is genuine and is not a collusive or sham Bid: N either 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 The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents representatives, owners, employees or parties in interest, including this affiant. (Signed) Title Subscribed and sworn to before me this Title My commission expires e & / a7W day of Stell , 20 . -od A044 • a 0 a $rv111Nw 11111111111P ow Olt LINDA K SENN COMMISSION NO. 803307 MY COMMISSION EXPIRES 07 au 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. O Yes Q'No O Yes O Yes O Yes O Yes O Yes O Yes My business is currently registered as a contractor with the Iowa Division of Labor. My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. My business is a general partnership or joint venture. More than 50 percent of the general partners or joint venture parties are residents of Iowa for Iowa income tax purposes. My business is an active corporation with the Iowa Secretary of State and has paid all fees required by the Secretary of State, has filed its most recent biennial report, and has not filed articles of dissolution. My business is a corporation whose articles of incorporation are filed in a state other than Iowa, the corporation has received a certificate of authority from the Iowa secretary of state has filed its most recent biennial report with the secretary of state, and has neither received a certificate of withdrawal from the secretary of state nor had its authority revoked. My business is a limited liability partnership which has filed a statement of qualification in this state and the statement has not been canceled. My business is a limited liability partnership which has filed a statement of qualification in a state other than Iowa, has filed a statement of foreign qualification in Iowa and a statement of cancellation has not been filed. My business is a limited partnership or limited liability limited partnership which has filed a certificate of limited partnership in this state, and has not filed a statement of termination. My business is a limited partnership or a limited liability limited partnership whose certificate of limited partnership is filed in a state other than Iowa, the limited partnership or limited liability limited partnership has received notification from the Iowa secretary of state that the application for certificate of authority has been approved and no notice of cancellation has been filed by the limited partnership or the limited liability limited partnership. My business is a limited liability company whose certificate of organization is filed in Iowa and has not filed a statement of termination. My business is a limited liability company whose certificate of organization is filed in a state other than Iowa, has received a certificate of authority to transact business in Iowa and the certificate has not been revoked or canceled 309-6001 (09-15) idder Status Form To be completed by all bidders Part A Please answer "Yes" or "No" for each of the following: Yes 0 No Yes 0 No IYes cNo 0 Yes QNo Yes QNo 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). My company has an office to transact business in Iowa. My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail. My company has been conducting business in Iowa for at least 3 years prior to the first request for bids on this project. My company is not a 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. To be completed by resident bidders Please Please Part B My company has maintained offices in Iowa during the past 3 years at the following addresses: Dates: / / / / /5- to / y / / Address. h. 959 City, State, Zip / o w!,,, tide''1 5442'% Dates: / / to / / Address: City, State, Zip: Dates: / / to / / Address: You may attach additional sheet(s) if needed. City, State, Zip* 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? 0Yes 0No 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 Part D I certify that the statements made on this document are true and complete to the best of my knowledge and I know that my failure to provide accurate and truthful information may be a reason to reject my bid. Firm Name: Signature: Date: 3 `9 J 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) 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 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 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. EOC - Page 1 of 2 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 •fficial) tate/11;1-#) (Title) (Date) EOC - Page 2 of 2 Prime Contractor Name: Project: /yr MBE/WBE BUSINESS ENTERPRISE PRE -BID CONTACT INFORMATION FORM Letting Date: g y% NO MBE/WBE SUBCONTRACTORS: If you are NOT using any MBE/WBE subcontractors to complete this project, sign below Attach a brief explanation as to why subcontracting was not feasible with this project If any MBE/WBE subcontractors will be used, please use the bottom portion of this form. Contractor Signature Title: Date: 3 -j SUBCONTRACTORS APPLICABLE: You are required, in order for your bid to be considered responsive, to provide the information on this form showing ALL of your MBE/WBE subcontractor contacts made for your bid submission. This information is subject to verification. Any questions may be directed to Contract Compliance Office 319-291-4429. You are required, in order for your bid to be considered responsive to provide the information on this Form showing your MBE/WBE Business Enterprise contacts made prior to your bid submission. This information is subject to verifications and confirmation. If you are unable to identify MBE/WBE firms to perform portions of the work, please contact Rudy Jones, Contract Compliance Officer, for assistance at (319) 291-4429 In the event it is determined that the MBE/WBE Business Enterprise goals are not met, then before awarding the contract the City of Waterloo will make a determination as to whether or not the apparent successful low bidder made good faith efforts to meet the goals. TABLE OF INFORMATION SHOWING BIDDER'S PRE -BID MBE/WBE BUSINESS ENTERPRISE CONTACTS Quotes Received Quotation used in bid Subcontractors MBE/WBE Contacted Dates Yes/No Contacted Dates Yes/No Dollar Amount be Subcontracted Proposed to be Ame, his ka j- I %/ 3-- r �C1 D 1 3- %g (Form CCO-4) Rev. 06-20-02 Revised February 2003 CONTRACTOR'S OR SUBCONTRACTOR'S AFFIRMATIVE ACTION PROGRAM Check box that applies to party completing program: ( 8i) General Contractor ( ) Subcontractor I. Section A to be completed by GENERAL CONTRACTORS only: A. ,r Name of Company / atarkeeS9r% Address of Company ,6', i Zip -5 2a /9 Telephone Number ( 319 ) 029© 5 7lv 7 Federal ID Number (if no Federal ID Number, Owner/President's Social Security Number) y7-<,?iroi 8roi N ame of Equal Employment Officer N ame of Project hiao / 4* P roject Contract Number Estimated Construction Work Dates L% -02/ 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 Number) N ame of Equal Employment Officer AAP — Page 1 of 8 D. Remainder of program to be completed by party completing program, either Prime or Subcontractor. The Owners and/or Principals of your company: Name Address Ethnic Position Sex Origin 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 II. EMPLOYER'S POLICY (Please read carefully.) A. We, the undersigned, recognize that we are morally and legally committed to nondiscrimination in employment. Any person who applies for employment with our company will not be discriminated against because of race, color, creed, sex, national origin, economic status, age, mental or physical handicap. B. The employment policies and practices of the undersigned are to recruit and hire employees 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, upgrading contracting and subcontracting for minorities and women and we will direct our 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. .a• �� We agree to put forth the maxiiti c!til:rt to achieve full employment and utilization of capabilities and productivity of all our citi ��' fig t regard to race, creed, color, sex, national origin, economic status, age, and me II give training and employmentWaterloo, Iowa, to the greatest extent feasible. P.O. BOX 459 I CIAR.KSVI AAP— Page 2of8 III. AFFIRMATIVE ACTIO A. C. will, therefore, r opportunities are women and loc recognizes that the effective application of a policy of just a policy statement, and ?619 (Name of Company) e our Affirmative Action Program to ensure that equal employment on the basis of individual merit, and to actively encourage minorities to seek employment with our company on this basis. will undertake the following six (6) steps to improve 1.l?'rrArit't�ttnen#:hn. loyment; 2. Local Recruitment and Employment; 3. Disabled Ve a , nd Vietnam Era Veteran Recruitment and Employment; 4. Handicappitment and Employment; 5. Female Re and and Employment; and 6. Tramin•w � � i9 and Promotional Opportunities. ens utilize 1. Local advertisin 2. Communit 3. Public an 4. Job Sery 5. (N for represen alibh 1 tititihS4t,ttte igher levels or skill and responsibility. will take whatever steps are necessary to adequate minority, female, and local representation. We will ruitment attempts: media (newspapers, radio, TV); izations (churches, clubs, schools); nstitutions in the area (UNI, Hawkeye Community College); a; and will seek qualified minority, female, and local group applicants ones, andLwfP f e asserted efforts to increase minority, female and group E All sources of employment used shall be aware that we are an Equal Employment Opportunity Employer. Labo g 'zations representing our employees will be notified of our Equal Employment Opportunity Poll irmative Action Program. F. Training, con G. otion and transfer activities at all levels will be monitored to ensure that full alified minority, female, and local group employees. will encourage other companies, with whom we are the same and we will assist them in their efforts. H. ;¢. = has taken the following Affirmative Action to ensure that B^x 459 cif VZLI , 619 AAP— Page 3of8 minority, female, local contractors and/or suppliers were provided opportunities to negotiate and/or bid on this project: (if none write "NONE") 1. (c&i 2.L d 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. 2. J. e • 0'C1 Lt!reir ) / le k Ox: I Y„rK#iRK, 9 K. In further accord amended, we est and we realize t L. (N recr with ai.ipp i# as necessary or when red u6s et??t9 will require approved Affirmative Action Programs from propose to work on this project and will take whatever steps are ority contractors have adequate representation of minority, female k force. h rules and guidelines issued pursuant to Executive Order 11246 as goals for our company, based on parity percentages supplied by the City, will be reviewed on an annual basis. Parity figures for Minority Parity ( Affi will keep records of specific actions relative to pgrading and promotion and will provide the City of Waterloo including activities of our SUBCONTRACTORS and suppliers ies located in Waterloo are as follows: PC.110x 459 P CLARKSVW, 619 The definition of Affirmative Action Goals is as follows: "Goals may not be rigid and inflexible quotas wh.ch 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 201_, 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. MP— Page 4of8 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: 61-"�1%e /Id lc Company Executive 3= y 2/ Date By: Equal Employment Opportunity Officer 3-yam Date City of Waterloo Affirmative Action Officer Approved Disapproved Reason: By: Date: MP— Page 6of8 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, Lodge Construction, Inc. as Principal, and North American Specialty 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 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 4th day of March 2021 , for FY 2021 Commercial St., Katoski Dr., and Hawkeye Rd. Rt Turn Lane Reconstruction Program, City of Waterloo, IA; Contract No. 1024 NOW, THEREFORE, • (a) If said Bid shall be rejected, or in the altemate, (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 March , A.D, ; 2021 C� Lodge Construction, Inc. (Seal) Principal By North Am = ican Specialty I yrance Compartkseal) By Witness Stacie Christensen urety Attorl'iey-ina Dione R. Young SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY WESTPORT INSURANCE CORPORATION GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Kansas City, Missouri and Washington International Insurance Company a corporation organized and existing under the law s of the State of New Hampshire and having its principal office in the City of Kansas City, Missouri, and Westport Insurance Coiporation, organized under the laws of the State of Missouri, and having its principal office in the City of Kansas City, Missouri does hereby make, constitute and appoint: JAY D. FREIERMUTH, CRAIG E. HANSEN, BRIAN M. DEIMERLY, SHIRLEY S. BARTENHAGEN, CINDY BENNETT, ANNE CROWNER TIM McCULLOH, STACY VENN, DIONE R. YOUNG, WENDY A. LEWIS, and STACIE CHRISTENSEN JOINTLY OR SEVERALLY Its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: ONE HUNDRED TWENTY FIVE MILLION ($125,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of North American Specialty Insurance Company and Washington International Insurance Compan) at meetings duly called and held on March 24 2000 and Westport Insurance Corporation by written consent of its Executive Committee dated July 18, 2011. "RESOLVED, that any two of the President, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached. ' .sueotd 'IJNtluJ ,, A. GQFlP01 2: of SEAL P. Inrnnitli Steven P. Anderson, Senior Vice Pre/dent of Washington International Insurance Company & Senior Vice President of North American Specialty Insurance Company & Senior Vice Presiden of Westport Insurance Corporation ✓qf By ( !r ';r I Mike A. Ito, Senior Vice President of Washington International Insurance Company & Senior Vice President of North American Specialty Insurance Company & Senior Vice President of Westport Insurance Corporation IN WITNESS WHEREOF, North American Specialty Insurance Company, Washington International Insurance Company and Westport Insurance Corporation have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this this 3RD day of DECEMBER , 20 20 State of Illinois County of Cook ss: North American Specialty Insurance Company Washington International Insurance Company Westport Insurance Corporation On this 3RD day of DECEMBER , 20 20, before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation and Michael A. Ito Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFICLAt SEAL u KENNY Notary Public - State of ffi 3rr My Commission Expires 12,ow2o21 M. Kenny, Notary Public I, Jeffrey Goldberg , the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company, Washington International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company, Washington International Insurance Company and Westport Insurance Corporation which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 3rd day of March c 2021 Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company & North American Specialty Insurance Company & Vice President & Assistant Secretary of Westport Insurance Corporation