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131D BOND Nationwide Mutual Insurance Company
1100 Locust St., Dept 2006
Des Moines, IA 50391 -2006
(866) 387-0457
CONTRACTOR: SURETY*
Brock Even Construction LLC Nationwide Mutual Insurance Company
13012 Fox Road 1100 Locust Street, Department 2006
Jesup, IA 50648 Des Moines, IA 50391
OWNER: City of Waterloo
715 Mulberry St
Waterloo, IA 50703
BOND AMOUNT; 51/b
PROJECT.
F .Y. 2021 Sidcxvalk Trait Repair Zone 1
The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor
and Surety bind themselves, their heirs, executors, administrators, successors and assigns, _jointly and severally , as provided
herein. The conditions of this Bond are such that if the Owner accepts the bid of the: Contractor within the time specified in
the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either
(I ) enters into a contract with. the Owner in accordance with the terms of such bid., and gives such bond or bonds as may be
specified in thehidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise
acceptable to the fawner, for the faithful performance of such Contract and for the prompt payment of labor and material
furnished in the prosecution thereof: or (2) pays to the Owner the difference, not to exceed the amount of this Bond,
between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with
another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in
full force and effect: The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend
the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding
sixty (60) days in aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and
Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days•
If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be
deemed to be a Subcontractor and the term Owner shall be deemed to be Contractor.
When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any
provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions
conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent
is that this bond shall be construed as a statutory bond and not as a common law bond.
Signed and sealed this th day of May 2021
Brock Even construction LL.0
(1'rincipalj ,/,S`ea1)
(1€etrt ss 'g"
(Title)
Nationwide
nwi Compgny
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(Title) km Attornev4n-F&t '
This document conforms to American Institute of Architects Document A310, 2010 edition
Power of Attorney
KNOW ALL MEN BY THESE. PRESENTS THAT:
Nationwide Mutual Insurance Company, an Ohio corporation AMCO Insurance Company, an Iowa corporation
Allied Property and Casualty Insurance Company, an Iowa corporation
hereinafter referred to severally as the "Curnpany" and collectively as "the Companies" does hereby make, constitute and appoint:
Jeffrey Cose
each in their individual capacity, its true and lawfui attorney-in-fact, with ful power and authority to sign, seal, and execute on its behalf any and all bands and
undertakings, and other obligatory instruments of similar nature, in penalties not exceed'r=g the sum of
$ 1,51 ,443 - One hundred fifty -one thousand four hundred fortyr =three
and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company; and all acts
of said Attorney pursuant to the authority given are hereby ratified; and confirmed;
This power of attorney is made and executed pursuant to and by authority of the foilo+wrig resolution duly adopted by the board of directors of the Company;
"RESOLVED, that the president, or any vice president be, and each hereby is, authorized and empowered to appoint attorneys-in-tact of the Company ,
and to authorize them to execute and deliver on behalf of the Company any and all bonds , forms, applications, memorandums, undertakings ,
recognizances, transfers, contracts of indemnity, policies , contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other
writings obligatory in nature that the business of the Company may require; and to modify or revoke , with or without cause, any such appointment or
authority; provided. However, that the authority granted hereby shad in no way limit the authority of other duly authorized agents to sign and countersign any
of said documents on behalf of the Company. '
' RESOLVEDFURTHER , that such attorneys-in-fact shall have full power and authority to execute and deliver any and all such documents and to bind the
Company subject to the terms and tmitatons of the poweer of attorney issued to them, and to affix the seal of the Company thereto; provided, however , that
said seal shall not be necessary for the validity of any such documents."
This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company.
Execution of Instruments Any vice president any assistant secretary or any assistant treasurer shal' have the power and authority to sign or attest all
approved documents, instruments, contracts, or other papers in connection with the operation of the business of the company in addition to the chairman of
the board, the chief executive officer; president, treasurer or secretary; provided , however, the signature of any of them, may be printed, engraved, or
stamped on any opproved document, contract, instrument , or other papers of the Company.
IN WiTNFSS WHEREOF, the Company has caused this instrument `o sealed and duly attested by the signature of its officer the 2T" day of February, 2019.
Artpni0 t. Albanese. Vice President of Nationwide Mutual Insurance Company, AWO Insurance
Company, Allied Property and ^asualty insuranci? Company
LC j � , `, EAL *� ACKNOWLEOGMENT
Ar STATE OF NGVJYORK CvUNTY OF NEW YORK' ss
t� � a �► On this 27`@ day of February, 2019, before me came the above-named officer for the Company
aforesaid; to me personally known to be the officer described in and who executed the preceding
nstrumerit , and he acknowedged the execution of the same, arid being by me duly sworn, deposes
I yc►�wun and says , that he is the officer of the Company aforesaid, that the seal affixed hereto Is the
tib
corporate seal of said Company, and the said corporate seal and his signature were duly affixed
/ . " i i and subscribed to said instrument by the authority and direction of said Company
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GER71FICATE s a'RMb r is. 2ou
1 , Laura B . Guy, Assistant Secretary of the Company, do hereby certify that the fcregoing s a fu 1, true and correct copy of the original power of attorney 'issued
by the Company; that the resolution Included therein is a true and correct transcript from tate minutes of the meetings of the boards of directors and the same has
not been revoked or amended in any manner; that said Antenio C. Albanese was on the date of the execution of the foregoing power of attorney the duty elected
officer of the Company. and the corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board
of directors ; and the foregoing power of attorney is still n full, farce and effect.
IN WITNESS WHEREOF , I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate seal of said Company this 18th day of
May _ 2421 __--
Assistant Secretary
BDJ 1 (02- 19)00
FORM OF BID OR PROPOSAL
FY 2021 SIDEWALK & TRAIL REPAIR PROGRAM — ZONE 1
CONTRACT NO. 1044
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 .
am&"p-n ann him LLC. , 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 F.Y. 2021 SIDEWALK & TRAIL
REPAIR PROGRAM — ZONE 1 , Contract No. 1044, all in accordance with the above-listed
documents and for the unitprices for work in place for the following items and quantities :
FY 2021 SIDEWALK & TRAIL REPAIR PROGRAM — ZONE 1
CONTRACT NO. 1044
SUDAS
SPECIFICATION
* SEE
BID SUPPLEMENTAL UNIT BID TOTAL BID
ITEM SP = SPCL PROV DESCRIPTION UNIT EST QTY PRICE PRICE
DIVISION 1 - CITY PROPERTIES
1 7030= 108-A-0 REMOVE SIDEWALK 2,430 . 6 SF $ $ VMS9t
2 7030= 108 -E-0 SIDEWALK, PCC, 4" 549. 5 SF $ 7o $ 15
3 7030= 108-E-0 SIDEWALK, PCC, 6" 1 , 881 . 1 SF $ 1 '� $
4 6010- 108-E-0 MANHOLE BOXOUT 1 . 0 EA $ co $
5 6010= 108 -E-0 MINOR MANHOLE ADJUSTMENT 1 . 0 EA $ LAmAim $ LAM. O
6 SP# 01 EROSION & SEDWENT CONTROL 1 . 0 LS $ $
7 8030408 -A-0 TRAFFIC CONTROL 1 . 0 LS $ ('(� $ 15LOCC,
FORM OF BID CONTRACT NO, 1044 Page 1 of 4
SURAS
SPECIFICATION
* SEE
BID SUPPLEMENTAL UNIT BID TOTAL BID
ITEM SP = SPCL PROV DESCRIPTION UNIT EST QTV PRICE PRICE
DIVISION 2 - ADA RAMP
REPAIRS
1 r7030408-A-0 REMOVE SIDEWALK 3 ,669 . 8 SF $ 3 � $ 3�
2 7030- 108 -E-0 SIDEWALK, PCC, 4 " 1 , 654. 8 SF $ $
3 7030= 108-E-0 SIDEWALK, PCC 6 " 11836.0 SF $ $
4 SP# 02 SIDEWALK CURB 26.6 LF $ @uco $ Co
DETECTABLE WARNING
5 7030- 108 -G-0 SURFACE 336. 0 SF $ CD $
6 7030- 108 -B-0 SAW CUT, 1 /2 " CURB OPENING 111 . 8 LF $ �] � GD $ 1
7 7040- 108-I-0 REMOVE CURB & GUTTER 179.4 LF $ y . OD $ II
8 7010- 108=E-0 CURB & GUTTER, 24", 6" 83 . 5 LF $ $
9 7010- 108 -E-0 CURB & GUTTER, 24 ", 9" 78 .2 LF $ tlJ $ m
10 7010- 108 -E-0 CURB & GUTTER, 24", 12" 17.7 LF $ $
11 7040- 108-H-0 REMOVE PAVEMENT 56. 7 SF $ �j.� $ 1 . 11
12 7040- 108 -A-0 PAVEMENT, HMA, 6" 56.7 SF $ , . LAD $ q 19 5$
13 2010- 108-E-0 EXCAVATION, CLASS 10 13929 .2 SF $ 3 )D $
14 9010- 108-C-0 HYDROSEEDING 15929.2 SF $ , brz> $ 1 , 5LA
15 SP# 01 EROSION & SEDIMENT CONTROL 1 . 0 LS $ co $ CO
16 8030= 108 =A-0 TRAFFIC CONTROL 1 . 0 LS $ $ dD
17 SP # 03 GUTTER DOWNSPOUT 1 . 0 LS $ $ ^ O. CD
DIVISION 3 - TRAIL REPAIRS
1 7030- 108=A-0 REMOVE SIDEWALK 211 . 0 SF $ $ 601 ,
2 7030- 108 -E-0 SIDEWALK, PCC, 6" 211 .0 SF $ IO� $ ItsaD
3 SP# 01 EROSION & SEDRVIENT CONTROL 1 . 0 LS $ $
4 8030= 108-A-0 TRAFFIC CONTROL 1 . 0 LS $ I $
DIVISION 4 -SIDEWALK INFILL
1 7030- 108-A-0 SIDEWALK REMOVAL 228.0 SF $ 3 ?1J $ yb
2 7030= 108-E-0 SIDEWALK, PCC, 4 " 2,254 .4 SF $ 50 $ 3�
Clb
3 7030= 108-E-0 SIDEWALK, PCC, 5 " 204. 3 SF $ $ ' LAC)
b1
4 7030= 108=E-0 SIDEWALK, PCC, 6" 286. 0 SF $ $ ( 9°b
5 7030= 108=G-0 DETECTABLE WARNING DEVICE 40. 0 SF
FORM OF BID CONTRACT NO. 1044 Page 2 of 4
SURAS
SPECIFICATION
* SEE
BID SUPPLEMENTAL UNIT BID TOTAL BID
ITEM SP = SPCL PROV DESCRIPTION UNIT EST QTY PRICE PRICE
DIVISION 4 —SIDEWALK INFILL
continued
9010- 108-C-0 HYDROSEEDING 2, 250. 0 SF $ . so $
6 r ,
7 7030= 108=B-0 SAW CUT1 /2 " CURB OPENING 21 . 0 LF $ Cb $
8 8030- 108-A-0 TRAFFIC CONTROL I .0 LS $ �, � $
EROSION AND SEDIMENT
9 SP # 01 CONTROL 1 . 0 LS $ $
10 7030408 -A-0 SIDEWALKREMOVAL 228 . 0 SF $ 30 $ yD
TOTAL DIVISIONS 1 , 29 3 & 4 $ �c> > 'Ay3 . 33
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 Dollars ($
in the form of 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 Resident Bidder Certification ( ), 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.
9 . The bidder has received the following Addendum or Addenda:
Addendum No . Date
FORM OF BID CONTRACT NO. 1044 Page 3 of 4
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 .
Lhyu k 'even OumAae�-► on . L.LC �C
(Name of Bidder) (Date)
BY: �L �VPxI Title (N) , Y
Official Address : (Including Zip Code) :
I.R. S . No.
FORM OF BID CONTRACT NO , 1044 Page 4 of 4
Bidder Status Form
To be completed by all bidders Part A
Please answer "Yes" or " No" for each of the following :
Yes ONo 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) .
Yes ® No My company has an office to transact business in Iowa .
Yes ® No My company 's office in Iowa is suitable for more than receiving mail , telephone calls , and e- mail .
Yes � No My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
Yes ONo 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. Please
complete Parts B and D of this form .
If you answered " No" to one or more questions above , your company is a nonresident bidder. Please
complete Parts C and D of this form .
To be completed by resident bidders Part B
My company has maintained offices in Iowa during the past 3 years at the following addresses :
Dates: �_ / _o / @U X to — / V aoAddress : IRA
City, State , Zip : Ae�n uo 71A . LAX
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 YesNo
force preferences or any other type of preference to bidders or laborers?
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 : ZbYCY`k. CObn r ACE i cin
Signature : Date : (.;7) 1 Is 1,�)
You must submit the completed form to the governmental body requesting bids per 876 Iowa Administrative Code
Chapter 166 . This form has been approved by the Iowa Labor Commissioner.
309-6001 (09- 15)
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of TDUJd )
County of ) ss cb `klJk )
I) rOck 'Even , being first duly sworn , deposes and says that :
1 . He is (Owner, Partner, Officer , Representative , or Agent) , of "LyU& LAIen
QoxtAn %M w , LLL` , the Bidder that has submitted the attached Bid ;
2 . He is fully- informed respecting the preparation and contents of the attached Bid and of all pertinent
circumstances respecting such Bid ;
3 , Such Bid is genuine and is not a collusive or sham Bid :
4 . Neither the said Bidder nor any of its officers , partners , owners , agents , representatives , employees , or
parties in interest , including this affiant, has in any way colluded , conspired , connived or agreed , directly or
indirectly , with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the
Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such
Contract , or has in any manner, directly or indirectly , sought by agreement or collusion or communication or
conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other
Bidder, or, to fix any overhead , profit or cost element of the bid price or the bid price of any other Bidder , or
to secure through any collusion , conspiracy , connivance , or unlawful agreement any advantage against the
City of Waterloo , Iowa , or any person interested in the Proposed Contract; and
5 . The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion ,
conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents , representatives ,
owners , employees , or parties in interest , including this affiant .
SPENCER WERFtiI AGE ;r
Piotarial Seal Iowa ( Signed )
ornmission Number (326617 VV
My Commission Expires Sep 21 , 2023
Title
Subscribed and sworn to before me this 2 � day of 120.4.
Tittle
My commission expires �� l � r 2j Z D 2J
MBE/WBE BUSINESS ENTERPRISE
PRE -BID CONTACT INFORMATION FORM
Prime Contractor Name : ;mck Eyep t^t`y6cu LILL
Project : FN 4DWI &AeuakK E -ra►1 irna►►- Amowam - 71kne I Letting Date : =moi aQ A �
Cornua Flo . IoLAy
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 beused =se e�k ot#sm portion of this form .
Contractor Signature :
Title :
Date : 52 1 /al -
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 MBEMBE 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
MBE/WBE Dates Dates Dollar Amount Proposed to
Subcontractors Contacted Yes/No Contacted Yes/No be Subcontracted
(Form CCO-4) Rev. 06-20-02
MBE/WBE BUSINESS ENTERPRISE
PRE- BID CONTACT INFORMATION FORM
NO MBE/WBE SUBCONTRACTORS EXPLANATION :
There are no MBE/WBE Subcontractors for the following :
Landscaping
- Saw Cutting
Concrete Removal
e--
Contractor Signature :
Title : bl6ner
Date :