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HomeMy WebLinkAboutLodge Construction, Inc.P.Q. Box 459 t CLARKSVILLE, IA 50619 CITY OF wfaiTERi 00 CITY CLERK'S OFFICE JUN 3 2021 PO 2' 4 _03 C Cle(IC lov)/tik 1"?' F)/ ,72.0:2 1 i3osideu g\IN askaLcA- n.iM." 0 J Ea BOX 459 I CLARKSVILLE, 150619 . _ 'rra-. e n iel ' r 14,4 C14( Clec Kam \AN: cid-k ek k RE (91'9‘ \i\ies4-eleL )31-a, le. „Act,* 99 7 ll `'' 211 T L OR PROPOSAL E S II _)ALE ilOSWALT TRACT IN!01, <`% 7 CHTY OF Honorable Mayor and City Council Waterloo, Iowa Gentlemen: 11,00, 0<<-:fllI, 1. The unde signed, 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 F.Y. 2021 wESI „ILIF: f}OOSWALE, Contract No. 997, all in accordance with the above listed documents and for the unit prices for work in place for the following items and quantities: Y. 2021 1 SIDAL E I;3O O SWALE CONTRACT IND. 997 BID ITEM 1 3 4 DESCRIPTION CLEARING & GRUBBING (VEGETATION) CLEARING & GRUBBING(Wlf_I.OWS) CLEARING & GRUBBING (TREES) TREE REMOVAL SNOW FENCE PROTECTION 36" DIA. STORM APRON — REMOVE & REINSTALL 36" DIA. STORM APRON — NFW 24" DIA. STORM APRON — REMOVE & REINSTALL 24" DIA. STORM APRON — NEW UNIT ACRES ACRES 0.37 EST. QTY. 0.61 ACRES EACH L I N FT EACH EACH 0.66 1.0 760.0 1.0 1.0 EACH EACH 1.0 �..0 UNIT BID PRICE $ 3. RSV Se 7 )51) � 53/00 rage $ 3)000 6bro $ VDU 375 TOTAL BID PRICE $ 02)30 $ 3)000 3oo0 � 330q0 ‘0.57 $ $ /)375" FORM OF BID CONTRACT NO. 997 Page 1 ©f 4 10 12" DIA. STORM APRON — REMOVE & REINSTALL 11 12" DIA. STORM APRON — NEW 12 24" DIA. RCP — REMOVE & REINSTALL 13 12" DIA. RCP — REMOVE & DISPOSE 14 CHAIN LINK FENCE — REMOVE at REPLACE 15 GRADING —WASTE REMOVAL 16 GRADING — NEW CI-IANNEL 17 GRADING — FILL AREAS EACH EACH LIN FT 1.0 1.0 20.0 LIN FT LIN FT CU YDS CU YDS 18 TOPSOIL — STOCKPILE & RESPREAD 19 36" DIA. STORM SEWER PIPE 244" DIA. STORM SEWER PIPE STORM SEWER MANHOLE — 60" DIA. (SW-401) SANITARY SEWER MANHOLE ADJUSTMENT PER PLAN SHEET 4 23 RETAINING WALLS 29 TURF REINFORCEMENT MAT (TRM CONCRETE FLOOR (FOREBAY) ENGINEERED SOIL CHOKER AGGREGATE STONE AGGREGATE CU YDS CU YDS LIN FT LIN FT EACH EACH LIN FT SQ YDS SQ FT 10.0 125.0 4.000.0 CU YDS TONS 720.0 880.0 2.0 2.0 165 110.0 610.0 113.3 8.0 TONS • 6" DIA. PERFORATED SUBDRAIN 30 6" DIA. SOLID SUBDRAIN 6" DIA. SOLID SUBDRAIN RISERS W/ 31 CAP 32 ENGINEERING FABRIC LIN FT LIN FT EACH / /Do 1) 374r $ /23 75" ee 11/ olg 023tr $ 5 7 $ ion- $ Immo $ 6 /613 61/ 7jear $ /Vol/ vor bAcbu 35sr $ 3o,sRs $ aao ti) 9 81.0$ 71 as 755.0 50.0 5.0 IN' $ ea° \s--) 757 /24aa .7/9Loo 33 GRANULAR SUBBASE 34 RIP RAP STONE SQ FT TONS TONS 450.0 164.2 20.0 /c$5. $ 02 eafrO 02,,a FORM OF BID CONTRACT NO. 997 Page2of4 EROSION CONTROL MAT 36 CHANNEL EROSION PROTECTION 37 CHANNEL EROSION PROTECTION MAINTENANCE 38 TEMPORARY SEEDING 39 APRON FOOTING 0 INTAKE PROTECTION SQ YDS LIN FTI EACH 850.0 426.0 4.0 $ 3 9)6151) $ ACRES EACH EACH 1.8 41 INTAKE PROTECTION MAINTENANCE EACH 4.0 TOTAL 2.0 4.0 A,75e0 $ ?c gao ;tigg--e $ 3P0 Qsle; $ A6Pylipi 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 Y a 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 Tye 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 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 510,000.00 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. FORM OF BID CONTRACT NO. 997 Page 3 of 4 9. The bidder has received the following Addendum or Addenda: Addendum No. I Date �' " 09- 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 pp 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 Su bcontractor(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. lC ac cfrui_4, (Name of bidder) (Date) Title 5.4 )&etc-r-/ d Official Address: (Including Zip Code): I.R.S. No. (5\kille 01/7 dago— FORM OF BID CONTRACT NO. 997 Page 4 of 4 NOWCOLLUSION AFFIDAVIT OF PRIME BIDDER State of Countyof1411< 1-- �-� K k\o‘14A-1. S t"- that: SS , being first duly sworn, deposes and says r 1. He is Owner Partner, Officer ij5 er sentative, or Agent) , of 147,6e Cc: k vi ti , 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; a. Such Bid is genuine and is not a collusive or sham Bid; J 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) Title Subscribed and sworn to before me this .3iA/ day of rYs , 20_. My commission expires a /, 3 LINDA K SENN COMMISSION NO. 803307 MY COMMISSION EXPIRES %aG/y; aZ3 NON -COLLUSION AFFIDAVIT CONTRACT NO. 1048 Page NCA 1 of 2 ROBINSON ENGINEERING FY 2021 WESTDALE BIOSWALE LANDSCAPING 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 EQUAL OPPORTUNITY CLAUSE CONTRACT NO. 1048 PAGE EOC 1 OF 2 ROBINSON ENGINEERING FY 2021 WESTDALE BIOSWALE LANDSCAPING Affirmative Action Program Contract Compliance Provisions relative to Resolution No. 24664. 6. In the event of the contractor's noncompliance with the nondiscrirnination clauses of this contract or with any of such rules, regulations and orders, this contract may be canceled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further contracts in accordance with procedures authorized by the City Council. 7. The contractor, subcontractor, vendor and supplier of goods and services will include, or incorporate by reference, the provisions of the non discrimination clause in every contract, subcontract or purchase order unless exempted by the rules, regulations or orders of the City's Affirmative Action Program, and will provide in every subcontract, or purchase order that said provisions will be binding upon each contractor, subcontractor, or supplier. 8. We, the undersigned, recognize that we are morally and legally committed to n on discrimination in employment. Any person who applies for employment with o ur company will not be discriminated against because of race, creed, color, sex, n ational origin, economic status, age, mental or physical disabilities. (Signed) lc-" (Appropriate Official) (Title) (Date) G-V EQUAL OPPORTUNITY CLAUSE CONTRACT NO. 1048 PAGE EOC 2 OF 2 ROBINSON ENGINEERING FY 2021 WESTDALE BIOSWALE LANDSCAPING Bidder Status Form To be completed by all bidders Part A PIe.. a answer "Yes" or "No" for each of the following: No 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). Dies ❑ No My company has an office to transact business in Iowa. %fie. ❑ 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. No 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. es Yes 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: � / � / I � to � � � / � l Address: PO, ,�0� 951 City, State, Zip: C to rs, nc 1-4 LiN-276 if 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 1. Name of home state or foreign country reported to the Iowa Secretary of State: Part C 2. Does your company's home state or foreign country offer preferences to resident bidders, resident labor Yes r or laborers? —Yes ■ No force preferences or any other type of preference to bidders 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: Lo6s-e. Ccw s•-hi/vl L Signature: __ Date: 4 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) orksheet: -authorization to Transact t+usiness 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. OiCes No My business is currently registered as a contractor with the Iowa Division of Labor. Yes No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. Yes o 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. es 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 Yes Yes Yes 0 Yes Yes ®Yes Ericio 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) ".1 a1 2 0 0 IX 0 r _• 0 V .}-I z a) 0 off Da. a. a) E 7 mt.') L 0 U E n_. 0 VJ as O c (0 W �- ('ram. = L O 0 Cri O O 0 0 0- rQ E c n 18 a`5i a) 0 (0S O ' ^ U O O 0 U 0 n V W c ifi co f' • 4- Oij z (1) Q. .0) 0 0 frn 0 0 ifi te ffl0 ai 0 r Cr ` 1 W k Contractor Signature: 0 <+J 0n\ 0) 0 fl `33 0 c *flan a) 0 c L O N 0) co U 0 0 E O 0 CO rrE 0 -a V) ('3 QSe ) O U a) ) 0 E 0 d V J cn erz .a 0) co O N Waterloo will make a irs as Q c. 0 ) E -a-a O V co V/ as O a) 45 w (/) • n uJ 1) (V :E; a) C L .52 c O c a) c a)i -' }0p� E co 2 V ) 0 Rra n n 1 • 0 J 0 kni !rn 4 L L-7 0 0 0-2 �DJ til V O ELI F J CJ `© j p ... • c) a rn g.i . O 1==3 �L 'I it5 a 0 Loi `j V 1 ir 0 0 ,0 tg r a)t:is OO pi ` n E (Th 0 ci \ s V V 1/ 5 -*I ri-) 21V1 j -iff= pi ' 1 8 --k ri-,Thi Lii (ID r 4 0 1 ofr 0 F`L \/ I b� 0 0 E EL Attachment 1 S `_' F Requh'ed FrontaEncl Sp, afic,athtns (This form must be completed and signed by Prime Con graGtOr and submitted with the bid.) U.S. Fnvironmental Protection Agency Certification o'a° 101111nSegregatod Facilities (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 establishments, 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 establishments, 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 terry "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 Tots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees 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 PROSMCTIVE SU 3C O NU U C T ORS or Riff,CUfl (,,RENT FOR Ci=RTIFICA HONS OF NONmS RELATED MCILI` II ,S A Certification of Non -segregated Facilities, as required by the May 9, 1967, order (33 F.I. 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). Signature Date n r \Am.\ 5e, Name and Title of Signer (Please Type) NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. EPA-7 5720-4.2 February 2021 Attachment 2 SRF Required Front k7 rdd Specitiic << idiorg (This form must be completed and signed by the Prime Contractor and submitted with the bid.) Debarments and Suspensi ns Anybidder or equipment supplier whose firm or affiliate is listed in on the U.S. General Services from the bidding Administration Excluded Parties List will be prohibitedgrocess. The excluded p parties records search engine is located at the System for Award Management (SAM) website: https://w ww.sarri.gov/SAM/. Pursuant to 2 CFR Part 180, as supplemented by 2 CFR 1532, any entity submitting a bid while the SAM website lists that entity as having an active exclusion will be determined by the DNR to be a nonresponsive bidder and will not be able to receive SRF funding. United States Environmental Protection Agency Washington, DC 20460 cer- ri ication Regarding Debarment, Suspen& ions awll Other Responsibility tatters 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 of 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 or 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 transactions (Federal, State, or local) terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. In addition, under 18 U SC Sec. 10 01, a false statement may result in a fine of up to $$10,000 or imprisonment for up to 5 years, or both. v\kA. B E.--3411_,Locfcv Typed Name & Title of Authorized Representative Signature of Authorized Representative Date am unable to certify to the above statements. My explanation is attached. February 2021 • Attachment 5 Mr Required ronty'End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid) PROHIBITION ION N Canal ` ELECC MMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR PIQUIPMENT This term and condition implements 2 CFR 200.216 and is effective for obligations and expenditures of EPA financial assistance funding on or after 8/13/2020. EPA recipients and subrecipients, including borrowers under EPA funded revolving loan fund programs, are prohibited from obligating or expending loan or grant funds to: (a) Procure or obtain, extend or renew a contract to procure or obtain; (b) Enter into a contract (or extend or renew a contract) to procure; or (c) Obtain the equipment, services, or systems that use "covered telecommunications equipment or services" identified in the regulation as a substantial or essential component of any system, or as critical technology as part of any system. Certain equipment, systems, or services, including equipment, systems, or services produced or provided by entities subject to the prohibition are recorded in the System for Award Management exclusion list, website: https:llwwrw►.san.ov/SAM/. (1) As described in Public Law 115,-232, section 889, covered telecommunications equipment or services includes: (i) Telecommunications equipment produced by I-luawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities). (ii) For the purpose of public safety, security of government facilities, physical security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hilcvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities). (iii) Telecommunications or video surveillance services provided by such entities or using such equipment. (iv) Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in consultation with the Director of the National Intelligence or the Director of the Federal Bureau of Investigation reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country. (2) Consistent with 2 CFR 200.471, costs incurred for telecommunications and video surveillance services or equipment such as phones, internet, video surveillance, and cloud servers are allowable except for the following circumstances: (i) Obligating or expending EPA funds for covered telecommunications and video surveillance services or equipment or services to procure (enter into, renew or extend contracts) or obtain the equipment, services, or systems as described in 2 CFR 200.216. understand the above prohibitions and certify that the project will be in compliance with all the requirements. 01/10. Typed Name & jitl9 of Authorized Representative 4 Signature of Authorized Representative tv-k/ Date February 2021 Revised February 2003 .CONTRA JR S OR SU CONTRACT = 9S AFHRIMIIIVE /1CTBON PROGRAM Check box that applies to party completing program: General Contractor Subcontractor I. Section A to be completed by GENERAL CONTRACTORS ORS only: A. N ame of Company toar,2- 5 Address of Company pu iv)/ vs--47 dip .5-0k ( / Telephone Number ( / ) , 42-9° Federal ID Number (if no Federal ID Number, Owner/President's Social Security Number) 117 deifrege9-- N ame of Equal Employment Officer N ame o7` Project \K\PykcteLle, Project Contract Number „.7 . eu e J cis .et. Estimated Construction Work Dates Start Finish Section B to be completed by SUBCON q RAC ORS, 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 S ocial Security Number) N ame of Equal Employment Officer C. Remainder of program to be completed by party completing program, either Prime or Subcontractor. AFFIRMATIVE ACTION CONTRACT NO. 1048 PAGE AA 1 OF 9 ROBINSON ENGINEERING FY 2021 WESTDALE BIOSWALE LANDSCAPING 1. The Owners and/or Principals of your company: Name itte Ethnic Address Position Sex Origin Cyr / Y LA, 1 tc \11\) le/k 508 � �7 2. 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: Name Address Type of Affiliation Decree 11. 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 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, u pgrading, 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. D. We agree to put forth the maximum effort to achieve full employment and u tilization of capabilities and productivity of all our citizens without regard to race, creed, color, sex, national origin, economic status, age, and mental or physical handicap. • E. 4017 r 14_5 44v`n (Name of Company) will give training AFFIRMATIVE ACTION CONTRACT NO. 1048 PAGE AA 2 OF 9 ROBINSON ENGINEERING FY 2021 WESTDALE BIOSWALE LANDSCAPING and employrnont opportunities to local residents of Waterloo, Iowa, to the greatest extent feasible. III. AFFIRMATIVE ACTION A. -. recognizes that the (Narne of Company) effective application of a policy of merit employment involves more than just a policy statement, and (4- r C C .1\ (Name of Company) will, therefore, reevaluate our Affirmative Action Program to ensure that equal employment opportunities are available on the basis of individual merit, and to actively encourage minorities, women and local residents to seek employment with our company on this basis. r,c, 'c Cc 1/ 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. C.2,"rc < < 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: D. 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. Ld C4$kLJCJVI-U 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. C�. 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. AFFIRMATIVE ACTION ROBINSON ENGINEERING FY 2021 WESTDALE BIOSWALE LANDSCAPING CONTRACT NO. 1048 PAGE AA 3 OF 9 F. Training, upgrading, promotion and transfer activities at all levels will be monitored to ensure that full consideration has been given to qualified minority, female, and local group employees. O. 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. H. Z• (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. 2. tu e has taken the following 1. 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") 2. Le CA J. /004e. CG[� 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. K. 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. -��'Ce � L will records of � keep (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%) N. Le/ts-i_ c_c �e�-�'r� i'� Affirmative Action (Name of Company) AFFIRMATIVE ACTION ROBINSON ENGINEERING FY 2021 WESTDALE BIOSWALE LANDSCAPING CONTRACT NO. 1048 PAGE AA 4 OF 9 Employment Goals: 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 1 O% 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 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). AFFIRMATIVE ACTION ROBINSON ENGINEERING FY 2021 WESTDALE BIOSWALE LANDSCAPING CONTRACT NO. 1048 PAGE AA 5 OF 9 Respectfully submitted, By: � Company Executive 9-1 2 Date By: 54e\i Lo Equal Employment Opportunity Officer 6r -f9 Date City of Waterloo Affirmative Action Officer Approved Disapproved Reason: By: Date: AFFIRMATIVE ACTION ROBINSON ENGINEERING FY 2021 WESTDALE BIOSWALE LANDSCAPING CONTRACT NO. 1048 PAGE AA 7 OF 9 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 3rd day of June 2021 , for FY 2021 Westdale Bioswale, Contract No. 997, Waterloo, IA . 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 fumish 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 27th day of May , An, 2021 By North Am r-ic By Witness Stacie Christensen Attor ey-in f- c Dione R. Young /1•1" Lodge Construction, Inc. (Seal) Principal n Specialty Insurance Company (Seal) urety , T if (Title) 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 laws of the State of New Hampshire and having its principal office in the City of Kansas City, Missouri, and Westport Insurance Corporation, 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. BAR I'ENHAGEN, 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 pros ided 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 Company 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 Secietary 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." • $tlUIINiUW,rrry SEAL t" rnr Steven P. Anderson, Senior Vice President of Washington international Insurance Company & Senior Vice President of North American Specialty Insurance Company & Senior Vice President of Westport Insurance Corporation By Mike A. Ito, Senior Vice President of Washington International Insurance Company &- Senior -Vice PresidentofNorth 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 On this 3RD day of DECEMBER , 20 20, before me, a Notary Public personally appeared ss: North American Specialty Insurance Company Washington International Insurance Company Westport Insurance Corporation 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. OFFICIAL SEAL IN KETN( Notary pubtic - State of ]Ii tois My Commission Cxprps 12042021 v 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 27thday of May 2021 . /,t sir Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company & North American Specialty Insurance Company & Vice President & Assistant Secretary of Westport Insurance Corporation