HomeMy WebLinkAboutLodge Construction, Inc.LODGE
CONSTE JCTLQN, INC.
P.O. Box 459 CIA»IC: LLF: TA 50619
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CITY OF WATERLOO
CITY CLERK'S OFFICE
AUG 26 2021 PH 2:43 19
25
P.O. Box 459 f V iW 7 tat IA 50619
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CITY OF WATERLOO
CITY CLERK'S OFFICE
AUG 262021 pH12:43:22
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FORM OF =ID OR PROPOSAL
FY 2022 CENTER FOR T M`ARTS PARKING IMPROVEMENTS
PHASE 2 (ART BLOCK)
C NTRACT NO. 1007
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
1. The undersigned, beinga Corporation existingunder the laws of the State of TX , a
g p
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 2022 CENTER FOR
THE ARTS PARKING IMPROVEMENTS, PHASE 2 (ART BLOCK), City Contract No. 1007, all in
accordance with the above -listed documents and for the unit prices for work in place for the following
items and quantities:
FY 2022 CENTER FOR THE ARTS PARKING IMPROVEMENTS
PHASE 2 (ART BLOCK)
CITY CONTRACT NO. 1007
SUDAS
UNIT
TOTAL
BID
UNIT
PRICE
TOTAL
ITEM
DESCRIPTION
NO.
QTY.
BID
PRICE
SPEC.
1
2010
Clearing
and
Grubbing
LS
1
$ 5p0'
$ 3
j000
es
2
2010
Topsoil,
Furnish
and
Spread
CY
100.0
$ t-
$ ilifroe,
3
2010
CY
300
$ 1 7 -
$ rI
/ot' -".
Class
10
Excavation,
Roadway
and
Borrow
4
2010
Subgrade
Preparation
SY
4868.6
$ i
$ iv" %165
L-
5
2010
Subgrade
Treatment,
Geogrid
(Type
2)
SY
600.0
$
3 --'
$ /)t)ot
6
2010
Modified
Subbase
TONS
1610.3
$ ,2,;�
$ .35;
V26 �?�~
7
4040
189.0
$ /a'
$
—
�3�
Storm
2000D
Sewer,
(CLASS
Gravity
III),
15
Main,
IN.
Trenched,
RCP,C
LF
8
4040
Main,
Trenched,
RCP,
LF
24.0
$
C
$
l/
Storm
2000D
Sewer,
(CLASS
Gravity
III),
21
IN.
9
6010
Manhole
Adjustment,
Minor
6.0
$ J
I
$ &
M
s
EA
10
6010
Removal
of
Intakes
and
Utility
Accesses
4.0
$ I ,5-0
8
$
)y0v
3
EA
11
6010
Intake,
6010.502
1.0
$ 3)
79 0
$ 3)-75
4e
EA
12
6010
Intake,
6010.505
4.0
$
ciao&
$
$ kit/goo
S-
EA
13
7010
SY
4057.6
$
sD /
Cement
Standard
Concrete
Durability,
or
Pavement,
8
SlipForm
IN.
Class
Portland
C,
Class
3
a31;b33
14
7010
Removal
Pavement
SY
3396.7
'
$ 2377h
$ qS1(°"t
ultP
$
.7
of
15
7030
SY
30.7
$
Removal
of
Sidewalk
16
7030
SY
133.0
$
$
?jag,
Sidewalk,
PCC,
6
IN.
17
32 13
16
Tan
Colored
Sidewalk,
PCC,
6
IN.
SY
394.0
$
$
6/O7o
FORM OF BID OR PROPOSAL
AECOM #60661493
FB-1-4
City Contract Nol 1007
FY22 Center for the Arts Parking Improvements
Phase 2 (Art Block)
Waterloo, Iowa
ITEM
SUDAS
TOTAL
UNIT
TOTAL
DESCRIPTION
UNIT
BID
PRICE
NO.
SPEC.
CITY.
BID
PRICE
-
$ YY) 0,2U
18
32
13
16
Grey
Colored
Sidewalk,
PCC,
IN.
6
SY
284.0
$ /CS'
$ 9 Caw
19
8010
Lighting
Type
Poles,
1
EA
4.0
$ ye? 76
i
$ atligeos
$ 939SV
20
8010
Lighting
Poles,
Type
2
EA
4.0
$ 6)/06
'--
�'
21
8010
Lighting
Poles,
Type
3
EA
11.0
$ 39So
�
$ /to 1,4
z
22
8010
Electrical
CircuitsLF
926.0
$ 4�
`r
$ .3) yre, ,
23
8010
Handholes
EA
3.0
$
see
6
Painted
Pavement
Markings,
Waterborne
$ b / 75_
24
8020
or
STA
12.50
$
29
Solvent
-Based
Painted
Symbols
and
Legends,
Waterborne
E
25
8020
EA
4.0
$$
or
Solvent
-Based
yr
$ -
26
5020
Relocate
Hydrant
EA
1.0
$
00
27
8030
Traffic
Control
LS
1.0
$j -e/c
4e
$ 4s
$ �� jam&
28
9040
SWPPP
Management
LS
1.0
$ 32
0
_
29
9040
Wattles,
Installation
LF
110.0
$ 3
$ 33e
30
9040
Wattles,
Maintenance
LF
110.0
$ /
$
/%
$
97C .---
31
9040
Inlet
Protection
Device,
Installation
EA
11.0
$ j
$
46
32
9040
Inlet
Protection
Device,
Maintenance
EA
11.0
$
/3
33
10010
Removals,
As
Per
Plan
LS
1.0
$ ,mac "
$
heci & o
53
34
11020
Mobilization
LS
1.0
$ 35,c0
$ 356•0
$ocac
0
35
PLAN
Concrete
Bollard
Sign
with
EA
4.0
$ esse
r
36
PLAN
Concrete
Bollard
Sign
$
3, 67C
without
EA
7.0
$
se;?,j"
'
37
PLAN
Bed
$ �571%
Preparation
SF
5578.0
$ /
38
PLAN
Fabric
Washed
Stone
Mulch
and
Weed
Barrier
SF
5370
ic-
$ / -se-$
1 �, n.
J
$
W
Shredded
Cedar
Mulch
and
Weed
Barrier
�v
39
PLAN
Fabric
SF
208
$
$ `t)
�C
r
Groundcover
(Feather
Reed
Grass,
1-Gal.
40
PLAN
EA
196
$ J/
Cont.)
72
$ 937
41
PLAN
Groundcover
Dropseed,
(Prairie
1-Gal.
Cont.)
EA
38
$ /1
Groundcover
(Stella
D'Oro
Daylily,
1-Gal.
'�✓
$
42
PLAN
EA
56
$
Cont.Vr
Groundcover
(Warrior
Switchgrass,
1-Gal.
`P
$ , p
43
PLAN
EA
184
$
Cont.)
$ 9).2 702
44
PLAN
Shrub
(Gro-Low
Sumac,
3-Gal.
Cont.)
EA
89
$
ri
$
g at50
45
PLAN
Aspen,
Tree
(Quaking
1.5"
Cal
B&B)
EA
5
$
05-4;
--
$
led
46
PLAN
Tree
(Skyline
Honeylocust,
2.5"
Cal.
B&B)
EA
1
$
9372
$
l zr6
47
PLAN
Tree
(Spring
Snow
Crabapple,
1.5" Cal.
B&B)
EA
14
$
&
90 s
$
3
/T7
48
PLAN
Tree
Arborvitae,
B&B)
(Techny
4-5'
Spec
EA
15
$e`-
$ 26 J,5'G .
'-
49
PLAN
Bike
Racks
EA
5
$
9sz
$ 2
0 0U
50
PLAN
Waste
Receptacles
EA
1
$ G jj0O
$ J'1) liert7 se
51
PLAN
Benches
EA
7
$ .
13
$egg, 353 s$
TOTAL
BID
AMOUNT
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.
FORM OF BID OR PROPOSAL
AECOM #60661493
FB-2-4 FY22 Center for the Arts Parking Improvements
City Contract Nol 1007 Phase 2 (Art Block)
Waterloo, Iowa
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. C, .
4. Security in the sum of
Dollars ($ ) in the form of
�,t , 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 Bidders 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
g 6•---1;2 I
10. The bidder shall list the MBE/WBE subcontractor(s), amount of subcontracts and bid items on the
City of Waterloo Minority and/or Women Business Pre -bid Contact Information Form submitted with
this Form of Bid or Proposal. The apparent low Bidder shall submit a list of all other Subcontractor(s)
to be used on this Project to the City of Waterloo by 5:00 p.m. the business day following the day
Bids on this Project are due along with the Non -Collusion Affidavits of All Subcontractor(s).
The Contractor shall submit information on subcontractors on "SUBCONTRACTOR REQUEST AND
APPROVAL" Form to be provided by City prior to approval of contract.
The subcontractors listed on this proposal and/or submitted to the Contract Compliance Officer
cannot be changed except for the following reasons:
1) The City of Waterloo does not approve the subcontractors.
2) The subcontractors submit in writing that they cannot fulfill their subcontracts.
11. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none"
or "NA".
12 The bidder has attached all applicable forms.
FORM OF BID OR PROPOSAL FB 3-4
AECOM #60661493 City Contract Nol 1007
FY22 Center for the Arts Parking Improvements
Phase 2 (Art Block)
Waterloo, Iowa
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.
tdce (Los-kwclic/1/4
(Name of Bidder) (Date)
BY: �Okn,%.,, 5 Pwvt Title 4?54
( Y"}-~`TC�
Official Address: (Including Zip Code):
r($14 rr 61E
I.R.S. No.
ClLS\)1lC
)D/t sc�l7
97t, ary68A2—
FORM OF BID OR PROPOSAL FB-4-4 FY22 Center for the Arts Parking Improvements
AECOM #60661493 City Contract Nol 1007 Phase 2 (Art Block)
Waterloo, Iowa
NON=COLLUSION AFFIDAVIT OF PRIME BIDDER
State of
County of /At
teikittket ece tive-
)ss
, being first duly sworn, deposes and says that:
1. He is (Owner, Partner, Officer, Representative, or Agent) , of
, 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.
(Signed)
Subscribed and sworn to before me this
20 .
My commission expires Z'7aze,� /S v611.3
Q n tp
NON -COLLUSION AFFIDAVITS NCA-1 of 2
AECOM #60661493 City Contract No. 1007
day of
jetet-c4c117-
Title
Title
/hrt
%% A t LINDA K SENN
COMMISSION NO, 803307
MY COMMISSION EXPIRES
v
FY22 Center for the Arts Parking Improvements
Phase 2 (Art Block)
City of Waterloo, Iowa
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.
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,
EQUAL OPPORTUNITY CLAUSE EOC-1 of 2 FY22 Center for the Arts Parking Improvements
AECOM #60661493 City Contract No. 1007 Phase 2 (Art Block)
City of Waterloo, Iowa
subcontract or purchase order unless exempted by the rules, regulations or orders of the City's
Affirmative Action Program, and will provide in every subcontract, or purchase order that said
provisions will be binding upon each contractor, subcontractor, or supplier.
8. We, the undersigned, recognize that we are morally and legally committed to non-discrimination
in employment. Any person who applies for employment with our company will not be
discriminated against because of race, creed, color, sex, national origin, economic status, age,
mental or physical disabilities.
(Signed)
(Appropriate Official)
fr 5j/.- 4---e‘c ;
(Title)
f tQ6 s- 02 i
EQUAL OPPORTUNITY CLAUSE EOC-2 of 2
AECOM #60661493 City Contract No. 1007
(Date)
FY22 Center for the Arts Parking Improvements
Phase 2 (Art Block)
City of Waterloo, Iowa
iddcr Status Ihs rmm
To be completed by all bidders
aril
Please answer "Yes" or "No" for each of the following:
1
Yes
Yes
Yes
Yes
Yes
N o My company is authorized to transact business in Iowa.
(To help you determine if your company is authorized, please review the worksheet on the next page).
N o My company has an office to transact business in Iowa.
N o My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail.
N o My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
N o My company is not a subsidiary of another business entity or my company is a subsidiary of another
business entity that would qualify as a resident bidder in Iowa.
If you answered "Yes" for each question above, your company qualifies as a resident bidder. 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.
Pr
To be completed by resident bidders
Par
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates: /
/ to
/ 6 / 31 t Address:
City, State, Zip: a I Ks `k ci i,> �m- 5ark l/
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
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?
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.
Yes ■ No
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.
ti
f Lffc' tGl‘erk 1 Ic,
Firm Name:
Signature:
e
Date:
.e--(1/:
You mug 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)
BSF-1
Wo rksh e ,_,t: „ uthG rkatidon t. Transact Bushiness
This worksheet may be used to help complete Part A of the Resident Bidder Status form. If at least one of the following
describes your business, you are authorized to transact business in Iowa.
Yes 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 E(N 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.
cfries No
0
Yes
Yes
Yes No
My business is an active corporation with the Iowa Secretary of State and has paid all fees
required by the Secretary of State, has filed its most recent biennial report, and has not filed
articles of dissolution.
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.
Yes No My business is a limited partnership or limited liability limited partnership which has filed a
certificate of limited partnership in this state, and has not filed a statement of termination.
•
Yes MI No My business is a limited partnership or a limited liability limited partnership whose certificate of
limited partnership is filed in a state other than Iowa, the limited partnership or limited liability
limited partnership has received notification from the Iowa secretary of state that the application
for certificate of authority has been approved and no notice of cancellation has been filed by the
limited partnership or the limited liability limited partnership.
Yes ftiZ My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
Yes aid
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)
BSF-2
TITLE VI CIVIL RIGHTS
During the performance of this contract, the contractor (for itself), its assignees, and successors in
interest (hereinafter referred to as the "contractor") agrees as follows:
1. Compliance with Regulations: The contractor shall comply with the Regulations relative to non-
discrimination in Federally assisted programs of the DOT Title 49 Code of Federal Regulations,
Part 21, as they may be amended from time to time, (hereinafter referred to as the Regulations),
which are herein incorporated by reference and made a part of this contract.
2. Nondiscrimination: The contractor, with regard to the work performed by it during the contract,
shall not discriminate on the grounds of race, color national origin, sex, age, or disability in the
selection and retention of subcontractors, including procurement of materials and leases of
equipment. The contractor shall not participate either directly or indirectly in the discrimination
prohibited by section 21.5 of the Regulations, including employment practices when the contract
covers a program set forth in Appendix B of the Regulations
3. Solicitations for Subcontracts, Including Procurement of Materials and Equipment: In all
solicitations either by competitive bidding or negotiation made by the contractor for work to be
performed under a subcontract, including procurement of materials or leases of equipment, each
potential subcontractor or supplier shall be notified by the contractor of the contractor's
obligations under this contract and the Regulations relative to non-discrimination on the grounds
of race, color, national origin, sex, age, or disability.
4. Information and Reports: The contractor shall provide all information and reports required by the
Regulations or directives issued pursuant there to, and shall allow access to its books, records,
accounts, other sources of information, and its facilities as may be determined by the Contracting
Authority, the Iowa DOT, or FHWA to be pertinent to ascertain compliance with such Regulations
orders and instructions. Where any information required of a contractor is in the exclusive
possession of another who fails or refuses to furnish this information the contractor shall so certify
to the Contracting Authority, the Iowa DOT or the FHWA as appropriate, and shall set forth what
efforts it has made to obtain the information.
5, Sanctions for Noncompliance: In the event of the contractor's noncompliance with the
nondiscrimination provisions of this contract, the Contracting Authority, the Iowa DOT, or the
FHWA shall impose such contract sanctions as they may determine to be appropriate, including,
but not limited to:
a. Withholding of payments to the contractor under the contract until the contractor
complies, and/or
b. Cancellation, termination, or suspension of the contract, in whole or in part.
6. Incorporation of Provisions: The contractor shall include the provisions of paragraphs (1) through
(6) in every subcontract, including procurement of materials and leases of equipment, unless
exempt by the Regulations, or directives issued pursuant thereto. The contractor shall take such
action with respect to any subcontract or procurement as the Contracting Authority, the Iowa
DOT, or the FHWA may direct as a means of enforcing such provisions including sanctions for
non-compliance: Provided, however, that, in the event of a contractor becomes involved in, or it
threatened with, litigation with a subcontractor or supplier as a result of such direction, the
contractor may request the Contracting Authority or the Iowa DOT to enter into such litigation to
protect the interests of the Contracting Authority or the Iowa DOT; and, in addition the contractor
may request the United States to enter into such litigation to protect the interest of the United
States.
TITLE VI CIVIL RIGHTS TVI-1 of 1 FY22 Center for the Arts Parking Improvements
AECOM #60661493 City Contract No, 1007 Phase 2 (Art Block)
City of Waterloo, Iowa
Revised February 2003
CONTRACTOR'S OR SU;CONTRACTOR'S AFFIRMATIVE ACTION PROGRAM
Check box that applies to party completing program:
) General Contractor
Subcontractor
I. Section A to be completed by GENERAL CONTRACTORS only:
A.
Name of Company
Address of Company p-o•, 30X rstc��sijinip ✓��t6,
Telephone Number (A 629&
Federal ID Number (if no Federal ID Number, Owner/President's Social Security Number)
tote_ Cc---.5-41/L)
9 an
N ame of Equal Employment Officer 54COC le, geJ
N ame of Project e ki -er' Xcr C- RI KID
P roject Contract Number
/('‘'
Estimated Construction Work Dates /0.-/taea/ / �' � ` 9-
Start Finish
S ection B to be completed by SUBCONTRACTORS only:
B.
N ame of General or Prime Contractor
N ame of Subcontractor
S ubcontractor's Address Zip
S ubcontractor's Telephone Number ( )
S ubcontractor's Federal ID Number (if no Federal ID Number Owner/President's Social Security
N umber)
N ame of Equal Employment Officer
C. Remainder of program to be completed by party completing program, either Prime or
Subcontractor.
The Owners and/or Principals of your company:
Name
54.t.„
°<5c
Address
Pfr- Uct r‘i
Position
e facrit4.,1 14).T-
:;4 15
2 Other Areas of Interest:
Sex
Ethnic
Origin
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
Type of
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 t .�t o; qualification and/or merit system should be
evaluated and revised, if necessary.
D. We agree to put forth the maximu
capabilities and productivity of
national origin, economi
E.
(Nam
and employment oppo
feasible.
achieve full employment and utilization of
out regard to race, creed, color, sex,
cal handicap.
will give training
Iowa, to the greatest extent
III. AFFIRMATIVE
A.
B.
C.
P.O. BO' if R S•LW:,
effective application o a policy o
statement, and
will, therefore, re-evaluate
employment opportunities
encourage minorities, w
on this basis.
following six (
t the
cy
(Name of
mative Action Prog t�ii I tts, mum I
e on the basis of individual merit, and to actively
residents to seek employment with our company
LARKSW LL!.,
1. Minority Recruitment and E
2. Local Recruitment and Em
3. Disabled Veteran and Vie
4. Handicapped Recruitme
5. Female Recrui
6. Training, Upgr
50(19
nt;
ion Program:...
will undertake the
teran Recruitment and Employment;
ment;
es.
will take
whatever. steps are nee% 5 if alagliciPaRMAtattalWork force has adequate minority,
female, and local representation. We will utilize the following methods in our recruitment
attempts:
1. Local advertising m
2. Community organ
3. Public and pri
4. Job Se
5. Other.
papers, radio, TV);
urches, clubs, schools);
he area (UNI, Hawkeye Community College);
LA5061 and local group pplan s or a job cafe hand will make asserted efforts to increase
minority, female and group representation in occupations at the higher levels or skill and
responsibility.
will seek qualified minority, female,
E. All sources of employment used shall be aware that we are an Equal Employment
Opportunity Employer. Labor organizations representing our employees will be notified
of our Equal Employment Opportunity Policy and Affirmative Action Program.
F. Training, upgrading, promotion a
ensure that full consideration h
group employees.
G.
(Na
companies with who
assist them in their
r activities at all levels will be monitored to
ven to qualified minority, female, and local
OX 459 I CI ARKSVWLLF, IA 50619
will encourage other
iness, to do the same and we will
H.
has taken the following
Affirmative Actiog90 `-1 s tR4 AV, local contractors and/or suppliers were
provided opportunities to negotiate and/or bid on this project: (if none, write "NONE")
1.
2.
I. 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")
J.
1.
2.
Affirmative Action P
project and will t
contractors have a
total work force.
P.O.BOX 459jc
K. In further accordance with rules
11246 as amended, we establi
percentages supplied by the City
annual basis.
L.
will require approved
ractors who propose to work on this
no. sary to ensure that non -minority
�.`minor , female and local persons in their
1
Jf n5cPs�'�I sued pursuant to Executive Order
als for our company, based on parity
ealize these goals will be reviewed on an
will keep records of
specific actions relate `F .�, :; r{�,= - ,: 1•;_' """}'' <- fining, upgrading and promotion
• - r . "/ ' tie:.- _. __. -• .•,ram �i �►i,�.7�. , 7 � !G/[ s4 ,�. , 414 ' 7 -. -
and will provide the _;� - i•�=i,•.: on relative to same, including
.-
activities of our SUBC 019tit or when requested.
M. Parity figures for companies located
Minority Parity = .08 (8%
Employment Goals:
P.O. BOX 459 I CLARKSVILLE, IA 50619
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 202kplease submit percentage targets for employing minorities and women.
If you already have reached your target for hiring minorities and women, please submit
that percentage.
are as follows:
Affirmative Action
`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.
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:
tc'c
Company Executive
_ c a_ (
4-
Date
By: -1-evc.
Equal Employment
Opportunity Officer
Date
City of Waterloo Affirmative Action Officer
Approved
Disapproved Reason:
By:
Date:
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BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Lodge Construction, Inc.
as Principal, and North American Specialty Insurance Company
� s :;tire=ty are held and firmly bound unto the CITY Or WA i ERE_00 , Iowa, hereinafter called
"OWNER." In the penal sum ---Five Percent of the Bid Submitted ---
Dollars (S
) 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
°,A.heroas the Principal has submitted the accompanying bid dated the 26th day of August
, 2021 , for FY 2022 Center for the Arts Parking Improvements Phase 2 (Art Block)
Contract No. 1007, City of Waterloo, IA
NOW, THEREFORE,
(a) If said Bid shall be rejected, or in the alternate,
(b) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the form specified
and shall furnish a bond for his faithful performance of said contract, and for the payment of all ersow_>
performing labor or furnishing materials in connection therev1ith, ard shall in all other respects perform i 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 tI-IfT 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 whici3 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 17th day of August A.D.. 2021
Lodge Construction, Inc.
Principal
North American Specialty Insurance Comparyseal)
Surety
Witness
Attorney -in -fact Stacie Christensen
/VC/
(Seal)
(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. 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 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 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."
``,\tiwtttl•Iiftlri���li
0),.6v 743e., acet-
`fit SEAL n=
a:tele iQla�;'ttf
`t
1311/2:s tel• Itekt.41c"
1111111110
By
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 President of North American Specialty Insurance Company
& Senior Vice President of Westport Insurance Corporation
eih
r !Eder 1
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:
On this 3RD day of DECEMBER , 20 20, before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of
North American Specialty Insurance Company
Washington International Insurance Company
Westport Insurance Corporation
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
V. KEP.N'f
Notary ?ubtic State of :tli 3�•s•
h'fy Cornmissbn Crpkres
12402021
•
•
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 17thday of
August
2021
f ti
�- ../r
ar t-
-9�
Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company &
North American Specialty Insurance Company & Vice President & Assistant Secretary of Westport Insurance Corporation