HomeMy WebLinkAboutS.M. Hertges & Sons Inc OATERI
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`n S.M. Hentges S.M. Hentges & Sons Inc.
& Sons Inca 650 Quaker Avenue, Suite 200
Jordan, MN 55352
W 952.492.5700 Fax 952.492.5705
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X City of Waterloo
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x 715 Mulberry Street
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F Waterloo IA 50703
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Bid Enclosed
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US Highway 63 Sanitary Sewer Upgrades- Phase 1
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Bids Due : Thursday , September 30 , 2021 @ 1 : 00 PM
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BID BOND
KNOW ALL MEN BY THESE PRESENTS , that we , S.M. Hentges & Sons Inc.
as Principal , and Liberty Mutual Insurance Company
as Surety are held and firmly bound unto the CITY OF WATERLOO Iowa , hereinafter called
"OWNER . " In the penal sum Five Percent (5 %) of Total Amount Bid-----------------------------------------------
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 30th day of September
20 21 for US HIGHWAY 63 SANITARY SEWER UPGRADES, PHASE I Contract No 1037
NOW, THEREFORE ,
(a ) If said Bid shall be rejected , or in the alternate ,
( b ) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the form specified
and shall furnish a bond for his faithful performance of said contract , and for the payment of all persons
performing labor or furnishing materials in connection therewith , and shall in all other respects perform the
agreement created by the acceptance of said Bid ,
Then this obligation shall be void , otherwise the same shall remain in force and effect ; it being expressly
understood and agreed that the liability of the Surety for any and all claims hereunder shall , in no event ,
exceed the penal amount of this obligation as herein stated .
By virtue of statutory authority, the full amount of this bid bond shall be forfeited to the Owner in liquidation
of damages sustained in the event that the Principal fails to execute the contract and provide the bond as
provided in the specifications or by law .
The Surety , for value received , hereby stipulates and agrees that the obligations of said Surety and its bond
shall be in no way impaired or affected by any extension of the time within which the Owner may accept
such Bid or execute such contract; and said Surety does hereby waive notice of any such extension .
IN WITNESS WHEREOF , the Principal and the Surety, have hereunto set their hands and seals , and such
of them as are corporations , have caused their corporate seals to be hereto affixed and these presents to
be signed by their proper officers this 21st day of September A . D . 2021 .
S.M. Hentges & Sons Inc. ( Seal )
rincipal
By O;r
/ (Title )
Liberty Mutual Insurance Company ( Seal )
Witness Surety
7' V VV1 VA I/ M/t/1�- - By
Witness Josh a R. Loftis, rA torney-in -fact
Bid Bond BB- 1 of 1 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo, Iowa
CORPORATE ACKNOWLEDGMENT
State of Minnesota )
) ss
County of Scott )
3 . : i r
On this sots, day of September 2021 , before me appeared N a p" NMP' VA�
to me personally known , who , being by me duly sworn , did say that he/she is the LBLAS Ine- s5 Ma � aa ,-
of S. M . Hentges & Sons Inc. a corporation , and that said instrument
was executed in behalf of said corporation by authority of its Board of Directors , and that said
tJ QAle- \A c v !�N e,� acknowledged said instrument to be the free act and deed of
said corporation .
JAMES JOHN KRABOWSKI
r���
Notary Public
State of Minnesota Notary Public H t-Cvn .-% n \.n County,
My Commission Ex irog
January 31 , 20 My commission expires � � � 31 -o Z5
SURETY ACKNOWLEDGMENT
State of Minnesota )
) ss
County of Hennepin )
On this 30th day of September 2021 before me appeared Joshua R. Loftis ,
to me personally know , who being by me duly sworn , did say that (s ) he is the Attorney-in - Fact of
Liberty Mutual Insurance Company , a corporation , that the seal
affixed to the foregoing instrument is the corporate seal of said corporation and that said instrument was
executed in behalf of said corporation by authority of its Board of Directors ; and that said
Joshua R . Loftis acknowledged said instrument to be the free act and deed of said corporation .
to
qL4 f"Olv`
r " >
SANDRA M ENGSTRUM
Notary Public Hennepin
NOTARYPUBLIt, = MINNESOTA County, Minnesota
C
M ommission Expires
M yJ'7'7� y" y January 31 , 2026 My commission expires 1 /31 /2026
d/
This Power of Attorney limits the acts of those named herein, and they have no authority to
T bind the Company except in the manner and to the extent herein stated.
Liberty Liberty Mutual Insurance Company
Mutual . The Ohio Casualty Insurance Company Certificate No: 8205072 -190054
10 SURETYWest American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS : That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Brian J.
Oestreich; Colby D. White; Emily White; Jerome T. Ouimet• Joshua R. Loftin Kurt C. Lundblad-, Lin Ulven • Melinda C Blodgett; Nathan Weaver; Nicole Stillings ; R
C . Bowman; R. W. Frank; Rachet Thomas; Ross S . Squires; Sandra M. Engstrum; Ted Jorgensen; Tina L. Don-task
all of the city of Minneapolis state of MN each individually if there be more than one named, its true and lawful attorney-in4act to make,
execute, seal , acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds , recognizances and other surety obligations, in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 22nd day of March 2021
Liberty Mutual Insurance Company
V IN31i �jy ln+s� %Nsup The Ohio Casualty Insurance Company
�JPC0 131 �n �a�'Gpr.P°'Za, y ¢ 4o�Okar9yCT West American Insurance Company
vi r 1912 y a Q 1919 0 LU M LU 1991 0
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Y�J1ysslCHusf ab Sd ��&AMe�s db !� 'NOigµP dh ??Lf /Jr ti`7! � 0
By : co
cu
cm State of PENNSYLVANIA ss David M . Carey, Assistant Secretary
aCounty of MONTGOMERY a )_
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42 = On this 22nd day of March 2021 before me personally appeared David M . Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance ai
0 5 Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such , being authorized so to do, execute the foregoing instrument for the purposes
a) > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. o
> �
c IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania , on the day and year first above written. Q
wO
Co a) / r u a O
i Y a y Common%walth of Pennsyt;an a ;rotary Seal
dj p rt ;; }.< 5. TeresaPasiella Notary Public
Q) '� tvlrutanm .ryG�urty ..� +��y E
O M tty uonvTussion expires March 28, 2025 B `i G( ( ( am O p
rro
Can=ssionnumber1126044 y • �
ktember. PenrsylvanaAssccistcq aNehanes eresaPastella, NotaryPublic Q o
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cThis Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual �0:
• — Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: I0 co
ARTICLE IV — OFFICERS : Section 12. Power of Attorney. °Q
06
o "T Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the
II > President may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety c
d
any anall undertakings, bonds, recognizances and other surety obligations. Such attorneys-in4act, subject to the limitations set forth in their respective powers of attorney, shall
o have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation . When so executed, such o m
Z 0 instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the co
provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. c )
I CL
ARTICLEXIII — Execution of Contracts : Section 5, Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, ;
shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings
bonds, recognizances and other surety obligations, Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in-
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed .
1, Renee C. Llewellyn, the undersigned , Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full , true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked .
IN TESTIMONY WHEREOF, I have hereunto set myhandand affixed the seals of said Companies this 30th day of September ,2021
Pv 1NSUp _ P,q`t iNSO,,p %NSU//
:J
11 1912 ry o z1919 � 0 91991 0
AL By
�C�J1�s`9ACHt1`� D . HA M45a 1hOIAMp' a
gv7 s � d Renee C. Llewellyn, Assistant Secretary
x
LMS-12673 LMIC OCIC WAIC Multi Co 02/21
I
Revised Per Addendum No . 1 - 9/24/2021
FORM OF BID OR PROPOSAL
US HIGHWAY 63 SANITARY SEWER UPGRADES — PHASE I
CITY OF WATERLOO , IOWA
CONTRACT NO . 1037
Honorable Mayor and City Council
Waterloo , Iowa
Gentlemen :
1 . The undersigned , being a Corporation existing under the laws of the State of !' L'�<
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 AECOM now on file in the office of the City Clerk , City Hall , Waterloo ,
Iowa , hereby proposes to furnish all supervision , technical personnel , labor, materials , machinery ,
tools , appurtenances , equipment, and services , including utility and transportation services required to
construct and complete the US HIGHWAY 63 SANITARY SEWER UPGRADES — PHASE I ,
CONTRACT NO . 1037 , all in accordance with the above- listed documents and for the unit prices for
work in place for the following items and quantities :
US HIGHWAY 63 SANITARY SEWER UPGRADES — PHASE I
CITY OF WATERLOO , IOWA
CONTRACT NO . 1037
Item SUDAS Unit Bid Total Bid
No . No . Description Unit Est. Qty. price Price
1 11 , 020 -A MOBILIZATION SUMP 1 . 0 $ 6 Z $� � P
2 8030-A TRAFFIC CONTROL SUM 1 . 0 $ Sd OOJst� $
3 2010- C CLEARING AND GRUBBING SUMP 1 . 0 $ b $ O
4 3010-B FOUNDATION ROCK TON 11660 . 0 $ f� 6" $ 7�x 76c�>
5 3010-F TRENCH COMPACTION TESTING LUMP to $ $
SUM / on oars /no cst�
6 4010- L ABANDON , FILL AND PLUG 21 - INCH LF 2 , 958 . 0 $ < < ` S�" m
SANITARY SEWER $ 6 �` 67H
7 4010- H REMOVE AND PLUG 21 - INCH LF 1 , 863 . 0 $ %�, , $
SANITARY SEWER
8 4010- K ABANDON SANITARY SEWER EA 9 . 0 $ $
MANHOLE �or� r'` ;7
9 6010- H REMOVE SANITARY SEWER MANHOLE EA 6 . 0 $ " `- $
jd_SO /60Gi�y�Lb
10 4060 CLEANING , INSPECTION AND TESTING LUMP 1 , 0 $ a> $
OF SANITARY SEWER GRAVITY MAINS SUM Zc� a Zo 6C�
11 4010-A-2 18- INCH SANITARY SEWER GRAVITY LF 1 , 123 . 5 $ - - $ 0
MAIN - DIRECTIONAL DRILLING6� �� Z I
24- INCH SANITARY SEWER GRAVITY $ /T..
12 4010-A- 1 MAIN - OPEN CUT LF 371 . 5 $ l J 7
13 4010 A- 1 48- INCH SANITARY SEWER GRAVITY MAIN - OPEN CUT LF 61213 . 0 $ � ✓ 6 ` $
14 4010-A-2 48- INCH SANITARY SEWER GRAVITY LF 342. 6 $ $
MAIN -TRENCHLESS �3� D6 '
15 6010-A 48- INCH CIRCULAR SANITARY SEWER EA 3 . 0 $ " ' $
MANHOLE , SW- 301 �� �O
Form of Bid FB- 1 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
Revised Per Addendum No . 1 - 9/24/2021
Item SUDAS Description Unit Est. Qty. Unit Bid Total Bid
No . No . Price Price
16 6010-A 72- INCH CIRCULAR SANITARY SEWER EA 1 . 0 $ $ 6°
MANHOLE , SW-301 7v 6C,6 76 6c�?
17 6010-A 84- INCH CIRCULAR SANITARY SEWER EA 1 . 0 $ aL $ � � 6
MANHOLE , SW-301 7v�Dc� 7�
18 6010-A 96- INCH CIRCULAR SANITARY SEWER EA 5 . 0 $ a $
MANHOLE , SW-301 � 6 moa g00 06p
19 6010-A 120- INCH CIRCULAR SANITARY EA 4 . 0 $ $
SEWER MANHOLE , SW-301 ��ooa ��d claa
20 6010 A 48- INCH TEE-SECTION SANITARY 0.
EA 11 $ bo $
SEWER MANHOLE , SW-305 go 330 de Qto60
21 6010-G CONNECTION TO EXISTING SANITARY EA 1 .
MANHOLE 0 $
Jd��o" $ baa
22 7010-A 6- INCH PCC PAVEMENT SY 25 . 4 $ $ 66
23 7010-A 8- INCH PCC PAVEMENT SY 373. 8 $ per`' $
24 7020- 13 8 - INCH HMA PAVEMENT SY 923 . 1 $ jdp °a $ 92 obo
25 7010- E 6 - INCH PCC CURB AND GUTTER LF 95 . 0 $ $ f3�daa
26 7030- H -2 GRAVEL SURFACING SY 260 . 0 $ Z,{ °1 $ Saabo
27 7030- 13 CURB AND GUTTER REMOVAL LF 95 . 0 $ 70ah $ /
/40�
28 7040-H PAVEMENT REMOVAL SY 1 , 582 . 3 $ frj $ Cya Qo
SEEDING , FERTILIZING AND
29 9010- B MULCHING FOR HYDRAULIC SEEDING ACRE 1 . 10
- TYPE 1 SEED MIX
SEEDING , FERTILIZING AND
30 9010- B MULCHING FOR HYDRAULIC SEEDING ACRE 7 . 11 $ u� bb
- TYPE 2 SEED MIX �6
SEEDING , FERTILIZING AND
31 9010-B MULCHING
SEED MIHYDRAULIC SEEDING ACRE 1 . 10 $ � $ 3 40. TYPE o
SEEDING , FERTILIZING AND
32 9010- B MULCHING FOR HYDRAULIC SEEDING ACRE 7 . 11 $ 2 6.50 `y $
- TYPE 5 SEED MIX
33 9040- F- 1 12- INCH WATTLES LF 81396 . 8 $ Sn $ 9 S
34 9040-G -2-a DITCH CHECKS EA 30 . 0 $ $ 3 SptS �
35 9040- E TEMPORARY ROLLED EROSION SY 27 , 477 . 3 $ J,9 $ g�
CONTROL PRODUCTS RECP I Zi'5
36 9040-A-2 SWPPP REQUIREMENTS SUMP 1 . 0 $ 67
�J . $ Z()
O oar'
SANITARY AND STORM SEWER DISCONNECT - DRAWINGS 10 -SS -01 THROUGH 10 -SS -06
37 6010-A STORM SEWER MANHOLE , SW-401 , EA 1 . 0 $ $ ter'
48- INCH , EJ 1040 A COVER 6o0a ( 6 �
38 6010-A STORM SEWER MANHOLE , SW-401 , EA 1 . 0 $
60- INCH , EJ 1040 A COVER 7�� 0 $ 7 Sd�
39 6010- B INTAKE , SW- 501 & SW-603 TYPE R EA 3 . 0 $
GRATE
40 6010- B INTAKE , SW-501 & SW-604 TYPE 6 EA 7 . 0 $
GRATE /O aob 7d oc
41 6010- G CONNECTION TO EXISTING STORM EA 1 . 0
SEWER STRUCTURE ZOOS Z �6
4030- B APRON WITH FOOTING AND GUARD ,
42 4030- C 12- INCH EA 1 . 0 $ fib $ 3 �a6 os
4030-C
4030- B APRON WITH FOOTING AND GUARD , 6a
F43T4030-C 18- INCH EA 1 . 0 $ $ Qa b
4030- D i
Form of Bid FB-2 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
Revised Per Addendum No . 1 - 9/24/2021
Item SUDAS Description Unit Est. Qty. Unit Bid Total Bid
No . No . Price Price
44 4020-A- 1 STORM SEWER , DUCTILE IRON PIPE , LF 24 .
10- INCH DIA. - OPEN CUT 6 $ $
! %' ''- /BZ
STORM SEWER , REINFORCED
45 4020-A- 1 CONCRETE PIPE , 12- INCH DIA . - OPEN LF 219 . 4 $ $ 7p
CUT
STORM SEWER , REINFORCED
46 4020-A- 1 CONCRETE PIPE , 15- INCH DIA . - OPEN LF 690 . 6 $ $
CUT ' Ai3 Z
STORM SEWER , REINFORCED
47 4020-A- 1 CONCRETE PIPE , 18- INCH DIA. - OPEN LF 253 . 8 $ J✓ $ /Z63,5� �
CUT
48 7010- E 6- INCH PCC CURB AND GUTTER LF 70 . 0 $ `� $
49 7030- H -2 GRAVEL SURFACING SY 14 . 5 $ ZS � $
50 7040- 1-1 PAVEMENT REMOVAL SY 1 , 221 . 0 $ $
51 6010- H REMOVE INTAKE EA 5 . 0 $ $ Jl�pvD
52 4020-G REMOVAL OF STORM SEWER LF 107 . 0 $ $ 3 TSS ba
53 7040-A 3- INCH HMA PATCH SY 356 . 0 $ $
54 2010- 1 6- INCH MODIFIED SUBBASE SY 356 . 0 $ Zd'" $ pia °D
55 9040-J EROSION STONE WITH ENGINEERING TONS 13 . 0 $ �� $
FABRIC /SO
56 9010- B HYDRAULIC SEEDING , FERTILIZING ACRE 0 .4 $ � � $
AND MULCHING i S ,
TOTAL AMOUNT BID $ �
2 . It is understood that the quantities set forth are approximate only and subject to variation and t 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
($ .S `'A ) in the form of EJ /.[D eo 4 .� is submitted herewith in accordance with
the INSTRUCTIONS TO BIDDERS .
5 . Attached hereto is a Non - Collusion Affidavit of Prime Contractor,
6 . Attached hereto is a Bidder Status Form indicating Resident Bidder Certification ( ) , or Non -
Resident Bidder Certification I ) . ( 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 9z/ /
-z e -G /
Form of Bid FB-3 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No , 1037 Waterloo , Iowa
Revised Per Addendum No . 1 = 9/24/2021
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 .
( Nam of Bidd r) (Date)
BY: Title Z�eejel "00
Official Address : ( Including Zip Code ) :
I . R . S . No . /C5/ i� (;L� 75
Form of Bid FB-4 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
AC®M
US Highway 63 Sanitary Sewer Upgrades —
Phase I
City of Waterloo , Iowa
City Contract No . 1037
AECOM #60651387
Prepared For.
City of Waterloo
715 Mulberry Street
Waterloo , Iowa 50703
Prepared By:
AECOM
501 Sycamore Street , Suite 222
P . O . Box 1497
Waterloo , Iowa 50704- 1497
September 2021
Attachment 1
SRF Required Front -End Specifications
(This form must be completed and signed by Prime Contractor and submitted with the bid)
U . S . Environmental Protection Agency
Certification of Non -Segregated Facilities
(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 term "segregated facilities "
means any waiting rooms , work areas , restrooms and washrooms , restaurants and other eating
areas , time clocks , locker rooms and other storage or dressing areas , parking lots , drinking
fountains , recreation or entertainment areas , transportation , and housing facilities provided for
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 PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR
CERTIFICATIONS OF NON -SEGREGATED FACILITIES
A Certification of Non -segregated Facilities , as required by the May 9 , 1967 , order (33
F . R . 7808 , May 28 , 1968 ) on Elimination of Segregated Facilities , by the Secretary of Labor,
must be submitted prior to the award of a subcontract exceeding $ 10 , 000 which is not exempt
from the provisions of the Equal Opportunity clause . The certification may be submitted either
for each subcontract or for all subcontracts during a period ( i . e . , quarterly, semiannually , or
annually) .
9 / 30 / 2021
Signature Date
Nate Hentges - Business Director
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 57204 . 2
SRFw2 January 2021
Attachment 2
SRF Required Front-End Specifications
(This form must be completed and signed by the Prime Contractor and submitted with the bid)
Debarments and Suspensions
Any bidder or equipment supplier whose firm or affiliate is listed in on the U . S . General Services
Administration Excluded Parties List will be prohibited from the bidding process . The excluded
parties records search engine is located at the System for Award Management (SAM ) website :
https : //www . sam . 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 non - responsive bidder and will not be able to receive SRF
funding .
United States Environmental Protection Agency Washington , DC 20460
Certification Regarding Debarment , Suspension , and
Other Responsibility Matters
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 .
Nate Hentges - Business Director
Typed Name & Title of Authorized Representative
9 / 30 / 2021
Signature of Authorized Representative Date
❑ I am unable to certify to the above statements . My explanation is attached .
SRF-3 January 2021
Attachment 3
SRF Required Front-End Specifications
(This form must be completed and signed by Prime Contractor and submitted with the bid)
Disadvantaged Business Enterprise ( DBE) Solicitation
It is EPA's policy that recipients of EPA financial assistance through the State Revolving Fund
programs award a "fair share " of subagreements to small , minority and women -owned
businesses , collectively know as Disadvantaged Business Enterprises ( DBEs ) . Iowa 's Fair
Share goals are :
Minority-Owned Business Women -Owned Business
Enterprise MBE Goal Enterprise (WBE ) Goal
Construction 1 . 7 % 2 . 2 %
Supplies 0 . 6 % 5 . 6 %
Services 2 . 5 % 11 . 3 %
Goods/Equipment 2 . 5 % 10 . 4 %
Average 1 . 8 % 7 . 4 %
Only work performed by certified DBEs can be counted toward the goals . In Iowa , DBEs must
be certified through the Iowa Department of Transportation ( IDOT) . Information on certification
requirements and a list of certified DBEs is on the IDOT website at
https : Hsecure . iowadot . gov/DBE/ Home/Index/.
Prime contractors ' DBE requirements for SRF projects include :
• Taking affirmative steps for DBE participation
• Documenting the efforts and the proposed utilization of certified DBEs
PROJECT INFORMATION
SRF Applicant : S . M . Hentges & Sons , Inc
Bidder: S . M . Hentges & Sons , Inc
Address : 650 Quaker Ave , Jordan MN 55352
Contact Person : Donna Kooiman
Signature : -
Phone Numbers 952 - 595 - 5107
E -Mail Address : officemanager@smhentges . com
Check if Prime Contractor is : ❑ Minority-Owned ❑ Women -Owned
SRF-4 January 2021
GOOD FAITH EFFORTS CHECKLIST
Please complete the checklist to determine if you have complied with the requirement to make
good faith efforts to ensure that certified DBEs have the opportunity to compete for
procurements funded by EPA financial assistance funds . Bidders/offerors must make good faith
efforts prior to submission of bids/proposals .
1 . Did you ensure that DBEs are made aware of contracting opportunities to the fullest extent
practicable through outreach and recruitment activities ? ❑X Yes ❑ No
2 . Did you make information on forthcoming opportunities available to DBEs and arrange time
frames for contracts and establish delivery schedules , where the requirements permit , in a way
that encourages and facilitates participation by DBEs in the competitive process ? This includes ,
whenever possible , posting solicitation for bids or proposals for a minimum of 30 calendar days
before the bid or proposal closing date . ❑X Yes ❑ No
3 . Did you consider in the contracting process whether firms competing for large contracts
could subcontract with DBEs ? This will include dividing total requirements , when economically
feasible , into smaller tasks or quantities to permit maximum participation by DBEs in the
competitive process . ❑X Yes ❑ No
4 . Did you encourage contracting with a consortium of DBEs when a contract is too large for
one of these firms to handle individually ? ❑x Yes ❑ No
5 . Did you use the services of the Small Business Administration and the Minority Business
Development Agency of the Department of Commerce to identify potential subcontractors ?
❑X Yes ❑ No
6 . List the potential DBE subcontractors that were contacted . Only list those that are certified
through the Iowa Department of Transportation .
Name How Contacted Response (e . g . did not respond ,
(e . g . letter, phone not interested , not competitive)
call , fax, e -mail
See Attached Solicitation List
PROPOSED UTILIZATION OF DBE SUBCONTRACTORS
Please include Attachments 4 and 5 to document the proposed utilization of certified DBE
subcontractors .
SRF-5 January 2021
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CONTRACT ADMINISTRATION PROVISIONS
Several contract provisions are required to prevent unfair practices that adversely affect DBEs .
These include :
1 . Prime Contractor must pay its Subcontractor for satisfactory performance no more than 30
days from the Prime Contractor' s receipt of payment from the SRF loan recipient .
2 . Prime Contractor must notify the SRF loan recipient in writing prior to termination of a DBE
subcontractor for convenience .
3 . Prime Contractor must employ the six Good Faith Efforts to solicit a replacement
subcontractor if a DBE subcontractor fails to complete work under a subcontract for any
reason .
SRF-6 January 2021
Attachment 4
SRF Required Front-End Specifications
(This form must be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid)
Disadvantaged Business Enterprise Program
DBE Subcontractor Performance Form
This form is intended to capture the DBE ' subcontractor' s2 description of work to be performed and the price of the work
submitted to the prime contractor. An EPA Financial Assistance Agreement recipient must require its prime contractor to
have its DBE subcontractors complete this form and include all completed forms in the prime contractor' s bid or proposal
package .
Subcontractor Name Project Name
Vutsefz CO U3 41 � w 63 S�� � r Sewer
Bid/Proposal No . Assistance Agreement ID No . Point of Contact
( if known )
Address
2 � l rs envy t° 2 v� r1 , 7
Telephone No . Email Address
Prime Contractor Name Issuing/Funding Entity
Contract Item Description of Work Submitted to the Prime Contractor Involving Price of Work Submitted to
Number Construction , Services , Equipment or Supplies the Prime Contractor
30 5eedCtn - rYr�' Z Z �1, 0156::46
3 , 5eec( i TY 04Cy pe
33 / �' V1 €s c>&
34 i Pik 1% Ch46W 3� 57
41
IV, I
i DBE Certified by — DOT SBA Meets/exceeds EPA certification standards?
Other: YES NO Unknown
'A DBE is a Disadvantaged, Minority , or Woman Business Enterprise that has been certified by an entity from which EPA accepts
certification as described in 40 CFR 33 . 204-33 . 205 or certified by EPA. EPA accepts certifications from entities that meet or exceed
EPA certification standards as described in 40 CFR 33 . 202 .
2Subcontractor is defined as a company , firm , joint venture , or individual who enters into an agreement with a contractor to provide
services pursuant to an EPA award of financial assistance .
IASRF61404 DBE Subcontractor Performance Form — Page 1
SRF- 7 January 2021
Disadvantaged Business Enterprise Program
DBE Subcontractor Performance Form
I certify under penalty of perjury that the forgoing statements are true and correct . Signing this form does not signify a
commitment to utilize the subcontractors above . I am aware of that in the event of a replacement of a subcontractor, I will
adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33 . 302 (c ) .
Prime Co r ctor Signature Print Name
Title Date
R
Subcontractor Signature Print Name
'44t Date
IASRF6100=3 DBE Subcontractor Performance Form — Page 2
I
SRF -8 January 2021
TI �= DT NURSERY F, F-ORESTRY SVG . LTD
? 41Q BR� M � R AV� NU�
`V'/AVF= RL_Y . lavYIA 90/677
P� 1�� ��� � � 31 ��� 35Z 0418 :AX ( 31Q) 35 ? 0400
DATE : 9/30/2021
PROJECT : US Highway 63 Sanitary Sewer Upgrades , Phase 1
Waterloo , IA
100% Will Apply to DBE Goal
ITEM NO . QTY DESCRIPTION UNIT UNIT PRICE TOTAL
29 1 . 10 Seeding , Fertilizing and Mulching for AC $5 , 500 . 00 $67050 . 00
Hydraulic Seeding - Type 1 Seed Mix
30 7 . 11 Seeding , Fertilizing and Mulching for AC $ 31500 . 00 $24 , 885 . 00
Hydraulic Seeding - Type 2 Seed Mix
31 1 . 10 Seeding , Fertilizing and Mulching for AC $3 , 500 . 00 $ 3 , 850 . 00
Hydraulic Seeding - Type 4 Seed Mix
32 7 . 11 Seeding , Fertilizing and Mulching for AC $23600 . 00 $ 183486 . 00
Hydraulic Seeding - Type 5 Seed Mix
33 8 , 396 . 8 12 " Wattles LF $ 3 . 10 $ 263030 . 08
34 30 Ditch Checks EA $ 125 . 00 $ 31750 . 00
35 27 ,477 . 3 Temporary Rolled Erosion Control SY $ 1 . 05 $ 28 , 851 . 17
Product ( RECP )
36 1 SWPPP Requirements LS $21500 . 00 $2 , 500 . 00
56 0 .4 Hydraulic Seeding , Fertilizing and AC $5$ 00 . 00 $ 29200 . 00
Mulching
Total $ 1161602 . 25
Notes
* Line Items Except Line Item 36 Include One Mobilization Each .
Additional Mobilizations Will Be Charged At $ 500 . 00 Each .
* Line Items Do Not Include Maintenance .
Q210WA00T
GETTING YOU THERE ))
January 25 , 2021
Vallarie Holm VIA ELECTRONIC MAIL
Tiedt Nursery, Ltd .
2419 E . Bremer Avenue
Waverly, IA 50677
RE : Affidavit of Continued DBE/ACDBE Certification Eligibility
Ms . Holm ,
This letter confirms receipt of your annual No Change Affidavit and supporting
documentation . The Iowa Department of Transportation ( Iowa DOT), in compliance
with 49 Code of Federal Regulations Part 26 (49 C . F . R. §§26 et seq . ) , is pleased to
inform you that your firm's information has been reviewed and approved . Your firm's
Disadvantaged Business Enterprise (DBE ) certification will remain valid for another
year.
The DBE Directory , located at hfgs ://secure. iowadot . .qov/DBE/Home/index/, will
continue to list your contact information and will include the following NAICS codes and
description of services performed :
NAICS Code : 237990 , 238990, 561730
Work Types : Erosion Control (Seed , Sod , Mat, and Silt Fence), Fencing , Herbicide
Application ; Landscaping (Trees and Shrubs), Mowing , and Retaining
Wails ; Supplier: Trees, Shrubs , Seed , Fertilizer, Erosion Control
Products, Plastic Tubing, and Fencing
As a DBE , you have the responsibility to comply with all aspects of 49 C. F . R. Part 26 ,
maintain an accurate mailing address and phone number with Iowa DOT and promptly
return all solicitation inquiries . If you have any questions, please contact this office.
Sincerely,
Danny Wagener
Civil Rights Compliance Officer
515-239- 1304 ® I Nikita . Rainey@iowadot. us Q Address *
I www . iowadot. gov 800 Lincoln Way, Ames, IA 50010
Attachment 4
SRF Required Front -End Specifications
(This form must be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid)
Disadvantaged Business Enterprise Program
DBE Subcontractor Performance Form
This form is intended to capture the DBE ' subcontractor's2 description of work to be performed and the price of the work
submitted to the prime contractor. An EPA Financial Assistance Agreement recipient must require its prime contractor to
have its DBE subcontractors complete this form and include all completed forms in the prime contractor's bid or proposal
package .
Subcontractor Name Project Name
US Hwy 63 Sanitary Sewer Upgrade - Phase 1
Bid/Proposal No . Assistance Agreement ID No . Point of Contact
( if known )
City Contract # 1037
Address
Telephone No . Email Address
Prime Contractor Name Issuing/Funding Entity
S . M . Hentges & Sons , Inc
Contract Item Description of Work Submitted to the Prime Contractor Involving Price of Work Submitted to
Number Construction , Services , Equipment or Supplies the Prime Contractor
DBE Certified by X DOT SBA Meets/exceeds EPA certification standards ?
Other: YES NO X Unknown
' A DBE is a Disadvantaged , Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts
certification as described in 40 CFR 33 . 204-33 . 205 or certified by EPA . EPA accepts certifications from entities that meet or exceed
EPA certification standards as described in 40 CFR 33 . 202 .
2Subcontractor is defined as a company, firm , joint venture , or individual who enters into an agreement with a contractor to provide
services pursuant to an EPA award of financial assistance .
IASRF6100 -3 DBE Subcontractor Performance Form — Page 1
SRF-7 January 2021
Disadvantaged Business Enterprise Program
DBE Subcontractor Performance Form
I certify under penalty of perjury that the forgoing statements are true and correct . Signing this form does not signify a
commitment to utilize the subcontractors above . I am aware of that in the event of a replacement of a subcontractor, I will
adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33 . 302 (c) .
Prime Contractor Signature Print Name
Nate Hentges
Title Date
Business Director 9 / 30 / 2021
Subcontractor Signature Print Name
Title Date
IASRF6100 -3 DBE Subcontractor Performance Form — Page 2
SRF-8 January 2021
Attachment 5
SRF Required Front-End Specifications
(This form must be completed and signed by Prime Contractor and submitted with the bid if utilizing DBE subcontractors)
Disadvantaged Business Enterprise Program
DBE Subcontractor Utilization Form
This form is intended to capture the prime contractor' s actual and/or intended use of identified certified DBE '
subcontractors2 and the estimated dollar amount of each subcontract . An EPA Financial Assistance Agreement Recipient
must require its prime contractors to complete this form and include it in the bid or proposal package . Prime contractors
should also maintain a copy of this form on file .
Prime Contractor Name Project Name
S . M . Hentges & Sons , Inc US Hwy 63 Sanitary Sewer Upgrade - Phase 1
Bid/Proposal No . Assistance Agreement ID No . Point of Contact
( if known )
City Contract # 1037 Nate Hentges
Address
650 Quaker Ave , Jordan MN 55352
Telephone No . Email Address
952 - 492 - 5700 Nate@smhentges . com
Issuing/ Funding Entity
I have identified potential DBE certified subcontractors
X YES NO
If yes , please com tete the table below . If no , please explain :
Subcontractor Company Address/Phone/Email Estimated Dollar Currently DBE
Name/Company Amount Certified ?
Name
L` /J�' .� 2 u i g cr��,f3.2 �.7 �< ,�v� G�u�c�J% , �f✓ 4 S
00 9
7;; ef a � c . Cis
. ,goc�
Continue on back if needed
' A DBE is a Disadvantaged , Minority , or Woman Business Enterprise that has been certified by an entity from which EPA accepts
certification as described in 40 CFR 33 . 204 -33 . 205 or certified by EPA. EPA accepts certifications from entities that meet or exceed
EPA certification standards as described in 40 CFR 33 . 202 .
2Subcontractor is defined as a company , firm , joint venture , or individual who enters into an agreement with a contractor to provide
services pursuant to an EPA award of financial assistance .
IASRF6100 -4 DBE Subcontractor Utilization Form — Page 1
SRF-9 January 2021
Attachment 5
SRF Required Front - End Specifications
(This form must be completed and signed by Prime Contractor and submitted with the bid if utilizing DBE subcontractors)
Disadvantaged Business Enterprise Program
DBE Subcontractor Utilization Form
This form is intended to capture the prime contractor' s actual and/or intended use of identified certified DBE '
subcontractors2 and the estimated dollar amount of each subcontract . An EPA Financial Assistance Agreement Recipient
must require its prime contractors to complete this form and include it in the bid or proposal package . Prime contractors
should also maintain a copy of this form on file .
Prime Contractor Name Project Name
S . M . Hentges & Sons , Inc US Hwy 63 Sanitary Sewer Upgrade - Phase 1
Bid/ Proposal No . Assistance Agreement ID No . Point of Contact
( if known )
City Contract # 1037 Nate Hentges
Address
650 Quaker Ave , Jordan MN 55352
Telephone No . Email Address
952 - 492 - 5700 Nate@smhentges . com
Issuing/Funding Entity
I have identified potential DBE certified subcontractors
X YES NO
If yes , please complete the table below . If no , please explain :
Subcontractor Company Address/Phone/Email Estimated Dollar Currently DBE
Name/Company Amount Certified ?
Name
Continue on back if needed
' A DBE is a Disadvantaged , Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts
certification as described in 40 CFR 33 . 204 -33 . 205 or certified by EPA . EPA accepts certifications from entities that meet or exceed
EPA certification standards as described in 40 CFR 33 . 202 .
2Subcontractor is defined as a company, firm , joint venture , or individual who enters into an agreement with a contractor to provide
services pursuant to an EPA award of financial assistance .
IASRF6100 -4 DBE Subcontractor Utilization Form — Page 1
SRF-9 January 2021
Disadvantaged Business Enterprise Program
DBE Subcontractor Utilization Form
I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a
commitment to utilize the subcontractors above . I am aware of that in the event of a replacement of a subcontractor, I will
adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33 . 302 (c) .
Prime Contractor Signature Print Name
Nate Hentges
Pt
Title Date
Business Director 9 / 30 / 2021
IASRF61004 DBE Subcontractor Utilization Form — Page 2
SRF- 10 January 2021
Attachment 6
SRF Required Front- End Specifications
(This form is for the voluntary use of DBE Subcontractors)
Disadvantaged Business Enterprise Program
DBE Subcontractor Participation Form
An EPA Financial Assistance Agreement Recipient must require its prime contractors to provide this form to its DBE
subcontractors . The use of this form by DBE subcontractors is voluntary and is not required for bidding. This form
gives a DBE ' subcontractor2 the opportunity to describe work received and/or report any concerns regarding the EPA-
funded project (e . g . in areas such as termination by prime contractor, late payments , etc . ) . The DBE subcontractor can ,
as an option , complete and submit this form to the EPA DBE Coordinator at any time during the project period of
performance .
Subcontractor Name Project Name
Bid/Proposal No . Assistance Agreement ID No . Point of Contact
(if known )
Address
Telephone No , Email Address
Prime Contractor Name Issuing/Funding Entity
Contract Item Description of Work Received from the Prime Contractor Involving Amount Received by
Number Construction , Services , Equipment or Supplies Prime Contractor
' A DBE is a Disadvantaged , Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts
certification as described in 40 CFR 33 . 204 -33 . 205 or certified by EPA. EPA accepts certifications from entities that meet or exceed
EPA certification standards as described in 40 CFR 33 . 202 .
2Subcontractor is defined as a company, firm , joint venture , or individual who enters into an agreement with a contractor to provide
services pursuant to an EPA award of financial assistance .
IASRF6100-2 DBE Subcontractor Participation Form — Page 1
SRF- 11 January 2021
Disadvantaged Business Enterprise Program
DBE Subcontractor Participation Form
Please use the space below to report any concerns regarding the above EPA-funded project :
Subcontractor Signature Print Name
Title Date
Return to : Regional Coordinator, Small Business Utilization , U . S . Environmental Protection Agency, Region 7 , 11201
Renner Blvd . , Lenexa , KS 66219
IASRF6100 -2 DBE Subcontractor Participation Form — Page 2
SRF- 12 January 2021
Attachment 7
SRF Required Front-End Specifications
Other Federal Requirements Language
A. Standard Federal Equal Employment Opportunity Construction Contract
Specifications ( Executive Order 11246)
1 . As used in these specifications :
a . " Covered area " means the geographical area described in the solicitation from which
this contract resulted ;
b . " Director" means Director, Office of Federal Contract Compliance Programs , United
States Department of Labor, or any person to whom the Director delegates authority;
C . " Employer identification number" means the Federal Social Security number used
on the Employer' s Quarterly Federal Tax Return , U . S . Treasury Department Form 941 .
d . " Minority" includes :
( i ) Black (all persons having origin in any of the Black African racial groups not of
Hispanic origin ) ;
( ii ) Hispanic (all persons of Mexican , Puerto Rican , Cuban , Central or South
American or other Spanish Culture or origin , regardless of race ) ;
( iii ) Asian and Pacific Islander ( all persons having origins in any of the original
peoples of the Far East , Southeast Asia , the Indian Sub- continent , or the Pacific
Islands ) ; and
( iv ) American Indian or Alaskan Native (all persons having origins in any of the
original peoples of North America and maintaining identifiable tribal affiliations
through membership and participation or community identification ) .
2 . Whenever the Contractor, or any Subcontractor at any tier subcontracts a portion of the
work involving any construction trade , it shall physically include in each subcontract in excess of
$ 10 , 000 the provisions of these specifications and the Notice which contains the applicable
goals for minority and female participation and which is set forth in the solicitations from which
this contract resulted .
3 . If the Contractor is participating ( pursuant to 41 CFR 64 . 5 ) in a Hometown Plan
approved by the U . S . Department of Labor in the covered area either individually or through an
association , its affirmative action obligations on all work in the Plan area ( including goals and
timetables ) shall be in accordance with that Plan for those trades which have unions
participating in the Plan . Contractors must be able to demonstrate their participation in and
compliance with the provisions of any such Hometown Plan . Each Contractor or Subcontractor
participating in an approved Plan is individually required to comply with its obligations under the
EEO clause , and to make a good faith effort to achieve each goal under the Plan in each trade
in which it has employees . The overall good faith performance by other Contractors or
Subcontractors toward a goal in an approved Plan does not excuse any covered Contractor' s or
Subcontractor's failure to take good faith efforts to achieve the Plan goals and timetables .
4 . The Contractor shall implement the specific affirmative action standards provided in
paragraphs 7a through p of these specifications . The goals set forth in the solicitation from
which this contract resulted are expressed as percentages of the total hours of employment and
training of minority and female utilization the Contractor should reasonably be able to achieve in
each construction trade in which it has employee in the covered area . Covered construction
contractors performing construction work in geographical areas where they do not have a
SRF- 13 January 2021
Federal or federally assisted construction contract shall apply the minority and female goals
established for the geographical area where the work in being performed . Goals are published
periodically in the Federal Register in notice form , and such notices may be obtained from any
Office of Federal Contract Compliance Programs office or from Federal procurement contracting
officers . The Contractor is expected to make substantially uniform progress in meeting its goals
in each craft during the period specified .
5 . Neither the provisions of any collective bargaining agreement, nor the failure by a union
with whom the Contractor has a collective bargaining agreement , to refer either minorities or
women shall excuse the Contractor' s obligations under these specifications , Executive Order
11246 , or the regulations promulgated pursuant thereto .
6 . In order for the nonworking training hours of apprentices and trainees to be counted in
meeting the goals , such apprentices and trainees must be employed by the Contractor during
the training period , and the Contractor must have made a commitment to employ the
apprentices and trainees at the completion of their training , subject to the availability of
employment opportunities . Trainees must be trained pursuant to training programs approved by
the U . S . Department of Labor.
7 . The Contractor shall take specific affirmative actions to ensure equal employment
opportunity . The evaluation of the Contractor' s compliance with these specifications shall be
based upon its effort to achieve maximum results from its actions . The Contractor shall
document these efforts fully , and shall implement affirmative action steps at least as extensive
as the following :
a . Ensure and maintain a working environment free of harassment , intimidation , and
coercion at all sites , and in all facilities at which the Contractor employees are assigned
to work . The Contractor, where possible will assign two or more women to each
construction project . The Contractor shall specifically ensure that all foremen ,
superintendents , and other on -site supervisory personnel are aware of and carry out the
Contractor' s obligation to maintain such a working environment, with specific attention to
minority or female individuals working at such sites or in such facilities .
b . Establish and maintain a current list of minority and female recruitment sources ,
provide written notification to minority and female recruitment sources and to community
organizations when the Contractor or its unions have employment opportunities
available and maintain a record of the organizations' responses .
c . Maintain a current file of the names , addresses and telephone numbers of each
minority and female off-the-street applicant and minority or female referral from a union ,
a recruitment source or community organization and of what action was taken with
respect to each such individual . If such individual was sent to the union hiring hall for
referral and was not referred back to the Contractor by the union or, if referred , not
employed by the Contractor, this shall be documented in the file with the reason
therefore , along with whatever additional actions the Contractor may have taken .
d . Provide immediate written notification to the Director when the union or unions with
which the Contractor has a collective bargaining agreement has not referred to the
Contractor a minority person or woman sent by the Contractor, or when the Contractor
has other information that the union referral process has impeded the Contractor's effort ,
to meet its obligations .
e . Develop on-the-job training opportunities and/or participate in training programs for
the area which expressly include minorities and women , including upgrading programs
and apprenticeship and trainee programs relevant to the Contractor' s employment
needs , especially those programs funded or approved by the Department of Labor. The
SRF- 14 January 2021
Contractor shall provide notice of these programs to the source complied under 7b
above .
f. Disseminate the Contractor' s EEO policy by providing notice of the policy to unions
and training programs and requesting their cooperation in assisting the Contractor in
meeting its EEO obligations ; by including it in any policy manual and collective
bargaining agreement ; by publicizing it in the company newspaper, annual report , etc . ;
by specific review of the policy with all management personnel and with all minority and
female employees at least once a year; and by posting the company EEO policy on
bulletin boards accessible to all employees at each location where construction work is
performed .
g . Review , at least annually , the company's EEO policy and affirmative action obligations
under these specifications with all employees having any responsibility for hiring ,
assignment , layoff, termination or other employment decisions including specific review
of these items with onsite supervisory personnel such as Superintendents , General
Foremen , etc . , prior to the initiation of construction work at any job site . A written record
shall be made and maintained identifying the time and place of these meetings , persons
attending , subject matter discussed , and disposition of the subject matter.
h . Disseminate the Contractor' s EEO policy externally by including it in any advertising in
the news media , specifically including minority and female news media , and providing
written notification to and discussing the Contractor's EEO policy with other Contractors
and Subcontractors with whom the Contractor does or anticipates doing business .
i . Direct its recruitment efforts , both oral and written , to minority, female and community
organizations , to schools with minority and female students and to minority and female
recruitment and training organizations serving the Contractor' s recruitment area and
employment needs . Not later than one month prior to the date for the acceptance of
applications for apprenticeship or other training by any recruitment source , the
Contractor shall send written notification to organizations such as the above , describing
the openings , screening procedures , and test to be used in the selection process .
j . Encourage present minority and female employees to recruit other minority persons
and women and , where reasonable , provide after school , summer and vacation
employment to minority and female youth both on the site and in other areas of a
Contractor's workforce .
k . Validate all tests and other selection requirements where there is an obligation to do
so under 41 CFR Part IBM .
1 . Conduct , at least annually , an inventory and evaluation at least of all minority and
female personnel for promotional opportunities and encourage these employees to seek
or to prepare for, through appropriate training , etc . , such opportunities .
m . Ensure that seniority practices , job classifications work assignments and other
personnel practices , do not have a discriminatory effect by continually monitoring all
personnel and employment related activities to ensure that the EEO policy and the
Contractor's obligations under these specifications are being carried out .
n . Ensure that all facilities and company activities are nonsegregated except that
separate or single- user toilet and necessary changing facilities shall be provided to
assure privacy between the sexes .
o . Document and maintain a record of all solicitations of offers for subcontracts from
minority and female construction contractors and suppliers , including circulation of
solicitations to minority and female contractor associations and other business
associations .
p . Conduct a review, at least annually, of all supervisors ' adherence to and performance
under the Contractor' s EEO policies and affirmative action obligations .
SRF- 15 January 2021
8 . Contractors are encouraged to participate in voluntary associations which assist in
fulfilling one or more of their affirmative action obligations ( 7a through p ) . The efforts of a
contractor association , joint contractor- union , contractor- community , or other similar group of
which the contractor is a member and participant , may be asserted as fulfilling any one or more
of its obligations under 7a through p of these Specifications provided that the contractor actively
participates in the group , makes every effort to assure that the group has a positive impact on
the employment of minorities and women in the industry , ensures that the concrete benefits of
the program are reflected in the Contractor's minority and female workforce participation , makes
a good faith effort to meet its individual goals and timetables , and can provide access to
documentation which demonstrates the effectiveness of actions taken on behalf of the
Contractor. The obligation to comply, however, is the Contractor' s and failure of such a group to
fulfill an obligation shall not be a defense for the Contractor' s noncompliance .
9 . A single goal for minorities and a separate single goal for women have been established .
The Contractor, however, is required to provide equal employment opportunity and to take
affirmative action for all minority groups , both male and female , and all women , both minority
and non- minority. Consequently , the Contractor may be in violation of the Executive Order if a
particular group is employed in a substantially disparate manner (for example , even though the
Contractor has achieved its goals for women generally , the Contractor may be in violation of the
Executive Order if a specific minority group of women is underutilized ) .
10 . The Contractor shall not use the goals and timetable or affirmative action standards to
discriminate against any person because of race , color, religion , sex , or national origin .
11 . The Contractor shall not enter into any Subcontract with any person or firm debarred
from Government contracts pursuant to Executive Order 11246 .
12 . The Contractor shall carry out such sanctions and penalties for violation of these
specifications and of the Equal Opportunity Clause , including suspension , termination and
cancellation of existing subcontracts as may be imposed or ordered pursuant to Executive
Order 11246 , as amended , and its implementing regulations , by the Office of Federal Contract
Compliance Programs . Any Contractor who fails to carry out such sanctions and penalties shall
be in violation of these specifications and Executive Order 11246 , as amended .
13 . The Contractor, in fulfilling its obligations under these specifications , shall implement
specific affirmative action steps at least as extensive as those standards prescribed in
paragraph 7 of these specifications so as to achieve maximum results from its efforts to ensure
equal employment opportunity . If the Contractor fails to comply with the requirements of the
Executive Order, the implementing regulations , or these specifications , the Director shall
proceed in accordance with 41 CFR 604 . 8 .
14 , The Contractor shall designate a responsible official to monitor all employment related
activity to ensure that the company EEO policy is being carried out, to submit reports relating to
the provisions hereof as may be required by the Government and to keep records . Records
shall at least include for each employee the name , address , telephone numbers , construction
trade , union affiliation if any , employee identification number when assigned , social security
number, race , sex , status (e . g . , mechanic, apprentice , trainee , helper, or laborer) , dates of
changes in status , hours worked per week in the indicated trade , rate of pay , and locations at
which the work was performed . Records shall be maintained in an easily understandable and
retrievable form ; however, to the degree that existing records satisfy this requirement ,
contractors shall not be required to maintain separate records .
SRF- 16 January 2021
15 . Nothing herein provided shall be construed as a limitation upon the application of other
laws which establish different standards of compliance or upon the application of requirements
for the hiring of local or other area residents ( e . g . , those under the Public Works Employment
Act of 1977 and the Community Development Block Grant Program ) .
Federal Register, Vol . 43 , No . 68 - Friday , April 7 , 1978 (Corrected May 5 , 1978 ) .
Effective Date : May 8 , 1978
Federal Register, Vol . 45 , No . 194 . Paragraph 4 , revised October 3 , 1980
Effective Date : September 30 , 1980
APPENDICES A and 13 -80
Notice of Requirement for Affirmative Action to Ensure Equal Employment Opportunity
( Executive Order 11246 )
1 . The Offerors or Bidder' s attention is called to the " Equal Opportunity Clause " and the
" Standard Federal Equal Employment Specifications " set forth herein .
2 . The goals and timetables for minority and female participation , expressed in percentage
terms for the Contractor' s aggregate workforce in each trade on all construction work in
the covered area , are as follows :
( See Appendix 13- 80 and Appendix A Below )
These goals are applicable to all the Contractor' s construction work (whether or not it is Federal
or federally assisted ) performed in the covered area . If the contractor performs construction
work in a geographical area located outside of the covered area , it shall apply the goals
established for such geographical area where the work is actually performed . With regard to this
second area , the contractor also is subject to the goals for both its federally involved and non -
federally involved construction .
The Contractor' s compliance with the Executive Order and in the regulations in 41 CFR Part
60-4 shall be based on its implementation of the Equal Opportunity Clause , specific affirmative
action obligations required by the specifications set forth in 41 CFR 60-4 . 3 ( a ) , and its efforts to
meet the goals . The hours of minority and female employment and training must be
substantially uniform throughout the length of the contract , and in each trade , and the contractor
shall make a good faith effort to employ minorities and women evenly on each of its projects .
The transfer of minority or female employees or trainees from Contractor to Contractor or from
project to project for the sole purpose of meeting the Contractor' s goals shall be a violation of
the contract , the Executive Order and the regulations in 41 CFR Part 60-4 . Compliance with
the goals will be measured against the total work hours performed .
3 . The Contractor shall provide written notification to the Director of the Office of Federal
Contract Compliance Programs within 10 working days of award of any construction
subcontract in excess of $ 10 , 000 at any tier for construction work under the contract
resulting from this solicitation . The notification shall list the name , address and telephone
number of the subcontractor, employer Identification number of the subcontractor,
estimated dollar amount of the subcontract , and the geographical area in which the
subcontract is to be performed .
SRF- 17 January 2021
4 . As used in this Notice , and in the contract resulting from this solicitation , the " covered
area " is ( State of Iowa ) .
APPENDIX A
The following goals and timetables for female utilization shall be included in all Federal and
federally assisted construction contracts and subcontracts in excess of $ 10 , 000 . The goals are
applicable to the contractor' s aggregate on -site construction workforce whether or not part of
that workforce is performing work on a Federal or federally assisted construction contract or
subcontract .
Area covered : Goals for Women apply nationwide .
Timetable Goals ( percent)
From Apr. 1 , 1978 until March 31 , 1979 . . . . . . . 3 . 1
From Apr. 1 , 1979 until March 31 , 1980 . . . 0 . 4 . 5 . 0
From Apr. 1 , 1980 until March 31 , 1981 . , . . . . . 6 . 9
Published , Federal Register May 5 , 1978
APPENDIX B -80
Until further notice , the following goals for minority utilization in each construction craft and trade
shall be included in all Federal or federally assisted construction contracts and subcontracts in
excess of $ 10 , 000 to be performed in the respective geographical areas . The goals are
applicable to each nonexempt contractor' s total onsite construction workforce , regardless of
whether or not part of that workforce is performing work in a Federal , federally assisted or
nonfederally related project , contract or subcontract . Construction contractors which are
participating in an approved Hometown Plan (see 41 CFR 60-4 . 5 ) are required to comply with
the goals of the Hometown Plan with regard to construction work they perform in the area
covered by the Hometown Plan . With regard to all their other covered construction work , such
contractors are required to comply with the applicable SMSA of EA goal contained in this
appendix B - 80 .
SRF- 18 January 2021
Economic Areas
State : Iowa Goal %
096 Dubuque IA :
SMSA Counties :
2200 Dubuque , IA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 6
IA Dubuque
Non - SMSA
Counties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 5
IA Allamakee , IA Clayton , IA Delaware , IA , Jackson IA , Winneshiek
099 Davenport Rock Island Moline , IA- IL :
SMSA Counties :
1960 Davenport Rock Island Moline , IA- IL . . . . . . . . 4 . 6
IL Henry , IL Rock Island Moline , IA Scott
Non - SMA
Counties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . 4
IL Carroll , IL Hancock , IL Henderson , IL , Mercer, IL Whiteside , IA Clinton , IA Des
Moines , IA Henry , IA Lee , IA Louisa , IA , Muscatine , MO Clark
100 Cedar Rapids , IA :
SMSA Counties :
1360 Cedar Rapids , IA . . . . . . . . . . . . . . . . . . . . . . . . 1 . 7
IA Linn
Non -SMSA Counties . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . 5
IA Benton , IA Cedar , IA Iowa , IA Johnson , IA , Jones , IA , Washington
101 Waterloo , IA:
SMSA Counties :
8920 Waterloo- Cedar Falls , IA . . . . . . . . . . . . . . . 4 . 7
IA Black Hawk
Non - SMSA Counties . . . . . . . . . . . . . . . . . . . . . . . . . . 2 . 0
IA Bremer, IA Buchanan , IA Butler, IA Cerro Gordo , IA Chickasaw, IA Fayette , IA Floyd ,
IA Franklin , IA Grundy, IA Hancock , IA Hardin , IA Howard , IA Mitchell , IA Winnebago , IA
Worth
102 Fort Dodge , IA :
Non -SMSA Counties . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 4
IA Buena Vista , IA Calhoun , IA Carroll , IA Clay , IA Dickinson , IA Emmet , IA Greene , IA
Hamilton , IA Humboldt , IA Kossuth , IA Palo Alto , IA Pocahontas , IA Sac , IA Webster, IA
Wright
103 Sioux City, IA:
SMSA Counties :
7720 Sioux City , IA- NE . . . . . . . . . . . . . . . . . . . . . . . . 1 . 9
IA Woodbury , NE Dakota
SRF- 19 January 2021
Non - SMSA Counties . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . 2
IA Cherokee , IA Crawford , IA Ida , IA Monona , IA O ' Brien , IA Plymouth , IA Sioux , NE
Antelope , NE Cedar, NE Cuming , NE Dixon , NE Knox , NE Madison , NE Pierce , NE
Stanton , NE Thurston , NE Wayne , SD Bon Homme , SD Clay, SD Union , SD Yankton
104 Des Moines , IA :
SMSA Counties :
2120 Des Moines , IA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . 5
IA Polk , IA Warren
Non SMSA Counties : 2 . 4
IA Adair , IA Appanoose , IA Boone , IA Clarke , IA Dallas , IA Davis , IA Decatur, IA Guthrie ,
IA Jasper, IA Jefferson , IA Keokuk , IA Lucas , IA Madison , IA Mahaska , IA Marion , IA
Marshall , IA Monroe , IA Poweshiek , IA Ringgold , IA Story , IA Tama , IA Union , IA Van
Buren , IA Wapello , IA Wayne
143 Omaha , NE :
SMSA Counties :
5920 Omaha , NE- IA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 . 6
IA Pottawattamie , NE Douglas , NE Sarpy
Non - SMSA Counties . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 . 3
IA Adams , IA Audubon , IA Cass , IA Fremont, IA Harrison , IA Mills , IA Montgomery , IA
Page , IA Shelby , IA Taylor, NE Burt , NE Cass , NE Colfax , NE Dodge , NE Platte , NE
Saunders , NE Washington
Published , Federal Register October 3 , 1980
B . Federal Labor Standards Provisions ( including Davis -Bacon prevailing wage rates)
Applicability
The Project or Program to which the construction work covered by this contract pertains is being
assisted by the United States of America and the following Federal Labor Standards Provisions
are included in this Contract pursuant to the provisions applicable to such Federal assistance .
( 1 ) Minimum wages . ( i ) All laborers and mechanics employed or working upon the site of the
work will be paid unconditionally and not less often than once a week , and without subsequent
deduction or rebate on any account ( except such payroll deductions as are permitted by
regulations issued by the Secretary of Labor under the Copeland Act (29 CFR part 3 ) ) , the full
amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of
payment computed at rates not less than those contained in the wage determination of the
Secretary of Labor which is attached hereto and made a part hereof, regardless of any
contractual relationship which may be alleged to exist between the contractor and such laborers
and mechanics . Contributions made or costs reasonably anticipated for bona fide fringe benefits
under section 1 ( b ) (2 ) of the Davis- Bacon Act on behalf of laborers or mechanics are considered
wages paid to such laborers or mechanics , subject to the provisions of paragraph (a ) ( 1 ) ( iv) of
this section ; also , regular contributions made or costs incurred for more than a weekly period
( but not less often than quarterly) under plans , funds , or programs which cover the particular
weekly period , are deemed to be constructively made or incurred during such weekly period .
Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the
wage determination for the classification of work actually performed , without regard to skill ,
SRF-20 January 2021
except as provided in Sec . 5 . 5 (a ) (4 ) . Laborers or mechanics performing work in more than one
classification may be compensated at the rate specified for each classification for the time
actually worked therein : Provided that , the employer' s payroll records accurately set forth the
time spent in each classification in which work is performed . The wage determination ( including
any additional classification and wage rates conformed under paragraph ( a ) ( 1 ) ( ii ) of this section )
and the Davis- Bacon poster (WH - 1321 ) shall be posted at all times by the contractor and its
subcontractors at the site of the work in a prominent and accessible place where it can be easily
seen by the workers .
( ii ) (A) The contracting officer shall require that any class of laborers or mechanics , including
helpers , which is not listed in the wage determination and which is to be employed under the
contract shall be classified in conformance with the wage determination . The contracting officer
shall approve an additional classification and wage rate and fringe benefits therefore only when
the following criteria have been met :
( 1 ) The work to be performed by the classification requested is not performed by a
classification in the wage determination ; and
(2 ) The classification is utilized in the area by the construction industry ; and
( 3 ) The proposed wage rate , including any bona fide fringe benefits , bears a reasonable
relationship to the wage rates contained in the wage determination .
( B ) If the contractor and the laborers and mechanics to be employed in the classification ( if
known ) , or their representatives , and the contracting officer agree on the classification and wage
rate ( including the amount designated for fringe benefits where appropriate ) , a report of the
action taken shall be sent by the contracting officer to the Administrator of the Wage and Hour
Division , Employment Standards Administration , U . S . Department of Labor, Washington , DC
20210 . The Administrator, or an authorized representative , will approve , modify, or disapprove
every additional classification action within 30 days of receipt and so advise the contracting
officer or will notify the contracting officer within the 30 -day period that additional time is
necessary .
( C ) In the event the contractor, the laborers or mechanics to be employed in the classification
or their representatives , and the contracting officer do not agree on the proposed classification
and wage rate (including the amount designated for fringe benefits , where appropriate ) , the
contracting officer shall refer the questions , including the views of all interested parties and the
recommendation of the contracting officer, to the Administrator for determination . The
Administrator, or an authorized representative , will issue a determination within 30 days of
receipt and so advise the contracting officer or will notify the contracting officer within the 30 -day
period that additional time is necessary.
( D ) The wage rate ( including fringe benefits where appropriate ) determined pursuant to
paragraphs ( a ) ( 1 ) ( ii ) ( B ) or ( C ) of this section , shall be paid to all workers performing work in the
classification under this contract from the first day on which work is performed in the
classification .
( iii ) Whenever the minimum wage rate prescribed in the contract for a class of laborers or
mechanics includes a fringe benefit which is not expressed as an hourly rate , the contractor
shall either pay the benefit as stated in the wage determination or shall pay another bona fide
fringe benefit or an hourly cash equivalent thereof.
( iv ) If the contractor does not make payments to a trustee or other third person , the contractor
may consider as part of the wages of any laborer or mechanic the amount of any costs
reasonably anticipated in providing bona fide fringe benefits under a plan or program , Provided ,
That the Secretary of Labor has found , upon the written request of the contractor, that the
applicable standards of the Davis- Bacon Act have been met . The Secretary of Labor may
require the contractor to set aside in a separate account assets for the meeting of obligations
under the plan or program .
SRF-21 January 2021
( 2 ) Withholding . The EPA shall upon its own action or upon written request of an authorized
representative of the Department of Labor withhold or cause to be withheld from the contractor
under this contract or any other Federal contract with the same prime contractor, or any other
federally- assisted contract subject to Davis - Bacon prevailing wage requirements , which is held
by the same prime contractor, so much of the accrued payments or advances as may be
considered necessary to pay laborers and mechanics , including apprentices , trainees , and
helpers , employed by the contractor or any subcontractor the full amount of wages required by
the contract . In the event of failure to pay any laborer or mechanic , including any apprentice ,
trainee , or helper , employed or working on the site of the work , all or part of the wages required
by the contract , the EPA may , after written notice to the contractor, sponsor , applicant , or
owner, take such action as may be necessary to cause the suspension of any further payment ,
advance , or guarantee of funds until such violations have ceased .
( 3 ) Payrolls and basic records . ( i ) Payrolls and basic records relating thereto shall be
maintained by the contractor during the course of the work and preserved for a period of three
years thereafter for all laborers and mechanics working at the site of the work . Such records
shall contain the name , address , and social security number of each such worker , his or her
correct classification , hourly rates of wages paid ( including rates of contributions or costs
anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in
section 1 ( b ) (2 ) ( B ) of the Davis- Bacon Act ) , daily and weekly number of hours worked ,
deductions made and actual wages paid . Whenever the Secretary of Labor has found under 29
CFR 5 . 5 ( a ) ( 1 ) ( iv ) that the wages of any laborer or mechanic include the amount of any costs
reasonably anticipated in providing benefits under a plan or program described in section
1 ( b ) (2 ) ( B ) of the Davis - Bacon Act , the contractor shall maintain records which show that the
commitment to provide such benefits is enforceable , that the plan or program is financially
responsible , and that the plan or program has been communicated in writing to the laborers or
mechanics affected , and records which show the costs anticipated or the actual cost incurred in
providing such benefits . Contractors employing apprentices or trainees under approved
programs shall maintain written evidence of the registration of apprenticeship programs and
certification of trainee programs , the registration of the apprentices and trainees , and the ratios
and wage rates prescribed in the applicable programs .
( ii ) (A) The contractor shall submit weekly for each week in which any contract work is
performed a copy of all payrolls to the (write in name of appropriate federal agency ) if the
agency is a party to the contract , but if the agency is not such a party , the contractor will submit
the payrolls to the applicant , sponsor, or owner, as the case may be , for transmission to the
(write in name of agency) . The payrolls submitted shall set out accurately and completely all of
the information required to be maintained under 29 CFR 5 . 5 (a ) ( 3 ) ( i ) , except that full social
security numbers and home addresses shall not be included on weekly transmittals . Instead the
payrolls shall only need to include an individually identifying number for each employee ( e . g . ,
the last four digits of the employee ' s social security number) . The required weekly payroll
information may be submitted in any form desired . Optional Form WH -347 is available for this
purpose from the Wage and Hour Division Web site at
http : //www . dol . gov/whd /programs/dbra /forms . htm or its successor site . The prime contractor is
responsible for the submission of copies of payrolls by all subcontractors . Contractors and
subcontractors shall maintain the full social security number and current address of each
covered worker , and shall provide them upon request to the (write in name of appropriate
federal agency) if the agency is a party to the contract , but if the agency is not such a party , the
contractor will submit them to the applicant , sponsor, or owner , as the case may be , for
transmission to the (write in name of agency) , the contractor, or the Wage and Hour Division of
the Department of Labor for purposes of an investigation or audit of compliance with prevailing
wage requirements . It is not a violation of this section for a prime contractor to require a
subcontractor to provide addresses and social security numbers to the prime contractor for its
SRF-22 January 2021
own records , without weekly submission to the sponsoring government agency ( or the applicant ,
sponsor, or owner) .
( B ) Each payroll submitted shall be accompanied by a " Statement of Compliance , " signed by
the contractor or subcontractor or his or her agent who pays or supervises the payment of the
persons employed under the contract and shall certify the following :
( 1 ) That the payroll for the payroll period contains the information required to be provided
under Sec . 5 . 5 (a ) ( 3 ) ( ii ) of Regulations , 29 CFR part 5 , the appropriate information is being
maintained under Sec. 5 . 5 (a ) ( 3 ) ( i ) of Regulations , 29 CFR part 5 , and that such information is
correct and complete ;
(2 ) That each laborer or mechanic ( including each helper, apprentice , and trainee ) employed
on the contract during the payroll period has been paid the full weekly wages earned , without
rebate , either directly or indirectly , and that no deductions have been made either directly or
indirectly from the full wages earned , other than permissible deductions as set forth in
Regulations , 29 CFR part 3 ;
( 3 ) That each laborer or mechanic has been paid not less than the applicable wage rates and
fringe benefits or cash equivalents for the classification of work performed , as specified in the
applicable wage determination incorporated into the contract .
( C ) The weekly submission of a properly executed certification set forth on the reverse side of
Optional Form WH - 347 shall satisfy the requirement for submission of the " Statement of
Compliance " required by paragraph (a ) ( 3 ) ( ii ) ( B ) of this section .
( D ) The falsification of any of the above certifications may subject the contractor or
subcontractor to civil or criminal prosecution under section 1001 of title 18 and section 231 of
title 31 of the United States Code .
( iii ) The contractor or subcontractor shall make the records required under paragraph (a ) ( 3 ) ( i )
of this section available for inspection , copying , or transcription by authorized representatives of
the EPA or the Department of Labor, and shall permit such representatives to interview
employees during working hours on the job . If the contractor or subcontractor fails to submit the
required records or to make them available , the Federal agency may , after written notice to the
contractor, sponsor, applicant , or owner, take such action as may be necessary to cause the
suspension of any further payment , advance , or guarantee of funds . Furthermore , failure to
submit the required records upon request or to make such records available may be grounds for ze
debarment action pursuant to 29 CFR 5 . 12 .
(4 ) Apprentices and trainees-4i ) Apprentices . Apprentices will be permitted to work at less
than the predetermined rate for the work they performed when they are employed pursuant to
and individually registered in a bona fide apprenticeship program registered with the U . S .
Department of Labor, Employment and Training Administration , Office of
Apprenticeship Training , Employer and Labor Services , or with a State Apprenticeship Agency
recognized by the Office , or if a person is employed in his or her first 90 days of probationary
employment as an apprentice in such an apprenticeship program , who is not individually
registered in the program , but who has been certified by the Office of Apprenticeship Training ,
Employer and Labor Services or a State Apprenticeship Agency (where appropriate ) to be
eligible for probationary employment as an apprentice . The allowable ratio of apprentices to
journeymen on the job site in any craft classification shall not be greater than the ratio permitted
to the contractor as to the entire work force under the registered program . Any worker listed on
a payroll at an apprentice wage rate , who is not registered or otherwise employed as stated
above , shall be paid not less than the applicable wage rate on the wage determination for the
classification of work actually performed . In addition , any apprentice performing work on the job
site in excess of the ratio permitted under the registered program shall be paid not less than the
applicable wage rate on the wage determination for the work actually performed . Where a
contractor is performing construction on a project in a locality other than that in which its
program is registered , the ratios and wage rates (expressed in percentages of the journeyman 's
SRF-23 January 2021
hourly rate ) specified in the contractor's or subcontractors registered program shall be observed .
Every apprentice must be paid at not less than the rate specified in the registered program for
the apprentice 's level of progress , expressed as a percentage of the journeymen hourly rate
specified in the applicable wage determination . Apprentices shall be paid fringe benefits in
accordance with the provisions of the apprenticeship program . If the apprenticeship program
does not specify fringe benefits , apprentices must be paid the full amount of fringe benefits
listed on the wage determination for the applicable classification . If the Administrator determines
that a different practice prevails for the applicable apprentice classification , fringes shall be paid
in accordance with that determination . In the event the Office of Apprenticeship Training ,
Employer and Labor Services , or a State Apprenticeship Agency recognized by the Office ,
withdraws approval of an apprenticeship program , the contractor will no longer be permitted to
utilize apprentices at less than the applicable predetermined rate for the work performed until an
acceptable program is approved .
( ii ) Trainees . Except as provided in 29 CFR 5 . 16 , trainees will not be permitted to work at less
than the predetermined rate for the work performed unless they are employed pursuant to and
individually registered in a program which has received prior approval , evidenced by formal
certification by the U . S . Department of Labor, Employment and Training Administration . The
ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan
approved by the Employment and Training Administration . Every trainee must be paid at not
less than the rate specified in the approved program for the trainee' s level of progress ,
expressed as a percentage of the journeyman hourly rate specified in the applicable wage
determination . Trainees shall be paid fringe benefits in accordance with the provisions of the
trainee program . If the trainee program does not mention fringe benefits , trainees shall be paid
the full amount of fringe benefits listed on the wage determination unless the Administrator of
the Wage and Hour Division determines that there is an apprenticeship program associated with
the corresponding journeyman wage rate on the wage determination which provides for less
than full fringe benefits for apprentices . Any employee listed on the payroll at a trainee rate who
is not registered and participating in a training plan approved by the Employment and Training
Administration shall be paid not less than the applicable wage rate on the wage determination
for the classification of work actually performed . In addition , any trainee performing work on the
job site in excess of the ratio permitted under the registered program shall be paid not less than
the applicable wage rate on the wage determination for the work actually performed . In the
event the Employment and Training Administration withdraws approval of a training program ,
the contractor will no longer be permitted to utilize trainees at less than the applicable
predetermined rate for the work performed until an acceptable program is approved .
( iii ) Equal employment opportunity . The utilization of apprentices , trainees and journeymen
under this part shall be in conformity with the equal employment opportunity requirements of
Executive Order 11246 , as amended , and 29 CFR part 30 .
(5 ) Compliance with Copeland Act requirements . The contractor shall comply with the
requirements of 29 CFR part 3 , which are incorporated by reference in this contract.
(6 ) Subcontracts . The contractor or subcontractor shall insert in any subcontracts the clauses
contained in 29 CFR 5 . 5 (a ) ( 1 ) through ( 10 ) and such other clauses as the (write in the name of
the Federal agency) may by appropriate instructions require , and also a clause requiring the
subcontractors to include these clauses in any lower tier subcontracts . The prime contractor
shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all
the contract clauses in 29 CFR 5 . 5 .
( 7 ) Contract termination : debarment . A breach of the contract clauses in 29 CFR 5 . 5 may be
grounds for termination of the contract , and for debarment as a contractor and a subcontractor
as provided in 29 CFR 5 . 12 .
SRF-24 January 2021
( 8 ) Compliance with Davis- Bacon and Related Act requirements . All rulings and
interpretations of the Davis- Bacon and Related Acts contained in 29 CFR parts 1 , 3 , and 5 are
herein incorporated by reference in this contract .
( 9 ) Disputes concerning labor standards . Disputes arising out of the labor standards
provisions of this contract shall not be subject to the general disputes clause of this contract .
Such disputes shall be resolved in accordance with the procedures of the Department of Labor
set forth in 29 CFR parts 5 , 6 , and 7 . Disputes within the meaning of this clause include disputes
between the contractor (and any of its subcontractors ) and the contracting agency, the U . S .
Department of Labor, or the employees or their representatives .
( 10 ) Certification of eligibility . ( i ) By entering into this contract, the contractor certifies that
neither it ( nor he or she ) nor any person or firm who has an interest in the contractor's firm is a
person or firm ineligible to be awarded Government contracts by virtue of section 3 (a ) of the
Davis - Bacon Act or 29 CFR 5 . 12 ( a ) ( 1 ) .
( ii ) No part of this contract shall be subcontracted to any person or firm ineligible for award of
a Government contract by virtue of section 3 (a ) of the Davis - Bacon Act or 29 CFR 5 . 12 (a ) ( 1 ) .
( iii ) The penalty for making false statements is prescribed in the
U . S . Criminal Code , 18 U . S . C . 1001 .
( b ) Contract Work Hours and Safety Standards Act . The Agency Head shall cause or require
the contracting officer to insert the following clauses set forth in paragraphs ( b ) ( 1 ) , (2 ) , (3 ) , and
(4 ) of this section in full in any contract in an amount in excess of $ 100 , 000 and subject to the
overtime provisions of the Contract Work Hours and Safety Standards Act . These clauses shall
be inserted in addition to the clauses required by Sec . 5 . 5 (a ) or 4 . 6 of part 4 of this title . As used
in this paragraph , the terms laborers and mechanics include watchmen and guards .
( 1 ) Overtime requirements . No contractor or subcontractor contracting for any part of the
contract work which may require or involve the employment of laborers or mechanics shall
require or permit any such laborer or mechanic in any workweek in which he or she is employed
on such work to work in excess of forty hours in such workweek unless such laborer or
mechanic receives compensation at a rate not less than one and one - half times the basic rate of
pay for all hours worked in excess of forty hours in such workweek .
(2 ) Violation ; liability for unpaid wages ; liquidated damages . In the event of any violation of
the clause set forth in paragraph ( b ) ( 1 ) of this section the contractor and any subcontractor
responsible therefor shall be liable for the unpaid wages . In addition , such contractor and
subcontractor shall be liable to the United States ( in the case of work done under contract for
the District of Columbia or a territory , to such District or to such territory ) , for liquidated
damages . Such liquidated damages shall be computed with respect to each individual laborer or
mechanic , including watchmen and guards , employed in violation of the clause set forth in
paragraph (b ) ( 1 ) of this section , in the sum of $ 10 for each calendar day on which such
individual was required or permitted to work in excess of the standard workweek of forty hours
without payment of the overtime wages required by the clause set forth in paragraph ( b ) ( 1 ) of
this section .
(3 ) Withholding for unpaid wages and liquidated damages . The loan recipient shall upon its
own action or upon written request of an authorized representative of the Department of Labor
withhold or cause to be withheld , from any moneys payable on account of work performed by
the contractor or subcontractor under any such contract or any other Federal contract with the
same prime contractor, or any other federally- assisted contract subject to the Contract Work
Hours and Safety Standards Act , which is held by the same prime contractor, such sums as
may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor
for unpaid wages and liquidated damages as provided in
the clause set forth in paragraph ( b ) (2 ) of this section .
(4 ) Subcontracts . The contractor or subcontractor shall insert in any subcontracts the clauses
set forth in paragraph ( b ) ( 1 ) through (4 ) of this section and also a clause requiring the
SRF-25 January 2021
subcontractors to include these clauses in any lower tier subcontracts . The prime contractor
shall be responsible for compliance by any subcontractor or lower tier subcontractor with the
clauses set forth in paragraphs ( b ) ( 1 ) through (4 ) of this section .
( c ) In addition to the clauses contained in paragraph ( b ) , in any contract subject only to the
Contract Work Hours and Safety Standards Act and not to any of the other statutes cited in Sec.
5 . 1 , the Agency Head shall cause or require the contracting officer to insert a clause requiring
that the contractor or subcontractor shall maintain payrolls and basic payroll records during the
course of the work and shall preserve them for a period of three years from the completion of
the contract for all laborers and mechanics , including guards and watchmen , working on the
contract . Such records shall contain the name and address of each such employee , social
security number, correct classifications , hourly rates of wages paid , daily and weekly number of
hours worked , deductions made , and actual wages paid . Further, the Agency Head shall cause
or require the contracting officer to insert in any such contract a clause providing that the
records to be maintained under this paragraph shall be made available by the contractor or
subcontractor for inspection , copying , or transcription by authorized representatives of the EPA
and the Department of Labor, and the contractor or subcontractor will permit such
representatives to interview employees during working hours on the job .
C . Preservation of Open Competition and Government Neutrality Towards
Government Contractors ' Labor Relations on Federal and Federally Funded
Construction Projects ( Executive Order 13202 , as amended by Executive Order
13208)
Executive Order 13202 , signed February 17 , 2001 and amended April 4 , 2001 , requires all
executive agencies that issue grants to ensure Government neutrality toward contractors ' labor
relations . This applies to recipients of SRF assistance . The Executive Order prohibits
discrimination against contractors and their employees in construction contracts based upon
labor affiliation or lack thereof.
SRF assistance recipients and any construction managers acting on their behalf must ensure
that bidding specifications , project agreements , and other controlling documents do not require ,
prohibit , or otherwise discriminate , with respect to labor affiliation or lack thereof.
D . Historical and Archeological Finds
If, during the course of construction , evidence of deposits of historical or archeological interest is
found , the contractor shall cease operations affecting the find . The owner shall then notify the
State Revolving Fund Environmental Review Specialist , who shall in turn notify the State
Historic Preservation Office . The SRF shall consult with the SHPO and other interested parties
to determine the proper course of action regarding the discovery . No further disturbance of the
deposits shall ensue until the SRF Environmental Review Specialist determines that the project
activities in that area may proceed . Compensation to the contractor, if any , for lost time or
changes in construction to avoid the find , shall be determined in accordance with changed
conditions or change order provisions of the specifications .
Authority for this derives from the National Historic Preservation Act ( 16 U . S . C . § § 470 et seq . )
and 36 CFR Part 800 . If human remains are discovered then state law also applies IC 2636 .
SRF-26 January 2021
E . Prohibitions on Procurement from Violating Facilities ( Section 306 , Clean Air Act ;
Section 508 , Clean Water Acts Executive Order 11738 )
Both the Clean Water Act and the Clean Air Act prohibit federal agencies from extending
assistance by way of loans or contracts to persons who have been convicted of violations of
either law . Executive Order 11738 was issued to coordinate enforcement by the U . S .
Environmental Protection Agency , which shall designate facilities which have given rise to a
conviction for an offense under the criminal provisions of the Clean Air Act and the Clean Water
Act ,
The Executive Order also prohibits agencies from extending assistance to facilities that are not
in compliance with either Act .
SRF assistance recipients may not procure goods , services , or materials from suppliers listed
by the EPA as violators .
The Excluded Parties Listing search engine is located at the System for Award Management
( SAM ) website : https : //www . sam . gov/SAM /.
Attachment 8
SRF Required Front - End Specifications
Right of Entry and Records Retention
The recipient shall provide access at all times for the Department of Natural Resources , the
Iowa Finance Authority , the state auditor, and the U . S . EPA Office of the Inspector General to
all project records and documents for inspection and audit purposes for a period of three years
after the date of last loan payment . The same access to the project site (s ) shall be provided for
inspection purposes .
567 Iowa Administrative Code paragraph 92 . 8 (2 ) . e . State inspections . Personnel of the department
shall have the right to examine all construction aspects of the project, including materials and
equipment delivered and stored on site for use on the project .
SRF-27 January 2021
Attachment 9
SRF Required Front - End Specifications
"American Iron and Steel " Requirements
H . R . 3547 , the " Consolidated Appropriations Act , 2014 , " enacted January 17 , 2014 by the U . S .
Congress , includes "American Iron and Steel " provisions that require Clean Water and Drinking
Water State Revolving Fund assistance recipients of these funds to use iron and steel produced
in the United States .
H . R . 3547 includes the following language in Division G , Title IV , under the heading , " Use of
American Iron and Steel " :
Sec . 436 . ( a ) ( 1 ) None of the funds made available by a State water pollution control
revolving fund as authorized by title VI of the Federal Water Pollution Control Act ( 33 U . S . C .
1381 et seq . ) or made available by a drinking water treatment revolving loan fund as
authorized by section 1452 of the Safe Drinking Water Act (42 U . S . C . 300j - 12 ) shall be
used for a project for the construction , alteration , maintenance , or repair of a public water
system or treatment works unless all of the iron and steel products used in the project are
produced in the United States .
( 2 ) In this section , the term " iron and steel products " means the following products made
primarily of iron and steel : lined or unlined pipes and fittings , manhole covers and other
municipal castings , hydrants , tanks , flanges , pipe clamps and restraints , valves , structural
steel , reinforced precast concrete , and construction materials .
( b ) Subsection ( a ) shall not apply in any case or category of cases in which the
Administrator of the Environmental Protection Agency ( in this section referred to as the
"Administrator" ) find that—
( 1 ) Applying subsection ( a ) would be inconsistent with the public interest ;
(2 ) Iron and steel products are not produced in the United States in sufficient and
reasonably available quantities and of a satisfactory quantity ; or
( 3 ) Inclusion of iron and steel products produced in the United States will increase the
cost of the overall project by more than 25 percent .
( c ) If the Administrator receives a request for a waiver under this section , the Administrator
shall make available to the public on an informal basis a copy of the request and
information available to the Administrator concerning the request , and shall allow for
informal public input on the request for at least 15 days prior to making a finding based on
the request . The Administrator shall make the request and accompanying information
available by electronic means , including on the official public Internet Web site of the
Environmental Protection Agency .
The final guidance and any published waivers are found at: https : //www . epa . gov/cwsrf/state-
revolving -fund - american - iron -and - steel -ais - requirement . In particular the contractor should pay
attention to the guidance for documentation of compliance . There is also a waiver for incidental
items ; in order to qualify for this waiver the total materials and costs for the project must be
tracked and incidental items identified .
SRF-28 January 2021
Sample "American Iron and Steel " Contract Language
In order to fulfill the requirements , the assistance recipient must in good faith design the project
and solicit bids for construction with U . S . - made iron and steel . The following information will be
included in any contracts resulting from this request for bids :
The Contractor acknowledges to and for the benefit of the City of
("Purchaser") and the State of Iowa ( the " State ") that it understands the goods and services under
this Agreement are being funded with monies made available by the Clean Water State
Revolving Fund and/or Drinking Water State Revolving Fund and such law contains provisions
commonly known as "American Iron and Steel ; " that requires all of the iron and steel products
used in the project to be produced in the United States ("American Iron and Steel Requirement")
including iron and steel products provided by the Contactor pursuant to this Agreement .
The Contractor hereby represents and warrants to and for the benefit of the Purchaser and the
State that (a) the Contractor has reviewed and understands the American Iron and Steel
Requirement , (b) all of the iron and steel products used in the project will be and/or have been
produced in the United States in a manner that complies with the American Iron and Steel
Requirement, unless a waiver of the requirement is approved , and ( c) the Contractor will provide
any further verified infonnation , certification or assurance of compliance with this paragraph , or
infonnation necessary to support a waiver of the American Iron and Steel Requirement, as may
be requested by the Purchaser or the State .
Notwithstanding any other provision of this Agreement, any failure to comply with this
paragraph by the Contractor shall permit the Purchaser or State to recover as damages against the
Contractor any loss , expense , or cost (including without limitation attorney ' s fees ) incurred by
the Purchaser or State resulting from any such failure (including without limitation any
impairment or loss of funding, whether in whole or in part, from the State or any damages owed
to the State by the Purchaser) . While the Contractor has no direct contractual privity with the
State , as a lender to the Purchaser for the funding of its project, the Purchaser and the Contractor
agree that the State is a third-party beneficiary and neither this paragraph (nor any other
provision of this Agreement necessary to give this paragraph force or effect) shall be amended or
waived without the prior written consent of the State .
Sample Certifications
As indicated in the contract language , it will be the responsibility of the Contractor to obtain
certifications that the products and materials used in the project are U . S . -made . EPA
recommends the use of a step certification process for documenting compliance with AIS
requirements , similar to one used by the Federal Highway Administration . Step certification
creates a paper trail which documents the location of the manufacturing process involved with
the production of steel and iron materials . Each handler (supplier, fabricator, manufacturer,
processor, coater, etc . ) of the iron and steel products certifies that their step in the process was
domestically performed .
The following information is provided as a sample letter of step certification for AIS compliance .
Documentation must be provided on company letterhead . In this example , there may be
multiple letters from different manufacturers if one manufacturer did not perform all of the steps .
SRF-29 January 2021
Date
Company Name
Company Address
City, State Zip
Subject : American Iron and Steel Step Certification for Project (XXXXXXXXXX)
I, ( company representative) , certify that the (melting , bending, coating, galvanizing, cutting , etc . )
process for (manufacturing or fabricating) the following products and/or materials shipped or
provided for the subject project is in full compliance with the American Iron and Steel
requirement as mandated in EPA ' s State Revolving Fund Programs .
Item , Products and/or Materials :
1 . Xxxx
2 . Xxxx
3 . Xxxx
Such process took place at the following location :
If any of the above compliance statements change while providing material to this project we
will immediately notify the prime contractor and the engineer .
Signed by company representative
Alternatively , the final manufacturer that delivers the iron or steel product to the worksite ,
vendor, or contractor, may provide a certification asserting that all manufacturing processes
occurred in the U . S . and providing detailed information on the steps involved .
The following is a template for this type of final certification .
SRF-30 January 2021
Template American Iron and Steel Certification Letter
SRF
STATE
On Manufacturer's Letterhead
IRO- & STEEL. r4 C .
1959 Steel Drive
Ironville, OH 12345
MATERIAL CERTIFICATION
April 30, 2015
RE: Job Name: Waterprojectville, Iowa — 2015 State Revolving Fund Water
Infrastructure Project
SRF Project Number CS 1920999 01 References the SRF Project
I certify that the processes for manufacturing or fabricating the following products
andior materials provided for the subject project tools place at the following U, S_
locations :
Quantity- Description Manufacturing Processes Location Where
Processes Occurred
3 count AB123456 i'' Gate Valve Melting, poured, machined Isom ille, OH
60 count X-1654321 Reinforced Concrete i4ielted, rolled. fabricated Steel City; Lk
Manhole
60 count XZ123456 Manhole Cover Melted, cast finished Stainless; MS
1200 linear feet r1B654321 4" Ductile Iron Water Melted, rolled, finished Pipet GA
Pipe
I fiuth 1 certify that products and/or materials are in full compliance with the
American Iron and teel requirements as mandated in the U. S_ Environmental Specifies the
Protection Agen 4s State Revolving Fund programs. If any of the above Manufacturing
compliance st ements change while providing material to this project we will Processes and
immediately notify the supplier, prime contractor_ consulting engineer_ or project the U .S .
owner. Locations
Specifies the On behalf of IRON & STEEL, INC _ , Where They
Products and Were
Performed
Quantities
w .5' �t
Signature of Jane Smith
Manufacturer's Product Quality Manager
Representative
SRF-31 January 2021
Covered and Non= Covered Items
The EPA issued a waiver for De Minimis incidental components of eligible water and
wastewater infrastructure projects . Funds used for such De Minimis incidental components
cumulatively may comprise no more than a total of 5 % of the total cost of the materials used in
and incorporated into a project . The cost of an individual incidental item may not exceed 1 % of
the total cost of the materials used in and incorporated into a project .
De Minimis incidental items include miscellaneous , generally low- cost components that are
essential for , but incidental to , the construction and are incorporated into the physical structure
of the project . For many of these incidental components , the country of manufacture and the
availability of alternatives are not readily or reasonably identifiable prior to procurement in the
normal course of business . For others , the country of manufacture may be known but the
miscellaneous character in conjunction with the low cost , individually and ( in total ) as typically
procured in bulk , mark them as properly incidental .
Examples of incidental components could include small washers , screws , fasteners ( i . e . , nuts
and bolts ) , miscellaneous wire , corner bead , ancillary tube , etc . Examples of items that are
clearly not incidental include significant process fittings ( i . e . , tees , elbows , flanges , and
brackets ) , distribution system fittings and valves , force main valves , pipes , treatment and
storage tanks , large structural supports , etc .
In consultation with their contractors , assistance recipients should determine the items to be
covered by this waiver and must retain relevant documentation ( i . e . invoices ) as to those items .
Assistance recipients must summarize in reports to the State of Iowa the types and /or
categories of items to which this waiver is applied , the total cost of incidental components for
each type or category , and the calculations by which they determined the total cost of materials
used in and incorporated into the project .
The successful bidder will fill out the materials spreadsheet ( shown below) and submit it to the
assistance recipient to indicate iron and steel items proposed to be procured for the project .
American Iron and Steel Materials Spreadsheet — to be Submitted by Successful Bidder
Iowa Department of Natural Resources - January 2021
Based on EPA Memorandum (4/15/2014): De Minimis Waiver of Section 436 of P. L. 113-76, Consolidated Appropriation Acts (CAA), 2014
Project:
Bidder: Date:
'Covered Product Categories include: Lined or unlined pipes or fittings; manhole covers; municipal castings; pipe clamps and restraints; valves; structural steel;
hydrants, tanks; flanges; reinforced precast concrete; construction materials.
" Incidental items are miscellaneous, generally low-cost items, often procured in bulk, such as washers, screws, fasteners, small amounts of wire, etc.
Covered Products Description of Covered Documentation Item is Bid Amount Bid Amount
Category' Products Will be Obtained Incidental and Covered Incidentals
will be Products
claimed under
De Minimis
Waiver` *
1 1 Choose an item
! 2 Choow on itr. rn .
3 C.hoo ars item . ------
4 Choase ari item . 7 ='
s
SRF-32 January 2021
At the end of construction , the contractor will submit a final list showing covered items being
claimed as incidental components under the De Minimis Waiver. Assistance recipients will
complete a De Minimis Waiver Incidental Components List for the entire project to demonstrate
compliance with the De Minimis Waiver cost requirements outlined above .
American Iron and Steel - De Minimus Waiver Incidental Components List
Iowa Department of Natural Resources — January 2021
Based on EPA Memorandum (4/15/2014 ( : De Minimus Waiver of Section 436 of P. L. 113-76, Consolidated Appropriation Acts ( CAA , 2014
This form is to be used by the State Revolving Fund (SRF) applicant to identify all non-domestic iron and steel incidental components permanently
incorporated into an SRF project that meet the requirements of the public interest De Minimis Waiver. This form can also be used by individual contractors to
submit their final incidental components list to the SRF applicant.
SRF Applicant:
SRF Project #: Submitted By:
Date : Individual Contractor De Minimis List LJ Final De Minimis List for SRF Project LJ
Total Materials Cost: Total amount claimed as De Percent:
Minimis Incidental (must be 596 or less of total materiels cost)
Components:
Contractor Name Covered Products Description of Covered Date Individual Quantity DollarAmount
Products Purchased Item/Unit Claimed as Incidental
(list each item typeseparotely) Cost Incidental Components
Example JR Construction Construction materials Steel Doors 1 -21 -2020 $500 5 $2500
1 it Choose an item.
2 Chnosr + n itis
These documents are available on - line at http : //www , iowasrf. com/about srf/use- of-american -
iron - and -steel/ .
SRF-33 January 2021
Attachment 10
SRF Required Front -End Specifications
(This form must be completed and signed by Prime Contractor and submitted with the bid)
PROHIBITION ON CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE
SERVICES OR EQUIPMENT
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 : //www. sam . gov/SAM/.
( 1 ) As described in Public Law 115 -232 , section 889 , covered telecommunications
equipment or services includes :
(i ) Telecommunications equipment produced by Huawei 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 Hikvision 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 .
I understand the above prohibitions and certify that the project will be in compliance with all the
requirements .
Nate Hentges - Business Director
Typed Name & Title of Authorized Representative
9 / 30 / 2021
Signature of Authorized Repr tative Date
SRF-34 January 2021
NON - COLLUSION AFFIDAVIT OF PRIME BIDDER
State of �%'v,�ZZ C) ;r 1 )
)ss
County of
,<l ...3 being first duly sworn , deposes and says tf7at :
1 . He is ( Owner , Partner OfficeK 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 ag ment on the part of the Bidder or any of its
agents , representatives , owners , employees , or a i inter 's ding this affiant .
( Signed )
ol Title
ts Subscribed and sworn to before me this day of m , 2021.
Tit e
My commission expires 2.u2. �
SPP cs DONNA M FOSTER
a° e " Commission Number 823049
My Commission Expires
January 9, 2023
Non-Collusion Affidavit NCA- 1 of 2 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
NON - COLLUSION AFFIDAVIT OF SUBCONTRACTOR
State of M //7v vle )
ss :
County of S C tt )
A/<, f 'r, I ,f7 /741 being first duly sworn , deposes and says that:
1 . He is Owner artner, Officer Representative , or Agent) of
�- - hereinafter referred to
as the "Subcontractor; "
2 . He is fully informed respecting the preparation and contents of the subcontractor's proposal
submitted by the subcontractor to
contract pertaining to the
project in
(City or County and State )
3 . Such subcontractor's proposal is genuine and is not a collusive or sham proposal ;
4 . Neither the subcontractor 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 proposal in connection with such contract or to refrain from submitting a
proposal in connection with such contract , or has in any manner, directly or indirectly, sought by
unlawful agreement or connivance with any other bidder, firm or person to fix the price or prices in
said subcontractor's proposal , or to fix any overhead , profit or cost element of the price of prices
in said subcontractor's proposal , or to secure through 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 subcontractor's proposal 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 day of 20_
Title
My commission expires
Non-Collusion Affidavit NCA-2 of 2 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
NON -COLLUSION AFFIDAVIT OF SUBCONTRACTOR
State of )
ss :
County of )
being first duly sworn , deposes and says that :
1 . He is (Owner, Partner, Officer, Representative , or Agent) of
hereinafter referred to
as the "Subcontractor; '
2 . He is fully informed respecting the preparation and contents of the subcontractor' s proposal
submitted by the subcontractor to
contract pertaining to the
project in
( City or County and State )
3 . Such subcontractor' s proposal is genuine and is not a collusive or sham proposal ;
4 . Neither the subcontractor 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 proposal in connection with such contract or to refrain from submitting a
proposal in connection with such contract , or has in any manner, directly or indirectly , sought by
unlawful agreement or connivance with any other bidder, firm or person to fix the price or prices in
said subcontractor's proposal , or to fix any overhead , profit or cost element of the price of prices
in said subcontractor's proposal , or to secure through 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 subcontractor's proposal 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 day of 120
Title
My commission expires
Non-Collusion Affidavit NCA-2 of 2 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 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 .
1 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 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM 460651387 Contract No. 1037 Waterloo, Iowa
subcontract orY
exempted urchase order unless b the rules , regulations or orders of the City's
p P
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 ) ( I'VM
Appropriate Official )
EEO Officer / Office Manager
(Title )
9 / 30 / 2021
( Date )
Equal Opportunity Clause EOC-2 of 2 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
Bidder Status Form
To be completed by all bidders Part A
Please answer "Yes" or " No" for each of the following :
❑X Yes ❑ 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) .
❑X Yes ❑ No My company has an office to transact business in Iowa .
X❑ Yes ❑ No My company's office in Iowa is suitable for more than receiving mail , telephone calls , and e-mail .
X❑ 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 .
❑X Yes ❑ 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 .
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 : 11 / 14 / 2008 to /CURRENT / Address : 3608 VANDALIA ROAD
City, State , Zip : DES MOINES , IOWA 50317
Dates : 05 / 13 / 2019 to / CURRENT / Address : 3230 99TH STREET
City, State , Zip : URBANDALE , IOWA 50322
Dates : 06 / 01 / 2018 to 05 / 13 / 2019 Address : 1275 NW STREET
You may attach additional sheet(s) if needed. City, State , Zip : CLIVE , IOWA 50325
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
F1 Yes ❑ No
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 : S . M . Hentges & Sons , Inc
Signature : Date : 9 / 30 / 2021
You must submit the completed form to the governmental body requesting bids per 875 Iowa Administrative Code
Chapter 156 . This form has been approved by the Iowa Labor Commissioner.
309-6001 (09- 15 )
Worksheet : Authorization to Transact Business
This worksheet may be used to help complete Part A of the Resident Bidder Status form . If at least one of the following
describes your business , you are authorized to transact business in Iowa .
XJ Yes ❑ No My business is currently registered as a contractor with the Iowa Division of Labor.
❑ Yes RX No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes .
❑ Yes X❑ No My business is a general partnership or joint venture . More than 50 percent of the general
partners or joint venture parties are residents of Iowa for Iowa income tax purposes .
❑X 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 .
❑X Yes ❑ No My business is a corporation whose articles of incorporation are filed in a state other than Iowa ,
the corporation has received a certificate of authority from the Iowa secretary of state , has filed
its most recent biennial report with the secretary of state , and has neither received a certificate of
withdrawal from the secretary of state nor had its authority revoked .
❑ Yes X❑ No My business is a limited liability partnership which has filed a statement of qualification in this
state and the statement has not been canceled .
❑ Yes ❑X No My business is a limited liability partnership which has filed a statement of qualification in a
state other than Iowa , has filed a statement of foreign qualification in Iowa and a statement of
cancellation has not been filed .
❑ Yes X❑ 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 ❑X 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 ❑X No My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination .
❑ Yes ❑X No My business is a limited liability company whose certificate of organization is filed in a state other
than Iowa , has received a certificate of authority to transact business in Iowa and the certificate
has not been revoked or canceled .
309-6001 (09- 15 )
BSF-2
Revised Per Addendum No . 1 - 9/24/2021
ITEMS OF POTENTIAL MBE/WBE PARTICIPATION
NOTICE TO PROSPECTIVE BIDDERS :
The following are items from the US HIGHWAY 63 SANITARY SEWER UPGRADES , - PHASE I , CONTRACT NO . 1037 ,
project that have a potential for MBE/WBE Participation . This listing , however, is not intended to be all encompassing ; to
preclude MBE/WBE Contractors from bidding on any items of the Proposal as a Subcontractor or the entire Proposal as a
Prime Contractor,
BID TOTAL
ITEM DESCRIPTION UNIT QTY
1 MOBILIZATION LUMP SUM 1 . 0
2 TRAFFIC CONTROL LUMP SUM 1 . 0
3 CLEARING AND GRUBBING LUMP SUM 1 . 0
4 FOUNDATION ROCK TON 11660 . 0
5 TRENCH COMPACTION TESTING LUMP SUM 1 . 0
6 ABANDON , FILL AND PLUG 21 - INCH SANITARY SEWER LF 29958 . 0
7 REMOVE AND PLUG 21 - INCH SANITARY SEWER LF 17863 . 0
8 ABANDON SANITARY SEWER MANHOLE EA 9 . 0
9 REMOVE SANITARY SEWER MANHOLE EA 6 . 0
10 CLEANING , INSPECTION AND TESTING OF SANITARY SEWER GRAVITY MAINS LUMP SUM 1 . 0
11 18- INCH SANITARY SEWER GRAVITY MAIN - DIRECTIONAL DRILLING LF 11123 . 5
12 24- INCH SANITARY SEWER GRAVITY MAIN - OPEN CUT LF 371 . 5
13 148wINCH SANITARY SEWER GRAVITY MAIN - OPEN CUT LF 61213 . 0
L16
-T48- INCH SANITARY SEWER GRAVITY MAIN RENCHLESS LF 342 . 6
48- INCH CIRCULAR SANITARY SEWER MANHOLE , SW-301 EA 3 . 0
72- INCH CIRCULAR SANITARY SEWER MANHOLE , SW- 301 EA 1 . 0
84- INCH CIRCULAR SANITARY SEWER MANHOLE , SW- 301 EA 1 . 0
96- INCH CIRCULAR SANITARY SEWER MANHOLE , SW-301 EA 5 . 0
19 120- INCH CIRCULAR SANITARY SEWER MANHOLE , SW-301 EA 4 . 0
20 48- INCH TEE-SECTION SANITARY SEWER MANHOLE , SW- 305 EA 11 . 0
21 CONNECTION TO EXISTING SANITARY MANHOLE EA 1 . 0
22 6- INCH PCC PAVEMENT SY 25 . 4
23 8- INCH PCC PAVEMENT SY 373 . 8
24 8- INCH HMA PAVEMENT SY 923 . 1
25 6- INCH PCC CURB AND GUTTER LF 95 . 0
26 GRAVEL SURFACING SY 260 . 0
27 CURB AND GUTTER REMOVAL LF 95 . 0
28 PAVEMENT REMOVAL SY 19582 . 3
29 SEEDING , FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING - TYPE 1 ACRE 1 . 10
SEED MIX
30 SEEDING , FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING TYPE 2 ACRE 7 . 11
SEED MIX
31 SEEDING , FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING - TYPE 4 ACRE 1 . 10
SEED MIX
32 SEEDING , FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING TYPE 5 ACRE 7 . 11
SEED MIX
33 12- INCH WATTLES LF 8 , 396 . 8
34 DITCH CHECKS EA 30 . 0
35 TEMPORARY ROLLED EROSION CONTROL PRODUCTS RECP SY 271477 . 3
36 SWPPP REQUIREMENTS LUMP SUM 1 . 0
37 STORM SEWER MANHOLE , SW-401 , 48- INCH , EJ 1040 A COVER EA 1 . 0
38 STORM SEWER MANHOLE , SW-401 , 60- INCH , EJ 1040 A COVER EA 1 . 0
39 INTAKE , SW-501 & SW- 603 TYPE R GRATE EA 3 . 0
40 INTAKE , SW- 501 & SW-604 TYPE 6 GRATE EA 7 . 0
41 1CONNECTION TO EXISTING STORM SEWER STRUCTURE EA 1 . 0
42 JAPRON WITH FOOTING AND GUARD , 12- INCH EA 1 . 0
MBE/WBE PARTICIPATION M- 1 of 6 Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60551387 Contract No . 1037 Waterloo , Iowa
Revised Per Addendum No . 1 - 9/24/2021
BID TOTAL
ITEM DESCRIPTION UNIT QTY
43 APRON WITH FOOTING AND GUARD , 18 - INCH EA 1 . 0
44 STORM SEWER , DUCTILE IRON PIPE , 10- INCH DIA . - OPEN CUT LF 24 . 6
45 STORM SEWER , REINFORCED CONCRETE PIPE , 12 - INCH DIA. - OPEN CUT LF 219 .4
46 STORM SEWER , REINFORCED CONCRETE PIPE , 15- INCH DIA . - OPEN CUT LF 690 . 6
47 STORM SEWER , REINFORCED CONCRETE PIPE , 18 - INCH DIA . - OPEN CUT LF 253 . 8
48 6- INCH PCC CURB AND GUTTER LF 70 . 0
49 GRAVEL SURFACING SY 14 . 5
50 PAVEMENT REMOVAL SY 1 , 221 . 0
51 REMOVE INTAKE EA 5 . 0
52 REMOVAL OF STORM SEWER LF 107 . 0
53 3- INCH HMA PATCH SY 356 . 0
54 6- INCH MODIFIED SUBBASE SY 356 . 0
55 JEROSION STONE WITH ENGINEERING FABRIC TONS 13 . 0
56 JHYDRAULIC SEEDING , FERTILIZING AND MULCHING ACRE 0 . 4
MBE/WBE GOALS FOR THIS PROJECT
IMPORTANT: Prime Contract Bidders should be aware that ten percent ( 10% ) MBE goal and a two percent (2 % ) WBE goal
is attached to this project. "Certified Return Receipt' letters are no longer needed with the bid showing proof of contacting
MBE or WBE Subcontractors , but the Pre- Bid Contact Information Form must be filled out completely .
City of Waterloo Contract Compliance Officer:
Contract Compliance Officer
Community Development Board
Carnegie Annex , Suite 202
620 Mulberry Street
Waterloo , IA 50703
Phone : (319 ) 291 -4429
MBE/WBE PARTICIPATION M -2 of 6 Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60551387 Contract No . 1037 Waterloo , Iowa
Revised Per Addendum No . 1 - 9/24/2021
SPECIAL PROVISIONS
1 . TRAFFIC CONTROL -- IMPROPER MAINTENANCE
The Engineer, or authorized representative , shall periodically review traffic control that has been
put in place by the Contractor. If traffic control devices are found to be without proper
maintenance , penalties shall be assessed . Improper maintenance shall include , but not be
limited to , the following situations :
A . Less than 100 percent of lights in working order .
B . Any barricade or sign moved or tipped over .
C . Fencing not supported in a vertical position .
D . Fencing not placed around excavations when workers/equipment is not working at the
location .
E . Lack of proper barricades or signage .
Each incident is treated as a separate citation on an individual basis . It is not intended that minor
deficiencies be price adjusted if corrected the day notification is given . In addition to a price
adjustment, the Engineer may suspend work for irresponsible and/or repeated failure to construct
the project using proper traffic control procedures .
Penalties : 1st Offense Written warning given by City .
2nd Offense $ 100
3rd Offense $ 250
4th Offense $ 500
5th Offense $ 1 , 000
6th Offense Engineer' s discretion ( amount
or more equal or greater than $ 1 , 000 )
2 . LIQUIDATED DAMAGES
Time is an essential element of this contract . It is important that the work be diligently pursued to
completion . If the work is not completed within the specified contract period , plus authorized
extensions , the Contractor shall pay to the City Liquidated Damages in the amount of $ 500 . 00 per
day , for each day , as further described herein , in excess of the authorized time .
Days beyond the specified completion date for which Liquidated Damages will be charged will be
working days that the Contractor does or could have worked from Monday through Saturday .
Sundays will be counted only if work is performed . Partial working days will be considered as a
full working day . Days not chargeable for Liquidated Damages will include rain days , Sundays if
no work is done , and legal holidays .
Working days will cease to be charged when only punch list items remain to be completed .
Punch list item do not include contract bid items or approved change/extra work orders .
When the Contractor believes the project to be substantially completed , a written notice stating
the same shall be submitted to the Engineer and a request made for a Punch List . If the work
under the Contract extends beyond the normal construction season for such work , the Contractor
shall submit to the Engineer in writing a request that working days counted toward the project be
suspended until work is resumed the following construction season .
This amount is not construed as a penalty . These damages are for the cost to the City of
providing the required additional inspection , engineering and contract administration .
Special Provisions SP- 1 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
Revised Per Addendum No . 1 - 9/24/2021
3 , HAUL ROUTES
Haul routes to and from the project site shall be submitted for review by the Engineer. In general ,
the Contractor shall request haul routes over the main streets in the area , staying on streets
within the project as much as possible and should not include truck -embargoed streets .
4 . STANDARD SPECIFICATIONS
The Standard Specifications , which are referenced in the contract documents , are designated as
follows :
SUDAS STANDARD SPECIFICATIONS - "2021 Standard Specifications for the Iowa Statewide
Urban Design and Specifications Program " ( unless otherwise noted ) and current revisions
thereof.
WATERLOO STANDARD SPECIFICATIONS - " Standard Specifications for Municipal Public
Works Construction , City of Waterloo , Iowa . "
5 , PERCENT OF CONTRACT TO BE PERFORMED BY CONTRACTOR
A . The prime contractor shall be required to perform at least 35 percent of the total contract
amount of the project .
6 . SPECIAL PROVISIONS
Standard Specifications are amended by the following additions . These are Special Provisions
and shall prevail over those published in the Standard Specifications .
33 30 05 Glass - Fiber Reinforced Polymer ( GFRP ) Pipe
7 . QUANTITY ADJUSTMENTS
The following Bid Items are exempted from consideration under the provisions of Section B .
" Scope of Work , " paragraph 7 of the " General Specifications for Construction " concerning the
variance of the "As - Built' quantity of the listed item by more than twenty ( 20 % ) percent from the
estimated quantity specified in the contract .
BID ESTIMATED
ITEM DESCRIPTION UNIT QUANTITY
1 MOBILIZATION LUMP SUM 1 . 0
2 TRAFFIC CONTROL LUMP SUM 1 . 0
3 CLEARING AND GRUBBING LUMP SUM 1 . 0
4 FOUNDATION ROCK TON 11660 . 0
5 TRENCH COMPACTION TESTING LUMP SUM 1 . 0
6 ABANDON , FILL AND PLUG 21 - INCH SANITARY SEWER LF 23958 . 0
7 REMOVE AND PLUG 21 - INCH SANITARY SEWER LF 13863 . 0
8 ABANDON SANITARY SEWER MANHOLE EA 9 . 0
9 REMOVE SANITARY SEWER MANHOLE EA 6. 0
10 CLEANING , INSPECTION AND TESTING OF SANITARY SEWER GRAVITY MAINS LUMP SUM 1 . 0
11 18- INCH SANITARY SEWER GRAVITY MAIN - DIRECTIONAL DRILLING LF 15123 . 5
12 24- INCH SANITARY SEWER GRAVITY MAIN - OPEN CUT LF 371 . 5
13 48- INCH SANITARY SEWER GRAVITY MAIN - OPEN CUT LF 61213 . 0
14 48- INCH SANITARY SEWER GRAVITY MAIN -TRENCHLESS LF 342 . 6
15 48- INCH CIRCULAR SANITARY SEWER MANHOLE , SW-301 EA 3 . 0
16 72- INCH CIRCULAR SANITARY SEWER MANHOLE , SW-301 EA 1 . 0
Special Provisions SP-2 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
Revised Per Addendum No . 1 - 9/24/2021
BID ESTIMATED
ITEM DESCRIPTION UNIT QUANTITY
17 84 - INCH CIRCULAR SANITARY SEWER MANHOLE , SW-301 EA 1 . 0
18 96 - INCH CIRCULAR SANITARY SEWER MANHOLE , SW-301 EA 5 . 0
19 120 - INCH CIRCULAR SANITARY SEWER MANHOLE , SW- 301 EA 4 . 0
20 48- INCH TEE - SECTION SANITARY SEWER MANHOLE , SW- 305 EA 11 . 0
21 CONNECTION TO EXISTING SANITARY MANHOLE EA 1 . 0
22 6- INCH PCC PAVEMENT SY 25 . 4
23 8- INCH PCC PAVEMENT SY 373 . 8
24 8- INCH HMA PAVEMENT SY 923 . 1
25 6 - INCH PCC CURB AND GUTTER LF 95 . 0
26 GRAVEL SURFACING SY 260 . 0
27 CURB AND GUTTER REMOVAL LF 95 . 0
28 PAVEMENT REMOVAL SY 11582 . 3
29 SEEDING , FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING - TYPE 1 SEED ACRE 1 . 10
MIX
30 SEEDING , FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING - TYPE 2 SEED ACRE 7 . 11
MIX
31 SEEDING , FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING - TYPE 4 SEED ACRE 1 . 10
MIX
32 SEEDING , FERTILIZING AND MULCHING FOR HYDRAULIC SEEDING - TYPE 5 SEED ACRE 7 . 11
MIX
33 12- INCH WATTLES LF 8 , 396 . 8
34 DITCH CHECKS EA 30 . 0
35 TEMPORARY ROLLED EROSION CONTROL PRODUCTS RECP SY 27 , 477 . 3
36 SWPPP REQUIREMENTS LUMP SUM 1 . 0
37 STORM SEWER MANHOLE , SW-401 , 48- INCH , EJ 1040 A COVER EA 1 . 0
38 STORM SEWER MANHOLE , SW-401 , 60- INCH , EJ 1040 A COVER EA 1 . 0
39 INTAKE , SW-501 & SW- 603 TYPE R GRATE EA 3 . 0
40 INTAKE , SW-501 & SW-604 TYPE 6 GRATE EA 7 . 0
41 CONNECTION TO EXISTING STORM SEWER STRUCTURE EA 1 . 0
42 APRON WITH FOOTING AND GUARD , 12 - INCH EA 1 . 0
43 APRON WITH FOOTING AND GUARD , 18 - INCH EA 1 . 0
44 STORM SEWER , DUCTILE IRON PIPE , 10- INCH DIA . - OPEN CUT LF 24 . 6
45 STORM SEWER , REINFORCED CONCRETE PIPE , 12 - INCH DIA . - OPEN CUT LF 219 . 4
46 STORM SEWER , REINFORCED CONCRETE PIPE , 15- INCH DIA . - OPEN CUT LF 690 . 6
47 STORM SEWER , REINFORCED CONCRETE PIPE , 18 - INCH DIA . - OPEN CUT LF 253 . 8
48 6- INCH PCC CURB AND GUTTER LF 70 . 0
49 GRAVEL SURFACING SY 14 . 5
50 PAVEMENT REMOVAL SY 19221 . 0
51 REMOVE INTAKE EA 5 . 0
52 REMOVAL OF STORM SEWER LF 107 . 0
53 3- INCH HMA PATCH SY 356 . 0
54 6- INCH MODIFIED SUBBASE SY 356 . 0
55 EROSION STONE WITH ENGINEERING FABRIC TONS 13 . 0
56 JHYDRAULIC SEEDING , FERTILIZING AND MULCHING ACRE 0 .4
8 . SHOP DRAWINGS , CERTIFICATES , AND EQUIPMENT LISTS
A . Submission of Drawings :
1 . The Contractor shall submit to the Engineer all shop drawings and equipment
drawings or lists as called for in the contract documents or as requested by the
Engineer . Drawings and listings shall be complete and shall contain all required
detail information conveyed according to the latest recommended standards for
detailing .
Special Provisions SP-3 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
Revised Per Addendum No . 1 - 9/24/2021
2 , The Contractor shall make any corrections required by the Engineer and submit the
revised shop or equipment drawings or listings for review . After review by the
Engineer , the shop or equipment drawings or listings will be so marked , dated ,
signed by the Engineer, and forwarded to the Contractor for reproduction and
distribution .
B . Submission of Equipment Lists :
1 . If requested in the contract documents , as soon as practicable after award of
contract and before any items of material or equipment are purchased , the
Contractor shall submit to the Engineer for review a complete list of the principal
fixtures and equipment to be incorporated into the work .
2 . The Contractor shall also submit applicable brochures , technical data , catalogs ,
cuts , diagrams , manufacturer's drawings and installation instructions , samples if
required , and other descriptive data including the complete description , trade
name , model number , type , size , and rating .
C . Engineer' s Review :
1 . Review by the Engineer shall not be construed as a complete check but will
indicate only that the general method of construction and detail is satisfactory . The
Engineer assumes no responsibility for errors in dimensions in the shop drawings
and assumes the Contractor will use material complying with requirements of the
contract documents or, where not specified , those of sound and reasonable quality ,
and will erect the subjects of such shop drawings according to recognized
standards of first quality work or, when specified , according to standards of the
contract documents .
2 . Any work done or material ordered by the Contractor prior to review by the
Engineer shall be at the Contractor' s risk .
9 . PROJECT RECORD DOCUMENTS
A . Maintain at the project site one record copy of the drawings , project manual , addenda ,
change orders and other modifications to contract , field orders or clarifications , shop
drawings , field test records , and associated permits .
B . Provide one marked up set of drawings to Engineer at substantial completion for use in
preparation of record drawings .
C . Maintain record documents in clean dry , legible condition and in good order. Do not use
record documents for construction purposes . Make record documents available for
inspection by Engineer.
* * * END OF SECTION
Special Provisions SP-4 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
Included as Part of Addendum No . 1 - 9/24/2021
PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS :
That we , of
(the " Principal " ) , and of
(the " Surety" ) , are held and firmly bound unto the City of Waterloo , Iowa
(the " Obligee " ) , in the penal sum of
Dollars ( $ ) , lawful money of the United States , for the payment of said sum in
connection with a contract (the " Contract" ) dated on or about for the
purpose of
. The Contract is incorporated herein by reference as though fully set forth herein .
Whenever the Principal shall be and is declared by the Obligee to be in default under the Contract, with the
Obligee having performed its obligations in the Contract, then the Surety, acknowledging that time is of the
essence , may promptly remedy the default, or shall promptly undertake to :
1 . Complete the Contract in accordance with its terms and conditions ; or
2 . Obtain one or more bids for completing the Contract in accordance with its terms and
conditions , and upon determination by the Surety of the lowest responsible bidder, or
negotiated proposal , or, if the Obligee elects , upon determination by the Obligee and the
Surety jointly of the lowest responsible bidder, or negotiated proposal , arrange for a contract
between such party and the Obligee . The Surety will make available as work progresses
sufficient funds to pay the cost of completion less the balance of the Contract price . The
cost of completion includes responsibilities of the Principal for correction of defective work
and completion of the Contract , the Obligee ' s legal and design professional costs resulting
directly from the Principal ' s default , and liquidated damages or actual damages if no
liquidated damages are specified in the Contract . The term " balance of the Contract price"
means the total amount payable by the Obligee to the Principal under the Contract and any
amendments thereto , less the amount properly paid by the Obligee to the Principal ; or
3 . Determine the amount for which it is liable to the Obligee and pay the Obligee that amount
as soon as practicable .
In the event this bond is enforced , Principal and Surety agree to indemnify Obligee and hold Obligee
harmless from and against any and all costs of enforcement, including but not limited to reasonable attorneys '
fees and expenses .
Every Surety on this bond shall be deemed and held , any contract to the contrary notwithstanding , to consent
to each and all of the following matters , without notice :
1 . To any extension of time to the Contract in which to perform the Contract .
2 . To any change in the plans , specifications , or Contract when such change does not involve
an increase of more than twenty percent ( 20 % ) of the total Contract price , and shall then be
released only as to such excess increase .
3 . That no provision of this bond or of any other contract shall be valid which limits to less than
one ( 1 ) year from the time of the acceptance of the work the right to sue on this bond for
defect in workmanship or material not discovered or known to the Obligee at the time such
work was accepted .
Performance Bond PFB- 1 of 2 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
If the Principal performs the Contract , then this bond shall be null and void ; otherwise it shall remain in full
force and effect . In no event shall the Surety' s total obligation exceed the penal amount of this bond .
Terms used herein shall include , as appropriate , the singular or plural number, or the masculine , feminine or
neuter gender.
IN WITNESS WHEREOF , the undersigned Principal and Surety have executed this Performance Bond as of _
PRINCIPAL SURETY
Name Name
By : By:
Title : Title :
[attach Power of Attorney]
NOTE : Date of BOND must not be prior to date of Contract.
If CONTRACTOR is Partnership , all partners should execute BOND .
If this project includes Federal Funds, the following applies to the payment bond .
IMPORTANT : Surety companies executing bonds must appear on the Treasury Department' s most
current list ( Circular 570 as amended ) and be authorized to transact business in the State where the
project is located .
Performance Bond PFB-2 of 2 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
Included as Part of Addendum No. 1 - 9/24/ 2021
PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS : that
( Name of Contractor)
(Address of Contractor)
a
hereinafter called Principal ,
( Corporation , Partnership or Individual )
and ,
( Name of Surety )
(Address of Surety )
hereinafter called Surety , are held and firmly bound unto
( Name of Owner)
(Address of Owner)
hereinafter called OWNER , in the penal sum of
Dollars ( $ ) in lawful money of the United States , for the payment of which sum well and
truly to be made , we bind ourselves , successors , and assigns , jointly and severally , firmly by these
presents .
THE CONDITION OF THIS OBLIGATION is such that whereas , the Principal entered into a certain
contract with the OWNER , dated the day of 20_, a copy of which
is hereto attached and made a part hereof for the construction of:
US HIGHWAY 63 SANITARY SEWER UPGRADES - PHASE I
CITY CONTRACT NO . 1037
WATERLOO , IOWA
NOW , THEREFORE , if the Principal shall promptly make payment to all persons , firms ,
SUBCONTRACTORS , and corporations furnishing materials for or performing labor in the prosecution of
the WORK provided for in such contract , and any authorized extension or modification thereof, including
all amounts due for materials , lubricants , oil , gasoline , coal and coke , repairs on machinery , equipment
and tools , consumed or used in connection with the construction of such WORK , and all insurance
premiums on said WORK , and for all labor, performed in such WORK whether by SUBCONTRACTOR or
otherwise , then this obligation shall be void ; otherwise to remain in full force and effect .
Payment Bond PB- 1 of 2 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
PROVIDED , FURTHER , that the said Surety for value received hereby stipulates and agrees that no
change , extension of time , alteration or addition to the terms of the contract or to the WORK to be
performed thereunder or the SPECIFICATIONS accompanying the same shall in any wise affect its
obligation on this BOND , and it does hereby waive notice of any such change , extension of time ,
alteration or addition to the terms of the contract or to the WORK or to the SPECIFICATIONS .
PROVIDED , FURTHER , that no final settlement between the OWNER and the CONTRACTOR shall
abridge the right of any beneficiary hereunder, whose claim may be unsatisfied .
IN WITNESS HEREOF , this instrument is executed in counterparts , each one
(number)
of which shall be deemed an original , this the day of , 20
ATTEST :
Principal
(Principal ) Secretary
(SEAL ) By (s )
(Address )
Witness as to Principal
s
(Address )
Surety
ATTEST : By all
Attorney-in-Fact
Witness as to Surety (Address )
(Address)
NOTE : Date of BOND must not be prior to date of Contract.
If CONTRACTOR is Partnership , all partners should execute BOND .
If this project includes Federal Funds , the following applies to the payment bond :
IMPORTANT : Surety companies executing bonds must appear on the Treasury Department' s most
current list (Circular 570 as amended ) and be authorized to transact business in the State where the
project is located .
Payment Bond PB-2 of 2 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo, Iowa
Included as Part of Addendum No. I - 9/24/2021
" General Decision Number : IA20210028 01 / 01 / 2021
Superseded General Decision Number : IA20200028
State : Iowa
Construction Types : Heavy and Highway
Counties : Adair , Adams , Allamakee , Appanoose , Audubon ,
Benton , Black Hawk , Boone , Bremer , Buchanan , Buena Vista ,
Butler , Calhoun , Carroll , Cass , Cedar , Cerro Gordo , Cherokee ,
Chickasaw , Clarke , Clay , Clayton , Clinton , Crawford , Dallas ,
Davis , Decatur , Delaware , Des Moines , Dickinson , Dubuque ,
Emmet , Fayette , Floyd , Franklin , Fremont , Greene , Grundy ,
Guthrie , Hamilton , Hancock , Hardin , Harrison , Henry , Howard ,
Humboldt , Ida , Iowa , Jackson , Jasper , Jefferson , Johnson ,
Jones , Keokuk , Kossuth , Lee , Linn , Louisa , Lucas , Lyon ,
Madison , Mahaska , Marion , Marshall , Mills , Mitchell , Monona ,
Monroe , Montgomery , Muscatine , O ' Brien , Osceola , Page , Palo
Alto , Plymouth , Pocahontas , Polk , Pottawattamie , Poweshiek ,
Ringgold , Sac , Shelby , Sioux , Story , Tama , Taylor , Union , Van
Buren , Wapello , Warren , Washington , Wayne , Webster , Winnebago ,
Winneshiek , Woodbury , Worth and Wright Counties in Iowa .
EXCLUDES SCOTT COUNTY
HEAVY AND " HIGHWAY CONSTRUCTION PROJECTS
Note : Under Executive Order ( EO ) 13658 , an hourly minimum wage
of $ 10 . 95 for calendar year 2021 applies to all contracts
subject to the Davis - Bacon Act for which the contract is awarded
( and any solicitation was issued ) on or after January 1 , 2015 .
If this contract is covered by the E0 , the contractor must pay
all workers in any classification listed on this wage
determination at least $ 10 . 95 per hour ( or the applicable
wage rate listed on this wage determination , if it is higher )
for all hours spent performing on the contract in calendar
year 2021 . If this contract is covered by the EO and a
classification considered necessary for performance of work on
the contract does not appear on this wage determination , the
contractor must pay workers in that classification at least
the wage rate determined through the conformance process set
forth in 29 CFR 5 . 5 ( a ) ( 1 ) ( ii ) ( or the EO minimum wage rate ,
if it is higher than the conformed wage rate ) . The EO minimum
wage rate will be adjusted annually . Please note that
this EO applies to the above - mentioned types of contracts
entered into by the federal government that are subject
to the Davis - Bacon Act itself , but it does not apply
to contracts subject only to the Davis - Bacon Related Acts ,
including those set forth at 29 CFR 5 . 1 ( a ) ( 2 ) - ( 60 ) . Additional
1
information on contractor requirements and worker protections
under the EO is available at www . dol . gov / whd / govcontracts .
Modification Number Publication Date
0 01 / 01 / 2021
SUTA2020 - 001 10 / 18 / 2017
Rates Fringes
Carpenter & Piledrivermen
ZONE 1 . . . . . . . . . . . . . . . . . . . . . . $ 28 . 52 14 . 08
ZONE 2 . . . . . . . . . . . . . . . . . . . . . . $ 26 . 73 14 . 08
ZONE 3 . . . . . . . . . . . . . . . . . . . . . . $ 26 . 73 14 . 08
ZONE 4 . . . . . . . . . . . . . . . . . . . . . . $ 26 . 25 11 . 50
ZONE 5 * * . . . . . . . . . . . . . . . . . . . . $ 25 . 15 9 . 90
CONCRETE FINISHER
ZONE 1 . . . . . . . . . . . . . . . . . . . . . . $ 28 . 10 7 . 40
ZONE 2 . . . . . . . . . . . . . . . . . . . . . . $ 28 . 10 7 . 40
ZONE 3 . . . . . . . . . . . . . . . . . . . . . a $ 28 . 10 7 . 40
ZONE 4 . . . . . . . . . . . . . . . . . . . . . . $ 25 . 45 6 . 40
ZONE 5 . . . . . . . . . . . . . . . . . . . . . $ 24 . 40 6 . 40
ELECTRICIAN ( STREET AND
HIGHWAY LIGHTING AND TRAFFIC
SIGNALS )
ZONE 1 , 21 AND 3 . . . . . . . , . . . . $ 25 . 05 6 . 80
ZONE 4 . . . . . . . . . . . . . . . . . . . . . . $ 23 . 75 6 . 80
ZONE 5 . . . . . . . . . . . . . . . . . . . . . . $ 21 . 60 6 . 80
IRONWORKER ( SETTING OF
STRUCTURAL STEEL )
ZONE 1 . . . . . . . . . . . . . . . . . . . . . . $ 31 . 50 10 . 90
ZONE 2 . . . . . . . . . . . . . . . . . . . . . $ 29 . 42 10 . 90
ZONE 3 . . . . . . . . . . . . . . . . . . . . . . $ 29 . 41 11 . 20
ZONE 4 . . . . . . . . . . . . . . . . . . . . . . $ 27 . 35 9 . 90
ZONE 5 * * . . . . . . . . . . . . . . . . . . . . $ 25 . 50 9 . 45
LABORER
ZONE 11 2 AND 3
GROUP A . . . . . . . . . . . . . . . . . . . . $ 23 . 75 9 . 68
GROUP AA . . . . . . . . . . . . . . . . . . . $ 26 . 13 9 . 68
GROUP B . . . . . . . . . . . . . . . . . . . . $ 21 . 90 9 . 68
GROUP C _ . . . . . . . . . . . . . . . . . . . $ 18 . 82 9 . 68
ZONE 4
GROUP A . . . . . . . . . . . . . . . . . . . . $ 21 . 27 9 . 08
GROUP B . . . . . . . . . . . . . . . . . . . . $ 19 . 95 9 . 08
GROUP C . . . . . . . . . . . . . . . . . . . . $ 17 . 07 9 . 08
ZONE 5
2
GROUP A . . . . . . . . . . . . . . . . . . . . $ 21 . 77 7 . 63
GROUP 8 . . . . . . . . . . . . . . . . . . . . $ 19 . 27 7 . 63
GROUP C . . . . . . . . . . . . . . . . . . . . $ 18 . 42 7 . 63
POWER EQUIPMENT OPERATOR
ZONE 1
GROUP A . . . . . . . . . . . . . . . . . . . . $ 32 . 55 14 . 90
GROUP B . . . . . . . . . . . . . . . . . . . . $ 31 . 00 14 . 90
GROUP C . . . . . . . . . . . . . . . . . . . . $ 28 . 50 14 . 90
GROUP D . . . . . . . . . . . . . . . . . . . . $ 28 . 50 14 . 90
ZONE 2
GROUP A . . . . . . . . . . . . . . . . . . . . $ 31 . 85 14 . 90
GROUP B . . . . . . . . . . . . . . . . . . . . $ 30 . 25 14 . 90
GROUP C . . . . . . . . . . . . . . . . . . . . $ 27 . 70 14 . 90
GROUP D . . . . . . . . . . . . . . . . . . . . $ 27 . 70 14 . 90
ZONE 3
GROUP A . . . . . . . . . . . . . . . . . . . . $ 29 . 70 24 . 65
GROUP B . . . . . . . . . . . . . . . . . . . . $ 27 . 90 24 . 65
GROUP Ce 9 a a 0 q 6 4 0 0 6 a 9 4 4 9 26 . 90 24 . 65
GROUP D . . . . . . . . . . . . . . . . . . . . $ 26 . 90 24 . 65
ZONE 4
GROUP A . . . . . . . . . . . . . . . . . . . . $ 31 . 05 12 . 50
GROUP B . . . . . . . . . . . . . . . . . . . . $ 29 . 91 12 . 50
GROUP C . . . . . . . . . . . . . . . . . . . . $ 27 . 83 12 . 50
GROUP D . . . . . . . . . . . . . . . . . . . . $ 27 . 83 12 . 50
ZONE 5
GROUP A . . . . . . . . . . . . . . . . . . . . $ 28 . 02 10 . 70
GROUP 8 . . . . . . . . . . . . . . . . . . . . $ 26 . 98 10 . 70
GROUP C . . . . . . . . . . . . . . . . . . . . $ 25 . 25 10 . 70
GROUP D . . . . . . . . . . . . . . . . . . . . $ 24 . 25 10 . 70
TRUCK DRIVER ( AND PAVEMENT
MARKING DRIVER/ SWITCHPERSON )
ZONE 1 . . . . . . . . . . . . . . . . . . . . . . $ 24 . 45 11 . 15
ZONE 2
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 24 . 45 11 . 15
ZONE 3 . . . . . . . . . . . . . . . . . . . . . . $ 24 . 45 11 . 15
ZONE 4 . . . . . . . . . . . . . . . . . . . . . . $ 24 . 45 6 . 95
ZONE 5
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 22 . 50 6 . 95
ZONE DEFINITIONS
ZONE 1 The Counties of Polk , Warren , and Dallas for all
Crafts , and Linn County Carpenters only .
ZONE 2 The Counties of Dubuque for all Crafts and Linn County
for all Crafts except Carpenters .
ZONE 3 The Cities of Burlington , Clinton , Fort Madison ,
Keokuk , and Muscatine ( and abutting municipalities of any
such cities ) .
ZONE 4 Story , Black Hawk , Cedar , Jasper , Jones , Jackson ,
Louisa , Madison , and Marion Counties ; Clinton County
( except the City of Clinton ) , Johnson County , Muscatine
3
County ( except the City of Muscatine ) , the City of Council
Bluffs , Lee County and Des Moines County .
ZONE 5 All areas of the state not listed above .
LABORER CLASSIFICATIONS - ALL ZONES
GROUP AA - ( Skilled pipelayer ( sewer , water and conduits ) and
tunnel laborers ; asbestos abatement worker ) ( Zones 1 , 2 and
3 ) .
GROUP A - Carpenter tender on bridges and box culverts ; curb
machine ( without a seat ) ; deck hand , diamond & core drills ;
drill operator on air tracs , wagon drills and similar
drills , form setter / stringman on paving work ; gunnite
nozzleman ; joint sealer kettleman ; laser operator ;
powderman tender ; powderman / blaster ; saw operator ,
( pipelayer ( sewer , water , and conduits ) ; sign erector * ;
tunnel laborer , asbestos abatement worker ( Zones 4 and 5 ) ) ,
sign erector .
GROUP B - Air , gas , electric tool operator ; barco hammer ,
carpenter tender ; caulker ; chain sawman ; compressor ( under
400 cfm ) ; concrete finisher tender ; concrete processing
materials and monitors ; cutting torch on demolition ; drill
tender ; dumpmen ; electric drills ; fence erectors ; form line
expansion joint assembler ; form tamper ; general laborer ,
grade checker ; handling and placing metal mesh , dowel bars ,
reinforcing bars and chairs ; hot asphalt laborer ;
installing temporary traffic control devices ;
jackhammerman ; mechanical grouter ; painter ( all except
stripers ) ; paving breaker , planting trees , shrubs and
flowers ; power broom ( not self - propelled ) ; power buggyman ;
rakers ; rodman ( tying reinforcing steel ) ; sandblaster ;
seeding and mulching ; sewer utility topman/bottom man ;
F
spaders ; stressor or stretcherman on pre or post tensioned
concrete ; stringman on re / surfacing / no grade control ;
swinging stage , tagline , or block and tackle ; tampers ;
timberman ; tool room men and checkers ; tree climber ; tree
groundman ; underpinning and shoring caissons over twelve
feet deep ; vibrators ; walk behind trencher ; walk behind
paint stripers ; walk behind vibrating compactor ; water
pumps ( under three inch ) ; work from bosun chair .
GROUP C - Scale weigh person ; traffic control / flagger ,
surveillance or monitor ; water carrier .
POWER EQUIPMENT OPERATOR CLASSIFICATIONS - ALL ZOITES
GROUP A - All terrain ( off road ) forklift ; asphalt breakdown
roller ( vibratory ) ; asphalt laydown machine ; asphalt plant ;
asphalt screed ; bulldozer ( finish ) ; central mix plant ;
concrete pump , crane ; crawler tractor pulling scraper ;
directional drill ( 60 , 000 ( lbs ) pullback and above ) ;
dragline and power shovel ; dredge engineer ; excavator ( over
4
�4 cu . yd . ) ; front end loader ( 4 cy and over ) ; horizontal
boring machine ; master mechanic ; milling machine ( over 350
hp ) ; motor grader ( finish ) ; push cat ; rubber tired backhoe
( over 34 cu . yd . ) ; scraper ( 12 cu . yd . and over or finish ) ;
Self - propelled rotary mixer / road reclaimer ; sidebroom
tractor ; slipform portland concrete paver ; tow or push
boat ; trenching machine ( Cleveland 80 or similar )
GROUP B - Articulated oft road hauler , asphalt heater / planer ;
asphalt material transfer vehicle ; asphalt roller ; belt
loader or similar loader ; bulldozer ( rough ) ; churn or
rotary drill ; concrete curb machine ; crawler tractor
pulling ripper , disk or roller ; deck hand/ oiler ;
directional. drill ( less than 60 , 000 ( lbs ) pullback ) ;
distributor ; excavator ( 1 / 2 cu . yd . and under ) ; form riding
concrete paver ; front end loader ( 2 to less than 4 cu .
yd . ) ; group equipment greaser ; mechanic ; milling machine
( 350 hp . and less ) ; paving breaker ; portland concrete dry
batch plant ; rubber tired backhoe ( 1 / 2 cu . yd . and under ) ;
scraper ( under 12 cu , yd . ) ; screening , washing and crushing
plant ( mobile , portable or stationary ) ; shoulder machine ;
skid loader ( 1 cu . yd . and over ) ; subgrader or trimmer ;
trenching machine ; water wagon on compaction .
GROUP C - Boom & winch truck ; concrete spreader / belt placer ;
deep wells for dewatering ; farm type tractor ( over 75 hp . )
pulling disc or roller ; forklift ; front end loader ( under 2
cu . yd . ) ; motor grader ( rough ) ; pile hammer power unit ;
pump ( greater than three inch diameter ) ; pumps on well
points ; safety boat ; self - propelled roller ( other than
asphalt ) ; self - propelled sand blaster or shot blaster ,
water blaster or striping grinder / remover ; skid loader
( under 1 cu . yd . ) ; truck mounted post driver .
GROUP D - Boiler ; compressor ; cure and texture machine ; dow
box ; farm type or utility tractor ( under 75 hp . ) pulling
disk , roller or other attachments ; group greaser tender ,
light plants ; mechanic tender ; mechanical broom , mechanical
heaters ; oiler ; pumps ( under three inch diameter ) ; tree
chipping machine ; truck crane driver / oiler .
* * CARPENTERS AND PILEDRIVERMEN , or IRONWORKERS ( ZONE 5 )
Setting of structural steel ; any welding incidental to bridge
or culvert construction ; setting concrete beams .
* ADDED CRAFT - SIGN ERECTOR
WELDERS - Receive rate prescribed for craft performing
operation to which welding is incidental .
i
Note : Executive Order ( EO ) 13706 , Establishing Paid Sick Leave
for Federal Contractors applies to all contracts subject to the
Davis - Bacon Act for which the contract is awarded ( and any
solicitation was issued ) on or after January 1 , 2017 . If this
contract is covered by the E0 , the contractor must provide
employees with 1 hour of paid sick leave for every 30 hours
they work , up to 56 hours of paid sick leave each year .
Employees must be permitted to use paid sick leave for their
own illness , injury or other health - related needs , including
preventive care ; to assist a family member ( or person who is
like family to the employee ) who is ill , injured , or has other
health- related needs , including preventive care ; or for reasons
resulting from , or to assist a family member ( or person who is
like family to the employee ) who is a victim of , domestic
violence , sexual assault , or stalking . Additional information
on contractor requirements and worker protections under the EO
is available at www . dol . gov/ whd / govcontracts .
Unlisted classifications needed for work not included within
the scope of the classifications listed may be added after
award only as provided in the labor standards contract clauses
( 29CFR 5 . 5 ( a ) ( 1 ) ( ii ) )
The body of each wage determination lists the classification
and wage rates that have been found to be prevailing for the
cited type ( s ) of construction in the area covered by the wage
determination . The classifications are listed in alphabetical
order of " " identifiers " " that indicate whether the particular
rate is a union rate ( current union negotiated rate for local ) ,
a survey rate ( weighted average rate ) or a union average rate
( weighted union average rate ) .
Union Rate Identifiers
A four letter classification abbreviation identifier enclosed
in dotted lines beginning with characters other than 'ItISU " " or
" UAVG " " denotes that the union classification and rate were
prevailing for that classification in the survey . Example :
PLUM0198 - 005 07 / 01 / 2014 . PLUM is an abbreviation identifier of
Ile
the union which prevailed in the survey for this
classification , which in this example would be Plumbers . 0198
indicates the local union number or district council number
where applicable , i . e . , Plumbers Local 0198 . The next number ,
005 in the example , is an internal number used in processing
the wage determination . 07 / 01 / 2014 is the effective date of the
most current negotiated rate , which in this example is July i ,
6
2014
Union prevailing wage rates are updated to reflect all rate
changes in the collective bargaining agreement ( CBA ) governing
this classification and rate .
Survey Rate Identifiers
Classifications listed under the " " SU " " identifier indicate that
no one rate prevailed for this classification in the survey and
the published rate is derived by computing a weighted average
rate based on all the rates reported in the survey for that
classification . As this weighted average rate includes all
rates reported in the survey , it may include both union and
non - union rates . Example : SULA2012 - 007 5 / 13 / 2014 . SU indicates
the rates are survey rates based on a weighted average
calculation of rates and are not majority rates . LA indicates
the State of Louisiana . 2012 is the year of survey on which
these classifications and rates are based . The next number , 007
in the example , is an internal number used in producing the
wage determination . 5 / 13 / 2014 indicates the survey completion
date for the classifications and rates under that identifier .
Survey wage rates are not updated and remain in effect until a
new survey is conducted .
Union Average Rate Identifiers
Classification ( s ) listed under the UAVG identifier indicate
that no single majority rate prevailed for those
classifications ; however , 100 % of the data reported for the
classifications was union data . EXAMPLE : UAVG - OH - 0010
08 / 29 / 2014 . UAVG indicates that the rate is a weighted union
average rate . OH indicates the state . The next number , 0010 in
the example , is an internal number used in producing the wage
determination . 08 / 29 / 2014 indicates the survey completion date
for the classifications and rates under that identifier .
A UAVG rate will be updated once a year , usually in January of
each year , to reflect a weighted average of the current
negotiated / CBA rate of the union locals from which the rate is
based .
WAGE DETERMINATION APPEALS PROCESS
1 . ) Has there been an initial decision in the matter ? This can
be :
7
* an existing published wage determination
* a survey underlying a wage determination
* a Wage and Hour Division letter setting forth a position on
a wage determination matter
* a conformance ( additional classification and rate ) ruling
on survey related matters , initial contact , including requests
for summaries of surveys , should be with the Wage and Hour
Regional office for the area in which the survey was conducted
because those Regional offices have responsibility for the
Davis - Bacon survey program . If the response from this initial
contact is not satisfactory , then the process described in 2 . )
and 3 . ) should be followed .
With regard to any other matter not yet ripe for the formal
process described here , initial contact should be with the
Branch of Construction Wage Determinations . Write to :
Branch of Construction Wage Determinations
Wage and Hour Division
U . S . Department of Labor
200 Constitution Avenue , N . W .
Washington , DC 20210
2 . ) If the answer to the question in 1 . ) is yes , then an
interested party ( those affected by the action ) can request
review and reconsideration from the Wage and Hour Administrator
( See 29 CFR Part 1 . 8 and 29 CFR Part 7 ) . Write to :
Wage and Hour Administrator
U . S . Department of Labor
200 Constitution Avenue , N . W .
Washington , DC 20210
The request should be accompanied by a full statement of the
interested party ' s position and by any information ( wage
payment data , project description , area practice material ,
etc . ) that the requestor considers relevant to the issue .
3 . ) If the decision of the Administrator is not favorable , an
interested party may appeal directly to the Administrative
Review Board ( formerly the Wage Appeals Board ) . Write to :
Administrative Review Board
U . S . Department of Labor
200 Constitution Avenue , N . W .
Washington , DC 20210
4 . ) All decisions by the Administrative Review Board are final .
END OF GENERAL DECISION
F
Advanced Phone : ( 3191396- 5269 Fax : ( 319) 396-0328
Traffic Control P . O . Box 8958 Cedar Rapids, IA 52408
,oil
QUOTATION
Bid Date : September 30 , 2021
Project : City of Waterloo - US Highway 63 Sanitary Sewer Upgrades , Phase I
Bid Item Description Units Quantity Per Unit Total
Item
2 Traffic Control LS 1 . 00 $ 24 , 500 . 00 $ 24 , 500 . 00
TOTAL : $24 , 500 . 00
- 100 % of this quote can be applied towards DBE Goal .
-Advanced Traffic Control will INITIALLY install and remove traffic control devices according to plans .
- Contractor is responsible for daily maintenance of traffic control devices .
-Contractor is responsible for daily setup , removal , and relocation of traffic control devices , if required .
-Quote does NOT include flaggers , traffic control diary , safety fencing , or temporary access measures .
- Quote assumes use of shoulder closures along US 63/Sergeant Rd . Please call for revised pricing if lane
closures will be needed .
Matt Ewe GtosI
Matt Brazelton , Estimator Accepted By Date
515-330-5769
mattcDadvanced4raffic. com
signed copy of this quotation must either be returned to A dvoncedTraffic Contro , Inc. or included in a subcontract prior to beginning work. This
quotation, if accepted, is sub 'ect to the parties neaotiatina in aood faith and executing a mutually acceptable written agreement. This ouotation
/V0_
CIA
Attachment 4
SRF Required Front- End Specifications
(This form must be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid)
Disadvantaged Business Enterprise Program
DBE Subcontractor Performance Form
This form is intended to capture the DBE ' subcontractor' sz description of work to be performed and the price of the work
submitted to the prime contractor. An EPA Financial Assistance Agreement recipient must require its prime contractor to
have its DBE subcontractors complete this form and include all completed forms in the prime contractor' s bid or proposal
package .
Subcontractor Name Project Name
Advanced Traffic Control , Inc . US Highway 63 Sanitary Sewer Upgrades , Phase I
Bid/Proposal No . Assistance Agreement ID No . Point of Contact
( if known )
Address PO Box 8958
Cedar Rapids , IA 52408
Telephone No . Email Address
319-396- 5269 vmiller@advanced -traffic . com
Prime Contractor Name Issuing/Funding Entity
Contract Item Description of Work Submitted to the Prime Contractor Involving Price of Work Submitted to
Number Construction , Services , Equipment or Supplies the Prime Contractor
2 Traffic Control $241500 . 00
DBE Certified by x DOT SBA Meets/exceeds EPA certification standards ?
Other: X YES NO Unknown
' A DBE is a Disadvantaged , Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts
certification as described in 40 CFR 33 . 204-33 . 205 or certified by EPA. EPA accepts certifications from entities that meet or exceed
EPA certification standards as described in 40 CFR 33 . 202 .
2Subcontractor is defined as a company, firm , joint venture , or individual who enters into an agreement with a contractor to provide
services pursuant to an EPA award of financial assistance .
IASRF6100 -3 DBE Subcontractor Performance Form — Page 1
SRF-7 January 2021
Disadvantaged Business Enterprise Program
DBE Subcontractor Performance Form
I certify under penalty of perjury that the forgoing statements are true and correct . Signing this form does not signify a
commitment to utilize the subcontractors above . I am aware of that in the event of a replacement of a subcontractor, I will
adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33 . 302 (c ) .
Prime Contractor Signature Print Name
Title Date
Subcontractor Signature Print Name
Vaugn Miller
Title Date
President 09/29/21
IASRF6100 =3 DBE Subcontractor Performance Form — Page 2
SRF-8 January 2021