HomeMy WebLinkAboutBoomerang Corp Boomerang Corp
13225 Circle Dr. Suite A
P . O . Box 227
Anamosa , Iowa 52205
City of Waterloo
City Clerk/Auditor
715 Mulberry St .
Waterloo , IA 50703
US Hwy 63 Sanitary Sewer t
Upgrade — Phase 1 LU
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Date & Time of Letting :
September 30 , 2021 0 Z
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1 : 00PM �; >a
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BID ENCLOSED
Boomerang Corp
13225 Circle Dr . Suite A
P . O . Box 227
Anamosa , Iowa 52205 !,
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City of Waterloo
City Clerk/Auditor
715 Mulberry St .
Waterloo , IA 50703
US Hwy 63 Sanitary Sewera
Upgrade — Phase 1 ��a c•a
if
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Date & Time of Letting : {
September 30 , 2021
1 : 00PM
f .
Bid Security j ,
Revised Per Addendum No . 1 - 9/24/2021
FORM OF BID OR PROPOSAL
i
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 .- OLLA
a Partnership consisting of the following partners : ti A
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 LUMP 10 $
sum 3,Soo, 000 . oD
2 8030-A TRAFFIC CONTROL SUMP 1 . 0 $ �{, Sop .p $ a?q
3 2010- C CLEARING AND GRUBBING SUMP 1 . 0 $ 4 icw pp $ it2 000 , 0()
4 3010-13 FOUNDATION ROCK TON 11660 . 0 $ y0 • (� $ (�/p 4t� . UQ
5 3010-F TRENCH COMPACTION TESTING LUMP 1 . 0 $ io c *00 $ D 5W , ()G
SUM
6 4010-L ABANDON , FILL AND PLUG 21 -INCH LF 2, 958 . 0 $ 0 $ ,59 , lb0 01)
SANITARY SEWER
7 4010-H REMOVE AND PLUG 21 - INCH LF 1 , 863 . 0 $ � D • UQ $ ; 7 D . C�D
SANITARY SEWER
8 4010-K ABANDON MANHOLE SANITARY SEWER EA 9 . 0 $ 11000 % 00 $ 91O40O . 00J
9 6010- H REMOVE SANITARY SEWER MANHOLE EA 6 . 0 $ I , $ 7 JQO . O
tl
10 4060 CLEANING , INSPECTION AND TESTING LUMP 1 . 0 $ X, CabG .00 06
OF SANITARY SEWER GRAVITY MAINS SUM 00� 0U
11 4010-A-2 18 INCH SANITARY SEWER GRAVITY LF 1 , 123 . 5 $ 3Dv . dv $337
MAIN - DIRECTIONAL DRILLING
12 4010-A- 1 INCH SANITARY SEWER GRAVITY
MAIN - OPEN CUT LF 371 . 5 $ (�jOQ •Q�j $
MA ,
13 4010-A- 1 INCH SANITARY SEWER GRAVITY
MAIN - OPEN CUT LF 6 , 213 . 0 $ 900 , 00 $ 5, 59 i 706 )
MA
14 4010-A-2 48- INCH SANITARY SEWER GRAVITY LF 342 . 6 $ ;l, y()o . to $ �g� ;2L,0 D
MAIN -TRENCHLESS
15 6010-A 48- INCH CIRCULAR SANITARY SEWER EA 3 . 0 $ $
MANHOLE , SW-301
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 Unit Bid Total Bid
No . No . Description Unit Est. Qty . price Price
16 6010-A 72- INCH CIRCULAR SANITARY SEWER EA 1 . 0 $2/-/ 661� . 6CJOki
MANHOLE , SW-301 $
17 6010-A 84- INCH CIRCULAR SANITARY SEWER EA 1 . 0 $ 39, $
MANHOLE , SW-301ib� " U
18 6010-A 96- INCH CIRCULAR SANITARY SEWER EA 5 . 0 $ L10, ow .661 $ �QLI (1Q� . 0 4 )
MANHOLE , SW-301
19 6010-A 120-INCH CIRCULAR SANITARY EA 4 . 0 $ 60, b0D • 60 $ 2'10, 000 . 0
SEWER MANHOLE , SW-301
20 6010-A 48- INCH TEE-SECTION SANITARY EA 11 . 0 $SU, 606 ) $ 006 . 0
SEWER MANHOLE , SW-305
21 6010-G CONNECTION TO EXISTING SANITARY EA 1 . 0 $56, 666 - 66 $ 'so 4006 . 0
MANHOLE
22 7010-A 6 - INCH PCC PAVEMENT SY 25 . 4 $ &40a 06 $ � 5ca4
23 7010-A 8- INCH PCC PAVEMENT SY 373 . 8 $ A1C 66 $ '4. 156 0 4/40
24 7020-B 8- INCH HMA PAVEMENT SY 923 . 1 $ S/ 66 $ I42q7 ,
25 7010-E 6- INCH PCC CURB AND GUTTER LF 95 . 0 $ LIS, 06 $ L1) ;x 4) 6
26 7030- H -2 GRAVEL SURFACING SY 260 . 0 $ r�Qp . 06 $ 5 , :20 ,
27 7030-B CURB AND GUTTER REMOVAL LF 95 . 0 $ $
28 7040- H PAVEMENT REMOVAL SY 11582 . 3 $ Q , Ub $ ,3 / (Dye,. 60
SEEDING , FERTILIZING AND � ` ��
29 9010- B MULCHING FOR HYDRAULIC SEEDING ACRE 1 . 10 $ LY, 6 �Q� 06 $ L1 AOL
TYPE 1 SEED MIX
FERTILIZING
30 9010-B MULCHING FOR HYDRAULIC SEEDING ACRE 7 . 11
- TYPE 2 SEED MIX
SEEDING , FERTILIZING AND
31 9010- 13 MULCHING FOR HYDRAULIC SEEDING ACRE 1 . 10 $ Q66 - 00 $ 2 a40a . b�
- TYPE 4 SEED MIX
SEEDING , FERTILIZING AND
32 9010-B MULCHING FOR HYDRAULIC SEEDING ACRE 7 . 11 $ �2, 6w . 00 $ 1q 2� ^ �
X , 00
- TYPE 5 SEED MIX I 33 9040- F- 1 12- INCH WATTLES LF 81396 . 8 $ 40D $ 8 . 2G 7 .
34 9040-G-2-a DITCH CHECKS EA 30 . 0 $ y, vd $ I (�
35 9040-E TEMPORARY ROLLED EROSION SY 27 ,477 . 3 $ O0 $ cJ /� OjcS� .
CONTROL PRODUCTS RECP
36 9040-A-2 SWPPP REQUIREMENTS LUMP 1 . 0 $ �% ()6ao() $ 240 ew , 0
SUM
SANITARY AND STORM SEWER DISCONNECT - DRAWINGS 10 -SS -01 THROUGH 10 -SS -06
STORM SEWER MANHOLE , SW-401 ,
37 6010 A 48- INCH , EJ 1040 A COVER EA 1 . 0 $ `j i/UQ• QU $ 51 q00 00
38 6010-A STORM SEWER MANHOLE , SW-401 , EA 1 . 0 $ 600. UQ $ 6d Q
60-INCH , EJ 1040 A COVER [ v
39 6010-B INTAKE , SW-501 & SW-603 TYPE R EA 3 . 0 $3, 00 U0 $ 9 , �pQn . (SLI
GRATE
40 6010-13 INTAKE , SW-501 & SW-604 TYPE 6 EA 7 . 0
GRATE 3 . Dov OG $ a
41 6010-G CONNECTION TO EXISTING STORM EA 1 . 0 $ 3� :z0D •(�Q $ 34d 4000 • DD
SEWER STRUCTURE
4030-B APRON WITH FOOTING AND GUARD ,
42 4030-C 12- INCH EA 1 . 0 $ 9 200 .60 $ 211SW • d0
4030-C
4030-B APRON WITH FOOTING AND GUARD ,
43 4030-C 18- INCH EA 1 . 0 $ .2, 860 . 6 () $ 91S00 • 0
4030- D
Form of Bid FB-2 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
i
I
Revised Per Addendum No . 1 - 9/24/2021
Item SUDAS Unit Bid Total Bid
No . No . Description Unit Est. Qty . Price Price `'
44 4020 A-1 STORM SEWER, DUCTILE IRON PIPE ,10- INCH DIA. - OPEN CUT 3�LF 24 . 6 $ j C L� 0, 31W , 0V
STORM SEWER , REINFORCED n +
45 4020-A- 1 CONCRETE PIPE , 12 INCH DIA. - OPEN LF 219 . 4 $ ( D QD $ t)6
CUT
STORM SEWER , REINFORCED I1
46 4020-A-1 CONCRETE PIPE , 15- INCH DIA. - OPEN LF 690 . 6 $ � a� • Up $ c3C-C , "7a ,
CUT
STORM SEWER, REINFORCED
47 4020-A- 1 CONCRETE PIPE , 18- INCH DIA. - OPEN LF 253 . 8 $ $ 7 9 1q, 06
CUT
48 7010-E 6- INCH PCC CURB AND GUTTER LF 70 . 0 $ `7g , U � $ 3 3 (00 . QG
49 7030-1-1-2 GRAVEL SURFACING SY 14 . 5 $ �� , QQ $
50 7040- H PAVEMENT REMOVAL SY 1 , 221 . 0 $
51 6010- H REMOVE INTAKE EA 5 . 0 $ J 06t. QC $ 5� QOD • 60
52 4020-G REMOVAL OF STORM SEWER LF 107. 0 $ c2o . 66 $ �2 ( yv . UC
53 7040-A 3- INCH HMA PATCH SY 356 . 0 $ 40f c) n $
54 2010- 1 6- INCH MODIFIED SUBBASE SY 356 . 0 $ j to 06 $ 5, ,40 0
55 9040-J EROSION STONE WITH ENGINEERING TONS 13 . 0 $ 1XvU $ it '5 (064 00
FABRIC
56 9010-B HYDRAULIC SEEDING , FERTILIZING ACRE 0. 4 $ yc)Lia C1� $ � , (� �0 • 00AND MULCHING
TOTAL AMOUNT BID
2 . It is understood that the quantities set forth are approximate only and subject to variation and that the
unit bid price for the work done shall govern in the actual payment to Contractor.
3 . In submitting this bid , the bidder understands that the right is reserved by the City of Waterloo , Iowa ,
to reject any or all bids . If written notice of the acceptance of this bid is mailed , telegraphed , or delivered
to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter before this
bid is withdrawn , the undersigned agrees to execute and deliver an agreement in the prescribed form
and furnish the required bond and certificate of the insurance within ten ( 10) days after the agreement
is presented to him for signature , and start work within ten ( 10) days after " Notice to Proceed " is issued .
4 . Security in the sum of r1 tom ! Dollars
($ Sc7(� ) in the form of C , 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 O . ( 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 . R —c qoi Date
02 X
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 .
( Name of idder) ( Date)
BY : � ` Title
Official Address : ( Including Zip Code) :
5 C 0J rcIe C; 1 S .L,( � � P
rl.�r�rn//nnom. I.tel►�.�Q ,�
I . R . S . No . `70( ' JCJ64 / u
it
Form of Bid FB-4 of 4 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM #60651387 Contract No . 1037 Waterloo , Iowa
NON - COLLUSION AFFIDAVIT OF PRIME BIDDER
State of
) ss
County of orw-
X3�x'Q_ h � i CKIQC � being first duly sworn , deposes and says that :
1 . He is ( Owner, Partner Officer Representative , or Agent) of lwmwan —`t'
the Bidder that has submitted the attached Bid ;
2 . He is fully informed respecting the preparation and contents of the attached Bid and of all
pertinent circumstances respecting such Bid ;
3 , Such Bid is genuine and is not a collusive or sham Bid ;
4 . Neither the said Bidder nor any of its officers , partners , owners , agents , representatives ,
employees , or parties in interest , including this affiant , has in any way colluded , conspired ,
connived or agreed , directly or indirectly , with any other Bidder , firm or person to submit a
collusive or sham Bid in connection with the Contract for which the attached Bid has been
submitted or to refrain from bidding in connection with such Contract , or has in any manner,
directly or indirectly , sought by agreement or collusion or communication or conference with any
other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder , or,
to fix any overhead , profit or cost element of the bid price or the bid price of any other Bidder, or
to secure through any collusion , conspiracy , connivance , or unlawful agreement any advantage
against the City of Waterloo , Iowa , or any person interested in the Proposed Contract ; and
5 . The price or prices quoted in the attached Bid are fair and proper and are not tainted by any
collusion , conspiracy , connivance or unlawful agreement on the part of the Bidder or any of its
agents , representatives , owners , employees , or parties in interest , including this affiant .
(Signed )
UP
Title /
Subscribed and sworn to before me this
day of 1 2000, it
Title
My commission expires
JENNA HAAG
` ^ Commission Number 768229
_ My Commission Expires
10WN
Non-Collusion Affidavit NCA- 1 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 :
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) .
Yes ElNo My company has an office to transact business in Iowa .
2 Yes ❑ No My company's office in Iowa is suitable for more than receiving mail , telephone calls , and e-mail .
' Yes ❑ No My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project .
EYes ❑ 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 �a" 1�t-
ddreesses(:�j, I ^
Dates : / /l 1 In to K / Address : � 0�5:� L, fYia KLrCi� �
City, State, Zip : I nn na 2 , 1CL �0 5
Dates : / ` C' to CaCLLI— / Address : et rcCbcl U �
City, State , Zip : 8no KnQ -ICA
Dates : / / to / / Address :
You may attach additional sheet(s) if needed. City, State, Zip :
To be completed by non -resident bidders Part C
1 . Name of home state or foreign country reported to the Iowa Secretary of State :
2 . Does your company' s home state or foreign country offer preferences to resident bidders , resident labor ❑ 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 : e0cle)
Signature : Date :
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)
BSF- 1
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 .
Yes ❑ No My business is currently registered as a contractor with the Iowa Division of Labor.
/❑` Yes ❑ No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes .
❑ Yes ❑ No My business is a general partnership orjoint venture . More than 50 percent of the general
partners or joint venture parties are residents of Iowa for Iowa income tax purposes .
es ❑ No My business is an active corporation with the Iowa Secretary of State and has paid all fees
required by the Secretary of State , has filed its most recent biennial report , and has not filed
articles of dissolution .
❑ Yes ❑ 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 ❑ 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 ❑ 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 ❑ 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 ❑ 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 ❑ 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 ❑ 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
MBE/WBE BUSINESS ENTERPRISE
PRE-BID CONTACT INFORMATION FORM J /
Prime Contractor Name : �nQ r Projec J �tA k Letting Date :
NO MBE/WBE SUBCONTRACTORS : If you are NOT using any MBEMBE subcontract rs`(qqo complete this project, sign below . Attach a brief
explanation as to why subcontracting was not feasible with this project. If any MBE/WBE subcontractors will be used , please use the bottom
portion of this form .
/ jj '�
Contractor Signature : �E%�Lf�t ! A 7 �r/L - Title : f Dater
SUBCONTRACTORS APPLICABLE : You are required , in order for your bid to be considered responsive , to provide the information on this form
showing ALL of your MBEM/BE subcontractor contacts made for your bid submission . This information is subject to verification . Any questions
should be directed to Contract Compliance Office 319 -291 -4429 .
You are required , in order for your bid to be considered responsive , to provide the information on this Form showing your MBEMBE Business
Enterprise contacts made prior to your bid submission . This information is subject to verifications and confirmation .
If you are unable to identify MBE/ BE firms to perform portions of the work , please contact Louis Starks , Contract Compliance Officer, for
assistance at (319) 291 -4429 .
In the event it is determined that the MBEMIBE Business Enterprise goals are not met, then before awarding the contract the City of Waterloo will
make a determination as to whether or not the apparent successful low bidder made good faith efforts to meet the goals .
TABLE OF INFORMATION SHOWING BIDDER'S PRE-BID
MBE/WBE BUSINESS ENTERPRISE CONTACTS
Quotes Received Quotation used in bid
MBE/WBE Dates Yes/No Dates Yes/No Dollar Amount Proposed to
Subcontractors Contacted Contacted be Subcontracted
P � - z ►�. �.t NA NA
Nomed m0favi* 9q& 7/ luo )�J /1 NA Nfq
IVA
( Form CCO-4) Rev. 06-20-02
MBEMBE Participation M-7 of 7 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM # 60651387 C ntract No. 1037/ _ ^ Waterloo, Iowa
C;r, pLr- s ( ,��-k /6 - a / ,^lG
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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 91 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) .
Signature Date
Sacoh lcklks V P
Name and Title of Signer ( Please Type)
NOTE : The penalty for making false statements in offers is prescribed in 18 U . S . C . 1001 ,
EPA- 7 5720-4 . 2
SRF-2 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 imnprisonment for up to 5 years , or both .
i Lca k\ R 'k c� k I eLc� - V
Typed Name & Title of Authorized Representative
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 ( ] DOT) . 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 :
Bidder :
Address : J, r
Contact Person :
Signature : .A Z "_ 94 WA=
Phone Number : 19 _ y Q� qqa45
E - Mail Address : cnhfmcl r . CD
rn
Check if Prime Contractor is : ❑ Minority - Owned V F1 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 ? tr 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 . Z 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 . 9 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? [9 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 ?
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
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PROPOSED UTILIZATION OF DBE SUBCONTRACTORS
Please include Attachments 4 and 5 to document the proposed utilization of certified DBE
subcontractors .
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SRF-5 , Jan ary 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
Advanced Traffic Control , Inc . US Highway 63 Sanitary Sewer Upgrades , Phase I
Bid/Proposal No . Assistance Agreement ID No . Point of Contact
( if known ) vh rn � � ► �
mom- WPl fe)n
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
`&Donnas- Cor (
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 $24 , 500 . 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
� P �t30J6 ,2
Subcontractor Signature Print Name
woo
Title Date
"Zl
1ASRF6100-3 DISE Subcontractor Performance Form — Page 2
SRF-B 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 /
= 1'Y1.Q.!-®-/l eb r c
US ILO (�Q 3 Slat) Ir lar SQ.l. er 21ck
Bid/Proposal No Q Assistance Agreement ID No . Point of Contact
( if known )
Address ( '� � X15 i rC (IL or # V SL., tQ R U 6c)x ;2a�)`
N)C ff d P �Tcxsl� 57c9900`
Telephone No , Email Address
3 17 — g b O - O y 3� t_on I reLCJSC boo M -era.n C 0 rp _ CO m
Issuing/Funding Entity
I have identified potential DBE certified subcontractors
YES NO
If yes , please com fete the table below. If no , please explain :
Subcontractor Company Address/Phone/Email Estimated Dollar Currently DBE
Name/Company Amount Certified ?
Name
(1c{ 0 2c - O . 60 )( ,395 , � S �A 5Zy
c 3t9 - 3�? (o -S�lc9 mci �t �oc�uo�ncec/�4�c . carr� ail, 600 . Co yle5
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 certifyunder penalty of perjury that the forgoing statements are true and correct . Signing this form does not signify a
p Y p l rY 9 9 9 9 Y
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
�. Saro'h kl ckle(
Title Date
IASRF61004 DBE Subcontractor Utilization Form — Page 2
SRF- 10 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 : httas : //www. sam . .qov/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 .
1 understand the above prohibitions and certify that the project will be in compliance with all the
requirements .
Typed Name & Title of Authorized Representative
3c / JC
Signature of Authorized Representative Date
SRF-34 January 2021
BID BOND
Boomerang Corp 13225 Circle Drive , Suite A , PO Box 227 , Anamosa IA 52205
KNOW ALL MEN BY THESE PRESENTS , that we ,
as Principal , and United Fire & Casualty Company 118 Second Avenue SE , PO Box 73909 , Cedar Rapids IA 52407-3909
as Surety are held and firmly bound unto the CITY OF WATERLOO Iowa , hereinafter cal led
" OWNER . " In the penal sum Five Percent of 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 Hwy 63 Sanitary Sewer Upgrade - Phase I
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 j
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 30th day of September A . D . 2021 t,)oaa,/
Boomerang Corp ( Seal)
Principal
By )�� gj � , P
(Title)
L United Fire & Casualty Company ( Seal)
Witness Surety
G�% Cf By
Witness Andy Scanlon VAttorney-i ac
Cassandra J . Daley - Attor y In F ct
l�J
Bid Bond BBA of 1 US Hwy 63 Sanitary Sewer Upgrades Ph I
AECOM X160651387 Contract No . 1037 Waterloo , Iowa
Uf9unUNITED FIRE & CASUALTY COMPANY, CEDAR RAPIDS , IA Inquiries : Surehy Department
UNITED FIRE & INDEMNITY COMPANY, WEBSTER, TX 118 Second Ave SE
FINANCIAL PACIFIC INSURANCE COMPANY, ROCKLIN , CA Cedar Rapids, IA 52401
CERTIFIED COPY OF POWER OF ATTORNEY
INSURANCE (original on file at Home Office of Company — See Certification)
"KNOW ALL PERSONS BY THESE PRESENTS, That United Fire & Casualty Company, a corporation duly organized and existing under the laws
of the State of Iowa; United Fire & Indemnity Company , a corporation duly organized and existing under the laws of the State of Texas; and
Financial Pacific Insurance Company , a corporation duly orgainized and existing under the laws of the State of California (herein collectively called
the Companies), and having their corporate headquarters in Cedar Rapids, State of Iowa, does make, constitute and appoint
TIMOTHY J , GASSMANN , , KEVIN S . MEASE , CASSANDRA J . DALEY , JENNIFER J . FREYMARK , JOAN A . BONEWITZ ,
MICHAEL L . BYL , '; LORI A . FRERICHS , KATIE A . MCGLAUN , ANDREW J . SCANLON , MEGAN A . KUKER , GLENDA R .
TIBBEN , KASSONIA R . DOCKER , RACHEL M . FRANKS , ASHLEY N . JACOBSEN , CHANDLER M . LAMM , EACH
INDIVIDUALLY
their true and lawful Attomey(s)-in-Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful bonds,
undertakings and other obligatory instruments of similar nature provided that no single obligation shall exceed $ 40 , 000 , 000 . 00
and to bind the Companies thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Companies
and all of the acts of said Attorney , pursuant to the authority hereby given and hereby ratified and confirmed.
The Authority hereby granted shall expire the 15th ' day of November , 2021 unless sooner revoked by United Fire & Casualty
Company, United Fire & Indemnity Company , and Financial Pacific Insurance Company ,
This Power of Attorney is made and executed pursuant to and by authority of the following bylaw duly adopted on May 15 , 2013, by the Boards of
Directors of United Fire & Casualty Company , United Fire & Indemnity Company, and Financial Pacific Insurance Company .
"Article VI — Surety Bonds and undertakings"
Section 2, Appointment of Attomey-in-Fact. "The President or any Vice President, or any other officer of the Companies may, from time to time , appoint by written
certificates attorneys-in-fact to act in behalf of the Companies in the execution of policies of insurance, bonds , undertakings and other obligatory instruments of like nature. ;
The signature of any officer authorized hereby, and the Corporate seal , may be affixed by facsimile to any power of attorney or special power of attomey or certification of
either authorized hereby; such signature and seal , when so used , being adopted by the Companies as the original signature of such officer and the original seal of the
Companies , to be valid and binding upon the Companies with the same force and effect as though manually affixed . Such attonneys-m4act, subject to the limitations set of
forth in their respective certificates of authority shall have full power to bind the Companies by their signature and execution of any such instruments and to attach the seal '
the Companies thereto . The President or any Vice President, the Board of Directors or any other officer of the Companies may at any time revoke all power and authority
previously given to any attorney-in-fact.
` IN WITNESS WHEREOF, the COMPANIES have each caused these presents to be signed by its
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�F c INsugq%ii, vice president and its corporate seal to be hereto affixed this 1 St h day of November , 2019
CO
' 9 CORArE °r= q CORPORATE __ = Q: - °
)ULY 2y Fo . 00 __ UNITED FIRE & CASUALTY COMPANY
i . _ Q.
SEAL Y ' SEAL s66 is = UNITED FIRE & INDEMNITY COMPANY
%,� os��, 6 <, /FQF?•' <
ER T6*rFINANCIAL PACIFIC INSURANCE COMPANY
By : .t
��/iees>• P� \,. /`//�/�{)�
,"ilpgnlnu,No�\` V
om ..> \. : r '
State of Iowa, County of Linn, ss : Vice President
On 15th day of November , 2019 , before me personally came Dennis J . - Richmann
to me known, who being by me duly sworn, did depose and say; that he resides in Cedar Rapids, State of Iowa ; that he is a Vice President of United Fire
& Casualty, Company, a Vice President of United Fire & Indemnity Company, and a Vice President of Financial Pacific Insurance Company the
corporations described in and which executed the above instrument; that he knows the seal of said corporations; that the seal affixed to the said
instrument is such corporate seal ; that it was so affixed pursuant to authority given by the Board of Directors of said corporations and that he signed his
name thereto pursuant to like authority , and acknowledges same to be the act and deed of said corporations.
. L Patti Waddell WaA&&,' Iowa Notarial Seal jaLv Commission number 713274 � otary Public
owe W Commission Expires 10/26/2022
My commission expires: 10/26/2022
I, Mary A . Bertsch, Assistant Secretary of United Fire & Casualty Company and Assistant Secretary of United Fire & Indemnity Company , and Assistant
Secretary of Financial Pacific Insurance Company , do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and
the copy of the Section of the bylaws and 'resolutions of said Corporations as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN THE
HOME OFFICE OF SAID CORPORATIONS, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said
Power of Attorney has not b nrevoked and is n v in full force anA effect.
In testi hereof I have her nt s b c 'bed n me and affixed corporate seal of the said Corporations
this day of , 20
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CORPORATE o ' = o i U .:2G�ULV.22 FO i gI
q `_ CORPORATE g By:
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SEAL ` . h SEAL
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