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CONTRACT AB-2022-02-04P
SEALED RFB FOR ASBESTOS ABATEMENT SERVICES
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IA 507 9 -11
111111111111111111111111
„20,50703—0000
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EXHIBIT "A"
SIGNATURE PAGE
The undersigned Proposer/Bidder, having examined these documents and having full knowledge of the
condition under which the work described herein must be performed, hereby proposes that they will fulfill the
obligations contained herein in accordance with all instructions, terms, conditions, and specifications set forth;
and that they will furnish all required services and pay all incidental costs in strict conformity with these
documents for the stated process as payment in full.
300 Allen Street, 307 Sumner Street, 335 Sumner Street, and 615 Glenwood Street.
Total "lump sum" bid: $ W,(050. 00 (FOWL n�o�skN✓ SWt�F' �Mo�t�,o ,rr1 iwo OW
The correct summation of the actual bid tabulation figures will supersede the listed total
Submitting Firm: P\VVANC14-0 GAM gorK?fVft, I14c
Address: 903 TZ\ ci<cd ST -
City: 1.,1P c X L'(4. 130
State: IA Zip: 50703
Authorized Representative (print) N. \ c\W:L POLE
Authorized Representative Signature
Date:
Phone:
02.-/ o 40 Z2.
311 -28?- L+44?
Email:
Fax:
61c+1A U.Pau QAovnwv:cyMivassrecoil
31 287- 14-141
EXCEPTIONS/DEVIATIONS to this Request for Proposal shall be listed in writing on an attached document
provided by the Bidder. Please be as specific as possible. Please check one:
Our company has no exceptions/deviations.
Our company does have exceptions/deviations which are listed on an attached document.
GENERAL INFORMATION. Freight and/or delivery charges, if any, shall be included in the price.
FIRM PRICING. Offered prices shall remain firm for a minimum of sixty (60) days after the due date of this
solicitation unless indicated otherwise. Accepted prices shall remain firm for the duration of the contract.
ADDENDA (It is the Bidder's responsibility to check for issuance of any addenda). The authorized
representative herby acknowledges receipt of the following addenda:
Addenda Number Date o2 a6S -24Z2- Addenda Number Date 0j " dg a2622 --
We choose not to bid at this time but would like to be considered for future requests for bid
RFB FOR ASBESTOS ABATEMENT SERVICES: Contract: AB-2022-02-04P: 300 Allen St, 307 Sumner St, 335 Sumner St, and 615 Glenwood St
Page 8 of 9
Our "not to exceed" bid price for each property is:
300 Allen Street
2,956.00
307 Sumner Street
11260 ,00
335 Sumner Street
S
615 Glenwood Street
� 5co,cD&
Total
� 9,650. 60
RFB FOR ASBESTOS ABATEMENT SERVICES: Contract: AB-2022-02-04P: 300 Allen St, 307 Sumner St, 335 Sumner St, and 615 Glenwood St
Page 9 of 9
BID BOND
KNOW ALL MEN BY MESE PRESENTS, that we, Advanced Environmental Testing and Abatement, Inc.
as Principal, and
Merchants Bonding Company (Mutual)
as Surety are held and firmly bound unto the CI CITY OF WATMLOO tea, hereinafter Galled
"OWNER_" ER_" In the penal sup
Dollars ($
---Five Percent of the Bid Submittedm
.. lawful money of the United States, for the payment
of which surer will and truly b o math), we bind ourselves, our heirs, executors administrators,
and
successors, jointly and severally, firmly by these presents. The condition of this obligation is such that
�. has submitted _ �° .. � . dated the 10th day���� February whereas the Principal submitted the accompanying bid
2022 = for Asbestos Abatement Services: Contract AB[1 ]2022-02-04P - 300 Allen
_e
Street, 307 Sumner Street, 335 Sumner Street, and 615 Glenwood Street,_Waterloo IA
NOW, THEREFORE,
(a) If said Bid shall be rejected, or in the alternate,
(h) If said Bid shall be accepted and the Principal shall execute and deliver a cunt: -act 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 Bide
Then phi a oblik nation sl-hail be void, otherwise the same 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 tie penal amount of this obligation as herein stated.
By virtue of statutory authority, tho 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 bend as
provided in the specifications or by Pam
The Surety, for value receivedi 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 exlensiorh
fit' S WHEREOF,aset their hands and seals, andsuch
IN ‘APTNESS the Principal and the Sun., hate=, hereunto
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 3rd dzl of February �_- -- nt Aria . 2022
Advanced Environmental Testing and Abatement, Inc. ea
Witness
Wite
Greg Krier
Principal
By __
Merchants it*
d..�
41/
By
Company (Mutual)
Seal
Attorney -in -tact Grace Rasmussen
(fitle)
ACOR Cs
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
NRMEAcT Cathy Wigant
CWIGANT
PRODUCER
Brummel Madsen Insurance
318 Main Street
Cedar Falls, IA 50613
INSURED
ADVAENV-01
CERTIFICATE OF LIABILITY INSURANCE
Advanced Environmental Testing & Abatement Inc
803 Ricker Street
Waterloo, IA 50703
PHONE
(ANC, No, Est): (319) 266-2644
E-MAIL
*RiEss• cathyw@brummelmadsen.com
INSURER(S) AFFORDING COVERAGE
DATE (MM/DDIYYYY)
11 /5/2021
I (A/c, No):(319) 277-2429
INSURER A Crum & Forster Specialty Insurance Company
INSURER B :Western National Mutual Insurance Company
INSURER C :
INSURER D :
INSURER E :
INSURER F :
NAIC #
44520
15377
COVERAGES CERTIFICATE NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
A
B
X
X
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE I X I OCCUR
Asbestos
X
Contractor Pollution
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X PRO-
JECT I I LOC
OTHER: Professional Liability
X
AU
X
OMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
AUTOS ONLY
SCHEDULED
_ AUTOS
AUTOS ONLYY
ADDL
INSD
X
X
SUBR
WVD
X
X
POLICY NUMBER
EPK136883
CPP 1013320
POLICY EFF
(MMIDDIYYYYI
9/13/2021
2/28/2021
POLICY EXP
IMMIDD/YYYY1
9/13/2022
2128/2022
REVISION NUMBER:
LIMITS
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
TRANSPORTATION
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PR
OPERTY
TY DAMAGE
$
$
$
$
$
2,000,000
50,000
5,000
2,000,000
5,000,000
5,000,000
1,000,000
1,000,000
A
B
B
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
DED I X 1 RETENTION $ 10,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER ME;MBOER EXCLUDED? ECUTIVE
OMandatory in NH)
f yes, de cribe under
DESCRIPTION OF OPERATIONS below
Umbrella Liab (auto)
YIN
Y
X
NIA
X
X
EFX118804
WCV 1001609
UMB 1016518
9/13/2021
9/13/2021
2/28/2021
9/13/2022
9113/2022
2/28/2022
EACH OCCURRENCE
AGGREGATE
X I PER
I I FROTH-
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
Ea Occ/ Aggregate
$
$
$
$
$
$
5,000,000
5,000,000
1,000,000
1,000,000
1,000,000
3,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mo e slumnpacFinanciale Is
red)Inc., a Delaware corporation, Mid -America
301 Bay Park Square, OX LLC, Ra der Hill Advisors, LLC, a New York Limited liability company,
Asset Management, Inc., Mid -America Real Estate - WI, LLC are included as additional insured on a primary/non-contributory basis on the General Liability
and Automobile Liability policies, if required by written contract or agreement subject to the policy terms and conditions. Waiver of Subrogation on the
General Liability, Automobile Liability, and Workers Compensation policies applies in favor of the additional insured. Umbrella follows form. Thirty (30) days'
notice shall be given to the additional insured before material change in or cancellation except for nonpayment of premium.
CERTIFICATE HOLDER
Shopko-Ashwaubenon, WI
c/o Mid -America Real Estate - Wisconsin, LLC
600 N Plankinton Avenue
Suite 301
Milwaukee, WI 53203
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
i
1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD 25 (2016/03)
ADVAENV-01
CWIGANT
ACORO'
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM!DDIYYYY)
11 /5/2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Brummel Madsen Insurance
318 Main Street
Cedar Falls, IA 50613
INSURED
Advanced Environmental Testing & Abatement Inc
803 Ricker Street
Waterloo, IA 50703
CONTACT Cathy Wigant
NAME:
PHONE
(A/C, No, Ext): (319) 266-2644
E-MAIL ADDRESS: cathY w brummelmadsen.com
INSURER(S) AFFORDING COVERAGE
4a, No):(319) 277-2429
INSURER A: Crum & Forster Specialty Insurance Company
INSURER B : Western National Mutual Insurance Company
INSURER C :
NAIL p
44520
15377
INSURER D :
INSURER E :
INSURER F :
•
•
WV Ld\/1V
Lbw vim.-•..
•v�.r
..r.....-...
.. ------ - _.
THIS IS TO
CERTIFY THAT THE POLICIES
OF INSURANCE
LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
CERTIFICATE MAY
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY
PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY
(MMIDD/YYYY)
EFF
POLICY
IMM/DDlYYYYI
EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
EACH
OCCURRENCE
$ 2,000,000
CLAIMS -MADE
X
OCCUR
X
X
EPK136883
9/13/2021
9/13/2022
DAMAGE
PREMISS
TO
RENTED
(Ea ocCurfence)
50,000
$
X
Asbestos
MED
EXP
(Any one person)
$ 5,000
2,000,000
X
Contractor
Pollution
PERSONAL
& ADV INJURY
$
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL
AGGREGATE
$ 5,000,000
POLICY
X
JE f
LOC
PRODUCTS
- COMP/OP
AGG
$ 5,000,000
X
OTHER: Professional
Liability
TRANSPORTATION
$ 1,000,000
B
AUTOMOBILE
LIABILITY
COMBINED
(Ea accident)
SINGLE
LIMIT
1,000,000
$
X
ANY AUTO
X
X
CPP 1013320
2/28/2021
2/28/2022
BODILY
INJURY
(Per person)
$
OWNED
SCHEDULED
BODILY
INJURY
$
ONLY
AUTOS
(Per accident)
AUTOS
HIRED
NON -OWNED
PROPERTY
Per accident)
DAMAGE
$
AUTOS
ONLY
AUTOS ONLY
,__
$
A
X
X
EACH
OCCURRENCE
$ 5,000,000
UMBRELLALIAB
OCCUR
X
x
EFX118804
9/13/2021
9/13/2022
5,000,000
EXCESS LIAB
CLAIMS -MADE
AGGREGATE
$
DED
X
RETENTION$ 10,000
$
B
PENSATION
ERS'
X
PERI
STATUTE
1
EERH
AND
EMPLOYKERS
LIABILITY
Y / N
X
WCV 1001609
9/13/2021
9/13/2022
1,000,000
PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
ANY
Mandatory
EXCLUDED?
Y
N /A
1,000,000
in NH)
E.L.DISEASE - EA EMPLOYEE
$
If
DESCRIPTION
yes, de
cribe unde
OF OPERATIONS
below
E.L. DISEASE - POLICY LIMIT
1,000,000
$
B
Umbrella
Liab (auto)
UMB
1016518
2/28/2021
2/28/2022
Ea Occ/ Aggregate
3,000,000
DESCRIPTION
OF OPERATIONS / LOCATIONS
/ VEHICLES
(ACORD
101, Additional Remarks Schedule,
may be attached If mo a space Is requi ed)
Mid Asset
2500 US Highway
Management,
Automobile
Liability, Automobile
shall be given
14 LLC, Raider Hill
Inc., Mid -America Real
Liability policies, if required
Liability, and Workers
to the additional insured
Advisors,
Estate - W
by written
Compensation
before material
LLC, a New York Limited Iiabi
, LLC are included as additional
contract or agreement subject
policies applies in
change in or cancellation
ity company, Column Financial, Inc., a Delaware corporation,
insured on a primary/non-contributory basis on the General
to the policy terms and conditions. Waiver of Subrogation
favor of the additional insured. Umbrella follows form. Thirty
except for nonpayment of premium.
-America
Liability
on
(30)
and
the General
days' notice
CERTIFICATE HOLDER
Shopko - Janesville, WI
c/o Mid -America Real Estate - Wisconsin, LLC
600 N Plankinton Ave
Suite 301
Milwaukee, WI 53203
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
tt /2
1/4
ACORD 25 (2016/03)
1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD