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NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of jlou) �
County of g /�t&k
1. He is
osOci
being first duly sworn, deposes and says that:
(Partner), (Officer), (Representative), or (Agent) of gi
submitteTthe attached Bid;
the Bidder that has
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,,inc1y ing this affiant.
ignature
Sir.atiw'e/
CD) air
Title
$ taxed/ ccnicb warn/tor War& vnei the
,3 0 (Low ofj4locc& , 2022.
MY we e4VAreis. / 02 5"
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BIDDER:
CITY OF WATERLOO, IOWA
Community Planning and Development Department
2022 and 2023 Residential Lots Mowing/Miscellaneous At eas Mowing and Lot Maintenance Services Contract
BID FORM
k CO( / VC
COMPANY NAME
ADDRESS: \ L' C cutn ;- `.
PHONE' c?n ) 3U.-cicitI D
1. The undersigned, being a Corporation existing under the laws of the State of or a limited liability company
existing under the laws of the State of , or a Partnership consisting of the following partners:
having been familiarized with the existing conditions on the project area affecting the cost of the work, and with all
the Contract Documents now on file in the offices of the City Clerk, City Hall, 715 Mulberry Street, Waterloo, Iowa,
and the Planning and Zoning Department, 715 Mulberry Street Waterloo Iowa hereby proposes to furnish all
supervision, technical personnel, labor, materials, machinery, tools, equipment, and services, including utility and
transportation services required to complete the proposed MOWINGS, in accordance with the contract documents and
for the unit price in place for the following amount:
Bid Price: Price per Lot/Area per occurrence for mowing and lot maintenance services for city owned Lots under 1
acre for appi oximately 222 Properties.
\w k\V L.. i � rti�cij
Written Price Per Lot/Occurrence:
q/
dollars ($ \ 1 )
Bid Price: Price per Hour per occurrence for mowing and lot maintenance services for city owned lots 1 acre or
more for approximately 8 Properties.
r
C41-110 dollars ($ 7 0 )
rrtten Price Per Hour/Occurrence:
2. It is understood that the quantities set forth are approximate only and subject to variation and that the unit price for the
work done shall govern the actual payment to the Contractor.
3. In submitting this bid, the Bidder understands that the City reserves the right to reject any or all bids and to award one
or more contracts for a single Option all Options together, or any combination of Options If written notice of
acceptance of this Bid is mailed or delivered to the undersigned within sixty (60) days after Bid Opening, the
undersigned agrees to execute and deliver an agreement in the prescribed form and furnish the required bond and
certificate of insurance within ten (10) days after the agreement is presented for signature and start work within ten
(10) days after "Notice to Proceed" is issued.
4. Security in the sum of
in the form of
BIDDERS.
_ ,�
ti- Five_ �,j dollars ($ t1SCi>, )
Co
; ��, ����n��
, is submitted herewith in accordance with NOTICE TO
5. Attached is a Non -Collusion Affidavit of Prime Contractor.
6. The Bidder is prepared to submit a fmancial and experience statement upon request.
7. 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.
8. The Bidder has received the following Addendum or Addenda:
Addendum No. Date: / /
/ /
/ /
9. The Bidder shall list the MBE/WBE subcontractors,amount of subcontracts and bid items listed on the City of
Waterloo Minority and/or Women Business Pre-bid Contract Information Form submitted with this Bid Form. 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 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
10. The Contractor shall provide a complete inventory of sufficient and proper equipment to perform all work in a safe
and timely manner. Equipment list may be submitted below or as a separate attachment:
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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(City of Waterloo)reserves the right to select alternatives, delete line items, and/or to reduce quantities
prior to the Awa f ontract due to budgetary limitations.
2.-SIGNED: JeJ DATE: zi /cp „2,-.-_,,
Name and Title