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PROPOSAL FORM
FOR
PAVE ARFF PARKING LOT
FAA AIP 3-19-0094-055 (CARES DEV)
AT THE
WATERLOO REGIONAL AIRPORT
WATERLOO, IOWA
Waterloo Regional Airport
2790 Livingston Lane
Waterloo, IA 50703
Gentlemen:
1. The undersigned, being a Corporation existing under the laws of the State of VI, 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 the City Engineer of the City of Waterloo now on file in the
office of the City Clerk, City Hall, Waterloo, Iowa, hereby proposes to furnish all supervision, technical personnel, labor,
materials, machinery, tools, appurtenances, equipment, and services, including utility and transportation services required
to construct and complete this Pave ARFF Parking Lot -- FAA AIP 3-19-0094-055 (CARES DEV), all in accordance
with the above -listed documents and for the unit prices for work in place for the following items and quantities:
2. The extent of the work involved is as follows:
The project for the improvements at the Waterloo Regional Airport, Waterloo, Iowa, FAA 3-19-0094-055 (CARES
DEV), Pave ARFF Parking Lot consists of 1,206 square yards of paved parking lot located between Hangar No. 4
and the ARFF Station alongside updates to existing utilities. This project includes removal and replacement of a
storm intake and pipe; replacement of bollards; installation of loop detectors, access card reader and associated
electrical circuits; installation and initial maintenance of sod, erosion control measures to be maintained during
construction. The purpose of this project is to replace the gravel lot with a paved lot to allow for better snow removal
and provide a parking area for both I-Iangar No. 4 and the ARFF Station.
3. The undersigned, in compliance with your Invitation for Bids dated t I' 3 , hereby proposes to do the
work called for in said Contract and Specifications and shown on said Plans and Addendum Nos.
�.� and to furnish all materials, tools, labor and all appliances and appurtenances necessary for the
said work at the following rates and prices:
FAA AIP 3-19-0094-055 (CARES DEV) P-1 Waterloo Regional Airport
AECOM Project #60675091 Pave ARFF Parking Lot
ITEMIZED PROPOSAL
WATERLOO REGIONAL AIRPORT
WATERLOO, IOWA
PROJECT: • PAVE ARFF PARKING LOT
FAA AIP PROJECT NO. 3-19-0094-055 (CARES DEV)
ITEM
NO.
SPEC.
NO.
DESCRIPTION
UNIT
ESTIMATED
QUANTITY
UNIT
PRICE
13ID
TOTAL
PRICE
BID
'
1
2101-2713090
EXCAVATION,
CLASS
13,
WASTE
CY
600.0
$ 13 `a"
$ 71100
e
''
$
$ /J,2„S0
2
2105-8425005
TOPSOIL,
FURNISH
AND
SPREAD
CY
25.0
50
3
2115-0100000
MODIFIED
SUBBASE
CY
200.0
$ 5-5'
$ /1 00u
4
2301-1033070
STANDARD
PORTLAND
PAVEMENT,
DURABILITY,
OR
CEMENT
CLASS
7
SLIP
IN.
C,
FORM
CONCRETE
CLASS
3
SY
1206.0
$ '
$ �i
/
8,,
5
2435-0251110
INTAKE,
SW-511
EA
1.0
$ t{f$'da
--
$ y)52:30
—
6
2503-0111012
STORM
TRENCHED,
POLYETHYLENE
SEWER
HIGH
GRAVITY
PIPE
DENSITY
(HDPE),
MAIN,
12
IN.
LF
5.0
$ 7 2 ''
$ 3 '0
OF
INTAKES
AND
7
2510-6750600
REMOVAL
UTILITY
ACCESSES
EA
1.0
$ 400 _
$ G00
2511-7526004
SIDEWALK,
P.C.
CONCRETE,
4
IN.
SY
18.0
$
(51 -
$ .2
ass
700
9
2519-3760000
ENTRANCE
BOLLARD
EA
2.0
$ //An —
$ aI
YO0
10
2523-0000200
ELECTRICAL
CIRCUITS
LF
70.0
$ 3 S ^
$ 2, tip
11
2525-0000200
LOOP
DETECTORS
EA
2.0
$ 4600 -
$ 3) a00 --
12
2533-4980005
MOBILIZATION
EA
1.0
$,5000
-
$ D...5;000 r-
READER
-
—
13
2599-9999005
INSTALLATION
ACCESS
CARD
EA
1.0
$
4 700
$ (..6
70d
14
2601-2639010
SODDING
SQ
11.0
$ 4&r f
$ 4/7/5"
e*
WATERING
FOR
SOD,
SPECIAL
_
15
2601-2643110
DITCH
PROTECTION
CONTROL,
OR
SLOPE
GAL
6600.0
$ 0 3
$ d
)
via
16
2602-0000530
GRATE
INTAKE
SEDIMENT
FILTERBA
EA
2.0
$ 3 I r-
$ Or
17
2602-0000540
MAINTENANCE
SEDIMENT
FILTER
OF
GRATE
BAG
INTAKE
EA
2.0
$ c 4—
$ l
18
2602-0000550
REMOVAL
SEDIMENT
OF
FILTER
GRATE
BAG
INTAKE
EA
2.0
$ NO
r
$ 3�d
se
19
2602-0010010
MOBILIZATIONS,
CONTROL
EROSION
EA
2.0
$ 30v r
$ 60 0 ea -
20
2602-0010020
MOBILIZATIONS,
EROSION
CONTROL
EMERGENCY
EA
1.0
$ ,3
rI
$ �0 r
d
4. It is the Airport's intention to evaluate bids reviewing both the total Bid. The Airport reserves the right to /&6 3 bet
award the contract based on the Total Bid only or the Base Bid plus Add Alternate Bid Option.
5. The undersigned understands that the above quantities of work to be done are approximate only and are
intended principally to serve as a guide in evaluating the bids. All quantities are subject to increase or decrease
and are to be performed at the unit prices stipulated herein.
6. It is understood that the schedule of minimum wage rates, as established by the Secretary of Labor and included
in the Specifications, are to govern on this project, and the undersigned certifies that he has examined this
schedule of wage rates and that the prices bid are based on such established wage sates.
7. The bidder shall make good faith efforts, as defined in Appendix A of 49 CFR Part 26, Regulations of the
Office of the Secretary of Transportation, to subcontract eight and four tenths (8.4%) percent of the dollar value
FAA AIP 3-19-0094-055 (CARES DEV)
AECOM Project #60675091
P-2 Waterloo Regional Airport
Pave ARFF Parking Lot
of the prime contract to small business concerns owned and controlled by socially and economically
disadvantaged individuals (DBE). Individuals who are rebuttably presumed to be socially and economically
disadvantaged include women, Blacks, Hispanics, Native Americans, Asian -Pacific Americans, and Asian -
Indian Americans. The apparent successful competitor will be required to submit information concerning the
DBE's that will participate in the contract. The information will include the name and address of each DBE, a
description of the work to be performed by each named firm, and the dollar value of the contract. If the bidder
fails to achieve the contract goal stated herein, it will be required to provide documentation demonstrating that
it made good faith efforts in attempting to do so. In the event that the apparent successful competitor for this
solicitation qualified as a DBE, the contract goal shall be deemed to have been met. A bid that fails to meet
these requirements will be considered nonresponsive.
8. The undersigned 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. The undersigned 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 undersigned 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, timeclocks, 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, color, religion, or national origin, because of habit, local custom, or any other reason. The
undersigned 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, and
that he will retain such certifications in his files.
9. The undersigned agrees, upon written notice of the acceptance of this bid, within ninety (90) days after the
opening of the bids, that he will execute the Contiact in accordance with the bid as accepted and give Contract
(Performance and Payment) bond on attached forms within fifteen (15) days after the prescribed forms are
presented for signature.
10. The undersigned understands, award of contract is contingent upon receipt of project funding from the Federal
Aviation Administration. If funding is not received, bid bonds will be returned to all bidders and the project
will be postponed.
11. The undersigned further agrees that if awarded the Contract, he will commence the work within ten (10)
calendar days after the receipt of a "Notice to Proceed" and that he will substantially complete all work
according to the terms of the entire contract within ninety (90) calendar days from the date established in the
Notice to Proceed. An extension of time may be allowed when extra or additional work is ordered by the
Engineer.
12. The undersigned agrees that within 30 days after award of this contract, the Contractor/Subcontractor shall file
a compliance report (Standard Form 100) if s/he has not submitted a complete compliance report within 12
months proceeding the date of award. This report is required if the Contractor/Subcontractor meets all of the
following conditions:
a. Contractors/Subcontractors are not exempt based on 41 CFR 60-1,5.
b. Has 50 or more employees.
c. Is a prime contractor or first tier subcontractor.
d. There is a contract, subcontract, or purchase order amounting to $50,000 or more.
13. To satisfy Clear Air and Water Pollution Control Requirements on all Construction Contracts and Subcontracts
exceeding $100,000.00 Contractors and Subcontractors agree:
FAA AIP 3-19-0094-055 (CARES DEV) P-3 Waterloo Regional Airport
AECOM Project 460675091 Pave ARFF Parking Lot
a. That any facility to be used in the performance of the Contract or to benefit from the Contract is not listed
on the Environmental Protection Agency (EPA) List of Violating Facilities.
b. To comply with all the requirements of Section 306 of the Clean Air Act (42 USC 1857(11)), and Section
508 of the Clean Water Act (33 USC 1368), Executive Order 11738, and Environmental Protection
Regulations (40 CFR Part (15)).
c. That as a condition for award of a Contract he shall notify the awarding official of the receipt of any
communication from EPA indicating that a facility to be utilized for performance of or benefit from the
Contract is under consideration to be listed on the EPA List of Violating Facilities.
d. To include or cause to be included in any Contract or Subcontract which exceeds $100,000.00 the
aforementioned criteria and requirements.
14. The contractor, by submission of this offer and/or execution of a contract, certifies that it:
a. is not owned or controlled by one or more citizens or nationals of a foreign county included in the list of
countries that discriminate against U.S. firms published by the Office of the United States trade
Representative (USTR);
b. has not knowingly entered into any contract or subcontract for this project with a contractor that is a citizen
or national of a foreign country on said list, or is owned or controlled directly or indirectly by one or more
citizens of nationals of a foreign country on said list;
c. has not procured any product nor subcontracted for the supply of any product for use on the project that is
produced in a foreign country on said list.
Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance with
49 CFR 30.17, no contract shall be awarded to a contractor or subcontractor who is unable to certify to the
above. If the contractor knowingly procures or subcontracts for the supply of any product or service of a
foreign country on the said list for use on the project, the Federal Aviation Administration may direct, through
the sponsor, cancellation of the contract at no cost to the Government.
Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will incorporate this
provision for certification without modification in each contract and in all lower tier subcontracts. The
contractor may rely upon the certification of a prospective subcontractor unless it has knowledge that the
certification is erroneous.
The contractor shall provide immediate written notice to the sponsor if the contractor learns that its certification
or that of a subcontractor was erroneous when submitted or has become erroneous by reason of changed
circumstances. The subcontractor agrees to provide immediate written notice to the contractor, if at any time it
learns that its certification was erroneous by reason of changed circumstances.
This certification is a material representation of fact upon which reliance was placed when making the award.
If it is later determined that the contractor or subcontractor knowingly rendered an erroneous certification, the
Federal Aviation Administration may direct, through the sponsor, cancellation of the contract or subcontract for
default at no cost to the Government.
Nothing contained in the foregoing shall be construed to require establishment of a system ofrecords in order to
render, in good faith, the certification required by this provision. The knowledge and information of a
contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course
of business dealings.
This certification concerns a matter within the jurisdiction of an agency of the United States of America and the
making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under
Title 18, United States Code, Section 1001.
FAA ALP 3-19-0094-055 (CARES DEV) P-4 Waterloo Regional Airport
AECOM Project 1160675091 Pave ARFF Parking Lot
1
15. The bidder/offeror certifies, by submission of this proposal or acceptance of this contract, that neither it nor its
principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department or agency. It further agrees by
submitting this proposal that it will include this clause without modification in all lower ties transactions,
solicitations, proposals, contracts, and subcontracts. Where the bidder/offer/contractor or any lower tier
participant is unable to certify this statement, it shall attach an explanation to this solicitation/proposal.
16. As an evidence of good faith in submitting this Proposal, the undersigned encloses bid security in the amount of
five (5) percent of the bid which, in case he refuses or fails to accept an award and to enter into a Contract and
file the required bonds within the prescribed time, shall be forfeited to the Waterloo Regional Airport as
liquidated damages.
17. 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).
18. 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).
19. The undersigned hereby declares that the only parties interested in this Proposal are named herein, that this
Proposal is made without collusion with any other person, firm or corporation, that no member of the Council,
Waterloo Regional Airport or agent of the City of Waterloo, Iowa, is directly or indirectly financially interested
in this bid.
20. In submitting this bid, it is understood that the right to reject any and all bids has been reserved and that this bid
may not be withdrawn for a period of ninety (90) days from the opening thereof.
21. Contractor certifies that all employees employed by Contractor or any subcontractor working on behalf of the
Contractor are in compliance with the Immigration Reform Control Act of 1986 (IRCA) and indemnifies the
Owner and holds harmless Owner for any violations of IRCA as a result of the Contractor's employees or his
subcontractor's employees working on behalf of' the Contractor on the Owner's project.
22. The undersigned certifies, to the best of his or her knowledge and belief, that:
a. No Federal appropriated funds shall be paid, by or on behalf of the Contractor, to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a member of Congress in Congress in connection with
the making of any Federal grant and the amendment or modification of any Federal grant.
b. If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal
grant, the Contractor shall complete and submit Standard Form-LLL, "Disclosure of Lobby Activities", in
accordance with its instructions.
c. The Undersigned shall require that the language of this certification be included in the award documents
for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $200,000 for each
such failure.
23. BUY AMERICAN CERTIFICATE (Title 49 U.S.C. Chapter 501)
FAA AIP 3-19-0094-055 (CARES DEV) P-5 Waterloo Regional Airport
AECOM Project 1160675091 Pave ARFF Parking Lot
As a condition of bid responsiveness, the bidder must how it intend to comply with the Buy American
preferences established under Title 49 U.S.C. Section 50101. Bidder must complete the attached Buy American
certification. If the bidder requests a permissible waiver to the Buy America requirements, the Bidder identified
as with the successful bid must submit a formal waiver request and component cost calculation within the
prescribed time identified on the Buy America certification.
24. Drug Free Work Place, Act of 1988.
a. By submission of this offer, the offeror, if other than an individual, who is making an offer that equals or
exceeds $25,000, certifies and agrees that with respect to all employees of the offeror to be employed
under a contract resulting from this solicitation, it will --no later than 30 calendar days after contract award
(unless a longer period is agreed to in writing, for contracts of 30 calendar days or more performance
duration;) or as soon as possible for contracts of less than 30 calendar days performance duration, but in
any case, by a date prior to when performance is expected to be completed--
(1) Publish a statement notifying such employees that the unlawful manufacturer, distribution,
dispensing, possession or use of a controlled substance is prohibited in the Contractor's workplace
and specifying the actions that will be taken against employees for violations of such prohibition;
(2) Establish an on -going drug -free awareness program to inform such employees about --
(a) The dangers of drug abuse in the work place;
(b) The Contractor's policy of maintaining a drug -free work place;
(c) Any available drug counseling, rehabilitation, and employee assistance programs; and
(d) The penalties that may be imposed upon employees for drug abuse violations occurring in the
work place;
(3) Provide all employees engaged in performance of the contract with a copy of the statement required
by subparagraph a.(1) of this provision;
(4) Notify such employees in writing in the statement required by subparagraph a.(1) of this provision
that, as a condition of continued employment on the contract resulting from this solicitation, the
employee will --
(a) Abide by the terms of the statement; and
(b) Notify the employer in writing of the employee's conviction under a criminal drug statute for a
violation occurring in the workplace no later than 5 calendar days after such conviction;
(5) Notify the Contracting Officer in writing within 10 calendar days after receiving notice under
subdivision a.(4) (b) of this provision, from an employee or otherwise receiving actual notice of such
conviction. The notice shall include the position title of the employee; and
(6) Within 30 calendar days after receiving notice under subdivision a.(4)(b) of this provision of a
conviction, take one of the following actions with respect to any employee who is convicted of a drug
abuse violation occurring in the work place;
(a) Take appropriate personnel action against such employee, up to and including termination; or
(b) Require such employee to satisfactorily participate in a drug abuse assistance or rehabilitation
program approved for such purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency.
Make a good faith effort to maintain a drug -free workplace through implementation of subparagraphs
a.(1) through a.(6) of this provision.
b. By submission of its offer, the offeror, if an individual who is making an offer of any dollar value, certifies
and agrees that other offeror will not engage in the 'unlawful manufacture, distribution, dispensing,
possession, or use of a controlled substance in the performance of the contract resulting from this
solicitation.
(7)
c. Failure of the offeror to provide the certification required by paragraphs a. or b. of this provision, renders
the offeror unqualified and ineligible for award. [See FAR 9.104-1(g) and 19.602-1a.(2)(a)].
FAA AIP 3-19-0094-055 (CARES DEV) P-6 Waterloo Regional Airport
AECOM Project 1160675091 Pave ARFF Parking Lot
d. In addition to other remedies available to the Government, the certification in paragraphs a. or b. of this
provision concerns a matter within the jurisdiction of an agency of the United States and the making of a
false, fictitious, or fraudulent certification may render the maker subject to prosecution under title 18,
United States Code, Section 1001.
25. Attachment to This Bid. The following documents are attached to and made a part of this Bid:
Po,i a -'
a. Bid Guaranty in the form of
b. Non -Collusion Affidavit of Prime Bidder.
c. Statement of Intent - Non -Discrimination and Equal Opportunity Statement.
d. Buy American Certification Statement.
e. Bidder's Information Sheet.
f. Synopsis of Experience Record. (IDOT Certification may be substituted.)
g. Completed DBE forms "Utilization Statement" and "Letter of Intent."
26. The Bidder shall indicate whether the bid is submitted by a/an:
❑ Individual, Sole Proprietorship
❑ Partnership
lIC Corporation
❑ Joint -venture: all parties must join -in and execute all documents
❑ Other
Respectfully submitted,
By
idde
ff, f jaturae . stir
Title
Pl. a . 13 °x Wier
Address
Gk. tAi 1.1k a Sa-Vb I %
(IncludeZip Code)
3 /9- ao- 747
Telephone No.
FAA AIP 3-19-0094-055 (CARES DEV) P-7 Waterloo Regional Airport
AECOM Project 1160675091 Pave ARFF Parking Lot
State of
NON-COLLUSION AFFIDAVIT OF PRIME BIDDER
County orD/ // *t k M.L.,(C )ss)
3-0 tA att 50141/J , beingfirst dulysworn, deposes and says that:
p
(1) He is Owner Partner Office : e resentative r A ent of
1.. OGty_ Cp wi'(u 04-1 1 VI C. , 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 Conti act, or has in any manner, directly or
indirectly, sought by agi eement 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.
Subscribed and sworn to before me
this /.59 day of
Title
My Commission Expires
soma /.S , 203
Iola 00000
inwuula
0
(Signed tte ,S4,$-tom(
LINDA K SENN
COMMISSION NO. 803307
MY COMMISSION EXPIRES
de
/,S 4.
FAA AIP 3-19-0094-055 (CARES DEV) P-9 Waterloo Regional Airport
AECOM Project #60675091 Pave ARFF Parking Lot
BUY AMERICAN CERTIFICATION FORM FOR MANUFACTURED PRODUCTS
(Non -building projects such as airfield/roadway construction, equipment acquisition, etc.)
As a matter of bid responsiveness, the Bidder or Offerer must complete, sign, date, and submit
this certification statement with their proposal. The Bidder or Offerer must indicate how they
intend to comply with 49 USC § 50101 by selecting one on the following certification statements.
These statements are mutually exclusive. Bidder must select one or the other (not both) by
inserting a checkmark (✓) or the letter "X".
❑ The Bidder or Offerer hereby certifies that it will comply with 49 USC § 50101 by:
a) Only installing steel and manufactured products produced in the United States, or;
b) Installing manufactured products for which the FAA has issued a waiver as indicated
by inclusion on the current FAA Nationwide Buy American Waivers Issued listing, or;
c) Installing products listed as an Excepted Article, Material or Supply in
Federal Acquisition Regulation Subpart 25.108.
By selecting this certification statement, the Bidder or Offerer agrees:
1. To provide to the Owner evidence that documents the source and origin of the steel
and manufactured product.
2. To faithfully comply with providing US domestic product.
3. To furnish US domestic product for any waiver request that the FAA rejects.
4. To refrain from seeking a waiver request after establishment of the contract,
unless extenuating circumstances emerge that the FAA determines justified.
❑ The Bidder or Offerer hereby certifies it cannot comply with the 100% Buy American
Preferences of 49 USC§ 50101(a) but may qualify for either a Type 3 or Type 4 waiver under
49 USC§ 50101(b). By selecting this certification statement, the apparent Bidder or Offerer
with the apparent low bid agrees:
1. To the submit to the Owner within 15 calendar days of the bid opening, a formal
waiver request and required documentation that support the type of waiver being
requested.
2. That failure to submit the required documentation within the specified timeframe is
cause for a non -responsive determination may result in rejection of the proposal.
3. To faithfully comply with providing US domestic products at or above the approved
US domestic content percentage as approved by the FAA.
4. To refrain from seeking a waiver request after establishment of the contract,
unless extenuating circumstances emerge that the FAA determines justified.
Bemired Documentation
Type 3 Waiver - The cost of the item components and subcomponents produced in the
United States is more that 60% of the cost of all components and subcomponents of the
"item". The required documentation for a type 3 waiver is:
a) Listing of all product components and subcomponents that are not comprised of 100% US
domestic content (Excludes products listed on the FAA Nationwide Buy American Waivers
Issued listing and products excluded by Federal Acquisition Regulation Subpart 25.108;
FAA AIP 3-19-0094-055 (CARES DEV) P-16 Waterloo Regional Airport
AECOM Project 1160675091 Pave ARFF Parking Lot
products of unknown origin must be considered as non -domestic products in their
entirety).
Cost of non -domestic components and subcomponents, excluding labor costs associated with final
assembly at place of manufacture.
b) Percentage of non -domestic component and subcomponent cost as compared to total
"item" component and subcomponent costs, excluding labor costs associated with
final assembly at place of manufacture.
Type 4 Waiver —Total cost of project using US domestic source product exceeds the total
project cost using non -domestic product by 25%. The required documentation for atype 4 of
waiver is:
a) Detailed cost information for total project using US domestic product.
b) Detailed cost information for total project using non -domestic product.
False Statements: Per 49 USC§ 47126, this certification concerns a matter within the jurisdiction
of the Federal Aviation Administration and the making of a false, fictitious or fraudulent
certification may render the maker subject to prosecution under Title 18, United States Code.
/P --ism?. 9-
Date
Ladic cc1/26-ha
Company Name
Title
ure
a41.14.1 404 tr
FAA AIP 3-19-0094-055 (CARES DEV) P-17 Waterloo Regional Airport
AECOM Project 1160675091 Pave ARFF Parking Lot
LETTER OF INTENT
Disadvantage Business Enterprise
(This page shall be submitted for each DBEfirm)
� LL.
Bidder/Offer Name: ootjt cows't
(.4u2.--
Address: P.a 3 0 K ySI
City: %(c.c tas v 1 t J State: j7 "' Zip: Sa6I Cf
DBE Firm: DBE Firm: 1 it64 /g/vo r
Address: ()LW roc/ gNe rru' A
City: P✓avet State:2/9 Zip:. -00-71
DBE Contact Person: Name:"Ildee th.,end Phone: (fig )2540'1 rn 8
Expiration Date: iZ/2°Z3
DBE Certifying Agency:
Classification:
rspoT
Each DBE Firm shall submit evidence (such as a photocopy) of their certification status.
Prime Contractor
Manufacturer
•
Subcontractor
Supplier
Joint Venture
Quantity
'Total
to
Work
be
performed
DBE
item(s)
by
Description
of Work
Item
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The bidder/offeror is committed to utilizing the above -named DBE firm for the work described above. The
estimated participation is as follows:`
D131:; contract amount: $ / / 00
AFFIRMATION:
The above -named DBE firm affirms irnls that it will perform the portion of the contract 1O1' the estimated dollar value as stated
above.
By: (Title)
nature)
e: In the event the bidder/offeror does not receive award ol the prime contract, any and all representations in this
Letter of Intent and Affirmation shall be null and void.
los
Percent of total contract: Li %
PA markt(
FAA AIP 3-19-0094-055 (CARES DEV) P-15 Waterloo Regional ;Airport
AECOM Project 1160675091 Pave ARFF Parking Lot
C3IOWADOTGETTING You �
January 6, 2022
Vallarie Holm
Tiedt Nursery, Ltd.
2419 E Bremer Avenue
Waverly, IA 50677
VIA ELECTRONIC MAIL
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 https;//secure.iowadot.gov/DBE/Home/Index/, will
continue to list your contact information and will include the following NAILS 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
Walls; 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 inquir les. If you have any questions, please contact this office.
Sincerely,
anyket
Danny Wagoner
Civil Rights Compliance Officer
t, l [515-239-1422]
z l [danny.wagener@iowadot.us]
(0) I www.iowadot.gov
Address: Civil Rights Bureau
1800 Lincoln Way, Ames, IA 50010
UTILIZATION STATEMENT
Disadvantage Business Enterprise
The undersigned bidder/offeror has satisfied the requirements of the bid specification in the following manner.
(Please mark the appropriate box)
❑ The bidder/offeror is committed to a minimum of 8.4% DBE utilization on this
contract.
MfThe bidder/offeror, while unable to meet the DBE goal of $• if %, hereby commits to
a minimum of y• t % DBE utilization on this contract and also submits
documentation, as an attachment demonstrating good faith efforts (GFE).
The undersigned hereby further assures that the information included herein is true and correct, and that the DBE finn(s) listed herein have agreed to
perfonn a commercially useful function in the work itetns noted for each firm. The undersigned further understands that no changes to this statement
may be made without prior approval from the Civil Right Staff of the Federal Aviation Administration.
tO e C (154 CJ firm. >r kke'
Bidder's/Offeror's Firm Name
/02 2/1.
Date
DBE UTILIZATION SUMMARY
Contract Amount
DBE Amount Contract
Percentage
DBE Prime Contractor $ x 1.00 = $ %
DBE Subcontractor $ !.3 /0 0 xi .00 = $ 7i/400_ eT • 7 %
DBE Supplier $ x 0.60 = $ _ %
DBE Manufacturer $ x 1.00 = $ %
Total Atnount DBE
DBE Goal
Note: If the total proposed DBE participation is less than the established DBE goal, Bidder tnust provide written documentation of the good
faith efforts as required by 49 CFR Part 26.
FAA AIP 3-19-0094-055 (CARES DEV) P-14 Waterloo Regional Airport
AECOM Project 1160675091 Pave ARFF Parking Lot
SYNOPSIS OF EXPERIENCE RECORD
(This synopsis must accompany Proposal Form.)
Name of Bidder Lody cedeks-kvotioit
Business Address l • 0• 13 ysal G IC A Ks.) (, 17
Individual ( ) Partnership ( ) Corporation
(Check One.)
Construction successfully completed within past five years sirnilar in size, scope, and difficulty of construction to the
work bid upon.
Name of Owner
1 XDOf
3'DO"1'"
4�1^Do le
5 AM-
2
3 6a
4
Name of
Project
Ars PA.( K
Groh J 44 'fool
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R{col.)
Number of Contract Days
Allowed for Above Projects
6c'
5 �pd
(By) YOk VL Se k
(TITLE) r.,-1;0-frc. r
� /S r -
Date i
Location of
Proiect
t/,( Ruts'
lov j stet. cotatip
Amount of
Contract
g4g) yyo
ill) 0 6
357 004
_-
96oa7
/Ov vP/
�,
Actual Number of Days to
Complete above Project
q6
NI
Fla
Lod%4c. co+ts 4irtatzeti
Name of Company
FAA AIP 3-19-0094-055 (CARES DEV) P-13 Waterloo Regional Airport
AECOM Project #60675091 Pave ARFF Parking Lot
BIDDER'S INFORMATION SHEET
A. BIDDER'S CAPACITY: (Check One)
1. Individual 0
2. Co -Partnership 0
3. Corporation
B. (IF ITEM 2 IS CHECKED, COMPLETE THE FOLLOWING)
State of
Names and Addresses of Partners
1.
2.
3.
4.
5.
C. (IF ITEM 3 IS CHECKED, COMPLETE THE FOLLOWING)
State of Incorporation
Names and Addresses of Officers:
President
Secretary
Treasurer
teve o G P.a. dos ��j e fri Kc4giej. rob /% �
Melo4 Pot go x Yin G/c.r Kvi11e 1/
/141/ 6 7Kent.; vr p v j7vx /in CA,r2,1/tl s-cf0/1
FAA AIP 3-19-0094-055 (CARES DEV) P-12 Waterloo Regional Airport
AECOM Project #60675091 Pave ARFF Parking Lot
STATEMENT OF INTENT
NONDISCRIMINATION
AND
EQUAL OPPORTUNITY STATEMENT
The Contractor does hereby certify to the Waterloo Regional Airport, that no person shall, in any way, be favored or
discriminated against because of his race, political or religious opinions and affiliations, national origins, sex, age, sexual
orientation, gender identity, disability, color, creed, marital status, employee union or association membership or office
herein.
If selected as the successful bidder, this contractor hereby agrees to file either a nondiscrimination and equal opportunity
statement and/or an Affirmative Action Program.
Improvements to the Waterloo Regional Airport consisting of
Pave ARFF Parking Lot
FAA AIP Project No. 3-19-0094-055 (CARES DEV)
Lootbe c.0.5-tyacm.
COMPANY
.54Cue- tO
EXECUTIVE OFFICER
.544•C •e- 0--
AFFIRMATIVE ACTION OFFICER
ADDRESS OF THE AFFIRMATIVE ACTION OFFICER
P°s. j7O)s vs—,
cAGtK6jdle J T-0 s-a 15
PHONE NUMBER 7 /?R32 oy70
FAA AIP 3-19-0094-055 (CARES DEV) P-11 Waterloo Regional Airport
AECOM Project 460675091 Pave ARFF Parking Lot
Buy America Conformance Listing
Title 49 U.S.0 Section 50101 (b)
For Airfield Development Projects funded under the
Airport Improvement Program
• Preparation of a Component Cost Calculation 'Table is not necessary for equipment listed on the FAA stational listing:
hup://www.fim.goviairports/aip/procurementifederal conlractprovisions/media/buy anterican waiver.xls
• Bidder shall submit a listing of equipment it proposes to install on the project that is included on the current National Buy
American conformance list.
Certification Signature:
Bidder hereby certifies that the above listed equipment, which we propose for installation on the subject
project, are on the current National Buy America Conformance list as established at:
http://www.faa.gov/airports/aip/procurement/federal contractjrovisions/media/buy_american_waiver.xls
I hereby certify the above information is accurate and complete.
�i avtshot
Date
FAA AIP 3-19-0094-055 (CARES DEV) P-20 Waterloo Regional Airport
AECOM Project #60675091 Pave ARFF Parking Lot
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we
Lodge Construction, Inc. asPrincipal, and
Swiss Re Corporate Solutions America Insurance Corporation as Surety are held and firmly
bound unto the Waterloo Regional Airport, 2790 Livingston Lane, Waterloo, Iowa, hereinafter call "Owner", in the penal
sum of Five Percent (5%) of the Total Amount Bid Dollars ($ 5% )
lawful money of the United States, foi 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 pi esents. The condition of this obligation
is such that whereas the Principal has submitted the accompanying bid, dated December 15 ,20.D
for Pave ARFF Parking Lot at the Waterloo Regional Airport, Waterloo, Iowa, FAA AIP 3-19-0094-055 (CARES
DEV).
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 12th day of December , A.D., 2022.
Principal Lodge str ion Inc.
By
(Tit
(Seal
By
(Attorney -In -Fact)
es4i ,fir
ty S
•
ReCorpor
C7
ions America Insurance Cot poi ation
Dione R. Young, Attorney -in -Fact (Sea?)
FAA AIP 3-19-0094-055 (CARES DEV)
AECOM Project 1160675091
P-8 Waterloo Regional Airport
Pave ARFF Parking Lot
SWISS RE CORPORATE SOLUTIONS
SWISS RE CORPORATE SOLUTIONS AMERICA INSURANCE CORPORATION ("SRCSAIC")
SWISS RE CORPORATE SOLUTIONS PREMIER INSURANCE CORPORATION ("SRCSPIC")
\VESTPORT INSURANCE CORPORATION ("WIC")
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT SRCSAIC, a corporation duly organized and existing under laws of the State of Missouri, and
having its principal office in the City of Kansas City, Missouri, and SRCSPIC, a corporation organized and existing under the laws of the State of
Missouri and having its principal office in the City of Kansas City, Missouri, and WIC, organized under the laws of the State of Missouri, and having its
principal office in the City of Kansas City, Missouri, each does hereby make, constitute and appoint:
JAY D. FREIERMUTH, CRAIG E. HANSEN, BRIAN M. DEIMERLY, CINDY BENNETT, ANNE CROWNER, TIM McCULLOH, STACY VENN,
DIONE R. YOUNG, STACIE CHRISTENSEN, SETH ROOKER, JENNIFER MARION, AND JOSEPH TIERNAN
JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of:
ONE HUNDRED TWENTY-FIVE MILLION ($125,000,000.00) DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both SRCSAIC and SRCSPIC at meetings duly called and held on the l8th of November 2021 and WIC by written consent of its
Executive Committee dated July 18, 2011.
"RESOLVED, that any two of the President, any Managing Director, any Senior Vice President, any Vice President, the Secretary or any Assistant
Secretary be, and each or any of them hereby is, authorized to execute a Power of Attorney qualifying the attorney named in the given Power of
Attorney to execute on behalf of the Corporation bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to
attest to the execution of any such Power of Attorney and to attach therein the seal of the Corporation; and it is
FURTHEP. RESOLVED, that the signature of such officers and the seal of the Corporation may be affixed to any such Power of Attorney or to
any cer;tifie'ate',,elating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Corporation when so affixed and in the fixture with regard to anv bond, undertaking or contract of surety to which it is attached."
„a+alu,npro.
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By
Janssens, Senior Vice President of SRCSAIC & Senior Vice President
of SRCSPIC & Senior Vice President of WIC
Gerald Jagrowski, Vice President of SRCSAIC & Vice President of SRCSPIC
& Vice President of WIC
1N WITNESS WHEREOF, SRCSAIC, SRCSPIC, and \VIC have caused their official seals to be hereunto affixed, and these presents to be signed by their
authorized officers
this 10 day of
State of Illinois
County of Cook
NOVEMBER , 20 22
ss
Swiss Re Corporate Solutions America Insurance Corporation
Swiss Re Corporate Solutions Premier Insurance Corporation
Westport Insurance Corporation
On this 10 day of NOVEMBER , 20 22 , before me, a Notary Public personally appeared Erik Janssens , Senior Vice President of SRCSAIC
and Senior Vice President of SRCSPIC and Senior Vice President of \VIC and Gerald Jagrowski , Vice President of SRCSAIC and Vice President of
SPCSPIC and Vice President of WIC, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney
as officers of and acknowledged said instalment to be the voluntary act and deed of their respective companies.
I OFFICIAL SEAL
.CHRt$ NAMANISCO
NOTARY Pli9tiCo;8TAtI 9f u 1
rmi"lskai ii Marl a4l'•
n I
I, Jeffrey Goldberg, the duly elected Senior Vice President and Assistant Secretary of SRCSAIC and SRCSPIC and WIC, do hereby certify that the above and
foregoing is a tale and correct copy of a Power of Attorney given by said SRCSAIC and SRCSPIC and WIC, which is still in full force and effect.
IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 12th day of December 2022
Jeffrey Goldberg, Senior Vice President &
Assistant Secretary of SRCSAIC and
SRCSPIC and WIC