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III- FORM OF BID
SOUTH STREET AND WEST 9TH STREET MINI -ROUNDABOUT
Iowa DOT Project Number: CS-TSF-8155(777)-85-07
City Project Number TOF-297
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council, Waterloo, Iowa
The undersigned, being a Corporation existing under the laws of the State of f i la
Partnership consisting of the following partners: , having
familiarized (himself) (themselves) (itself) with the plans and specifications as well as all other contract documents
listed in the Table of Contents and Addenda (if any), now on file in the office of the City Clerk, City Hall, Waterloo,
Iowa, proposes to construct and build SOUTH STREET AND WEST 9111 STREET MINI -ROUNDABOUT, all in accordance
with the above -listed documents for the prices listed below:
ITEM
NO
ITEM
CODE
DESCRIPTION
UNITS
EST.
QUANTITY
UNIT PRICE
TOTAL
PRICE
1
2010-A-0
Clearing
and
Grubbing
UNIT
184
27
-
%We
3,�'Mo
22010-D-3
Topsoil,
Offsite
CY112
3 s'
3
2010-E-0
Excavation,
Class
10
CY
500
7 c
is
j
i
S"QO
4
2010-G-0
Subgrade
Preparation,
12"
SY
2835
/
a,
8«35
5
2010-H-0
Subgrade
Treatment,
Geogrid
SY
2439
7O `
q
6
2010-1-0
Subbase,
Modified,
6"
SY
2439
A i
In
.
7
4020-A-1
Storm
Class
III,
Sewer,
15"
Trenched,
RCP
LF
186
`7'
QQ
`) ?A 8
8
4020-A-1
Storm
Class
III,18"
Sewer,
Trenched,
RCP
LF
64
fa.34A
9
4020-D-0
Removal
30"
or
Less
of
Storm
Sewer, RCP,
LF
177
kr5"a.
J
10
4040-A-0
Subdrain,
HDPE,
6"
LF
702
`/,a^
aja0°
0?dS^O°
V/v
t-
p-
11
4040-D-0
Subdrain
Connections,
Outlets
HDPE,
and
6"
EA
16
12
5020-G-0
Valve
Box Replacement
EA
5
-
13
5020-C-0
Fire
Hydrant
Assembly
EA
1
14
5020-G-0
Utility
Adjustment
EA
1
6-v¢
SRO
15
5020-1-0
Fire
Removal
Hydrant
Assembly
EA
1
1J366
/J00
—
16
6010-A-0
Manhole,
SW-401,
48"
EA
2
`/4agi
VI°1919
cr.
17
6010
B 0
Intake,
SW-501
EA
1
,0-449
'
/raD
FORM OF BID
South Street and West 9th Street Mini -Roundabout
CS-TSF-8155(777)-85-07 1 City Project No. TOF 297 i 1213950
PAGE III-1
18
6010-B-1
Intake,
SW-505
EA
4-i_0RJ
C49O
19
6010-E-0
Manhole
Adjustment,
Minor
EA
2
4,00--
;ow°
.
20
6010-H-0
Remove
Manhole
EA
3
.rQ, a,
fisave
--
21
6010-H-0
Remove
Intake
EA
4
j--pd "
at 000
22
7010-A-0
Pavement,
PCC,
9"
SY
1733
-
23
/ b/ /6q
23
7010-A-1
Pavement,
Colored
PCC,
9"
SY
648
ls..v
7.71490
24
7010-1-0
PCC
Testing
Pavement
Samples
and
LS
1
b
c
lj
n
25
7020-B-0
Pavement,
HMA,
9"
SY
58
//0
l0
/>Y8d
26
7030-A-0
Removal
of
Sidewalk
/
Shared
SY
325
6-,
Use
Path
7
p?1.1745"
27
7030-A-0
Removal
of
Driveway
SY
105
7 t
73S
28
7030-E-0
Sidewalk,
PCC,
4"
SY
17277
---
!3
J?
V'/ --
29
7030-E-0
Sidewalk,
PCC,
6"
SY
145
—
` •
ti•
131
3ya
30
7030-G-0
Detectable
Warning
SF
128
39 �.
I1�
?�r '
31
7030-H-1
Driveway,
Paved,
PCC,
6"
SY
80
9 --
7,,
5=7° —
32
7040-H-0
Pavement
Removal
SY
1710
9
is;3?so
33
8020-B-0
Waterborne
Markings
Pavement
STA
10
/ 5
l j
?SD
34
8020-E-0
Thermoplastic
Markings
Preformed
STA
2
I/o
�1�/
�jOPavement
35
8030-A-0
Temporary
Traffic
Control
LS
1
..D --
*V
�a-v
36
8040-A-0
Type
A Sign,
Sheet
Aluminum
SF
166
01 / —
(.
gjal
/4 �=
37
8040-B-0
Steel
Gauge
2"
Square
X 2"
Perforated
Tubing
Post
14-
LF
240
' .
-
3J bDO
38
8040-C-0
Removal
of
Signs
and
Posts
EA
5
cad `
/30 r
39
9010-B-0
Hydraulic
Fertilizing,
1
Seeding,
and
Mulching,
Seeding,
Type
AC
0.14
€1000
^,
^ v0
40
9010-D-0
Watering
MGAL
21
3s--U `
73.5-0 r
9040-D-1
41
Filter
Sock,
9"
LF
636
U �-
Obt
7/�/�
7
9040-D-2
Filter
42
Sock,
Removal
LF
636
r__
/
7rr
43
9040
T
1
Inlet
Sock
Protection
Device, Filter
EA
S,�'O
F---r
0000
44
9040-T-2
Inlet
Maintenance
Protection
Device,
EA
5
.: -
r
020a
45
9085-SP-1
Removal
Bench
and
Reinstallation
of
LS
1
.
CAC
.c.
car
46
9090-SP-1
Roadway
Lighting
EA
1
:35
000
.3f 0Uo
FORM OF BID
South Street and West 9th Street Mini -Roundabout
CS-TSF-8155(777)-85-07 I City Project No. TOF 297 11213950
PAGE III-2
47
11,010-B
Monument
Replacement
Preservation
(By City)
and
N/A
N/A
N/A
N/A
48
11,020-A
Mobilization
LS
1
l30G
igitgVa
ea
49
11,050-A-0
Concrete Washout
LS
1
0,
TOTAL
BID
fj'3333
1
Total Bid Price in Writing: -cage hutidisd. 4w the *AU"141 41111"-Dollars
00
Total Bid Price:$ SR3.)3.n3
(numbers)
1. 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 notice of the acceptance of this bid is mailed, emailed, faxed, 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 within ten (10) days after the agreement is
presented to him.
2. The bidder has received the following Addendum or Addenda:
i. Addendum No. Date /•• "8-20--
3. The City reserves the right to reduce project size prior to the award of a contract due to budgetary limitations.
4. The City reserves the right to select a bid that is most advantageous to the City, price included.
tt1� 1(ktot.t. of Bidder) (Date)
BY: Title s4- '_ `}" Cs/
fficial Address: (Including Zi p Code):
Ao• Box V31
cici Ks \s ft/49 soi9
R.S. Nov7-aav6a2ol--
FORM OF BID
South Street and West 9th Street Mini -Roundabout
CS-TSF-8155(777)-85-07 I City Project No. TOF 297 11213950
PAGE III-3
IV- NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
STATE OF
) SS
COUNTY OF 8%f(1
J d� K. SG h. , being first duly sworn, deposes and says that:
Red
of
(Owner, Partner, Office Representative, Agent, Other (explain)
, the Bidder that has submitted the attached bid.
(3) He is fully responsible for the preparation and contents of the attached Bid and of all pertinent circumstances
respecting such bid.
(4) Such Bid is genuine and is not a collusive or sham Bid.
(5) Neither the said Bidder nor any of its officers, partners, owner, agents, representatives, employees, or parties in
interest including this affiant, nor any employee or official of the City of Waterloo, Iowa, or the Owner of the property
interested in the proposed contract.
(6) 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, employers,
or parties in interest includiin his affiant or by any employee or official of the City of Waterloo, Iowa.
Signed:
Title:
Subscribed and sworn to me by
'r//
.,.%,J//<„‘b(t
before me this 1 day of I)e, , 2022.
Notary Public in and for S,44i ti / County, Iowa.
LINDA K SENN
COMMISSION NO. 803307
MY COMMISSION EXPIRES
aoa
NON -COLLUSION AFFIDAVIT
South Street and West 9th Street Mini -Roundabout
CS-TSF-8155(777)-85-07 I City Project No. TOF 297 11213950
PAGE III-1
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made with your bid submission. This information is subject to verification and
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V- BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we,
Swiss Re Corporate Solutions America
principal, and Insurance Corporation
Lodge Construction, Inc.
, as
, as surety we held and firmly bound unto the
CITY OF WATERLOO, Iowa. In the penal sum Five Percent (5%) of the Total Amount Bid Dollars
($ 5%
), lawful money of the United States, for the payment of which sum will and truly
be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally,
firmly by these presents. The condition of this obligation is such that whereas the principal has submitted
the accompanying bid dated the 15th day of December 2022, for the South Street and
West 9h Street Mini -Roundabout Project (Iowa DOT Project No. CS-TSF-8155(777)-85-07.
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/her 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 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 city in liquidation
of damages sustained if 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 city 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 officers this 12th day of
December , A.D. 2022.
(
Lodge Construction, Inc. StC
@al
)
Principal
•
�/17, e2X 1,/4// By l (Title)
esi'
Witness
Swiss Re Corporate Solutions America
Insurance Corporation
S • rety
By
Sara Huston Witness Attorney -in -Fact
BID BOND
South Street and West 9th Street Mini -Roundabout
CS-TSF-8155(777)-85-07 I City Project No. TOF 297 11213950
oung
(Seal)
PAGE V•1
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, I3RIAN 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 18th 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
FURTHER RESOLVED, that the signature of such officers and the seal of the Corporation may be affixed to any such Power of Attorney or to
fay certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon tlit: Corporation when so affixed and in the future with res?ard to anv bond, undertaking or contract of surety to which it is attached."
iiiiiiii
•%%,Sc%..... C
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,.3'1\G/i.r..s
By,
Erik Janssens, Senior Vice President of SRCSAIC & Senior Vice President
of SRCSPIC & Senior Vice President of WiC
Gcj : 1�0� 0�
By
iiiiiiiiiiiiiiiiiii
Gerald Jagrowski, Vice President of SRCSAIC & Vice President of SRCSPIC
& Vice President of WIC
IN WITNESS WHEREOF, SRCSAIC, SRCSPIC, and WIC have caused their official seals to be hereunto affixed, and these presents to be signed by their
authorized officers
this 10 day of NOVEMBER , 20 22
State of Illinois
County of Cook
ss
Swiss Re Corporate Solutions America Insurance Corporation
Swiss Re Corporate Solutions Premier Insurance Corporation
'Westport Insurance Corporation
On this 1 0 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 WIC and Gerald Jagrowski , Vice President of SRCSAIC and Vice President of
SPCSPIC and Vice President of \VIC, 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 instrument to be the voluntary act and deed of their respective companies.
Natty
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 true and correct copy of a Power of Attorney given by said SRCSAIC and SRCSPIC and \VIC, 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