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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 , a
Partnership consisting of the following partners: eaid_xv-QAc-tist 1 t4C.. , 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 9TH STREET MINI -ROUNDABOUT, all in accordance
with the above -listed documents for the prices listed below:
ITEM
ITEM
CODE
DESCRIPTION
UNITS
QUANTITY
EST.
UNIT
PRICE
TOTAL
PRICE
1
2010-A-0
Clearing
and
Grubbing
UNIT
184
AO
„7 30 %—
2
2010-D-3
Topsoil,
Offsite
CY
112
'
3
2010-E-0
Excavation,
Class
10
CY
500
--
4
2010-G-0
Subgrade
Preparation,
12"
SY
2835
.l
1-1252
SP
•
5
2010-H-0
Subgrade
Treatment,
Geogrid
SY
2439
3
,_
'1.3
V1
6
2010-1-0
Subbase,
Modified,
6"
SY
2439
--
3
sok2-4
7
4020-A-1
Storm
Class
III,15"
Sewer,
Trenched,
RCP
LF
186
IW'
—
I(60j62CO`_
8
4020-A-1
Storm
Class
III,
Sewer,
18"
Trenched,
RCP
LF
64
—
&ni
105
4
9
4020-D-0
Removal
30"or
Less
of
Storm
Sewer,
RCP,
LF
177
)0`
"7
I"7Ot
es
10
4040-A-0
Subdrain,
HDPE,
6"
LF
702
15
jo,GJ3O:`
11
4040-D-0
Subdrain
Connections,
Outlets
HDPE,
and
6"
EA
16?�
Zoni
12
5020-G-0
Valve
Box
Replacement
EA
5
L250C
13
5020-C-0
Fire
Hydrant
Assembly
EA
1
,—
lr�ti
hlt �
C
14
5020-G-0
Utility
Adjustment
EA
1
5350-:
SSD%
15
5020-1-0
Fire
Removal
Hydrant
Assembly
EA
1
l 2.501
1250
16
6010-A-0
Manhole,
SW-401,
48"
EA
2
r 1
C:
sae%
�'1
17
6010-B-0
Intake,
SW-501
EA
1
Seco'
55Mi
FORM OF BID
South Street and West 9th Street Mini -Roundabout
CS-TSF-8155(777)-85-07 I City Project No. TOF 297 1 1213950
PAGE III-1
18
6010-B-1
Intake,
SW-505
EA
4
•itOt
501..
19
6010-E-0
Manhole
Adjustment,
Minor
EA
2
I \Sr >
Z 3co'y
20
6010-H-0
Remove
Manhole
EA
3
21
6010-H-0
Remove
Intake
EA
4
, ion
-
/Goon r
22
7010-A-0
Pavement,
PCC,
9"
SY
1733
lG\7
t 5I-1Z31`_
23
7010-A-1
Pavement,
Colored
PCC,
9"
SY
648
12�
c�
SS
, q •7�;"
,2ss
1J
24
7010-1-0
PCC
Testing
Pavement
Samples
and
LS
1
laDo 7
/Coo
,..
I
25
7020-B-0
Pavement,
HMA,
9"
SY
58
ids
‘
(0oq6
,-e
26
7030-A-0
Removal
Use
Path
of
Sidewalk
/ Shared
SY
325
/0
a
SZS-6'
27
7030-A-0
Removal
of
Driveway
SY
105
/0
I^
/Qso'
/1
6 fo
--
+-
28
7030-E-0
Sidewalk,
PCC,
4"
SY
172
67 V
29
7030-E-0
Sidewalk,
PCC,
6"
SY
145
.� 2 '
ia�
4
/,, �-
`70
30
7030-G-0
Detectable
Warning
SF
128
31
7030-H-1
Driveway,
Paved,
PCC,
6"
SY
80
32
7040-H-0
Pavement
Removal
SY
1710
2.5
12
0
33
8020-B-0
Waterborne
Markings
Pavement
STA
10
I 7.-0
12CO%
34
8020-E-0
Thermoplastic
Pavement
Markings
Preformed
STA
2
',` "
`
t;
(.Q5b
i
35
8030-A-0
Temporary
Traffic
Control
LS
1
36
8040-A-0
SF
166
Zebra
3.10
Type
A
Sign,
Sheet
Aluminum
37
8040-B-0
Steel
Gauge
2"
Square
X
2"
Perforated
Tubing
Post
14-
LF
240
'
1 5
38
8040-C-0
Removal
of
Signs
and
Posts
EA
5
%010
-
S
39
9010-B-0
Hydraulic
Fertilizing,
1
Seeding,
and
Mulching,
Seeding,
Type
AC
0.14
/Jf�i
2 IO,
40
9010-D-0
Watering
MGAL
21
`325."
(0g`LS;
41
9040-D-1
Filter
Sock,
9"
LF
636
3. yg
2104
219
42
9040-D-2
Filter
Sock,
Removal
LF
636
,25
-1q5'
!,
43
9040-T-1
Inlet
Sock
Protection
Device,
Filter
EA
5
185'
q
25 •
44
9040-T-2
Inlet
Maintenance
Protection
Device,
EA
5
•35
_
1 i5 r
45
9085-SP-1
Removal
and
Reinstallation
of
LS
1
'TO'
gele"
46
9090-SP-1
Roadway
Lighting
EA
1
�
2�
v
1 �p:
E3Z,om'
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
1115/0'
,.
ea) r
0;
49
11,050-A-0
Concrete
Washout
LS
1
TOTAL
BID
5'061398.2
Total Bid Price in Writing:/ (ZL/s'
54 d ied A) g�V'tf-45
/ !��.Yl/� l /l�'� Dol ars
'L o
Total Bid Price: $ 5-aa 3 q�. (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. l Date /2 /8 ZZ
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.
(Mectie• I a 1 IS (Narpe,of Bidder) J� (Date ,
BY: 1 TitleA-77/144t
Official Address: (Including Zip Code):
104 ` eACLCAC1n U t
ntoecy_ sypCnq
I.R.S. No.
�- CP 2 i CQS 4
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 ,
(1) He is
(2)
, being first duly sworn, deposes and says that:
of
?Orrisatk. (Owner, Partner, O ffice resentat, Agent, Other (explain)
�•-- -L,�L. , 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 includ'ng t is affjnt, or by any employee or official of the City of Waterloo, Iowa.
Signed:
Title: ;r7,ct,t-7zr,C gm
scribed apd sworn to me by Ma44 BOh (eh before me this 1&ay of Deathr2022.
C W
Notary Public in and for 4/ilkh-
County, Iowa.
JENNIFER R. WISSLER
Commission Number 761292
• My Commission Expires
owl' January 4, 2025
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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YES/ DOLLAR AMT. PROPOSED
NO TO BE SUBCONTRACTED
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South Street and West 9t Street Mini -Roundabout
0
Ln
m
ri
N
CS-TSF-8155(777)-85-07 I City Project No. TOF 297
V- BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we,
principal, and Travelers Casualty and Surety Company of America
Peterson Contractors, 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 9th 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 6th day of
December , A.D. 2022.
Peterson Contractors, Inc.
P 'vtpal
•=-AQA_ILAR. V , y � �� . i -Tale)
(Seal)
Witness
president
Traveler sualty d Surety Company of America (Seal)
Su
t orney-in-Fact Anne Crowner
BID BOND
South Street and West 9th Street Mini -Roundabout
CS-TSF-8155(777)-85-07 I City Project No. TOF 297 11213950
PAGE V-1
TRAVELERSJ
Travelers Casualty and Surety Company of America
Travelers Casualty and Surety Company
St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Anne Crowner of
WAUKEE , Iowa , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
State of Connecticut
By:
City of Hartford ss.
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
My Commission expires the 30th day of June, 2026
Robert L. Rane 7 enior Vice President
l4
Anna P. Nowik, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority
may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may
remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or
any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided
that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,
or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive
Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the
Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;
or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her
certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice Presideni,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to
any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -
Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of
Attomey or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed
and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or
understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect.
Dated this 6th
day of December
2022
etet
Kevin E. Hughes, Assistant Secretary
To verify the authenticity of this Power of Attorney, p/ease call us at 1-800-421-3880.
Please refer to the above -named Attorneys) -in -Fact and the details of the bond to which this Power of Attorney is attached.