Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
American Road Maintenance
Visit theupsstore.com to find a location near you. Domestic Shipments • To qualify for the Letter rate, UPS Express Envelopes may only contain correspondence, urgent documents, and/or electronic media, and must weigh 8 oz. or less. UPS Express Envelopes containing items other than those listed or weighing more than 8 oz. will be billed by weight. International Shipments • The UPS Express Envelope may be used only for documents of no commercial value. Certain countries consider electronic media as documents. Visit ups.com/importexport to verify if your shipment is classified as a document. • To qualify for the Letter rate, the UPS Express Envelope must weigh 8 oz. or less. UPS Express Envelopes weighing more than 8 oz. will be billed by weight. Note: Express Envelopes are not recommended for shipments of electronic media containing sensitive personal information or breakable items. Do not send cash or cash equivalent. KYLE PAULSON (480) 309-7102 THE UPS STORE #3694 34145 PACIFIC COAST HWY DANA POINT CA 92629-2808 SHIP CITY CLERK TO: 715 MULBERRY ST 0.6 LBS LTR 1 OF 1 SHP WT 1 LBS DATE: 29 MAR 2023 WMTER600 I��3-5fl4 IR 58? 9• 1111 II III IIIII�I UPS EARLY TRACKING it 1Z E66 1W5 15 9954 4783 11 i 1+ i BILLING: P/P i i i i I3H 13.00F ZZP 450 07.5U 02/2023 SEE NOTICE ON REVERSE regarding UPS Terms, and notice of limitation of liability. Where allowed by lave, shipper authorizes UPS to act as forwarding agent for export control and customs purposes. If exported from the US, shipper certifies That the commodities, technology or software were exported from the US in accordance with the Export Ad REstO223 Regulations. Diversion contrary to law is prohibited. Apply shipping documents on this side. Do not use this envelope for: UPS Ground° UPS Standard° UPS 3 Day Select° UPS Worldwide Expedited° Visit theupsstore.com to learn more about our Print Er Business Services. Serving you for more than 100 years United Parcel Service. nmiur umr nr tIM WM7 912 ups International Shipping Notice — Carriage hereunder may be subject to the rules relating to liability and other terms and/or conditions established by the Convention for the Unification of Certain Rules Relating to International Carriage by Air (the "Warsaw Convention") and/or the Convention on the Contract for the International Carriage of Goods by Road (the "CMR Convention"). These commodities, technology or software were exported from the U.S. in accordance with the Export Administration Regulations. Diversion contrary to U.S. law prohibited. 01880250709 08/21 United Parcel Service ups THE UPS STORE Print & Business Services THE UPS STORE EX") ImeSS Envelope FAXING LOCKERS theupsstore.com • theupsstorefranchise.com Sealed Bid Proposal of American Road Maintenance 4554 E Eco Industrial PI Tucson, AZ 85756 Bid On: Waterloo Regional Airport Runway 12/30 Taxiway A East, Taxiway E Project No. FAA AIP 3-19-0094-056 Bid Opening: March 30th, 2023 at 1:00 pm City Clerk 715 Mulberry Street Waterloo, IA 50703 PROPOSAL FORM FOR PAVEMENT REHABILITATION (RUNWAY 12/30, TAXIWAY A EAST, TAXIWAY E) FAA AIP 3-19-0094-056 AT THE WATERLOO REGIONAL AIRPORT WATERLOO, IOWA Waterloo Regional Airport 2790 Livingston Lane Waterloo, IA 50703 Gentlemen: r 1. The undersigned, being Corporation ( isting under the laws ofthe State of ILLINOIS , a Partnership consisting ofthe following partners: L. , 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 PAVEMENT REHABILITATION (RUNWAY 12/30, TAXIWAY A EAST, TAXIWAY E) -- FAA AIP 3-19-0094-056, 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 work to be performed in this project shall include the following described improvements at the Waterloo Regional Airport, Waterloo, Iowa: • P-608 Asphalt Surface Treatment for Runway 12-30 outside of the Runway 18-36 Runway Safety Area • P-608 Asphalt Surface Treatment for Taxiway A from concrete limits near Taxiway B to Runway 12-30 and Taxiway E • Crack Sealing on Runway 12-30, Taxiway A and Taxiway E • Asphalt Joint Repair on Runway 12-30 • Pavement Marking Removals and Replacement for Runway 12-30, Taxiway A and Taxiway E 3. The undersigned, in compliance with your Invitation for Bids dated 317/23 , hereby proposes to do the work called for in said Contract and Specifications and shown on said Plans and Addendum Nos. 1 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 3-19-0094-056 P-1 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) Revised Per Addendum No. 1—3/27/2023 ITEMIZED PROPOSAL WATERLOO REGIONAL AIRPORT WATERLOO, IOWA PROJECT: • PAVEMENT REHABILITATION (RUNWAY 12/30, TAXIWAY A EAST, TAXIWAY E) FAA AIP PROJECT NO.3-19-0094-056 ITEM NO. SPEC. NO. DESCRIPTION UNIT ESTIMATED QUANTITY UNIT PRICE BID TOTAL PRICE BID 1 GP 105 MOBILIZATION DEMOBILIZATION AND LS 1 $ 35,000 $ 35,000 2 P-101 JOINT AND CRACK REPAIR LF 61,000 $1.15 $ 70,150 3 1'-101 SPALLED PAVEMENT AND REPAIR FAILED ASPHALT SF 1,500 $15 $ 22,500 4 P-101 COLD MILLING SF 1,500 $ 5 $ 7,500 5 P-608 ASPHALT SURFACE TREATMENT SY 156,500 $ 1.40 $ 219,100 6 P-620 PAVEMENT MARKING REMOVAL SF 91,000 $1 $ 91,000 7 P-620 AIRFIELD REFLECTIVE MARKING -WATERBORNE) (YELLOW- SF 5,000 $ $65 $ 3,250 8 P-620 AIRFIELD REFLECTIVE MARKING -WATERBORNE) (WHITE- SF' 129,0(111 $ .65 $ 83,85� 9 P-620 AIRFIELD REFLECTIVE MARKING -WATERBORNE) (BLACK -NON- SF 1,9lll► $ ,65 $ 3 185 10 P-620 REFLECTIVE GRADATION MEDIA A) (TYPE I, LB '/,'/fill $ 1 $ 7,75� TOTAL BID AMOUNT $ 543,285 4. It is the Airport's intention to evaluate bids; and the Airport reserves the right to award or reject based on available funding. 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 rates. 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 seven and one-third (7.33%) percent of the dollar value 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 FAA AIP 3-19-0094-056 P-2 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) 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 Contract 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 forty-five (45) 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: 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(h)), 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 requii ements. 14. The contractor, by submission of this offer and/or execution of a contract, certifies that it: FAA A1P 3-19-0094-056 P-3 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) a. is not owned or controlled by one or more citizens or nationals of a foreign country 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 or 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 of records 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. 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 tier 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). FAA AIP 3-19-0094-056 P-4 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) 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) 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 -- FAA AIP 3-19-0094-056 P-5 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) (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; 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; 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. 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 19.602-1 a.(2)(a)]. d. In addition to other remedies available to the Government, the certification in paragraphs a. or b. of this provision concems 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: a. Bid Guaranty in the form of Bid bond b. Non -Collusion Affidavit of Prime Bidder. c. Statement of Intent — Non -Discrimination and Equal Opportunity Statement. (3) (5) (7) FAA AIP 3-19-0094-056 P-6 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) 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 I/ Corporation ❑ Joint -venture: all parties must join -in and execute all documents ❑ Other Respectfully su oad Maintenance idder By/ Kyle Paulson Signature Officer ' Title 4554 E Eco Industrial PI Tucson, AZ 85756 Address 85756 (Include Zip Code) 480-309-7102 Telephone No. FAA AIP 3-19-0094-056 P-7 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) BID BOND KNOW ALL MEN BY THESE PRESENTS, that we American Road Maintenance, Inc., 4554 E Echo Industrial PL, Tucson, AZ 85756 as Principal, and Travelers Casualty and Surety Company of America, One 'Power Square, Hartford, CT 06183 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 Total Amount Bid Dollars ($ 5%TAB ) 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 ofthis obligation is such that whereas the Principal has submitted the accompanying bid, dated March 30 ,2024 for PAVEMENT REHABILITATION (RUNWAY 12/30, TAXIWAY A EAST, TAXIWAY E) at the Waterloo Regional Airport, Waterloo, Iowa, FAA AIP 3-19-0094-056. 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 27thday of March , A.D., 20 23. Wi W arah Timmons Principal By ( aintenance, Inc. (Seal) SuretyTrav Casual nd Surett,Company of America By -7/ ,dC!�• (Attorney -In -Fact) Sean J. Mauley, Jr. (Seal) FAA AIP 3-19-0094-056 AECOM Project #60695145 P-8 Waterloo Regional Airport Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) TRAVELERS 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 SEAN J MCCAULEY JR of DALLAS , Texas , 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. { Jy Y W'2N State of Connecticut 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 By: Robert L. Raneenior Vice President 114 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 President, 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 Attorney 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 t2j 1��day of Mw+ C/n , YV'-'> Kevin E. Hughes, Ass( tint Secretary To verify the authenticity of this Power of Attorney, please call us at 1-800-421-3880. P/ease refer to the above -named Attorney(s)-in-Fact and the details of the bond to which this Power of Attorney is attached. t' e• rrr `iCTt1114: ..S4,�i,�: s.ekt.. . , ji f F� S y,ostis • tr'.•r-rfr%:1-40 Gc0�7YaiC�`clls+d� �h•&Is+G•t�.TAq[ySfiTT72. 0 woo(0o i� o•�•=o +a) wOSCOWC9O c . . oC7z 1 l 'I!),{ a�1�714 • ILl9L{U6'L'J • fr. • Ifal:» • 'Sr9a"fETUt�iS�d'2[1w•. •n•X�LP•?}D5d'�° v, �'•yr,'••„"/`�'�(jt%4} �' Yi✓• ,Li •�1ljjMl,'r yyj^•�hL.V'�11v,,�flf� . ti lat." tV\OS .Z;1 " . I ,�s'sS�t:eeta�7 �rri)f .'• c fir;;. • '.'';{:a/'}•r ' \1�.1. {f� a r �•1: CJ. ` �4�^ti.\/ fr:!Irf•i•S�� ` :1417 r:ia t:. // f ;;J:. "A %• % !/�= ;, r r• tri. Atli/4 r . 1, +Its'`•• 't?.,�.. -/.•- dta tsS., �✓``mot Viti rl NON -COLLUSION AFFIDAVIT OF PRIME BIDDER )ss State of California County of Orange Kyle Paulson (1) He is (Owner, Partne American Road Maintenance , being first duly sworn, deposes and says that: epresentative, or Agent) of , 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 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, including this affiant. Subscribed and sworn to before me this 29th day of March 12023 Title (Signed) Title Kyle Pa Ison / Officer SEE ATTACHED CERTIFICATE My Commission Expires , 20. FAA AIP 3-19-0094-056 P-9 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) JURAT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of 6 rUr1 ye Subscribed and sworn to (or affirmed) before me on this a 7 day of 202-3 by I% yfe,vir% Moab proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature (Seal) KARL D. DEQUILLETTES Notary Public • California Orange County Commission # 2439035 My Comm. Expires Feb 24, 2027 , ♦ OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT Noth-60iitts ion Micricjg (Title or description of attached document) Uf- Iprinne Bidder (Title or description of attached document continued) Number of Pages Document Date Additional information 2015 Version www.NotaryClasses.com 800-873-9865 INSTRUCTIONS The wording of all Jurats completed in California after January 1, 2015 must be in the form as set forth within this Jurat. There are no exceptions. If a Jurat to be completed does not follow this form, the notary must correct the verbiage by using a jurat stamp containing the correct wording or attaching a separate jurat form such as this one with does contain the proper wording. In addition, the notary must require an oath or affirmation from the document signer regarding the truthfulness of the contents of the document. The document must be signed AFTER the oath or affirmation. If the document was previously signed, it must be re -signed in front of the notary public during the jurat process. • State and county information must be the state and county where the document signer(s) personally appeared before the notary public. • Date of notarization must be the date the signer(s) personally appeared which must also be the same date the jurat process is completed. • Print the name(s) of the document signer(s) who personally appear at the time of notarization. • Signature of the notary public must match the signature on file with the office of the county clerk. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different jurat form. Additional information Is not required but could help to ensure this jurat is not misused or attached to a different document. • Indicate title or type of attached document, number of pages and date. • Securely attach this document to the signed document with a staple. 1 State of NON -COLLUSION AFFIDAVIT OF SUBCONTRACTOR (To Be Submitted After Bid But Prior to Award) County of ) No subs )ss ) , being first duly sworn, deposes and says that: (1) He is (Owner, Partner, Officer, Representative, or Agent of , the Bidder that has submitted the attached Bid: (2) He is fully informed respecting the preparation and contents ofthe 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 ofthe 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. (Signed) Title Subscribed and sworn to before me this day of , 20. Title My Commission Expires , 20. FAA AIP 3-19-0094-056 P-10 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) 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 aff►liations, national origins, sex, age, sexual orientation, gender identity, disability, color, creed, marital status, employee union or association membership or off►ce 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 Pavement Rehabilitation (Runway 12/30, Taxiway A East, Taxiway E) FAA AIP Project No. 3-19-0094-056 American Road Maintenance COMPANY Kyle Paulson EX TIVE OFFICER Marc Hakim AFFIRMATIVE ACTION OFFICER ADDRESS OF THE AFFIRMATIVE ACTION OFFICER 4554 E Eco Industrial PI Tucson, AZ 85756 PHONE NUMBER 480-309-7102 FAA AIP 3-19-0094-056 P-11 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) BIDDER'S INFORMATION SHEET A. BIDDER'S CAPACITY: (Check One) 1. Individual 0 2. Co -Partnership ❑ 3. Corporation M 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 ILLINOIS Names and Addresses of Officers: President Joe Coghill Secretary Kyle Paulson Treasurer Marc Hakim 4554 E Eco Industrial PI Tucson, AZ 85756 4554 E Eco Industrial PI Tucson, AZ 85756 4554 E Eco Industrial PI Tucson, AZ 85756 FAA AIP 3-19-0094-056 P-12 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwvy 12/30, Txy A East, Txy E) SYNOPSIS OF EXPERIENCE RECORD (This synopsis must accompany Proposal Form.) Name of Bidder American Road Maintenance 4554 E Eco Industrial PI Tucson, AZ 85756 Individual ( ) Partnership ( ) Corporationt(4 (Check One.) Construction successfully completed within past five years similar in size, scope, and difficulty of construction to the work bid upon. Business Address Name of Name of Owner Project 1 Albert Lea Airport Albert Lea Airport Location of Project Albert Lea Airport 2 Aspen/Pitkin County Airport Aspen/Pitkin County Airport 3 San Angelo Airport San Angelo Airport San Angelo Airport 4 Scotts Bluff Airport Scotts Bluff Airport Scotts Bluff Airport 5 Dallas Fort Worth Airport Dallas Fort Worth Airport 1 25 2 30 3 25 421 Number of Contract Days Allowed for Above Projects 5 45 (By) Kyle Paulson (TITLE) Officer Date 3/28/23 Amount of Contract 455,109 1,940,052 702,405 832,179.30 565,340 Actual Number of Days to Complete above Project 12 15 10 14 17 American Road Maintenance Name of Company FAA AIP 3-19-0094-056 AECOM Project #60695145 P-13 Waterloo Regional Airport Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) 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) 7.33% V The bidder/offeror is committed to a minimum of Bak% DBE utilization on this contract. u The bidder/offeror, while unable to meet the DBE goal of %, hereby commits to a minimum of % 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 firm(s) listed herein have agreed to perform a commercially useful function in the work items 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. American Bidder's/Offrtf • Firm Nam gnnaature intenance 3/28/23 Date DBE UTILIZATION SUMMARY Contract Amount DBE Amount Contract Percentage DBE Prime Contractor $ x 1.00 = $ DBE Subcontractor $ x 1.00 = $ DBE Supplier $ 66,372 x 0.60 = $ 39,823 7.33 DBE Manufacturer $ x 1.00 = $ Total Amount DBE DBE Goal $ 39,823 7.33 $ 39,823 7.33 % Note: If the total proposed DBE participation is less than the established DBE goal, Bidder must provide written documentation of the good faith efforts as required by 49 CFR Part 26. FAA AIP 3-19-0094-056 P-14 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) Bidder/Offer DBE Firm: DBE Contact Person: DBE Certifying Agency: Classification: LETTER OF INTENT Disadvantage Business Enterprise (This page shall be submitted for each DBE firm) Name: American Road Maintenance Address:4554 E Eco Industrial PI Tucson, AZ 85756 zip: 85756 City: Tucson State: AZ DBE Firm: AliSource Construction Supply Address: 12801 NE Airport Way City: Portland State: OR Name: Debbie Rockway DOT zip: 97230 Phone: ( 50)3-858-8922 Expiration Date: 4/20/24 Each DBE Firm shall submit evidence (such as a photocopy) of their certification status. ■ ■ Prime Contractor Manufacturer lJ Subcontractor Supplier Joint Venture Work item(s) to be performed by DBE Material supply Description of Work Item Crack fill material Quantity 40,666 Ibs Aggregate Paint 78,250 Ibs Total 1210 gal 28,672 Beads 7,750 Ibs 11,700 20,500 5,500 The bidder/offeror is committed to utilizing the above -named DBE firm for the work described above. The estimated participation is as follows: g 66,372 @ 60% DBE contract amount: Percent of total contract: 7.33 % AFFIRMATION: The above -named DBE firm affirms that it will perform the portion of the contract for the estimated dollar value as stated above. By: Zere6g ,e,7President (Signature) (Tide) Note: In the event the bidder/offeror does not receive award of the prime contract, any and all representations in this Letter of Intent and Affirmation shall be null and void. FAA AIP 3-19-0094-056 P-15 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) BUY AMERICAN CERTIFICATION FORM FOR MANUFACTURED PRODUCTS (Non-huilding 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". 0 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. C] 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. Required 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 3-19-0094-056 P-16 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) 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. 3/29/23 Date American Road Maintenance Company Name Officer Title FAA AIP 3-19-0094-056 P-17 Waterloo Regional Airport AECOM Project 1160695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) Buy America Waiver Request Title 49 U.S.0 Section 50101 (b) For Airfield Development Projects funded under the Airport Improvement Program (Revised 4/19/2010) Instructions for Permissible Waivers Section 50101(b)(1) Waiver: The bidder may not request a waiver based upon the best interests of the public. The FAA Office of Airports publishes such waivers at: http://www. faa. gov/airports/aip/procurement/federal_contract_provisions/media/buy_american_waiver. xls Section 50101(b)(2) Waiver: The bidder may not request a waiver based upon insufficient supply of U.S. manufactured. The FAA Office of Airports publishes such waivers at: http://www. faa.gov/airports/aip/procurement/federal_contract_provisions/media/buy_american_waiver.xls Section 50101(b)(3) Waiver: The bidder may request a waiver if 60% or more of the components are produced in the United States and final assembly occurs in the U.S. Bidder is hereby advised that the Owner's approval with the bidder's waiver request is contingent upon FAA approval. 1. "Equipment" in Section 50101 shall mean the following: a) Individual type "L" items (Airfield Lighting Equipment) as listed in FAA Advisory Circular 150/5345-53. b) Individual bid items as established within FAA Advisory Circular 150/5370-10. The bid item application may not be applied for the type "L" items listed in AC 150/5345-53. c) A waiver request may only address one specific equipment item. Submit separate requests for each equipment item for which a waiver. d) Items listed under the Nationwide Waiver do not require further review. Please refer to the following webpage: http://www. faa.gov/airports/ai p/procurement/federal_contract_prov isionshnedia/buy_american_waiver.xls 2. The bidder must base the U.S. percentage upon the value that results from completing a component cost calculation table similar to the attached format. Bidder shall avoid mere pro forma efforts to establish the waiver request percentage. The Bidder must submit the component cost calculation table as an attachment to the waiver request. 3. Components/subcomponents are the material and products composing the "equipment". 4. The final assembly of the AIP-funded "equipment" must be within the USA (Section 50101(b)(3)(B)). Final assembly is the substantial transformation of the components and subcomponents into the end product. 5. All steel used in the "Equipment" must be produced in the United States. 6. The Buy American requirements apply to all tier contractors and subcontractors. All contractors/subcontractors are required to provide appropriate documentation that indicates origin of manufacturer and percentage of domestic made product. 7. The bidder is hereby advised there is no implied or expressed guarantee that a requested waiver will be issued by the Federal Aviation Administration (FAA). Less than 60% USA component/subcomponent proposed for this facility CANNOT be waived. Products made with foreign steel are not eligible for a waiver. 8. North America Free Trade Act (NAFTA): Free Trade Agreements such as NAFTA do not apply to the AIP. Products and material made in Canada or Mexico must be considered as foreign made products. 9. Preparation of a Component Cost Calculation Table is not necessary for equipment listed on the FAA national listing: http://www.faa.gov/airports/aip/procurement/federal_contract_provisionslmedia/buy_american waiver.xls. Bidder however shall submit a listing of any equipment it proposes to install on the project that is included on the National Buy American conformance list. Instructions for Section 50101(b)(4) Waiver: 1. The bidder may request a waiver if application of Buy America preferences results in a 25% cost increase in the nverall nroiect. This waiver is rarely applicable. Consult the Owner before making this request. FAA AIP 3-19-0094-056 P-18 Waterloo Regional Airport AECOM Project #60695145 Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) 010 U.S. Department of Transportation xr, Federal Aviation Administration OMB CONTROL NUMBER: 2120.0569 EXPIRATION DATE: 6/30/2023 - CONFIDENTIAL - NOT SUBJECT TO DISCLOSURE UNDER EXEMPTION # 4 OF THE FREEDOM OF INFORMATION ACT Buy American Product Content Percentage Worksheet Company Name: Address: Telephone: Fax: Product Structure: Multi -Level Bill of Materials (through level 2 only) FM Item Number (if applicable): US Content (%) (attach Certificate of Origin, US Customs Form 434, if applicable): Other (%): FAA Eligible Item: Total Material Cost: Dale: Point of Contact: Email: Address of Final Assembly Location: The undersigned certifies that this information is true and accurate to the best of their knowledge. A false certification represents a violation of 18 U.S.0 § 1001 and 49 U.S.0 § 47126. Signatory has the burden of proof to establish compliance. Signature: Name: Kyle Paulson 100% buy american Instruction: Items listed in Federal Acquisition Regulation Part 25.104 may be counted as US Origin but should include a note stating the item Is exempt in 25.104. Level codes: Level 0 is the final product; Level 1 Is a component; Level 2 is a sub -component. Level (0, 1 , 2) Part Number Itorn Doscriptlon Quantity Per Unit FM Form 5100-136 (8/20) SUPERSEDES PREVIOUS EDITION Unit of Moasuro Price/Unit of Moasuro US Origin Price/Unit of Measure US Origin CostiEach Other Price/Unit of Moasuro Other Cost/Each FAA AIP 3-19-0094-056 AECOM Project #60695145 P-19 Waterloo Regional Airport Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) - CONFIDENTIAL - NOT SUBJECT TO DISCLOSURE UNDER EXEMPTION # 4 OF THE FREEDOM OF INFORMATION ACT Level (0,1,2) Part Number Item Description Quantity Unit of Price/Unit Per Unit Measure of Moasure US Origin U3 OriginOther Price/Unit CoeUEsch PrlcolUlcolUnit of Measure of Measure Other CosUEach FAA Form 5too-138 (8/20) SUPERSEDES PREVIOUS EDITION Page 2 of 2 FAA AIP 3-19.0094-056 AECOM Project 1160695145 P-20 Waterloo Regional Airport Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) gib U.S. Department of Transportation l✓ Fodorat Aviation Administration OMB CONTROL NUMBER: 2120-0569 EXPIRATION DATE: 6/30/2023 — CONFIDENTIAL — NOT SUBJECT TO DISCLOSURE UNDER EXEMPTION # 4 OF THE FREEDOM OF INFORMATION ACT SAMPLE - FAA Buy American Preference Construction Project Content Percentage Worksheet Airport Sponsor. Sample Airport Authority Airport Worksile: Sample Municipal Airport Worksite LOCID: SMP Project Description: Reconstruct Runway 18/38 Project Material Structure List (Bill of Materials) — SAMPLE Date: 09/16/2020 Total material cost: $1,623,900.00 U.S. Content: 5.00 % Non-U.S. Content: 96.00 % Material Lino Level (1 or 2) 2 3 5 1 6 7 8 1 1 1 2 2 Materials Pavement items Pavement Item Component Pavement Item Subcomponent Cost of U.S. Origin Materials $1,000,000.00 $50,000.00 $250,000.00 Painting and Marking Component Painting and Marking Component Electrical and Lighting Electrical and Lighting Subcomponent Electrical and Lighting Subcomponent $1,900.00 $120,000,00 $0.00 50.00 $24,000.00 $0.00 $50,000.00 58,000.00 $0.00 SUBTOTAL 51,4451900.00 $0.00 $0.00 $20,000.00 $0.00 $78.000.00 FAA Form 6100.143 (8/20) TOTAL MATERIAL COST: $1,523,900.00 U.S. Content: 5.00 Non-U.S, Content: 95.00 % For FAA Use Only Page iv of iv FAA AIP 3-19-0094-056 AECOM Project #60695145 P-21 Waterloo Regional Airport Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) grb U.S. Department of Transponat on Ilk, Fa -dotal Aviation Adminlalratlon OMB CONTROL NUMBER: 2120.0569 EXPIRATION DATE: 6/30/2023 — CONFIDENTIAL — NOT SUBJECT TO DISCLOSURE UNDER EXEMPTION # 4 OF THE FREEDOM OF INFORMATION ACT FAA Buy American Preference Construction Project Content Percentage Worksheet Date: Airport Sponsor: Airport Worksite: Workslte LOCID: Project Description: Total material cost: U.S. Content: Non-U.S. Content: Project Line 1 Material Material Level (.1 or 2) Structure List (Bill of Materials) r.laleria s coal of U.S. Origin Materials Cost of Non-tJ.s Materials all 2 3 4 5 6 7 8 9 10 - FM Form 5100-143 (8/20) For FM Use Only Page 1 of 2 FAA AIP 3-19-0094-056 AECOMM Project 1160695145 P-22 Waterloo Regional Airport Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) rrateria! inc Level (1 or 2) Materials r U.S. Origin Materials Cost of Non•U.S. ' Materials 11 12 13 14 15 _. 18 17 18 19 20 SUBTOTAL TOTAL MATERIAL COST: U.S. Content: 100 Non-U.S. Content: The undersigned certifies that this information is true and accurate to the best of their knowledge. A false certification represents a violation of 18 U.S.0 § 1001 and 49 U.S.0 § 47128. Signatory has the burden oablish compliance. Signature: Name: Kyle Paulson Title: Officer FM Form 5100.143 (8/20) For FAA Use Only FAA AIP 3-19-0094-056 AECON,1 Project fl60695145 P-23 Waterloo Regional Airport Pavement Rehab. (Rwy 12/30, Txy A East, Txy E) Page 2 of 2 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 national listing: http:/lwrirw.faa.gov/airporls/aip/procurement/federal contract provisions/media/bur american waiver.xls • Bidder shall submit a listing of equipment it proposes 10 install on the project that is included on the current National Buy American conformance list. Equipment Type Name of Manufacturer Product Number All listed 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 contract provisions/media/buy american waiver.xls I hereby certify the above information is accurate and complete. American Road Maintenance 3/29/23 Bidder's Firm Name Date Signature FAA AIP 3-19-0094-056 AECOM Project 460695145 Pavement Rehab (Rwy 12/30, Txy A East, Txy E) P-24 Waterloo Regional Airport AMERICAN ROAD MAINTENANCE '7Gr ge r4t tcaa sae List of Airfield Jobs Completed in the Last Three Years 1 Airport Job Total Alamo Landing Field Andrew Othole Memorial Airport ASI Aspen CO-Prollne Aspen/Pitkin County Airport Atmore Airport Atoka Municipal Airport Atwood Rawlins County Airport Aztec Municipal Airport Banning Municipal Airport Beatty Alrport Belen Alrport Bell Helicopter Practice Airfield Benson Airport Bert Mooney Airport Big Sky Field Airport Bluegrass Airport Boundary County Airport Brownwood Airport Bullhead City Alrport Burbank Airport Camdenton Airport Camp Pendleton Carson City Airport Caruthersvllle Memorial Airport Casper/Natrona County Intnl Airport Centennlet Airport Central Colorado Regional Airport Chandler Municipal Airport Chattanooga Airport Clayton Alrport Cleburne Regional Airport Cochise Aviation College Harriet Alexander Field -Salida Kit Carson County Alrport-Burlington Converse County Airport Dawson Community Airport Giendive MT Delta Regional Airport Deming Municipal Airport Driggs•Reed Memorial Alrport Durango Airport Espanola Municipal Airport Fall River Mills Alrport Farmington Alrport Fort Morgan French Valley Alrport Fresno Yosemite Itnl Alrport $21,661.20 $199,205.00 $20,078.10 $44,138.70 $1,940,052.74 $89,250.00 $190,955.40 $157,242.30 $133,761.44 $ 324,666.05 $127,545.00 $204,082.80 $188,721.50 $182,162.03 $772,981.86 $85,910.31 $41,878.00 $196,780.00 $252,710 $59,362.30 $58,641.50 $178,659.80 $241,405.50 $284,983.40 $280,199.70 $928,301.53 $176,250.00 S271,587,90 $97,710.00 $30,000.00 $47,762.50 $166,333.50 $131,173.20 $165,771.00 $203,362,70 $41,626.72 $403,747.98 $162,970.00 5171,040.60 $244,223.45 $202,611.40 $294,375.00 $128,715.00 $210,599.15 $122,342.50 $120,730.00 $184,800.00 Airport FT Dodge Ft Worth Gallup Municipal Airport Gibson County Airport Granhy-Grand County Airport Grand Junction Regional Airport Buchanan Airport Grant County Airport Great Falls International Airport Greenlee County Airport Hanford Hatch Municipall Airport Havre City Airport Hawthorne Industrial Airport (NV) Hawthorne Municipal Alrport Hobby Airport Holyoke Airport Hulett Municipal Alrport Jacqueline Cochran Regional Airport Johnson County Alrport las Cruces Airport Las Vegas NM Airport LAWA Lemhl County Alrport Long Beach Airport Lusk Alrport Main Street Materials Meeker Coulter Field Airport Midway Island Atoll Millard Airport Mission Field Mobile Regional Airport Mandell Field Airport Monte Vista Moriarty Municipal Airport NE Wyoming Airport NW Arkansas Memorial Airport Oakdale Municipal Airport Oceanside Municipal Alrport Owyhee Airport Palo Alto Airport Perry Stokes•Trinldad Plains Alrport Poplar Alrport Portales Municipal Airport Prescott Airport Pueblo Airport Job Total J $661,386.60 $565,340.00 $220,236.25 $124,996.25 $24,536.05 $144,225.00 $ 70,400.00 $138,100.00 $1,222,598.13 $146,625.00 $313,853.70 $212,920.75 $316,405.48 $372,740.20 $374,458.11 $68,902,75 $192,713.50 $246,109.75 $1,028,663.42 5114,128.62 $383,002.50 $147,900.00 $157,270.00 $99,485.00 $84,226.00 $77,803.43 $43,792.00 $239,270.34 $3,479,507.51 $136,064.75 $174, 285.35 $68,190.06 $72,539.97 $238,838.57 $179,176.20 $95,461.82 $99,895.10 $115,282.50 S57,850.00 $214,853.02 $27,625.00 $142,335.00 $138,911.39 $138,754.64 $104,525.00 $135,502.50 $387,217.35 Airport Questa Municipal Airport Rangely Airport Raton Municipal Airport Red Bluff Municipal Airport Reedley Municipal Airport Rolle Airport Rominger Airport Ronan Airport Roswell International Alrpro Route 25 Salinas Airport San Angelo Airport San Carlos Apache Airport Santa Fe Alrport Santa Rosa Route 66 Airport Scotts Bluff Alrport Shawnee Regional Airport Shelby Alrport Sheridan County Airport Sherwood Alrport Sidney -Richland Regional Alrport Sioux Falls Regional Airport Slayton Airport Socorro Municipal Airport Stockton Metro Airport Taos Regional Airport Taylor Alrport Telluride Regional Airport Texas A&M Tucson Drag Strip Tucson International Airport Tucumcari Municipal Alrport Ukiah Municipal Airport Van Nuys Airport Vaughn Municipal Alrport Victoria Regional Airport Wells Municipal Alrport Western Emulsions. Wheatland County Airport White Sulpher Springs Airport Wickenburg Airport Willits Municipal Airport Yampa regional Airport Yellowstone Airport TOTAL Job Total $148,285.50 $283,140.08 $326,836.00 5301,885.00 $44,782,00 $84,737.00 $147,037.50 $170,970.82 $254,150.99 $44,265,50 $393,708.00 $702,404.90 $9,160.00 $282,470.00 $126,999.50 $832,179.30 $498,097.95 $201,423.52 $426,351.50 $125,674.36 $533,956.64 $113,525.00 $119,937.50 $207,270.00 $87,162.00 $296,553.54 $273,504.05 $394,580.25 $1,004,939.95 $8,750.00 $48,858.25 $349,482.25 $110,775.00 $183,480.65 $84,660.00 $99,312.00 $148,200.50 $500,00 $85,787.06 $133,218.80 $166,411.93 $78,900.00 $153,218.40 $274,320.88 $34,691,127.39 AMERICAN ROAD MAINTENANCE 'Zf/c go rite aria odic" KEY PERSONNEL EXPERIENCE Joe Coghill — Owner 20 plus years of experience in asphalt maintenance specializing in airfield pavements Proficient in the processes of seal coating, clack sealing, joint sealing, paint and rubber removal, pavement markings and layout, and friction testing meet all FAA requirements Supervises contracts, the bid process and scheduling of crews Kyle Paulson — Officer 10 plus years of experience in asphalt maintenance specializing in airfield pavements Proficient in the processes of seal coating, crack sealing, joint sealing, paint and rubber removal, pavement markings and layout, and friction testing o meet all FAA requirements Estimator and contract administrator Dan Mueller — Project Manager 8 plus years of experience in asphalt maintenance specializing in airfield pavements Proficient in the processes of seal coating, crack sealing, joint sealing, paint and rubber removal, pavement markings and layout, and friction testing to meet all FAA requirements Certified friction tester Supervises all projects and the coordination of personnel Walt Bills — Foreman 25 plus years of experience in construction as a CDL driver and equipment operator Proficient in the processes of seal coating, crack sealing, joint sealing, paint and rubber removal, pavement markings and layout, and friction testing to meet all FAA requirements Works on site as a crew leader and liaison for the engineers and management Derek Hyatt — Asphalt Distributor Driver - 10 plus years of experience in construction as a CDL driver and equipment operator - Proficient in the processes of seal coating, crack sealing, joint sealing, paint and rubber removal, pavement markings and layout, and friction testing to meet all FAA requirements - Specializes in the application of the P-608 and P-608R process on airfields Mario Alfaro — Airfield Marking Foreman - 25 plus years in pavement markings - Specializes in the layout and placement of pavement marking on airfields - Assures all striping of the project meets the requirements and specifications of the owner and engineer AMERICAN ROAD MAINTENANCE tithe 90 t!€ arm .alto" List of Available Equipment 6 Ram 2500 Utility Trucks 3 Ram 3500 Flatbed Utility Trucks 3 Bearcat Asphalt Distributors with Sand Applicators 1 Etneyre Asphalt Distributor with Sand Applicator 3 Friction Testers 2 Water blasting paint removal trucks 6 Graco ride on striping machines 2 Truck mounted tac pot kettles 4 Crack seal routers 2 Crafco crack seal kettles 1 Vacuum sweeper 4 Billy Goat blowers 2 Transport tankers 2 Forklifts 2 Air compressors 2 Scarifiers • AMERICAN ROAD MAINTENANCE '71/e je at rtftn wr!!R' BIDDING POWER OF ATTORNEY Know all men by these presents: American Road Maintenance, Inc doing business as a Corporation under the laws of the State of Illinois have a principal place of business at 4554 E Eco Industrial P1, AZ 85756, hereby constitutes and appoints Kyle Paulson to act for and on its behalf as a true and lawful agent and attorney of the grantor and in the name, place and stead of said grantor, from this date, in the United States either in writing, electronically, or by other authorized means, to: Endorse or sign documents required in connection with the bidding and or securing bids for said grantor; Perform any act on condition, which may be required in connection with such bids; Sign or swear to any document and to perform any act that may be necessary in connection with the preparation and submittal of such bids; Giving to said agent the attorney full power and authority to do whatever is necessary to be done as fully as said grantor could do if present and acting, hereby confirming all that the said agent and attorney shall lawfully do by virtue of these presents' • This power of attorney to remain full force and effect until revocation in writing is duly given to and received by grantee. Appointment as Officer/Estimator: Grantor authorizes the above grantee to act as lawful agent and sign or endorse documents per twining to the bidding for work for the Grantor. IN WITNESS WHEROF, the said American Road Maintenance, Inc caused these presents to be sealed and signed: Joe Z-11- 18 ghillesident of American Road Maintenance, Inc Date Witness: 4 ASPHALT SYSTEMS INC. ADVANCED PRESERVATION MATERIALS November 12, 2020 Re: P-608 Emulsified Asphalt Seal Coat To Whom It May Concern, Per the requirements stated in P-608.5.2 Contractor Qualifications, American Road Maintenance exceeds the specified qualifications. Respectfully Submitted, John John Hunter Asphalt Systems Inc. 1.71) EJ.IN 1 \I. c ;R( t I1' AME SCAN ROAD MAINTENANCE 9 JINC Reviewed Financial Statements For the Year Ended December 31, 2022 Available upon request Always firth/ i7 LV a l u e 3/28/23, 12:52 PM Details for AIISource Construction Supply dba AIISource Construction & Safety Supply - Iowa DOT DBE Directory Services (https:/Iclireclory.iowa.gov/service/In(t tWONMr,14WadA .gg.Ya4ti13006.1488473035&ia_sly= 1680033018721 ) Agoncies (http ;://directory.iowa.gov/?ia s 1680033018721) HOME (HTTPS:I/WWW.IOWADOT.GkV) I Social (Iiitps://directory.iowa.gov/social/In ?ia_sly=1680033018721) ONLINE SERVICES (HTTPS://W ' ? I':./ARI\JV\A/.IOVVADOT. 7OV/GIVII TRAVEL (HTTPS://WWW.IOWADOT.GOV/TRAVEL#TRAVEL) .1 DETAILS FOR ALLSOORCLOONSTRAtTION SUPPLY. DBA AP _,LSOU O(NST UCTION :l& SAFETY SUPPLY nRivf l'f ' \"-1#.St'(HTTPS://WWW.IOWADOT.GOV/DRIVERSV+�EHICLES#DRIVERSVEHICLES) I • 1-9 i • . 1 /search/google?ia_slv=1680033018721) ESERVICE: Firm Name: AIISource Construction Supply dba AIISource Construction & Safety Supply BUSINESS (HTTPS:// WIIW.IOWADOT.GOV/BUSINESS#BUSINESS) I Owner: Debra Rockway a Address: 12801 NE Airport Hwy • FORMS (HTTPS://FORMS.IOWADOT.GOV/BROWSEFORMS.ASPX) Addt'I Address: ABIO{Ias WWv? 7IWACbOQ.103 RUTUS#ABOUT) Phone: 503-858-8922 (te1:503-858-8922) Addt'I Phone: 503-919-0126 (te1:503-919-0126) Fax: 503-620-5786 Email: debbier@asupply.net (mailto:debbier@asupply.net) Date Certified: 04/20/2021 TSB Certified: No SBA 8A Certified: No ACDBE: No Ethnicity: Caucasian Certification Type: WBE Website: www.asupply.net (http://www.asupply.net) © IOWA DOT (HTTPS://IOWADOT.GOV) EMPLOYEES (HTTPS://IOWADOT.GOV/EMPLO P/QL,I I S(rg/���ND pTIATt4ft M[[ TS P,$:///IIO ADOT./GOV//IP(O�LICI(E�►Sy_�AnNaD__STTAT+E�M pN,TS//]AcC(CcSS�J(B�InLITY-ST TEM N}�j\/0h(� REEKS (alticvi/bniax�'CMCrnit aiL`KAL�l.�f�4e.-3ih'C'proa1iY01/I�cQgkel MY ^°t1-ILITTOC•! 1 n% • Sea https://secure.iowadot.gov/DBE/Directory/Details/547?currentFilter=allsource¤tType=firmName 1/1