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HomeMy WebLinkAboutFM Controls, Inc.:61-1 M 0 0 0-1 4.--- 1/4 y. H c;-1 o 7, en C--' NP ari 3 .3-1 c 1 PROPOSAL FORM FOR IMPROVE TERMINAL BUILDING (Upgrade HVAC System Control) FAA AIP 3-19-0094-054 (CARES DEV) AT THE WATERLOO REGIONAL AIRPORT WATERLOO, IOWA Waterloo Regional Airport 2790 Livingston Lane Waterloo, IA 50703 Gentlemen: 1. The undersigned, being a Corporation existing under ,the laws of the State of ` ,� , a Partnership consisting of the following partners: On n L_i, Awt 1l-erta �-'e, having familiarized (himself) (themselves) (itself) with the existing conditions on th&Sroject 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 Improve Terminal Building (Upgrade HVAC System Controls) -- FAA AIP 3-19-0094-054 (CARES DEV), all in accordance with the above - listed documents and for the unit prices for work in place for the following items and quantities: 2. The extent of the work involved is as follows. The FAA 3-19-0094-054 (CARES DEV) Improve Terminal Building (Upgrade HVAC System Controls) project which consists of the replacement of the existing Heating, Air Conditioning and Ventilation (HVAC) control system within the Waterloo Airport (ALO) terminal building. The existing HVAC Direct Digital Controls (DDC) is no longer compatible with current electronic controls. This project upgrades the existing HVAC DDC head -end equipment, replaces non-functioning portions of the HVAC control system, provides freeze protection for the Air Handling Unit's (AHU) hot water coils, and rebalances the system to ensure proper operation and control. This upgraded head -end equipment will be installed on a networked computer that will allow remote monitoring and control of the HVAC system. 3. The undersigned, in compliance with your Invitation for Bids dated Lim / Z,.3 , hereby proposes to do the work called for in said Contract and Specifications and shown on said Plans and Addendum Nos. and to furnish all materials, tools, labor and all appliances and appurtenances necessary for the said work at the following rates and prices: FAA AIP 3-19-0094-054 (CARES DEV) P-1 Improve Terminal Building - HVAC Proposal Form Waterloo Regional Airport - 60675091 ITEMIZED PROPOSAL WATERLOO REGIONAL AIRPORT WATERLOO, IOWA PROJECT: • IMPROVE TERMINAL BUILDING (Upgrade HVAC System Controls) FAA AIP PROJECT NO. 3-19-0094-054 (CARES DEV) • ITEM NO. DESCRIPTION UNIT ESTIMATED QUANTITY UNIT PRICE BID TOTAL PRICE BID BASE BID 1 UPGRADE SYSTEM THE EXISTING HVAC DDC LS 1 $ l u,1 Li ttO $1 j (01 1-1 (00 2 APPLY SCHEDULES HVAC DDC TO SYSTEM MODES LS 1 $ 5,1 $ 5, 9 43 O 50 TOTAL BASE BID $ 1222 v j' 4. It is the Airport's intention to evaluate bids reviewing both the Total. The Airport reserves the right to award the contract based on the Total Bid. 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 zero (0%) 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 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 tern "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. FAA AIP 3-19-0094-054 (CARES DEV) P-2 Improve Terminal Building - HVAC Proposal Form Waterloo Regional Airport - 60675091 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 ninety (180) calendar days fiom 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 requited 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 requirements. 14. The contractor, by submission of this offer and/or execution of a contract, certifies that it: a. is not owned or controlled by one or more citizens or nationals of a foreign 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. FAA AIP 3-19-0094-054 (CARES DEV) P-3 Improve Terminal Building - HVAC Proposal Form Waterloo Regional Airport - 60675091 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 o1 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 are 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 tiei 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 evidence of good faith in submitting this Proposal, the undersigned encloses bid security in the amount of five (5) percent of the bid which, in case he refuses or fails to accept an award and to enter into a Contract and file the required bonds within the prescribed time, shall be forfeited to the Waterloo Regional Airport as liquidated damages. 17. By entering into this contract, the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). 18. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). 19. The undersigned hereby declares that the only parties interested in this Proposal are named herein, that this Proposal is made without collusion with any other person, firm, or corporation, that no member of the Council, Waterloo Regional Airport o1 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. FAA AIP 3-19-0094-054 (CARES DEV) P-4 Improve Terminal Building - HVAC Proposal Form Waterloo Regional Airport - 60675091 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 of 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 Workplace, Act of 1988. a. By submission of this offer, the offeror, if other than an individual, who is making an offer that equals or exceeds $25,000, certifies and agrees that with respect to all employees of the offeror to be employed under a contract resulting from this solicitation, it will --no later than 30 calendar days after contract award (unless a longer period is agreed to in writing, for contracts of 30 calendar days or more performance duration;) or as soon as possible for contracts of less than 30 calendar days performance duration, but in any case, by a date prior to when performance is expected to be completed-- (1) Publish a statement notifying such employees that the unlawful manufacturer, distribution, dispensing, possession, or use of a controlled substance is prohibited in the Contractor's workplace and specifying the actions that will be taken against employees for violations of such prohibition. (2) Establish an on -going drug -free awareness program to inform such employees about -- (a) The dangers of drug abuse in the workplace. (b) The Contractor's policy of maintaining a drug -free workplace. (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 workplace. FAA AIP 3-19-0094-054 (CARES DEV) P-5 Improve Terminal Building - HVAC Proposal Form Waterloo Regional Airport - 60675091 (3) Provide all employees engaged in performance of the contract with a copy of the statement required by subparagraph a. (1) of this provision. (4) Notify such employees in writing in the statement required by subparagraph a.(1) of this provision that, as a condition of continued employment on the contract resulting from this solicitation, the employee will -- (a) Abide by the terms of the statement; and (b) Notify the employer in writing of the employee's conviction under a criminal drug statute for a violation occurring in the workplace no later than 5 calendar days after such conviction. (5) Notify the Contracting Officer in writing within 10 calendar days after receiving notice under subdivision a. (4) (b) of this provision, from an employee or otherwise receiving actual notice of such conviction. The notice shall include the position title of the employee; and (6) Within 30 calendar days after receiving notice under subdivision a.(4)(b) of this provision of a conviction, take one of the following actions with respect to any employee who is convicted of a drug abuse violation occurring in the workplace. (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. (7) 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-la (2)(a)]. d. In addition to other remedies available to the Government, the certification in paragraphs a. or b. of this provision concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under title 18, United States Code, Section 1001. 25. Attachment to This Bid. The following documents are attached to and made a part of this Bid: a. Bid Guaranty in the form of e t J lE t VI CI ( tinJ ©`a a ell b. Non -Collusion Affidavit of Prime Bidder. c. Statement of Intent — Non -Discrimination and Equal Opportunity Statement. d. Buy American Certification Statement. e. Bidder's Information Sheet. f. Synopsis of Experience Record. (IDOT Certification may be substituted.) g. Completed DBE forms "Utilization Statement" and "Letter of Intent." FAA AIP 3-19-0094-054 (CARES DEV) P-6 Improve Terminal Building - HVAC Proposal Form Waterloo Regional Airport - 60675091 26. The Bidder shall indicate whether the bid is submitted by a/an: ❑ Individual, Sole Proprietorship ❑ Partneiship lg Corporation ❑ Joint -venture: all parties must Join -in and execute all documents ❑ Other Respectfully submitted, By Bidder 11)73 ae0- Li Signature 0W Li cr Title (off 16+ Ace- 5�� �r1- Qo e ,e., Ter..U� Address 5voS )l (Include Zip Code) 57 5 -15-7c _ in 5 t, Telephone No. FAA AIP 3-19-0094-054 (CARES DEV) P-7 Improve Terminal Building - HVAC Proposal Form waterloo Regional Airport - 60675091 NON -COLLUSION AFFIDAVIT OF PRIME BIDDER State ofA County of u tbdrANtr that: )ss , being first duly sworn, deposes and says (1) He is (Owner, Partner, Officer, Representative, or Agent) of lm Con-1-0 01 'S �, a , the Bidder that has submitted the attached Bid: (2) He is fully informed respecting the preparation and contents of the attached bid and of all pertinent circumstances respecting such bid. (3) Such bid is genuine and is not a collusive or sham bid. (4) Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham bid in connection with the Contract for which the attached bid has been submitted or to refrain from bidding in connection with such Conti act, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, fine 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 1 day of (� 1 , 200l (VI— Title My Commission Expires March , 2006 (Signed) (Dr\ Title CYQ tN �- k„ „\ }� L~., THERESA LURSEN 4 z Notarial Seal - It.��i�rYA r *WA Commi : sion No. 781898 My Commission Expires 10/ -..__. FAA AIP 3-19-0094-054 (CARES DEV) Proposal Form P-9 Improve Terminal Building - HVAC Waterloo Regional Airport - 60675091 l STATEMENT OF INTENT NONDISCRIMINATION AND EQUAL OPPORTUNITY STATEMENT The Contractor does hereby certify to the Waterloo Regional Airport, that no person shall, in any way, be favored or discriminated against because of his race, political or religious opinions and affiliations, national origins, sex, age, sexual orientation, gender identity, disability, color, creed, marital status, employee union or association membership or office herein. If selected as the successful bidder, this contractor hereby agrees to file either a nondiscrimination and equal opportunity statement and/or an Affirmative Action Program. Improvements to the Waterloo Regional Airport consisting of Improve Terminal Building (Upgrade HVAC System Controls) FAA AIP Project No. 3-19-0094-054 (CARES DEV) ref\ co n-'-• ok s 1, C , I, 11 �VyV �u cl�v� COMPANY EXECUTIVE OFFICER AaMATIVE ACTION OFFICER ADDRESS OF THE AFFIRMATIVE ACTION OFFICER Dace t4 5Oca+9 PHONE NUMBER C 15 - G' 7 o 0- 41 5 FAA AIP 3-19-0094-054 (CARES DEV) P-11 Improve Terminal Building - HVAC Proposal Fonn Waterloo Regional Airport - 60675091 BIDDER'S INFORMATION SHEET A. BIDDER'S CAPACITY: (Check One) 1. Individual ❑ 2. Co -Partnership ❑ 3. Corporation B. (IF ITEM 2 IS CHECKED, COMPLETE THE FOLLOWING) State of Names and Addresses of Partners 2. 3. 4. 5. C. (IF ITEM 3 IS CHECKED, COMPLETE THE FOLLOWING) State of Incorporation tom (44) Names and Addresses of Officers: President Secretary Treasurer Don LuAw k -- In en-5 A Lurez, cat? Mktr 4 y LerS FAA ATP 3-19-0094-054 (CARES DEV) P-12 Improve Terminal Building - HVAC Proposal Fonn Waterloo Regional Airport - 60675091 SYNOPSIS OF EXPERIENCE RECORD (This synopsis must accompany Proposal Form.) Name of Bidder FIM O✓1 fro) y e_ Business Address (C'9--- 11)\' ALA 4-A-4'` Pori- Dv c? f= ��" S o5 `'1 Individual ( ) Partnership ( ) Corporation ( ) (Check One.) Construction successfully completed within past five years similar in size, scope, and difficulty of construction to the work bid upon. Name of Owner Name of Proiect 1 f c'_614- ! 24.TiCA4- $Jcr'A'j 2 M it) tvi ‘i 1\ 5 C Qn 4 IT4 5ptc.tA 14 Want, Ct1y Ca otice. 5 c Cx-rdry Roevt., lbw I (:► ii Number of Contract Days Allowed for Above Projects 1 Ito 2 3 4 I.Bo 5 3 tv 5 '3 s o (Signed) cFb._et w (By) Do-n t•--v aw t (TITLE) O w A �►�' Date ''Y ' 3 - ` -4n'2- PS Location of Proiect Amount of Contract Al231, Coo Actual Number of Days to Complete above Project 5 3 /'50 '3 o to boo° 244 C•kvf5 C> Name of Company FAA AIP 3-19-0094-054 (CARES DEV) Proposal Fonn P-13 Improve Terminal Building - HVAC Waterloo Regional Airport - 60675091 UTILIZATION STATEMENT Disadvantage Business Enterprise The undersigned bidder/offeror has satisfied the requirements of the bid specification in the following manner. (Please 'nark the appropriate box) lei The bidder/offeror is committed to a minimum of 0% DBE utilization on this contract. ❑ 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 tnic 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 finn. 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. Bidder's/Offeror's Firm Name Date DBE UTILIZATION SUMMARY Contract Amount DBE Amount Contract Percentage DBE Prime Contractor $ x 1.00 = $ DBE Subcontractor $ x 1.00 = $ DBE Supplier $ x 0.60 = $ DBE Manufacturer $ x 1.00 = $ Total Amount DBE DBE Goal $ % 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 3-19-0094-054 (CARES DEV) Proposal Form P-14 Improve Terminal Building - HVAC Waterloo Regional Airport - 60675091 BUY AMERICAN CERTIFICATION FORM FOR TOTAL FACILITY (Building projects such as Terminal, SRE, ARFF, etc.) As a matter of bid responsiveness, the Bidder or Offeror must complete, sign, date, and submit this certification statement with their proposal. The Bidder or Offeror must indicate how they intend to comply with 49 USC § 50101 by selecting one of the following certification statements These statements are mutually exclusive. Bidder must select one or the other (i.e. not both) by inserting a checkmark (V) or the letter "X". ■ The Bidder or Offeror 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 Offeror 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 products. 3. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. 14 The Bidder or Offeror hereby certifies it cannot comply with the 100% Buy American Preferences of 49 USC § 50101(a) but may qualify for either a Type III or Type IV waiver under 49 USC § 50101(b). By selecting this certification statement, the apparent Bidder or Offeror 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 results 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 furnish US domestic product for any waiver request that the FAA rejects. 5. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. Required Documentation Type III Waiver — The cost of components and subcomponents produced in the United States is more that 60% of the cost of all components and subcomponents of the "facility". The required documentation for a Type III waiver is: a) Listing of all manufactured products 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; products of unknown origin must be considered as non -domestic products in their entirety). b) Cost of non -domestic components and subcomponents, excluding labor costs associated with final assembly and installation at project location. FAA AIP 3-19-0094-054 (CARES DEV) P-I6 Improve Terminal Building - HVAC Proposal Form Waterloo Regional Airport - 60675091 c) Percentage of non -domestic component and subcomponent cost as compared to total "facility" component and subcomponent costs, excluding labor costs associated with final assembly and installation at project location. Type IV 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 a Type IV 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. q 1 t31 -Lori 3 Date ( A-f-c,1 n C_ ULecu-1 %c Signature v ouiti Cr. Company Name Title FAA ATP 3-19-0094-054 (CARES DEV) P-17 Improve Terminal Building - HVAC Proposal Fonn Waterloo Regional Airport - 60675091 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we as Principal, FM Controls, Inc. as Surety are held and firmly and Merchants Bondin Com an Mutual bound un to the Waterloo Re ional Ail ott 2790 Livin stop Lane Waterloo Iowa, hereinafter calls,Ow($5 r", in the) penal sum of 5% of the total amount bid r ur y one of the United States, for the payment of which sum will and truly be made, we bi T} eu selve , o oheirs ethis executors, executorr s, administrators, and successors, jointly and severally, firmly by these peApril llth obligation is such that whereas the Principal has submiHVAC System ed the accompanying bid, datatetle Waterloo Regional Airport,2023, for Improve Terminal Building (Upgrade Y Waterloo, Iowa, FAA AIP 3-19-0094-054 (CARES DEV). NOW, THEREFORE, (A) If said Bid shall be rejected, or in the alternate, rm (B) If sai d bid shall be accepted and the Principal shall execute and deliver a Contract in thefpersons perform g labor d and shall furnish a bond for his faithful performance re°ithsaid a d shall inContract, and for all other respects e perform the agreement created by or furnishing materials in connection t the acceptance of said bid. g essl then this obligation shall be void, otherwise the same shall remain in force and effect;itbeing cexd pr the y undemoun and agreed that the liability of the Surety for any and all claims hereunder shall, in noevent, of this obligation as herein stated. tio By virtue of statuto authority, the full amount of this bid bond shall be forfeited de tee Owner in liquida innthe of damages sustained in the event that the Principal fails to execute the Contract and pro vSpecifications or by law. ty ts e n The Surety, for value received, hereby stipulates and agrees that the obligations of saidaccept such i tdbond slhall b in no way impaired or affected by any extension of the time within which the Owner may san Contract; and said Surety does hereby waive notice of any such extension. IN WITNESS WHEREOF, the Principal and the Surety, have hereunto set tirhands tndo seals, andd sbyuch tlofthem as are corporations, have caused their corporate seals to be hereto affixed andthesepn officers this 1 lth day of April , A.D., 2023. W itnzi Witness FAA AIP 3-19-0094-054 (CARES DEV) Proposal Fonn Principal By Donald Ludwi (Title) Surety By Brandan Schoenfeld (Attorney -In -Fact) P-8 __(Seal) Improve Terminal Building - HVAC Waterloo Regional Airport - 60675091 M E RCHANTS BONDING COMPANY;,, POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa, d/b/a Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Ashlee Neumann; Brandan Schoenfeld; Carol Durbin; Donovan Day; Edward M Smith; Ryan E Smith their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments 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. This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenti ng to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 11th day of April , 2023 • . • • " • • • . MERCHANTS BONDING COMPANY (MUTUAL) .,`�Q►��ON.'4� �•. •••�Q��G .C�14••• MERCHANTS NATIONAL BONDING, INC. ;hy:.ORP049,4� ro* : • •�o••oIsP0q� 1 *. d/b/a MERCHANTS NATIONAL INDEMNITY COMPANY .Q.• • z. n • ' ; a'• 1933 v 2003 •• •• • ., �y• By• STATE OF IOWA •• COUNTY OF DALLAS ss. On this 11th day of April 2023 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. President Kim Lee Commis&on Numter 702737 My Commiss•on Excites April 14, 2024 ctcre) Notary Public (Expiration of notary's commission does not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 11th day of April POA 0018 (10/22) � .•o?P O• coR41/4 q •ep • v 2003 ; � • •.� ••••`0 •••.• w .•�•` Secretary 2023 •