HomeMy WebLinkAboutPeterson Contractors, Inc.m O�
rri
n O re
co ro
0
ri
0 x
D
0
tri
J1
E�ERS�H
aAVKASIRS
• BOX A
REINBECK, IOWA 50669-0155
Ve(C)93socL___.
wE. sed•\ Mfvf..+CCOS
C.AsierRACc 40 1084
CieN aF c� �-�-0o
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Peterson Contractors, Inc.
as Principal, and Travelers Casualty and Surety Company of America
as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called
"OWNER." In the penal sum Five Percent of the Total Amount Bid
Dollars ($ 5% ) lawful money of the United States, for the payment
of which sum will and truly be made, we bind ourselves, our heirs, executors, administrators, and
successors, jointly and severally, firmly by these presents. The condition of this obligation is such that
whereas the Principal has submitted the accompanying bid dated the 4th day of May
• 2023 , for FY 2023 E. San Marnan Dr. Reconstruction Project in the City of
Waterloo, Iowa; Contract No. 1084
NOW, THEREFORE,
(a) If said Bid shall be rejected, or in the altemate,
(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 famishing matenals 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 19th day of April , A.D. 2023
Witness
Witness Al y . uy h /
Peterson,_Contractors, Inc. (Seal)
prosidont
Travelers Casualty and Surety Company of Amer�RD
S
Anne Crowner
Attomey-in-fact
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 Anne Crowner of
WAUKEE Iowa
, their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
State of Connecticut
By:
City of Hartford ss.
On this the 21 st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing
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
• �,�,4,1• 1 0N''F�
Robert L. Raneenior Vice President
to be the Senior
instrument for the
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 19th day of April
"'^""1-
401143
it\
a R&RTTORD,
`COL01*
J8
2023
Kevin E. Hughes, Assi§tant Secretary
To verify the authenticity of this Power of Attorney, please call us at 1-800-421-3880.
Please refer to the above -named Attorney(s)-in-Pact and the details of the bond to which this Power of Attorney is attached.
FORM OF BID OR PROPOSAL
F.Y. 2023 E. SAN MARNAN DR. RECONSTRUCTION PROJECT
CONTRACT NO. 1084
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
1. The undersigned, being a Corporation existing u r the laws o the State of
a Partnership consisting of the following partners: tia „L %r c .
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 F.Y. 2023 E. SAN MARNAN
DR. RECONSTRUCTION PROJECT, Contract No. 1084, all in accordance with the above -listed documents and
for the unit prices for work in place for the following items and quantities:
F.Y.
2023
E. SAN
MARNAN
DR.
RECONSTRUCTION
PROJECT
CONTRACT
NO.
1084
ITEM
BID
SPECIFICATION
SUPPLEMENTAL
SP
=
SUDAS
SPCL
*
SEE
PROV
E. SAN
MARNAN
DESCRIPTION
DIVISION
DR.
RECONSTRUCTION
I
UNIT
EST
QTY
UNIT
PRICE
BID
TOTAL
PRICE
BID
DIVISION
2 -
EARTHWORK
1.01
2010-108-D
*
TOPSOIL,
4
INCHES,
ON
OR
OFF
SITE
SY
5,141.00
$ (.0 1
$ 30
q
1.02
2010-108-D
*
TOPSOIL,
4
INCHES,
OFF
SITE
SY
3,787.00
$ G Sa
$ 2-j
(pM5
Ie
1.03
2010-108-E
*
EXCAVATION,
CLASS
10
CY
2,900.00
$ Co Z,
$ 1.6+as
1.04
2010-108-E
*
EXCAVATION,
CLASS
10,
WASTE
CY
1,312.00
$ 12,,s9
$
1(,,4O0
i
1.05
2010-108-F
*
EXCAVATION,
CLASS
10,
BELOW
GRADE
CY
1,500.00
$ [2,k;
$ c 1
1.06
2010-108-G
SUBGRADE
PREPARATION,
6
INCH
DEPTH
SY
23,567.00
$ l
2%%q5%
it'
,la$
SUBGRADE
TREATMENT,
WOVEN
GEOTEXTILE
OR
1.07
2010
108-I
*
GEOGRID
SY
4,500.00
6d
$ 4 ► -
$ ,2001M
-
1
1.08
2010-108-J
*
SUBBASE,
MODIFIED,
10
INCH
SY
23,567.00
$ 13
775
$312„I
a221
1.09
IADOT
2121
GRANULAR
SHOULDER
TYPE
B,
4
INCH
DEPTH
SY
4,700.00
$� '?.
$ 3Z.i�QD
-GRDI?�Sg.�
SUBTOTAL
EARTHWORK
$
DIVISION
4
-
SEWERS
AND
DRAINS
-
STORM
1.10
4020-108-D
*
REMOVAL
EQUAL
TO
OF
36
STORM
INCH
SEWER,
RCP,
LESS
THAN
OR
LF
32.00
$ 20►
-
$ lAer
STORM
SEWER
ABANDONMENT,
FILL
AND
PLUG,
e
1.11
2010-108-L-1
R.C.P.,
18
INCH
LF
236.00
$ Ji5►
$
�2�Q®�
1.12
SP
#
9
REMOVAL
OF
EXISTING
DRAIN
TILE
LF
1,700.00
$
$ da►
1.13
4040-108-A
SUBDRAIN,
TYPE
SP,
6
INCH
LF
5,961.00
$ 1
$ 7f
32r
1'
1.14
4040-108-D
SUBDRAIN
OUTLET
TO STRUCTURE,
6
INCH
EACH
2.00
$ 11W;
$ 200
7
1.15
4040-108-D
SUBDRAIN
OUTLET
TO
DITCH,
6
INCH
EACH
34.00
$ t.,, Obr
$
I3,(00
SUBTOTAL
SEWERS AND
DRAINS
- STORM
$ /o3,4
3,S
FORM OF BID
CONRACT NO. 1084
Page 1 of 5
ITEM
BID
SPECIFICATION
SUPPLEMENTAL
SP
=
SUDAS
SPCL
*
SEE
PROV
E. SAN
MARNAN
DESCRIPTION
DIVISION
DR.
RECONSTRUCTION
I
UNIT
EST
QTY
UNIT
PRICE
BID
TOTAL
PRICE
BID
DIVISION
6 -
STRUCTURES
FOR
STORM
SEWERS
1.16
6010-108-B
INTAKE,
SW-510,
DOUBLE
OPEN
THROAT
EACH
1.00
$ %
$ 7SOise-
1.17
6010-108-G
CONNECTION
STRUCTURE,
TO
SUBDRAIN
EXISTING
INTAKE,
PIPE
OR
EACH
2.00
$ 4sW
-
`
.�
$ 67�'
REMOVE
MANHOLE,
INTAKE,
AND
FLARED
END
1.18
6010-10II
H
*
SECTIONS,
STORM
EACH
9.00
$ /000 +
$ WO
as
1.19
SP,/
17
MINOR
ADJUSTMENT,
INTAKE,
SW-501
EACH
1.00
$ /5730_,'r
$ /Soo
7:
MINOR
ADJUSTMENT,
MANHOLE,
SW-401
W/
SW-602
_
*
d.
1.20
6010
10II
E
TYPE
E
CASTING
&
CITY
OF
WATERLOO
COVERS
EACH
1.00
'
$ /SOO
i
SUBTOTAL
STRUCTURES
FOR
STORM
SEWER
$ or'
DIVISION
7
-
STREETS
AND
RELATED
WORK
1.21
7010-108-A
PAVEMENT,
PCC,
9
INCH,
C-SUD
OR
C-4,
CL
3
AGG
SY
21,169.00
$ 54
�Fl�(��
�°
r
1.22
7010-108-1
PCC
PAVEMENT
SAMPLES
AND
TESTING
LS
1.00
$ ?Q �.
$ 30/QS6,
1.23
11,050-108-A
CONCRETE
WASHOUT
LS
1.00
$
(Data:
$ (p000
-
SIDEWALKS,
DRIVEWAYS
SHARED
USE
PATHS
AND
$
$
r N
1.24
7030-108-H-1
DRIVEWAY,
PAVED,
PCC,
6
INCH,
C-4
SY
182.60
$ (es;
$ ,f j
8c4
i-
PAVEMENT
REHABILITATION
$
$
�-
a
_
1.25
7040-108-H
*
PAVEMENT
REMOVAL,
CONCRETE
SY
21,320.00
$
(Q ,*
$ /3
Z
&
1.26
7040-108-1
CURB
AND
GUTTER
REMOVAL
LF
350.00
$ )0.-
$ 3
r
1.27
7010-108-E
CURB
3
AGG
AND
GUTTER,
24
IN
WIDE,
6
IN
THICK,
M-4,
CL
LE
350.00
$ 291
$ /0/150:-
5
S,sZS.
SUBTOTAL
STREETS
AND
RELATED
WORK
$ 1►
DIVISION
CONTROL
8
-
PAVEMENT
MARKINGS
AND
TRAFFIC
TRAFFIC
SIGNALS
1.28
IA
0000310
-DOT
2523-
TYPE
REPLACE
1
HANDHOLE,
REMOVE,
SALVAGE,
AND
EACH
3.00
$ ���
$ 33.
E
PAVEMENT
MARKINGS
1.29
8020-108-B
PAINTED
PAVEMENT
MARKINGS,
STA
82.82
`�
SOLVENTqD
/WATERBOURNE$
i
•
$ ��.Z
1.30
IA
9109020
DOT
2528
TEMPORARY
LANE
SEPARATOR
SYSTEM
LF
1,360.00
$ ism-
llama:-
1.31
8020-108-I<
PAVEMENT
MARKING
REMOVED
STA
1.40
$ ,s [
$ 2,/6Or
1.32
8020-108-F
RETROFLECTIVE
REMOVABLE
TAPE
MARKINGS
STA
63.00
$ ,sis-
$ WO
1.33
8020-108-H
PRECUT
THERMOPLASTIC
SYMBOLS
AND
LEGENDS,
EACH
14.00
P
$ en5;
$ a
r
_
TEMPORARY
TRAFFIC
CONTROL
1.34
8030-108-A
TEMPORARY
TRAFFIC
CONTROL
LS
1.00
$ 4Sicfreg4.
$ (pSstr
1.35
8030-2.02/PLANS
DIRECTIONAL
SIGNS,
PER
DETAILS
EACH
45.00
$ ;
$ /1 ZSZ id
1.36
IA
DOT
- 4188.07
PORTABLE
DYNAMIC
MESSAGE
SIGN
DAY
220.00
$ 75,
$ /O, sae .
1.37
IA
DOT
- 2518
SAFETY
CLOSURE
EACH
8.00
$ 2,SZ5 r
$ ZCICO.
SUBTOTAL
PAVEMENT
MARKING
AND
TRAFFIC
CONTROL
$ t$4'110-•
9g
DIVISION
9 - SITE
WORK
AND
LANDSCAPING
SEEDING
_
1.38
9010-10II
B *
HYDRAULIC
MULCHING
SEEDING,
-
TYPE
1
SEEDING,
FERTILIZING
AND
SY
8,928.00
/-24
$
$ /0/t71
1.39
9010-108-B
*
HYDRAULIC
MULCHING
SEEDING,
-
TYPE
2
SEEDING,
FERTILIZING
AND
SY
800.00
0
$ beer_
`�
i
1.40
9010-108-E
*
WARRANTY
SY
2,232.00
$ at It-
$ /ll(D ;a -
FORM OF BID
CONTRACT NO. 1084_ADDENDUM NO. 1
Page 2 of 5
EROSION
AND
SEDIMENT
CONTROL
1.41
9040-108-0-2
EROSION
CONTROL
MULCHING,
HYDROMULCHING
SY
$ 3360
$ Cap
i
6,000.00
$ [j,
1.42
9040-108-T-1
INLET
DROP
IN PROTECTION
DEVICE,
INTERMEDIATE
AND
EACH
2.00
$ 25�'
1.43
9040-108-T-2
*
INLET
PROTECTION
DEVICE,
MAINTENANCE
EACH
2.00
$ yp 1
$ /00i
1.44
9040-108-T-2
*
INLET
PROTECTION
DEVICE,
REMOVAL
EACH
2.00
$ sor-
$ /00,`"
1.45
9040-108-M-1
SILT
FENCE
INSTALLATION
LF
500.00
$ 02,E
$ izso1
1.46
9040-108-M-2
SILT
FENCE
MAINTENANCE
LF
500.00
$ 0 05
$ 2rieb-
1.47
9040-108-M-3
SILT
FENCE
REMOVAL
LF
500.00
$ ) cra
$ Or
1.48
9040-108-F-1
WATTLE,
8
INCH
INSTALLATION
LF
200.00
$ 7
$
r
,
1.49
9040-108-F
WATTLE,
8
INCH
MAINTENANCE
LF
200.00
$
$ /6
$
ZOO
°,Is
1.50
9040-108-F-2
WATTLE,
8
INCH
REMOVAL
LF
200.00
$
I
i'
SUBTOTAL
SITE
WORK
AND
LANDSCAPING
$ 18,
662
E•ZS!
DIVISION
11
-
MISCELLANEOUS
1.51
11010-108-A
CONSTRUCTION
SURVEY
LS
1.00
$?��
$1c
1.52
SEE
EST
REF
TEMPORARY
PCC,EXCAVATE,
RESTORE
PAVING,
PLACE,
6"
HMA
MAINTAIN,
OR
6"
REMOVE
&
SY
400.00
%®`
$
W/� E0-'"A
�
4
$
1/3/000,
o
SUBTOTAL
MISCELLANEOUS
$
TOTAL
BID
DIVISION
I
3c/0,
567i
``�
$
07,
ITEM
BID
SPECIFICATION
SUPPLEMENTAL
SP
=
SUDAS
SPCL
*
SEE
PROV
E.
SAN
MARNAN
DR.
DESCRIPTION
DIVISION
WATER
II
MAIN
RELOCATION
UNIT
EST
QTY
UNIT
PRICE
BID
TOTAL
PRICE
BID
DIVISION
2
-
EARTHWORK
2.01
2010-108-D
*
TOPSOIL,
4
INCHES,
OFF
SITE
SY
258.00
$ 1 i-
$ 206Str
2.02
2010-108-E
*
EXCAVATION,
CLASS
10
CY
64.00
$ 2r),
$ /nor
2.03
2010-108-G
SUBGRADE
PREPARATION,
6
INCH
DEPTH
SY
247.00
$ ,43.�
$ 141.
2.04
2010-108-J
*
SUBBASE,
MODIFIED,
10
INCH
SY
247.00
$ z0.
$ LICHOr
SUBTOTAL
EARTHWORK
$
et6Z5s,e
DIVISION
5
-
WATER
MAINS
AND
APPURTENANCES
PIPES
AND
FITTINGS
2.05
5010-108-A-1
WATER
MAIN,
TRENCHED,
DUCTILE
IRON,
16
INCH
LF
213.00
$ 2
$ SZ50
$ _As
;
2.06
5010-108-C-1
FITTING,
DUCTILE
IRON,
90
DEGREE,
MJ,
16
INCH
EA
1.00
$ 7 /yet,
2.07
5010-108-C-1
FITTING,
DUCTILE
IRON,
45
DEGREE,
MJ,
16
INCH
EA
2.00
$ zoct
$ ,Pot
2.08
5010-108-C-1
FITTING,
DUCTILE
IRON,
22.5
DEGREE,
MJ,
16
INCH
EA
4.00
$ ?rj;
$
i
2.09
5010-108-C-1
FITTING,
DUCTILE
IRON,
TEE,
MJ,
16
INCH
X
16
INCH
EA
1.00
$ s ,-
$ cket,
$ imor
$ iyloo°,
s
2.10
5010-108-C-1
GATE
VALVE,
MJ,
16
INCH,
INSTALL
ONLY
EA
1.00
$ 9C&5
2.11
5010
108-C-1
FITTING,
MJ,16
INCH
CAST
IRON
TO
DUCTILE
IRON
COUPLING,
EA
3.00
.-
$ (0&O1
2.12
5010-108
C 1
FITTING,WATER
CORPORATION
INTO
SERVICE
16
INCH
TAP,
MAIN
3/4
INCH
EA
2.00
$ /MO'
$ 2DW
�
•
2.13
5010-108-E-2
WATER
3/4
INCH
SERVICE
CORPORATION,
COMPRESSION,
EA
2
00
$ AVM$
a�
WOO(
2.14
5010-108-E-1
WATER
SERVICE
PIPE,
COPPER,
3/4
INCH
LF
24.00
$ 907
$ t((t
$ iz
i
r
2.15
5010-108-G
WATER
D.I.P.,
16
MAIN
INCH
ABANDONMENT,
FILL
AND
PLUG,
LF
160.00
//
$ '/
SUBTOTAL
WATER
MAINS
AND
APPURTENANCES
$ 02. L //0.
429-
FORM OF BID
CONRACT NO. 1084
Page 3of5
SUDAS
SPECIFICATION
* SEE
BID SUPPLEMENTAL
ITEM SP = SPCL PROV
2.16
2.17
2.18
7010-108-A
11,050-108-A
DIVISION II - ALTERNATE A
DESCRIPTION
DIVISION 7 - STREETS AND RELATED WORK
UNIT
7040-108-H *
EST QTY
PAVEMENT, PCC, 9 INCH, C-SUD OR C-4, CL 3 AGG SY 222.00
CONCRETE WASHOUT
PAVEMENT REHABILITATION
PAVEMENT REMOVAL, CONCRETE
LS
SY
1.00
260.00
SUBTOTAL STREETS AND RELATED WORK $ 'Z : f/
UNIT BID
PRICE
$ tio:
TOTAL BID
PRICE
$ 2s' O
$ /7f7&O
$
tor
$ 3960(
2.19
9010-108-B *
DIVISION 9 - SITE WORK AND LANDSCAPING
SEEDING
HYDRAULIC SEEDING, SEEDING, FERTILIZING AND 258.00
MULCHING - TYPE 1 SY
SUBTOTAL SITE WORK AND LANDSCAPING $9C
$0
-710
TOTAL BID DIVISION II $
Ns; 5ci/:�o
TOTAL BID DIVISION I $ c213 /400 Slog
TOTAL BID DIVISION II
TOTAL BID DIVISION I + DIVISION II
/Ligo511,to
$ Koo,
2. It is understood that the quantities set forth are approximate only and subject to variation and that the unit bid price
for the work done shall govern in the actual payment to Contractor.
3. In submitting this bid, the bidder understands that the right is reserved by the City of Waterloo, Iowa, to reject any
or all bids. If written notice of the acceptance of this bid is mailed, telegraphed, or delivered to the undersigned
within thirty (30) days after the opening thereof, or at any time thereafter
before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the prescribed form
and furnish the required bond and certificate of the insurance within ten (10) days after the agreement is presented
to him for signature, and start work within ten (10) days after "Notice to Proceed" is issued.
4. Security in the sum of a cc romanL.7%3Lt Dollars ($
) in the form of tP, is submitted herewith in accordance with the
INSTRUCTIONS TO BIDDERS.
5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor.
6. Attached hereto is a Bidder Status Form.
7 The bidder is prepared to submit a financial and experience statement upon request.
3. The Prime Contractor and Subcontractor(s), which have performed an aggregate of $10,000.00 in work for the
City in the current calendar year, are prepared to submit an AAP or Update and an EOC, within ten (10) days of
notification that the bid submitted is lowest and acceptable.
FORM OF BID
CONTRACT NO. 1084_ADDENDUM NO. 1 Page 4 of 5
The bidder has received the following Addendum or Addenda:
Addendum No. Date 6 Z Z3
10. The bidder shall list the MBE/WBE subcontractor(s), amount of subcontracts and bid items on the City of Waterloo
Minority and/or Women Business Pre -bid Contact Information Form submitted with this Form of Bid or Proposal.
The apparent low Bidder shall submit a list of all other Subcontractor(s) to be used on this Project to the City of
Waterloo by 5:00 p.m. the business day following the day Bids on this Project are due along with the Non -Collusion
Affidavits of All Subcontractor(s).
The Contractor shall submit information on subcontractors on "SUBCONTRACTOR REQUEST AND APPROVAL"
Form to be provided by City prior to approval of contract.
The subcontractors listed on this proposal and/or submitted to the Contract Compliance Officer cannot be changed
except for the following reasons:
1) The City of Waterloo does not approve the subcontractors.
2) The subcontractors submit in writing that they cannot fulfill their subcontracts.
11. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none" or "NA".
12. The bidder has attached all applicable forms.
13. The Owner reserves the right to select alternates, delete line items, and/or to reduce quantities prior to the award
of a contract due to budgetary limitations.
CT--Effe--50/ Co
(Nprpe of Kidd
tnhcoes
5/4/23
(De)
BY: /�f ,�Title se77,14i-et
Official Address: (Including Zip Code):
/&Y Siatdvicalc Sr
/ Le- &-Da c
I.R.S. No. Li2r O la
FORM OF BID
CONRACT NO. 1084 Page 5 of 5
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of
County of„V)
1. He is
)ss
(Owner, Partner, Officer
epresentativ
being first duly sworn, deposes and .ys that:
or Agent) , of ::receso
, the Bidder that has su •mi ed 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:
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
(Signed)
S?sfr(Title
Subscribed and sworn to before me this
(it`V�T tla
My commission expires
day of kA 0,z , 20,2
U)ti //4/ filealtrer
.n
L2":JNNIFER R. WISSLER
° Commission Number 761292
° My Commission Expires
rO"f, January 4, 2025
EQUAL OPPORTUNITY CLAUSE
(As provided in Executive Order No. 11246)
All contractors, subcontractors, vendors and suppliers of goods and services doing business with the City and value of said
business equals or exceeds ten thousand dollars ($10,000.00) annually agree as follows:
1. The contractors, subcontractor, vendor and supplier of goods and services will not
discriminate against any employee or applicant for employment because of race, color, creed, sex, national origin,
economic status, age, mental or physical handicap, political opinions or affiliations. The contractor, subcontractor, vendor
and supplier will develop an Affirmative Action program to ensure that applicants are employed and that employees are
treated during employment without regard to their race, creed, color, sex, national origin, religion, economic status, age,
mental or physical disability, political opinions or affiliations. Such actions shall include but not be limited to the following:
a. Employment
b. Upgrading
c. Demotion or Transfer
d. Recruitment and Advertising
e. Layoff or Termination
f Rates of Pay or Other Forms of Compensation
g. Selection for Training Including Apprenticeship
2. The contractor, subcontractor, vendor and supplier of goods and services will, in all solicitations or advertisements for
employees, state that all qualified applicants will receive consideration for employment without regard to race, creed,
color, sex, national origin, religion, economic status, age, mental or physical disabilities, political opinion or affiliations.
3. The contractor, subcontractor, vendor and supplier or his/her collective bargaining representative will send to each
labor union or representative of workers which he/she has a collective bargaining agreement or other contract or
understanding, a notice advising said labor union or workers' representative of the contractor's commitment under this
section.
4. The contractor, subcontractor, vendor and supplier of goods and services will comply with all published rules,
regulations, directives, and order of the City of Waterloo Affirmative Action Program Contract Compliance Provisions.
5. The contractor, subcontractor, vendor and supplier of goods and services will furnish and file compliance reports within
such time and upon such forms as provided by the Affirmative Action Officer. Said forms will elicit information as to
the policies, procedures, patterns, and practices of each subcontractor as well as the contractor himself/herself and
said contractor, subcontractor, vendor and supplier will permit access to his/her employment books, records and
accounts to the City's Affirmative Action Officer, for the purpose of investigation to ascertain compliance with this
contract and with rules and regulations of the City's Affirmative Action Program Contract Compliance Provisions
relative to Resolution No. 24664.
6. In the event of the contractor's non-compliance with the non-discrimination clauses of this contract or with any of such
rules, regulations and orders, this contract may be canceled, terminated or suspended in whole or in part and the
contractor may be declared ineligible for further contracts in accordance with procedures authorized by the City Council.
7 The contractor, subcontractor, vendor and supplier of goods and services will include, or incorporate by
reference, the provisions of the non-discrimination clause in every contract, subcontract or purchase order
unless exempted by the rules, regulations or orders of the City's Affirmative Action Program, and will provide
in every subcontract, or purchase order that said provisions will be binding upon each contractor,
subcontractor, or supplier.
8. We, the undersigned, recognize that we are morally and legally committed to non-discrimination in employment. Any
person who applies for employment with our company will not be disnated against because of race, creed, color,
sex, national origin, economic status, age, mental or • -ical di
(Signed)
i
(Approp ate 0 ficial)
(Title)
o edag
(Date)
TITLE VI CIVIL RIGHTS
During the performance of this contract, the contractor (for itself), its assignees, and successors
in interest (hereinafter referred to as the `contractor") agrees as follows:
1. Compliance with Regulations: The contractor shall comply with the Regulations relative
to non-discrimination in Federally assisted programs of the DOT Title 49, Code of
Federal Regulations, Part 21, as they may be amended from time to time, (hereinafter
referred to as the Regulations), which are herein incorporated by reference and made a
part of this contract.
2. Nondiscrimination: The contractor, with regard to the work performed by it during the
contract, shall not discriminate on the grounds of race, color, national origin, sex, age, or
disability in the selection and retention of subcontractors, including procurement of
materials and leases of equipment. The contractor shall not participate either directly or
indirectly in the discrimination prohibited by section 21.5 of the Regulations, including
employment practices when the contract covers a program set forth in Appendix B of the
Regulations.
3. Solicitations for Subcontracts, Including Procurement of Materials and Equipment: In all
solicitations either by competitive bidding or negotiation made by the contractor for work
to be performed under a subcontract, including procurement of materials or leases of
equipment, each potential subcontractor or supplier shall be notified by the contractor of
the contractor's obligations under this contract and the Regulations relative to non-
discrimination on the grounds of race, color, national origin, sex, age, or disability.
4. Information and Reports: The contractor shall provide all information and reports
required by the Regulations or directives issued pursuant there to, and shall allow
access to its books, records, accounts, other sources of information, and its facilities as
may be determined by the Contracting Authority, the Iowa DOT, or FHWA to be pertinent
to ascertain compliance with such Regulations, orders and instructions. Where any
information required of a contractor is in the exclusive possession of another who fails or
refuses to furnish this information the contractor shall so certify to the Contracting
Authority, the Iowa DOT, or the FHWA as appropriate, and shall set forth what efforts it
has made to obtain the information.
Sanctions for Noncompliance: In the event of the contractor's noncompliance with the
nondiscrimination provisions of this contract, the Contracting Authority, the Iowa DOT, or
the FHWA shall impose such contract sanctions as they may determine to be
appropriate, including, but not limited to:
a. Withholding of payments to the contractor under the contract until the contractor
complies, and/or
b. Cancellation, termination, or suspension of the contract, in whole or in part.
6. Incorporation of Provisions: The contractor shall include the provisions of paragraphs
(1) through (6) in every subcontract, including procurement of materials and leases of
equipment, unless exempt by the Regulations, or directives issued pursuant thereto.
The contractor shall take such action with respect to any subcontract or procurement as
the Contracting Authority, the Iowa DOT, or the FHWA may direct as a means of
enforcing such provisions including sanctions for non-compliance: Provided, however,
TITLE VI CIVIL RIGHTS
Page 1 of 2
that, in the event of a contractor becomes involved in, or it threatened with, litigation with
a subcontractor or supplier as a result of such direction the contractor may request the
Contracting Authority or the Iowa DOT to enter into such litigation to protect the interests
of the Contracting Authority or the Iowa DOT; and, in addition, the contractor may
request the United States to enter into such litigation to protect the interest of the United
States.
TITLE VI CIVIL RIGHTS Page 2 of 2
Bidder Status Form
To be completed by all bidders
Please answer "Yes" or "No" for each of the following:
Les ❑ No My company is authorized to transact business in Iowa.
(To help you determine if your company is authorized, please review the worksheet on the next page).
[Ves ❑ No My company has an office to transact business in Iowa.
Q'Yes ❑ No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail.
✓Yes ❑ No My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
["Yes ❑ No My company is not a subsidiary of another business entity or my company is a subsidiary of another
business entity that would qualify as a resident bidder in Iowa.
If you answered "Yes" for each question above, your company qualifies as a resident bidder. Please
complete Parts B and D of this form.
If you answered "No" to one or more questions above, your company is a nonresident bidder. Please
complete Parts C and D of this form.
Part A
To be completed by resident bidders
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates: ,2 / 2 /(� to e-10--teayr Address: I1)14 1--BA(V-A .1 OUS
Part B
City, State, Zip: __' ' n%P_�.� 1.1-\ l8:5�fr29
Dates: _ / / to / / __ Address:.
City, State, Zip: —_
Dates: / / to / / Address:
You may attach additional sheet(s) if needed. City, State, Zip:
To be completed by non-resident bidders Part C
1. Name of home state or foreign country reported to the Iowa Secretary of State:
2. Does your company's home state or foreign country offer preferences to bidders who are residents? ❑ Yes ❑ No
3. If you answered "Yes" to question 2, identify each preference offered by your company's home state or foreign country
and the appropriate legal citation.
You may attach additional sheet(s) if needed.
To be completed by all bidders Part D
certify that the statements made on this document are true and complete to the best of my knowledge and I know that my
failure to provide accurate and truthful information may be a reason to reject my bid.
Firm Name: R,;\tx cs_))- L._ >_1,1! oy ViNi iN \mac_
M
Signature: �ti. 4� ,�(1C,1 ��t_l� e (` c% ir'..4.d>�--� Date:
Th2q-ir
You must submit the completed form to the governmental body requesting bids
per 875 Iowa Administrative Code Chapter 156.
This form has been approved by the Iowa Labor Commissioner.
309-6001 02-14
Worksheets Authorization to Transact Business
This worksheet may be used to help complete Part A of the Resident Bidder Status form. If at least one of the following
describes your business, you are authorized to transact business in lowa.
Rje ❑ No My business is currently registered as a contractor with the Iowa Division of Labor.
❑ Yes [✓No My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes.
❑ Yes (] No My business is a general partnership or joint venture. More than 50 percent of the general
partners or joint venture parties are residents of Iowa for Iowa income tax purposes.
Er Yes 0 No
0 Yes ✓CNo
0 Yes 3"No
My business is an active corporation with the Iowa Secretary of State and has paid all fees
required by the Secretary of State, has filed its most recent biennial report, and has not filed
articles of dissolution.
My business is a corporation whose articles of incorporation are filed in a state other than Iowa,
the corporation has received a certificate of authority from the Iowa secretary of state, has filed
its most recent biennial report with the secretary of state, and has neither received a certificate of
withdrawal from the secretary of state nor had its authority revoked.
My business is a limited liability partnership which has filed a statement of qualification in this
state and the statement has not been canceled.
❑ Yes 2-No My business is a limited liability partnership which has filed a statement of qualification in a
state other than lowa, has filed a statement of foreign qualification in Iowa and a statement of
cancellation has not been filed.
❑ Yes (Elio My business is a limited partnership or limited liability limited partnership which has filed a
certificate of limited partnership in this state, and has not filed a statement of termination.
Yes
My business is a limited partnership or a limited liability limited partnership whose certificate of
limited partnership is filed in a state other than Iowa, the limited partnership or limited liability
limited partnership has received notification from the Iowa secretary of state that the application
for certificate of authority has been approved and no notice of cancellation has been filed by the
limited partnership or the limited liability limited partnership.
Yes LYl Neo My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
El Yes (�No
My business is a limited liability company whose certificate of organization is filed in a state other
than Iowa, has received a certificate of authority to transact business in Iowa and the certificate
has not been revoked or canceled.
309-6001 02-14
Prime Contractor ame:
P roject:
MBE/WBE BUSINESS ENTERPRISE
PRE -BID CONTACT INFORMATION FORM
Letting Date:
N O MBE/WBE SUBCONTRACTORS: If you are NOT using any MBE/WBE subcontractors to complete this project,
sign below. Attach a brief explanation as to why subcontracting was not feasible with this project. If any MBE/WBE
subcontractors will be used, p ee se use he bottomportion of this form.
Contract r Signature: _
Title: ksfrt2`�dY�—.�t/i
Date: ( TA( -
S UBCONTRACTORS APPLICABLE: You are required, in order for your bid to be considered responsive, to provide
the information on this form showing ALL of your MBE/WBE subcontractor contacts made for your bid submission.
This information is subject to verification. Any questions may be directed to Contract Compliance Office 319-291-
4429.
You are required, in order for your bid to be considered responsive, to provide the information on this Form showing
your MBE/WBE Business Enterprise contacts made prior to your bid submission. This information is subject to
verifications and confirmation.
If you are unable to identify MBE/WBE firms to perform portions of the work, please contact Rudy Jones, Contract
Compliance Officer, for assistance at (319) 291-4429.
In the event it is determined that the MBE/WBE Business Enterprise goals are not met, then before awarding the
contract the City of Waterloo will make a determination as to whether or not the apparent successful low bidder made
good faith efforts to meet the goals.
TABLE OF INFORMATION SHOWING BIDDER'S PRE -BID
MBE/WBE BUSINESS ENTERPRISE CONTACTS
Quotes
Received
Quotation
used
in
bid
Subcontractors
MBE/WBE
Contacted
Dates
Yes/No
Contacted
Dates
Yes/No
Dollar
Amount
be
Subcontracted
Proposed
to
Q%duccCssv1/4Y5VIASTUri•14f'zi
5.395
E5
\'‘,5KO
1
42.S,
D.C.
CAD
2�oe
1\06
(Form CCO-4) Rev. 06-20-02