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HomeMy WebLinkAboutWoodruff Construction.r• + ♦:: 1 WOODRUFF CONSTRUCTION 1717 Falls Ave l Waterloo, IA 50701 BID for: F.Y. 2023 \XTWTP Final Clarifier No. 3 Rehabilitation Prepared for: City of Waterloo Bid Date: 715 Mulberry Street 7/6/2023 Waterloo, IA 50703 WOODRUFF CONSTRUCTION losk. 1717 Falls Ave I Waterloo, IA 50701 BID SECURITY for: F.Y. 2023 \ T WTP Final Clarifier No. 3 Rehabilitation Prepared for: City of Waterloo Bid Date: 715 Mulberry Street 7/6/2023 Wateiloo, IA 50703 FORM OF BID OR PROPOSAL F.Y. 2023 WASTEWATER TREATMENT PLANT FINAL CLARIFIER NO. 3 REHABILITATION CITY OF WATERLOO, IOWA CITY CONTRACT NO. 1067 Honorable Mayor and City Council Waterloo, Iowa 1. The undersigned, being a Corporation existing under the laws of the State of Iowa , a Partnership consisting of the following partners: Woodruff Construction, Inc. , having familiarized (himself) (themselves) itsel 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 Wastewater Treatment Plant Final Clarifier No. 3 Rehabilitation, City Contract No. 1067, all in accordance with the above -listed documents and for the Lump Sum Base Bid cost: LUMP SUM BASE BID: 00a ►v, J//on Sfir'i-cj34voi1-l4z-oucamoi t 4- Dollars $ 0 7 ?is, (Words) hun4vtt4 h vte f-y_-A'vet (Lumbers) See Section 01 29 00—Contract Considerations for discussion of Cash Allowances to include in the Bid. FORM OF BID Section BF-1 4463.016/City Contract No. 1067 BIDDER: Woodruff Construction, Inc. BID FORMS CITY OF WATERLOO WATERLOO, IOWA F.Y 2023 WASTEWATER TREATMENT PLANT FINAL CLARIFIER NO. 3 REHABILITATION CITY CONTRACT NO. 1067 Prepared by: STRAND ASSOCIATES, INC.® 910 West Wingra Drive Madison, WI 53715 www.strand.com Issued for Bid June 21, 2023 Cgii STRAND ASSOCIATES' Excellence in Engineering Since 1946 2. Cash Allowances The following Cash Allowances shall be included in the Lump Sum Base Bid. The Cash Allowances for non -Lump Sum items shall be equal to the product of the quantity included in the Lump Sum Base Bid and the Unit Price. The Cash Allowances will be adjusted in the event that estimated quantities to be included in the Lump Sum Base Bid are different from final measured quantities. A single Unit Price shall be bid for each item. Failure to include one or more of the following Unit Price items may result in rejection of the entire Bid as nonconforming. For items with a quantity of 1, the Cash Allowance shall be adjusted based on actual final costs. CASH ALLOWANCES Number Item Description included Estimated Lump Base Quantity Sum in Bid the Unit Bid Unit Price Included Lump Total Bid Sum Bid in Price Base the 1. Concrete Surface (Section Repairs 03 Surface 01 30) Repair —Top of Slab 10 CF $ 1 1 (000 00 $ 1 b 1000 " Qd 2. Concrete Slab (Section Removal Surface 03 01 and 30) Repair Replacement —Concrete Base 20 CY $ I ,1 �^ >� ' (� $ QA 1000 c�U 3. Crack (Section Repairs 03 64 —Chemical 00) Grout Injection 100 LS $ $ 4. Final Repair (Section Clarifier —Support 46 43 Equipment 22) Truss Repairs Inspection and 1 LS $5,000.00 $5,000.00 5. Final Repair (Section Clarifier —Unidentified 46 43 Equipment 22) Repairs Inspection and 1 LS $50,000.00 $50,000.00 FORM OF BID Section BF-2 4463.016/City Contract No. 1067 4. In submitting this bid, the Bidder understands that the right is reserved by the City of Waterloo, Iowa, to reject any or all bids. If written notice of the acceptance of this bid is mailed, telegraphed, or delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the prescribed form and furnish the required bond and certificate of the insurance within ten (10) days after the agreement is presented to him for signature, and start work within ten (10) days after "Notice to Proceed" is issued. 5. Security in the sum of 5% of bid Dollars ($ 5% of bid ) in the form of Bid Bond is submitted herewith in accordance with the INSTRUCTIONS TO BIDDERS. 6. Attached hereto is a Non -Collusion Affidavit of Prime Contractor. 7 Attached hereto is a Resident Bidder Certification ( X ), or Non -Resident Bidder Certification ( ). (Mark one.) 8. The Bidder is prepared to submit a financial and experience statement upon request. 9. 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. 10. The Bidder has received the following Addendum or Addenda: Addendum No. Date N/A N/A 11. 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. 12. The Bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none" or "NA." 13. The Bidder has attached and completed all applicable forms, including the entire Iowa SRF Required Front -End Specifications. 14. CITY 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. FORM OF BID Section BF-3 4463.016/City Contract No. 1067 Woodruff Construction, Inc. July 6, 2023 (Date) Title John Mallen, NE Region President Official Address: (Including Zip Code): Corporate Office: 1890 Kountry Lane Bidding Office: 1717 Falls Ave Fort Dodge, IA 50501 Waterloo, IA 50701 I.R.S. No, 76-0721180 END OF SECTION FORM OF BID Section BF-4 4463.016/City Contract No. 1067 INFORMATION NEEDED FOR IOWA CONSTRUCTION SALES TAX EXEMPTION CERTIFICATE CONTRACTOR NAME: Woodruff Construction, Inc. ADDRESS: 1717 Falls Ave Waterloo, IA 50701 (Check One) PRIME FEDERAL ID#: Z 76-0721180 SUBCONTRACTOR PROJECT NAME: Waterloo \VWTP Clarifier 3 Rehabilitation PROJECT CONTRACT NO.: DESCRIPTION OF WORK: ■ ■ ■ ■ ■ ■ ■ ■ ■ City Contract No. 1067 Brickwork Carpentry Concrete Drywall -Plaster -Insulation Electrical Excavation/Grading Flooring Heavy Construction Heating -Ventilating -Air Cond • ■ ■ ■ ■ ■ ■ IN ■ Landscaping Painting Paving Plumbing Roofing -Siding -Sheet Metal Windows Wrecking -Demolition Other (Please specify) gi General Contractor SALES TAX EXEMPTION Section STE-1 4463.016/City Contract No. 1067 NON -COLLUSION AFFIDAVIT OF PRIME BIDDER State of Iowa ) )ss County of Black Hawk ) John Mallen , being first duly sworn, deposes and says that: 1. He is (Owner, Partner, Office Representative • r Agent) , of , the Bidder that has • • - • e 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. (Signed) JYn Mallen, NE Region President Subscribed and sworn to before me this 6th day of July , 20 23. (At Brandy Luna Title Sr. Administrative Assistant My commission expires 10/22/2025 • BRANDY LUNA ity. COMMISSION NUMBER 820800 MY COMMISSION EXPIRES 1 /O VP 10/22/2025 NON -COLLUSION AFFIDAVIT Section NCA-1 4463.016/City Contract No. 1067 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. EQUAL OPPORTUNITY CLAUSE Section EOC-1 4463.016/City Contract No. 1067 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 discriminated against because of race, creed, color, sex, national origin, economic status, age, mental or physical disabilities. (Signed) (Appropriate Official) John Mallen, NE Region President (Title) July 6, 2023 (Date) END OF SECTION EQUAL OPPORTUNITY CLAUSE Section EOC-2 4463.016/City Contract No. 1067 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. 5. 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, 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 Section CR-1 4463.016/City Contract No. 1067 Bidder Status Form To be completed by all bidders Part A Please answer "Yes" or "No" for each of the following: Yes ❑ 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). [Z] Yes ❑ No My company has an office to transact business in Iowa. Ej Yes ❑ No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail. JE 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 Paris C and D of this form. To be completed by resident bidders Part B My company has maintained offices in Iowa during the past 3 years at the following addresses: Dates: 08 / 01 / 1990 to Present / Dates: 05 / 25 / 1996 to Present / Dates: 02 / 08 / 2016 to Present/ You may attach additional sheet(s) if needed. / Address. 1890 Kountry Lane City, State, Zip. Fort Dodge, IA 50501 / Address: 1920 Philadelphia Street, S"1'h 102 City, State, Zip: Ames, IA 50010 / Address' 501 Greenfield Drive City, State, Zip- Tiffin, IA 52340 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 resident bidders, resident labor force preferences or any other type of preference to bidders or laborers? 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. Yes I INo You may attach additional sheet(s) if needed. To be completed by all bidders Part D I 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: Woodruff Construction, Inc. Signature: John Mallen, NE Region President You 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 Date: 7/6/2023 RB-1 4463.016/City Contract No. 1067 Worksheet: 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 Iowa. Yes No Yes ❑ No Yes II No My business is currently registered as a contractor with the Iowa Division of Labor. My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. 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. Yes 1J 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. Yes U No 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. Yes 1J No 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 1J No My business is a limited liability partnership which has filed a statement of qualification in a state other than Iowa, has filed a statement of foreign qualification in Iowa and a statement of cancellation has not been filed. Yes LJ No 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 ter mination. Yes 1J No 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 U No My business is a limited liability company whose certificate of organization is filed in Iowa and has not filed a statement of termination. Yes 1f 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. RB-2 4463.016/City Contract No. 1067 Additional Sheet for Bidder Status Form (continued) My company has maintained offices in Iowa during the past 3 years at the following addresses: Dates: 7/17/2017 to Present Dates: Address: 1717 Falls Avenue City, State, Zip: Waterloo, IA 50701 to Address: City, State, Zip: Revised February 2003 CONTRACTOR'S OR SUBCONTRACTOR'S AFFIRMATIVE ACTION PROGRAM Check box that applies to party completing program: ( Z ) General Contractor ( ) Subcontractor I. Section A to be completed by GENERAL CONTRACTORS only: A. Name of Company Woodruff Construction, Inc. 1717 Falls Ave Address of Company Wateiloo, IA Telephone Number ( 319 ) 233-3349 Federal ID Number (if no Federal ID Number, Owner/President's Social Security Number) 76-0721180 Name of Equal Employment Officer Sara Orr Name of Project Waterloo \XTWTP Clarifier 3 Rehabilitation Project Contract Number City Contract No. 1067 Estimated Construction Work Dates 8/1/23 / 12/31/2023 Zip 50701 Start Finish Section B to be completed by SUBCONTRACTORS only: B. Name of General or Prime Contractor Name of Subcontractor Subcontractor's Address Zip Subcontractor's Telephone Number ( ) Subcontractor's Federal ID Number (if no Federal ID Number Owner/President's Social Security Number) Name of Equal Employment Officer AFFIRMATIVE ACTION Section AA-1 4463.016/City Contract No. 1067 C. Remainder of program to be completed by party completing program, either Prime or Subcontractor. 1 The Owners and/or Principals of your company: Ethnic Name Address Position Sex Origin Donald A. Woodruff Fort Dodge, IA President Jason Rechkemrner Ames, IA COO Sara Orr Ames, IA VP of Operations 2. Other Areas of Interest: If your company has branches or subsidiaries, or if your company is a branch or subsidiary of a parent organization, give the following information: Type of Name Address Affiliation Degree Woodruff Construction maintains offices in Fort Dodge, Ames, Tiffin, Waterloo, and Spencer, IA II. EMPLOYER'S POLICY (Please read carefully.) A. We, the undersigned, recognize that we are morally and legally committed to nondiscrimination in employment. Any person who applies for employment with our company will not be discriminated against because of race, color, creed, sex, national origin, economic status, age, mental or physical handicap. B. The employment policies and practices of the undersigned are to recruit and hire employees without discrimination, and to treat them equally with respect to compensation and opportunities for advancement, including training, upgrading, promotion and transfer. However, we realize the inequities associated with employment training, upgrading, contracting and subcontracting for minorities and women and we will direct our efforts to correcting any deficiencies to the maximum extent possible. The same will be required of our SUBCONTRACTORS and suppliers. C. We submit this program to assure compliance with Executive Order 11246, as amended, and other subsequent orders that may pertain to equal employment opportunity and merit employment policies, fully realizing that our qualification and/or merit system should be evaluated and revised, if necessary. D. We agree to put forth the maximum effort to achieve full employment and utilization of capabilities and productivity of all our citizens without regard to race, creed, color, sex, national origin, economic status, age, and mental or physical handicap. AFFIRMATIVE ACTION Section AA-2 4463.016/City Contract No. 1067 E Woodruff Construction will give training (Name of Company) and employment opportunities to local residents of Waterloo, Iowa, to the greatest extent feasible. III. AFFIRMATIVE ACTION A. B. C. Woodruff Construction recognizes that the (Name of Company) effective application of a policy of merit employment involves more than just a policy statement, and Woodruff Construction (Name of Company) will therefore, re-evaluate our Affirmative Action Program to ensure that equal employment opportunities are available on the basis of individual merit, and to actively encourage minorities, women and local residents to seek employment with our company on this basis. Woodruff Construction (Name of Company) following six (6) steps to improve our Affirmative Action Program: will undertake the 1. Minority Recruitment and Employment; 2. Local Recruitment and Employment; 3. Disabled Veteran and Vietnam Era Veteran Recruitment and Employment; 4. Handicapped Recruitment and Employment; 5. Female Recruitment and Employment; and 6. Training, Upgrading and Promotional Opportunities. Woodruff Construction will take (Name of Company) whatever steps are necessary to ensure that our total work force has adequate minority, female, and local representation. We will utilize the following methods in our recruitment attempts: 1. Local advertising media (newspapers, radio, TV); 2. Community organizations (churches, clubs, schools); 3. Public and private institutions in the area (UNI, Hawkeye Community College); 4. Job Service of Iowa; and 5. Other. D. Woodruff Construction will seek qualified minority, (Name of Company) female, and local group applicants for all job categories and will make asserted efforts to increase minority female and group representation in occupations at the higher levels or skill and responsibility. E. All sources of employment used shall be aware that we are an Equal Employment Opportunity Employer. Labor organizations representing our employees will be notified of our Equal Employment Opportunity Policy and Affirmative Action Program. AFFIRMATIVE ACTION Section AA-3 4463.016/City Contract No. 1067 F Training, upgrading, promotion and transfer activities at all levels will be monitored to ensure that full consideration has been given to qualified minority, female, and local group employees. G Woodruff Construction will encourage other (Name of Company) companies with whom we are associated and/or do business, to do the same and we will assist them in their efforts. H. Woodruff Construction has taken the following (Name of Company) Affirmative Action to ensure that minority, female, local contractors and/or suppliers were provided opportunities to negotiate and/or bid on this project: (if none, write "NONE") 1. Bid Invitations Sent 2. Follow-up calls) made I. As a result of the above efforts, we have involved minority, female, and local contractors and/or suppliers in the following areas of subcontracting: (if none, write "NONE") 1. I'0'1S9S keocieGka +I 1\0he " , , (\molt( J. 2. Woodruff Construction will require approved (Name of Company) Affirmative Action Programs from all nonexempt contractors who propose to work on this project and will take whatever steps are necessary to ensure that non -minority contractors have adequate representation of minority, female and local persons in their total work force. K. In further accordance with rules and guidelines issued pursuant to Executive Order 11246 as amended we establish the goals for our company, based on parity percentages supplied by the City, and we realize these goals will be reviewed on an annual basis. L. Woodruff Construction will keep records of (Name of Company) specific actions relative to recruitment, employment, training, upgrading and promotion and will provide the City of Waterloo with any information relative to same, including activities of our SUBCONTRACTORS and suppliers as necessary or when requested. M. Parity figures for companies located in Waterloo are as follows: Minority Parity = .08 (8%) N Woodruff Construction (Name of Company) AFFIRMATIVE ACTION Section AA-4 4463.016/City Contract No. 1067 Affirmative Action Employment Goals: The definition of Affirmative Action Goals is as follows: "Goals may not be rigid and inflexible quotas which must be met, but must be targets, reasonably attainable by means of applying every good faith effort to make all aspects of the entire Affirmative Action Program work." For the year 2020, please submit percentage targets for employing minorities and women. If you already have reached your target for hiring minorities and women, please submit that percentage. *Goals for Minorities: Goals for Women: OA OA Your affirmative action goals should be between 1% and 10% or more for minorities and 1 % and 5% or more for women. Please be advised that the goals or targets are purely your estimation of how many women and minorities your company can reasonably expect to hire in 2020. Note, that none of the goals are rigid or inflexible. They are targets that your company calculates as reasonably attainable. This will help the City in its monitoring procedures as required by City of Waterloo Resolution No. 1984-142(4). AFFIRMATIVE ACTION Section AA-5 4463.016/City Contract No. 1067 CONTRACTOR'S TOTAL WORK FORCE (WATERLOO) NAME AND ADDRESS JOB CATEGORY RACE SEX HOURLY WAGE SEE NEXT PAGE INDICATE: DISABLED VETERAN: DV VIETNAM ERA VETERAN: VV HANDICAPPED: H AFFIRMATIVE ACTION Section AA-6 4463.016/City Contract No. 1067 Rate City State ZIP Code Position Sex Iv1 M H WEBSTER CITY IA 50595 Craft Worker H NEVADA IA .5020'1 Craft Worker F W TIFFIN IA 52340 Administrative M I- I H IOWA CITY IA 52 240 Croft Worker W AMES IA S0014 Adrniriistrirtivp N[VADA IA 50201 Administrative \Pi 60WRIL IA 50543 Administrative I Vii F W IA 50501 Administrative FLIRT DODGE F ENV DES MOINES IA 50309 Administrative IA 52240 Manager F \Al IOWA CITY M AMES IA 50010 Craft Worker H M H MT PLEASAN'1 IA 52611 Craft Worker F W NOR I H LIBERTY IA 52317 Manager 52240 Craft Worker M H IOWA CITY IA M I-1 MARSI IA1LIOWN IA IA 50158 50010 Craft Worker M AMES craft Worker H M 11 BOONE IA 50036 Craft Worker M IA 5007.5 Craft Worker El I SWORTH H __ S0701 F W WATERLOO IA Administrative W AMES IA IA 50014 Manager F M B FORT DODGE I ahorer 50501. M H AMES IA SUU10 Craft Worker IA M H BOONE 5003E Craft Worker M H MARSHALLTOWN IA S0158 Craft Worktbr. ivl H N[VADA IA 50201 Craft Wurkr'r M H AMES IA 5001.0 C r a t Worker M H DLS MOINFS IA 5031.3 Craft Worker. We hereby certify that we are in compliance with all City and Federal Affirmative Action Regulations and agree to accept all liability for failure to comply. Respectfully submi ted, By: mpany Executive JOHN MALLEN 7 6/2023 Date By: 5t'ta On'L' SARA ORR Equal Employment Opportunity Officer 7/6/2023 Date City of Waterloo Affirmative Action Officer Approved Disapproved Reason: By: Date: END OF SECTION AFFIRMATIVE ACTION Section AA-7 4463.016ICity Contract No. 1067 DESCRIPTION OF JOB CATEGORIES 1 Officials/Manager: Occupations in which employees set broad policies, exercise overall responsibility for execution of all policies, or direct individual departments or special phases of the agency's operations or provide specialized consultation on a regional, district or area basis. Includes: department heads, bureau chiefs, division chiefs, directors, deputy directors, controllers, examiners, wardens, superintendents, unit supervisors, sheriffs, police and fire chiefs and inspectors and kindred workers. 2. Professionals: Occupations which require specialized and theoretical knowledge which is usually required through college training or thorough work experience and other training which provides comparable knowledge. Includes: personnel and labor relations workers, social workers, doctors, psychologists, registered nurses, economists, dietitians, lawyers, system analysts, accountants, engineers, employment and vocational rehabilitation counselors, teachers or instructors, police and fire captains and lieutenants and kindred workers. 3. Technicians: Occupations which require a combination of basic scientific or technical knowledge and manual skill which can be obtained through specialized post -secondary school education and through equivalent on-the-job training. Includes: computer programmers and operations draftsmen, surveyors, licensed practical nurses, photographs, radio operators, technical illustrators, police and fire sergeants and kindred workers. 4. Office/Clerical: Workers are responsible for internal and external communication, recording and retrieval of data and/or information and other paper work required in an office. Includes: bookkeepers, messengers, office machine operators, clerk -typists, stenographers, court transcribers, hearing reporters, statistical clerks, dispatchers, license distributors, payroll clerks and kindred workers. 5. Skilled Craft Workers: Workers perform jobs which require special manual skill and a thorough and comprehensive knowledge of the processes involved in the work which is acquired through on-the-job training programs. Includes: Mechanics and repairman, electricians, heavy equipment operators stationary engineers, skilled machine occupations, carpenters, compositors and typesetters and kindred workers. 6. Sales Workers: Occupations engaging wholly and primarily in direct selling. Includes: advertising agents and salesman, insurance agents and brokers, real estate agents and brokers, stock and bond salesmen, demonstrators, salesmen and sales clerks, grocery clerks and cashier checkers, and kindred workers. 7 Operatives (semi -skilled l Workers who operate machine or processing equipment or perform other factory -type duties of intermediate skill level which can be mastered in a few weeks and require only limited training. Includes: apprentices (auto mechanics), plumbers, building trades, metal working trades, bricklayers, carpenters, electricians, machinists mechanics, printing trades, etc., operatives, attendants (auto service and parking), plasterers, chauffeurs, deliverymen and furnacemen, heaters (metal), laundry and dry cleaning operatives, milliners, mine operatives and laborers, motormen, oilers and greasers, (except auto painters), (except construction and maintenance), photographic process workers, stationary fireman, truck and tractor drivers, weavers, (textile), welders and flame cutters and kindred workers. AFFIRMATIVE ACTION Section AA-8 4463.016/City Contract No. 1067 8. Laborers (unskilled): Workers in manual occupations which generally require no special training. Perform elementary duties that may be learned in few days and require the application of little or no independent judgment. Includes: garage laborers, car washers and greasers, gardeners (except farm) and groundskeepers, longshoremen, and stevedores, lumbermen, craftsmen and woodchoppers, laborers performing lifting, digging, mixing, loading and pulling operations and kindred workers. 9. Apprentices: Persons employed in a program including work training and related instruction to learn a trade or craft which is traditionally an apprenticeship, regardless of whether the program is registered with a Federal or State agency. 10. Trainees (on-the-job): Production... persons in formal training for craftsmen when not trained under apprentice programs --operative laborer, and service occupations. White Collar. . . persons engaged in formal training for clerical, managerial, professional, technical, sales, office and clerical occupations. END OF SECTION o AFFIRMATIVE ACTION Section AA-9 4463.016/City Contract No. 1067 CD 0 0) J 2 cn u w O •474, U Z OH 2 °o i OV cd Z U . QFew Z w 0 0 CO U CI. G . O U O Prime Contractor Name: Rehabilitation c O C (LS Q x 4- 0 .Q CO 0 CO _o E. L 4-• O tea O O E O 0 c mo U a)= O a) (o co a) .c 0- a) -a N (On EO o -Q = O r-+ L cp L O U U C � O O U U Q .fl � O co O wW CO W 0 John Millen, NE Region President Contractor Signature: 0) O 0 E L LE c O O E L O L Q _O ai .( O 0) T3 0 0 a) 0 —J m U a a 0 is w 0 °0 E g2U E-" = U O >� U o �U �Qo T3 a) _o T3 ...c O 0 c O CO a) 0 U a) .2 c 0 1- c O a) �, ca Q a) L U 0)) c w to .0) a) L Q W L w U_ co' O co o c +-' O c E U L 6. u' o o Casco c 1 •- O O 05 O U co L � O c c.)O a) J� a) ..c U Q) a) a .0 > Q. o o0-c >o c® (oc o'- o oot t O La c 1� 0 o w a) co o 'gin 4- - w -a o. a� 2 — a) .o g .O eaN Q) U Ca N CO ea 00) 0 �- o 4- 0) U O c 0) Q a) c O L J as 0) c O c a) 0 1 a. 0) W 0 0 m 0 Z 0 0 u. TABLE OF Quotes Received Quotation used in bid )ntracl r v Z 0 0 '2�'2. CD 0 era, : 0 401) A Po U CI = 0 a 63 - .. igi N cn \ N cn\cn\ N cn \\ N cV cn \ N N cn \\ \-0 N c�] cn \ N cn\ N cn \\ \-0 N ci cn \ N cn \ N Cr) \\ \ N Cr) \ N cn \ N Cr) \\ \O N Dnta Atlas Painting Carter Electric OEL Construction Svcs TMI Coatings Weidner Construction Intracto 0 Z N N cn NQ 0 0 SRF Required Front -End Specifications PLEASE NOTE: Attachment 10 is a new program requirement and is effective for all SRF projects bid after January 2021. Attachment 1: Certification of Non -Segregated Facilities Form (to be completed and signed by Prime Contractor and submitted with the bid) SRF STATE REVOLVING FUND Attachment 2: Statement in Advertisement for Bids on Debarment and Suspension/Certification Regarding Debarment and Suspension Form (to be completed and signed by Prime Contractor and submitted with the bid) Attachment 3: Disadvantaged Business Enterprise Certification Form (to be completed and signed by Prime Contractor and submitted with the bid) Attachment 4: DBE Program Subcontractor Performance Form (to be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid) Attachment 5: Attachment 6: Attachment 7: Attachment 8: Attachment 9: Attachment 10: DBE Program Subcontractor Utilization Form (to be completed and signed by Prime Contractor and submitted with the bid) DBE Program Subcontractor Participation Form (for voluntary use of DBEs) Other Federal Requirements Language A. Standard Equal Employment Opportunity Specifications B. Federal Labor Standards Provisions (including Davis -Bacon prevailing wage rates**) C. Preservation of Open Competition and Government Neutrality D. Historical and Archeological Finds E. Prohibitions on Procurement from Violating Facilities Right of Entry and Records Retention Use of American Iron and Steel Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment (to be completed and signed by Prime Contractor and submitted with the bid) **The Davis Bacon wage determination received from the Iowa Finance Authority must also be included in the front-end specifications. Section SRF-1 4463.016/City Contract No. 1067 INVESTING IN IOWA'S WATER www.iowasrf.corn Attachment 1 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid) U.S. Environmental Protection Agency Certification of Non -Segregated Facilities (Applicable to contracts, subcontracts, and agreements with applicants who are themselves performing federally assisted construction contracts, exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause.) By the submission of this bid, the bidder, offeror, applicant, or subcontractor 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. He 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 bidder, offeror, applicant, or subcontractor 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, time clocks, 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, creed, color, or national original, because of habit, local custom, or otherwise. He further 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; that he will retain such certifications in his files; and that he will forward the following notice to such proposed subcontractors (except where the proposed subcontractors have submitted identical certifications for specific time periods): NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CERTIFICATIONS OF NON -SEGREGATED FACILITIES A Certification of Non -segregated Facilities, as required by the May 9, 1967, order (33 F.R. 7808, May 28, 1968) on Elimination of Segregated Facilities, by the Secretary of Labor, must be submitted prior to the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Opportunity clause. The certification may be submitted either for each subc• • act or for a, i subcontracts during a period (i.e., quarterly, semiannually, or annually). 7/6/2023 Signa : re ' - Date John Mallen, NE Region President Name and Title of Signer (Please Type) NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. EPA-7 5720-4.2 Section SRF-2 4463.016/City Contract No. 1067 Attachment 2 SRF Required Front -End Specifications (This form must be completed and signed by the Prime Contractor and submitted with the bid) Debarments and Suspensions Any bidder or equipment supplier whose firm or affiliate is listed in on the U.S. General Services Administration Excluded Parties List will be prohibited from the bidding process. The excluded parties records search engine is located at the System for Award Management (SAM) website: https://www.sam.gov/SAM/. Pursuant to 2 CFR Part 180, as supplemented by 2 CFR 1532, any entity submitting a bid while the SAM website lists that entity as having an active exclusion will be determined by the DNR to be a non -responsive bidder and will not be able to receive SRF funding. United States Environmental Protection Agency Washington, DC 20460 Certification Regarding Debarment, Suspension, and Other Responsibility Matters The prospective participant certifies to the best of its knowledge and belief that it and the principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. In addition, under 18 U SC Sec. 10 01, a false statement may result in a fine of up to $10,000 or imprisonment for up to 5 years, or both. John Mallen, NE Region President Typed Nam rized Representative 7/6/2023 re (3f Authorized Representative Date Sign I am unable to certify to the above statements. My explanation is attached. Section SRF-3 4463.016/City Contract No. 1067 Attachment 3 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid) Disadvantaged Business Enterprise (DBE) Solicitation It is EPA's policy that recipients of EPA financial assistance through the State Revolving Fund programs award a "fair share" of subagreements to small, minority and women -owned businesses, collectively know as Disadvantaged Business Enterprises (DBEs). Iowa's Fair Share goals are: Minority Enterprise -Owned (MBE) Business Goal Women Enterprise -Owned (WBE) Business Goal Construction 1.7% 2.2% Supplies 0.6% 5.6% Services 2.5% 11.3% Goods/Equipment 2.5% 10.4% Average 1.8% 7.4% Only work performed by certified DBEs can be counted toward the goals. In Iowa, DBEs must be certified through the Iowa Department of Transportation (IDOT). Information on certification requirements and a list of certified DBEs is on the IDOT website at https://secure.iowadot.gov/DBE/Home/Index/. Prime contractors' DBE requirements for SRF projects include: • Taking affirmative steps for DBE participation • Documenting the efforts and the proposed utilization of certified DBEs PROJECT INFORMATION SRF Applicant: Bidder: Woodruff Construction, Inc. Address: 1717 Falls Ave, Waterloo, IA 50701 Contact Person: Nate Goetsch Signature: Phone Number: 319-233-3349 E-Mail Address: nateg@woodruff.bui1d Check if Prime Contractor is: Minority -Owned Women -Owned Section SRF-4 4463.016/City Contract No. 1067 GOOD FAITH EFFORTS CHECKLIST Please complete the checklist to determine if you have complied with the requirement to make good faith efforts to ensure that certified DBEs have the opportunity to compete for procurements funded by EPA financial assistance funds. Bidders/offerors must make good faith efforts prior to submission of bids/proposals. 1. Did you ensure that DBEs are made aware of contracting opportunities to the fullest extent practicable through outreach and recruitment activities? X Yes ❑ No 2. Did you make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs in the competitive process? This includes, whenever possible, posting solicitation for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date. ❑ Yes X No 3. Did you consider in the contracting process whether firms competing for large contracts could subcontract with DBEs? This will include dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by DBEs in the competitive process. Yes X No 4. Did you encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually? ❑ Yes X No 5. Did you use the services of the Small Business Administration and the Minority Business Development Agency of the Department of Commerce to identify potential subcontractors? I-1 Yes X No 6. List the potential DBE subcontractors that were contacted. Only list those that are certified through the Iowa Department of Transportation. Name How (e.g. call, fax, Contacted letter, e-mail) phone Response not interested, (e.g. not did not competitive) respond, Atlas Painting Email \)\ (k v \M%X nA Carter Electric Email 1\ OEL Construction Services Email TMT Coatings Email k 1 Weidner Construction Email 1) . Youngblut Contracting, Inc. Email '11 PROPOSED UTILIZATION OF DBE SUBCONTRACTORS Please include Attachments 4 and 5 to document the proposed utilization of certified DBE subcontractors. Section SRF-5 4463.016/City Contract No. 1067 CONTRACT ADMINISTRATION PROVISIONS Several contract provisions are required to prevent unfair practices that adversely affect DBEs. These include: 1. Prime Contractor must pay its Subcontractor for satisfactory performance no more than 30 days from the Prime Contractor's receipt of payment from the SRF loan recipient. 2. Prime Contractor must notify the SRF loan recipient in writing prior to termination of a DBE subcontractor for convenience. 3. Prime Contractor must employ the six Good Faith Efforts to solicit a replacement subcontractor if a DBE subcontractor fails to complete work under a subcontract for any reason. Section SRF-6 4463.016/City Contract No. 1067 Attachment 4 SRF Required Front -End Specifications (This form must be completed and signed by Prime and DBE Subcontractor for each subcontract and submitted with the bid) Disadvantaged Business Enterprise Program DBE Subcontractor Performance Form This form is intended to capture the DBE1 subcontractor's2 description of work to be performed and the price of the work submitted to the prime contractor. An EPA Financial Assistance Agreement recipient must require its prime contractor to have its DBE subcontractors complete this form and include all completed forms in the prime contractor's bid or proposal package. Subcontractor Name Project Name CI t'-oiP Cl4,1 I'3o - ZoTh ins; A cr . 3 Pak Bid/Proposal No. Assistance (if known) Agreement ID No. Point of Contact Address Telephone No. Email Address Prime Woodruff Contractor Construction, Name Inc. Issuing/Funding Entity Contract Number Item Description Construction, of Work Submitted Services, to the Equipment Prime Contractor or Supplies Involving Price the of Prime Work Submitted Contractor to tJIA 1\-)Itc /1/40 DBE Certified by DOT SBA Meets/exceeds YES EPA certification NO standards? Unknown Other: 'A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 2Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. IASRF6100-3 DBE Subcontractor Performance Form — Page 1 Section SRF-7 4463.016/City Contract No. 1067 Disadvantaged Business Enterprise Program DBE Subcontractor Performance Form I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c). Prime Contractor Signature Print Name John Mallen Title Date / NE Region President 7/6/2023 Subcontractor Signature Print Name Date Title IASRF6100-3 DBE Subcontractor Performance Form — Page 2 Section SRF-8 4463.016/City Contract No. 1067 Attachment 5 SRF Reauired Front -End Snecifications (This form must be completed and signed by Prime Contractor and submitted with the bid if utilizing DBE subcontractors) Disadvantaged Business Enterprise Program DBE Subcontractor Utilization Form This form is intended to capture the prime contractor's actual and/or intended use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract. An EPA Financial Assistance Agreement Recipient must require its prime contractors to complete this form and include it in the bid or proposal package. Prime contractors should also maintain a copy of this form on file. Prime Woodruff oodruff Contractor Construction, Name Inc. Project Nt Name `L, LUTP C,Lc N .� 9-4- o � c. . 7o (� -- E2_' ,o Bid/Proposal No. Assistance (if known) Agreement ID No. Point Nate of Goetsch Contact Address 1717 Falls Ave, Waterloo, IA 50701 Telephone (319) 233-3349 No. Email nateg@woodruff.build Address Issuing/Funding Entity I have identified potential DBE certified subcontractors YES ')< NO 99 I_ If yes, please complete the table below. If no, please explain: 00 1 St?4 \Zt f�Pd O k) .41 Name/Company Subcontractor Name Company Address/Phone/Email Estimated Amount Dollar Current Certified? y DBE Continue on back if needed 'A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 2Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. IASRF6100-4 DBE Subcontractor Utilization Form - Page 1 Section SRF-9 4463.016/City Contract No. 1067 Disadvantaged Business Enterprise Program DBE Subcontractor Utilization Form I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 (c). Prime ontractor Signature Print Name John Mallen Date Title NE Region President 7/6/2023 IASRF6100-4 DBE Subcontractor Utilization Form — Page 2 Section SRF-10 4463.016/City Contract No. 1067 Attachment 6 SRF Required Front -End Specifications (This form is for the voluntary use of DBE Subcontractors) Disadvantaged Business Enterprise Program DBE Subcontractor Participation Form An EPA Financial Assistance Agreement Recipient must require its prime contractors to provide this form to its DBE subcontractors. The use of this form by DBE subcontractors is voluntary and is not required for bidding. This form gives a DBE1 subcontractor2 the opportunity to describe work received and/or report any concerns regarding the EPA - funded project (e.g. in areas such as termination by prime contractor, late payments, etc.). The DBE subcontractor can, as an option, complete and submit this form to the EPA DBE Coordinator at any time during the project period of performance. Subcontractor Name Project C'. 2 Name WWI() fi C\cuk (Ma3 P-� vutt -er Bid/Proposal No. Assistance (if known) Agreement ID No. Point of Contact Address Telephone No. Email Address Prime Woodruff Contractor Construction, Name Inc. Issuing/Funding Entity Contract Number Item Description Construction, of Work Received Services, from Equipment the Prime or Contractor Supplies Involving Amount Prime Received Contractor by 1A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certification as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202. 2Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. IASRF6100-2 DBE Subcontractor Participation Form — Page 1 Section SRF-1 1 4463.016/City Contract No. 1067 Disadvantaged Business Enterprise Program DBE Subcontractor Participation Form Please use the space below to report any concerns regarding the above EPA -funded project: Subcontractor Signature Name Print Title Date Return to: Regional Coordinator, Small Business Utilization, U.S. Environmental Protection Agency, Region 7, 11201 Renner Blvd., Lenexa, KS 66219 IASRF6100-2 DBE Subcontractor Participation Form — Page 2 4 • Section SRF-12 4463.016/City Contract No. 1067 Attachment 10 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid) PROHIBITION ON CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT This term and condition implements 2 CFR 200.216 and is effective for obligations and expenditures of EPA financial assistance funding on or after 8/13/2020. EPA recipients and subrecipients, including borrowers under EPA funded revolving loan fund programs, are prohibited from obligating or expending loan or grant funds to: (a) Procure or obtain, extend or renew a contract to procure or obtain; (b) Enter into a contract (or extend or renew a contract) to procure; or (c) Obtain the equipment, services, or systems that use "covered telecommunications equipment or services" identified in the regulation as a substantial or essential component of any system, or as critical technology as part of any system. Certain equipment, systems, or services, including equipment, systems, or services produced or provided by entities subject to the prohibition are recorded in the System for Award Management exclusion list, website: https://www.sam.gov/SAM/. (1) As described in Public Law 115-232, section 889, covered telecommunications equipment or services includes: (i) Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities). (ii) For the purpose of public safety, security of government facilities, physical security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities). (iii) Telecommunications or video surveillance services provided by such entities or using such equipment. (iv) Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in consultation with the Director of the National Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country. (2) Consistent with 2 CFR 200.471, costs incurred for telecommunications and video surveillance services or equipment such as phones, Internet, video surveillance, and cloud servers are allowable except for the following circumstances: (i) Obligating or expending EPA funds for covered telecommunications and video surveillance services or equipment or services to procure (enter into, renew or extend contracts) or obtain the equipment, services, or systems as described in 2 CFR 200.216. I understand the above prohibitions and certify that the project will be in compliance with all the requirements. John Mallen, NE Region President Typed Nam itle thorized Representative 7/6/2023 Sig , ure of Au orized Representative Date Section SRF-34 4463.016/City Contract No. 1067 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we, Woodruff Construction, Inc. as Principal, and Liberty Mutual Insurance Company as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called "OWNER." In the penal sum Five Percent (5%) of the Total Amount Bid Dollars ($ 5% ) lawful money of the United States, for the payment of which sum will and truly be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. The condition of this obligation is such that whereas the Principal has submitted the accompanying bid dated the 6th day of July , 2023 , for F.Y. 2023 Wastewater Treatment Plant Final Clarifier No. 3 Rehabilitation, Contract No. 1067, Waterloo, Iowa . 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 1st day of July , A.D. 20 23 Li-66 iiii ist, Witne r\ �� Surety n n ViSuel n 1912 Sara Huston Attorney -in -fact c" Witne •• s CindyBennett ©z aq Woodruff Construction, Inc. (Seal) Principal Liberty Mutual Insurance Company By Mal) BID BOND Section BB-1 4463.016/City Contract No. 1067 Liberty Mutual. SURETY This Power of Attomey limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Oho Casualty Insurance Corpany is a corporation duly agarzed under the Taws of the State of New Hampshire, that Liberty Mlual Insurance Carparry is a corporation duly organized under the laws of the State of Massachusetts, aril West American Insurance Company is a corporation duly organized under the laws of the State of Inciana (herein collectively called the Carpares), pusuant to and by authority herein set forti>, does hereby nacre, constitute and appoint, A nne Crowner, Brian M. Deimerly, Cindy Bennett, Craig E. Hansen, Dione R. Y oung, J ay D. Freierrnuth, Seth D. Rooker, Stacie Christensen, Stacy Venn, Tim McCulloh Certificate No: 8205943-190056 all of the city of Waukee state of IA each irrividually if there be more than one marred, its true and Iavvfil attorney -in -fact to make, execute, seal, acknoAledge and deliver, for and on its behalf as surety and as its act and deed, arty and all undertakings, borxis, recogrizances and othersurety obligations, in pusuance of these presents and shall be as bincirg upon the Compares as if they have been duly signed by the president and attested by the secretary of the Compares in their °An proper persons. IN WITNESS WHEREOF, this POAer of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Compares have been affixed thereto this 13th day of July , 2021 . By: State of PENWYLVANIA Canty of MOP,TGOME RY ss On this 13t1 i day of J my , 2021 before ire personally appeared David M Carey, who acknoAledged himself to be the Assistant Secretary of Liberty Ritual Insurance Company, The Olio Casualty Carpany, and West Anedcan Insurance Company, and that he, as suck being authorized so to do, execute the foregang instrument for the purposes therein contained by sigrrg on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed rry nacre and affixed ny notarial seal at King of Prussia, Perrsytvara, on the day and year first above written Liberty M.rtual Insurance Carpany The Oho Casualty Insurance Carpary West Arrerican Insurance Corpar y C—; Commonwealth of Pennsylvania - Notary Seal Teresa Pastella, Notary Pub:'c Montgomery County My commission expires March 28, 2025 Commiss'on number 1126044 Member, Pennsylvania Association of Notaries David M Carey, Assistant Secretary By: iptA4) eresa Pastella, Notary Pudic This Poner of Attorney is made and executed pursuant to and by authority of the fdloAing By -laves and Authorizations of The Ohio Casualty Irnurarce Company, Liberty Mutual Irsuance Carpariy, and West American Insurance Corpanywhich resolutions are rxwin fill force and effect reacirg as fdlars: ARTICLE IV ' OFFICERS: Secton 12. Poner of Attorney. Ary officer or other official of the Corporation authorized for that purpose in writing bj the Chairrron or the President and subiect to such limitation as the Chairman a- the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknonledge and deliver as surety any and all undertakings, bad, recogrizarces and other suety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective posers of attorney, shall have full poser to hid the Corporation lay their signature and execution of any such irtst nests and to attach thereto the seal of the Corporation When so executed, such instrurents shall be as binxirg as if signed by the President and attested to by the Secretary. Any porAer or awry granted to any representative or attorney -in -fact under the provisions of this article rray be revoked at any time by the Board, the Chairrranl, the President or by the officer or officers grar$irg such poser or authority. ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company aurthotized for that purpose in writing by the chairman or the president, and subiect to such limitations as the chairman or the president rray prescribe, shall appart such attorneys -in -fact as may be necessary to act in behalf of the Company to make, execute, seal, ackrxrAledge and deliver as surety any and all undertakings, 'Ponds, recognzances and other surety obligations. Such attorneys -in -fact subject to the 'irritations set forth in their respective posers of attorney, shall have fill poAer to bird the Company by their signature and execution of ary such instruments and to attach thereto the seal of the Company. When so executed such instnr e is shall be as Mincing as if signed by the president and attested by the secretary. Certificate of Designation - The President of the Company, actirg pursuant to the Bylaws of the Corrpary, authorizes David M Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to crake, execute, seal, ackno iecge and deliver as surety any and all undertakings, bonds, recognzances and other surety obligations. Authorization - By u.narmous consent of the Companys Board of Directors, the Company consents that facsirrile or mechanically reproduced signature of any assistart secretary of the Conpary, wherever appearing upon a certified copy of ary poAer of attorney issued by the Corrpany in connection with surety bonds, shall be valid and bracing upon the Company with the sarre force and effect as though manually affixed L Renee C. LleAeltyr>, the urndersignea, Assistant Secretary, The Ohio Casualty Irntrarlce Compamy, Liberty M ial Insurance Company, and West Arrerican Insurance Company do hereby certify that the original poser of attorney of which the foregoirg is a full, true and correct copy c f the Poner of Attorney executed by said Compares, is in full force and effect and has nct been revoked IN TESTIMONY WHEREOF, I have hereunto set rry hard aril affixed the seals of said Compares this 1st day of July , 2023 . By: Szi(cemear... Renee C. Llewellyn Assistant Secretary cn E O o 'i c E o U O 0_O a) • (>3 c E o a) Q `o O O � L N OD r CL Cr Lco ' o co c'3— co -0 0 c U oco a) o� LL LMS-12873 LMIC OCIC WAIC Muld Co 02/21