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PUOMI[*:` '
FOR
F (024 SOD[E B/AlJjc EI PAII
ASS ESSFM KT PROGRAMr=iZOKIE
CONTRACT \10000 .103
CITY OF
WATERLOO
Engineering
1 hereby certify that this engineering
document was prepared by me or under
my direct personal supervision and that I
am a duly licensed Professtonal Engineer
under ,the of the State of Iowa.
WILLIAU irv. CASTLE, P.E.
License Number 19715
My License Renewal Date is December 31, 2023.
Pages or sheets covered by this seal
•
Miledes
FY 2024 SIDEWALK REPAIR ASSESSMENT PROGRAM - ZONE 3
CONTRACT NO. 1082
CONTRACT DOCUMENTS
TABLE OF CONTENTS
1. NOTICE OF PUBLIC HEARING
2. NOTICE TO BIDDERS
3. INSTRUCTIONS TO BIDDERS
4. FORM OF BID OR PROPOSAL
5. SALES TAX EXEMPTION INFORMATION FORM
6. FORM OF BID BOND
NON -COLLUSION AFFIDAVITS
8. EQUAL OPPORTUNITY CLAUSE
9. TITLE VI CIVIL RIGHTS
10. BIDDER STATUS FORM
(Prime)
11. CONTACTOR'S AFFIRMATIVE ACTION PROGRAM
12. ITEMS OF POTENTIAL MBE/WBE PARTICIPATION
MBE/WBE GOALS FOR THIS PROJECT,
NORM LEVIER FOR SOLICITING SUBCONTRACTOR QUOTES
LETTER OF INTENT TO BID (MBFJWBE LETTER)
SUBCONTRACTOR BID REQUEST FORM
MBE AND/OR WBE PRE -BID CONTACT INFORMATION FORM
13. CERTIFIED MBE/WBE CONTRACTORS LIST
14. STATEMENT OF BIDDER'S QUALIFICATIONS
16. SPECIAL PROVISIONS
17. GENERAL SPECIAL PROVISIONS
18. GENERAL SPECIFICATIONS FOR CONSTRUCTION
19. SUPPLEMENTAL GENERAL SPECIFICATIONS FOR CONSTRUCTIONS
20. FORM OF CONTRACT
21. FORM OF PERFORMANCE BOND
22. FORM OF PAYMENT BOND
Highlighted items must be included with bid.
mum Or no OU PROPOSAL
R.Y. 2024 SiDrikflfALK REPAIR A88E88UI NN`i PROK RAWl I • GONF 3
COM UUACT NO. 1002
GI oY Or WA i WNLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen: •
1. The undersigned, being a Corporation existing under the laws of the State of
,®‘ a Partnership consisting of the following partners:
j sK Even Coink'\on
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. 2024 SIDEWALK REPAIR ASSESSMENT PROGRAM —
ZONE 3, Contract No. 1082, 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. 2024 SIDEWALK REPAIR ASSESSMENT PROGRAM — ZONE 3
CONT AWT NO. 1082
BID
ITEM
DESCRIPTION
4" PCC R/R SIDEWALK
5" PCC R/R SIDEWALK
6" PCC R/R SIDEWALK
CLASS A PCC R/R SIDEWALK
7
10
Class F Sidewalk Patch
CLEAN WALK
SF
SF
SF
SF
EACH
(ITY.
9,550.51
1,960.9
2,805.4
295.9
29.0
WATER VALVE ADJUSTMENT
WATER VALVE CAP REPLACEMENT
DETECTABLE WARNING SURFACE
JOINT SEAL
EACH
EACH
EACH
EACH
LF
UNIT BID
PRICE
6.0
6.0
6.0
1.01
25.3
9 /i
q Ate`
TOTAL BID PRICE
$ /03ig:.
7)'3 V, .�.
$ 2269,14)
/34 e
$ 9ceit
TOTAL 31D
9oa
$
FORM OF BID
CONTRACT NO. 1082 Page 1 of 3
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
proscribed 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 51/
Dollars ($ ?5_i. OLe ) in the form of oleNct
is submittod 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.
8. The Prime Contractor and Subcontractor(s), which have performed an aggregate
of $10,000.00 in work for the City in the current calendar year, are prepared to
submit an AAP or Update and an EOC, within ten (10) days of notification that the
bid submitted is lowest and acceptable.
9. The bidder has received the following Addendum or Addenda:
Addendum No. Date
10. The bidder shall list the MBE VVBE subcontractor(s), amount of subcontracts and
bid items on the City of Waterloo Minority and/or Women Business Pre -bid
Contact Information Form submitted with this Form of Bid or Proposal. The
apparent low Bidder shall submit a list of all other Subcontractor(s) to be used on
this Project to the City of Waterloo by 5:00 p.m. the business day following the day
Bids on this Project are due along with the Non -Collusion Affidavits of All
Subcontractor(s).
The Contractor shall submit information on subcontractors on
"SUBCONTRACTOR REQUEST AND APPROVAL" Form to be provided by City
prior to approval of contract.
FORM OF BID
CONTRACT NO. 1082 Page2of3
KNOW ALL MEN BY THESE PRESENTS, that we,
BID BOND
Brock Even Construction LLC
as Principal, and Nationwide Mutual Insurance Company
bound unto the
Five Percent of Amount Bid
as Surety, are held and firmly
CITY OF WATERLOO , Iowa, hereinafter called "OWNER." In the penal sum
Dollars ($ 5% of Amount Bid ) 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 7th day of
September , 20 23 , for F.Y. 2024 Sidewalk Repair Assessment Prngram
Zone 3. Contract No. 1082
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 September , A.D. 20 23
Witness
0142L(2_
frecera6
Witness
BID BOND
Brock Even Construction LLC (Seal)
Principal
Dy
621 H4
Nationwide Mutual Insurance Company (Seal)
Sit rety
By
Moore, Attorney -in -fact
duca
(Title)
Page 1 of 1
Power of Attorney
KNOW ALL MEN BY THESE PRESENTS THAT:
Nationwide Mutual Insurance Company, an Ohio corporation
hereinafter referred to severally as the "Company" and collectively as "the Companies" does hereby make, constitute and appoint:
Anita R. Calderon, Dana R. Clark, Mike Kuper, Matthew Gilmer, Joshua Severson, Andrew Roby, Robert N. Johnston, Elizabeth Moore, Ashlee Heldt, Ben Lewis, Jeff Cose,
Aaron J. Jamison, Kim Wells, Carmon R. Wilson, Spencer Paris, Larry D. Slegh, Richard E. Harman IV, Logan Dorpinghaus, Corcy Days, Jill DeRobertis, Dominic Amoroso,
Kyle I-Iuntrod, Twanisha Siejkowski, Heidi Cornelison, Michael Mailer, Stephen G. Sanker, Brian Pflum, Guy Tenold, Cassie McKittrick, Ashley Leavell, Cara Buljubasic,
Trevor Sharp, Joshua Coleman, Amy Palmer, Jennifer Anderson, Randi Allen, Andrew Jennings, Andrew P. Andersen, Jesse Huston, Kwanah Kim, Maxine Coffin
each in their individual capacity, its true and lawful attorney -in -fact, with full power and authority to sign, seal, and execute on its behalf any and all bonds and
undertakings, and other obligatory instruments of similar nature, in penalties not exceeding the sum of
FIVE MILLION AND NO/100 DOLLARS ($5,000,000.00)
and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company; and all acts
of said Attorney pursuant to the authority given are hereby ratified and confirmed.
This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company:
"RESOLVED, that the president, or any vice president be, and each hereby is, authorized and empowered to appoint attorneys -in -fact of the Company,
and to authorize them to execute and deliver on behalf of the Company any and all bonds, forms, applications, memorandums, undertakings,
recognizances, transfers, contracts of indemnity, policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other
writings obligatory in nature that the business of the Company may require; and to modify or revoke, with or without cause, any such appointment or
authority; provided, however, that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any
of said documents on behalf of the Company."
"RESOLVED FURTHER, that such attorneys -in -fact shall have full power and authority to execute and deliver any and all such documents and to bind the
Company subject to the terms and limitations of the power of attorney issued to them, and to affix the seal of the Company thereto; provided, however, that
said seal shall not be necessary for the validity of any such documents."
This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company.
Execution of Instruments. Any vice president, any assistant secretary or any assistant treasurer shall have the power and authority to sign or attest all
approved documents, instruments, contracts, or other papers in connection with the operation of the business of the company in addition to the chairman of
the board, the chief executive officer, president, treasurer or secretary; provided, however, the signature of any of them may be printed, engraved, or
stamped on any approved document, contract, instrument, or other papers of the Company.
IN WITNESS WHEREOF, the Company has caused this instrument to be sealed and duly attested by the signature of its officer the 20th day of August, 2021.
eiSEAli'.•*
•4
4,ii`sss
Antonio C. Albanese, Vice President of Nationwide Mutual Insurance Company
ACKNOWLEDGMENT
STATE OF NEW YORK COUNTY OF NEW YORK: ss
On this 20th day of August, 2021, before me came the above -named officer for the Company
aforesaid, to me personally known to be the officer described in and who executed the preceding
instrument, and he acknowledged the execution of the same, and being by me duly
sworn, deposes and says, that he is the officer of the Company aforesaid, that the seal affixed
hereto is the corporate seal of said Company, and the said corporate seal and his signature were
duly affixed and subscribed to said instrument by the authority and direction of said Company.
Stephanie Rubino McArthur
Notary Public, State of New York
No. 02MC6270117
Qualified in New York County
Commission Expires October 19, 2024
Afteadvacksiti. ?ma,
Notary Pub:
My Comm;ss!on Exp'.res
October 19, 2024
CERTIFICATE
I, Laura B. Guy, Assistant Secretary of the Company, do hereby certify that the foregoing is a full, true and correct copy of the original power of attorney issued
by the Company; that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same has
not been revoked or amended in any manner; that said Antonio C. Albanese was on the date of the execution of the foregoing power of attorney the duly elected
officer of the Company, and the corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board
of directors; and the foregoing power of attorney is still in full force and effect.
IN WITNESS WHEREOF, I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate seal of said Company this
September , 2023
Q.ut0. rV • Gyve.
1st day of
Assistant Secretary
BDJ 1(0t3-21)00
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 limitatioris.
?)(1.-VAA lion Corn A-4tOn „TLC 9/(0/
(Name of Bidder) (Date)
BY: j r60.\< e n Title OLO‘ntor
Official Address: (Including Zip Code):
x Ra
ACSUp 5N,01--RS
I.R.S. No. Lkto s 5\ao b5�
FORM OF BID CONTRACT NO. 1082 Page 3 of 3
INFORMATION NLJUDf D
FOR
IOWA CONSTRUCTION S ALLS `rAX CI~RTIFICATE
CONTRACTOR NAME: )ft k Thnthuet1m
ADDRESS: \tam& vox Pa �ot16g1
(Check One): PRIME
FEDERAL ID#: lo-,5to36ba7s
SUBCONTRACTOR
PROJECT NAME `Pr &VA 3tde.uaak e \r Rse mpn - Pic ram - -mime 3
PROJECT CONTRACT NO.: I
DESCRIPTION OF WORK:
❑ Brickwork
❑ Carpentry
Concrete
❑ Drywall -Plaster -Insulation
❑ Electrical
O Excavation/Grading
❑ Flooring
❑ Heavy Construction
O Heating -Ventilating -Air Cond
❑ Landscaping
❑ Painting
❑ Paving
❑ Plumbing
❑ Roofing -Siding -Sheet Metal
❑ Windows
❑ Wrecking -Demolition
❑ Other (Please specify)
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of Inv 3J .,
County of ;?,0k \\iio\C )
1 He is
L� C-
)ss
being first duly sworn, deposes and says that:
(Owner, Partner, Officer, Representative, or Agent) , of 1ypeV Even nynskruthion,
the Bidder that has submitted the attached Bid;
2. He is fully -informed respecting the preparation and contents of the attached Bid and of all pertinent
circumstances respecting such Bid;
3. Such Bid is genuine and is not a collusive or sham Bid:
4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees, or
parties in interest, including this affiant, has in any way colluded conspired connived or agreed, directly or
indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the
Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such
Contract, or has in any manner, directly or indirectly sought by agreement or collusion or communication or
conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other
Bidder, or, to fix any overhead, profit or cost element of the bid price or the bid price of any other Bidder, or
to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against the
City of Waterloo, lowa, 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.
m.
(Signed)
Subscribed and sworn to before me this
Title
bt-kt day of
lI
w
My commission expires 1 1
MARGIE KNIPP ►
COMMISSION NO. 814768
MY COMMISSION EXPIRES
January 22, 20.2.57 _•
pkrw&'ex , 20,2
btattiS Fon i
Please answer "Yes" or "No" for each of the following:
`co be completed by all bidders Pa A
Yes Q 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).
G-6 Yes - No My company has an office to transact business in Iowa.
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.
complete Parts B and D of this form.
If you answered "No" to one or more questions above, your company is a nonresident bidder.
complete Parts C and D of this form.
To be completed by resident bidders
Please
Please
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates: 1 / a / I 1 to _._. / to / E3 Address: _Ia01 Rd
Dates: / /
to / /
Park
City, State, Zip: F - 50104 K
Address.
City, State, Zip'
Dates: / / to / / Address*
You may attach additional sheet(s) if needed. City, State, Zip:
To be completed by fof°resident bidders
Park 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? 0
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 hp completed by all bidders
Park 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:
Signature:�
Date; b �c�3
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 (09-15)
11111E/Ullf3E BUSINESS ENTERPRISE
PREnBIEJ CONTACT ACT ONFORMATION FORM
Prime Contractor Name:2fed{ E'j.tn C om }tan ! LLt
Project:naa@� e,Ls _ Letting Date:
ConA-C'j ma. iO
NO M@EMfl/BE SUBCONTRACTORS: If you are NOT using any MBENVBE 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, plgaise use the bottom portion of this form.
Contractor Signature:
Title: C'�► ►>t,P r _
cV� r
Date: 1?
SUBCONTRACTORS RACTORS 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. udy . &Yeaas @ U)akerloo T'R O tri
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 INFOVUA`fION SNOWING BIDDER'S PRE$$ID
MBENU $ BUSINESS ENTERPRISE' CONTACTS
Quotes Received
MBERRIBE
Subcontractors
Dates
Contacted
Yes/No
Dates
Contacted
Yes/No
Quotation used in bid
Dollar Amount Proposed to
be Subcontracted
•
(Form CCO-4) Rev. 06-20-02