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BID BOND
KNOW ALL BY THESE PRESENTS:
That we, Cellsite Solutions, LLC
Sampk Bid Bond Form
, as Principal, and
Merchants National Bonding, Inc. , as Surety, are held and firmly bound
unto City of Waterloo, Iowa , as Obligee, (hereinafter
referred to as "the Jurisdiction"), in the penal sum of
dollars ($ ), or five (5) percent of the amount
bid in lawful money of the United States, for which payment said Principal and Surety bind themselves, their heirs,
executors, administrators, successors, and assigns jointly and severally, firmly by these presents.
The condition of the above obligation is such that whereas the Principal has submitted to the Jurisdiction a certain proposal,
in a separate envelope, and hereby made a part hereof, to enter into a contract in writing, for the following described
improvements;
2023 PREFABRICATED SHELTER, CONTRACT NO. 1087
The City of Waterloo (Owner) is seeking bids from contractors who can supply and install a prefabricated concrete
communication shelter that will securely house the network equipment, power systems, and supporting environmental
components required to operate the Waterloo Fiber FTTU network for the Owner (the Project). The shelter will be
located at Fire Station 6, 3233 Ansborough Ave, Waterloo, IA 50701 (See Attachment D—Site Location).
(CONT. BID BOND)
Project Name FY 2023 Prefabricated Shelter, Contract No. 1087
The Surety 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 Jurisdiction may accept such bid or execute such Contract; and said
Surety does hereby waive notice of any such extension.
In the event that any actions or proceedings are initiated with respect to this Bond, the parties agree that the venue thereof
shall be Black Hawk County, State of Iowa. If legal action is required by the Jurisdiction against the
Surety or Principal to enforce the provisions of the bond or to collect the monetary obligation incurring to the benefit of
the Jurisdiction, the Surety or Principal agrees to pay the Jurisdiction all damages, costs, and attorney fees incurred by
enforcing any of' the provisions of this Bond. All rights, powers, and remedies of the Jurisdiction hereunder shall be
ctinulative and not alternative and shall be in addition to all rights, powers and remedies given to the Jurisdiction, by law.
The Jurisdiction may proceed against Surety for any amount guaranteed hereunder whether action is brought against
Principal or whether Principal is joined in any such action or actions or not.
NOW, THEREFORE, if said proposal by the Principal be accepted, and the Principal shall enter into a contract with
Jurisdiction in accordance with the terms of such proposal, including the provision of insurance and of a bond as may be
specified in the contract documents, with good and sufficient surety for the faithful performance of such contract, for the
prompt payment of labor and material furnished in the prosecution thereof, and for the maintenance of said improvements
as may be required therein, then
this obligation shall become null and void; othenvise, the Principal shall pay to the Jurisdiction the full amount of the bid
bond, together with court costs, attorney's fees, and any other expense of recovery.
Signed and sealed this 12th day of September
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"By
SURETY:
Merchants National Bonding, Inc.
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Vihr
- s h, Atto
ompany
ey-in-Fact/Officer
ey-in-Fact
Printed Name of Attorney-in-Fact/Officer
Holmes, Murphy and Associates LLC
Company Name
2727 Grand Prairie Parkway
Company Address
Waukee, IA 50263
City, State, Zip Code
(515) 223-6800
Company Telephone Number
PRINCIPAL:
, 20 23
Cellsite Solutions, LLC
By iG(/` _
Bidder
Signature
fct Hen A:A?$
Printed Paine
CFo
Title
4150CStSW
Address
Cedar Rapids, IA 52404
City, State, Zip Code
(319) 826-3404
Telephone Number
NOTE: All signatures on this bid bond must be original signatures in ink; copies, facsimile, or electronic signatures will
not be accepted. This bond must be sealed with the Surety's raised, embossing seal. The Certificate or Power of Attorney
accompanying this bond must be valid on its face and sealed with the Surety's raised, embossing seal.
.MERCHANTS
BONDING COMPANY,.
POWER OF ATTORNEY
Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.,
both being corporations of the State of Iowa, d/b/a Merchants National Indemnity Company (in California only) (herein collectively called the
"Companies") do hereby make, constitute and appoint, individually,
Amy Huynh; Anne Crowner, Ben Williams; Brian M Deimerly; Cameron M Burt; Cindy Bennett; Craig E Hansen; D Gregory Stitts; Dione R Young;
Donald E Appleby; Douglas Muth; Ginger Hoke; Grace Rasmussen; Greg Krier; Jay D Freiermuth; Jennifer Marino; Jessica Jean Rini; Jessie Allen;
Joe Tiernan; John Cord; Kate Zanders; Keeton Welch; Mark R DeWitt; Mark Sweigart; Mary Ashley Allen; Megan A Brown; Michelle R Gruis; Sara
Huston; Sarah C Brown; Seth D Rooker; Tim McCulloh; Todd Bengford; W R Withrow
their true and lawful Attorneys) -in -Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings,
contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of
persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions
or proceedings allowed by law.
This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board
of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of
Merchants National Bonding, Inc., on October 16, 2015.
"The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and
authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto,
bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof."
"The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney
or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the
Company, and such signature and seal when so used shall have the same force and effect as though manually fixed."
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the
Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction
contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department
of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of
its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given
to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner -
Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 5th day of September , 2023
Q .••,'t O NA • • OG co;:.• ,,.....,•�♦♦•
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2003 ; � y C: By
•0 • d�,`L •
STATE OF 101/�'A •♦♦,♦'•�.• • .•`��'' ••• • i `1 ••• President
COUNTY OF DALLAS ss. �,''""'''**
On this 5tli day of September 2023 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn
did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the
seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf
of the Companies by authority of their respective Boards of Directors.
MERCHANTS BONDING COMPANY (MUTUAL)
MERCHANTS NATIONAL BONDING, INC.
d/b/a MERCHANTS NATIONAL INDEMNITY COMPANY
Kim Lee
CommissOn Number 702737
My Commission Expires
April 14, 2024
Notary Public
(Expiration of notary's commission does not invalidate this instrument)
I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby
certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full
force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 12th day of September , 2023 .
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Secretary
POA 0018 (10/22)
Bidder Status Form
To be completed by all bidders
Part A
Please answer Yes" or "No" for each of the following:
Yes QNo
Yes ONo
es ONo
Yes ONo
-Yes
ONo
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).
My company has an office to transact business in Iowa.
My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail.
My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
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.
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: 61-
Dates:'Dt
0 l 2 "" to Ptoe,"�
Address: S \di
City, State, Zip: CS- e �)..4 S
n ZS to a 1 (-)' )— Address: n Lb 5 P %St-
�
p "City, State, Zip: i,It A `1 Z4��
Dates: OL ‚Srto ` 4- 4 Address: t tok) r� to eA Jw1
You may attach additional sheet(s) if needed. City, State, Zip: C. 'c LNb
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? O Yes ONo
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
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:
Cast -it S Liye,s t t_c_
Date: ?/y/ZoZ5
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)
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 QNo
O Yes Olo
O Yes ®No
O Yee No
O Yes ,pNo
O Yes 9_,No
Q
O Yes'Q No
O Yes
O Ye479 No
Aq;
Yes
�_.
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.
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.
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.
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.
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.
My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
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 (09-15)
Revised February 2003
CONTRACTOR'S OR SUBCONTRACTOR'S AFFIRMATIVE ACTION PROGRAM
Check box that applies to party completing program:
(
(
) General Contractor
) Subcontractor
Section A to be completed by GENERAL CONTRACTORS only:
A.
Name of Company
Address of Company Zip
Telephone Number ( )
Federal ID Number (if no Federal ID Number, Owner/President's Social Security Number)
Name of Equal Employment Officer
Name of Project
Project Contract Number
Estimated Construction Work Dates /
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 PROGRAM Page 1 of 8
CITY OF ,
lt,S L'. •TERLOO
J leak
. ty RE -BID CONTACT INFORMATION FORM
Prime Contractort�ame• l� \`c t S a\OrJ / LLC
Project: ( u.nf c.( l J% I ACAu )
MBE/WBE BUSINESS ENTERPRISE
Letting Date:
`7/l$Iza 23
NO MBEAVBE 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 please use the bottoty\ portion of this form.
Contractor Sipltature: j
Title: 7 >Y C tvi
Date: Oil 141 10 l
SUBCONTRACTORS 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 IvMBEAVBE Business Enterprise contacts made prior to your bid submission. This information is subject to
verifications and confirmation.
If you are unable to identify MBEAVBE finns 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 MBEAVBE 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
MBE/WBE
Subcontractors
Dates
Contacted
!
Yes/No
Dates
Contacted
Yes/No
Dollar
Amount Proposed
be Subcontracted
to
Pc'cAAWS
C\(I1
N.)
rJ
N j \
Prk
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Q�.\A
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° to
N
N
N
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(Form CCO-4) Rev. 06-20-02
N1BE/WBE BUSINESS ENTERPRISE
PRE -BID CONTACT INFORMATION FORM INSTRUCTIONS
)'rime Contractor Responsibilities:
Prime Contractors bidding on City of Waterloo contract work are required to ensure that MBE/WBE businesses are
provided the opportunity to participate in the performance of contracts and subcontracts. Prime contractors are required to
assist N1BE/WBE businesses in overcoming barriers to participation, and must make good faith efforts to secure bids from,
and award subcontracts to, MBE/WBE businesses. For all contract bids of $50,000 or more, the following is required to
demonstrate good faith efforts in accordance with this policy:
1. "MBE/WBE BUSINESS ENTERPRISE PRE -BID CONTACT INFORMATION FORM" submitted with the primecontractor
bid, properly completed and signed on Fonn CCO-4 (Rev. 06-20-02). Please note that this document must include all
subcontractor contacts, bids received, and awarded - not just those related to disadvantaged business enterprise vendors.
2. A minimum of three (3) MBE/WBE business contacts must be made and documented, if there are at least three (3)
MBE/WBE businesses offering services in the areas to be subcontracted (see City of Waterloo MBE/WBE Certified List). If
less than three (3) are offering the services to be subcontracted, then a contact is required for any that are listed as
providing that service. If you have submitted a MBE/WBE contact not on the City's MBE/WBE list, attach a copy of the
certification from another government agency.
3. Contacts to each NIBE/WBE businesses are required to be a minimum of seven (7) working days prior to the date the
prime contractor submits the bid to the City of Waterloo.
4. The following documentation must accompany the "MBE/WBE BUSINESS ENTERPRISE PRE -BID CONTACT
INFORMATION FORM" for each MBE/WBE business contacted:
a. A copy of the bid received from the MBE/WBE, OR
b. If no bid was received, a copy of correspondence received from the MBE/WBE with a "no bid" response, OR
c. If no response was received, a copy of the solicitation sent to the MBE/WBE with proof of mailing attached.
5. If any MBE/WBE business submitting bids are not selected for subcontract award, documentation must accompany the
"MBE/WBE BUSINESS ENTERPRISE PRE -BID CONTACT INFORMATION FORM" on why the MBE/WBE was not
selected. These reasons could include:
a. Not low bid. Copies of the competing bids may be required for verification.
b. MBE/WBE did not bid, withdrew bid or was n o n -responsive.
c. Documentation of other business -related reason for not selecting the MBE/WBE business for a subcontract.
d. Prime contractor self performs work.
e. Any other reason relied on by the Prime Contractor.
The Contract Compliance Officer will determine the weight to be given to each item listed above (supported by appropriate
documentation) based on overall program goals.
Subcontractors Responsibilities:
1. Each MBE/WBE firm planning to submit quotes on construction projects with goals, shall submit a Letter of
intent to Bid (Form CCO-5) to the City Contract Compliance Officer seven (7) working days prior to bid opening, listing
specific items which the MBE/WBE firm is interested in bidding. If the City Contract Compliance Officer does not
receive sufficient scope letters seven (7) working days prior to bid opening, goals on subject project will be reduced
accordingly. Agreements between the bidder/proposer and an MBE/WBE in which the MBE/WBE promises not to
provide subcontracting quotations to other bidders/proposers are prohibited.
Fonn CCO-4A Rev. 07-08-02
owp.
NON -COLLUSION AFFIDAVIT OF PRIME BiDDEIZ
State of /v l.JO. )
County of Line) )
) ss
/ti• , being first duly sworn, deposes and says that:
1. He is (Owner, Partner, 1 fficer, ' epresentative, or Agent) , of Cid ?.`fe Sol��1�f.►S, j_�'�
, the Bidder t is las 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, fine or person to fix the price or prices in the attached Bid or of any other Bidder, or, to fix any overhead,
profit or cost element of the bid price or the bid price of any other Bidder, or to secure through any collusion,
conspiracy, connivance, or unlawful agreement any advantage against the City of Waterloo, Iowa, or any
person interested in the Proposed Contract; and
5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion,
conspiracy, connivance or unlawfiul agreement on the part of the Bidder or any of its agents, representatives,
owners, employees, or parties in interest, including this affia
(Signed)
ccd
I the
Subscribed and sworn to before me this /11 day of ct p�-�% btr , 2013
/6le
My commission expires 11• r tin g 2-0 2 S
se ROCHELLE CLARAHAN
r Commission Number 837947
My Commission Expires
March 8, 2025
(CONT. BID BOND) Project Name
The Surety 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 Jurisdiction may accept such bid or execute such Contract; and said
Surety does hereby waive notice of any such extension.
In the event that any actions or proceedings are initiated with respect to this Bond, the parties agree that the venue thereof
shall be County, State of Iowa. If legal action is required by the Jurisdiction against the
Surety or Principal to enforce the provisions of the bond or to collect the monetary obligation incurring to the benefit of
the Jurisdiction, the Surety or Principal agrees to pay the Jurisdiction all damages, costs, and attorney fees incurred by
enforcing any of the provisions of this Bond. All rights, powers, and remedies of the Jurisdiction hereunder shall be
cumulative and not alternative and shall be in addition to all rights, powers and remedies given to the Jurisdiction, by law.
The Jurisdiction may proceed against Surety for any amount guaranteed hereunder whether action is brought against
Principal or whether Principal is joined in any such action or actions or not.
NOW, THEREFORE, if said proposal by the Principal be accepted, and the Principal shall enter into a contract with
Jurisdiction in accordance with the terns of such proposal, including the provision of insurance and of a bond as may be
specified in the contract documents, with good and sufficient surety for the faithful performance of such contract, for the
prompt payment of labor and material furnished in the prosecution thereof, and for the maintenance of said improvements
as may be required therein, then
this obligation shall become null and void; otherwise, the Principal shall pay to the Jurisdiction the full amount of the bid
bond, together with court costs, attorney's fees, and any other expense of recovery.
Signed and seated this
day of , 20
SURETY: PRINCIPAL:
Surety Company Bidder
By By
Signature Attorney-in-Fact/Officer Signature
Printed Name of Attomey-in-Fact/Of cer Printed Name
Company Name Title
Company Address Address
City, State, Zip Code City, State, Zip Code
Company Telephone Number Telephone Number
NOTE: All signatures on this bid bond trust be original signatures in ink; copies, facsimile, or electronic signatures will
not be accepted. This bond must be sealed with the Surety's raised, embossing seal. The Certificate or Power of Attorney
accompanying this bond must be valid on its face and sealed with the Surety's raised, embossing seal.
1
BID BOND
KNOW ALL BY THESE PRESENTS:
Sample Bid Bond Form
That we, , as Principal, and
, as Surety, are held and firmly bound
unto , as Obligee, (hereinafter
referred to as "the Jurisdiction"), in the penal sum of
dollars (S ), or percent of the amount
bid in lawful money of the United States, for which payment said Principal and Surety bind themselves, their heirs,
executors, administrators, successors, and assigns jointly and severally, firmly by these presents.
The condition of the above obligation is such that whereas the Principal has submitted to the Jurisdiction a certain proposal,
in a separate envelope, and hereby made a part hereof, to enter into a contract in writing, for the following described
improvements;
2023 PREFABRICATED SHELTER, CONTRACT NO. 1087
The City of Waterloo (Owner) is seeking bids from contractors who can supply and install a prefabricated concrete
communication shelter that will securely house the network equipment, power systems, and supporting environmental
components required to operate the Waterloo Fiber FTTU network for the Owner (the Project). The shelter will be
located at Fire Station 6, 3233 Ansborough Ave, Waterloo, IA 50701 (See Attachment D — Site Location).
Official Address: (Including Zip Code): n
')' Sb C ✓ "1 C',i � (JL pJ 11� L, Q �� S .�J'1 S )4O Y
. 1
I.R.S. No. 110 (A/ Zia CA
FORM OF BID CONRACT NO. 1087 Page 3 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. 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 Dollars ($
) in the form of $ `gyp jnA , 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.
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 MP 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.
NO
Date NI
I
10. The bidder shall list the MBENVBE 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.
c79J \\CV, Si,.,0`Wu NS , L LE--- ,
(Name of Bl tfer)
BY:
FORM OF BID
Title ara
(uate)
CONRACT NO. 1087 Page 2 of 3
FORM OF BID OR PROPOSAL
F.Y. 2023 PREFABRICATED SHELTER
CONTRACT NO. 1087
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
1. The undersigned, being a Corporation existin u der the laws of the State of D-Q / ta.v�? a Partnership
c'q ,
consisting of the following partners: C .e.`\ ,. (' (:) ok-Nti'•" (• 4.4 1- 1- vIh•� j(
, 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 PREFABRICATED SHELTER,
CONTRACT NO. 1087, all in accordance with the above -listed documents and for the unit prices for work in place for the
following items and quantities:
FY 2023 PREFABRICATED SHLETER CONTRACT NO. 1087
Description
Total Cost
TOTAL DIVISION 1 BASE BID
$
' ;
R
o i C. V
ALTERNATE A (3.1 DC POWER DISTRIBUTION SYSTEM & 3.2 AC
N /1,�INVERTER
e.
^\{
TOTAL DIVISION 1 BASE BID + ALTERNATE A
$
b. u 0
, -) 1
7�
FORM OF BID
CONRACT NO. 1087 Page 1 of 3