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HomeMy WebLinkAboutWard Diesel (Beecher) FAA AIP 3-19-0094-055 - 4.3.2023CONTRACT FOR INSTALL ARFF VEHICLE EXHAUST SYSTEMS FAA AIP 3-19-0094-055 (CARES DEV) AT THE WATERLOO REGIONAL AIRPORT WATERLOO, IOWA THIS AGREEMENT, made and entered into this 3rd day of April .2023, by and between the WaterloQ Regional Airport for the City of Waterloo, Black [-Iawk County. Iowa, hereinafter referred to as the "Owner" and Ward Diesel Filter Systems, a corporation organized and existing under the laws of the State of New York, a partnership consisting of sole owner Scott H. Beecher, hereinafter referred to as the "Contractor." WITNESSETH: That the Contractor for and in consideration of Twenty -Two Thousand One Hundred Four Dollars ($22,104-00), based on the unit bid prices payable as set forth in the Specifications constituting a part of this Contract, hereby agrees to construct in accordance with the Plans and Specifications therefore, and in the location designated on the Plans, the various items of work awarded said Contractor on the day of , 2023, as follows, being numbered one (1) as shown in schedule of prices bid in the attached Proposal, Attachment A, which is a part of this Contract. Said Specifications and Plans are hereby made apart of and the basis of this Agreement and a true copy of said Plans and Specifications is now with the Waterloo Regional Airport in the office ofthe Director of Aviation, Waterloo, Iowa, under date of , 2023. I. That in consideration of the foregoing, the Owner hereby agrees to pay the Contractor promptly and according to the requirements of the Specifications, the amounts set forth, subject to the conditions as set forth in the Specifications. 2. That it is understood that the parties named herein are the only persons interested in this Contract and principals. 3. That the Contractor has examined the site of the proposed work, Plans, Specifications, and Contract Documents in order that he might become familiar with the character, quality, and quantity of the work to be performed, the materials to be furnished and the requirements of the Specifications, and Contract Documents. 4. It is hereby further agreed that any reference herein to the "Contract" shall include all "Contract Documents" for the Waterloo Regional Airport, FAA Project Nos. 3-19-0094-055 Install ARFF Vehicle Exhaust Systems and said "Contract Documents" are hereby made apart of this agreement as fully as if set out at length herein, and that this contract is limited to the items in the proposal as signed by the "Contractor" and included in the "Contract Documents." 5. That in the event any surety upon any bond furnished in connection with this Contractbecomes unacceptable to the Owner, or if any such surety shall fail to furnish reports as to his financial condition from time to time as requested by the Owner, the Contractor agrees to furnish promptly such additional security as may be required from time to time to protect the interests of the Owner or of persons supplying labor or materials in the prosecution of the work contemplated by the Contract. 6. That the Contractor shall not commence any work to be performed under this Contract until he has obtained from responsible insurance companies, all insurance required, as set forth in the General Provisions and that the Contractor shall maintain this insurance in full force and effect until the work to be performed under this Contract has been accepted by the Owner. 7. That the Contractor shall not start working on any alterations requiring a supplemental agreement until the agreement setting forth the adjusted price shall be executed by the Owner and the Contractor. FAA A!P 3-19-0094-055 (CARES DEV) C-1 Install ARFF Vehicle Exhaust Systems Contract Waterloo Regional Airport - 60675091 8. That the Contractor, at all times, shall observe and comply with all federal, state, territory or possession and local laws, codes, ordinances and regulations in any manner affecting the conduct of the work, and the Contractor and his surety shall indemnify and save harmless the Owner and all his officers, Engineer, agents and servants against claims or liability arising from or based on the violation of any such law, ordinance, deregulation, order or decree, whether by himself or his employees. 9. That it is further understood and agreed by the parties to this Contract that the above work shall be commenced within 10 days after "Notice to Proceed" and shall be completed according to the terms of the entire contract within ninety (90) calendar days from the date established in the Notice to Proceed. Failure to complete within the allotted time will result in assessment of liquidated damages in the amount of $500.00 per calendar day for each day in excess of the authorized contract time. 10. The Contractor and Owner understand and agree that time is of essence for completion of the Work and that the Owner will suffer additional expense and financial loss if said work is not completed within the authorized Contract Time. Furthermore, the Contractor and Owner recognize and understand the difficulty, delay, and expense in establishing the exact amount of actual f-mancial loss and additional expense. Accordingly, in place of requiring such proof, the Contractor expressly agrees to pay the Owner as liquidated damages the non -penal sum of $500.00 per day for each calendar day required in excess of the authorized Contract Time for the overall contract. Furthermore, the Contractor understands and agrees that: a. the Owner has the right to deduct from any moneys due the Contractor, the amount of said liquidated damages. b. the Owner has the right to recover the amount of said liquidated damages from the Contractor, Surety, or both. 11. The Contractor understands and agrees that all certifications made by the Contractor within the Proposal shall apply under this Agreement as if fully rewritten herein. The Contractor further certifies the following: a. Certification of Eligibility (29 CFR Part 5.5) (1) By Entering into this contract, the Contractor certifies that neither he or she nor any person or firm who has an interest in the Contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1); (2) No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(aX1); (3) The penalty for making false statements is prescribed in the U.S. Criminal Code 18 U.S.C. b. Certification of Non -Segregated Facilities (41 CFR Part 60-1.8) The federally assisted construction Contractor certifies that it does not maintain or provide, for its employees, any segregated facilities at any of its establishments and that it does not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. The Bidder certifies that it will not maintain or provide, for its employees, segregated facilities at any of its establishments and that it will not permit its employees to perform their services at any location under its control where segregated facilities are maintained. The Bidder agrees that a breach of this certification is a violation of the Equal Opportunity Clause, which is to be incorporated in the contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms, and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated an the basis of race, color, religion, or national origin because of habit, local custom, or any other reason. The Bidder agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause and that it will retain such certifications in its files. FAA AIP 3-19-0094-055 (CARES DEV) C-2 Install ARFF Vehicle Exhaust Systems Contract Waterloo Regional Airport - 60675091 11 It is further understood that any action in court against the Contractor or sureties on his bond because of damage to property or individuals by said Contractor or his workmen, or because of the violation of any provisions of the Specifications, or on account of the failure of said Contractor to fully comply with these provisions, shall be brought in the District Court of the State of Iowa in and for Black Hawk County. 13. Second Party shall maintain all work done hereunder in good order for a period of 12 months from and after the date it is accepted by the Waterloo Regional Airport, City of Waterloo, Iowa, which maintenance shall be without expense to First Party or the abutting property. In the event of the failure or default of Second Party to remedy any or all defects appearing in said work within a period of 12 months from the date of its acceptance by said Board and after having been given ten (10) days' notice so to do by registered letter deposited in the United States Post Office in said City, addressed to said Contractor at the address herein given, then First Party may proceed to remedy such defects and the cost and expenses thereof may be recovered from said Second Party and the sureties on its bond by action brought in any court of competent jurisdiction, but such suit may be brought in the District Court of Black Hawk County, Iowa. IN WITNESS WHEREOF, the parties,hereto have Sit heir hands for the purpose herein expressed to this and three other instruments of like tenor, as of the day of p l l , 2023. CITY OF WATERLOO By QuertEirt liarf sP Mayor ATTEST: 7(eCCey FeCch(e nu City Clerk Secretary CONTRACTOR Ward Diesel Filter Systems By l� Firm Name Signature Title 11-5,7 Sc.6412A, Aefilaatcdiy lLf'rs Business Address s Witness FAA AIP 3-19-0094-055 (CARES DEV) C-3 Install ARFF Vehicle Exhaust Systems Contract Waterloo Regional Airport - 60675091 NOW, THEREFORE, the conditions of this ab .ration fully comply with the terms and conditions ofsai ontra of warranties and/or guarantees for workmanship an : m of time beyond completion of said contract, and such specifications, and shall indemnify and save the OW process, composition or anything which is patented, claims for damages by reason or any default or glig in and about the performance of said con • ct, an comply with and perform any and all warrantie: and/or be void; otherwise of full force and effect. PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS: That we, Ward Diesel Filter Systems, as PRINCIPAL, also referred to as CONTRACTOR, and , as SURETY, are held and firmly bound unto Waterloo Regional Airport, 2790 Livingston Lane, Waterloo, lowa 50703 as OWNER, in the full sum of Twenty -Two Thousand One Hun .1 - d Four Dollars ($22,104.00) for the payment of which, well and truly to be made, we bind ourselves, our heirs, ex utors, administrators, successors and assigns, jointly and s> era ly, by these presents. WHEREAS, the above-boun: Principal has entered into a contract with the 0 ER dated the day of 2023, for improvements at the Waterloo ' egional Airport, which includes: The FAA 3-19-0094-055 (C RES DEV) Install ARFF Vehicle Ex : ust Systems project which consists of the purchase and installatio of two (2) Ward NO SMOKE 2 ve cle exhaust filtration systems. These filtration systems are custom ins : l Iations that apply a porous ce is catalyst designed to reduce gaseous matter from diesel exhaust. This work and all other incidentals shall be erformed as shown the Drawings and described in the Specifications. are sue that if the above -bound PRINCIPAL shall faithfully and ct, eluding, but not limited to, any obligations created by way ate als which warranty and/or guarantee may extend for a period t:- ations or additions as may be made therein or in the plans and R harmless against any claims for using any form of material, ewise indemnify and save the OWNER harmless against all gen•-, want of skill or care on the part of said PRINCIPAL or d s 11 comply with all laws pertaining to said work, and shall guaran es provided for in said contact, then this obligation shall PROVIDED, further than upon either the efault of the PRINCIPA ► or the failure of the said PRINCIPAL to promptly and efficiently prosecute said Work, i any respect, in accordance ith the Contract Documents, the above bound SURETY shall either remedy the de t of the PRINCIPAL or shall charge of said Work and complete the Contract at his own expense, pursuant to its t . s, receiving, however, any baianc • of the funds in the hands of said OWNER due under said contract. It shall be the duty of the SU receipt of a declaration of perform the contract prom on which the remedy or writing to the OWN E and/or correction of performance of the promptly remedy TY to give an unequivocal notice in writing fault of the SURETY'S election either to reme ly, time being of the essence. In said notice of elect' erformance will commence, and it shall be the duty of t mmediately upon completion of (a) the remedy and/or corre ach item of condemned work, (c) the furnishings of each o ontract. The SURETY shall not asset solvency of its PRINCIPAL e default or defaults or perform the contract. the OWNER within ten (10) days after the default or defaults promptly or to , the SURETY shall indicate the date SURETY to give prompt notice in on of each default, (b) the remedy 'tied item of work, and (d) the justification for its failure to In the event sat PRINCIPAL shall fail or delay the prosecution and completion of said Wor d said SURETY shall also fail to ac . romptly as hereinabove provided, then the OWNER shall cause ten (10) days' not e of such failure to be given, both + said PRINCIPAL and SURETY, and at the expiration of said ten (10) days, if : id PRINCIPAL or SURETY do not proceed promptly to execute said Contract, the OWNER shall have the authority to ause said Work to be done and when the same is completed and the cost thereof estimated, the said PRINCIPAL and SURETY shall and hereby agree to pay any excess in the cost of said Work above the agreed price to be paid under said Contract. Upon completion of said Contract pursuant to its terms, if any funds remain due on said Contract, the same shall be paid to said PRINCIPAL and SURETY. FAA AIP 3-19-0094-055 (CARES DEV) Contract C- Install ARFF Vehicle Exhaust Systems Waterloo Regional Airport - 60675091 The said PRINCIPAL and SURETY further agree as part of this obligation to pay all such damages of any kind to person or property that may result from a failure in any respect to perform and complete said Contract including, but not limited to, all repair and replacement costs necessary to rectify construction error, architectural and engineering costs and fees, all (but not limited to) consultant fees, all testing and laboratory fees, and all legal fees and litigation costs incurred by the OWNER. The decision ofth- OWNER, upon any disputed question connected with the -xecution of said Contract, or any failure or delay in the pros • cution of the Work by said PRINCIPAL or SURETY, - all be final and conclusive. The SURETY agrees t .t, other than as is provided in this bond, it may it demand of the OWNER the OWNER shall (a) perform any thing or : t, (b) give any notice, (c) furnish any clerical . sistance, (d) render any service, (3) furnish any papers or documents, or (f) ake any other action of any nature or desc tion which is not required of the OWNER to be done under the contract doc ents. 1N WITNESS WHEREOF, the RETY and PRINCIPAL have xecuted this instrument under their several seals this day of , 2023, the ame and corporate seal of each corporate party being hereto affixed, and these presents du signed by its undersig -d representative, pursuant to authority of its governing body. IN THE PRESENCE OF: Witness Witness PRINCIPAL: By: SURETY: NOTE: (a) Where the Performanc Bond is executed by an a rney-in-fact, there shall be attached to each copy of (b) the Bond a certified ■ py of Power of Attorney pro erly executed and dated. Each copy of the B , nd shall be countersigned by an au ' orized agent of the bonding company licensed to do business in e State of Iowa. The title of the pers n countersigning the Bond shall appear after his or her signat e. (c) The seal of th : bonding company shall be attached to each c • y of the bond. (d) The Contraor's signature on the bond shall correspond with th- signature in the contract. (e) The bond hall be accompanied by a corporate resolution (which : y be combined with the corporate resoluti ■ granting the signing officer authority to execute contracts) ranting the corporate officer who execut - the Bond the authority to do so. (f) Surety companies executing bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State of Iowa. FAA ALP 3-19-0094-055 (CARES DEV) C-5 Install ARFF Vehicle Exhaust Systems Contract Waterloo Regional Airport - 60675091 G I 1711,1;ili PAYMENT BOND KNOW ALL ME BY THESE PRESENTS: That we, Ward Diesel Filter Systems, as PRINCIPAL, also referred to as CONTRACTOR, an. , as SURETY, are + - Id and firmly bound unto Waterloo Regional Ai : ort, 2790 Livingston Lane, Waterloo, Iowa 50703 as OWNER, ' the full sum of Twenty -Two Thousand One Hundred .ur Dollars ($22,104.00), for the use and protection of sai+ • WNER and all subcontractors and all persons supplying la: or, materials, machinery and equipment for the perfo ce of the work provided for in the contract hereinafter referred •, for the payment of which, well and truly to br made, we bind ourselves, our heirs, executors, administrators, succ . sors and assigns, jointly and severally, by . se presents. WHEREAS, the above -bound Prin pal has entered into a contract wit he OWNER dated the day of , 2023, for improvement . t the Waterloo Regional Airport, which includes: The FAA 3-19-0094-055 (CARE . DEV) Install ARFF V isle Exhaust Systems project which consists of the purchase and installation oft , o (2) Ward NO S i S KE 2 vehicle exhaust filtration systems. These filtration systems are custom installa ons that apply . +orous ceramic catalyst designed to reduce gaseous matter from diesel exhaust. This work and all other incidentals shall be per NOW, THEREFORE, the condition of this obli payment to all claimants as hereinafter defi provided for in said Contract, then this obli do however, to the following conditions: d as shown on the Drawings and described in the Specifications. tia ' is such that if the above -bound PRINCIPAL shall promptly make d, for .11 labor and materials supplied in the prosecution of the work n shall + void; otherwise, it shall remain in full force and effect, subject, 1. The said SURETY to this bo for value received, ' ereby stipulates and agrees that no change or changes, extension of time orextensio of time, alteration ofalte ; tions or addition or additions to the terms of the contract or to the work to be perfo d thereunder, or the specifica ons or drawings accompanying same shall in any wise affect its obligation on th-. bond, and it does hereby waive n+tice of any such change or changes, extension of time or extensions of time, a eration or alterations or addition or . • ditions to the terms of the contract or to the work or to the specifications drawings. 2. A claimant is der ed as any subcontractor and any person suppl ing labor, materials, machinery, or equipment in the prosecutio f the work provided for in said contract. Signed and scale • this FAA AIP 3-19-0094-055 (CARES DEV) C-6 Install ARFF Vehicle Exhaust Systems Contract Waterloo Regional Airport - 60675091 IN THE PRESENCE OF: Witness Witness PRINCIPAL: Bv: SURETY: Bv: NOTE: (a) Where the Payment Bond is execut - by an atto Bond a certified copy of Power of Att+ ey p (b) Each copy of the Bond shall be counters' to do business in the State of Iowa. Th his or her signature. y-in-fact, there shall be attached to each copy of the perly executed and dated. d by an authorized agent of the bonding company licensed isle f the person countersigning the Bond shall appear after (c) The seal of the bonding compan shall be attacheto each copy of the bond. (d) The Contractor's signature o the bond shall correspd with the signature in the contract. (e) The bond shall be acco • anied by a corporate resolution which may be combined with the corporate resolution granting th . igning officer authority to execute c ntracts) granting the corporate officer who executes the Bond t i authority to do so. (f) Surety compani - . executing bonds must appear on the Treasury D . artment's most current list (Circular 570 as amend-. and be authorized to transact business in the State .f Iowa. FAA AIP 3-19-0094-055 (CARES DEV) C-7 Install ARFF Vehicle Exhaust Systems Contract Waterloo Regional Airport - 60675091 PROPOSAL FORM FOR INSTALL ARFF VEHICLE EXHAUST SYSTEMS FAA AIP 3-19-0094-055 (CARES DEV) AT THE WATERLOO REGIONAL AIRPORT WATERLOO, IOWA Waterloo Regional Airport 2790 Livingston Lane Waterloo, IA 50703 Gentlemen: , I 1. The undersigned, being a Corporation existing under the laws of the State of .IV CU.1 /e71c., a Partnership consisting of the following partners: n Cc,. N , 7-, , 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 Install ARFF Vehicle Exhaust Systems -- FAA AIP 3-19-0094-055 (CARES DEV), all in accordance with the above -listed documents and for the unit prices for work in place for the following items and quantities: 1 The extent of the work involved is as follows. The FAA 3-19-0094.055 (CARES DEV) Install ARFF Vehicle Exhaust Systems project Which consists of the purchase and installation of two (2) Ward NO SMOKE 2 vehicle exhau t filtration systems. These filtration systems are custom installations that apply a porous ceramic catalyst designed,to:reduce gaseous mattertfrom diesel exhaust. This system shall be completed and tested on location. Testing, training, and a 2-year warranty for each system is required. 3. The undersigned in compliance with your Invitation for Bids dated Ric jvn,()V 2312.222, hereby proposes to do the work called for in said Contract and Specifications and shown on said Plans and Addendum Nos. t a k'u 1 2!l V- and to furnish all materials, tools, labor and all appliances and appurtenances necessary for the id sawork at theFollowing rates and prices: FAA AIP 3-19-0094-055 (CARES DEV) P-1 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 ITEMIZED PROPOSAL WATERLOO REGIONAL AIRPORT WATERLOO, IOWA PROJECT: • INSTALL ARFF VEHICLE EXHAUST SYSTEMS FAA AIP PROJECT NO, 3-19-0094-055 (CARES DEV) ITEM NO. DESCRIPTION UNIT ESTIMATED QUANTITY UNIT BID PRICE TOTAL BID PRICE BASE BID 1 NO SMOKE 2 diesel exhaust filtration EA 2 $ 1' i OS Z. $ ZZ1 i 04 ill ti TOTAL BID $ 2,21 104 , u O 4. The Airport reserves the right to award the contract based on the Total Bid. 5. The undersigned understands that the above quantities of work to be done are approximate only and are intended principally to serve as a guide in evaluating the bids. All quantities are subject to increase or decrease and are to be performed at the unit prices stipulated herein. 6. It is understood that the schedule of minimum wage rates, as established by the Secretary of Labor and included in the Specifications, are to govern on this project, and the undersigned certifies that he has examined this schedule of wage rates and that the prices bid are based on such established wage rates. 7. The bidder shall make good faith efforts, as defined 4n Appendix A of 49 CFR Part 26, Regulations of fife Office:uf the Secretary arf Transportation, to subcontract zero (0%) percent of the dollar value of the prime contract to small business concerns owned and controlled by socially and economically disadvantaged individuals (DBE). Individuals who are rebuttably presumed to be socially and economically disadvantaged include women, Blacks, Hispanics, Native Americans, Asian -Pacific Americans, and Asian -Indian Americans. The apparent successful competitor will be required to submit information concerning the DBE's that will participate in the contract. The information will include the name and address of each DBE, a description.uf the work to be performed by each named firm, and the dollar value of the contract. If tine bidder fails to achieve the contract goal stated herein, it will be required to provide documentation demonstrating that it made good faith efforts in attempting to do so. In the event that the apparent successful competitor for this solicitation qualified as a DBE, the contract goal shall be deemed to have been met. A bid that fails to meet these requirements will be considered nonresponsive. 8. The undersigned certifies that he does not maintain or provide for his employees any segregated facilities at any of his establishments, and that he does not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The undersigned certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The undersigned agrees that a breach of this certification is a violation of the equal opportunity clause in this contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, or national origin, because of habit, local custom, or any other reason. The undersigned agrees that (except where he has obtained identical certifications from proposed subcontractors for specific time periods) he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the equal opportunity clause, and that he will retain such certifications in his files. 9. The undersigned agrees, upon written notice of the acceptance of this bid, within ninety (90) days after the opening of the bids, that he will execute the Contract in accordance with the bid as accepted and give Contract (Performance and Payment) bond on attached forms within fifteen (15) days after the prescribed forms are presented for signature. FAA AIP 3-19-0094-055 (CARES DBV) P-2 Inslali ARFF Vehicle Exhaust Systems Proposal Foam Waterloo Regional Airport - 60675091 10. The undersigned understands, award of contract is contingent upon receipt of project funding from the Federal Aviation Administration. If funding is not received, hid-1,>ettds-will-be-retur-neel-te-a11-biddei and the project will be postponed. !� 11. The undersigned further agrees that if awarded the Contract, he will commence the work within ten (10) calendar days after the receipt of a "Notice to Proceed" and that he will substantially complete all work according to the terms of the entire contract within ninety (118) calendar days from the date established in the Notice to Proceed. An extension of time may be allowed when extra or additional work is ordered by the Engineer. 12. The undersigned agrees that within 30 days after award of this contract, the Contractor/Subcontractor shall file a compliance report (Standard Form 100) if s/he has not submitted a complete compliance report within 12 months preceding the date of award. This report is required if the Contractor/Subcontractor meets all of the following conditions: a. Contractors/Subcontractors are not exempt based on 41 CFR 60-1,5. b. Has 50 or more employees. c. Is a prime contractor or first tier subcontractor. d. There is a contract, subcontract, or purchase order amounting to $50,000 or more. 13. To satisfy Clear Air and Water Pollution Control Requirements on all Construction Contracts and Subcontracts exceeding $100,000.00 Contractors and Subcontractors agree: a. That any facility to be used in the performance of the Contract or to benefit from the Contract is not listed on the Environmental Protection Agency (EPA) List,o'f Violating Facilities. b. To comply with all the requirements of Section 306 of the Clean Air Act (42;USC 1857(h)), and Section 508 of the Clean Water Act (33 USC 1368), Executive Order 11738, and Environmental Protection Regulations (40 CFR Part (15)). c. That as a condition for award of a Contract he shall notify the awarding official of the receipt of any communication from EPA indicating that a facility to be utilized for performance of or benefit from the Contract is under consideration to be listed on the EPA List of Violating Facilities. d. To include or cause to be included in any Contract or Subcontract which exceeds $100,000.00 the aforementioned criteria and requirements. 14. The contractor, by submission of this offer and/or execution of a contract, certifies that it: a. is not owned or controlled by one or more citizens or nationals of a foreign country included in the list of countries that discriminate against U.S. firms published by the Office of the United States trade Representative (USTR). b. has not knowingly entered into any contract or subcontract for this project with a contractor that is a citizen or national of a foreign country on said list or is owned or controlled directly or indirectly by one or more citizens or nationals of a foreign country on said list. c. has not procured any product nor subcontracted for the supply of any product for use on the project that is produced in a foreign country on said list. Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance with 49 CFR 30.17, no contract shall be awarded to a contractor or subcontractor who is unable to certify to the above. If the contractor knowingly procures or subcontracts for the supply of any product or service of a foreign country on the said list for use on the project, the Federal Aviation Administration may direct, through the sponsor, cancellation of the contract at no cost to the Government. FAA ALP 3-19-0094-055 (CARES DEV) P-3 Install ARFF Vehicle Exhaust Systems Proposal Fonn Waterloo Regional Airport - 60675091 '15. Further, the contractor agrees that, if awarded a contract resulting from this solicitation, it will incorporate this provision for certification without modification in each contract and in all lower tier subcontracts. The contractor may rely upon the certification of a prospective subcontractor unless it has knowledge that the certification is erroneous. The contractor shall provide immediate written notice to the sponsor if the contractor learns that its certification or that of a subcontractor was erroneous when submitted or has become erroneous by reason of changed circumstances. The subcontractor agrees to provide immediate written notice to the contractor, if at any time it learns that its certification was erroneous by reason of changed circumstances. This certification is a material representation of fact upon which reliance was placed when making the award. If it is later determined that the contractor or subcontractor knowingly rendered an erroneous certification, the Federal Aviation Administration may direct, through the sponsor, cancellation of the contract or subcontract for default at no cost to the Government. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by this provision. The knowledge and information of a contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. This certification concerns a matter within the jurisdiction of an agency of the United States ofAmerica and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code, Section 1001. The bidder/offeror certifies, by submission ofthis proposal or acceptance.of this contract, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. It farther agrees by submitting this proposal that it will include this clause without modification in all lower tiertransactions, t;olicitations, proposals, contracts, and subcontracts. Where the bidder/offer/contractor or any lower tier participant is unable to certify this statement, it shall attach an explanation to this solicitation/proposal. 16. As evidQxlreof-geod-faith-ins - this Proposal, the undersigned encloses bid s hearn ufftof five (5) percent of the bid which, in case he re i1 �.�.•+'- : :. �i a�var� and to enter into a Contract and file the required s-witlrirrite prescribed time, shall be forfeited to ie ter-loo-R.egioual Airport as Iiquid c am ages. 17. By entering into this contract, the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). 18. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). 19. The undersigned hereby declares that the only parties interested in this Proposal are named herein, that this Proposal is made without collusion with any other person, firm, or corporation, that no member of the Council, Waterloo Regional Airport or agent of the City of Waterloo, Iowa, is directly or indirectly financially interested in this bid. 20. In submitting this bid, it is understood that the right to reject any and all bids has been reserved and that this bid may not be withdrawn for a period of ninety (90) days from the opening thereof. 21. Contractor certifies that all employees employed by Contractor or any subcontractor working on behalf of the Contractor are in compliance with the Immigration Reform Control Act of 1986 (IRCA) and indemnifies the Owner and holds harmless Owner for any violations of IRCA as a result of the Contractor's employees or his subcontractor's employees working on behalf of the Contractor on the Owner's project. FAA AIP 3-19-0094-055 (CARES DEV) P-4 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 22. The undersigned certifies, to the best of his or her knowledge and belief, that: a. No Federal appropriated funds shall be paid, by or on behalf of the Contractor, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee ofa member of Congress in Congress in connection with the making of any Federal grant and the amendment or modification of any Federal grant. b. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee ofa Member of Congress in connection with this Federal grant, the Contractor shall complete and submit Standard Form-LLL, "Disclosure of Lobby Activities", in accordance with its instructions. c. The Undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code, Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $200,000 for each such failure. 23. BUY AMERICAN CERTIFICATE (Title 49 U.S.C. Chapter 501) As a condition of bid responsiveness, the bidder must how it intend to comply with the Buy American preferences established under Title 49 U.S.C. Section 50101. Bidder muat•complete the attached Buy American certification. If the bidder requests a permissible waiver to the Buy America requirements, the Bidder identified as with the successful bid must submit a formal waiver request and component cost calculation within the prescribed time identified on the Buy America certification. 24. Drug Free Workplace, Act of 1988. a. By submission of this offer, the offeror, if ottmr than an individual, who is making an offer that equals or exceeds $25,000, certifies and agrees that with respect to all employees of the offeror to be employed under a contract resulting from this solicitation, it will --no later than 30 calendar days after contract award (unless a longer period is agreed to in writing, for contracts of 30 calendar days or more performance duration;) or as soon as possible for contracts of less than 30 calendar days performance duration, but in any case, by a date prior to when performance is expected to be completed -- (I) Publish a statement notifying such employees that the unlawful manufacturer, distribution, dispensing, possession, or use ofa controlled substance is prohibited in the Contractor's workplace and specifying the actions that will be taken against employees for violations of such prohibition. (2) Establish an on -going drug -free awareness program to inform such employees about -- (a) The dangers of drug abuse in the workplace. (b) The Contractor's policy of maintaining a drug -free workplace. (c) Any available drug counseling, rehabilitation, and employee assistance programs; and (d) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace. (3) Provide all employees engaged in performance of the contract with a copy of the statement required by subparagraph a. (1) of this provision. FAA ALP 3-19-01394-055 (CARES ARV) P-5 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 (4) Notify such employees in writing in the statement required by subparagraph a.(1) of this provision that, as a condition of continued employment on the contract resulting from this solicitation, the employee will -- (a) Abide by the terms of the statement; and (b) Notify the employer in writing of the employee's conviction under a criminal drug statute for a violation occurring in the workplace no later than 5 calendar days after such conviction. Notify the Contracting Officer in writing within 10 calendar days after receiving notice under subdivision a. (4) (b) of this provision, from an employee or otherwise receiving actual notice of such conviction. The notice shall include the position title of the employee; and (6) Within 30 calendar days after receiving notice under subdivision a.(4)(b) of this provision of a conviction, take one of the following actions with respect to any employee who is convicted of a drug abuse violation occurring in the workplace. (a) Take appropriate personnel action against such employee, up to and including termination; or (b) Require such employee to satisfactorily participate in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency. (5) (7) Make a good faith effort to maintain a drug -free workplace through implementation of subparagraphs a. (1) through a. (6) of this provision. b. By submission of its offer, the offeror, if an individual who is making an offer of any dollar value, certifies and agrees that other offeror will not engage in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance in the performance of the contract resulting from this solicitation. c. Failure of the offeror to provide the certification required`by paragraphs a. orb. of this provision, renders the offeror unqualified and ineligible for award. [See FAR 9.104-1(g) and '1 };6D2-1a.(2)(a)]. d. In addition to other remedies available to the Governmellt, the certification in;paragraphs a. or b. of this provision concerns a matter within the jurisdiction of an agency of the United'States and the making of a false, fictitious, or fraudulent certification may render The maker subject to prosecution under title 18, United States Code, Section 1001. 25. Attachment to This Bid. The following documents are attached to and made a part of this Bid: JV a. Bid Guaranty in the form of J A. b. Non -Collusion Affidavit of Prime Bidder. c. Statement of Intent — Non -Discrimination and Equal Opportunity Statement. d. Buy American Certification Statement. e. Bidder's Information Sheet. f. Synopsis of Experience Record. (IDOT Certification may be substituted.) g. Completed DBE forms "Utilization Statement" and "Letter of Intent." FAA AIP 3-19-0094-055 (CARES DEV) P-6 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 26. The Bidder shall indicate whether the bid is submitted by a/an: it Individual, Sole Proprietorship ❑ Partnership ❑ Corporation ❑ Joint -venture: all parties must join -in and execute all documents ❑ Other Respectfully submitted, By Signa ltle / 1 ZSv Sc� bti i Z y P-o c d Address rft- by i171s/LIS (Include Zip Code) U0-7- 74/ of 49 Telephone No. • •at:aR 7 7AP4c041 IN* UVfiVi lit P,fa.ti .'1itAuq yri.i• 1i:(Xrr;:)-"It4tO old 4friiir•7f)nvrn 140 7�Tki FAA AIP 3-19-0094-055 (CARES DEV) P-7 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 NON -COLLUSION AFFIDAVIT OF PRIME BIDDER State of j\I(A) ti4 ) )ss County of Cl.‘&fa !/%1 % ) SC O ! / b e,eck { , being first duly sworn, deposes and says that: (1)t� He is / tAhlei (Owner. Partner. Officer. Representative. or Agent) of 641 '4 CI i A •Sal WN ridiP t /Via , ZLC d' Jb/ . [Al) 0.1111 + j'i{y ,1-1, 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 anyother 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, oi•rtmlawful 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 bill are fair and proper and are not tainted b ollusion, conspiracy, connivance, or unlawful agreement on the part of the:Bidder or any of its agents, representatives, owne , employees, or parties in interest, including this affiant. (Sign di Title Subscribed and sworn to before me this / day of ZC1 -i76 l°. Title My Commission Expires �S , 20-.5 THOMAS P ROGAN Notary Public, State of New Kok Chemung County No. 01R06000s14 Commission Expires December 15, 2n u�$ FAA All'. 3-19-0094-055 (CARES DEV) P-8 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 STATEMENT OF INTENT NONDISCRIMINATION AND EQUAL OPPORTUNITY STATEMENT The Contractor does hereby certify to the Waterloo Regional Airport, that no person shall, in any way, be favored or discriminated against because of his race, political or religious opinions and affiliations, national origins, sex, age, sexual orientation, gender identity, disability, color, creed, marital status, employee union or association membership or office herein. If selected as the successful bidder, this contractor hereby agrees to file either a nondiscrimination and equal opportunity statement and/or an Affirmative Action Program. Improvements to the Waterloo Regional Airport consisting of INSTALL ARFF VEHICLE EXHAUST SYSTEMS FAA AIP 3-19-0094-055 (CARES DEV) "F/Jtc 6M-S51 tn sNolttlion S l-LC- 614 COMPANY t+ (,,rd D 4 se,4 H l�vS yS r 3 EXECUTIVE OFFKJER AFFIRMATIVE ACTION OFFICER ADDRESS OF THE AFFIRMATIVE ACTION OFFICER &u/azav kd 1-/ofcciiwls (NI phtys PHONE NUMBER Lai - / --el 7 C FAA AIP 3-19-0094-055 (CARES DEV) P-9 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 UTILIZATION STATEMENT Disadvantage Business Enterprise The undersigned bidder/offeror has satisfied the requirements of the bid specification in the following manner. (Please mark the appropriate box) The bidder/offeror is committed to a minimum of 0% DBE utilization on this contract. ❑ The bidder/offeror, while unable to meet the DBE goal of %, hereby commits to a minimum of % DBE utilization on this contract and also submits documentation, as an attachment demonstrating good faith efforts (GFE). The undersigned hereby further assures that the infomnation included herein is true and correct, and that the DBE firm(s) listed herein have agreed to perform a commercially useful function in the work items noted for each firm. The undersigned further understands that no changes to this statement may be made without prior approval from the Civil Right Staff of the Federal Aviation Administration. f 9 11' ss/e t)A 72JiM/ lUiLL(— Bidder's/ • ror's Fi n Narnc I �{ >---- Signatifrc Date DBE UTILIZATION SUMMARY Al IA -••111•1•••10 Contract Amount DBE Prime Contractor $ DBE Subcontractor $ DBE Supplier $ DBE Manufacturer $ DBE Amount Contract Percentaec x 1.00= $ % x1.00= $ % x0.60= $ % x1.00= $ % Total Amount DBE $ DBE Goal $ Note: If the total proposed DBE participation is Tess than the established DBE goal, Bidder must provide written documentation of the good faith efforts as required by 49 CFR Part 26. FAA AIP 3-19.0094.055 (CARES DEV) P-10 Install ARFF Vehicle Exhaust Systems Proposal Fomr Waterloo Regional Airport - 60675091 LETTER OF INTENT Disadvantage Business Enterprise (This page shall be submitted for each DBE firm) Bidder/Offer Name: DBE Firm: Address: City: State: Zip: DBE Firm: Address: City: State: Zip: DBE Contact Person: Name: Phone: ( ) DBE Certifying Agency: Classification: Expiration Date: Each DBE Firm shall submit evidence (such as a photocopy) of their certification status. ❑Prime Contractor ❑Subcontractor ❑Joint Venture DManufacturer ❑ Supplier Work item(s) to be performed by DBE Description of Work Item Quantity Total The bidder/offeror is committed to utilizing the above -named DBE firm for the work described above. The estimated participation is as follows: DBE contract amount: $ Percent of total contract: AFFIRMATION: The above -named DBE firm affirms that it will perform the portion of the contract for the estimated dollar value as stated above. By: (Signature) (Tide) Note: In the event the bidder/offeror does not receive award of the prime contract, any and all representations in this Letter of Intent and Affirmation shall be null and void. FAA AIP 3-19-0094-055 (CARES DEV) P-1 1 Install ARFF Vehicle Exhaust Systems Proposal Form waterloo Regional Airport - 60675091 BUY AMERICAN CERTIFICATION FORM FOR TOTAL FACILITY (Building projects such as Terminal, SRE, ARFF, etc.) As a matter of bid responsiveness, the Bidder or Offeror must complete, sign, date, and submit this certification statement with their proposal. The Bidder or Offeror must indicate how they intend to comply with 49 USC § 50101 by selecting one of the following certification statements. These statements are mutually exclusive. Bidder must select one or the other (i.e. not both) by inserting a checkrnark (/) or the letter "X". The Bidder or Offeror hereby certifies that it will comply with 49 USC. 50101 by: a) Only installing steel and manufactured products produced in the United States, or; b) Installing manufactured products for which the FAA has issued a waiver as indicated by inclusion on the current FAA Nationwide Buy American Waivers Issued listing, or; c) Installing products listed as an Excepted Article, Material or Supply in Federal Acquisition Regulation Subpart 25.108, By selecting this certification statement, the Bidder or Offeror agrees: 1. To provide to the Owner evidence that documents the source and origin of the steel and manufactured product. 2. To faithfully comply with providing US domestic products. 3. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. ❑ The Bidder or Offerrsr'hereby certifies it cannot comply with the 100% Buy American Preferences of 49 USC § 50101(a) but -may qualify for either Type Ill or Type IV waiver under 49 USC § 50101(.13). By selecting this certification statement, the apparent Bidder or Offeror with the apparent low bid agrees: 1, To the submit to•the Owner within 15 calendar days of the bid opening, a formal waiver request and required documentation that support the type of waiver being requested. 2. That failure to submit the required documentation within the specified timeframe is cause for a non- responsive determination may results in rejection of the proposal. 3. To faithfully comply with providing US domestic products at or above the approved US domestic content percentage as approved by the FM. 4, To furnish US domestic product for any waiver request that the FAA rejects. 5. To refrain from seeking a waiver request after establishment of the contract, unless extenuating circumstances emerge that the FAA determines justified. Required Documentation Type III Waiver — The cost of components and subcomponents produced in the United States is more that 60% of the cost of all components and subcomponents of the °facility". The required documentation for a Type III waiver is: a) Listing of all manufactured products that are not comprised of 100% US domestic content (Excludes products listed on the FAA Nationwide Buy American Waivers Issued listing and products excluded by Federal Acquisition Regulation Subpart 25.10B; products of unknown origin must be considered as non -domestic products in their entirety). b) Cost of non -domestic components and subcomponents, excluding labor costs associated with final assembly and installation at project location. FAA AIP 3-19-0094.055 (CARES DEV) P-12 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 c) Percentage of non -domestic component and subcomponent cost as compared to total "facility' component and subcomponent costs, excluding labor costs associated with final assembly and installation at project location. Type IV Waiver— Total cost of project using US domestic source product exceeds the total project cost using non -domestic product by 25%. The required documentation for a Type IV of waiver is: a) Detailed cost information for total project using US domestic product. b) Detailed cost information for total project using non -domestic product. False Statements: Per 49 USC § 47126, this certification concerns a matter within the jurisdiction of the Federal Aviation Administration and the making of a false, fictitious orfraudulent certification may render the maker subject to prosecution under Title 18, United States Coe: Y2A 13 l22 Date 11 -� 6hA,S�reh c0�hi,; /dittlf o art L�.c Company Name FAA ALP 3-19-0094-055 (CARES DEV) P-13 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 Buy America Waiver Request Title 49 U.S.C. Section 50101 (b) For Airfield Development Projects funded under the Airport Improvement Program (Revised 4/19/2010) Instructions for Permissible Waivers Section 5010!@)(1) Waiver: The bidder may not request a waiver based upon the best interests of the public. The FAA Office of Airports publishes such waivers at: http:Ilwww, faa.govlairports/aiplprocurement)federal_contract_provisions/medialbuy_american_waiver,xls Section 50101(0(2) Waiver: The bidder may not request a waiver based upon insufficient supply of U.S. manufactured. The FAA Office of Airports publishes such waivers at: http;llwww, faa, govlairponsla iplprocure men tlfedera l_c on tract_proof si on s/med i a/buy_americ an_wa iv er,xl s Section S0101(b)(3)Waiver: The bidder may request a waiver if 60% or more of the components are produced in the United States and final assembly occurs in the U.S. Bidder is hereby advised that the Owner's approval with the bidder's waiver request is contiogent upon FAA approval. 1. "Equipment" in Section 50101 shall mean the following; a) Individual type "L" items (Airfield Lighting Equipment) as listed in FAA Advisory Circular 350/5345-53. b) Individual bid items as established Within FAA Advisory Circular 150/5370-10. The bid item application may not be applied for the type "L"irlems listed in AC 1$015345-53. c) A waiver request'may only address aue specific equipment item. Submit separate requests for each equipment item for which a waiver. d) Items listed under the Nationwide Waiver do not require further review. Please refer to the following webpage: http://www.faa;gov/airports/aip/procurementlfederat_contract provisionslmedialbuy_american_waiver.xls 2. The bidder must base the U.S. percentage upon the value that results from completing a component cost calculation table similar to the attached format. Bidder shall avoid mere pro forma efforts to establish the waiver request percentage. The Bidder must submit the component cost calculation fable as an attachment to the waiver request. 3. Components/subcomponents are the material and products composing the "equipment". 4, The final assembly of the AIP-funded "equipment" must be within the USA (Section 50101(b)(3)(B)). Final assembly is the substantial transformation of the components and subcomponents into the end product. 5. All steel used in the "Equipment" must be produced in the United States. 6, The Buy American requirements apply to all tier contractors and subcontractors. All contractors/subcontractors are required to provide appropriate documentation that indicates origin of manufacturer and percentage of domestic made product. 7. The bidder is hereby advised there is no implied or expressed guarantee that a requested waiver will be issued by the Federal Aviation Administration (FAA), Less than 60% USA component/subcomponent proposed for this facility CANNOT be waived, Products made with foreign steel are not eligible for a waiver. 8. North America Free Trade Act (NAFTA): Free Trade Agreements such as NAFTA do not apply to the AIP. Products and material made in Canada or Mexico must be considered as foreign made products. 9. Preparation of a Component Cost Calculation Table is not necessary for equipment listed on the FAA national listing: http://www.faa.govlairports/aip/procurement/federal_contract_provisions/medialbuy_american waiver.xls. Bidder however shall submit a listing of any equipment it proposes to install on the project that is included on the National Buy American conformance list. Instructions for Section 50101(b)(4) Waiver: 1. The bidder may request a waiver if application of Buy America preferences results in a 25% cost increase in the overall project. This waiver is rarely applicable. Consult the Owner before making this request. FAA AIP 3-19-0094-055 (CARES DEV) Proposal Form P-14 Install ARFF Vehicle Exhaust Systems Waterloo Regional Airport - 60675091 Buy America Waiver Request Title 49 U.S.C. Section 50101 (b)(3) For Airfield Development Projects funded under the Airport Improvement Program COMPONENT COST CALCULATION TABLE (Type 3 Waiver) • In lieu of completing this table, bidder may prepare a spreadsheet that addresses the same information and calculations as presented herein. • Preparation of a Component Cost Calculation Table is not necessary for eq:tcpMen icoted on the FAA national listing: http•//wxw.filo env/airports/atp/procurement/fedcral contract nrovisionsimcdla/huv amtrtran waiver.xis. • The component breakout shall be along major components of the equipment. Submit separate calculation for each different equipment types. Do not combine the component cost calculations of different types of equipment. • For Airfield development projects, equipment is defined as the "L" items (Airfield Lighting Equipment) as listed in FAA Advisory Circular 150/5345-53 and the b) individual bid items as established within FAA Advisory Circular 150/5370-10. The individual bid item method may not be applied to the "L" type items. • An authorized person shall attest under signature and date that the submitted information is accurate and complete. Equipment Type: Component/Subcomponents Name of Manufacturer Country oferiszin Cost of Foreign Manufactured Components/Subcomponents Cost of USA Manufactured Components/Subcomponents Sum of US Manufactured Component/Subcomponent Costs: Sum of all Equipment Components and Subcomponents: Percentage aaEgtiipment Components Manufactured in the United States: Place of Final Assembly: Certification Signature Bidder hereby requests a waiver to Buy America preferences based upon Section 50101(b)(3) for the equipment identified above. The bidder certifies that of the cost of components and subcomponents comprising the equipment are produced in the United States and that final assembly occurs within the United States. 1 hereby certify the above information is accurate and complete. Bidder's Firm Name Date Signature FAA AIP 3-19-0094-055 (CARES DEV) Proposal Form P-I5 Install ARFF Vehicle Exhaust Systems Waterloo Regional Airport - 60675091 Buy America Conformance Listing Title 49 U.S.C. Section 50101 (b) For Airfield Development Projects funded under the Airport Improvement Program • Preparation of a Component Cost Calculation Table is not necessary for equipment listed on the FAA national listing: hup://www.lisagov/airporistaip/procurementffederal contract provisions/media/buy american waiver.xIs • Bidder shall submit a listing of equipment it proposes to install on the project that Is included on the current National Buy American conformance list. Equipment Type Rio S m4& Name of Manufacturer Uiox1 Novi Yli)-,tl- f Product Number NO Smo14_ Certification Sienature: Bidder hereby certifies that the above listed equipment, which we propose for installation on the subject project, are on the current National Buy America Conformance list as established at: http://1vww.faa.gov/airports/aip/procurement/federal contract provisions/media/buy american waiver.xls I hereby certify the above information is accurate and complete. I 2,1 47,2_ Bidder's F;r l>/P[ te. a Date Signatu FAA AIP 3-19-0094-055 (CARES DEV) P-16 Install ARFF Vehicle Exhaust Systems Proposal Form Waterloo Regional Airport - 60675091 Bidder Status Form You -may attach additional sheet(s) if needed. To be completed by all bidders Please answer "Yes" or "No" for each of the following: Yes ❑ No El Yes EX No ❑ Yes ,gNo VkYes ❑ No ❑ Yes p No Part A 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: Dates: / / to / / Address: City, State, Zip: / / to / Address: City, State, Zip: )ates: / / to / / _ Address: City, State, Zip: To be completed by non-resident bidders Part C 1. Name of home state or f reign country reported to the Iowa Secretary of State: NDAI 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? ❑ Yes j\No 3. If you answered "Yes" to question 2, identify each preference offered by your company's home state or foreign country and the appropriate legal citation. You may attach additional sheet(s) if needed. To be completed by all bidders Part D 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: iSsi , n �l or I..CU11►t6 (uT 0, LL C )ignature: �'� Date: 143 J L You must submiNhe-co • e ed 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) BEECEMI-01 MARK CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 8/15/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Swan Morss Insurance PO Box 179 Elmira, NY 14902 INSURED Beecher Emission Solution Technologies LLC DBA Ward Diesel Filter Systems 1250 Schweizer Road Horseheads, NY 14845 CONTACT Mark Reynolds PE (A/C, Ext): (607) 846-4481 1072 F(AJC, No): (607) 732-0120 nI E-MAIL MReynolds@SwanMorss.com INSURER(S) AFFORDING COVERAGE INSURER A : Ohio Casualty Insurance Company INSURER B :Ohio Security Insurance Company INSURER C : NAIC # 24074 24082 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR TYPE OF INSURANCE INSD SWVD POLICY NUMBER UBR POLICY EFF POLICY EXP (MM/DD/Yl'YY) (MM/DO/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X X BK055733773 9/20/2022 9/20/2023 DAMAGE TO RENTED PREMI�E,S (Ea 4CCurrenc8j $ 300,000 MED EXP (Any one person) $ 15,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY ONLY UT�O S SCHEDULED AUTOS ANY SOLY X X COMBINED SINGLE LIMIT (Ea accident) 1�000�000 $ BAS55733773 9/20/2022 9/20/2023 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY err accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X EACH OCCURRENCE S 4,000,000 US055733773 9/20/2022 9/20/2023 AGGREGATE S DED I X I RETENT ON $ 10,000 $ 4,000,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N X XW055733773 9/20/2022 9/20/2023 E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Waterloo, Waterloo Regional Airport, and AECOM, and their agents, officers and employees are named as an Additional Insured with respect to General Liability, Auto Liability, and Umbrella Liability coverage as required by written contract per the policy terms and conditions. Waiver of Subrogation applies. Regarding: Waterloo Regional Airport - CARES 3-19-0094-055 - ARFF Station Parking Lot CERTIFICATE HOLDER CANCELLATION The City of Waterloo 715 Mulberry St Waterloo, IA 50703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD